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.

 

How A Misguded Moral Crusade Victimizes Trans People

I am glad that attention has been paid to the discrimination and violence transgender people too often face.

There is a related issue that receives a lot of notice but is almost never discussed as a transgender issue: prostitution and human trafficking.

I am not a lawyer or policy-maker.  However, before continuing this post, I will do my best to distinguish prostitution from human trafficking, as the terms are often used interchangeably.

As I understand it, human trafficking involves the transportation of people--mainly young women and girls--from one place to another for the purpose of employing them as sex workers.  Prostitution is the sex work itself:  sexual acts performed for money, whether for one's self or (as is more common) a pimp or other boss.  It is the demand for the work of prostitution that fuels human trafficking.

However, both are transgender issues because trans people--particularly young male-to-females--are disproportionately involved in sex work. We disproportionately have the "risk factors" that can lead to becoming involved with such work--and vulnerable to human trafficking.

Though there are some who become sex workers voluntarily (We've all heard about young women who do it to pay for college.), the vast majority have left homes, schools communities or nations where they were sexually exploited or otherwise abused.  

Young trans people are more likely than others to experience such conditions. And when some young trans or gay kid runs away from home to escape bullying or other kinds of abuse, he or she finds him or herself as a stranger in some place or another with no educational or other credentials (Many don't finish high school.) and few or no marketable skills.  How many options for legal employment are available to such people?

So they turn to sex work.  I admit, I am glad I haven't had to make such a choice:  I'm not sure of how long I would have survived if I had. And I don't condone the demand for such services.  However, no one has ever been able to eradicate it. Attempts to do so are, as Noy Thrupkaew has written, misguided moral crusades.

Such crusades are not only misguided. they are destructive to the very people who are exploited by human trafficking and prostitution:  the sex workers themselves.  It seems that whenever some "get tough on crime" politician decides to go after the "Johns," it's the sex workers themselves who end up in the criminal justice system.  And, of course, we know which gender makes up most of each category!  

As Thrupkaew points out, there are a few who are sex workers by choice and would not want to go into any other line of work.  However, most want to get out of the trade; most can't.  The only ways out for most are arrest or death.  Either one precludes the possibility of a "normal" life after sex work.  Most of those who are arrested return to the work they were doing before the cops picked them up.  If it's so difficult for a high-school dropout with no marketable skills to get a job, imagine how much more difficult it is with such disadvantages combined with the burden of a criminal record.

The only way to improve the lives of people, especially transgenders, who become sex workers, is to make it possible for them to leave the trade.  If they can complete their educations in places where they don't face the daily threat of harassment or worse, and get safe places to live and  jobs that will allow them to pay for their housing and other experiences, they would be much less likely to turn to, or stay in, sex work.