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 And all too often, that DIY will be done based on incomplete or outdated or just plain wrong information, all of which the web is overflowing with.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.