Wednesday, September 21, 2016

Playing With Fire

The healthcare system here in the U.S. is broken. Over the weekend they had a free dental clinic in Hartford and over a thousand people lined up to dental work done. The trans community is also facing a healthcare crisis.

To transition it cost money, money that many insurance programs don’t cover. Money for electrolysis, money for therapy, and money for hormones.
Sketchy Pharmacies Are Selling Hormones to Transgender People
Burdened by cost and medical discrimination, many people are taking a do-it-yourself approach to transitioning.
The Atlantic
By Gillian Branstetter
August 31, 2016

After meeting a few transgender women at the famed music and arts festival, Andrea decided to pursue her own transition. But when she sought out feminizing hormones through clinics around her home in Philadelphia, she ran into lengthy waiting lists and high costs. So she decided to experiment on her own. She ordered Estradiol, a commonly prescribed form of estrogen, and Spironolactone, a testosterone blocker traditionally prescribed to transgender women, from an online pharmacy without a prescription.

Andrea’s decision to manage her own transition outside of a doctor’s care is common. With a lack of transgender-related services across the country, as well as discrimination from medical professionals and insurance companies, many transgender patients are conducting their own hormone replacement therapy, a regiment of medications meant to help them develop some of the secondary sexual characteristics of their gender identity.
When I first started on CGH therapy back in 2004 my insurance didn’t cover the Estradiol and I had to pay for it out of pocket, almost $200 for a three month supply from an online pharmacy. Now that insurance pays for it I pay the same price because I have to pay the deductible gap but at least I am buying it from a U.S. pharmacy.

The other problem is,
According to Joshua Safer, the medical director of Boston University’s Center for Transgender Medicine and Surgery, Katherine’s story is common. “The big roadblocks are lack of providers who have been willing to provide the treatment in the first place and lack of financial support,” he says. “It is still the case in much of the country … that transgender individuals will reach out to their existing and logical providers and are told ‘I don’t do that. I won’t prescribe you those hormones. I don’t feel comfortable.’”
Trying to find an endo is near impossible and those who work on an informed consent is even harder to find. But self medicating is even riskier, hormones are very powerful and they should only be used under health provider supervision.

Then there is a problem of being shunned by doctors because we are trans…
Safer believes this hesitance is less a matter of malice than it is a matter of ignorance. Still, he sees discrimination as an “enormous” problem within the medical community. He admitted to hearing “snide jokes” and “honest, hostile opinions” of transgender patients from his colleagues. “There are still providers with outright hostility,” he says. “I have a patient who reported coming in for a broken limb to an emergency room and being sent out of the emergency room because the doctors determined they were trans—which is entirely unrelated to the situation.”
This is such a real problem!

Trans men have a hard time finding an OB/GYN to take care of their medical needs.

A trans man who co-presented with me at a training for homeless shelter staff said the other day said when he was found with a heart problem during a routine exam they rushed him to the hospital. When the ER doctor found out he was trans and on “T” the refused to treat him and told him to go back to the doctor who prescribed that “shit.”

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