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- Title
Exploring Anabolic Androgenic Steroid Use Among Cisgender Gay, Bisexual, and Queer Men.
- Authors
Kutscher, Eric; Arshed, Arslaan; Greene, Richard E.; Kladney, Mat
- Abstract
Key Points: Question: How and why do cisgender gay, bisexual, and queer men use anabolic androgenic steroids (AAS), and what are their unique health care needs? Findings: In this qualitative study of 12 men, AAS use was secondary to multifactorial motivators, including a likely AAS use disorder and muscle dysmorphia. Despite all participants experiencing harms from use, men seeking medical assistance found practitioners to be insistent on AAS cessation and, thus, developed their own harm reduction techniques. Meaning: Cisgender gay, bisexual, and queer men using AAS reported insufficient medical support, suggesting that further research is warranted on the utility of practitioner education, the safety and efficacy of community-developed harm reduction methods, and the impact of AAS decriminalization on health care outcomes for this patient population. This qualitative study examines nonprescribed use of anabolic androgenic steroids among gay, bisexual, and queer cisgender men in New York, New York. Importance: Anabolic androgenic steroids (AAS) are disproportionately used by sexual minority men, with the physical and mental health implications of AAS use incompletely understood. Objective: To understand the reasons for use and health care needs of gay, bisexual, and queer cisgender men using AAS. Design, Setting, and Participants: This qualitative study was conducted from November 2021 to May 2023 using self-administered questionnaires and semistructured interviews that were transcribed and coded using reflexive thematic analysis. Participants were recruited through convenience and snowball sampling from lesbian, gay, bisexual, transgender, and queer clinical centers in New York, New York, as well as through online platforms. All patients self-identified as cisgender and gay, bisexual, or queer. Exposures: History of nonprescribed AAS use for a minimum of 8 consecutive weeks was required. Main Outcomes and Measures: The primary outcomes were reasons for and health implications of AAS use and interactions with health care practitioners, as determined through interviews. Interview transcripts were collected and analyzed. Results: Thematic saturation was reached after interviews with 12 male participants (mean [SD] age, 44 [11] years), with the majority of participants identifying as gay (10 participants [83%]), White non-Hispanic (9 participants [75%]), being in their 30s and 40s (9 participants [75%]), holding a bachelor's degree or higher (11 participants [92%]), and having used steroids for a mean (SD) of 7.5 (7.1) years. One participant (8%) self-identified as Black, and 2 (17%) identified as Hispanic. Seven men (58%) met the criteria for muscle dysmorphia on screening. Nine overarching themes were found, including internal and external motivators for initial use, continued use because of effectiveness or fear of losses, intensive personal research, physical and emotional harms experienced from use, using community-based harm reduction techniques, frustration with interactions with the medical community focused on AAS cessation, and concerns around the illegality of AAS. Conclusions and Relevance: In this qualitative study, AAS use among cisgender gay, bisexual, and queer men was found to be associated with multifactorial motivators, including a likely AAS use disorder and muscle dysmorphia. Despite all participants experiencing harms from use, men seeking medical help found insufficient support with practitioners insistent on AAS cessation and, thus, developed their own harm reduction techniques. Further research is needed to assess the utility of practitioner education efforts, the safety and efficacy of community-developed harm reduction methods, and the impact of AAS decriminalization on health care outcomes for this patient population.
- Subjects
NEW York (State); COMPETENCY assessment (Law); SUBSTANCE abuse; PSYCHOLOGY of gay people; ANDROGENS; TESTOSTERONE; STEROIDS; FEAR; HORMONES; HEALTH attitudes; QUALITATIVE research; RESEARCH funding; GENDER identity; DRUG addiction; LGBTQ+ people; ANABOLIC steroids; QUESTIONNAIRES; TRANSGENDER people; MEDICAL care; INTERVIEWING; HUMAN sexuality; STATISTICAL sampling; ATTITUDES toward sex; PSYCHOLOGY of LGBTQ+ people; SELF medication; EMOTIONS; HEALTH Insurance Portability &; Accountability Act; DESCRIPTIVE statistics; FRUSTRATION; HARM reduction; THEMATIC analysis; MOTIVATION (Psychology); CISGENDER people; RESEARCH methodology; NEEDS assessment; BISEXUAL people; SEXUAL minorities; PUBLIC welfare; MEDICAL screening; COMPARATIVE studies; DATA analysis software; PSYCHOSOCIAL factors
- Publication
JAMA Network Open, 2024, Vol 7, Issue 5, pe2411088
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.11088