Many transgender people in the United States are rushing to get more treatment, fearing that the incoming Trump administration will follow through on threats to restrict their medical care.
“Lo and behold, this subreddit has exploded since Emperor Trump took the throne. Literally overnight we had almost 1,000 new people,” she wrote, shortly after the Nov. 5 election, about gender-affirming hormone therapy. There was a post on a Reddit forum dedicated to sharing advice.
A popular underground hormone manufacturer has stopped accepting new orders to get through a backlog. “[We]did not expect to be hit so hard after the election,” Manufacturer wrote on Reddit. Plume Health, a provider focused on gender-affirming care, also noticed a “spike” in calls after the election, said Jerica Kirkley, co-founder and chief medical officer of the virtual clinic. Ta.
Throughout his campaign, Donald Trump pledged to cut federal funding from health care providers who provide gender-affirming care, and on his first day in office, he called on everyone to stop promoting gender and gender transition at any age. I will sign an executive order directing federal agencies.” At the office. Transgender youth may be hit hardest. A case the Supreme Court will hear this week could further strengthen bans on transgender medical care for minors.
In the wake of his victory, some people on online forums are stocking up on prescriptions in case they have to manage their own treatment in the future, checking out online and overseas pharmacies, and in rare cases, synthesizing the hormones themselves. It has been shown that. (The National Harm Reduction Coalition notes that homemade hormones may not contain the same levels as the prescribed hormones that patients are accustomed to taking, may work differently, and therefore have different effects and side effects.) (Warning that it may cause.)
“No matter the loss of freedom, the hardships ahead, or the strength of the enemy, DIY is always an option,” the Reddit note reads.
Self-managed abortion has received a lot of attention since the Supreme Court struck down Roe v. Wade, but despite its rich history, self-managed gender-affirming care has received less attention. The study found that 31% of transgender people in London, 49% in San Francisco, and 79% in Rio de Janeiro had administered their own hormones without a prescription at some point.
“People have been self-managing their hormones for longer than doctors have been managing them,” says Sociology Professor at Brooklyn College, who has written about self-managed abortion and gender-affirming hormone therapy. Naomi Blaine says. “The emergence of gender-affirming hormone therapy in the medical profession was in many ways driven and led by people with experience in self-management.”
Meanwhile, Eli Ehrlich, a graduate student at the University of California, Santa Cruz and author of the forthcoming book Before Gender, urges cisgender people to consider sharing hormones with their transgender peers. I recommend that you do so. (Many cisgender women take birth control pills or estrogen during menopause, while many cisgender men take testosterone.)
“The moral panic around transgender care demonizes the same hormones that politicians' wives and daughters take,” she says. “Transgender people should have the same access to these medications as cisgender people.”
Safely self-manage
Ahead of the election, the National Harm Reduction Coalition produced a 60-page report on best practices for hormone self-management, including using new supplies, vetting online pharmacies, and leveraging local and online communities. The report says people looking to take care of themselves should be wary of allergic reactions when using medications from nontraditional sources, use clean syringes, and test hormones on other medications. It states that you should be careful and be aware of the possible side effects of using hormones. dizziness, blood clots, etc.
“Talk to others in your community who take similar hormones to determine which sources are safer for DIY GAHT,” the guide suggests. It uses the acronym for DIY Gender Affirming Hormone Therapy. “If you begin to feel unwell while taking DIY GAHT, stop taking it and seek medical attention.”
Transgender people, like many patients managing other aspects of their health, rely on in-person and online community networks to safely self-manage. One Reddit community for transgender people who want to take control of their own care has more than 82,000 members.
Blaine said there is a “nearly limitless communication network for cancer patients” where people can share information about medications. “Community-based knowledge sharing occurs in a huge number of different contexts, and this is one of them.”
According to the World Health Organization (WHO), the world will face a shortage of an estimated 18 million health workers by 2030. With 400 million people already without access to essential health services, WHO has developed guidelines for self-care interventions that people can implement. It can be taken to promote one's own health.
Since 2019, these guidelines include a recommendation for self-managed abortion. In 2022, WHO acknowledged that the guidelines should be further expanded to include recommendations for gender-affirming health care self-management.
“Ideally, gender-affirming hormone therapy would occur within a supportive health care system, but many transgender and gender diverse people lack access to such support systems. “No. Instead, they may try to access such treatments through friends, colleagues, or the internet without consulting a health care professional.”
If/When/How and the Transgender Law Center, which launched the Trans Health Legal Fund in 2023 to support transgender people facing investigation and arrest, Some organizations offer assistance to reduce the legal risks of managing “or being prosecuted for seeking medical care.'' ”
Possession of prescription drugs without a prescription is a misdemeanor in most states, but depending on the amount and type of drug, it can be charged as a felony, and testosterone is a Schedule III controlled substance under the Anabolic Steroid Control Act of 1990. deserves special attention. .
Plume Health's Kirkley said nothing has changed so far, and that since a wave of state treatment bans, primarily aimed at minors, began in 2022, transgender people have faced limited medical care. Emphasize that you have dealt with this. She and her colleagues continue to tell patients: “There is nothing that will limit our ability to provide care for the foreseeable future.” They rely on local organizations to “recognize the realities on the ground and what that means for health care access.” We recommend that you do so.
