Seriously considering self medicating (UK)

[Windy]

Hey all,

I've had a...difficult time with Charring Cross gender clinic, the main one for people in London who want to get hormones. I was away in a different county for uni, and my application was passed around (or just fobbed off) for 2 years without anything happening. Things started to move when I got to Bristol for my masters course, but CX again managed to fub things; I got struck off the database because they apparently hadn't received my psychiatric report, even though my GP had sent that in. Twice. And then charring cross found it again. I appreciate my gatekeepers aren't malicious (only embarassingly incompetent). Waiting times are about six months for a first appointment, but I'll be off to Sweden in January for 4 years.

I'm an academic, I have to go where the money is (and there aren't many places where it is!). I told this to CX, and sent in a letter asking to speak to someone there about it (as they requested, oddly they don't have an email) a month ago now, but apparently they still haven't received it!

This is becoming very frustrating now. I've come close to the "edge" several times before, and really I can't wait much longer to start HRT. What are my options, if there are any? I apologise for the sob story...

[arbon]

You probably wont get much support for that here. They'll just say you have waited this long, whats another 6 months or 4 years?

Do what you need to do, but research as much as you can. There lots of info out there on the web. Even discussion groups.
And if you do it try to get into a doctor to get blood test done on your own dime. Be honest about the tests you need and why.

[I Am Paula]

I'm assuming this is some form of socialized medicine ie National Health. My Mother hated the National Health, it's Doctors, it's hospitals, and anything else to do with it. She went only to private Drs. and hospitals. She had to pay for it, but so be it. Does that option not exist for you?

[GretchenJ]

I would be EXTREMELY CAREFUL about Self Medication as it can be quite dangerous.
Maybe take all of your medical documents to Sweden with you and see if you can find a doctor over there.

Best of luck and take care !!!
http://www.transgenderlondon.com/self_medication_and_hrt.htm

[Dawn cd]

Any chance you could get treatment in Sweden? I realize that may not be covered by National Health, but there must be some arrangement for medical care while you're there. Do you plan not to get sick for four years?

[Rianna Humble]

It seems that you have had some problems, but as you say it is not down to malice.

Sweden is in the EU so has some reciprocal healthcare arrangements with the NHS. Why don't you look into what they provide?

As Arbon says, you will not get much support for the idea of self medicating here - it is just too risky when you have the possibility of doing something the legit way. If you are willing to risk your money on self-medicating, what about trying for a private consultation with a non-NHS Gender clinic?

[chelyann]

please rethink this,, but if you do please be very careful-- Good luck

[Alex R]

To echo the advice above: Don't!

Have a read at
(http://www.northernconcord.org.uk/Drugs.htm) http://www.northernconcord.org.uk/Drugs.htm

I know it's not cheap to go private compared to the NHS - especially the consulations and blood tests - but if there's any way of taking that approach it's a zillion times better than self medicating.

[Ariamythe]

I'll add my own two cents to the chorus: self-medication seems like a bad, bad idea. Hormones don't just kill erections or give you budding breasts; they impact every part of the body from skin to bones (http://transgenderscience.tumblr.com/post/62891984704/why-transfolk-should-not-self-medicate-hrt) in some way. You're basically doing a big 180 on your entire endocrine system. That's not something to be undertaken lightly! Because of this, HRT carries with it increased risk factors for things like diabetes and deep vein thrombosis. Doctors know how to monitor for signs of complications; you do not.

And one other thing? Self-medicating women have less satisfactory breast growth (http://www.ncbi.nlm.nih.gov/pubmed/23055547), probably because they aren't getting their levels measured and meds adjusted properly.

Situations can suck and gatekeeping is awful and the need to transition can be maddening. But self-medicating is not the solution it seems to be.

[bas1985]

Hi Windy, if the Avatar picture is you than you are already quite feminine, and young.

I know it hurts, but in this case it is better to have someone expert driving. I have to wait the Italian gatekeepers too,
and it is SLOW. Probably I can start HRT not before April-May next year. It hurts. it is a pain to wait but that's life.

[robindee36]

Sounds like you are, rightfully, frustrated with the medical system.

While I am not an expert, there is enough published to conclude HRT is a serious undertaking. Doing it without basic blood chemistry monitoring could leave you in a world of hurt. Serious organ damage, who knows what other mal effects.

In our youth we are all 10 ft (3.05m for the rest of the world) tall and bullet proof. However, that is not the reality of it all and we can damage ourselves. My suggestion is to forego the self administration route, even though you can purchase the meds on line. Either get to the mainland and find a doc there or pony up the cash and see a private doc in the UK. I assume you can forego the NICE and purchase private medical services?

In any case, perhaps patience and a diligent options search would be wise.

Best of fortunes in whatever path you choose.

Hugs, Robin

[arbon]

Self medicating does come with higher risk. But a lot of us have done it, including myself.
My earlier post was not a judgment about whether you should or not. Its up to you.
All the information is out there, it is easy to find.

[LeaP]

Given any reasonable and common combination of anti-androgens and estrogen, I'm not sure that risk is higher so much as it is unknown. Having hit one problem myself, I'm not going to advocate self-medicating, either. But then, I'm not in your position. As I asked in another thread, sometimes I wonder if care guidelines cause more problems than they solve. Seems that particular unknown risk is acceptable in medicine.

[ameliabee]

Seriously y'all? Cut the dogmatic idiocy. Lol, titty skittles suddenly become EXTREMELY DANGEROUS when you order them in as opposed to picking up a prescription. Absolutely ridiculous. Can't take your rears to Susan's? It's almost like this kind of madness is cooked up by a bunch of bitter old trans women who want the younger ones to suffer further testosterone poisoning.


I'll add my own two cents to the chorus: self-medication seems like a bad, bad idea. Hormones don't just kill erections or give you budding breasts; they impact every part of the body from skin to bones (http://transgenderscience.tumblr.com/post/62891984704/why-transfolk-should-not-self-medicate-hrt) in some way. You're basically doing a big 180 on your entire endocrine system. That's not something to be undertaken lightly! Because of this, HRT carries with it increased risk factors for things like diabetes and deep vein thrombosis. Doctors know how to monitor for signs of complications; you do not.

And one other thing? Self-medicating women have less satisfactory breast growth (http://www.ncbi.nlm.nih.gov/pubmed/23055547), probably because they aren't getting their levels measured and meds adjusted properly.

Situations can suck and gatekeeping is awful and the need to transition can be maddening. But self-medicating is not the solution it seems to be.

Spreading lies and misinterpreting statistics. Classy, yo.

-----

OP, do your homework, but as long as you're safe about it and don't have any conditions that would interfere, by all means, do what you must.

[Ariamythe]

Ameliabee, if there's something I posted that's a lie, by all means correct me on it. I can cite published studies that support everything I said. Can you?

[Aprilrain]

I did it for about 6 months when I first started. By the time I got in to see the Endo all of my blood work was normal and my hormones were in the range for a female. Do what you have to do but deffinetly get in to see a doctor about blood work within 6 months of starting.

[LeaP]

... titty skittles suddenly become EXTREMELY DANGEROUS when you order them in as opposed to picking up a prescription. ... It's almost like this kind of madness is cooked up by a bunch of bitter old trans women who want the younger ones to suffer further testosterone poisoning.


"titty skittles" - um, seriously? Just who isn't being serious here?

From a population statistics standpoint, HRT isn't particularly dangerous, particularly in the short-term (<1 year). There was a recent study to that effect ... though the subjects were monitored (obviously).

From an individual standpoint, you don't know WHAT risk you are assuming. Individuals don't assume population risks, they have their own. You either will have a problem or not. 100 or nothing. If you are unmonitored, you don't know your platelet counts, your prolactin levels, your potassium levels, your liver enzymes, etc. If you are self-monitored, you are better off, presuming you know enough. Better know your ankle-brachial index, too - oh, you don't have a doppler wand? OK, skip the circulatory thingy. No, wait, that's only for old people, isn't it?

"... as long as you're safe about it and don't have any conditions ..."

As if you would know.

Why not just be honest and tell people that you believe that assuming risk in the dark is OK?

Sheesh.

[Marleena]

It's almost like this kind of madness is cooked up by a bunch of bitter old trans women who want the younger ones to suffer further testosterone poisoning.


Well that got my attention! I was hoping for at least older and wiser.:D I hope I don't come across as bitter? Older and wiser would be nice and just urging people to be careful and be monitored for potential risk factors.

[robindee36]

I'm not going after that bait Marleena, sorry you got snarked. I'm with you though, the girl asked for ideas, options, and there were a variety offered.

Sad that one particular point of view needs to be isolated and vilified. Its just a bloody opinion. People need to play nicely in this sandbox and respect of differing perspectives is what adds value to this forum.

Age does not equate with wisdom; neither does lack there of make a girl omniscient.

Hugs all, Robin (Yeah, one of those older girls)

[LeaP]

It's not "just" an opinion, Robin. It's a judgment with consequences. I'm not going to say that there are no circumstances under which someone should ever self medicate. I don't believe that. What makes the OP interesting is that Windy's circumstances beg the question.

Examples:

One might reasonably self medicate if the risk of not doing so is greater than the risk of doing so.

One might self medicate if there is no other option.

One might self medicate if they have (actually have… important distinction) the knowledge and means to monitor properly.

Etc.

What I don't buy is the BS that you can simply assume it's safe.

I also don't buy the BS that going ahead is a calculated risk, based on one's own self-assessment of health. Most people know some things about their health with reasonable certainty. That doesn't mean they have all of the facts and knowledge relevant. That is what makes it an unknown risk and not a calculated risk.

But, as I said above, that doesn't mean you shouldn't go ahead anyway, at least in some circumstances. But people really should be honest with themselves about what they're doing.

[Ann Louise]

It's frustrating because I wrote a thoughtful, reasoned response to this OP very early today and of course my box crashed. And if you're doing some or all of this already, then please please excuse me. This post is for others, too, so please bear with me. So here's the condensed version, and once again IN MY HUMBLE OPINION ONLY:

1. Take care of your facial, breast, hand, arm, leg, and genital hair. By whatever means. It will take years. It is a genuine long term and expensive pain in the @$$, and it hurts everwhere; good training for your other surgeries,

2. Study, observe, ask, and try out clothing yourself as a woman. A plain old every day working blue-collar or professional woman. Not a teen x-dresser, not a mid-twenties experimenting with an "adult" look. And not an old bag trying to look 35 years old again. Get it figured out personally for you. It will take years to get this down properly, and to present yourself with dignity and self-respect.

3. Study, and observe the way the woman you admire and want to emulate truly act. How they comport themselves. They stand differently, walk differently, hold and swing their arms and legs differently, and make eye contact with strangers differently. It will take years to figure this out flawlessly.

4. Don't do internet endocrinology. Just reading T, E, and potassium levels are not enough. An endocrinologist uses your entire blood panel, your actual physical exams, your entire medical history, and even the way you strike her eyes when she first sets them on you to assess what's going on with you. If you don't kill yourself, you very well could screw up your initial physical transition, and if you thought the long wait for bona fide HRT to get going took a long time, it will take years for you to try to remediate any herbal/illicit estrogen t-blocking you try to do yourself with an internet degree in endocrinology.

5. The psychological tone that you will set for yourself from here forward will be tainted by the misguided notion that you Really Are That Smart, and that you did just fine. You are messing with the rest of your beautiful life. You have the chance to be a beautiful woman instead of a bundle of could-haves and should-haves that will take years to get over, if ever. And finally,

6. YOUR VOICE. There are many arguments here about the role that female voice actually plays in your genuine life. Some say speak softly, some say just raise your pitch, some way use up and down, sing-song inflections. Some speak down to you as if they were Ph.D'd phoneticians. Some use you-tubes, some use "straw phonation, and some spend hundreds og $ on DVDs and voice coaches. Point is it takes most of us years to get the voice right.

There's plenty to do pre-HRT honey. Just get with it.

Love you (really) Ann

[Cheryl123]

No, Wendy your problems are due to maliciousness. They are due to an incredibly horrible system of medical care – in my opinion of course, and perhaps this is an isolated example. I hope it is. But it is absolutely appalling that you could go for two years without receiving treatment. I am so sorry. By all means get a ticket to Stockholm if you can get treatment there, assuming you can afford it.

Yes, there are dangerous to taking hormones on your own. But there is also a huge danger in continuing to live without HRT. Only you can decided which course is better for you. You can also explore the middle ground. Purchase your own hormones in the short term and at the same time find a doctor or clinic to provide medical supervision. Hopefully after another year you will be accepted into the system and have your program adjusted accordingly. (I am not advocating this approach, merely mentioning it). It goes without saying, do your homework if you decide to go this route.

Regarding risks, all of the studies I have read use a very small sample size. None of the studies compare the risk of taking hormones to the risk not taking them (i.e. a life of depression and worse) And with older trans-women (over 40) when problems arise from estrogen use, it's difficult to separate whether the problem was caused by the estrogen or from pre-existing conditions and poor life-style. Regarding young adults and adolescents, the latest study in the Netherlands (July 2013 issue of Clinical Endocrinology News – it's on line) found the short term (1 year) use of moderate doses of estradiol and cyproterone acetate to have only a low risk.

I hope you will be able to find good medical care soon.

[Rianna Humble]

Cheryl, your total ignorance of the way that healthcare works in a country other than your own does not excuse you ascribing Wendy's delays to malice.

Wendy has several options in this country short of buying stuff on the Internet that contains {deity} knows what! Before you accuse me of scare mongering, the dangers of buying any kind of medication from Internet providers are well documented and it is only days since someone over here died from buying slimming tablets online that turned out to be rat poison.

As she is willing to buy stuff outside the legitimate supply system, she should be willing to consider a private clinic - a road that some other UK members have trodden before her.

As I said above, the UK and Sweden have reciprocal health care agreements so it will not be a case of if she can afford it. The risk of not taking hormones for a few more months is nothing like as dire as you portray.

[Bunny Girl Zoe]

I was self medicating before was put on them but i advice not to as risk's as high with self medicating but if you go down that path then please get regular tests done, and start with low dose. But my advice to anyone thinking of it is not to, yes nhs waiting is a right pain but lot better under there care than diy root.

[Kelly DeWinter]

Lets get back on topic, there is no sense in getting a honest request thread closed because of petty bickering. To the OP . There are other threads where people have had success with CX for treatment. perhaps there is another issue, it sounds as if there is not proper followup/record keeping somewhere . Can you have copies of your records sent to you and then you send them in ? Self Medicating allways seemed to me to be an act of desperation to me . Is there something in your treatment that is causing CX to NOT want to start treatments for you ?

[LeaP]

... The risk of not taking hormones for a few more months is nothing like as dire as you portray.

Probably not, but I have to say that the very long timelines, multiple referrals, and procedural issues associated with trans care I read of in the NHS system come off as incredibly problematic to me. This may not be malice and may have budget justifications, etc., but but does not strike me as good health care in this instance.

I wonder what the incidence of self-medicating in the UK is vs. other places. Seems like that might be a useful indicator.

[Nigella]

As Rianna has pointed out, the NHS is not the only route for us UK girls, but it is the slowest. AFAIK all the surgeons (all 3 of them at present) are private, the Gender Clinics we are referred to get their funding from the users own funding authority and can only deal with a certain number of new referrals per year. At present, I am taking a place at the clinic, even though I have had SRS. Not until they discharge me from the Gender clinic, will my place become available for a new referral. It may just be a case of demand outstripping supply, but that is one of the pitfalls of a universal care system. I guess, if you can get it free, go for it, but be prepared to wait. Want it quickly, jump the queue and go private.

As for self medicating, that is an individuals choice. The general consensus, which is right IMHO, is don't. The OP and anyone else who asks about this way of getting hormones have the right to do as they wish, they have asked for advice, it is given freely, its up to them what they do with it.