Moderators: If this type of discussion is out of bounds under Forum rules, my apologies, and please be so kind as to delete it.
I was temporarily banned from another forum this weekend for, as far as I can tell, advising somebody on HRT.
Now I understand the logic: In advising somebody else on DIY, you are enabling them, and are partially responsible for them taking a very risky decision.
On the other hand though, somebody who is desperate enough to self medicate will find a way to do so, with or without your help. And all too often, that DIY will be done based on incomplete or outdated or just plain wrong information, all of which the web is overflowing with.
I feel that, if they're going to do it anyway, by not pointing them at the the most complete, most up to date information you are aware of, you are partially responsible should they end up getting bad info.
Now, I realise there is also a question of legal liability and the like, and I'm not arguing that forum policies be changed, here or elsewhere. This is really just a question for me of trying to figure out for myself which really is the right course of action in this kind of situation.
There is a bar to discussions about how, where and how much, Simone. That's true for a lot of forums simply because the danger of 'playing' with powerful change-agents. Add to that the possible liability and the anguish that might arise from someone misusing and then killing themselves on the basis of what I had said to them....
Well, those might give you some of the major reasons.
I'm going to be really honest with you here: it sounds like what you are looking for is some vindication for your dismissal from the other board. "Wasn't this really alright because, after all, she/he was going to get the 'mones anyway?"
You know your answer. No, it wasn't alright given the rules of that board and this board.
There are private messages, emails etc: a number of ways to send info to other posters that will not be placed in a public forum with access to goodness knows who and making for goodness knows what possible liability and anguish for other people.
So, you could probably have 'pointed' all you wanted to, the context of your pointing was the problem. You're a really smart girl, Simone. I think you already know that.
I'd say what might be required in this case is for you to recognize that you made a mistake in breaking the other site's rules and paid a price for that. It made you upset to have that occur, but you brought it on yourself. And know it.
I feel for your upset, but I believe we both know the mods/admins at that site had every reason to do what they did. Had you done what you did in the context of an email to the person no one could have justifiably banned you at all.
And I would strongly advise that everyone here maintain the rule about medications and what one can and cannot write about them here. The rules at Susan's aren't going to change in this regard. Nor will the rule about making a fuss about the rules.
Like I said, I just really don't think the problem you have is one of 'helping' someone. It's a problem of being vindicated somehow for your actions.
Nichole
I don't mind the banning Nichole. Frankly I did mess up by not using a PM or some other mechanism, and I'm fine with the consequences of that oversight
I really am muddy on the issue though, because to me it boils down to a choice between two evils. Either way, if something bad happens to the other party, I am partly responsible, and that sucks.
My personal take is that I am NOT responsible for another's actions provided they are not my young children. Then I have a legal responsibility for them, and a moral one within myself.
What someone decides to do with internet access is their responsibility. Given their ability to find such a forum I would imagine that they could also find links at a clearinghouse and more links from those links.
The argument in favor of telling someone how to DIY as somehow my responsibility falls for me in that regard. Information is readily available and there are newsgroups that discuss ONLY the use of hormones.
If such people can find the chat sites they can find the newsgroups as well. Someone trying to get info 'quickly' without doing it for themselves is simply a matter of them not wishing to take the time for the research.
I cannot see your being somehow responsible for that choice of their own.
N~
What I've found is that often with people that are thinking of self medicating or are currently self medicating, it's not about what's dangerous to them that matters in helping them. It's really about telling them with a gentle hand that yes, their gender dysphoria and body issues are serious enough that they are willing to take drastic steps to put things in their body that may harm them, and that this gender dysphoria is serious enough for them to seek out a counselor or a doctor to help them sort out their problems and emotions. I've found that surprisingly most when presented with a hand that's willing to tell them find what help they need, to be told that everything is alright, and that a gender therapist is not going to judge them negatively or otherwise for these feelings, that they are willing to seek out and get to a counselor, doctor, or a tg support group.
Yes, most of these people are desperately lost when they start grasping at straws like this, but it's not always about legal liabilities (which are there) but also about getting the people the help they really need and want. Because no amount of hormones is going to change someone's negative self image if they don't first understand who they are and why they need to take such drastic measures.
-Kit
Quote from: Nichole on March 17, 2008, 06:30:32 AM
Someone trying to get info 'quickly' without doing it for themselves is simply a matter of them not wishing to take the time for the research.
That's a good point. Wonder why that one didn't tumble into consciousness for me sooner... ;)
Quote from: lady amarant on March 17, 2008, 06:37:25 AM
Quote from: Nichole on March 17, 2008, 06:30:32 AM
Someone trying to get info 'quickly' without doing it for themselves is simply a matter of them not wishing to take the time for the research.
That's a good point. Wonder why that one didn't tumble into consciousness for me sooner... ;)
Because maybe you are a bit more miffed than you think?
Like I said, you're a very smart girl. ;)
N~
Quote from: Nichole on March 17, 2008, 06:46:16 AM
Because maybe you are a bit more miffed than you think?
Like I said, you're a very smart girl. ;)
N~
Hmmm. Maybe. Probably. I did deserve it though.
And thanks, though I hardly deserve the compliment.
Here's my perspective:
Don't say anything you are not willing to take personal responsibility for.
That said, I'm not responsible for what other people say, only what I say.
Sometimes we have to break the rules.
People are in danger, or perhaps about to do something really stupid and they need to be told.
Self medication is a hot topic because primarily of liability as far as I can tell.
That and that people don't want to see others get hurt.
Now on a personal note, I am personally against the censoring of the world, for the reason that real problems and issues don't often get addressed properly or even at all due to some peoples discomfort with talking about those issues (in whatever subject matter, Transgender, politics, world issues, etc, it's all the same)
People in our community used to inject raw silicone brake fluid into their breasts.
Some people in the big cities (especially kids) still do this.
I'll quote somebody who can say it better than me:
Quotefrom Transparrent, Love, Family, and Living the T with Transgender Teenagers. By Chris Beam:
"(From chapter: 'Body' interviewing Dr. Marvin Belzer) "...Essentially, he explained, if kids are prostituting themselves for hormones, if kids are living on the street rather than in foster care to earn enough money to buy hormones, if kids are risking their lives and HIV status for hormones, then for goodness' sake, give them hormones. The equation, for him, is obvious."
I feel the same way about information.
If people are going to do something anyway, at least give them information that they can accurately use and not just be guessing.
The current medical practice, and system, is incredibly poor with regard to Transgender people, and leaves many to fall through the cracks
In many parts of the world and even in our own perspective "first world" countries, people simply can not afford the medical care costs "required" as a prerequisite to hormones.
In our own cities and towns.
We do not have national health care in the US, and even in the UK where they do, it is shoddy at best with regard to Transgender care.
In my opinion we need to realize this and not just leave members of our community hanging.
Because kids especially will do stupid things if they get too impatient.
Are there liability concerns? Yes.
But there also seems to be a real need that needs to be addressed.
The "Standards of Care", in my opinion, is an idealistic goal, one that falls way short of the needs it's meant to address.
Those are my thoughts.
Sara
You raise some valid points Sarah. But the thing is, these extreme cases in which self-medding may apply are the last resort, and not the most common scenarios. From my experience in talking to people in chatrooms and support groups, these are people that have the means one way or the other to go and get themselves cared for by a doctor, but would rather fly 'under the radar' to avoid scrutiny. They procrastinate and procrastinate on going to get help, several years pass, and they enter into a self-inflicted crisis mode. And then even the self-medders often don't even bother to go and get themselves checked out by a doctor before, during, or after.
Unless it's stressed heavily with someone the importance of not 'flying under the radar,' you're basically letting most of them delude themselves into believing that their gender issues will go away through HRT, but in reality it'll just become one extra thing on top of a mountain.
I am definitely not against the free availability of information, but like a good library, just because I support that the library stocks information doesn't mean that I condone every single book in there. The information is available for anyone to find if they do their due diligence (and it doesn't take much.)
However, I have met and talked with many transsexual prostitutes, some very young. They are unfortunately some people who have other issues that may never get taken care of in their lifetime. Of them, I know a number (in this state, the majority) that do get their hrt through a doctor. The reason many turn to prostitution isn't because they are trying to fund their hormones or their transition. They can't afford life at all, after having been severed from their families and left for dead for all intensive purposes. Here, they congregate in houses together to afford life, in some places 10 in a house. Many of the people I know that now work jobs here waiting tables and otherwise started out as prostitutes. The problem starts in the home and family for the young ts's who will stop at nothing to express their gender. Giving them access to hormones with a doctor's care hasn't solved their problems.
-Kit
Just to be absolutely clear, here are the rules about HRT discussions:
_________________________
8. The discussion of hormone replacement therapy(HRT) and it's medications are permitted, with the following limitations:
A. Advocating for or against a specific medication or combinations of medications for personal gain is strictly prohibited.
B. Discussing the means to acquire HRT medications without a prescription, and self medication without a doctors care is prohibited.
C. Discussing dosages is strongly discouraged to prevent information obtained on this site from being used to self medicate.
We can not in good conscience condone the self administering of these medications. Not only may self medication be illegal, but HRT medications can cause serious health problems, and many have the potential for life-threatening side effects that can only be detected and prevented with proper medical supervision.
____________________________________
If you stay within those boundries you should be fine.
Sarah L.
Oh HAI doktyer Simone!
How much longer till you get your PHD?
LOL.
Quote from: DarthKitty on March 17, 2008, 12:59:07 PM
You raise some valid points Sarah. But the thing is, these extreme cases in which self-medding may apply are the last resort, and not the most common scenarios.
It's a lot more common than you think.
We are also discussing globally, not just in the US or UK.
Even here, it is relatively common for financial reasons.
That, is the number one reason why most people who don't, don't, in the US:
They simply can't afford it.
In the UK:
They are simply unable wait the absurd amount of years, and years, required.
Sara
Posted on: March 17, 2008, 11:30:36 AM
An added note:
If we are to fix this situation, the cost required has to be zero.
People should only have to pay for meds.
the prerequisites need to be either free or almost free.
and it needs to be readily available.
In the UK, people need to be streamlined into a matter of 3 months or less before they are on hormones.
If people have to wait years, they are going to self medicate.
If people can't
afford the "standards" they are going to self medicate.
That's how it is.
Sara
Posted on: March 17, 2008, 11:36:16 AM
Oh yeah,
It's worth mentioning that in the U.S., it's mostly youth that are falling through the cracks.
Teens and college-age or students mostly.
They are the ones who mostly can't afford it.
I'm not going to blame a kid, who is selling herself on the street just to afford meds for self medicating. A lot of kids get kicked out by their parents for being Trans.
A lot of college students are so broke they don't know where there are going to find their next meal.
And it's hard to find an entry level job if you are out.
You can't just say they are being blatantly irresponsible.
Most people if they are able will do the best thing.
The key here is if they are
able.
Many are not.
And that is a real reality.
Sara
It is very easy to start think along the lines of " here is a person at the end of their tether, if they dont get started with transition they may attempted or suceed at suicide "
But in my experience, the reality of the issue is that the majority of the people that have or do self med simply refuse to get treatment , imho usually because of fear. To help these people to not face the fear that comes along with transition will quite probably put them into a more difficult and dangerous situation and thats not taking into account the actual dangerous side effects of the hormones themselves.
Now i am not saying that following the SOC is possible in all cases, but its far too easy to believe that the 'DIY is the only way' situation is more common than it actually is.
I also postulate that alot of people that are on hormones _and_ started more recently (when they are so widely availible) have considered DIY'ing, and can now look back and realise that they were in fact not ready to start.
And on the note of the cost, diy hormones are not that cheap. and any GP should be able to do at least simple liver function and potassium etc etc tests for relatively little
Quote from: Sarah on March 17, 2008, 01:36:16 PM
It's a lot more common than you think.
We are also discussing globally, not just in the US or UK.
Even here, it is relatively common for financial reasons.
That, is the number one reason why most people who don't, don't, in the US:
They simply can't afford it.
In the UK:
They are simply unable wait the absurd amount of years, and years, required.
Someone who can't afford the care to make sure that they do this safely shouldn't be tossing pharmaceuticals into their bodies without thinking about the consequences. It's our responsibilities as representatives of the community to make sure if we're going to offer advice, that they do this safely, which means doctors. Nobody wants to have to sit through day in and day out dealing with people who are ready to chop off their body parts because they're not emotionally ready to deal with the real issues at hand. And no one's trained for that except therapists and doctors. We here aren't. We provide an arm for a support, and a hand on the shoulder, and try to get them the best help available to them. For anyone at that extreme, if someone's not recommending they see a therapist, we are doing them a disservice.
And yes it's quite common worldwide. It's a pandemic. To the point where advocating (either directly or indirectly through providing the information) this stuff without a doctor's care, where if our community participates in that propagation of information, you're either looking at scenario 1) they're going to make things easier for transgendered patients, or the more likely 2) a bigger clamping down on what care is available. No pharmaceutical company wants the liability of dealing with this.
Quote from: Sarah on March 17, 2008, 01:36:16 PM
If we are to fix this situation, the cost required has to be zero.
People should only have to pay for meds.
the prerequisites need to be either free or almost free.
and it needs to be readily available.
In the UK, people need to be streamlined into a matter of 3 months or less before they are on hormones.
If people have to wait years, they are going to self medicate.
If people can't afford the "standards" they are going to self medicate.
Affording the "standards" is one thing. But for a lot of whom you're referring to, it's not "affording" but reluctance. Yes there are those that can't afford the care, and yet can afford other luxuries at the expense of proper care. And yes I'm aware there are extreme cases beyond that.
Procrastinating until it's a crisis to get on that waiting list, that's another thing. We should be telling people to get on that waiting list ASAP, and doing our due diligence to provide the support where we can.
Getting someone to see a doctor and make sure they don't hurt themselves in the process of transitioning, that's what we should be striving for. I agree with that it needs to be made more available, but that doesn't change our responsibility right now should be to the overall welfare of the individual, not their immediate need.
-Kit
I understand that conditions are such that some trans people feel they need to self-administer hormones. If I encounter such a person, usually in the Chat rooms and sometimes elsewhere, I advise them that DIY is a bad move and to, at least, find a GP who will administer the appropriate tests to monitor the hormone's toxic effects on the liver and kidneys. I will not advise them on how to continue. I certainly will not give information on how to start and that includes discussing the dosages that I'm taking.
That said, advising someone how to self-administer, where to get them without a prescription and how much to take is clearly outside of the rules. It matters not if this information can be found elsewhere, it should not come through the use of this site, either through a public channel or a PM. The rules are clear on that.
If the person asking for such information found us, they can find the sites that do give the info. If they do, so be it. This way Susan, and our site, are absolved of any responsibility - legal or otherwise - in case these people damage themselves. And that preserves the site and its availability to the English speaking world.
hugs and smiles
Emelye
Your choice Kit.
I think it was Racheal who said something like "by the time they end up seeing me(in the UK) they will be asking me if I want to become a Guy."
Umm have your read how long the wait is in the UK?
Long.
And do you have any idea how expensive hundreds of dollars to thousands is to a teen or college student?
I still haven't had laser, and I'm full time.
This is expensive, Kit.
You do what you want,
but I don't blame people for self medicating.
Housing, books, transportation, utils, food, Tuition, Meds, on a very low income...
I'm hoping to afford laser by next quarter.
I also need 2,000 dollars worth of equipment for school.
I understand perfectly why someone would self medicate.
This process is freakin expensive.
I'm better off than most my age.
I get help from my parents which takes away a lot of the burden for tuition.
I'm still gonna have to take out loans this quarter to pay for my equipment costs.
For kids who are paying their way through school themselves, transitioning may be almost impossible if they didn't self medicate.
And then there's the teens..
Many disowned for being Trans and having to live with friends.
This is not a nice society to kids.
Sara
Quote from: Sarah on March 17, 2008, 02:18:26 PM
This is expensive, Kit.
You do what you want,
but I don't blame people for self medicating.
Mirroring what Emelye says above, if someone's self-medicating, they get the following advice: 1) they should get a counselor, 2) barring that being a possibility, they should see a doctor to get the tests to make sure their bloodwork is within safe levels. People can't be stopped from doing what they want. But that doesn't mean I can't recommend to them, and yourself as well, to make sure if you are doing this, that you do it as close to right as possible and make sure that you don't cause yourself more health problems in the future. Just because we don't condone it, doesn't mean we don't care about what happens to you.
*huge hugs*
-Kit
Quote from: DarthKitty on March 17, 2008, 02:23:21 PM
2) barring that being a possibility, they should see a doctor to get the tests to make sure their bloodwork is within safe levels.
That costs about 500 dollars.
::)
Hugs to you too.
Sara
Putting aside all arguements in favor of self administering, the costs involved, finding a doctor, etc., the rules at this site are very specific and are to be followed.
-------------------------
8. The discussion of hormone replacement therapy(HRT) and it's medications are permitted, with the following limitations:
A. Advocating for or against a specific medication or combinations of medications for personal gain is strictly prohibited.
B. Discussing the means to acquire HRT medications without a prescription, and self medication without a doctors care is prohibited.
C. Discussing dosages is strongly discouraged to prevent information obtained on this site from being used to self medicate.
We can not in good conscience condone the self administering of these medications. Not only may self medication be illegal, but HRT medications can cause serious health problems, and many have the potential for life-threatening side effects that can only be detected and prevented with proper medical supervision.
--------------------------
Sarah L.
QuoteThat costs about 500 dollars.
It costs me 50 euro, every three months.
Quote from: dawn on March 17, 2008, 02:33:46 PM
QuoteThat costs about 500 dollars.
It costs me 50 euro, every three months.
You are in Europe.
You are in the USA.
what kind of game are we playing here ? :D
seriously though you said "That costs about 500 dollars" , firstly i wonder why you said "about" and didnt give a figure, but more importantly giving that figure may lead others to not check the price for themselves, believing they could never afford it. And to clarify, 50 euro, thats with no financial aid or the like, thats just the price.
I have to agree with the standards for not addressing this issue. Kit brings up a huge point about liability. And that liability could well extend to Susan, this site and even further - the tendency is to sue everyone, and let the court sort it out. I know I can pretty much win any workplace disagreement about safety with the remark "Hey, let's call the insurance carrier and ask them."
Anyway you look at it you are dealing with powerful drugs that have long term effects. And any such medication needs a doctor and labwork.
"Feeling slightly ban-shy, she bravely donned her sword and buckler to enter the fray once more..."
Okay. A bit of background:
I have a friend I chat to fairly often who lives in Mumbai. Transsexual people used to be fairly well regarded as manifestations of Shiva's duality, and they had an important part in the religious life of India because of that. When the English colonised India, they banned all forms of sexual and gender variance, and unfortunately the taboos have stayed even if the English didn't. Today, Hijra are streetwalkers or beggars. Society only even tolerates them because they are nominally scared of Shiva's wrath. Incidentally, few Hijra are ever in a position to access HRT, but do routinely have castration surgery done as soon as they can afford it. Sadly, this is a major obstacle to passing for most hijra.
So my friend doesn't want to be a Hijra, but India pretty-much makes NO provision for transition in the way we know it. Her dream is to save enough money to go to Thailand, but in the meantime she self-medicates in an effort to 'blend'.
I'll come clean. I gave her direct advice on HRT.
Pretty-much everybody else I come across asking for help, I advise to find a therapist, get in touch with their GP, or failing that to at least take some time to read up on the subject properly. I usually link them to the same studies and reports I used to educate myself in the matter, because here I do feel that we ALL need to know a lot more about the drugs entering our bodies, especially when many endos are still prescribing conjugated oestrogens and the like. I do not however provide direct help unless I am convinced they have no way other way out.
I agree with Kit and Nichole that, in most cases people are looking for short-cuts or simply want to stay off the grid, but there ARE situations where DIY really is the only option.
So my feeling is that, if there is ANY other option but DIY and advice on DIY, then that is the right course. But there are always going to be individual cases that defy the 'right course', and in those circumstances, I can't justify letting somebody potentially hurt themselves if I could have at least made the chance of that a bit less.
That said, DIY information probably SHOULDN'T be freely posted on forums like this, because yes, many people WILL abuse it. But if somebody in genuine need comes to me asking for help, I'm not going to say no.
Unlike some of the commentators I have worked for 6 of the past 7 years with the "young, college-aged, and street-level prostitutes" as a clinician. One year of that was in a LBGT gender-program in Philly that is totally free to the destitute. Totally free. It's also used by rather well-to-do people to legally obtain scripts without going through their insurance.
No, it doesn't have a pharmacy so the hormones aren't free.
The other five years I worked at an inner city mental health center where I worked with a number of gender-variant people, male- and female-bodied.
Their issues: childhood sexual abuse, physical abuse and emotional abuse in their homes of origin, often severe and persistent mental health disorders and a huge variety of personality disorders of which Borderline & Antisocial predominated and in the case of trauma, severe PTSD, and were exacerbated by Bi-polar w/ psychotic features (schizo-affective,) Depressive and Schizophrenia.
This is inner-city northeast corridor. Prostitution, drug-sales and she-male/gay movies were the primary means of support these women and men used. To a person they were 99% also users of street-drugs and were often addicted. They were often 'run' by pimps and those who were not pimped were beaten unmercifully and told to 'get out or die' in no uncertain terms by pimps and/or gangs.
Strangely enough, many would enter treatment for their trauma/abuse issues and drug-use and would continue to make their livings in the sex-trade. When they did so their incidence of 'self-medication' dropped drastically. They used the free clinics, sliding-scale gender therapists and regular pharmacies to obtain scripts and medications. Some, on general welfare, through Medicaid.
When they related the causes for self-medication they often would admit they self-medicated because 1) they were spending their money on drugs, clothes and food 2) ignorance of assistance, 3) ignorance of the FACT that the SOC provides a mandatory prescription-policy for those already on hormones. When they received education as to the facts about industrial-grade silicone injections to body transformation most discontinued its use. They were unaware that prescription hormones would regularly make the sorts of body-changes for them that the silicone was providing.
They were also unaware that the silicone hardens over time and flows until it hardens. Both effects cause severe deformations and increase one's risk of death drastically.
I cannot say what life is like elsewhere but that's what its like here. These kids and young adults did not want to continue harming their bodies. One of the most frequent remarks I have heard over those years has been "Why would I want to do all that just to die before or during the process." That from survivors.
When they came in they would often plead 'unfairness' and the fact they were 'just young and nobody knows what we are going through or cares.' Once they found that some of us did actually care very much and did know what they were going through, in many cases without having lived the life ourselves, they got better. Did better and refused to be victimized unmercifully anymore.
Its all well and good to make suppositions about age and availability. But, good information tends to rout poor information. If people want to become activists and helpers then have at it. Push for free-clinics in your area. Push for parity treatment for mental health with medical health. Donate to organizations that are already doing the work. Get yourself educated about the state of affairs and how you can become a player in a way other than posting on a forum. Volunteer your time after you're educated to an LBGT service organization in your area.
One post, made in violation of a forum rules, or even thirty will not give the assistance provided by your body involved in any one of the above.
Nichole
Well said Nicole.
Sarah L.
Well it really depends.
If your going to plan on self-medicating AT LEAST educate yourself properly by opening up some medical books on the endocrine system and do some serious research before hand. Find all the side effects and such.
But the problem is that many of the side effects can't be deteremined and usually come up as miscellanous.- I knew of this one woman that said she felt GREAT...what happened after 4 months of feeling "great"?- she went into FULL CARDIAC ARREST and now has to take 4 prescription drugs for LIFE!
Their are many chemicals and substances in the body that are altered by HRT.
I do know of people that have been self-medicating for a long time and have had no health problems BUT usually most people don't understand that HRT takes very good health and caution.
I'm not recommending it but it is possible that you'll come out fine if you excersice, watch your diet, quit smoking, alcohol, and do some tests on your kidney and liver by a doctor. But their is still a risk no matter what and doesn't mean you'll come out fine even if your very healthy.
I defeintly understand why people self-med because of money, living in a country where the system is flawed or because of a lack of resources- but again make sure you are completely aware that you need to keep an eye on your health and that your literally playing "russian roulette" with your body because doctors are the ones who have done not only research about properly adminsitring these meds BUT can do tests on the body to make sure nothing is wrong. And yes- some doctors don't know a lot BUT neither do many of us. It's also not about research and information- you have to have medical equipment to do bloodwork and tests!
- I'm nuetral on Self-Med
By the way, Dawn, it can be cheaper than that, it depends on the doctor.
But everything is expensive without insurance.
There are some clinics that will do it for a low cost, but most private doctors charge more.
This will be my last post to this thread,
But I wanted to point out,
That I had to take out student loans in order to be able to cover the costs associated with transitioning.
I took it on as debt.
That's not an easy thing to do.
I know others who have to do other means in order to cover their costs.
Things that are not ideal sometimes.
I think we forget sometimes that poverty is a very real issue in this country.
50 dollars means a lot to some people.
Especially, more often than not, people my age or younger.
I'd really like to not have that dismissed.
I would appreciate it.
Sara
Ugh. I self medicate because I don't have the time or cash right now to be travelling halfway across the country just to talk to someone who is goign to make me make the same $300 trip 1-2 times a month for half a year before even letting me get anything out of the damned thing. Why not simply do it on my own and when I finally do ahve time to see a therapist demonstrate that I'm living WELL as a woman and am LOVING IT?
If I could do it the 'proper' way then I would. But I'm not even sure if I agree with the system to start with, but I'd still do it because believe it or not, I dislike breaking the rules.
Sara hit the nail on the head with us college kids.
As far as prostitution and such, I'm really mixed up in my opinions of this. I can honestly say that it doesn't bother me to be used. In fact I've been a prostitute before, and I've still got 2 clients that I see about once a month who've become very close friends of mine over the course of half a decade. I believe that a lot of transsexuals get more out of prostition than just cash, they get acceptance of a kind that they can't find elsewhere, even if it is just skin deep sexual obsession with the abnormal, it's still being appreciated in some method. I spoke with a lawyer in california who's had a lot of experience with TG's, and I was shocked when he said that most transwomen he's ever known have done some street work, even if they didn't need the money, just to do it he said. If I wanted to do it, I might. In fact it crosses my mind quite a bit, considering my looks and petiteness. It's just a dangerous thing though, I'd much rather have a stable well paying job than some cheap thrill of running around on the streets.
Idk why I even went into that mess, I guess I just wanted to let you all know that it's not as rare as it seems, I could actually appreciate being appreciated enough to be able to charge for services for my beauty and sexual appeal.
And it think that is where folks can get them selves in trouble "Living like a woman" doesn't make a person a woman, much the same as taking HRT either prescribed or DIY does not make that person a man or a woman. There are some out there who can and do fool themselves into believing this and believing that, and see taking HRT as the road to womanhood, it isn't.
The information folks pass to each other on HRT, whether it be advice, dosage, how to obtain black market HRT is strictly between those concerned, and if those same folks feel comfortable enough, and competent enough to be the source of this information, or just playing doctor then more the power to them, go for it, start your own web site, we just can't and won't permit it here.
I may have read every bit of literature in the world on HRT, but that doesn't qualify me to dispense medical advice either professionally, ethically, morally, or legally.
Steph
I think that
- Considering the mess that Ifeel the SOC is;
- The barrier to treatment that the process is that protects
more the doctors than the patient
- The fact that there is very little research on HRT
used in transexual which makes the endo's
as ill informed as anyone.
- That there is a huge community of users that didn't exist in the past that can be used
to share knowledge and warnings
- That even if you DIY, your physician will in most case follow your vitals closely,
which reduces risk
- That there is a lot of empirical evidence born through practice and studies
on women using HRT and collated through the internet that reduce risk further
- That the risks of HRT are oversold considering that tylenols
are far more dangerous (deaths and liver damage a gogo).
- That the new types of HRT drugs have a significantly safer profile than in the past,
have a better understood biological effect and can be monitored more easily.
- That HRT is reversible
- Etc.
To make aiding anyone not much of an ethical problem to me.
But, hey, I'm all for people using marijana and LSD if they do it in their home
(not driving or putting others in danger),
a view not shared by many americans (but more canadians do share this view).
Haha, you rock out Keira.
Quote from: Annwyn on March 17, 2008, 09:49:52 PM
Haha, you rock out Keira.
X2 :laugh:
im not a doctor... but i play one on t.v. and im all for doing things the proper way because SRS is not do it your-self ... believe me..... i've tried....yeeeeeeahhh
I just want to reinforce that I DO NOT think places like Susan's and the like should do anything that makes them legally liable, dispensing DIY advice or otherwise. We need open, public spaces for gender variant people to be able to meet and interact safely and EASILY. For those who just don't have access to therapy, peer counselling becomes a VERY important part of their lives. Introducing DIY advice would push places like Susan's out of the "mainstream", which would be a very bad thing. Likewise, GenderDynamix is an activist group back home, and being associated with "shady" practices could destroy all the work they do.
This was purely a question on PERSONAL ethics.
Thanks for all the responses.
Knowing what reasonable dosages are is very important even if one is under a doctor's care. Since many doctors don't have a clue and may prescribe dangerous dosages if the patient is not informed.
Blood tests can be useful if something goes wrong, but even among doctors there is considerable difference about this. Here they tend to take many tests before starting HRT and only small tests (without any hormones etc) once a year during HRT.
Quote from: Steph on March 17, 2008, 09:18:07 PM
And it think that is where folks can get them selves in trouble "Living like a woman" doesn't make a person a woman, much the same as taking HRT either prescribed or DIY does not make that person a man or a woman.
True. Then again, especially in the last stages the SoC are not really about whether you are a woman but rather about whether you are better off living as one -- because after SRS that's what you'll have to do. In this sense it's understandable that the diagnostic criteria to an extent emphasise the social implications of the condition over the physical aspects.
Nfr
Quote from: Keira on March 17, 2008, 09:34:55 PM
I think that
- Considering the mess that Ifeel the SOC is;
- The barrier to treatment that the process is that protects
more the doctors than the patient
- The fact that there is very little research on HRT
used in transexual which makes the endo's
as ill informed as anyone.
- That there is a huge community of users that didn't exist in the past that can be used
to share knowledge and warnings
- That even if you DIY, your physician will in most case follow your vitals closely,
which reduces risk
- That there is a lot of empirical evidence born through practice and studies
on women using HRT and collated through the internet that reduce risk further
- That the risks of HRT are oversold considering that tylenols
are far more dangerous (deaths and liver damage a gogo).
- That the new types of HRT drugs have a significantly safer profile than in the past,
have a better understood biological effect and can be monitored more easily.
- That HRT is reversible
- Etc.
To make aiding anyone not much of an ethical problem to me.
I'd like to make it very clear what the SOC states, so people happening upon this thread do not get the wrong impression:
QuoteEligibility Criteria. The administration of hormones is not to be lightly undertaken because of
their medical and social risks. Three criteria exist.
1. Age 18 years;
2. Demonstrable knowledge of what hormones medically can and cannot do and their social
benefits and risks;
3. Either:
a. A documented real-life experience of at least three months prior to the administration
of hormones; or
b. A period of psychotherapy of a duration specified by the mental health professional
after the initial evaluation (usually a minimum of three months).
In selected circumstances, it can be acceptable to provide hormones to patients who have not
fulfilled criterion 3 – for example, to facilitate the provision of monitored therapy using
hormones of known quality, as an alternative to black-market or unsupervised hormone use.
The most important aspect of the entire SOC as it stands today is not about protecting doctors and therapists. While there are guidelines and recommendations within it about protecting a health care provider's liability in dealing with extreme cases, they are more guidelines that state "if you are ill-equipped to handle a particular patient, you are not required to provide sub-quality care." Everything else about it is making sure that care is available and open to patients. As it is, it is still recognized as a living document that is subject to change.
Arming a person with knowledge to head down this long journey we're all on, we are all in agreement that it is about education. There are no shortcuts on the road to being both of body and mind the correct gender. Everybody at some point in time is going to have to deal with the ramifications of heading down this road, whether they want to face the facts now or later. The best thing we can do for all our peers here is arm them the best way we can for the life ahead.
Regardless of anyone's opinion of the SOC, it makes an important read that should be mandatory for anyone considering this course in life. It outlines so much of what to expect, not only from the therapeutical or medical value of its contents, but also of what life changes need to be made and considered:
https://www.susans.org/wiki/Standards_of_Care_for_Gender_Identity_Disorders (https://www.susans.org/wiki/Standards_of_Care_for_Gender_Identity_Disorders)
PDF direct link to the official SOC distribution repository http://wpath.org/Documents2/socv6.pdf (http://wpath.org/Documents2/socv6.pdf)
That people have a big problem with their local health care systems and individual situations, these are not in debate here. As Nichole stated above so eloquently, if you want to change the situation for the better, get out there and help the community where you live to get better local support and health care where possible. Write letters, send emails, attend town meetings, anything contributes to getting things changed. With a global group like we have here, and with the number of people who want things changed, if we can reach out in our own communities and create waves locally, we can make rivers run.
-Kit
I second Kit. It becomes too easy for any of us to be critical. Especially when we are using few if any of our abilities to do anything but criticize.
There are way more supporters and friendly endos, therapists and others out here who are ready to help and learn for us to comfortably just sit and complain about the state of affairs.
There's nothing wrong with criticism and suggestions to better care and educative functions. But, to do that effectively if you have complaints then address them with your providers. A job in a pharmacy or with a pharmaceutical company does not an expert make.
But, if in having those employments someone can pass their knowledge along to providers to effect a better way of doing transition, then it seems to me that she or he should do so.
I understand that the words below have become almost a cliche, but cliches become powerful when they are applied to a life or many lives. The fact that they are repeated often doesn't mean they are invalid.
We can change the world, but only if we are willing to enter into dialogue with the world.
Nichole
Quote- The fact that there is very little research on HRT
used in transexual which makes the endo's
as ill informed as anyone.
The more people that do not go into the system, the harder it will be to collect actual facts about wanted and unwanted side affects.
Quote- That there is a huge community of users that didn't exist in the past that can be used
to share knowledge and warnings
Chinese whispers are a less than ideal and accurate way to get your infromation.
Quote- That even if you DIY, your physician will in most case follow your vitals closely,
which reduces risk
In my experience most who self med do not see a physcian regularly, and if they have no reason to believe that your liver function (for example) should be monitored then they usually wont.
Quote- That there is a lot of empirical evidence born through practice and studies
on women using HRT and collated through the internet that reduce risk further
Empirical - """depending upon experience or observation alone, without using scientific method or theory, esp. as in medicine.""
QuoteThat the risks of HRT are oversold considering that tylenols
are far more dangerous (deaths and liver damage a gogo).
I dont see how the fact that there more be more dangerous drugs available reduces the risks
QuoteThat HRT is reversible
Alot of the effects of HRT are NOT reversible.
Keira i dont not wish to start a flame, nor do i have anything against you, but you made alot of points that i feel need to be countered.
I think i seen somebody mention that people here dont know what it is like for college kids. Just for the record i am 21, unemployed, and in growing debt. They are temporary problems that i will sort out, i dont see any reason to let my health suffer because of them.
Anyone who's got the guts to walk into a therapists office and say that he/she is the wrong gender and wants to fix it should also be able to get on hormones. TYLENOL has friggin side effects, but I don't have to go through 6 months of therapy for that. Hell, dextromethorphan, asprin, corcidin, and some really bad ones like Alli(weight loss) and Yohimbe don't even NEED a prescription and are much ,much worse than HRT.
The system is messed up.
I'm protesting via boycott and passive agressive display of defiance.
The end.
Dawn, I feel you're tone is insulting OK,.
Your response is as much your opinion
and much more categoric than your
answers warrant
All the things I said reduce the risk to quasi zero
taken as a whole. So, going after them individually
makes no sense.
The chinese whisper crack is extremely condescending,
you don't know me, I could be a medical researcher for
all you know.
You answer, by the way clearly shows
that you don't know what your talking about. There's
plenty of solid information backed by studies and practice
online, in particular one forum which I'm not going to
point to because its against this forum's policy.
There 100 times more risks from smoking or drinking
or even eating trans fats every day,
there's hundreds of disease linked to obesity
and more are found every day,
so hey, are you going to put a
doctor in front of every taco joint or bar.
Risks are relative to others.
Everything has a risk.
That's how you deal with risks one against the other,
not trying to reduce all risks to zero, or giving
some risks some mythical quality regardless
of their number.
All of these things alone would not be alone would mean nothing, but put together
will make it relatively safe. There are no absolutes.
If you give sky diving or climbing equipment to someone
who wants to start in both sports
what are the ethics of that? Both are more risky than HRT for sure.
If someone is not willing to go to a regular doctor, why do you think they'll
want to subject themselves to dozens of psychologists sessions they can't afford
or don't want for whatever reason to get to this elusive letter.
BTW, I've dealt with hundreds of DIYer online and in real life in the last 15 years (that's
how long I've been in therapy by the way) and at least half eventually get to a doctor,
because there are other reasons for going to the doctor besides DIY and you'll
have to face him eventually if you want regular health care.
As for the reversibility of HRT, all but potential sterility are absolutely reversible (breasts may need to be taken out with surgery, but that's still reversible). Sterility itself is not assured
(some had a child after years while still on HRT!) nor absolute, its possible that your sperm count will not go back to what it was before, but even if its very low, its still possible to procreate with assisted means (just not in the natural way).
There's reality that many DIY eventually drift "in the system". I've known plenty of those too.
They just didn't want to deal with the medicalisation of the first step. I feel myself that
Posted on: March 18, 2008, 08:22:19 AM
While the SOC may say there is a fast track.
I've talked to enough people to know that in reality, at least in Montreal
in the public sector (which is the only one poor people would be able to afford)
you have to wait a very very long time for hormones no matter how
well adjusted and certain you are that you want them.
Private care is too expensive for A LOT OF PEOPLE.
and that's the only way to get HRT in 3 months around here.
What I hate is dogma.
The fact that TS is medicalised at all is a sad obligation because we
need access to HRT and surgery. So, it is to protect the doctor
and patient or they'd give your the letters right away. I can
get 20 operations on my face which will make me look like someone else
but need letters to get HRT? Not logical is it...
I sincerely did not mean to be condescending or insulting, but i atleast attempted to attack the points.
QuoteYou answer, by the way clearly shows
that you don't know what your talking about
You are clearly neither attacking my post nor the issues in this thread.
I do not think it is a matter of ethics. Anyone coming to Internet forum for advice of DIY hormones lacks the knowledge and good sense of keeping themselves alive. Then again people do all sorts of things knowingly to destroy themselves. I sure would not want to be a party to helping someone hurt themselves.
Dawn, you clearly attacked me
all your responses dripped sarcasm.
What would be the point of going into details
I can't do it on this forum anyway.
I said you clearly don't know what your talking about
because you seem to be spouting dogma
rather than looking at facts.
The facts are the risks are relatively low,
the reason, HRT now uses the same hormones as in
50% of humanity. The risks are different from having
T in your body, but that doesn't make them high.
T has it own sets of risks.
BTW, I am followed by my own doctor.
I have been in therapy for a long time
and I've been involved in the millieu
medicalised or not, to have a very
good idea of both sides of the equation.
Discounting with a hand wave is not an argument.
Its stridency I am against. I'm tired of it.
That's all, I'm not answering here again because I'm not
going to change your mind and your sarcasm won't
change mine.
So, hey.
The arguements here seem to be going in circles and getting too personal.
Therefore, I am locking the topic for a day.
Sarah L.
Posted on: March 18, 2008, 07:59:28 AM
I am unlocking this topic.
If things get out of hand again I will lock and or delete it.
Sarah L.
Quote from: lisagurl on March 18, 2008, 10:31:09 AM
I do not think it is a matter of ethics. Anyone coming to Internet forum for advice of DIY hormones lacks the knowledge and good sense of keeping themselves alive. Then again people do all sorts of things knowingly to destroy themselves. I sure would not want to be a party to helping someone hurt themselves.
Actually this is not true. Net is a good place to access medical articles as well as to compare different HRT regimens and to avoid mistakes.
What do you think people without knowledgeable doctors should do? Just eat "whatever" the GPs prescribe without problems? Use an endo that is used to treating menopausal women and does not have any idea of how estro needs differ between mtf and menopausal hrt?
There are three separate components:
- Where are the meds obtained from? - pharmacy+prescription or somewhere else
- Who decides the meds and dosages?
- Are lab tests needed?
Getting meds outside the official system can be illegal and cause potential problems. Then again it depends heavily on the source used, and getting a prescription is quite easy in many places.
Being informed about the dosages is very important. Most people I know get prescriptions from doctors but manage their dosing by themselves - and this is largery done by sharing information over the net.
Some lab tests are probably good. However the amount (and frequency) of tests required by different doctors varies quite a lot. Here liver function and prolactine are usually seen as the most important tests (and are taken yearly together with some others).