Working out how much medication a person receives after a diagnosis of gender dysphoria is harder than it sounds: there is no single register, and most studies rely on surveys or on samples from specialist clinics. A team from the Epidemiology Department of the Lazio Regional Health Service (Italy) went to a different kind of source — the health information systems of an entire region — to answer that question. Their result, published in Pharmacoepidemiology and Drug Safety, draws a clear pattern: 72.1% of people with gender dysphoria received at least one medicine in the year after their diagnosis, against 43.1% in a general-population sample matched for age and sex assigned at birth.
A cohort rebuilt from health records
The study is retrospective and population-based. The authors identified everyone with a first hospital admission carrying a diagnosis of gender dysphoria between 2011 and 2021 in Lazio, Italy’s most populous region. They then analysed prescriptions dispensed during the twelve months after discharge and compared consumption with a general-population group matched for age and sex assigned at birth at a 1:10 ratio. For each therapeutic class they calculated the proportion of people with at least one dispensing and its 95% confidence interval.
The cohort comprised 365 people, with a median age of 26. Of them, 52.9% had been assigned male at birth (AMAB) and 47.1% female at birth (AFAB). In other words, a snapshot of a young population that reaches the health system through a hospital admission with a recorded diagnosis.
Almost twice as many prescriptions as the general population
The overall difference is striking: 72.1% (interval 67.5% to 76.7%) versus 43.1% (41.5%-44.7%). The figure sharpens when split by sex assigned at birth: 83.9% of AMAB people received at least one drug that year, against 58.7% of AFAB people. The most dispensed classes were anti-infectives (35%), sex hormones (35%), gastrointestinal and metabolic agents (28%) and nervous system drugs (18%).
The profiles are not interchangeable either. Among AMAB people, estrogens, anti-androgens and vitamins predominated; among AFAB people, acid-related disorder drugs, psychotropics and testosterone were more frequent. It is an administrative reflection of two distinct clinical pathways, and also of a difference in mental health burden already described by other work.
What the register cannot tell
These numbers must be read with their limits in view. The cohort is defined by a hospital admission with a diagnosis of gender dysphoria, so it leaves out those who are never admitted, those seen only in outpatient or private care, and those whose diagnosis is not recorded: it is not a random sample of all trans people in the region. Follow-up lasts one year, there are no clinical outcome data, and dispensed prescriptions are not the same as treatments actually taken or adhered to. The period studied (2011-2021) predates several changes in guidelines and in care organisation, and everything happens in a single Italian region.
Why the pharmaceutical map matters
Even with those caveats, the study provides something that rarely exists: an objective measure of this population’s contact with medication, calculated from real prescription data rather than from what people remember. The authors stress its usefulness for monitoring the long-term safety of treatments and for spotting prescription patterns that deserve review, from psychotropic use to anti-infectives. It is the kind of information any health system needs if it wants to plan care for people with gender dysphoria without relying on indirect estimates.
Source: Pharmacological Therapy in Patients With Gender Dysphoria: A Cohort Study in the Lazio Region, Italy. Belleudi V, Lopes S, Servadio M, Bellini A, Addis A. Pharmacoepidemiology and Drug Safety 2026;35(8):e70445. DOI: 10.1002/pds.70445.
Article published on dosier.es. Image generated with artificial intelligence (marta ai → marta.syf.es).
