We propose to launch a mixed-methods study entitled "Hormone Overdose and Misuse (HODM) in Chinese Transgender and Gender Non-conforming (TGNC) Population". If you would like to join, please apply for this take or email zengbentuoxmu@outlook.com.

Strength: To our knowledge, this is the first mixed-methods study evaluating hormone overdose and misuse in Chinese TGNCs. Generally, HODM is a condition where TGNC individuals use sex hormones in excessive doses, or use hormone-like drugs which have been shown to be harmful with evidence, such as hexestrol.

Design: Our study comprises four stages: (1) expert panel meeting and stakeholder engagement; (2) a cross-sectional study to evaluate the incidence of HODM and related factors; (3) a qualitative study to investigate causes, motivations and triggers of HODM; (4) a prospective cohort study.

Where we are: We are in the initial stage of this study. A protocol has been prepared, and we are waiting for the approval of the ethics committee. The study will start around October, and continue until Sept 2023 (except for the cohorts).

Who we need: during Stage 1, we need following experts to help us determine the definition, criteria, types and grades of HODM, and to discuss study design:

• Endocrinologists in the field of gender affirming hormone therapy (GAHT), or relevant hormone therapy fields;
• Pharmacists in the field of gender affirming hormone therapy (GAHT), or relevant hormone therapy fields;
• Clinicians who have prescribed hormones for TGNCs;
• Researchers in the field of transgender health;
• Statisticians and Methodologists in the field of mixed-methods study, qualitative study, or cohort study;

We also need stakeholders to participate in and to discuss related factors, causes, and triggers:

• Transgender and Gender Non-conforming Individuals who have experienced gender-affirming hormone therapy;
• Parents of TGNCs;
• Primary care doctors who have contacted with TGNCs;
• Psychiatrists who are LGBT-friendly and have experienced TGNC patients;
• Psychological Counsellors who are LGBT-friendly and have experienced TGNC patients;
• Plastic Surgeons with previous experience in Gender Affirming Surgery.

What we can offer: This study does not receive any external funding, so we cannot provide financial support. However, all those who participate in our study will be either co-authors or receive acknowledgements. This depends on how much you are involved. We are developing a score system for eligible authors. All experts listed above will be co-authors! 

There are two groups: experts and stakeholders. For experts, there are no degree or title requirements; but for statistician and methodologist, you may have conducted relevant studies and participated in the design or statistical analysis procedures. Experienced students can also be eligible. For stakeholders, there are no other requirements except for what we mention above. Our meeting and communication will be in English or Chinese (Mandarin).