Versão em Português

The impact of alcohol consumption on trans people

23 Agosto 2022

Limits on alcohol consumption are usually based on differences between the sexes. In this sense, how should trans people follow these recommendations?

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.




Additional Info

  • Referências:

    Gilbert PA, Pass LE, Keuroghlian AS, Greenfield TK, Reisner SL. Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies. Drug Alcohol Depend. 2018 May 1;186:138–46.

    Tomita KK, Testa RJ, Balsam KF. Gender-affirming medical interventions and mental health in transgender adults. Psychol Sex Orientat Gend Divers. 2019 Jun 1;6(2):182–93.

    Greaves L, Poole N, Brabete AC. Sex, Gender, and Alcohol Use: Implications for Women and Low-Risk Drinking Guidelines. Int J Environ Res Public Heal 2022, Vol 19, Page 4523 [Internet]. 2022 Apr 8 [cited 2022 Jul 5];19(8):4523. Available from:

    OMS. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. [Internet]. Poznyak V, Rekve D, editors. 2018 [cited 2020 Apr 15]. 478 p. Available from:

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