trans-axolotl:
would people be interested in a post about DIY hrt from a harm reduction perspective
okay fabulous i love being trans and love harm reduction so this is great. usual disclaimer that this is not medical or legal advice. this is drawn from my own + community experiences plus internal resources from the org I work with.
DIY HRT and Harm reduction
Most important things to know: DIY HRT is one possible way to access hormones, and there are safer and riskier ways to DIY HRT. In the context of increasing transphobic legislation in the US, I think it’s important that people know their options and can discuss this without having to deal with our community putting moral judgments onto DIY HRT. I’m not going to spend a bunch of time getting into super specific information about dosage, methods of HRT, or where to find HRT, because a ton of that information is on this website which I highly recommend! Instead I’m going to be focusing on how to make informed decisions about DIY HRT and how to understand the risks.
Source Safety
When getting HRT without a prescription, it’s important to consider the reliability and safety of your source. When at all possible, finding a healthcare provider who will provide HRT under the table is a good way to ensure that what you’re getting is actually legitimate HRT. The next safest option is buying from a legitimate online pharmacy that provides pharmaceutical-grade hormones. This is where research + community knowledge comes in. Reading reviews, talking to other trans people, or buying from known sources in your community is a way to help reduce the risk of getting a product that is not legitimate HRT. When buying without a prescription, there is always some risk that what you are getting includes other chemicals, is for veterinary use, or has other contaminants. Checking your hormones before usage for anything odd, like bits floating in the liquid instead of pure liquid, for example, can be a good way to reduce risk. Overall, it’s important to know that there are some risks involved with how you source your hormones, which is why talking to community members, reading reviews, and learning about trusted sites + people can be an important step for safer sourcing.
Injection Safety
If injecting your hormones, it’s super important to know safe injection practices, especially if you have challenges accessing a consistent needle supply.
- Do your shots in a clean, sanitized environment. Wash your hands and use alcohol swabs on your hormone vial, your injection site
- Avoid sharing needles with anyone else. Sharing needles puts you at a higher risk of acquiring HIV, HEP C, and other bloodborne illnesses.
- Avoid reusing your own needles if possible, as it increases infection risk.
- If you must reuse or share needles and have no other options, clean needles with bleach first! Check out this handout for more info.
To access free needles and syringes, check out this directory of harm reduction organizations that provide needle exchange services.
Legal Safety
Estrogen, spironolactone, and other anti-androgens are not controlled substances. They are legal to buy online in the United States.
Due to the absolute bullshit that is the Controlled Substances Act and the War on Drugs, Testosterone is considered a Schedule III substance. This means that it is illegal to buy and sell testosterone without a prescription in the United States. Realistically though, the risk of conviction for possession in a DIY HRT situation is currently incredibly low. A study following Anabolic Steroid Cases in US district courts from 2013-2017 found that there were only 63 cases in those 5 years, and that most cases were for selling steroids online or in the context of other criminalized substance convictions. (Decrim now for all drugs, including testosterone-check out this resource to learn more about decrim)
So, what that means is that the legal risk for buying DIY testosterone is relatively quite low, but it is still good practice to be intentional and considerate about what information you share publically, especially if you live in a state with gender-affirming care bans. To reduce risk, it can help to share information privately among trans circles, not admit DIY HRT use to any law enforcement, and not bring unprescribed testosterone through security checkpoints on planes, for example. We don’t really know how new transphobic laws are going to affect prosecution right now, so it’s good to be cautious without fearmongering or overexaggerating risk.
Miscellaneous
Regular blood testing is a good way to keep an eye out for any medical complications and also adjust dosage when needed. For intersex people, much of the available information online about DIY HRT is likely relevant to us, although we might have some additional needs or concerns. There isn’t any widely available data that really explores what gender-affirming HRT looks like for us, but anecdotal community evidence suggests that we usually get all the same effects, but will often experience a different timeline than dyadic trans people. Depending on our variation, we might need a lower dose than dyadic trans people because of our existing hormone levels. Blood tests can help track our levels and signify to us if our dosage is too high and our testosterone is converting to estrogen, for example. When doing DIY HRT as an intersex person, it can be important to research the other medications we might be on and understand the role they play. If we are already on an anti-androgen medication, that’s really important info to know before adding more HRT.
Overall I want to link this harm reduction guide specifically for HRT, and just affirm that DIY HRT has a long history in trans communities, and that this is something we have always done. HRT is absolutely not a necessity to be valid as a trans person and there are so many ways to exist as trans. However, it’s important for us to acknowledge that DIY HRT is a method of HRT that can sometimes be more accessible for us, and that it’s important for us to have access to accurate information that helps us make decisions about what’s right for us. hormones are fun and fabulous and i support trans people getting them in whatever way works for us!
