An Old Medical Crisis Is New Again
With a side order of Thoreau.
The Washington Post is reporting on a new trend: trans people skirting medical best practices to maintain access to care, in particular uninterrupted hormone therapy. To be clear the story also reports on other measures QTs are taking as well, but the headline of the piece, “LGBTQ+ Americans stockpile meds and make plans to move after Trump’s win,” obviously highlights these efforts to create medical back-up plans.
What is not stated in the piece, and what always bothers me about this type of otherwise good reporting, is the missing historical context: The new trend isn’t new.
Back in the early 1990s when I first came out, it was positively common to take medications prescribed for someone else while trying to navigate a gatekeeping system designed to deter as many people as possible from medical transition. While many didn’t do this, many did, and given the lack of demographic data and the underground nature of these actions, it’s impossible to say just how many times this happened. What is possible to say is that it started at least as early as the 1960s and was common enough that there was a euphemism for underground access to hormones. If you wanted to share with someone that you’d started your medical transition even though you hadn’t yet found a doctor willing to prescribe your hormones for you, you could say that you “found” some. In Portland the euphemism was that you found your estrogens “on the bus.”
For some weird reason maybe only trans guys will understand, an FtM friend of mine told me he found his T “in a sock.”
Trans people with competent doctors would share information about their dosages, which could be double checked with other sources, and others with friends willing to pass along hormones would access a prescription through their own doctors. Sometimes this came in the form of birth control pills, which (depending on the formula) can contain the same drugs prescribed for medical transition, though not always in the same ratio. It would be up to the individual to determine how to take the pills to, as closely as practical, approximate the doses that the individual thought best.
Let me be clear: hormones are generally well tolerated by the body, but this is a bad and dangerous system. The dangers aren’t huge, as drugs go, or are huge but take decades to manifest (like very high hormone levels increasing the risks of some cancers) with plenty of time for a doctor to help out later. Extremely high doses of hormones would be much like smoking cigarettes in this example: yes, the eventual danger is incredibly serious, but if you only smoke for a year or two until you get in to see a doctor that gets you off of that shit, both long term and short term damage are likely to be very, very low. On top of this, different people are different: there’s no knowing whether you might be a rare person who doesn’t tolerate hormones well, and without training in endocrinology, you’re unlikely to see any warning signs early.
Trans people need and deserve appropriate health care, but history has shown us that we will find ways to access medicines whether or not society chooses to make this easy or even legal. If you think testosterone isn’t floating around every gym frequented by cops, you’re fooling yourself. They’re constantly dosing themselves illegally with steroids and T. If there are people willing to sell testosterone illegally to guys they know to be cops, it’s not going to be hard for FtM guys to gain access. And if you think that it’s hard for a trans person cut off from estrogens to find a lesbian friend who is perfectly happy to get birth control pills from their doctor, you’re absolutely nuts.
The WaPo story highlights one person who is, apparently legally, stockpiling medicines to last, “a few weeks if federal lawmakers banned her care.” They might be skipping a single day each week in order to slowly build up that stash, or they might be exploiting the fact that monthly prescriptions are generally refillable after 28 days because people have lives and the convenient day to go to the pharmacy isn’t always the day you take your last pill from a bottle. This, too, would allow someone to slowly accumulate medicines. This is not particularly good, but at least it represents someone under medical supervision, and missing a dose here or there of any medication is fairly typical in the real world.
But for those who have reached the point of dipping into that stockpile after having lost a doctor, or who access hormones from other, illegal sources, proper medical supervision won’t be possible. This has the potential to return us to the 1990s (or even the 1960s). That’s bad, but it’s not new.
It’s disappointing to see a media outlet like WaPo, a large enough organization with enough experience to know that this isn’t the first time trans people have hoarded hormones, act as if trans history does not exist. They can and should be aware of how this has played out in the past, and how banning trans care doesn’t end it any more than banning abortion ends that. In both cases, it just adds unnecessary risk for the individual and costs for society.
Thoreau often said that in an unjust society, the place for a just man is prison. I don’t like where we’re headed, but we have faced lack of care before, and I know just how damaging living in the closet can be. If an adult trans person came to me unable to access hormones through legitimate channels with appropriate supervision, so long as they came across competent to me, you can bet I’d help them find some hormones on the bus. The theocrats can simply raise their own taxes to pay to keep me in prison if they want to stop me.
Crip Dyke also writes for the delightfully cussmouthed Wonkette!
You could also follow me on BlueSky. Pretty sure that would make you cool or something.
I think one thing to keep in mind as well is that the people who are potentially banning trans healthcare are essentially Christian nationalists and don't care about the health and well being of trans people, let alone women or poor people or really any minority group. They don't care that banning abortions leads to more unsafe abortions. To them, people like that aren't people and they should suffer consequences up to and including death. They don't care that banning trans healthcare leads to riskier sources of hormones and suicide because to them, trans people aren't people and they should suffer the consequences up to and including death. Same principle applies to black and brown people, people with other religions... The point to them is not to make the world safer or better, it's to cause suffering for these groups so that they might become their idea of 'Christian' or die off completely, whichever comes first. And the things also is, at this point basically all mainstream media has been bought by people who basically buy into this whole framework. Of course they're going to frame these groups negatively.
I say this as a trans person. They won't erase us. They tried back on May 6th, 1933, they failed, and and they're not going to succeed this time either. We will do everything we can to thrive regardless of what the monsters think of us and try to do to wipe us from history and the world.
My husband got testosterone cream for... something. (Not that, people!) He had a bad reaction and quit soon, but he got all the refills and gave them to our FtM pal. And that was in this century!
In original packaging, of course, with the labels peeled off.