Reply To: Pursuing their HRT as “informed” and self medicating

[DeeAnn Hopings]

I realize that some trans people do self-medicate, for any number of reasons. In my estimation, there are some particular reasons not to.

https://www.bumc.bu.edu/endo/clinics/transgender-medicine/guidelines/

This passage is significant:

Monitoring for transgender women (MTF) on hormone therapy:

1. Monitor for feminizing and adverse effects every 3 months for first year and then every 6– 12 months.
2. Monitor serum testosterone and estradiol at follow-up visits with a practical target in the female range (testosterone 30 – 100 ng/dl; E2 <200 pg/ml).
3. Monitor prolactin and triglycerides before starting hormones and at follow-up visits.
4. Monitor potassium levels if the patient is taking spironolactone.
5. BMD screening before starting hormones for patients at risk for osteoporosis. Otherwise, start screening at age 60 or earlier if sex hormone levels are consistently low.
6. MTF patients should be screened for breast and prostate cancer appropriately.

It is likely that none of these would happen if self-medicating. I would have to think that monitoring these various things have significance, else why make them a part of the process?