Something That Hasn't Changed (Unfortunately)

Last night, I stopped by the LGBT Community Center.  I hadn't been there in a while, but early in my transition, I sometimes felt as if I were living there.

Anyway, I bumped into a few people I haven't seen in some time. One of them is someone I'll call Lorna.  She participated in two of the support groups I attended early in my transition.  Back then, she was still living as male but was exploring her gender identity and sexuality.  After a few other life-changing events which I won't reveal, so as not to run the risk of outing her, she recently began her transition.

I was reminded that more than a decade has passed since we attended those support groups.   A lot has changed since then, but something--disturbingly--hasn't:  Apparently, desperate trans women are still buying "German hormones" on the streets.  Someone offered them to Lorna; she refused.

 When I started my transition, it was undoubtedly easier to get hormones through legitimate means--and get the other care I needed--than it was for people who made the transition a decade before me, or the ones who transitioned a decade before them.  Still, then--as now--some trans people, especially the young, cannot access mainstream healthcare for all sorts of reasons, the most common being a lack of documentation.  Very often, young trans people are kicked out of, or run away from , their families or are bullied out of their schools and communities.  Or they are fleeing countries where they are likely to be incarcerated or murdered, sometimes by the very people who have the power to imprison them.

As long as such conditions prevail, we're still going to have lots of trans teenagers who won't make it to the third decade of their lives.  I don't think any society would stand for such a mortality rate in any other group of people.  But, as long as there are barriers to access of the improved health care, young (and sometimes not-so-young) people will continue to buy (or trade sex for) "German" hormones or other black- and gray- market substances and treatments.

When Transgenders Self-Medicate

For about nine months before I began to live and work full-time as a woman, I was taking estrogen and Spironolactone.  For about a year and a half before that, I was attending support groups and participating in various activities related to the community, some of them at the LGBT Community Center in New York City.

At a Center event, I met a trans woman who was probably a few years older than I am now.  I don't know whether or not she ever had the surgery, but it was easy to see that she'd been living for a long time as a woman--and, most likely, taking hormones.  I also suspected that she had--or might still have--been involved in sex work.

I haven't seen her in a long time, but early in my transition, I was bumping into her everywhere--or so it seemed.  She always had advice--some of it good--on some aspect or another of the life on which I was embarking.  Thankfully, I ignored what was probably the worst advice she gave me.

"Forget about the doctors, clinics, even--what's that place you go to?"

"Callen-Lorde", I said.  

"Yeah, forget about them.  Forget about all of that.  You have to go through so much to get your hormones."

"I've got them."

"But those horomones will take forever to work on you."

"Well, I am on a low dose now.  So far, so good.  As long as my next tests are good, my doctor'll up my dosage."

"Still, it's going to take years and years for them to work."

"Well, I've had to wait years to get to this point..."

"Don't you want to have a woman's body soon?"

"Yeah. But..."

"Well, I can get you some German hormones."

"German?  What's the difference?"

"Well, you know, German girls are bigger.  So they get stronger hormones."

I squinted at her.   She pulled a package from her bag.  I know a few dozen words of German, but somewhow I knew, just from looking at that label, that ingesting those hormones wouldn't be a good idea.

Later, I learned---from where or whom, I can't recall--that a lot of trans women--especially young ones engaged in sex work--buy those German hormones, which are meant for livestock.

I mention this incident because I came across this article advising trans people not to self-medicate with hormones.  Turns out, there are a lot of discussion groups about that very subject, including some on how to go about getting hormones from outside the medical establishment.

The temptation to do so is great, especially for young trans women, many of whom have run away from abuse at home or bullying at school and have no medical insurance or other resources and are scarred by prejudice and hostility they experienced from health-care professionals.

Self-medication is generally a bad idea for anybody.  But the risks are even greater for trans people because the precarious situations in which too many of us live leave us even more vulnerable to exploitation by "professionals" with questionable--or no--credentials.

That might be the biggest hazard trans people face, after the discrimination and violence to which too many of us fall victim.