# Academic literature — community drug-checking & DIY HRT

**Last updated:** 2026-04-23
**Scope:** the peer-reviewed evidence base most relevant to the corpus's core question — community testing of self-sourced pharmaceuticals (HRT, peptides, anabolic-androgenic steroids, recreational drugs). The corpus is built primarily on community primary sources (testing.trans.diy, finnrick.com, Janoshik, Trans Harm Reduction, vendor pages, equipment listings) and pharmacopoeia / vendor documentation. This file is the parallel academic record. Other files cite these papers by short tag (e.g., "Piatkowski 2025a"); resolve them here.

> **Headline finding (Kennedy 2022).** A WHO-commissioned systematic review of 3,792 citations found **zero studies on drug-checking or contamination quality control of DIY hormones**. The community testing infrastructure documented in this corpus (testing.trans.diy, Trans Harm Reduction, Artemis Analytical, Janoshik for AAS) is ahead of the peer-reviewed evaluation literature for HRT specifically. The closest published analogs are AAS testing (Piatkowski 2025a/b), black-market AAS quality (Magnolini 2022), and recreational-drug checking generally (Maghsoudi 2022, Park 2023, Brunt 2017, Caudevilla 2016).

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## Reading list — top 10

### 1. Piatkowski et al. 2025a — World's first AAS testing trial

**Citation.** Piatkowski T, Cresswell SL, Coomber R, Davey G, Whitaker L, Barratt MJ, et al. The world's first anabolic-androgenic steroid testing trial: A two-phase pilot combining chemical analysis, results dissemination and community feedback. *Addiction*. 2025;120(7):1366–1377. doi:[10.1111/add.70009](https://doi.org/10.1111/add.70009). PMID 39911049.

**Why it matters.** The single most methodologically transferable paper to the HRT context. AAS oil-injectables are chemically the same form-factor as half a DIY HRT cabinet; the lab stack (Radian-ASAP direct mass detection + Orbitrap LC-MS + FTIR with NIST spectral matching) is richer than what community HRT labs currently publish.

**Key finding.** **13% of 23 analyzed AAS samples contained a substance different from the label** — e.g. an oxandrolone tablet that actually contained stanozolol, a testosterone enanthate ampoule that actually contained testosterone cypionate. Quantitative analysis was completed for only one sample (testosterone propionate, 96.2 mg/mL vs label) due to reference-standard acquisition difficulties — the same bottleneck `06-reference-standards/overview.md` documents. **No endotoxin, microbial, or heavy-metals testing** — the same gap our `summary.md` Q2 highlights for HRT.

### 2. Piatkowski et al. 2025b — AAS testing as consumer engagement

**Citation.** Piatkowski T, Coomber R, Francis C, Kill E, Davey G, Cresswell S, et al. Anabolic-androgenic steroid testing as a tool for consumer engagement and harm reduction: a sequential explanatory mixed-method study. *Harm Reduction Journal*. 2025;22:114. doi:[10.1186/s12954-025-01270-4](https://doi.org/10.1186/s12954-025-01270-4). PMID 40616139.

**Why it matters.** Companion paper expanding 2025a to 58 AAS samples + 25 qualitative interviews. The behaviour-change evidence the public-health case for community HRT testing depends on, applied to the closest analog. Also the only published number on community-AAS-testing turnaround tolerance: 2–3 months feedback was experienced as a significant delay.

**Key finding.** Of 46 chemically-assessed samples, **9 had compound misidentification (~20%)** and **15 had dosage inconsistency (~33%)**. After results dissemination, users reported modifying usage and reduced trust in specific suppliers. Direct support for the mechanism testing.trans.diy is built around.

### 3. Magnolini et al. 2022 — Systematic review, fake AAS on the black market

**Citation.** Magnolini R, Falcato L, Cremonesi A, Schori D, Bruggmann P. Fake anabolic androgenic steroids on the black market — a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature. *BMC Public Health*. 2022;22:1371. doi:[10.1186/s12889-022-13734-4](https://doi.org/10.1186/s12889-022-13734-4).

**Why it matters.** Pooled 19 studies, **5,413 black-market anabolic samples** from Europe and Brazil. Provides the most statistically grounded counterfeit/substandard priors in the peer-reviewed literature. Methods reviewed: LC-MS, GC-MS, NMR, IR, DSC — the exact stack the corpus discusses.

**Key finding.** **36% counterfeit overall (95% CI 29–43%)**, with an additional 37% (CI 17–63%) failing quality standards. **Injectable oil-based solutions had higher counterfeit rates (43–65%) than oral tablets (29–37%)** — important for HRT, which is largely oil-injectable. **Bacterial skin commensals documented in injectables** — the external evidence that the bioburden concern in `03-microbial-pyrogen/bioburden.md` is empirically grounded, not theoretical.

### 4. Kennedy et al. 2022 — WHO systematic review of self-administered HRT

**Citation.** Kennedy CE, Yeh PT, Byrne J, et al. Self-administration of gender-affirming hormones: a systematic review of effectiveness, cost, and values and preferences of end-users and health workers. *Sex Reprod Health Matters*. 2022;29(3):2045066. doi:[10.1080/26410397.2022.2045066](https://doi.org/10.1080/26410397.2022.2045066). PMC8942532.

**Why it matters.** The only WHO-adjacent systematic review touching DIY HRT. **The peer-reviewed confirmation that the literature gap on community HRT testing is real**, not a search artifact.

**Key finding.** 3,792 citations reviewed, only 5 met inclusion criteria. **No studies identified on drug-checking, contamination, or quality control of DIY hormones.** Reported self-administration prevalence ranges from 11% (Ontario) to 78.7% (Rio de Janeiro). Motivations: cost, access, anti-trans discrimination, faster transition. Citeable as the load-bearing "this corpus is documenting an unserved research area" claim.

### 5. Caudevilla et al. 2016 — Energy Control international cryptomarket service

**Citation.** Caudevilla F, Ventura M, Fornís I, Barratt MJ, Vidal C, Gonzalez Lladanosa C, Quintana P, Muñoz A, Calzada N. Results of an international drug testing service for cryptomarket users. *Int J Drug Policy*. 2016;35:38–41. doi:[10.1016/j.drugpo.2016.04.017](https://doi.org/10.1016/j.drugpo.2016.04.017). PMID 27239011.

**Why it matters.** The cleanest peer-reviewed precedent for a mail-in international drug-checking service for gray-market users. Same acquisition channel (online vendors), same workflow, same "we don't judge where you bought this" model that testing.trans.diy / Trans Harm Reduction operate under.

**Key finding.** GC-MS analysis of 219 samples 2014–2015. **In 200 of 219 samples (91.3%) the detected compound matched what the user reported purchasing.** 39.8% of cocaine samples contained levamisole. The 91.3% identity-match rate is the best external benchmark we have for what to expect in well-functioning gray-market supply — useful in `08-interpretation-qc/qc-protocols.md` as the prior for community-lab accuracy expectations.

### 6. Park et al. 2023 — North American drug-checking services census

**Citation.** Park JN, Tardif J, Thompson E, et al. A Survey of North American Drug Checking Services Operating in 2022. *Int J Drug Policy*. 2023;121:104206. doi:[10.1016/j.drugpo.2023.104206](https://doi.org/10.1016/j.drugpo.2023.104206). PMC10843152.

**Why it matters.** Real census of 16 North American community drug-checking programs (9 US, 5 Canada, 2 Mexico), ~50,000 samples 2014–2022, 125,000 people served. Maps the actual technology stack the field uses — answers "what hardware does a real community lab deploy?" from external survey data, not vendor pages.

**Key finding.** Onsite tech most common: fentanyl strips (88%), FTIR (63%), reagent (25%), benzo strips (25%), Raman (12%). Offsite confirmation: GC-MS (44%), LC-MS (31%), **HPLC (6%)**, NMR (6%). **HPLC is rare in community drug-checking services.** This recalibrates how to read testing.trans.diy / Artemis / THR — their HPLC- and GC-MS-centric stacks are atypically capable for the community-testing field median.

### 7. Goncalves et al. 2021 — IR vs UPLC-HRMS field accuracy

**Citation.** Goncalves R, Titier K, Latour V, Peyré A, Castaing N, Daveluy A, Molimard M. Suitability of infrared spectroscopy for drug checking in harm reduction centres. *Int J Drug Policy*. 2021;88:103037. doi:[10.1016/j.drugpo.2020.103037](https://doi.org/10.1016/j.drugpo.2020.103037). PMID 33207305.

**Why it matters.** 136 samples paired by FTIR and UPLC-HRMS as gold standard. The cleanest method-comparison paper available — exactly the "does the cheap technique agree with the expensive technique on real samples" validation study a Bronze-tier discussion needs.

**Key finding.** **IR-vs-HRMS discordance ~8% (11 of 136).** IR unsuitable for blotters, cannabis, mixed or low-content matrices. Bounded conclusion: FTIR is a useful front-line screen but not a confirmatory method. The corpus's `02-analytical-chemistry/technique-comparison-matrix.md` and `05-home-lab-setup/budget-tier-bronze.md` should cite this as the empirical anchor on FTIR limitations. For oil HRT (a known FTIR-difficult matrix) the expected discordance is probably worse than 8%, but this is the right baseline.

### 8. Maghsoudi et al. 2022 — Systematic review of drug-checking services

**Citation.** Maghsoudi N, Tanguay J, Scarfone K, Rammohan I, Ziegler C, Werb D, Scheim AI. Drug checking services for people who use drugs: a systematic review. *Addiction*. 2022;117(3):532–544. doi:[10.1111/add.15734](https://doi.org/10.1111/add.15734).

**Why it matters.** The canonical landscape paper on community drug-checking. 90 studies (54 peer-reviewed, 19 conference, 17 grey lit), 72% European. Lets the corpus position the HRT question against a 30-year established field.

**Key finding.** Drug-market monitoring is the most-studied domain (70%); behavioural influence less (34%); service-model outcomes least (19%). Common outcomes measured: unexpected substance detection (56%), expected substance detection (49%), NPS detection (44%). Published evidence on enacted behaviour change and downstream health outcomes remains thin.

### 9. Brunt et al. 2017 — TEDI pan-European dataset

**Citation.** Brunt TM, Nagy C, Bücheli A, Martins D, Ugarte M, Beduwe C, Ventura Vilamala M. Drug testing in Europe: monitoring results of the Trans European Drug Information (TEDI) project. *Drug Test Anal*. 2017;9(2):188–198. doi:[10.1002/dta.1954](https://doi.org/10.1002/dta.1954). PMID 26888408.

**Why it matters.** 45,859 samples 2008–2013 across Spain, Switzerland, Belgium, Austria, Portugal, Netherlands. Demonstrates federation of distinct community drug-checking services with harmonised methods + shared data — the model testing.trans.diy is implicitly attempting for HRT.

**Key finding.** Cross-national drug-market differences are large and only visible through aggregation. Establishes the surveillance value of federated community-lab data beyond any individual lab.

### 10. Harper, Powell & Pijl 2017 — Forensic drug-testing methods for POC harm reduction

**Citation.** Harper L, Powell J, Pijl EM. An overview of forensic drug testing methods and their suitability for harm reduction point-of-care services. *Harm Reduction Journal*. 2017;14:52. doi:[10.1186/s12954-017-0179-5](https://doi.org/10.1186/s12954-017-0179-5). PMC5537996.

**Why it matters.** The closest peer-reviewed parallel to `02-analytical-chemistry/technique-comparison-matrix.md`. Maps every analytical technique against cost, discrimination power, and POC feasibility. Includes MS ($5k–$200k+), IMS, IR/Raman ($10k–$60k), spot/colour ($2–$5), TLC, immunoassay.

**Key finding.** Published technique-discrimination ranking: MS > IMS > IR/Raman > immunoassay > TLC > colour tests. Recommends handheld IR or Raman as the best POC accuracy-portability-cost balance. Useful as the published authority for the HPLC-DAD-as-universal-core claim.

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## Secondary literature

### DIY HRT as harm-reduction (qualitative)

- **Welty H. (2025).** "Creating ourselves:" A qualitative analysis of DIY HRT practices in nonbinary adults. *Soc Sci Med*. 2025;373:117965. doi:[10.1016/j.socscimed.2025.117965](https://doi.org/10.1016/j.socscimed.2025.117965). PMID 40168834. *Frames DIY HRT as communal care and bodily autonomy. Useful for the framing of `01-existing-services/overview.md` and `summary.md` as harm-reduction work, not transgression.*
- **August-Rae B, Baker JT, et al. (2024).** "Not just rebellious, it's revolutionary": Do-it-yourself hormone replacement therapy as Liberatory Harm Reduction. *Soc Sci Med*. 2024;345:116700. doi:[10.1016/j.socscimed.2024.116700](https://doi.org/10.1016/j.socscimed.2024.116700). *Authors' list verified from search results; full text behind ScienceDirect paywall — re-verify before citing as primary.*
- **Datta S. (2024).** Beyond anxiety: Autonomy and harm reduction approaches to DIY Hormone Replacement Therapy. *Indian J Med Ethics*. 2024;IX(4):265–270. doi:[10.20529/IJME.2024.065](https://doi.org/10.20529/IJME.2024.065). PMID 39817293. *Justifies DIY HRT under patient-autonomy ethics.*

### Community drug-checking — additional methods + behaviour

- **Brunt TM, Niesink RJM. (2011).** The Drug Information and Monitoring System (DIMS) in the Netherlands: implementation, results, and international comparison. *Drug Test Anal*. 2011;3(9):621–634. doi:[10.1002/dta.323](https://doi.org/10.1002/dta.323). PMID 21898860. *DIMS is the oldest (since 1992) and largest community drug-checking service worldwide; the methodological reference for "what does mature government-backed community drug-checking look like."*
- **Measham F, Turnbull G. (2021).** Intentions, actions and outcomes: A follow-up survey on harm reduction practices after using an English festival drug checking service. *Int J Drug Policy*. 2021;95:103270. doi:[10.1016/j.drugpo.2021.103270](https://doi.org/10.1016/j.drugpo.2021.103270). *The Loop's UK festival data; >50% disposed of unexpected samples, 2-in-5 reduced dose for as-expected samples — behaviour-change evidence comparable to Piatkowski 2025b.*
- **Schori D, Magnolini R, Werner I, Hoover A, Bruggmann P, Quednow BB. (2025).** Pilot evaluation of an anabolic-androgenic-steroid drug-checking program in Zürich. *Harm Reduction Journal*. 2025. PMC12147309. *Cited under `01-existing-services/international-state-funded.md` as the primary source for the Zürich DIZ/SaferParty AAS program (Aug 2023, GC-MS, 71 samples / 52 clients, 52% counterfeit/substandard finding).*
- **HAARLEM study group / Anabolenpoli (2022).** Multiple publications including the HAARLEM baseline (PMID 31663164) and the UPLC-QTOF-MS/MS analytical paper (PMID 35938779). *Documents the Netherlands' Anabolenpoli (Spaarne Gasthuis Haarlem) AAS clinic, est. 2011, insurance-covered with referral. Cited under `01-existing-services/international-state-funded.md`.*

### Grey literature

- **EUDA / EMCDDA (2023).** Health risk communication strategies for drug-checking services in Europe. Published 2023-11-17. The most recent official European policy document on how community drug-checking should communicate results. URL: euda.europa.eu/news/2023/new-guidance-drug-checking-services-health-risk-communication_en.
- **WEDINOS PHILTRE annual reports.** Public Health Wales. The largest publicly-available community drug-checking dataset in the UK. URL: phw.nhs.wales/publications/publications1/wedinos-annual-report/.
- **TEDI Network.** tedinetwork.org. Operational federation of European drug-checking services with harmonised data — the federation model testing.trans.diy parallels.

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## What this literature does and doesn't license the corpus to claim

**Licenses with peer-reviewed support:**

- "Roughly 13–20% of self-sourced AAS samples contain a substance different from the label" (Piatkowski 2025a/b).
- "Roughly 36% of black-market AAS samples are counterfeit; injectables are worse than orals" (Magnolini 2022).
- "Bacterial skin commensals are documented in injectable AAS" (Magnolini 2022) — supports the bioburden concern for HRT injectables by analogy.
- "FTIR vs gold-standard discordance is ~8% on recreational drugs" (Goncalves 2021) — bounds bronze-tier expectations.
- "User-reported identity matches lab-detected identity ~91% of the time on a mail-in cryptomarket service" (Caudevilla 2016) — a useful ceiling expectation for HRT vendor identity.
- "Community drug-checking changes user behaviour — disposal, dose reduction, peer warning" (Measham 2021, Piatkowski 2025b) — the public-health case for testing.
- "HPLC is rare in community drug-checking services; testing.trans.diy / THR / Artemis are unusually capable" (Park 2023).
- "There is no peer-reviewed evidence base for community testing of DIY HRT" (Kennedy 2022).

**Does NOT license:**

- Specific HRT vendor failure rates — none published. The 13% AAS prior is the best surrogate.
- Any specific endotoxin contamination rate for oil-based HRT — no peer-reviewed measurement.
- Comparative effectiveness of self- vs provider-administered HRT — Kennedy 2022 explicitly found no studies.
- Sensitivity/specificity figures for community HRT testing methods — no paired-sample validation studies exist.

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## Source confidence notes

- Citations resolved against PubMed and DOI for all top-10 papers — **C1** on citation integrity.
- Findings extracted from full PMC text: Piatkowski 2025a/b, Magnolini 2022, Park 2023, Goncalves 2021, Harper 2017 — **C1**.
- Findings from abstracts + secondary summaries: Maghsoudi 2022, Brunt 2011, Brunt 2017, Kennedy 2022, Measham 2021 — **C2** (full text 403/paywall).
- Welty 2025 abstract retrieved; full text paywalled — **C2**.
- August-Rae 2024 — author list inferred from secondary sources; **C3**, re-verify before primary use.
- "Zero peer-reviewed papers on community HRT testing" — based on targeted Google Scholar / PubMed / web search and corroborated by Kennedy 2022's systematic review of 3,792 citations finding none. **C2** (absence-of-evidence on a narrow topic).

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## Cross-references

Per-topic citations of the above papers live in:

- `summary.md` — TL;DR + Closing notes (Piatkowski 2025a, Kennedy 2022, Magnolini 2022, Caudevilla 2016).
- `01-existing-services/overview.md` — the field-context paragraph (Park 2023, Maghsoudi 2022, Brunt 2017).
- `01-existing-services/international-state-funded.md` — Schori 2025, HAARLEM 2022.
- `02-analytical-chemistry/technique-comparison-matrix.md` — Park 2023, Goncalves 2021, Harper 2017.
- `02-analytical-chemistry/ftir.md` — Goncalves 2021.
- `03-microbial-pyrogen/bioburden.md` — Magnolini 2022.
- `08-interpretation-qc/qc-protocols.md` — Caudevilla 2016, Goncalves 2021, Piatkowski 2025a.
- `10-cost-benefit/when-to-diy-vs-outsource.md` — Measham 2021, Piatkowski 2025b.
- `gaps.md` — Kennedy 2022 as the gap-confirmation citation.