Self-medication and providing guidance?

[Melissa Jill]

I know self-medicating is a massive no-no, but doesn't providing guidance make sense? Telling someone they shouldn't do it in all likelihood isn't going to stop them doing it, so really shouldn't we at least offer the best advice to give other trans-people the least risk from self-dosing. Lives could certainly be saved from doing this.

[Miranda-E]

that would be the sensible approach, but will rarely be allowed.

[Katesback]

Think I take the approach that natural selection puts forth. The strong will do thier homework and learn while the weak will take risks.

[Bree-asaurus]

The information is out there if you want to find it...

I don't recommend doing it yourself, but understand that in some situations it's all you can do. Before I even talked to a doctor about HRT I had found out everything I needed to know myself. Google is a girl's best friend.

Here in San Antonio, we have one doctor that prescribes. He's super cool and all, but really has no idea what he's doing. I take it upon myself to do my own research, and sometimes my own medicating and decisions regarding bloodwork.

I'm sure there are people willing to talk about this kind of stuff with you, but you're going to have to first show some initiative and learn all you can on your own. After all it is your responsibility and the information is pretty easy to find.

And honestly, if you can have a doctor on your side, that will be beneficial for events later on in your transition. I don't know why you would want to skip a doctor's help, when later on he can write letters of recommendation for name/gender changes and surgeries...

[StaceyJane]

I did a lot of research before I started HRT. I was lucky to find a doctor who knows what she's doing. I do have to drive a bit but I feel better working with a doctor.
I went into my first appointment knowing a great deal about HRT. When she told me she wanted to start me on spiro first I understood what the drug is and what it does.

I know that people can get the info online easily enough and I understand why it's the only way in some circumstances. The problem I have is when I see what dosages people are using so many times it seems like way too much. I know people want results but they have to understand that more isn't always better, especially when your blood levels aren't being monitored.

[Bree-asaurus]

I know that people can get the info online easily enough and I understand why it's the only way in some circumstances. The problem I have is when I see what dosages people are using so many times it seems like way too much. I know people want results but they have to understand that more isn't always better, especially when your blood levels aren't being monitored.

Yeah I agree. I don't think many people that self-medicate get any kind of blood work done. There are places that you can get tested for specific levels without a doctor's prescription... but I don't think many people who do this without a doctor's supervision care, unfortunately. They just want their candy and they want it now and they don't want to have to ask for it.

[Lorileah]

Issue #1, you are not a medical professional with a patient/doctor relationship. Thus you would be giving medical advice without a license.

Issue #2. if something untoward happened you would be an accessory and since you ar beyond your area of expertise giving advice that could cause illness or injury, you would be liable

Issue #3, you don't know the person on the other end. If they are adult or minor, mentally stable or not, healthy or not.

It is illegal to give advice as to treatment or diagnosis without a client patient relationship (read you have actually seen the person) and especially without being certified and licensed. Just because you think you know something doesn't mean you can give advice. Legally and ethically you would be practicing without a license

[Kaitlyn Michele]

Transsexuals have been "breaking the law" since the 50's...our predecessors made the rules because of desperation and the fact no one cares about us..there were no rules...transsexuals made the rules as they went..and even today have to game the system to get treated the right way...

After having seen what i have seen, and knowing what i know, i could care less about what laws say about transsexual women that are honestly trying to start HRT...
any means neccessary includes getting a doctor if possible, and if you are stupid you will skip blood tests that can save your life...but otherwise there are lots of well known honest HRT sources out there outside of endo doctors (that often refuse us)

I worked hard until i found my medical pros...3 therapists and 3 doctors until i found the right ones... that was my choice...

[Bree-asaurus]

Transsexuals have been "breaking the law" since the 50's...our predecessors made the rules because of desperation and the fact no one cares about us..there were no rules...transsexuals made the rules as they went..and even today have to game the system to get treated the right way...

After having seen what i have seen, and knowing what i know, i could care less about what laws say about transsexual women that are honestly trying to start HRT...
any means neccessary includes getting a doctor if possible, and if you are stupid you will skip blood tests that can save your life...but otherwise there are lots of well known honest HRT sources out there outside of endo doctors (that often refuse us)

I worked hard until i found my medical pros...3 therapists and 3 doctors until i found the right ones... that was my choice...

That kind of defines the tone of our ordeal... "any means neccessary"

[arbon]

Information is shared - I've gotten all my information from the net and from other trans women, just not on open forums like this. My doctor so far has just gone along with what I was doing self medicating (really other then the occasional blood work I am still self medicating for all intents and purposes).


The problem I have is when I see what dosages people are using so many times it seems like way too much

Not just those that self medicate - consider the wide range of dosages and regimes prescribed by doctors - it is all over the board.

[Hope]

The new WPATH SOC recognize this fact, and accordingly have removed every barrier to obtaining responsible medically supervised care. So there is really NO excuse for self-medicating.

It is impossible even for a physician, to make a good diagnosis and put together an appropriate treatment plan for someone on-line, no matter how detailed a history a person could provide.

If you want to start HRT - awesome. But go to a physician and do it responsibly.

[Cindi Johnson]

The information is out there, it's just not here on this site. I'd be willing to bet that more TG's self-medicate than use the medical system, at least here in the USA. Face it, our health care system sucks in this country, particularly for those who are younger, poorer, less-educated, and less white. (Which is not the demographic of this website's users.) And the drugs are readily available, again via the wonders of the internet.

If you have no complicating issues (obesity, smoking, diabeties, STD's, etc., etc.,) then the risks involved- at low dosages - are not really great, in my opinion. But of course there are risks. This being a free country (more or less), my belief is that an individual should be allowed to take the risks she chooses to take.

I know that this is not the predominate view here. I've been dissed too many times by the oh so many "experts" on this site when I acknowledged self medicating and when I've argued that, for example, not all TG's need therapy. I expect more of the same now (it does get old, though).

So, to answer the OP, such discussions and information can be useful to the many girls who lack access to the existing health care industry, but this is not the site for such discussions.

[Julia_in_Pa]

To self medicate is understandable and I've had many many friends that have done so.

If I felt I had no other choice at that point and time but to do so then by all means I would self medicate.
Do your homework and study types of medications, dosages and side effects.

Do what you have to do that's all I'm saying.


Julia

[Kate T]

The new WPATH SOC recognize this fact, and accordingly have removed every barrier to obtaining responsible medically supervised care. So there is really NO excuse for self-medicating.

It is impossible even for a physician, to make a good diagnosis and put together an appropriate treatment plan for someone on-line, no matter how detailed a history a person could provide.

If you want to start HRT - awesome. But go to a physician and do it responsibly.


Issue #1, you are not a medical professional with a patient/doctor relationship. Thus you would be giving medical advice without a license.

Issue #2. if something untoward happened you would be an accessory and since you ar beyond your area of expertise giving advice that could cause illness or injury, you would be liable

Issue #3, you don't know the person on the other end. If they are adult or minor, mentally stable or not, healthy or not.

It is illegal to give advice as to treatment or diagnosis without a client patient relationship (read you have actually seen the person) and especially without being certified and licensed. Just because you think you know something doesn't mean you can give advice. Legally and ethically you would be practicing without a license

To the above add:

1. If something goes pear shaped who is going to pay for fixing the problem? Medical practitioners have professional liability (or "malpractice") insurance for a reason. If it is a drug problem then the manufacturer will have to foot the bill.

2. Persuant to above without medical supervision and documentation of doses how are we supposed to develop and advance our knowledge of best dosing regimes, adverse event reporting.

3. Where are you going to get your meds? Internet? There is a MASSIVE quality control issue (especially for you guys in north america where some of the stuff getting around is little better than contaminated sugar pills from china, india or mexico / south america).

I am not sure what the situation is in the US but certainly in Aus and the UK you essentially get free / massively subsidised visits to a GP, and even if your regular GP can't help you there are a number of Gender health centres that typically have GP services as well for FREE!

I know my mothers Endocrinologist did a lot of TS work and basically he "bulk billed" all his TS patients after the first consult. (Bulk Billing is a term used in Australia where the patients medical fees are covered by the national health insurance scheme known as Medicare).

[josee]

There is a Yahoo Group with this topic as it's main focus. Might find some info there.

[Jaimie]

doesn't providing guidance make sense?

If someone wants to know more about hormones they should rely on legitimate sources. Medical journal articles can be found on at:

http://www.ncbi.nlm.nih.gov/pubmed/

There are a few excellent review articles on the endocrine care of transsexual people that can be found on PubMed. If your doctor is inexperienced with administering hormones to transsexual people you can refer them to the same articles. And of course both the patient and the doctor should be familiar with:

http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf

[Kelsy]

The warnings about self medicating need to be heeded but the vast majority of people who do self medicate have no problems. The risks are real!
There is an advantage to self medicating, once your therapist or doctor becomes aware that that is what you are doing they will in most cases fast track you to presciption medications once they check your physicals. I think the reasons for self medicating need to be explored though. why do it?? Is it money? I've found that prescription hormones are cheaper ,more reliably effective, and are readily available. Do you think that taking hormones on the sly for some fantasy fulfilment is a wise thing to do? well If it has something to do with a sexual fetish it could hinder you male sexual function. Maybe you just want some nice boobs, chances are you'll get your wish and the guys at work will have an appreciation of the new you! Or is it something else? Therapy will help you understand what drives you before you change how your body and mind work. hormones will change how you think and how your body functions. If all of the changes are welcome and you fell relaxed and comfortable with the new you then chances are this is what you needed from the start!

I self medicated for a year and a half after researching what the risks and effects would be. I even even did things like take a low dose asprin because I was deathly afraid of deep leg thrombosis and blood clots etc. I did it secretly because I was out to no one. I wasn't completely truthful about who I knew I was. I came to a point where I knew I could hide no longer and that is when I sought out a gender therapist got things figured out and started telling the truth.

Kelsy

[Aprilrain]

I was self administering hormones for about 6 months after I got my letter for hormones from my therapist. The reason I did this is I could not get an appointment with the one Endo in this city who sees trans patients. They literally said don't call us we'll call you! I was not about to wait some undisclosed amount of time to see a doctor when I already had had blood work done and every thing was normal besides I'm young and healthy. Meanwhile I attempted to find a GP who would prescribe hormones for me. Most would touch the subject with a ten foot pole and the one who would prescribed a third of what I was taking. She would not order blood work for hormone levels but I did get the most thorough STD panel available in spite of the fact that I had only been with one woman in the past ten years. She said hormone levels were unimportant. What? As far as the supposed reports of "fake" Internet drugs, I had no problems what so ever getting real estrogen and real anti androgens from the big on line pharmacy that pretty much everyone uses. I know it was the real deal because when I finally got that appointment with the Endo my hormone levels were more or less with in normal ranges for a female. Sugar pills and toxic waste don't do that. I like my Endo but it's still up to me to make sure my hormone levels are where I want them to be. When I finally saw the doc h just asked me what I was taking and wrote scripts for exactly that! This was before we had the results of my blood work! It's clear to me that even the "experts" are tossing darts blindly at a dart board.

[Kristy_K]

I also self administering hormones for about 6 months by using the information found on the net. When I started seeing a Dr. and did my blood work I found out I was over doing for my body and put my liver at risk. Finding and telling the right therapist isn't as bad as one may thinks it would. A good therapist is your friend and will help you.

Kristy

[Miranda-E]

To the above add:



I am not sure what the situation is in the US but certainly in Aus and the UK you essentially get free / massively subsidised visits to a GP, and even if your regular GP can't help you there are a number of Gender health centres that typically have GP services as well for FREE!

I know my mothers Endocrinologist did a lot of TS work and basically he "bulk billed" all his TS patients after the first consult. (Bulk Billing is a term used in Australia where the patients medical fees are covered by the national health insurance scheme known as Medicare).

The situation in the US is simple. If you aren't one on the lucky few with health insurance. simply talking to a doctor can be 10%-25% of your monthly income.
If you have not so great insurance, you have to fork over cash for the copay at time of care.

[arbon]

I started self medicating because I could not find a doctor. My therapist was willing to write the letter but was telling me I was going to have to go to portland (14 hrs from where i live!) or seattle - that the only doctor she knew in the region that was working with trans people retired and most of her trans patients were traveling out of state. I tried my regular GP and got a no and that she did not think any of the other local doctors would be willing to either (she said she talked to a few of them about it for me). she told me I had to go to a gender clinic or center -like at Hopkins or Standford or some place like that - she was about 20 years behind I think and I tried to explain that to her but oh well.

Did find a doctor a few hours away that some sisters pointed me to, but...I don't know. She told me to not to worry about the levels, she does not need to check them they don't tell her anything anyways (she felt my breast and said what I was doing seemed to be working and to keep doing that). And when there was something off on my blood work (not hormone related, I hope) the issue of course became one of insurance to do more tests, which I don't have, so no tests. Which is my problem not hers, I know that. Without insurance, or lots of cash, well your just kinda SOL.

I would love to find a local doctor - long term that is a goal, because I am not the only trans person in this county and it would be freakin wonderful if we could get a doctor here to help us out a bit. This state is like in a blackhole for trans care. But at $150 to $175 a pop for a simple office visit to try to talk one into it - It could get real expensive real quick being told no.

Self medicating is not a good thing. I don't like that I have been doing it, it is not something I would choose to do normally, and I no it is a huge risk but I was and am willing to take it. It is what it is. It was something I felt I needed to do.

I am really grateful that there is so much information available on the net and people to share their experiences.

[Kate T]

Do you not have any gender centres or the like that offer subsidised or free medical services to TG people who cannot afford "standard" medical fees?

[Traci Elizabeth]

We have Safe Harbor on here where dosages can be discussed. From my experience with Safe Harbor, someone will ask the question of what doses are you taking for HRT? And a lot of us respond with what "WE" are taking not what you should take. But it should not take a scientist to figure that one out.

[giuseppina]

Perhaps not, but what happens when you're getting too much to be healthy? That's where an endocrinologist comes in.

Hormones aren't my thing, but for those who want them, please go to an endocrinologist. They know when things are at the right dose, and when things start to go awry, evidence in bloodwork usually appears before something life-threatening happens.