“All the Anavar here, all of it is f**king wrong!”: responding to the gendered risks of Australia’s steroid market through testing and community care

Objective Anabolic-androgenic steroids (AAS) are widely used for performance enhancement and body modification, yet the risks associated with these substances, particularly for women, remain underexplored. This study aims to examine the gendered dynamics of AAS use in Australia, focusing on the misrepresentation and underdosing of oxandrolone (Anavar) and related compounds, and to explore how both men and women respond to these risks within the unregulated market.Method We conducted 41 interviews with AAS consumers regarding findings from a steroid testing trial. Using an iterative analytical approach, we foregrounded lived-living experiences to identify key thematic categories. This provided insights into perceptions of substance quality, consumer decision-making, and the broader sociocultural dynamics shaping AAS use.Results Participants reported widespread misrepresentation and underdosing of oxandrolone, with women disproportionately affected. These inconsistencies contributed to adverse health outcomes, including rapid virilization and irreversible physiological changes in women. The data show women are using selective sourcing strategies as informal harm reduction measures.Conclusions The findings underscore the importance of gender-sensitive harm reduction strategies and steroid checking services to address the risks of misrepresented AAS. Peer support networks and community-driven initiatives play a crucial role in fostering safer AAS use, especially for women in the AAS market.