Studies that seek to define patterns of alcohol consumption and its risks usually categorize limits according to sex. This is because the female body has, on average, less water (total and percentage) and less enzymes that metabolize alcohol. Thus, by drinking less alcohol, females are able to reach blood alcohol concentrations similar to what is observed in males.

With regard to gender, differences were also observed in the way men and women consume alcohol; such studies, however, focus on cisgender populations, that is, people whose gender identity (“male” or “female”) conforms to the gender identity socially attributed to their biological sex; transgender people, in turn, are those whose gender identity is in opposition to the gender socially assigned to biological sex. A review of the scientific literature carried out in 2018 points out the need for studies focusing on gender minorities in order to better understand the limits and effects of alcohol consumption in transgender people and other gender-nonconforming populations (1).

However, although there are no defined patterns of consumption for these gender minorities, there are some prudential recommendations that can help guide consumption. These recommendations should take into account both physiological and psychological aspects. In this regard, the recommendations are as follows:

 1 – Transgender men and women undergoing hormone replacement therapy should follow the “zero alcohol” recommendation, as alcohol consumption can interfere with treatment and put the person at greater risk of alcohol use disorders (2).

 2 – It is recommended that transgender men and women who are not undergoing hormone replacement therapy, and who wish to drink, consume a maximum of one dose of alcohol per occasion. This recommendation is based on what is indicated for other populations at greater risk, such as the elderly and females. The lack of studies and guides to provide the best care and recommendation for the transgender population is reiterated (1,3).

It is worth remembering that, according to the World Health Organization (WHO), there is no absolutely safe pattern of alcohol consumption (4). The consumption recommendations, for cis or trans people, aim to reduce risks, not eliminate them.