"Not just rebellious, it's revolutionary": Do-it-yourself hormone replacement therapy as Liberatory Harm Reduction.

DIY HRT practitioners reported experiencing transphobia within medical spaces as a primary driver of their decision to pursue DIY hormone therapy.

• Study used in-depth interviews with 36 U.S.-based DIY HRT practitioners
• Participants described medical spaces as sites of transphobia rather than care
• Experiences within professionalized medical systems contributed to mistrust and avoidance of formal healthcare
• Care barriers included medication costs, difficulty accessing healthcare providers, and mistrust in professionalized medical systems

DIY HRT practitioners framed their practice as community-driven, accessible, and empowering rather than primarily risky.

• Analysis drew on Liberatory Harm Reduction and lay expertise frameworks
• Participants constructed adaptive health-promoting practices through self-organized online forums and mutual aid
• These practices challenged biomedical conceptualizations of risk
• DIY HRT was described by one participant as 'not just rebellious, it's revolutionary'

DIYers used self-organized online forums and mutual aid networks to construct risk mitigation strategies.

• Sample consisted of 36 U.S.-based individuals engaging in DIY HRT
• Participants described goals, challenges, and risk mitigation strategies
• Online forums served as infrastructure for lay expertise sharing among DIYers
• These community structures enabled health-promoting practices outside formal medical systems

For some transgender people, hormone replacement therapy is characterized in the literature as 'an ontological necessity for a livable life.'

• This framing is drawn from Fondén (2020, p. 29) and used as a foundational premise of the study
• The study situates DIY HRT within the broader context of trans people's need for gender-affirming care
• DIY HRT was pursued by participants specifically because formal access routes were unavailable or unwelcoming

DIY HRT practitioners affirmed trans agency through their engagement in self-directed health practices that challenge biomedical authority.

• The Liberatory Harm Reduction framework was used to analyze participant narratives
• The lay expertise framework helped interpret how DIYers developed non-professional health knowledge
• Participants' practices were described as challenging biomedical conceptualizations of risk
• The study argues that DIY HRT affirms trans agency as a form of community-based resistance