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Finasteride is sometimes used in hormone replacement therapy for male-to-female transsexuals in combination with a form of estrogen due to its antiandrogen properties.[9][10] However, little clinical research of finasteride use for this purpose has been conducted and evidence of efficacy is limited. Indeed, finasteride is a substantially weaker antiandrogen in comparison to conventional antiandrogens like spironolactone and cyproterone. Furthermore, it has been associated with inducing depression and anxiety at a high rate in both male and female patients,[11] symptoms that are very common in transsexuals, who are already at a high risk.[12] As a result, prescription of finasteride for this indication in male-to-female transsexuals may not be particularly useful, and could put them at risk for detrimental emotional side effects. Finasteride has also been found to mitigate the effects of withdrawal after chronic alcohol use.[13]
