Catherine Sarah: It's not a matter of choice. If some higher-up in the health system doesn't decide you can use a medication, you can't, period. Higher-ups who are usually quite cautious with health risks, as well as costs.
Maegan: Yes, it is. They use it on some criminals. I find it a much more sensible approach to the trans issue (at least once everyone is sure of the problem), because instead of just fiddling with testosterone and eventually getting levels down, its main purpose is to, well, destroy, not to mention it's a progestin, so whatever unproven advantages there could be with progesterone, you might as well get them too. Switching to spiro after a while makes sense, too, I guess, since once the organs aren't producing so much anymore, fiddling with what is left might be the most effective course of action.