title: Balancing benefits and harm: chemical use and bodily transformation among Indonesia's transgender waria.
abstract: BACKGROUND
  Members of Indonesia's diverse male-to-female transgender community often describe themselves as waria. Waria do not equate being feminine with being female. They do not want to be women; they aspire to be like women. It entails cultivating mannerisms and wearing make-up and women's clothes, shaving one's legs and styling one's hair. But some go further in their practices of self-administered, chemically assisted bodily transformation.
  
  
  METHODS
  Field research took place in Makassar, the capital city of South Sulawesi; in a smaller town in the regency of Bulukumba on the south coast of Sulawesi; and in the special region of Yogyakarta in Java. Data were collected through repeated in-depth interviews with ten waria youths aged between 18 and 26 in each site; interviews with pharmacists, drug and cosmetics store clerks; three focus group discussions at each site; and participant observation.
  
  
  RESULTS
  Our respondents saw their bodies as 'projects' they can manipulate with pharmaceutical products and cosmetics. To lighten their skin, they experimented with different brands of exfoliating liquid, whitening cream, powder, foundation, face soap and skin scrub. To grow breasts and reduce muscle mass, they experimented with different brands and dosages of contraceptive pills and injections in order to get faster, better and longer-lasting results.
  
  
  CONCLUSIONS
  Harm reduction programs often neglect chemicals that are not narcotics, not related to sexually transmitted infections, and which are legally and freely available. Safety issues arise when otherwise safe products are used off-label in large quantities. Drug policy-makers are paying insufficient attention to the safety of cosmetics.
authors.affiliation: Department of Anthropology, Faculty of Social and Political Sciences, Hasanuddin University, Makassar, Indonesia; European Research Council Chemical Youth project, University of Amsterdam, The Netherlands. Electronic address: nurulilmiidrus@yahoo.com.
authors.forename: Nurul Ilmi
authors.initials: NI
authors.lastname: Idrus
authors.affiliation: European Research Council Chemical Youth project, University of Amsterdam, The Netherlands. Electronic address: davidhymans@hotmail.com.
authors.forename: Takeo David
authors.initials: TD
authors.lastname: Hymans
mesh_terms: D000293:Adolescent; D001828:Body Image; D003358:Cosmetics / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007214:Indonesia; D008297:Male; D004366:Nonprescription Drugs / Q000009:adverse effects*; D012309:Risk-Taking; D060386:Sex Workers; D012919:Social Behavior; D063106:Transgender Persons; D055815:Young Adult
chemical_list: D003358:Cosmetics; D004366:Nonprescription Drugs
keywords: Beauty enhancement; Chemical use; Harm reduction; Indonesia; Waria
references.citation: J Sex Res. 2011 Mar;48(2-3):285-96
references.pmid: 20336575
references.citation: J Sex Med. 2012 Oct;9(10):2641-51
references.pmid: 22906135
references.citation: Anthropol Med. 2014;21(2):217-29
references.pmid: 25175296
references.citation: Clin Endocrinol (Oxf). 1997 Sep;47(3):337-42
references.pmid: 9373456