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How to Research Transfeminine Hormone Therapy in the Academic Literature and Obtain Papers

By Aly W. | First published September 19, 2018 | Last modified October 8, 2021

Notice: This page was originally posted as a thread on Reddit and has not yet been properly or fully revised since being moved to Transfeminine Science.

Abstract / TL;DR

Learning how to find and navigate the scientific and medical literature is an important skill for anyone who is interested in gaining a deeper understanding of transgender hormone therapy. Scientific publications can be found with databases and search engines like Google Scholar, PubMed, and Google Books. Many papers are behind paywalls, but full-text copies of papers can be obtained through open-access journals, subscription journal access, libraries, and through sites like Sci-Hub and LibGen. Some papers are not yet available online and may only exist in physical form or in archival systems. These can be obtained by visiting libraries, through interlibrary loan for those with access, from online marketplaces like Amazon and AbeBooks, and through digitizers like Archive.org and HathiTrust. As a collector of literature on sex hormones and transgender hormone therapy, the present author may also be able to help obtain or provide publications for interested persons. It is the intent of this article to provide everything one needs to know to get started researching the academic literature on transgender hormone therapy as well as to obtain any necessary publications required to do so.

Introduction

If you would like to research transfeminine hormone therapy beyond the content on say this site, Wikipedia, and social media (e.g., Reddit), it may not be immediately clear to many aside from Google Search how to do so. Scientific information on transfeminine hormone therapy is found in the published academic literature. The purpose of this article is to explain what the scientific literature is, how it can be found and navigated, and how publications from the literature can be accessed and obtained.

What is the Scientific Literature?

Scientific knowledge is published and recorded in the academic literature. These include academic journal articles, which are published in scientific journals, and books, including edited scientific books and textbooks. Academic journal articles can be subdivided into original research articles (otherwise known as studies), literature reviews (summaries of original research/studies), and systematic reviews/meta-analyses (systematically review original research and perform statistical analyses on the pooled data from the studies). Original research articles are referred to as primary sources, while literature reviews and edited books or book chapters are referred to as secondary sources. Encyclopedias like Wikipedia and others, which are not part of the formal scientific literature, are referred to as tertiary sources. The citations on Wikipedia are mainly secondary sources, usually reviews and book chapters.

Finding Scientific Literature

There are specific public search engines that can be used to find literature. In general, Google Search is very much not optimal for such purposes and is best avoided. To find academic literature on transfeminine hormone therapy, search engines and databases such as Google Scholar, PubMed/MEDLINE, and Google Books are the most useful. Other public websites and search engines, such as Microsoft Academic, can also be useful, but the preceding websites are the most widely used and important resources. There are also a variety of private search engines and databases, such as Elsevier’s Embase. However, these sites require subscriptions and aren’t accessible to most.

Google Scholar

Google Scholar is a search engine by Google that indexes journal articles and patents. It indexes the vast majority of published journal articles and patents, and hence almost any journal article or patent can be found with it. In addition, Google Scholar indexes the full texts of articles and patents, so when you search with Google Scholar, you’re searching the texts of the entire publications. Google Scholar also allows for the use of advanced search features such as “AND”, “OR”, “-“ (without), “intitle:”, and many others. It allows for searching within a defined date range, searching by specific journals or authors, and other advanced search features as well. Because of its vast database, its indexing and searching of full texts, and its advanced search features, Google Scholar is a very powerful tool for searching the scientific literature.

PubMed/MEDLINE

PubMed (MEDLINE) is publicly run by the NCBI / NIH of the United States government and is a search engine (PubMed) and database (MEDLINE) of biomedical journal articles. It contains the titles, abstracts, authors, journal names, keywords/index terms, and publication types of biomedical journal articles, but does not index the full texts of articles. PubMed also does not have as vast of a database of biomedical journal articles as Google Scholar; many publications are missing from PubMed, although its database is still certainly massive. The lack of full-text search and the more limited selection of articles with PubMed are major limitations compared to Google Scholar. Sometimes, PubMed also doesn’t provide an external link to the web page for the journal article; in such cases, Google Scholar can be used to find it instead.

There a few features that make PubMed advantageous to Google Scholar in various instances. One is that PubMed allows for search queries that distinguish between original research publications, review publications, and other types of journal articles (e.g., clinical trials). To only return search results for and hence find literature reviews is a highly useful feature which can be very handy. Literature reviews provide high-quality condensed overviews and interpretation of multiple original studies, and are excellent for gaining knowledge about a given topic quickly and for finding original studies (which they cite). Another advantage of PubMed is that it allows for ordering of results by date, which Google Scholar essentially does not. This is useful for searching research in chronological order and finding the most recent scientific research. A final advantage of PubMed is that it only contains biomedical publications, and hence its search results can be more focused than those of Google Scholar (which indexes all academic publications, including social sciences, humanities, etc.). Similarly to Google Scholar, PubMed supports the use of advanced search features (e.g., “AND”, “OR”, etc.), though these are somewhat more tedious to use in the case of PubMed.

Google Books

Google Books is a search engine by Google that indexes books. It appears to index the great majority of published books, and hence it seems that most books can be found with it. Like Google Scholar, Google Books searches the full texts of books, and has advanced search features. Unlike Google Scholar however, Google Books does not link to external websites for the books it catalogues; instead, you can peruse the texts right in Google Books. However, Google Books usually only offers previews of books, with many pages generally being omitted from view, and many books only offer “snippet” previews or no previews at all. Nonetheless, Google Books is an excellent resource for finding and reading scientific literature, particularly high-quality secondary sources.

Obtaining Publications

Accessing Full-Texts of Online Publications

Journal articles are often blocked by paywalls. Generally, only the abstract and snippets in Google Scholar search results are provided for free viewing. Most academics and students get their access to the full texts of journal articles via universities and other organizations, which pay for subscriptions to the journals. It’s also possible to pay to access the full text of a journal article, but they’re generally prohibitively (and abhorrently) expensive (e.g., US$30 to $40 for a single journal article). If you don’t have journal access, many public universities allow visitors to use their Wi-Fi networks and computers in their libraries and computer labs, and on-campus, there is automatic access to journals. And of course the libraries of many public universities have physical copies of most publications.

Sci-Hub

For those who don’t have journal access, Sci-Hub (see the Wikipedia article for the website URL) is an alternative to getting the full-text PDFs of journal articles. It’s a shadow library website based in Russia which as of writing has over 80 million journal articles. By inputting the URL, Digital Object Identifier (DOI) (e.g., “10.1080/13697130500148875”), or title of a given journal article, Sci-Hub will instantly fetch and display the full-text PDF of the article for you. In my experience, it has around 90% of journal articles that I try to access. For anyone without journal access, Sci-Hub is the place to go. In addition, oftentimes universities and other organizations will lack access to certain journals or journal articles even if they have journal subscriptions; in these cases, Sci-Hub is similarly very handy for getting those missing articles that fall through the cracks of broad journal subscriptions. Sci-Hub also is often faster for accessing the full texts of journal articles than going through the original journal publisher websites. Note that inputting PubMed URLs does not work in Sci-Hub.

Although Sci-Hub is technically piracy, there are reasons to not feel bad about using it. Despite its nature as a piracy website, Sci-Hub has been praised by many academics and researchers. Alexandra Elbakyan, the woman behind Sci-Hub, was named by the prestigious Nature Publishing Group as “one of the 10 people who mattered most” in 2016. Why the praise for Sci-Hub, you might ask? There are a variety of reasons. One reason is that the authors of journal articles are not paid for their work, and instead generally have to pay the journals to have their articles published. This may come as a surprise, but it’s the unfortunate reality; the actual researchers and scientists do not get a cent of the profits from the publications they write and the research they conduct, with the profits instead going only into the pockets of the publishing companies. Another reason is that most of the research that journal articles report and are derived from is publicly funded by taxpayer money. In this context, one might think that it would be fair for the publications to be publicly accessible, but this is of course not the case. A third reason is that journal articles are exorbitantly expensive; US$30 to read a single article is rather ridiculous, and makes reading the scientific literature very difficult and limited for anyone without journal access via a university or other organization. It’s notable also that many institutions in developing countries cannot afford journal subscriptions, making journal access impossible for many people throughout the world, including even students and academics.

The only essential functions that journals really provide are scholarly peer review and prestige (as in impact factor). As such, with the facts considered—researchers not being paid for their work, the research being funded by taxpayer money, the considerable and arguably undeserved profits of academic publishers, and the selective access to knowledge—many academics have criticized the current academic publishing establishment and have called for a better system. In particular, there is an emerging philosophy of open knowledge, espoused perhaps most notably by Wikipedia, which at its core is characterized by the notion that knowledge should be free and accessible to all and that open knowledge is beneficial to society. The philosophy of open knowledge is also seen with the recent emergence of open-access journals such as PLOS One. It’s logical to assume that if journal publications were open and accessible to all, general scientific literacy and participation would be likely to increase. Taken together, the preceding are why Sci-Hub and its founder Alexandra are being praised (and why you should not feel guilty about using Sci-Hub—as well as why you should tell others about it).

See here for an excellent article by the founder of PLOS on the topic of open-access science. See here for another great (and much shorter) article on this topic.

LibGen

Library Genesis (see the Wikipedia article for the website URL), or LibGen for short, is another Russia-based shadow library website. It is specific to books, and is very useful for getting the full-text PDFs (or other formats) of many books, for instance those found on Google Books or Amazon. The selection of LibGen is more limited than the analogous case of the journal articles via Sci-Hub, but you can in any case get a surprising number of high-quality scientific books through the site. Sci-Hub often redirects to LibGen in the case of DOIs that are for book chapters.

Publications Not Available Online

Many publications, whether they are journal articles, book chapters, whole books, or dissertations, are not available online. Or, at least, not via Sci-Hub, LibGen, or subscription journal access. This is particularly true for older publications from before the age of the modern web. Moreover, sex-hormone endocrinology and pharmacology, the foundation of transgender hormone therapy, is an old field dating back over a century. As such, many publications in this discipline are quite old. A reliable sign that a publication isn’t available online is when it has a PubMed or Google Scholar entry but no associated publisher page (example). So how does one obtain publications that aren’t online?

Archival Sites

In some cases publication archival sites like the Internet Archive’s Text Archive and HathiTrust Digital Library have online copies of publications that have not yet been digitized by their publishers or copyright holders and that are not otherwise on the web. However, public access to most HathiTrust items are restricted due to copyright. For a time during the COVID-19 pandemic, many HathiTrust items were open to people with university affiliations via the Emergency Temporary Access Service (ETAS). However, this has since been deactivated for most participating libraries as lockdown has been lifted. Tools to download items from the ETAS such as HathiTrust ETAS Downloader and ETAS Download Helper were developed during the time that the ETAS was active.

Visiting Libraries and Interlibrary Loan

The main way is through libraries, particularly university libraries. Libraries often have incredible physical collections of publications, including entire sets of journals. You can use a website called WorldCat to search libraries throughout the world for publications and see which ones have them. WorldCat indexes books, book chapters, journals and journal articles, dissertations, and other resources. You can also use a given library’s own library search system, a common system being Primo. (The University of California, Irvine’s Primo library search system is here, for instance.) There is a good chance that a library with the publication will be near you and that you’ll be able to make a trip to the library and find the publication there. You can then read the publication, check it out if it’s loanable, or, if you’re so inclined, take photos of the pages with your phone or a camera for reading later (good for a single trip to get lots of publications). Note that you generally do not have to be a student or faculty/staff member to visit and access university libraries.

If you are a university student or faculty/staff member however, you have a special library privilege known as interlibrary loan (ILL). Some community college students and faculty/staff members may also have a more limited ILL service. With ILL, you can request publications from your university library that the library does not own. Your library will contact other libraries and will attempt to obtain the publication. Libraries have lending agreements with many other libraries, and your library will check with all the libraries it has lending agreements with that have the publication to see if they have a loanable copy of the item. Oftentimes, this will be successful. If the publication is a book or dissertation, it’ll be physically shipped to your library for you to pick up and borrow for a period of time. If it’s a journal article or book chapter, it’ll be scanned into a PDF and then sent to you by email or posted on your library’s online ILL request portal.

When using ILL, your library will try to obtain the publication you want from other libraries for free. Occasionally your library won’t be able to obtain the publication you want for free however. If you’re an undergraduate student, the request will come back as unsuccessful in this case. If you really want the publication, you can obtain it still by contacting the library and paying the fees for the item. This is often quite expensive though (e.g., $30 for a single publication).

If you’re a faculty or staff member at a university, such as a professor, postdoctoral researcher, junior research specialist, visiting scholar, library employee, or other type of eligible employee, many universities will subsidize the cost per ILL request for non-free items up to a certain amount. A subsidization of $50 per transaction will cover virtually any requested publication. It probably doesn’t matter if you’re a paid or volunteer faculty or staff member when it comes to this service—as long as you’ve been formally appointed, you should be eligible for it. Faculty/staff members and graduate students at major universities should be able to get almost any publication for free through the university’s ILL service. Not all of them will be, but the vast majority of requests are likely to be successful.

Libraries can be a very powerful resource for obtaining publications. Surprisingly, many people, including university students and even professors from my experience, are unaware of the vastness of the collections of their university libraries and what their universities can provide with their ILL service (or even that there is an ILL service).

Buying From Online Book Sellers

The other way to obtain publications that aren’t available online, namely books, is to buy them on websites like Amazon, AbeBooks, and eBay. Books that were recently released or are brand new can be very expensive, limiting the practicality of this route when it comes to the newest published content. But many books that are used and are more than a few years old can be purchased for a fraction of whatever their original sales price was. It’s not uncommon to find amazing books for only $5 to $10. Buying books obviously costs money, but oftentimes the rewards are worth it.

Papers via Transfeminine Science

The present author enjoys collecting literature on sex hormones and transgender hormone therapy. Over time she has accumulated a large collection of papers and books in these areas. This includes many items that aren’t otherwise available online. If there is a relevant publication you’re trying to obtain and you haven’t been successful in getting it, feel free to let me know and I might be able to help.

Commercial Document Delivery Services

Certain commercial document delivery services like EurekaMag and Documents Delivered exist and for a fee can obtain almost any paper or book chapter that exists whether available online or offline. However, these services currently charge $30 for each offline publication, which is quite a steep cost. Nonetheless, for those desperate enough or for items important enough, these services can provide publications when other avenues of obtaining them may not be successful. Books and dissertations are less practical with these services as often only one chapter can obtained per order or the cost may be based on the number of pages in the item of interest and may be much higher than for a single paper.