Reply To: What were you feeling when you began Hormone Replacement Therapy?

Marianne Tornander

I have not started HRT and probably never will be able to get it or any other procedures through the medical system in Sweden. Stating this I have often met skepsis and disbelief so l will take this chance to explain my situation.

The onlY legal way to transgender care in Sweden is through one of eight national gender clinics working under NHS (and they plan to make them three to save money and concentrate expertise). Formalized in the worlds first law about “change of identity in special cases” the once very progressive system, though being somewhat updated, now seems very old school.
Having anything done medically and/or legally still largely requires a diagnosis of gender identity disorder/transsexuality set through lengthy contacts with a team of a doctor, psychiatrist, psychologist and councellor and the waiting lines to most clinics are several years as their budgets haven’t been increased anywhere close to the demand. Once you’ve managed your way through all the road blocks and gate keeping, and have the diagnosis, you are eligible to have any reasonable gender affirming procedure virtually for free, short only of FFS (and even that can be provided on an individual basis in exceptional cases and may be generally available in the future).
The cost for any medical appointment through the National Health Service in Sweden is capped at $30 per visit and $125 per year for aults and free for children up to age 18, no matter if it is getting prescriptive cough medicine, giving birth, having an advanced cancer treatment or a full genital reconstruction and breast augmentation combo. The rest is on the taxpayers through the government and health care regions functioning as both universal insurance companies and providers. So whatever you need done there will be no immense medical bills to pay, making you go into bankruptcy.

The crucial thing is how to define and determine need. For the pregnant woman coming in with contractions or the highly anemic child with leukaemia the need is unquestionable and for an intersexed person wanting their groin looking ‘normal’ for one sex or the other having that done seems reasonable, but what about us, falling under the transgender umbrella? However you look at it there is technically nothing wrong with most of our bodies. The relevant pieces are in place and work the way they are supposed to. It is our minds that to some extent disagree with our default factory setup, triggering a multitude of possible psychological reactions with consequences that may ultimately lead to self hatred, self destruction and attempted suicide. The only viable solution msy be to transition, but a transition can very well add a bunch of new problems and it is usually the job for the therapist to help you decide if it will be advisable for you or not. In many places in US the therapist is no longer mandatory for having HRT but in Sweden their opinions have much more leverage and you have to convince them there is a great desl of suffering going on to get their recommendation, something l could not do.

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