The four most important things I learned during my first year of transition
A transwoman’s perspective
Published: October 2, 2013
3. An alarming number of transgender women self-medicate
Until fairly recently, psychologists required trans patients to do what was known as the real-life test before they would write a hormone-recommendation letter clearing physicians to prescribe hormone-replacement therapy. The test required those wishing to transition to live full-time as the gender they were transitioning to for several months. The real-life test was particularly unfair to those who had a harder time passing, as HRT leads to the development of the secondary sex characteristics of the gender one is transitioning to. WPATH-SOC (The World Professional Association for Transgender Health’s Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People) still mandates that transgender individuals seek counseling prior to HRT. WPATH-SOC is nonbinding, but it still heavily influences doctors worldwide. A lot of trans individuals are uncomfortable with the idea of someone playing gatekeeper with their gender. After one obtains a HRT letter they still have to worry about the cost of an office visit and bloodwork that most insurance companies won’t cover. These combined transition expenses can amount to hundreds of dollars before one can even get a prescription. Another reason self-medication occurs is because a lot of doctors don’t know what to do with us. Some doctors will outright refuse to treat a trans patient, citing that they don’t know enough about our medical needs or that they don’t approve of us. Some transwomen live in areas where no medical help is available to them at all. HRT is dangerous, and self-medicating can be deadly. Living with gender dysphoria can be a living hell, and many transwomen gladly take the risk and self-medicate. Almost every transwoman I’ve met has admitted to self-medicating at some point in her transition. FTMs have a harder time self-medicating, as testosterone is harder to procure than estrogen.
4. People might be more supportive and understanding than you think
I was expecting doom and gloom when I came out. To say that I expected the worst would be an understatement. I always knew that it was OK to be yourself, but for some reason I didn’t believe that applied to me. I know it’s sad, but I was convinced that I’d become be a pariah if I said I was anything other than a cisgender heterosexual. I was truly overwhelmed by the love and support that was shown to me after I came out. No one sent me hate mail or deleted me on Facebook. Instead more than 100 people swiftly gave me kind words of support and congratulations. I never would have expected that and it touched me deeply. I haven’t come out to everyone in my family yet, but the ones that know have been very supportive. My aunt has helped me with some of my medical expenses, and my mom gave me some of her old clothes. If anyone reading this is still in the closet, I implore you to come out regardless of where you fall in the LGBT spectrum. You’ll probably find more support than you ever imagined.
> Email Audrey Bergquist