Sunday, January 31, 2016

Nothing New Here In CT

The big news is only news there, here in Connecticut Planned Parenthood has been providing healthcare for trans people for over a decade.
Planned Parenthood Is Helping Transgender Patients Access Hormone Therapy
Slate
By Vanessa Vitiello Urquhart
January 29, 016

For transgender Americans, finding safe, affordable, and nonjudgmental medical treatment can be a struggle. Hormone therapy, which typically consists of testosterone (for patients seeking to become more masculine) or estrogen plus androgen blockers (for patients seeking a feminizing effect), is among the most commonly used treatments in medical transition. Across much of the country, it can be difficult to find doctors who are willing to prescribe the drugs required for hormone replacement therapy, and medical practitioners who choose not to prescribe hormones to these patients may be ignorant or insensitive to patients who come in to request them. Fortunately, a large national organization with a name most people are already familiar with has stepped up to bridge the gap in access to treatment for transgender patients. Planned Parenthood affiliates are increasingly offering HRT as one of the many vital health care services they offer to underserved communities.

Eric Ferrero, Planned Parenthood’s vice president of communications told me via email that at least 26 Planned Parenthood locations are currently offering testosterone or estrogen therapy to transgender patients and that the number of affiliates offering these services is growing. He added:
Last year, a new health center offering transgender services opened in North Carolina—and this weekend, a colleague of mine at a conference met a transgender woman from Tennessee who shared the huge difference it’s making in the lives of transgender people in the region. She said it was the only place within a 3-hour drive that would provide HRT, and she was so grateful to have that access. Those are the kinds of patients we have to reach.
The Planned Parenthood in New Haven has been providing Cross Sex Hormones since around 2005 and as they normally do they provide the healthcare and your ability to pay.
While all the other local clinics require a letter from the patient’s therapist before they will prescribe HRT, Planned Parenthood operates on an informed consent basis. This means that all patients whose bloodwork indicates they are good candidates for the treatment will be prescribed testosterone or estrogen and androgen blockers, so long as they understand the likely effects and accept the possible side effects that go along with it, after those side effects have been explained to them. This distinction can be crucial to poorer patients, who may struggle to afford the months of therapy that can be required before a letter is forthcoming. (There are still some questions about the informed consent model, due to worries about poorly prepared patients taking drugs that can have irreversible physical effects. However, informed consent has been widely advocated by transgender people themselves, many of whom have had negative experiences with gatekeepers preventing or delaying their access to these treatments.)
Okay, now for one of my pet peeves.

This article uses Hormone Replacement Therapy or HRT to describe the treatment of hormones to trans people. I use Cross Sex Hormones. There is a reason why I do this and that is because the levels on types of hormones that we take is many orders of magnitude greater than that is normally giving to women going through menopause and in an emergency situation that could be a matter of life and death. Those of us on a patch take around 0.100 to 0.200 mg of estradiol while those women on HRT are usually taking 0.025 to 0.050 mg of estradiol and also progesterone. In addition we usually take anti-androgens.

Why is this important?

Because of the higher dosages of estrogen we are more susceptible to DVT, Gallstones, elevated liver enzymes, weight gain, hypertriglyceridemia, cardiovascular disease, hypertension, type 2 diabetes, and breast cancer than if we were taking dosages equal to the levels used in HRT. So if you are being wheeled into an emergency room and they are asking you what meds you are taking and you reply HRT they might not be looking for the above diseases.

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