Just discovered part of my HRT has been discontinued due to an AI note taking error. Gynae did not say discontinue, and I have letters to prove it. Now I may have to be without testosterone until this is proven, which may mean another 6 month wait to resee a gynaecologist via NHS. Hopefully my letters will suffice, but currently unclear.
I am beyond furious. Also, wow. Fuck living in this dystopia.
Keep every medical record you get, you're going to need it in this new terrifying timeline.
Sorry for not being around, I've been busy. Doing what you might ask? Well, in the past year:
* Co-authored informed consent guidance for GPs, which is now published and slowly being adopted by care providers
* Worked on a website informing immigrants on how to access local healthcare and navigate insurance
* Participated in a few very small community research groups
Despite those things, there's always more to do.
Attempting to sidestep bad care won't necessarily improve outcomes and won't improve care for any other non-trans aspects of care.
Where OTC HRT proponents miss the mark, is that whilst it does remove a barrier, it makes it possible to fall into the river. Not everyone wants to (or can) manage their hormonal transition themselves, and by putting it on the shelves we won't be any closer to improving other aspects of trans health care, such as that which GPs and endocrinologists provide.
OTC medications are as a whole in the global north usually restricted for short term treatment of ailments. Painkillers after the big night out, antihistamines for the few weeks of pollen, loperamide after those bad microwaved leftovers. With very few recent notable exceptions (namely progestin based birth control), no other medications are intended for lifetime, consistent use that require ongoing blood work.
There's some patients that for very good health reasons should delay starting HRT or reconsider after further somatic (not psychological) evaluation, transmasculine people for example should avoid Testosterone if they are knowingly pregnant, even if they don't intend to carry to term.
In informed consent standards of care, an important aspect is the provider asserting the patient can give consent - they are of age, not impeded by impairment, have a legal guardian, etc. This could be facilitated by "behind the counter" administration, but puts burden on pharmacists, and may not prevent certain negative circumstances.
🧵 In some spaces, especially in some activist spaces some folks espouse a goal of trans emancipation as having over the counter (OTC) access to HRT. This has got a lot of issues and misses the mark on the problem, let me explain:
#transhealth
It's hard to see this presentation as informative, but only as performative information. Harm reduction and safety are dependent on having community who can disseminate good information and hold each other accountable, not from instructing an audience to take a picture of some compounding instructions on a slide.
There was some harm reduction in this talk, steering people who may choose self-compounding towards transdermal over injection but saying "Take as much T as you want, though... maybe" falls short. High levels of T is known to bring increased risk of polycythemia, which is commonly mitigated by lowering dose, blood donation/letting.
Thayer