How much medication does a person with gender dysphoria actually take, and which drugs? An epidemiology team at the Lazio Regional Health Service in Italy answered that question by looking directly at real health records rather than surveys or questionnaires. The picture that emerges is revealing: people with gender dysphoria do not simply take the hormones prescribed for transition — they carry a far heavier load of medication than the general population.
The researchers identified 365 people with a recorded diagnosis of gender dysphoria between 2011 and 2021, all with a hospitalisation for this condition as the starting point. Their median age was 26, a young cohort: 52.9% had been assigned male at birth and 47.1% assigned female. Prescriptions over the following year were then compared with a sample of people of the same age and sex, at a ten-to-one ratio.
The gap is striking. Within the twelve months after discharge, 72.1% of people with gender dysphoria received at least one prescription, versus 43.1% in the comparable general population. The difference is even greater among those assigned male at birth: 83.9% took some medication, compared with 58.7% of those assigned female.
What is prescribed? The most common drug classes are anti-infectives (35%), sex hormones (35%), gastrointestinal and metabolic agents (28%) and nervous-system drugs (18%). But the patterns shift according to sex assigned at birth. In people assigned male, oestrogens, anti-androgens and vitamins stand out, consistent with feminising hormone protocols. In those assigned female, drugs for acid-related disorders, psychotropics and testosterone are more frequent.
That 18% of these young people receive nervous-system drugs confirms the well-known mental-health burden that accompanies gender dysphoria: anxiety, depression, minority stress. And the elevated use of antibiotics and thyroid medication points to additional clinical vulnerabilities that are only hinted at today and deserve close monitoring.
The study, published in Pharmacoepidemiology and Drug Safety, does not assess the effectiveness of treatments but the real pharmacological footprint of this population. The authors stress that these figures justify careful long-term safety monitoring of therapies and, above all, multidisciplinary, person-centred care. The excess medication is not an isolated statistic: it reflects complex healthcare needs that hormone transition alone does not cover.
