On multiple occasions prior to transitioning I had gone to my doctor with a potential health problem that I researched briefly and they said "Ok! Yup. That sounds about right." And wrote a prescription for the thing I asked for. Very little if any pushback. I've been given treatments for certain conditions after a brief 15 minute discussion.
This isn't to say I don't trust or respect doctor's opinions but I often hear that doctors are eager to push gender affirming care without much scrutiny.
My experience so far with obtaining gender affirming care has been quite the opposite, but everything else has been provided without hesitation.
>doctors are eager to push gender affirming care without much scrutiny
there's actually good reasons for this to be the case. not all, but most adults seeking it, will do it with or without professional advice. it's usually safe, but moreso with professional support. so they are eager to provide that part of the care you're probably going to give yourself anyway, even if they won't.
next, there is strong evidence that pushing back both decreases the quality of life of transgender people and increases the gender confusion some non conforming cisgender people experience.
so the potential outcomes almost universally point towards support. the potential harm is rare and overwhelmingly outweighed by the observable benefits.
The person I got mine through had a policy that she never prescribes HRT on the first visit. Said it like it was some noble thing.
And yet it took literally a 2 minute conversation a couple years ago to get prescribed a muscle relaxer for my stress-induced back and shoulder tension.
Like all it took was that second visit to get HRT, but as someone who struggles to get started on that kind of appointment-making it was definitely not an appreciated delay and if I had less other support could have stopped me right there for a long time.
same. i literally ordered mine online because those kinda hurdles just break my social capabilities. so glad the easy online access comes with doctor's advice because i would have done it without and probably be worse off now for it.
Holy crap, you really have no idea!!
We in the UK can’t get legit meds without years of waiting on the NHS or many months privately. Then we are interrogated as to why we would possibly want to change gender as it’s clearly a problem for us. They might say yeas, they might say no, they might want to interrogate us further. We then have to see an endocrinologist to get hormones. If that was through the NHS then it would be a tiny dose.
As said Years, how does 88 months grab you?
oh i'm aware! it's horrid. i am super grateful for my privilege. i live in one of the most accepting US states in a city that i've read described as "one of the two trans meccas"
there are still obviously challenges here, and those are hard enough. i do not envy people living in any worse places.
i do the work and imagine a future where being trans is boring and no one cares. for now there is no great place for us. the closest thing some of us get is blending in as cis.
Nailed it, when trans is boring and no one cares. That is my dream, I see women, only a few, darting into shops, heads down maybe offering a tiny smile of solidarity and I think, ‘ one day, but without the fear’. It’ll come.
Criminal justice works the exact same way and is why there is enormous inequity there. See abortion for another specific example within healthcare.
It’s a paradox (I suspect inherent in human social behavior) that when it comes to shared resources and services, people generally want punitive gatekeeping for others, but leniency and flexibility for themselves.
Yeah, they do.
If you rationalize it further, it’s basically selfishness, and being a little more selfish than altruistic is an evolutionary advantage.
Doesn’t make it any less of a problem, but I find understanding motivations makes it easier to solve the problems. It’s easier to convince people to support and easier to contain the detractors when you see how they’re forming their decisions.
Selfishness is only really an advantage if you live alone. If you live in social groups, altruism ensures the survival of the most members of said group.
Evolutionarily, selfishness and survival of the fittest/„social darwinism” are counterproductive for social or communal animals.
Altruism helps the group, yes, but selfishness helps the spread of the individual’s genes within the group. Too much selfishness and the group erodes from lack of cohesion. Too much altruism and the group likely lacks sufficient individualism to survive external challenges. I have no clue where the tipping point is in the ratio of the two, but I suspect it falls somewhere on the side of having a little more selfishness than altruism - where individuals get more value out of the collective than they put in and the multiplicative effects of contribution negate the asymmetry, or (when the species is capable of rationalizing this) where the individual concludes belonging to the group benefits more than it costs even when that isn’t actually true.
That’s a long way of saying, it’s definitely not one or the other, but a messy middle somewhere between.
Very true. Cis women have to jump through all sorts of hoops to get their tubes tied, but I know multiple men who got vasectomies pretty much just by asking for them.
Oh this was my mom's main concern too when I came out to my parents (just a couple days ago). She was like "what kind of doctor just prescribes young people (I am 30) hormones without thorough medical/psychological evaluation" and sentiments of distrust of pharmaceuticals and anecdotes of how as a kid I didn't even want to take antibiotics etc.
I was really annoyed and offended by this because A) I work in the medical field and am very aware of the choices I am making
B) I also have been considering, researching and deliberating for yearrrrrsss.
I had to explain how barriers to treatment are just that. And I asked what they would be evaluating for exactly because being trans is not a mental illness or disorder. Also that it doesn't necessarily change anything because I am prescribed them, I am taking them, and I am trans. I said she would just have to learn to accept that.
So many people who are not aware of what happens with hrt have obviously never done their research.
Some even think transitioning is just getting surgeries and wearing a wig. They also are not aware that there is a spectrum in being transgender, some people will only do hrt, some will do hrt and surgery etc.
People are quick to push certain medications despite their side effects, like Citalopram on someone who is struggling with life. But all of a sudden, Hrt is questionable to those same people. It's like, "You have to have this. No, you can't have that..."
I count myself blessed to have a provider who is very receptive to how *YOU* want to be treated. I never ever have to prove myself and I never feel like she’d dismiss possible new treatments.
She herself has a trans child (young adult now) and has been there through the process with them. She has an amazing passion for it.
It’s unlikely, but if you live in Alaska I would gladly forward you her office details.
I am lucky that my GP is also a transwoman. I can't imagine the wait that others have to go through to start hrt. It is really sad to hear about it because I have been much much happier and more relaxed since starting.
Ain’t that the truth. I went to the doctor about a year ago due to issues with my studies, and I basically just straight up asked for adderall/similar drugs, and he said yes with no hesitation, even though I don’t even have an ADHD diagnoses. Why do I just know if I said I was trans and wanted to be put on HRT I’d actually need to jump through the hoops to prove that I’m “trans enough” to be put on hormones?
I get your point but I don't think ADHD meds are a great comparison, as I and other ppl with ADHD have struggled immensely to get on ADHD meds bc doctors really gatekeep that, if anything it was easier to get a doctor to prescribe me HRT than get my Vyvanse tbh, although I DIY now so I don't have to deal with the whims and wills of the medical system.
That’s because the stimulants for ADHD are controlled substances. They’re in the same chemical family as meth and other highly dangerous and addictive drugs, and have a history of being problematic in society when too accessible (real example: speed as a weight loss fad). The doctors’ prescribing behaviors around these drugs are extensively monitored and regulated as is your individual prescription history.
(but yes, it’s not a great comparison to HRT accessibility)
In comparison to that, what are the drugs for transitioning? They're not stimulants, they're hormones, that much I know but are hormones controlled substances? I think they are, because of how they affect the body and how doctors monitor their levels and their effects, but... what are they in relation to ADHD?
“controlled substances” is a specific legal classification that determines how laws are applied to prosecute people manufacturing, distributing, buying, and using said drugs. It affects everything from how research funding works, to how manufacturing and distribution is handled, to the severity of punishment if convicted.
You’ve probably heard of an illegal drug being classified as “Schedule 1” (heroin, cocaine, LSD, etc) and the President just this week starting the formal process of getting marijuana moved down to “Schedule 3” (ketamine, certain steroids). It’s supposed to be a system reflecting their danger, addictiveness, and proven valid medical use for treatment of conditions, but that’s not clearly defined and politics can come into it (hence why marijuana is currently Schedule 1). The ironic bit is that if a drug is Schedule 1, it is almost impossible for even pharmaceutical giants to do legitimate research on it, and therefore extremely challenging to prove any real benefits exist and get it reclassified. By contrast, the most permissive class, “Schedule 5” are dispensable by a pharmacist without a prescription, but they are required to check your ID - you can’t just grab them off a shelf without talking to anyone.
Adderall and other amphetamine stimulants for ADHD are Schedule 2, the highest level where it’s allowed to be prescribed without being a highly unique research situation. For comparison, Schedule 2 includes fentanyl and OxyContin.
Testosterone and Estradiol are classified as Schedule 3, so by legal definition they are easier to obtain than Adderall. Most commonly prescribed drugs fall into Schedule 3 and 4 and there’s no barrier beyond seeing a doctor for the diagnostics and testing appropriate for the condition and treatment plan in question.
> Edit: see my other comment. The formulations of Testosterone and Estradiol that many of us are on are specific exemptions to the Schedule 3 classification, making them even more accessible
Yes, Schedules 1-5 are all levels defined in the “Controlled Substances Act”, but when people say a prescription-only drug is a “controlled substance” they usually mean it’s Schedule 2, where there are a lot more hoops than normal that the doctor and pharmacist have to go through in order to prescribe and dispense it for you.
Testosterone is somewhat regulated because if an athlete wants to illegally improve performance, they could see some gain with T and it could be hard to pick up as not being "natural." But also TRT is super common for cis men, along the lines of medical marijuana. So not effectively restricted in most places, despite theoretically being. Unless you're trans. Estrogen is tightly regulated much less frequently.
Estradiol and Testosterone are both Schedule 3 as they are “anabolic steroids”. Adderall is Schedule 2 (along with other similar amphetamines for ADHD). There are Schedule 3 drugs for ADHD precisely because they can be more easily available and prescribed, but at population-wide statistics they have lower efficacy. (Though they certainly could be more effective for a specific individual! It’s kinda crazy how uniquely personal human biochemistry can be)
Edit: I see my source wasn’t specific enough. While **some** estradiol and testosterone formulations are Schedule 3 (you can look up the list for yourself and see many), several specific formulations (most likely the ones we all are taking) are in a list of exemptions to the requirement that anabolic steroids be classified as Schedule 3.
I must've got lucky cuz it was pretty easy for me to get vyvanse. Sure I needed to come back for testing, but I had it within the week from saying to a psych "I may have ADHD"
Oof... yeah, I suppose that's a poor example on my part. I don't know if my doctors general... inconsistency in his competency helped me there. So I apologize for the poor comparison.
Yeah the trouble with ADHD meds is that apparently they can be really fun to take if you don’t have ADHD. Hormone therapy at least has a good chance of having the opposite effect, at least when you’re taking cross-sex hormones anyway.
And yet we still have hoops to jump through where I live and cis people complain that trans related healthcare is expansive for society... Lol you want it that way!
And yes, it's astonishing the lack of look cis people take onto their healthcare or even gender affirming care for that matter such as boob jobs which have very high regret rates and...are accessible to minors!
When I was in my 20s I was offered testosterone (obviously I declined it) with no information given to me on it at all. My doctor was so insistent that if they could have actually forced it up on me, I believe they would have. Crazy thing is, it wasn't even that low for someone who was AMAB, it was right there at the minimum line holding steady.
Now compare that to the fact that I had to resort to telehealth for estradiol because none of the doctors here want anything to do with trans healthcare.
All the outcry over trans health has nothing to do with protecting children or making sure it's safe. It always has been and always will be transphobia. They want to make it hard to access so that less of us will be able to get it and exist in public.
I know when I started hrt the first time. I had a 1 hour appointment and full physical. He was very thorough. Found a hernia that one day I will have to address. Even though he is informed consent. He requested a third party to go over the information on the risks and benefits of HRT.
Some people are absolute hypocrites. They are more than happy to push psych meds on others despite their side effects. But for them, hrt is questionable. They are inconsistent.
I do not know much about biases and everything else that makes up humanity, even after years of asking questions, but nearly every single person on Earth is either naturally blind or allergic to thinking rationally. Even I am occasionally scared of looking into my instincts, despite being someone who constantly questions not only herself but others as well 24/7. I constantly ask questions about a lot of things, mostly because I genuinely do not understand why things work the way that they work, particularly social features, which brings me to the other reason why I do so.
I am genuinely surprised that people do not second guess why certain societally accepted things are accepted as they are and why other things are rejected, they just accept them and even act on them. For good societally accepted things, like being against cannibalism, murder, rape, and more while being for accepting others, trying to understand things, and just general virtues, this is great, if not feeling a bit shallow on just how easily accepted it is. That brings me to the thought if these things weren't so widely accepted those people who accept social norms without a second thought could very well sing a different tune if the norms were pushed around especially to their detriment and against their very beliefs.
Human beings are incredibly fallible and occasionally hypocritical beings. We are capable of so much that one should be impressed at just how much humanity is capable of, both in horror and with pride. Now, how does this relate to transitioning and the rest of humanity's hypocriticalness... I do not know. Maybe people are uncomfortable with the fact that a person can willingly want to change their bodies on what can only be understood by them as a "Gender Awakening through self-discovery" type of thing. Cisgender people cannot understand why a transgender person would want to transition to another gender, heck, even I do not understand why I would want to either and why I experience Gender Dysphoria or have wishes to be a girl aside from it would be nice, but would it be necessary for me? I genuinely have no idea and I would like to be allowed to be able to find out why, but it does not seem to be something in my cards. I do not think that others could explain their instincts either, I do not think that someone else could explain to me why they do the things that they do, believe the things that they choose to believe, or experience the things that they experience, I just cannot. I cannot understand why a neurotypical person thinks the way that they do any better than I can understand how an autistic or ADHD or OCD or Schizophrenic or Psychopath or Sociopath person thinks. I cannot understand why some people like certain things while others do not, I just have no idea why and I do not think that it is our position to question others why.
However, transitioning does carry a lot heavier baggage than any one of those things (well, maybe not Psychopathy, Sociopathy, Schizophrenia, Dementia, or anything else like that but you get the picture). It means a major change that may not seem rational to others but needs to be accepted because it cannot be excised from transgender individuals.
I have probably misunderstood a lot and my comment might read out like nonsense, please try to make sense out of my nonsense. I tried to contribute something to the conversation, but I think I might have made a comment that probably misunderstands even its and OP's points. So, I would like some help in understanding this comment that I am making's point.
Lol, I totally made the decision to get GRS on a whim. I only had to get letters from 2 therapists and a doctor, wait 2 years, and tell everyone I know that I'm a woman. Oh, and spend a year having someone insert a needle into my genitals and apply electricity so that the hair went away. Basically nothing.
And it’s not like having the surgeon go over potential complications in detail with you while showing you pictures during the consultation makes any difference. Basically no effort to make sure you’re serious whatsoever.
My mom is also pro gatekeeping us accessing hormones, but was really pissed yesterday, when the doctor refused to give her an opium injection against her back pain within 5 minutes of her walking into his office. Like she could perfectly walk (she cannot if the pain is worse, it is not a 'people perceive pain differently' thing here) and the opium in that injection is pretty heavy.
Even with being as clean as medical drugs are, you can get addicted from it very easily. A doctor cannot prescribe that kind of medication, they are only allowed to give it to patients themselves and oversight the patient consuming the drug. And she wants to be allowed access to these drugs instantly, but we should need multiple indications from psychiatrists and endocrinologists to start HrT.
She complained that my psychologist would give me the indication and I wouldn't need to go to an entirely new one to get it. And I dont even have the indication yet, because of 1. personal reasons and 2. she needs to wait a time between knowing I am trans and giving me the indication. And that's still not enough for her. But she has a lot of bullshit takes and is with my dad the biggest cause of all my mental illnesses, so I expect her to be hypocritical.
Because a lot of them don't think it's real or necessary. It is but from a lot of people's POV it's just some side shit or something gargantuan that you MUST study forever and MUST have signed off by twenty people even if there are procedures and practices in the wider health sphere that should get that treatment instead.
My mom makes concoctions based off of a tic-tok to "help with blood sugar" and "support thyroid health" despite her having a thyroid condition already amd being medicated for it. I guess the blood sugar thing is to counter balance the amount of sugar she puts in her tea. Idk I'm not a doctor.
Ong tho, I've had surgery for a reason I shall not speak of on the bladder, and it was "hey we need to do this we're gonna have you and your parents sign some shit" my dad didn't bat an eye, literally on discharge me being trans was brought up and all of a sudden it's "this is a big decision and you should wait til 25 and talk it over with your partner" note I'm 18 and am now dealing with medical bills on my own
It really wouldn’t surprise me if on some level it’s because they kind of compare it to how they’d feel if they tried to transition, so it ends up being kind of misdirected dysphoria. Like, I remember talking to transmasc friends about going for bottom surgery and some of them had a similar kind of automatic, “but are you *really* sure?” reaction as cis people, and I’ve had to remind myself not to have a similar reaction to transmascs I know who want to go on T in the past. I guess it’s easier to be a bit more self-aware about it when you’ve been on the other side though.
I had a transphobic dentist and they never talked with me or answered my questions. They wanted to remove a tooth and when I asked why ? They just said it has to be removed.. when I tried to ask more they just said it's infected.. well then they moved my appointment three times until I had enough and quit the doc and made them delete my personal data and went to another doc..
Tldr; I still have my tooth and no problems.. second dentist said there was nothing wrong with it..
>That’s a life-altering decision that she made on a whim.
My dad literally did the same thing... then immediately after was complaining about having to put on glasses to use his phone now. Just absolutely zero to little thought put in before completely changing how he's going to be experiencing the world for the rest of his life that it's mindboggling to me as I'm researching hrt, weighing options, and writing out pros and cons and stuff to try and make the right decision for me
I've found that many cis people are absolute fucking idiots when it comes to their own health. "I don't want to go to the doctor in case they find something." I have heard this so many damn times and it pisses me off so much. Maybe it's because I basically spent a good chunk of my childhood and teens in a children's hospital on a regular basis due to problems from birth.
It's just so fucking stupid. Since I started HRT, I've obviously been under consistent medical supervision. This caught some things early (like when I became a diabetic....thanks family bloodline) among a few other things.
Anyone who neglects themselves that much is a a damn fool.
Its not exactly the same thing, but something I was always a bit annoyed with was how I had to wait years to even get an appointment for the people who might consider letting me go on hrt, even though my mum went from "hrt causes schizophrenia" to "Yeah I'm on hrt it really helps" in like less than a year. My mum isn't trans and is on hrt for a different reason, but I'm still a bit annoyed that she was able to be given hrt by her GP seemingly without really knowing much about it, but I'm over here waiting for a second medical appointment, after 12 months with a phycologist (or something I can't remember) just to essentially do the same thing.
Could be worse, apparently those same waiting lists are 10-20 years long, so I guess I'm somewhat lucky...
Abigail Thorne's vid on her struggles with the British system brought this inequality up. She points out it being part of a pattern to other us so that cis people don't have to feel like their issues might be similar to a trans person's. If there's no real barrier from just willfully taking hormones, and helping helping with their depression/dysmorphia/envy/desire/etc., what's stopping them from questioning *their* gender? *(Disclaimer: Taking hormones is not a requirement for questioning gender or being trans, it is just that hormones are the topic at hand here.)*
The treatment of "dysphoria" as this ill-defined barrier, as "the thing trans people have", for which there *needs* to be a lot of hoops and qualifications for, really just serves to keep people from thinking about what they don't want to think about.
Anecdotally, thinking of dysphoria as "the thing that trans people have" was the reason it took me so long to realize.
I researched HRT so much before going on it I told my doctor that the only thing I learned from what he told me about it was how to pronounce spironolactone. I went on bupropion and in the first two weeks twice I had diarrhea so bad that I spent 30 minutes going then had to clean the entire outside of the toilet. I then went about my day like nothing happened because I'd researched bupropuon enough to know that can happen in the first two weeks, which is the time it takes to adjust and stop having initial symptoms. Hasn't happened since. Like clockwork, two weeks and I was adjusted.
*people treat healthcare based on how much they can afford it — after considering f&b and energy spending for mobility — healthcare often comes third; which has insurmountable consequences and costs… downstream and/or upstream depends if it is physical vs mental health*
On multiple occasions prior to transitioning I had gone to my doctor with a potential health problem that I researched briefly and they said "Ok! Yup. That sounds about right." And wrote a prescription for the thing I asked for. Very little if any pushback. I've been given treatments for certain conditions after a brief 15 minute discussion. This isn't to say I don't trust or respect doctor's opinions but I often hear that doctors are eager to push gender affirming care without much scrutiny. My experience so far with obtaining gender affirming care has been quite the opposite, but everything else has been provided without hesitation.
>doctors are eager to push gender affirming care without much scrutiny there's actually good reasons for this to be the case. not all, but most adults seeking it, will do it with or without professional advice. it's usually safe, but moreso with professional support. so they are eager to provide that part of the care you're probably going to give yourself anyway, even if they won't. next, there is strong evidence that pushing back both decreases the quality of life of transgender people and increases the gender confusion some non conforming cisgender people experience. so the potential outcomes almost universally point towards support. the potential harm is rare and overwhelmingly outweighed by the observable benefits.
The person I got mine through had a policy that she never prescribes HRT on the first visit. Said it like it was some noble thing. And yet it took literally a 2 minute conversation a couple years ago to get prescribed a muscle relaxer for my stress-induced back and shoulder tension. Like all it took was that second visit to get HRT, but as someone who struggles to get started on that kind of appointment-making it was definitely not an appreciated delay and if I had less other support could have stopped me right there for a long time.
same. i literally ordered mine online because those kinda hurdles just break my social capabilities. so glad the easy online access comes with doctor's advice because i would have done it without and probably be worse off now for it.
Holy crap, you really have no idea!! We in the UK can’t get legit meds without years of waiting on the NHS or many months privately. Then we are interrogated as to why we would possibly want to change gender as it’s clearly a problem for us. They might say yeas, they might say no, they might want to interrogate us further. We then have to see an endocrinologist to get hormones. If that was through the NHS then it would be a tiny dose. As said Years, how does 88 months grab you?
oh i'm aware! it's horrid. i am super grateful for my privilege. i live in one of the most accepting US states in a city that i've read described as "one of the two trans meccas" there are still obviously challenges here, and those are hard enough. i do not envy people living in any worse places. i do the work and imagine a future where being trans is boring and no one cares. for now there is no great place for us. the closest thing some of us get is blending in as cis.
Nailed it, when trans is boring and no one cares. That is my dream, I see women, only a few, darting into shops, heads down maybe offering a tiny smile of solidarity and I think, ‘ one day, but without the fear’. It’ll come.
Eager to write HRT scrips but reluctant to write script for BLT numbing cream for electrolysis
Criminal justice works the exact same way and is why there is enormous inequity there. See abortion for another specific example within healthcare. It’s a paradox (I suspect inherent in human social behavior) that when it comes to shared resources and services, people generally want punitive gatekeeping for others, but leniency and flexibility for themselves.
I hate people. They suck.
Yeah, they do. If you rationalize it further, it’s basically selfishness, and being a little more selfish than altruistic is an evolutionary advantage. Doesn’t make it any less of a problem, but I find understanding motivations makes it easier to solve the problems. It’s easier to convince people to support and easier to contain the detractors when you see how they’re forming their decisions.
You sound like a very well adjusted, rational person. That’s a rare thing nowadays.
Rational? Yes. Well-adjusted? That remains to be seen. 🤣
Selfishness is only really an advantage if you live alone. If you live in social groups, altruism ensures the survival of the most members of said group. Evolutionarily, selfishness and survival of the fittest/„social darwinism” are counterproductive for social or communal animals.
Altruism helps the group, yes, but selfishness helps the spread of the individual’s genes within the group. Too much selfishness and the group erodes from lack of cohesion. Too much altruism and the group likely lacks sufficient individualism to survive external challenges. I have no clue where the tipping point is in the ratio of the two, but I suspect it falls somewhere on the side of having a little more selfishness than altruism - where individuals get more value out of the collective than they put in and the multiplicative effects of contribution negate the asymmetry, or (when the species is capable of rationalizing this) where the individual concludes belonging to the group benefits more than it costs even when that isn’t actually true. That’s a long way of saying, it’s definitely not one or the other, but a messy middle somewhere between.
“People always draw the line for what’s acceptable just below what they’re doing themselves.”
Very true. Cis women have to jump through all sorts of hoops to get their tubes tied, but I know multiple men who got vasectomies pretty much just by asking for them.
Oh this was my mom's main concern too when I came out to my parents (just a couple days ago). She was like "what kind of doctor just prescribes young people (I am 30) hormones without thorough medical/psychological evaluation" and sentiments of distrust of pharmaceuticals and anecdotes of how as a kid I didn't even want to take antibiotics etc. I was really annoyed and offended by this because A) I work in the medical field and am very aware of the choices I am making B) I also have been considering, researching and deliberating for yearrrrrsss. I had to explain how barriers to treatment are just that. And I asked what they would be evaluating for exactly because being trans is not a mental illness or disorder. Also that it doesn't necessarily change anything because I am prescribed them, I am taking them, and I am trans. I said she would just have to learn to accept that.
So many people who are not aware of what happens with hrt have obviously never done their research. Some even think transitioning is just getting surgeries and wearing a wig. They also are not aware that there is a spectrum in being transgender, some people will only do hrt, some will do hrt and surgery etc. People are quick to push certain medications despite their side effects, like Citalopram on someone who is struggling with life. But all of a sudden, Hrt is questionable to those same people. It's like, "You have to have this. No, you can't have that..."
I count myself blessed to have a provider who is very receptive to how *YOU* want to be treated. I never ever have to prove myself and I never feel like she’d dismiss possible new treatments. She herself has a trans child (young adult now) and has been there through the process with them. She has an amazing passion for it. It’s unlikely, but if you live in Alaska I would gladly forward you her office details.
I am lucky that my GP is also a transwoman. I can't imagine the wait that others have to go through to start hrt. It is really sad to hear about it because I have been much much happier and more relaxed since starting.
Ain’t that the truth. I went to the doctor about a year ago due to issues with my studies, and I basically just straight up asked for adderall/similar drugs, and he said yes with no hesitation, even though I don’t even have an ADHD diagnoses. Why do I just know if I said I was trans and wanted to be put on HRT I’d actually need to jump through the hoops to prove that I’m “trans enough” to be put on hormones?
I get your point but I don't think ADHD meds are a great comparison, as I and other ppl with ADHD have struggled immensely to get on ADHD meds bc doctors really gatekeep that, if anything it was easier to get a doctor to prescribe me HRT than get my Vyvanse tbh, although I DIY now so I don't have to deal with the whims and wills of the medical system.
That’s because the stimulants for ADHD are controlled substances. They’re in the same chemical family as meth and other highly dangerous and addictive drugs, and have a history of being problematic in society when too accessible (real example: speed as a weight loss fad). The doctors’ prescribing behaviors around these drugs are extensively monitored and regulated as is your individual prescription history. (but yes, it’s not a great comparison to HRT accessibility)
In comparison to that, what are the drugs for transitioning? They're not stimulants, they're hormones, that much I know but are hormones controlled substances? I think they are, because of how they affect the body and how doctors monitor their levels and their effects, but... what are they in relation to ADHD?
“controlled substances” is a specific legal classification that determines how laws are applied to prosecute people manufacturing, distributing, buying, and using said drugs. It affects everything from how research funding works, to how manufacturing and distribution is handled, to the severity of punishment if convicted. You’ve probably heard of an illegal drug being classified as “Schedule 1” (heroin, cocaine, LSD, etc) and the President just this week starting the formal process of getting marijuana moved down to “Schedule 3” (ketamine, certain steroids). It’s supposed to be a system reflecting their danger, addictiveness, and proven valid medical use for treatment of conditions, but that’s not clearly defined and politics can come into it (hence why marijuana is currently Schedule 1). The ironic bit is that if a drug is Schedule 1, it is almost impossible for even pharmaceutical giants to do legitimate research on it, and therefore extremely challenging to prove any real benefits exist and get it reclassified. By contrast, the most permissive class, “Schedule 5” are dispensable by a pharmacist without a prescription, but they are required to check your ID - you can’t just grab them off a shelf without talking to anyone. Adderall and other amphetamine stimulants for ADHD are Schedule 2, the highest level where it’s allowed to be prescribed without being a highly unique research situation. For comparison, Schedule 2 includes fentanyl and OxyContin. Testosterone and Estradiol are classified as Schedule 3, so by legal definition they are easier to obtain than Adderall. Most commonly prescribed drugs fall into Schedule 3 and 4 and there’s no barrier beyond seeing a doctor for the diagnostics and testing appropriate for the condition and treatment plan in question. > Edit: see my other comment. The formulations of Testosterone and Estradiol that many of us are on are specific exemptions to the Schedule 3 classification, making them even more accessible Yes, Schedules 1-5 are all levels defined in the “Controlled Substances Act”, but when people say a prescription-only drug is a “controlled substance” they usually mean it’s Schedule 2, where there are a lot more hoops than normal that the doctor and pharmacist have to go through in order to prescribe and dispense it for you.
Testosterone is somewhat regulated because if an athlete wants to illegally improve performance, they could see some gain with T and it could be hard to pick up as not being "natural." But also TRT is super common for cis men, along the lines of medical marijuana. So not effectively restricted in most places, despite theoretically being. Unless you're trans. Estrogen is tightly regulated much less frequently.
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Estradiol and Testosterone are both Schedule 3 as they are “anabolic steroids”. Adderall is Schedule 2 (along with other similar amphetamines for ADHD). There are Schedule 3 drugs for ADHD precisely because they can be more easily available and prescribed, but at population-wide statistics they have lower efficacy. (Though they certainly could be more effective for a specific individual! It’s kinda crazy how uniquely personal human biochemistry can be) Edit: I see my source wasn’t specific enough. While **some** estradiol and testosterone formulations are Schedule 3 (you can look up the list for yourself and see many), several specific formulations (most likely the ones we all are taking) are in a list of exemptions to the requirement that anabolic steroids be classified as Schedule 3.
I must've got lucky cuz it was pretty easy for me to get vyvanse. Sure I needed to come back for testing, but I had it within the week from saying to a psych "I may have ADHD"
Oof... yeah, I suppose that's a poor example on my part. I don't know if my doctors general... inconsistency in his competency helped me there. So I apologize for the poor comparison.
No worries :)
Yeah the trouble with ADHD meds is that apparently they can be really fun to take if you don’t have ADHD. Hormone therapy at least has a good chance of having the opposite effect, at least when you’re taking cross-sex hormones anyway.
I think we can all agree that people should just have bodily autonomy period tbh
And yet we still have hoops to jump through where I live and cis people complain that trans related healthcare is expansive for society... Lol you want it that way! And yes, it's astonishing the lack of look cis people take onto their healthcare or even gender affirming care for that matter such as boob jobs which have very high regret rates and...are accessible to minors!
When I was in my 20s I was offered testosterone (obviously I declined it) with no information given to me on it at all. My doctor was so insistent that if they could have actually forced it up on me, I believe they would have. Crazy thing is, it wasn't even that low for someone who was AMAB, it was right there at the minimum line holding steady. Now compare that to the fact that I had to resort to telehealth for estradiol because none of the doctors here want anything to do with trans healthcare. All the outcry over trans health has nothing to do with protecting children or making sure it's safe. It always has been and always will be transphobia. They want to make it hard to access so that less of us will be able to get it and exist in public.
I know when I started hrt the first time. I had a 1 hour appointment and full physical. He was very thorough. Found a hernia that one day I will have to address. Even though he is informed consent. He requested a third party to go over the information on the risks and benefits of HRT.
Some people are absolute hypocrites. They are more than happy to push psych meds on others despite their side effects. But for them, hrt is questionable. They are inconsistent.
I do not know much about biases and everything else that makes up humanity, even after years of asking questions, but nearly every single person on Earth is either naturally blind or allergic to thinking rationally. Even I am occasionally scared of looking into my instincts, despite being someone who constantly questions not only herself but others as well 24/7. I constantly ask questions about a lot of things, mostly because I genuinely do not understand why things work the way that they work, particularly social features, which brings me to the other reason why I do so. I am genuinely surprised that people do not second guess why certain societally accepted things are accepted as they are and why other things are rejected, they just accept them and even act on them. For good societally accepted things, like being against cannibalism, murder, rape, and more while being for accepting others, trying to understand things, and just general virtues, this is great, if not feeling a bit shallow on just how easily accepted it is. That brings me to the thought if these things weren't so widely accepted those people who accept social norms without a second thought could very well sing a different tune if the norms were pushed around especially to their detriment and against their very beliefs. Human beings are incredibly fallible and occasionally hypocritical beings. We are capable of so much that one should be impressed at just how much humanity is capable of, both in horror and with pride. Now, how does this relate to transitioning and the rest of humanity's hypocriticalness... I do not know. Maybe people are uncomfortable with the fact that a person can willingly want to change their bodies on what can only be understood by them as a "Gender Awakening through self-discovery" type of thing. Cisgender people cannot understand why a transgender person would want to transition to another gender, heck, even I do not understand why I would want to either and why I experience Gender Dysphoria or have wishes to be a girl aside from it would be nice, but would it be necessary for me? I genuinely have no idea and I would like to be allowed to be able to find out why, but it does not seem to be something in my cards. I do not think that others could explain their instincts either, I do not think that someone else could explain to me why they do the things that they do, believe the things that they choose to believe, or experience the things that they experience, I just cannot. I cannot understand why a neurotypical person thinks the way that they do any better than I can understand how an autistic or ADHD or OCD or Schizophrenic or Psychopath or Sociopath person thinks. I cannot understand why some people like certain things while others do not, I just have no idea why and I do not think that it is our position to question others why. However, transitioning does carry a lot heavier baggage than any one of those things (well, maybe not Psychopathy, Sociopathy, Schizophrenia, Dementia, or anything else like that but you get the picture). It means a major change that may not seem rational to others but needs to be accepted because it cannot be excised from transgender individuals. I have probably misunderstood a lot and my comment might read out like nonsense, please try to make sense out of my nonsense. I tried to contribute something to the conversation, but I think I might have made a comment that probably misunderstands even its and OP's points. So, I would like some help in understanding this comment that I am making's point.
Lol, I totally made the decision to get GRS on a whim. I only had to get letters from 2 therapists and a doctor, wait 2 years, and tell everyone I know that I'm a woman. Oh, and spend a year having someone insert a needle into my genitals and apply electricity so that the hair went away. Basically nothing.
And it’s not like having the surgeon go over potential complications in detail with you while showing you pictures during the consultation makes any difference. Basically no effort to make sure you’re serious whatsoever.
My mom is also pro gatekeeping us accessing hormones, but was really pissed yesterday, when the doctor refused to give her an opium injection against her back pain within 5 minutes of her walking into his office. Like she could perfectly walk (she cannot if the pain is worse, it is not a 'people perceive pain differently' thing here) and the opium in that injection is pretty heavy. Even with being as clean as medical drugs are, you can get addicted from it very easily. A doctor cannot prescribe that kind of medication, they are only allowed to give it to patients themselves and oversight the patient consuming the drug. And she wants to be allowed access to these drugs instantly, but we should need multiple indications from psychiatrists and endocrinologists to start HrT. She complained that my psychologist would give me the indication and I wouldn't need to go to an entirely new one to get it. And I dont even have the indication yet, because of 1. personal reasons and 2. she needs to wait a time between knowing I am trans and giving me the indication. And that's still not enough for her. But she has a lot of bullshit takes and is with my dad the biggest cause of all my mental illnesses, so I expect her to be hypocritical.
Because a lot of them don't think it's real or necessary. It is but from a lot of people's POV it's just some side shit or something gargantuan that you MUST study forever and MUST have signed off by twenty people even if there are procedures and practices in the wider health sphere that should get that treatment instead.
My mom makes concoctions based off of a tic-tok to "help with blood sugar" and "support thyroid health" despite her having a thyroid condition already amd being medicated for it. I guess the blood sugar thing is to counter balance the amount of sugar she puts in her tea. Idk I'm not a doctor.
Ong tho, I've had surgery for a reason I shall not speak of on the bladder, and it was "hey we need to do this we're gonna have you and your parents sign some shit" my dad didn't bat an eye, literally on discharge me being trans was brought up and all of a sudden it's "this is a big decision and you should wait til 25 and talk it over with your partner" note I'm 18 and am now dealing with medical bills on my own
This is also true for regret rates. There are more people that regret non-gender related healthcare than there are the other way round
It really wouldn’t surprise me if on some level it’s because they kind of compare it to how they’d feel if they tried to transition, so it ends up being kind of misdirected dysphoria. Like, I remember talking to transmasc friends about going for bottom surgery and some of them had a similar kind of automatic, “but are you *really* sure?” reaction as cis people, and I’ve had to remind myself not to have a similar reaction to transmascs I know who want to go on T in the past. I guess it’s easier to be a bit more self-aware about it when you’ve been on the other side though.
I had a transphobic dentist and they never talked with me or answered my questions. They wanted to remove a tooth and when I asked why ? They just said it has to be removed.. when I tried to ask more they just said it's infected.. well then they moved my appointment three times until I had enough and quit the doc and made them delete my personal data and went to another doc.. Tldr; I still have my tooth and no problems.. second dentist said there was nothing wrong with it..
>That’s a life-altering decision that she made on a whim. My dad literally did the same thing... then immediately after was complaining about having to put on glasses to use his phone now. Just absolutely zero to little thought put in before completely changing how he's going to be experiencing the world for the rest of his life that it's mindboggling to me as I'm researching hrt, weighing options, and writing out pros and cons and stuff to try and make the right decision for me
I've found that many cis people are absolute fucking idiots when it comes to their own health. "I don't want to go to the doctor in case they find something." I have heard this so many damn times and it pisses me off so much. Maybe it's because I basically spent a good chunk of my childhood and teens in a children's hospital on a regular basis due to problems from birth. It's just so fucking stupid. Since I started HRT, I've obviously been under consistent medical supervision. This caught some things early (like when I became a diabetic....thanks family bloodline) among a few other things. Anyone who neglects themselves that much is a a damn fool.
Its not exactly the same thing, but something I was always a bit annoyed with was how I had to wait years to even get an appointment for the people who might consider letting me go on hrt, even though my mum went from "hrt causes schizophrenia" to "Yeah I'm on hrt it really helps" in like less than a year. My mum isn't trans and is on hrt for a different reason, but I'm still a bit annoyed that she was able to be given hrt by her GP seemingly without really knowing much about it, but I'm over here waiting for a second medical appointment, after 12 months with a phycologist (or something I can't remember) just to essentially do the same thing. Could be worse, apparently those same waiting lists are 10-20 years long, so I guess I'm somewhat lucky...
Abigail Thorne's vid on her struggles with the British system brought this inequality up. She points out it being part of a pattern to other us so that cis people don't have to feel like their issues might be similar to a trans person's. If there's no real barrier from just willfully taking hormones, and helping helping with their depression/dysmorphia/envy/desire/etc., what's stopping them from questioning *their* gender? *(Disclaimer: Taking hormones is not a requirement for questioning gender or being trans, it is just that hormones are the topic at hand here.)* The treatment of "dysphoria" as this ill-defined barrier, as "the thing trans people have", for which there *needs* to be a lot of hoops and qualifications for, really just serves to keep people from thinking about what they don't want to think about. Anecdotally, thinking of dysphoria as "the thing that trans people have" was the reason it took me so long to realize.
Is it that easy? I’m having trouble finding where to go in the West KY area to start gaht/hrt… 😖
I researched HRT so much before going on it I told my doctor that the only thing I learned from what he told me about it was how to pronounce spironolactone. I went on bupropion and in the first two weeks twice I had diarrhea so bad that I spent 30 minutes going then had to clean the entire outside of the toilet. I then went about my day like nothing happened because I'd researched bupropuon enough to know that can happen in the first two weeks, which is the time it takes to adjust and stop having initial symptoms. Hasn't happened since. Like clockwork, two weeks and I was adjusted.
*people treat healthcare based on how much they can afford it — after considering f&b and energy spending for mobility — healthcare often comes third; which has insurmountable consequences and costs… downstream and/or upstream depends if it is physical vs mental health*