"Creating ourselves:" A qualitative analysis of DIY HRT practices in nonbinary adults.

Nonbinary adults engage in DIY HRT as a form of knowledge production, generating and sharing information outside of formal medical systems.

• Participants described accessing information through online communities, forums, and peer networks rather than through medical providers.
• DIY HRT sites were characterized as containing a 'wealth of knowledge and resources' that participants found more relevant to their nonbinary transition goals than formal medical sources.
• Participants described actively researching hormone effects, dosages, and sourcing as a self-directed educational process.
• Medical providers interviewed also acknowledged gaps in formal medical knowledge about nonbinary HRT needs.

DIY HRT functions as a site of communal care among nonbinary people, with participants supporting each other through shared resources and mutual aid.

• Participants described giving and receiving support from peers in DIY HRT communities, including sharing medications, information, and emotional support.
• Communal care networks were framed as filling gaps left by inadequate formal healthcare systems.
• The study used qualitative, in-depth interviews with nonbinary adults who engage in DIY HRT practices and medical providers who prescribe HRT.
• Participants described a sense of collective responsibility for community members' health and transition needs.

Nonbinary participants pursued DIY HRT to achieve bodily autonomy and fulfill transition-related goals not addressed by binary-focused medical systems.

• Participants described wanting hormonal outcomes that did not conform to binary transition endpoints, which were often not supported by medical providers.
• DIY practices included both accessing hormones through non-medical pathways and self-altering prescribed dosages.
• The framing of 'creating ourselves' reflected participants' sense of agency in shaping their own bodies outside of medical gatekeeping.
• Existing research has primarily focused on binary trans populations, leaving nonbinary-specific needs understudied.

Systemic disinvestment in trans healthcare knowledge and quality care was identified as a primary driver of DIY HRT engagement among nonbinary people.

• Participants described encountering providers who lacked knowledge about nonbinary HRT needs or who refused to provide care aligned with nonbinary goals.
• Medical providers interviewed acknowledged limitations in available clinical guidance for nonbinary patients.
• Participants framed DIY HRT not as a risky workaround but as a rational response to inadequate formal care.
• The study design included both nonbinary adult participants and medical providers who prescribe HRT, providing multiple perspectives on care gaps.

DIY HRT is particularly salient for nonbinary people compared to binary trans populations because they are often not seeking a binary transition.

• The paper notes that extant research has primarily focused on binary trans populations despite DIY HRT being common across trans communities.
• Nonbinary participants sought hormonal changes that produced partial, non-standard, or fluctuating effects not aligned with standard medical protocols.
• The study was conducted using qualitative, in-depth interviews to capture the lived experiences of this understudied population.
• The nonbinary-specific context of DIY HRT had not been previously examined in the literature according to the authors.