Susan's Place Transgender Resources

Black market hormones
Bootleg prescription drugs put trans folks' lives in danger

By Quinn Albaugh
Published: Mar 15

http://mcgilldaily.com/articles/28604 (http://mcgilldaily.com/articles/28604)

A couple of summers ago, I met a transwoman in New York City who was planning on ordering estrogen and an anti-androgen over the Internet. She had conducted meticulous research and claimed to have figured out the proper dosage, given her weight, her medical history, and other factors.

My reaction: "Isn't that dangerous?"

Hormones produce sweeping effects on the body. In addition to encouraging the development of secondary sex characteristics, hormones also affect one's libido, alcohol tolerance, and behaviour. Testosterone affects heart functioning and can increase the risk of sleep apnea. Estrogen generally produces sterility in transwomen in under a year.

Yes, they are dangerous and in some cases illegal.  But how many began with them, or stolen ones?  And until there is a proper means for all Transsexuals to begin the journey, the black market will continue to supply them.

It is up to the ones who are doing what they have to by the SOC, it let our brothers and sisters know they must not do the black market drugs.

There are too many wasteful expensive restrictions, people should be free to do whatever they want witht heir own body rather than be manipulated by a corrupt system. I feel I deserve the right, as long as I'm responsible, to take care of my own body, i don't need some BS TS association to look after me.

I'm feeling guilty agreeing with janet here.

One the one hand, she's absolutely right. But on the other, I'm petrified, as I'm sure janet is, about possibly encouraging someone to do this.

It's time to stop treating us as if we don't have the intellect to make rational decisions.

  When I see phrases like "manipulated by a corrupt system" or "BS TS association" I wonder where you are because I would never describe my experience with the medical system here (US midwest) to be corrupt. I take that to mean dishonest and not even following their own established protocols.  I found it to be imperfect for sure and I do understand the frustrations there can be and temptation to find alternate ways. It was hard to find people that had experience or preparation for TS protocols and willingness to help me but I just had to be persistent. The protocols may not be perfect but were not impossible to work with.

  When the medical system is supplying you with services, drugs, and surgery that can be dangerous and irreversible then they are participating with you.  I think it is reasonable for them to ask you to follow protocols that are meant to help them confirm whether you do have the knowledge and responsibility to do what you are asking them to help you with.  It's especially true these days where so many people blame (and sue) those helpers if things don't turn out the way they expected.  Exactly what the protocols should be has been and will be debated more and will change over time.  I learned a great deal about the risks and processes of changes to my body before deciding to transition.  I still know I will never know as much as my doctors, pharmacists, surgeon, therapists, lawyers who helped me with transition even though I also taught most of them a few things so I was glad to have them. By working within the system I help to make it better in the future for others.

Another way of thinking about this for anyone wanting to go outside the system is to ask yourself what is REALLY likely to be the most successful path to reach your ultimate goal. Will trying to bypass the system really get you everything you want?  Ultimately you are responsible for your own body because you have to live with it.

Those people don't have the moral authority to rip into those black market drug dealers.

Simple fact is I told my GP about my feelings when I was *20* I'm 24 next month. They are completely corrupt and utterly useless I don't expect any resources to come from the NHS or the decadent protocol that basically says "leave him to die" The only reason I'm dealing with them at all is to appease my naive friends and family. Thus far I've been proven right the only practical resource I've gotten thus far is a single useless blood test bag with the WRONG name on it. Despite me telling him that isn't my name anymore.

I jump all the hoops am friendly and polite to everyone I meet but I don't expect any of them to give a damn.

So don't rip into the few groups of people who have actually helped me out. Sure I know they are drug dealers and criminal mercenaries who exploit the crap out of me to give me what I need but least they actually helped me and gave me a tiny degree dignity over my otherwise bleak and miserable life.

A claim that the so called Legitimate medical establishment cannot claim to do.

I'd probably use internet stuff...

I research EVERYTHING and can tell my doctor as much or more about all my medications than he can...

and what is NHS?

Quote from: Ashleyjadeism on February 07, 2011, 07:12:54 PM
and what is NHS?

National Health Service.  From the UK

Ah... I hear alot of bad things about that...

Quote from: straycat on February 07, 2011, 08:25:02 AMWhen I see phrases like "manipulated by a corrupt system" or "BS TS association" I wonder where you are because I would never describe my experience with the medical system here (US midwest) to be corrupt... The protocols may not be perfect but were not impossible to work with.

They're impossible if you can't afford three+ months of therapy or if you can't afford an endocrinologist or if you have to drive out of state to find a GP who'll see you just for regular stuff, not to mention anything trans-related. The SOC only works for people with enough money to make it work, and even then, as in pebbles' case, it doesn't work well.

QuoteAnother way of thinking about this for anyone wanting to go outside the system is to ask yourself what is REALLY likely to be the most successful path to reach your ultimate goal. Will trying to bypass the system really get you everything you want?

You're assuming we have a choice.

Well, okay, we do: use whatever means necessary or don't transition medically.

Quote from: Ashleyjadeism on February 07, 2011, 07:21:06 PM
Ah... I hear alot of bad things about that...

Yeah, it terrible.

Universal health care, free at the point of use. Free hospitals. Community care. Fixed price prescriptions.

I really don't know how we cope.

Don't worry spacial, public health care for welfare people in the US is pretty much like NHS, not much, doing less, and we're going to bother you a whole lot about it too.  The only real difference is that a lot of people in the US have real health care, which comes with a job.  But I can see where that is not exactly the Brit policy.

Oh the NHS is brilliant if you ever get Leukemia, Or Need an organ transplanted, or have a heart attack. BIG stuff that will kill you.

They however are completely useless if you have GID an eating disorder, bipolar disorder, a rotton tooth, An impacted wisdom tooth, PCOS, trapped nerve ect

Things that will cripple you but not kill you.

Quote from: Ashleyjadeism on February 07, 2011, 07:21:06 PM
Ah... I hear alot of bad things about that...

Sorry but you heard WRONG then.

The NHS has limitations. It is not so good with certain things, but if you have an immediately life threatening condition it works pretty darned well and a fraction of the cost.

It may not be brilliant at dealing with the initial diagnosis and treatment of Trans folks, but at least they do try... and for people who approach the system in the right way they do eventually fund FREE surgery. The down side is that you do have to be very patient because it can take an age, which is why many of us do go privately.

However I've been fully transitioned as an adult for nearly 30 years and I've been postop for over 25... In all that time the NHS has supplied me with any hormones that I have needed for a very minimal price. So I reckon it has saved me several thousand pounds at least.

In short just bear in mind that whilst the British NHS is not perfect, and as Pebbles said, it has irritating shortcomings, even so the majority of Brits would not want to live without it, because we know that it is a very effective safety net. We can still opt for private care, and like most Americans, many of our jobs come with that, but if we are without, we don't face the same grim prospects that you do.

Oh yeah - and blackmarket hormones. Leaving aside any questions of blood tests and other monitoring, which I found out was important when it was revealed that I had an unsuspected intersex condition which was affecting my blood responses, the problem is being sure that you are actually getting what you are paying for.

I'm not getting on any soapbox, because nearly 30 years ago I did it myself whilst I was waiting for the NHS to catch up. Back then there was no internet so we used to buy stuff from other girls, or out of the back door from sympathetic doctors, so we knew it was the real deal. Now with the net vendors, without access to a lab, you don't actually KNOW for sure if you are buying genuine stuff - or some dodgy fake. That is the real danger. So it's not really about being control freaks. There are some genuine reasons why using the blackmarket is potentially dangerous

I will make one point about the NHS, which may be a criticism.

The priority is always given to those areas that can generate the most outrage and demand among the chatting classes.

Women's health is the top priority. Gynachology and obstetrics take a huge amount of the funds. (Why babies need to be born in hospitals I will never know).

Children's heath tends to come second.

General medicine, fractures, gastro-intestinal surgery and so on.

The elderly come next. This is a huge problem.

Last come any sort of mental health issues. Into this area, so much tends to be lumped.

But the biggest drain of funds is from administration. This is largely because of the endless inititives from central government, which are little more than a sop. Each time, a new set of managers are recruited, they each set up new systems, need a new army of secretaries and administrators, new offices and so on. Existing managers seem to shuffle around, looking busy.

If the US does get a decent health service, I would hope they will look at ours and others and try to identify the problems.

The US normally is quite good at administration, except in your defense departments. I'm pretty sure the US could have a health service that would be cheaper than ours and still be the envy of the world.

It is sad but true that you get what you pay for. If you purchase a car, get a DL, registration, put gas in it, pay for insurance, and cover maintenance on it then you get to work in 15 minutes. If you take a public bus for $2, you get to work in two hours. This is the difference between government systems and private systems.

I've seen time and time again on this board the same problems with people who live in countries such as the UK or Canada. The hormones may be free or extremely cheap, but as Pebbles basically pointed out you spend 4+ years trying to get them.

Neither system is fair but I consider the private system freer. If healthcare (or other things) are mostly public then there is no competition, no incentive to improve care or service. Plus, with whatever little private options there are these won't have competition either (except against the public system) and thus will drive the cost of the private care/services significantly upward forcing practically everyone except the extremely wealthy to choose the crappy public system.

In a mostly private system, you still have the drawbacks that those who basically can't afford anything don't get anything but with the competition that results, most people do get care and get it relatively quickly. My employer gives us options and I chose the more expensive one so that I would have the freedom to go to any doctor, any clinic, etc. and still have part of the care covered. As a result, after less than four months of therapy (which I got an appointment less than a week after I called) I was approved for hormones. When I called the doctor for the hormones I got an appointment in two days and a prescription right then and there. It cost money but it was efficient. A system that is run solely by the government is not going to be an efficient one. Had I been in some of these other countries, I probably would have spent now six months and not even had one therapist appointment.

I feel for those who have to put up with this crap as well as those in the private system who are broke and can't afford it. I'd favor a solution that could get the impoverished people efficient care but that would not punish those who do have money by making it less efficient for them. Someone on this board mentioned something about having to go to months of therapy only to be referred to a government gender clinic only to have to wait more months to even be considered for HRT. That is ridiculous. This is why I'm not a socialist. Most people do or can get jobs so I don't see why a socialist system should be imposed on everyone.

Quote from: Britney_413 on February 09, 2011, 02:17:38 AM
It is sad but true that you get what you pay for. If you purchase a car, get a DL, registration, put gas in it, pay for insurance, and cover maintenance on it then you get to work in 15 minutes. If you take a public bus for $2, you get to work in two hours. This is the difference between government systems and private systems.

I've seen time and time again on this board the same problems with people who live in countries such as the UK or Canada. The hormones may be free or extremely cheap, but as Pebbles basically pointed out you spend 4+ years trying to get them.

Neither system is fair but I consider the private system freer. If healthcare (or other things) are mostly public then there is no competition, no incentive to improve care or service. Plus, with whatever little private options there are these won't have competition either (except against the public system) and thus will drive the cost of the private care/services significantly upward forcing practically everyone except the extremely wealthy to choose the crappy public system.

In a mostly private system, you still have the drawbacks that those who basically can't afford anything don't get anything but with the competition that results, most people do get care and get it relatively quickly. My employer gives us options and I chose the more expensive one so that I would have the freedom to go to any doctor, any clinic, etc. and still have part of the care covered. As a result, after less than four months of therapy (which I got an appointment less than a week after I called) I was approved for hormones. When I called the doctor for the hormones I got an appointment in two days and a prescription right then and there. It cost money but it was efficient. A system that is run solely by the government is not going to be an efficient one. Had I been in some of these other countries, I probably would have spent now six months and not even had one therapist appointment.

I feel for those who have to put up with this crap as well as those in the private system who are broke and can't afford it. I'd favor a solution that could get the impoverished people efficient care but that would not punish those who do have money by making it less efficient for them. Someone on this board mentioned something about having to go to months of therapy only to be referred to a government gender clinic only to have to wait more months to even be considered for HRT. That is ridiculous. This is why I'm not a socialist. Most people do or can get jobs so I don't see why a socialist system should be imposed on everyone.

The point you are missing Britney is that the NHS is NOT a monopoly. Plenty of people in the UK, myself included, opt for private medicine, and those options are no more expensive to us than they are in countries that have no public system. If Pebbles had the money she could have private care. If she doesn't then in our system she gets treated more slowly, but in a pure private system she simply doesn't get treated at all.

So it isn't an either or situation. You can have both as indeed we do. The only difference is that those who simply can't afford it, who in completely private system are basically screwed and can simply shove off and die untreated, in our NHS have an option. Yes they wait, and yes the service they get is VASTLY inferior to those of us who choose to pay, but they DO get looked after, whereas in a completely private system they just get told to shut up and put up with it!

Yes the rest of us pay a small premium - but it isn't than much, and if we didn't pay it towards something worthwhile like universal healthcare the government would probably spend it anyway on something silly like another pointless war.

So overall I know which system I prefer, and its niether the completely private system, nor the completely public one. It is what we in the Uk are lucky enough to have, the best of BOTH.

Quote from: Britney_413 on February 09, 2011, 02:17:38 AMMost people do or can get jobs so I don't see why a socialist system should be imposed on everyone.

Because you don't know what it's like for those who can't get jobs.

Ummmmmm...wasn't this a thread about the dangers of black market hormones? Not the merits of public vs private health care? Which though extremely interesting is probably best left for another thread. :)

Quote from: Helena on February 09, 2011, 04:20:38 AM
Ummmmmm...wasn't this a thread about the dangers of black market hormones? Not the merits of public vs private health care? Which though extremely interesting is probably best left for another thread. :)

Sometimes thread topics do evolve just like any conversation - and indeed there is a common theme to the topic - which is easy access to appropriate and relevant care. So in this particular instance I beg to respectfully differ on that point.

Quote from: Britney_413 on February 09, 2011, 02:17:38 AM
Neither system is fair but I consider the private system freer. If healthcare (or other things) are mostly public then there is no competition, no incentive to improve care or service. Plus, with whatever little private options there are these won't have competition either (except against the public system) and thus will drive the cost of the private care/services significantly upward forcing practically everyone except the extremely wealthy to choose the crappy public system.

The problem with private system only in USA is that we have approx 50 million people with no insurance whatsoever. You are already paying for their emergency room care in your private insurance rates.

QuoteThis is why I'm not a socialist. Most people do or can get jobs so I don't see why a socialist system should be imposed on everyone.

We already have "socialism", as you call it. Our elected representatives have a fantastic health care plan that they can buy into, and that we, the taxpayers, are paying for! Medicare and Medicaid work quite well for those who are retired or disabled. We could have a Medicare for All in the US that would cover everyone in need, and private care and plans would still exist for those who had the money.

None of my Canadian or European friends who I've talked to would trade their system for ours!

Z

Quote from: rejennyrated on February 09, 2011, 06:15:45 AM
Sometimes thread topics do evolve just like any conversation - and indeed there is a common theme to the topic - which is easy access to appropriate and relevant care. So in this particular instance I beg to respectfully differ on that point.

As long as it doesn't devolve into a poo slinging match...i'm well aware of how contentious the whole issue of public health care is in the states.

Quote from: rar on February 07, 2011, 07:41:44 PM
They're impossible if you can't afford three+ months of therapy or if you can't afford an endocrinologist or if you have to drive out of state to find a GP who'll see you just for regular stuff, not to mention anything trans-related. The SOC only works for people with enough money to make it work, and even then, as in pebbles' case, it doesn't work well.

You're assuming we have a choice.

Well, okay, we do: use whatever means necessary or don't transition medically.

I really do sympathize with you; just trying to encourage anyone in your situation to not give up. At first I was afraid to try, and worried about costs, but eventually found a therapist that only charged $15 per session (a clinic with income based sliding scale) with visits every 2 weeks so 3 months was under a $100. I realize even that might be hard for some.  I wish you the best.

Quote from: pebbles on February 07, 2011, 02:39:39 PM
Those people don't have the moral authority to rip into those black market drug dealers.

Simple fact is I told my GP about my feelings when I was *20* I'm 24 next month. They are completely corrupt and utterly useless I don't expect any resources to come from the NHS or the decadent protocol that basically says "leave him to die" The only reason I'm dealing with them at all is to appease my naive friends and family. Thus far I've been proven right the only practical resource I've gotten thus far is a single useless blood test bag with the WRONG name on it. Despite me telling him that isn't my name anymore.

I jump all the hoops am friendly and polite to everyone I meet but I don't expect any of them to give a damn.

So don't rip into the few groups of people who have actually helped me out. Sure I know they are drug dealers and criminal mercenaries who exploit the crap out of me to give me what I need but least they actually helped me and gave me a tiny degree dignity over my otherwise bleak and miserable life.

A claim that the so called Legitimate medical establishment cannot claim to do.

The NHS has to help you. There was a link posted on here late last week with a couple of leaflets about Transgender. YOu need to take the GP one to your GP and show them that they have to prescribe hormones if you are self medicating. They also have a duty of care o check your blood numbers if you tell them you are self medicating.

Your GP is also supposed to refer you to Charring Cross for diagnosis. IF they haven't then go and find a new GP who will.

Where are you in the UK ?

Quote from: Catherine on February 13, 2011, 10:46:24 AM

Your GP is also supposed to refer you to Charring Cross for diagnosis. IF they haven't then go and find a new GP who will.

Where are you in the UK ?

yes Jenny PMed me those I'm seeing him in a few weeks time I will bring it up them.

Wanna know what precisely happened to me. When I was 20 told a GP who didn't do anything didn't refer me on or anything just told me that the NHS dosen't deal with that stuff.

He wouldn't hear debate on the matter I tried seeking out local mental health services about this but they wanted a GP referral or to see me first hand as I was too ashamed (And feeling all the worse thanks to GP experience) for why I needed to see someone. So they turned me away too.

A couple of years later I'm self medicating I see a different GP.

He was naive but more understanding... He referred me to a local psychiatrist. the psych gave me a mental assessment
to me and told me he thinks I'm a transsexual and I don't have anything else wrong with me.

He said he would refer me to the people who have to approve funding for this stuff once funding is approved you goto charing cross barring the 9 month waiting period. and time to get funding approved.

6 weeks later I got a letter from him saying something like "whoops I did it wrong I referred you to the wrong people. so you've not got your referral yet. Wait abit longer please" Then another 6 weeks later I got a different letter saying "Oh whoops... Your GP is suppose to make the referral not me apparently. sorry for wasting another 6 weeks"

The GP sends me off to the hospital to see an endocrinologist I saw the Endo and he disliked me immensely he has a problem with transsexuals and he mentioned he dosen't feel he should deal with me at all but will because he has to.
He kept using my old name after I told him otherwise he toyed with the idea of prescribing a hormone regime before dismissing it. explaining that I haven't died yet and I appear to have gotten reasonable results already so he will just leave me to it.

He then gave me two blood test bags with my male name on it despite me telling him that isn't my name one to use now and one in 6 months time I went off got the blood test which checked my Kidneys, Liver, and thyroid. he did not check Prolactin/Testosterone/Estrogen

It took longer than anticipated to get my blood tests back because he used my wrong name and caused an administrative panic as that name is no longer linked to an NHS number ¬.¬ when I finally got them back they said I was fine.

I suspect it's gonna get better and better (sarcasm) because I'm graduating soon and will be moving away from here which will probably give the PCT a good reason to not help me. That will now definitely be before I can arrive at that first appointment.

I'm currently in colchester southeastern England I will be moving back to Hampshire southern England soon.

Quote from: pebbles on February 13, 2011, 01:00:29 PM
yes Jenny PMed me those I'm seeing him in a few weeks time I will bring it up them.

Wanna know what precisely happened to me. When I was 20 told a GP who didn't do anything didn't refer me on or anything just told me that the NHS dosen't deal with that stuff.

He wouldn't hear debate on the matter I tried seeking out local mental health services about this but they wanted a GP referral or to see me first hand as I was too ashamed (And feeling all the worse thanks to GP experience) for why I needed to see someone. So they turned me away too.

A couple of years later I'm self medicating I see a different GP.

He was naive but more understanding... He referred me to a local psychiatrist. the psych gave me a mental assessment
to me and told me he thinks I'm a transsexual and I don't have anything else wrong with me.

He said he would refer me to the people who have to approve funding for this stuff once funding is approved you goto charing cross barring the 9 month waiting period. and time to get funding approved.

6 weeks later I got a letter from him saying something like "whoops I did it wrong I referred you to the wrong people. so you've not got your referral yet. Wait abit longer please" Then another 6 weeks later I got a different letter saying "Oh whoops... Your GP is suppose to make the referral not me apparently. sorry for wasting another 6 weeks"

The GP sends me off to the hospital to see an endocrinologist I saw the Endo and he disliked me immensely he has a problem with transsexuals and he mentioned he dosen't feel he should deal with me at all but will because he has to.
He kept using my old name after I told him otherwise he toyed with the idea of prescribing a hormone regime before dismissing it. explaining that I haven't died yet and I appear to have gotten reasonable results already so he will just leave me to it.

He then gave me two blood test bags with my male name on it despite me telling him that isn't my name one to use now and one in 6 months time I went off got the blood test which checked my Kidneys, Liver, and thyroid. he did not check Prolactin/Testosterone/Estrogen

It took longer than anticipated to get my blood tests back because he used my wrong name and caused an administrative panic as that name is no longer linked to an NHS number ¬.¬ when I finally got them back they said I was fine.

I suspect it's gonna get better and better (sarcasm) because I'm graduating soon and will be moving away from here which will probably give the PCT a good reason to not help me. That will now definitely be before I can arrive at that first appointment.

I'm currently in colchester southeastern England I will be moving back to Hampshire southern England soon.

Ok well I am in Southampton. IF you need a group to help you along then the one that I attend will probably be good for you.

Go to www.chrysalis-gii.co.uk (http://www.chrysalis-gii.co.uk) and get in contact. Once you have spoken to them they can help by pressuring the right people to do the right things for you.

You seem to have gotten in a hole with the NHS but it is sortable even though it has wasted time.

If your GP doesn't refer you to the shrinks immediately you need to get a new one.  They are supposed to do it straight away even though we are now recognised as having a condition and not mental illness.

The protocol is to refer to the shrinks who will decided after a few consultations to refer you to charring cross.. then you apply for the funding.... 2 months.... you then get an appointment at charring cross which can be 6 months or more later...

when you get to charring cross you see one doctor if he thinks you are trans then you get a blood test and an appointment with a different doctor in 3-4 months... if he agrees then you get hormones.

Once you get in the system then things are pretty straight forward. It is just getting past ignorant GP's of which there are loads.

IF you need to know anything about chrysalis then pm or email me...

Quote from: straycat on February 13, 2011, 05:52:40 AMAt first I was afraid to try, and worried about costs, but eventually found a therapist that only charged $15 per session (a clinic with income based sliding scale) with visits every 2 weeks so 3 months was under a $100. I realize even that might be hard for some.

But I can find hormones on the black market for less than $100, and I can have them in my possession much sooner than weeks or months.

So, where is exactly is the motive for me to seek therapy?

It seems that people have missed the whole point of this topic.  The black market promises a product which is FAST and CHEAP.  People like stuff that is fast and cheap.  Therapy is not fast, and usually not cheap.  Until this changes, the demand for hormones on the black market will not change.

Quote from: Catherine on February 14, 2011, 05:19:04 AM

Ok well I am in Southampton. IF you need a group to help you along then the one that I attend will probably be good for you.

Go to www.chrysalis-gii.co.uk (http://www.chrysalis-gii.co.uk) and get in contact. Once you have spoken to them they can help by pressuring the right people to do the right things for you.

You seem to have gotten in a hole with the NHS but it is sortable even though it has wasted time.

If your GP doesn't refer you to the shrinks immediately you need to get a new one.  They are supposed to do it straight away even though we are now recognised as having a condition and not mental illness.

The protocol is to refer to the shrinks who will decided after a few consultations to refer you to charring cross.. then you apply for the funding.... 2 months.... you then get an appointment at charring cross which can be 6 months or more later...

when you get to charring cross you see one doctor if he thinks you are trans then you get a blood test and an appointment with a different doctor in 3-4 months... if he agrees then you get hormones.

Once you get in the system then things are pretty straight forward. It is just getting past ignorant GP's of which there are loads.

IF you need to know anything about chrysalis then pm or email me...

We are I think getting a fair way off topic now - but just one thing to add. Until I found and read those documents I would have said exactly what you have done, but reading "small print" it turns out that it is possible in theory at least to get started on HRT though your GP before you have even reached a CIC - oh an one thing to note - NOT everyone will end up at CXH - there are several other places where you can be diagnosed - CXH is just the best known one of them.

An efficient healthcare system would avoid black market hormones and surgeries. People will naturally be inclined to travel the path of least resistance to get what they need. After reading some of the stories here about people spending years and going through dozens of different government departments and still not getting any hormones, I'd probably be going black market too. That is why I can't stand government programs because they install gatekeepers which do more to stand in the way of getting people what they need than actually helping. It happens in private systems too but usually only when a lack of money is involved. I'd favor a healthcare system with no gatekeepers, and forced personal responsibility. In other words, whatever drugs you want you get but you agree to the consequences. This is a much more efficient way than barriers set up to "protect people from themselves" by forcing people to go through strings of health providers just to see if they are fit for a treatment. But that means people also have to use their brains at the same time and be careful about what they are jumping into.

Quote from: Britney_413 on February 15, 2011, 02:10:30 AM
An efficient healthcare system would avoid black market hormones and surgeries. People will naturally be inclined to travel the path of least resistance to get what they need. After reading some of the stories here about people spending years and going through dozens of different government departments and still not getting any hormones, I'd probably be going black market too. That is why I can't stand government programs because they install gatekeepers which do more to stand in the way of getting people what they need than actually helping. It happens in private systems too but usually only when a lack of money is involved. I'd favor a healthcare system with no gatekeepers, and forced personal responsibility. In other words, whatever drugs you want you get but you agree to the consequences. This is a much more efficient way than barriers set up to "protect people from themselves" by forcing people to go through strings of health providers just to see if they are fit for a treatment. But that means people also have to use their brains at the same time and be careful about what they are jumping into.

Funnily enough it turns out that it isn't quite like that though. The official guidelines that I found say that everyone should have access to hormones and they actually allow for the possibility for this to happen without gatekeepers. In any case the gatekeeper mentality was started by the whole WPATH thing with its requirements for certain letters and so on.

What has actually happened in the UK though is that this new guideline document has been "lost" in the muddle of bureaucracy and so everyone including most of the patients THINKS there are still gatekeepers - when in actual fact far from installing them the government abolished them in 2008 when it published this new protocol. If read carefully, it allows early access to hormones on an informed consent basis and as a harm reduction measure. No more HRT gatekeepers.

Pebbles and others like her are having problems not because of government policy, but because of confusion. The uk system has been evolving rapidly in recent times as our understanding of what it means to be trans has changed from the mental health model that you in the USA still hold, to a medical one that we now hold. Meanwhile some parts of our system like Pebble's GP haven't yet caught up and are still trying to operate in the old way.

Quote from: VeryGnawty on February 14, 2011, 05:47:24 AM
So, where is exactly is the motive for me to seek therapy?

It seems that people have missed the whole point of this topic.  The black market promises a product which is FAST and CHEAP.  People like stuff that is fast and cheap.  Therapy is not fast, and usually not cheap.

I like fast and cheap too, but sometimes fast and cheap is dangerous and may not bring the best results. I think the motivation for us to seek therapy other than just because it is required can be in order to be safer under medical supervision, have guidance in the process, and avoid doing things we might regret later.

There are numerous accounts on this site and elsewhere of medical problems that can occur with HRT.  Many of us have other issues, possibly caused by GID, for which therapy can be helpful.  It can be good to have guidance in transition and dealing with all the changes in our work, families, and daily life in order to have a successful transition.

Therapists know of a number of kinds of people who come to them with the desire for hormones and sex reassignment surgery but for whom it would not be appropriate.  They include criminals wanting to change their identity to escape the law, people with Munchausen syndrome or psychiatric disorders that make them delusional, and others that learn in the process of therapy that they are not transsexual.  If hormones and surgery are available without any kind of intelligent evaluation these people and/or our society suffers.

I'm just trying to present the other side, why it can be good to have therapy and medical supervision particularly now that we are gaining more acceptance and it is easier now than in the past to do so.

The new version of the DSM will make GID less stigmatizing and more sympathetic to us. More doctors are less strict than WPATH because they realize too much of it is unnecessary. In the U.S., major cities  have LGBT health clinics. E.g., Chicago has Howard Brown where I was able to start HRT after showing informed consent as to the benefits and risks. I had an hour consultation and blood tests, though I can't remember if I had blood tests at an earlier visit or the same day my RN gave me my prescriptions. I didn't need any expensive psychiatric tests or counseling.

Major retailers such as Wal-Mart have cheap generic drug programs. http://www.walmart.com/cp/1078664 (http://www.walmart.com/cp/1078664) has list. Most are $4/$10 for a 30/90 day supply. That includes Estradiol and spironolactone. Finasteride is $9/30 days. They also have medroxyprogesterone acetate for the $4/$10 price, but I'll pay the higher price for micronized progesterone elsewhere because it's safer.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ (http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/) has an excellent hour video plus other info comparing the health care systems of the U.S., U.K., Switzerland, Germany, Taiwan, and Japan.

The U.S. has by far the highest administrative costs in the world, spends the most per capita, yet gets far from the best outcomes in many areas. The WHO's last ranking of country health systems in 2000 at http://www.photius.com/rankings/healthranks.html (http://www.photius.com/rankings/healthranks.html) rates the U.S. at just 37! They've stopped ranking because of the complexity, and probably the difficulty of weighting different factors.