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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. Conclusion 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. [ABSTRACT FROM AUTHOR]

Although young people in their everyday lives consume a bewildering array of pharmaceutical, dietary and cosmetic products to self-manage their bodies, moods and sexuality, these practices are generally overlooked by sexual and reproductive health programmes. Nevertheless, this self-management can involve significant (sexual) health risks. This article draws from the initial findings of the University of Amsterdam's ChemicalYouth project. Based on interviews with 142 youths, focus group discussions and participant observation in South Sulawesi, Indonesia, we found that young people – in the domain of sexual health – turn to pharmaceuticals and cosmetics to: (1) feel clean and attractive; (2) increase (sexual) stamina; (3) feel good and sexually confident; (4) counter sexual risks; and (5) for a group of transgender youths, to feminize their male bodies. How youth achieve these desires varies depending on their income and the demands of their working lives. Interestingly, the use of pharmaceuticals and cosmetics was less gendered than expected. Sexual health programmes need to widen their definitions of risk, cooperate with harm reduction programmes to provide youth with accurate information, and tailor themselves to the diverse sexual health concerns of their target groups. Si dans leur vie quotidienne, les jeunes consomment une palette étonnante de produits pharmaceutiques, diététiques et cosmétiques pour autogérer leur corps, leurs humeurs et leur sexualité, ces pratiques sont généralement ignorées par les programmes de santé sexuelle et génésique. Néanmoins, cette autogestion peut comporter d'importants risques de santé (sexuelle). L'article s'inspire des conclusions initiales du projet ChemicalYouth de l'Université d'Amsterdam. Nous fondant sur des entretiens avec 142 jeunes, des discussions de groupe et l'observation des participants à Sulawesi-Sud, Indonésie, nous avons découvert que les jeunes, dans le domaine de la santé sexuelle, ont recours aux produits pharmaceutiques et cosmétiques pour : 1) se sentir propres et attirants ; 2) accroître leur endurance (sexuelle) ; 3) être à l'aise et confiants sexuellement ; 4) contrer les risques sexuels ; et 5) pour un groupe de jeunes transsexuels, féminiser leur corps masculin. La manière dont les jeunes réalisent ces désirs varie selon leur revenu et les exigences de leur vie professionnelle. Il est intéressant de noter que l'utilisation de produits pharmaceutiques et cosmétiques est moins différencié selon les sexes qu'escompté. Les programmes de santé sexuelle doivent élargir leurs définitions du risque, coopérer avec les programmes de réduction des risques pour donner des informations exactes aux jeunes et s'ajuster aux diverses préoccupations de santé sexuelle de leurs groupes cibles. Aunque en su diario vivir las personas jóvenes consumen una desconcertante selección de productos farmacéuticos, dietéticos y cosméticos para automanejar su cuerpo, estado de ánimo y sexualidad, los programas de salud sexual y reproductiva generalmente hacen caso omiso de estas prácticas. No obstante, este automanejo puede implicar riesgos significativos para la salud (sexual). Este artículo se basa en los hallazgos iniciales del proyecto ChemicalYouth de la Universidad de Amsterdam. Mediante entrevistas con 142 jóvenes, discusiones en grupos focales y observación participativa en Sulawesi meridional, Indonesia, encontramos que la juventud –en el ámbito de salud sexual– recurre a farmacéuticos y cosméticos para: (1) sentirse limpia y atractiva; (2) aumentar su resistencia (sexual); (3) sentirse bien y con confianza sexual; (4) contrarrestar los riesgos sexuales; y (5) para un grupo de jóvenes transgénero, feminizar su cuerpo masculino. La manera en que la juventud logra estos deseos varía según su ingreso y las exigencias de su vida laboral. Curiosamente, el uso de farmacéuticos y cosméticos era menos influido por género que lo esperado. Los programas de salud sexual deben ampliar su definición de riesgo, cooperar con programas de reducción de daños para proporcionar a la juventud información exacta y adaptarse conforme a las diversas inquietudes de sus grupos objetivos en cuanto a la salud sexual. [ABSTRACT FROM AUTHOR]