For those who are not transitioning or simply do not know what Self Medicating is, let me explain:
Self Medicating HRT is done when a transgender person takes Hormone Replacement Therapy on their own without a doctor's supervision and/or consent. In theory, when one takes the necessary steps to transition to another gender the following is usually adhered to (according to the standards of transgender care):
1. Counseling with an approved Psychologist or Psychiatrist.
2. If the Counselor finds you are ready (either mentally or physically or both), then your Doctor will ok the use of HRT. He or She will write a letter approving you to seek out these medical part of your journey.
a. Hormone approval time is different for everyone and is different in various countries. Some therapists require you to be in therapy for however long he or she finds you are ready. Some therapists even require you to live out the Real Life Experience first (living fulltime in your preferred gender).
b. Again, this is different depending on the country you reside in and their own established set of parameters for transgender care.
3. You seek out an Endocrinologist. Typically, you seek out an Endocrinologist who is sympathetic or understands the transgender processes. Some Endocrinologists will not place you under their care. Some Endocrinologists will. It all depends on the doctor.
4. The Endocrinologist will then do a series of blood work and tests to determine if you are a candidate for Hormone Replacement Therapy. The blood work is done primarily for two reasons: 1. To make sure you are healthy enough to do this and 2. To monitor your progress of the newly introduced hormones in your body.
5. While you see your Endocrinologist for ongoing lab tests, he or she will then make changes to your HRT or keep it the same depending on your results.
6. Real Life Experience (RLE) for typically one year at the minimum for SRS letters. Typically, in the United States, you are allowed HRT before doing the RLE. I know in some countries, they require you to do some time of RLE prior to HRT. RLE is extremely important because why you are utterly convinced you know you are the other gender, the RLE will make sure that your feelings are truly gender oriented. RLE is not as simple as it sounds.
Wearing makeup, skirt, and everything girly out in public can be a real challenge when you do it for the very first time. Many therapists highly recommend you to do this one a part time bases. I, however, went fulltime RLE right off the bat and it was during my first day of classes at Seminary. After the first 50 minutes of our orientation day, I ran into the bathroom and threw up. The social changes you go through when you do your RLE on the first day can be very intense. RLE is a therapist's boot camp way of knowing if you are really serious about this and trust me, if you do RLE and you ease into it, then you are serious.
7. Recommendation for Sexual Reassignment Surgery (SRS or GRS) (or Feminine Facial Surgery or Breast Augmentations). The final step is the letters for the final process of your "medical" aspect of transitioning. Some transgender girls forgo this part because they feel they do not need SRS to feel complete.
Now I mentioned the entire list because as you can see, the Hormone Replacement Therapy covers steps 1, 2, 3, 4, and 5. My point is, it is a very involving process.
Your body literally goes through a metamorphic change. Your scent may change, your breast may grow larger, your skin may become smoother, your body features may become more soft and curvy vs hard and rigid and you will go through some emotional changes. Eliminating one hormone in your body that your body is very used to and then introducing an entirely new hormone into your body is a big deal!
There is so many changes that do go through your body both mentally and physically that I find it to be more wise to seek out the proper steps to be properly medicated versus trying to do it on your own.
There are many reasons why people self medicate:
1. They may be married and not "out" to their spouse or partner. Going through this medical steps will be very difficult to hide who you are. Ordering these medications from the internet and shipping it to a PO Box is a lot more easier for them.
2. They may not be able to afford all those necessary steps needed to be legitimately prescribed HRT. Let's face it, in the United States we do not have a very good health plan. You either work for a company that gives it to you at a highly discounted price or you don't have it at all. If you have no medical insurance, seeing a therapist for months will become very expensive.
3. They may have medical insurance but their provider may not cover HRT for transgender people as some insurance companies do not see it as a "necessary medical intervention." Many Endocrinologists will label the diagnoses in a manner where it will be covered but there are those insurance companies that will outright refuse your prescriptions.
4.Some may not want to go through the standards of care but just want to jump right in and start "pill popping."
I know many girls think "oh i heard it before but I never knew one person who got sick." Well, I knew of three who died and two who have had major strokes. And I have only transitioned for about two years now. So, yes. It does happen. It really isn't a scare tactic to make you see a therapist or doctor.
Please understand the medical complexities and workings of the drugs you are taking. For example, I knew a girl who was popping in 400mg of Spiro daily. Good lord. 400 mg is overkill and the only thing she was doing was destroying her kidneys because of all the sodium being sucked out of her body at rapid successions. She often complained she had to pee every twenty minutes. Hmm...maybe because she was eating spiro like it was Candy Canes??
I knew of another girl who was popping in 14 mg of Estrogen daily. Not only is 14mg of Estrogen daily very, very, very expensive (especially without a prescription) but it was also wasteful. Your body does not metabolize 14mg of estrogen like that. The only thing she was doing was destroying her liver and to this day, she does have abnormal liver function.
Know the right amounts you should be taken. This is probably the most important thing to know.
Here are some disadvantages to self medicating
1. You have no idea how effectively it is working in your system. When a doctor does lab tests, he or she does that to make sure you are getting the full effects of HRT. Randomly popping in pills and gauging if its working because your nipples are sore is not a good way to monitor your progress.
2. Its crazy expensive if you don't know what you are doing. For example, a three months prescription of all the HRT you will need typically is about 35 dollars. (depending on your insurance company). I knew some girls who were spending 250 a month (750 dollars every 3 months) on HRT.
The bulk of those expenses were on massive doses of Progesterone. If you take massive doses of progesterone without medical supervision you minus well be playing Russian roulette. Its about as deadly. As you can see, 35 dollars is a little bit more cheaper than 750 dollars.
3. You have no idea what you are ingesting. True, there are some reputable overseas pharmacy companies you can order from but there are also so many out there that will put fillers in your medication. You may think you are ingesting a pure pill but most of it could be corn starch. Unless you have a lab at home, you simply do not know. The medications you are taking when prescribe comes from FDA approved pharmacy companies that has strict codes of Legislation. India, for self medicators, those codes are not as strict.
When it comes to self medicating, I will never judge anyone. I will never put anyone down for self medicating or give them "what for." However, you may see me expressing my concern over your safety if you tell me the levels of HRT you are taking or what combinations that may be deadly.
A friend will always help a friend from doing something from inadvertently hurting themselves. It is not judging but it is only through love that I would try to help someone where if they are self medicating that they need to know how to do it right.
Please be safe. Please research your drugs and quantities.
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