I was planning to write a longer post for this mega and then Silksong happened so... oops?
Short version is this week is my 9th tranniversary. I don't remember which day exactly so I like to say it was 9/11 so I'd never forget. What ultimately cracked my egg all those years ago was not the deep yearning when looking at women that I couldn't identify as envy or the increasingly intense and umm horny dreams where I had the power to instantly change my gender. No it was that fucking faceapp gender swap filter. I just kept staring at that pic like it was a mirror into an alternate universe where I was happier and suddenly everything clicked into place. The first few years were hit or miss with a lot of other life changes happening at the time that interfered with getting properly started so in some ways it's more like a 5 or 6 year tranniversary but whatever. 
It's weird to say I'm almost done but I really am so close to making all the changes I wanted. I'll never stop being trans, but I'm definitely moving from trans(itioning) femme to trans(itioned) femme and that's quite exciting. And maybe a little wistful looking back at the journey.
Have a good week everyone!
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Because DIY isnt, like, easy or straight forward and you have to deal with crypto and its still good to have an endo/prescriber who can figure out your lab values but also help you deal with mental health shit and fertility shit (the two most common concerns with the transgender patient population besides gender affirming care). Some people have insurance that covers meds and otherwise have to pay out of pocket for DIY.
I get the fear that a doctor might not be an ally to say the least. Knowing how to get DIY is a good skill even if you have a great doc who has your back. And I get that doctors aren't all geniuses who know the WPATH in and out - or know when to ignore the WPATH recommendations and go with current research. I don't know how to handle the balance of risks and benefits with yall yankees.
its not the fear of a doctor not being an ally (though many such cases) but the fact that most doctors dont got a bloody clue what they are doing when it comes to trans healthcare period, or just dont care to know. also you really dont need a doctor to read two numbers from a lab and compare them to well known baselines.
i feel like calling getting prescription E "easy or straightforward" is just sugarcoating it, especially right now when its so unstable. the amount of hoops you potentially have to jump through is significant.
the US govt (yes this is a US centric post as stated, but it also applies to like... many places at the moment) is actively trying to collect everyones medical records, is actively trying to ban trans people from existence, and is actively throwing people in concentration camps. i dont see how recommending someone go risk that over at least researching diy is a good idea.
It's been said already, but going through doctors is a necessity for surgery. That's not to imply DIY is worse or anything, just the reality of the situation. The risk of medical history being used maliciously is an acceptable risk for someone in this situation.
At least when I started 1.5 years ago, it was super easy and straightforward (as someone with insurance, not a minor, and in a large state with informed constant) despite being in Texas. Figuring out the grey market seems much more difficult (and expensive). Of course the lack of reliability means that I'd want backups (either stockpiles or being ready to switch to DIY). Also Texas specifically has also shown it wants lists of trans people for some reasons and I'm sure it not for anything bad (/s), so maybe not going through official means makes a lot of sense.
Im definitely not saying people should be prescription only. I think grey market is good and is part of how we as a community stay resilient. I think its important to get people on HRT as quick as possible and, yeah, that usually means grey market. But DIY isnt an easy process and crypto isnt easy so there's reasons why people suggest going through a doctor still.
I know people have had shitty experiences with doctors. I have my own experiences, and I trust mine. I have a different set of experiences because my docs were through the gender clinic or through a trans healthcare thing specifically. I work with a bunch. I work with a bunch of dumb ass doctors and I work with a bunch of genius doctors that make me glad Im not doing their jobs.
Its not just 2 lab values, it depends on what youre taking. Monitoring E and T levels isnt difficult and you can do that on your own for sure.
😭
This is the main reason I’m even looking into non-DIY as an option. The other reason is the potential for surgeries at some point.
That said, it seems like the safer and more stable option is DIY, and like you said that’s a good thing to know how to handle anyway. I’m strongly leaning that’s direction. I tend to have a bit of a DIY streak anyways, and I super do not trust medical records to be in any way private.
Hey just so you know, in most states you can get your own labs without seeing a doctor in person. Plenty of people are using DIY HRT with the same lab tests you would get from Planned Parenthood.
Good to know. This isn’t the first time you’ve dropped some helpful knowledge on me. Thank you!
You're welcome! If you have any questions about blood tests I'm happy to share what I know.
US Politics
Even prior to more recent events being able to get HRT through your Dr in the US was a crapshoot at best, and within the past 9 months there have been consistent and escalating legislative attacks against trans healthcare. Even in the few areas where HRT via prescription is more easily accessible, there is anxiety around how reliable and stable that will be moving into the future.There are also many instances of hardline advocating for HRT via prescription being paired with hardline anti-DIY sentiment. As not straight forward as it can be, there are gonna be circumstances (that I would argue happen more often than not) where DIY is going to be the most simple and reliable way to get HRT and giving information and assistance regarding DIY is gonna be significantly more constructive than insisting the "proper" way is through a doctor
Yeah I agree, DIY is absolutely part of how trans people should know to get HRT. Yeah it can be faster and it means no one can shut off our medication just cause some legal bullshit.
So I don't live in the US. But I have seen many trans women with either completly ineffective, or dangerous officially prescrived hormones regimes here. The diy girlies generally speaking have better hrt regimes here, cause they have more of a clue and motivation than cis doctors. Docs are neglectful at best, ime. (I also have an endo I ignore, cause he is neglectful, just so that the insurance knows I am trans. And to give the prescription E to others)