PharmaSMaSH is an academic research study that explores how people self-manage sexual and reproductive health treatments. It is a ground-breaking project that studies this issue by focusing on how people use medicines to manage their own sexual and reproductive health. It tracks how these medicines move across political and regulatory boundaries and explores three main groups of medical products and the communities built around them.

What’s the premise?

People with stigmatised gender or sexual identities – like gay, lesbian, bisexual, trans, and non-binary people – as well as those with stigmatised reproductive health needs, such as people seeking abortion or contraception, have long faced exclusion and mistreatment in healthcare. For these groups, getting medical care can be especially difficult because of stigma, discrimination, poor-quality services, or high costs.

Sometimes, the medicines or treatments people need aren’t available through formal healthcare systems, or local providers refuse to offer them. When this happens, people may decide to manage their own care, often because they have no other choice, or out of fear of mistreatment.

At the same time, digital technologies are changing how people access healthcare. Online platforms make it easier to find reliable health information and to buy or import medicines that might not be available (or even legal) where they live.

These online options allow communities to push against local laws and social norms, sharing medicines and health knowledge across borders.