: Due to limited access to formal healthcare, many use excessive estrogen supplements without medical supervision or undergo invasive, unsafe procedures like subcutaneous silicone injections to achieve a more feminine appearance . Legal and Social Context
: There are high rates of substance use often linked to the stress of sex work or coping with discrimination . ladyboy abuse
: Over one-third of those reporting physical assault cited police as the perpetrators . : Due to limited access to formal healthcare,