Navigating Everyday Lives and Medicalization: How Limited Accessibilty of Gender Affirming Hormone Treatment Shapes Community and Identity of Chinese Transwomen Community?

Abstract: In China, the scarcity of medical resources and limited social visibility has led the transgender community to create a large, yet under-researched underground hormone therapy market. While there is extensive research on transgender healthcare globally, the medical-based identity and trans feminine embodied practices of Chinese transwomen, particularly how they navigate daily life through hormone therapy, remain largely unexplored. This study focuses on how gender-affirming medical care, particularly hormone therapy, permeates into the emotional, embodied, and everyday experiences of Chinese transwomen.

Transwomen within this community often self-identify as “Self-Medicating Transwomen” (药娘), reflecting their reliance on informal hormone therapy. Using a mixed-methods approach—including oral histories, secondary data analysis, and online ethnography—this research investigates how hormone therapy plays a key role in shaping the narratives, identities, and struggles of Chinese transwomen, extending beyond medicalization into their daily lives.

Our findings reveal that hormone therapy is both a contested form of medical regulation and a powerful tool for performing and affirming gender. It helps transwomen envision their futures and negotiate their place within a broader gender-diverse community. Through emotional experiences and bodily transformations, hormone therapy enables them to embody femininity, creating a unique "transnormativity" that distinguishes them from other gender-diverse groups. This study calls for greater attention to the everyday struggles of Chinese transwomen and emphasizes the need for inclusive medical services, legal recognition, and social support systems to better address their unique challenges.