I always was a woman, simply one with a hormone deficiency. My being deprived of estrogen injections is like a diabetic prevented from taking insulin
For two years, I took injectable estrogen once every two weeks.
Id carefully expose the needle and draw out the thick liquid, filling the syringe, and tap out the bubbles. Then Id enlist a friend to help inject it. It typified to me that gender transition is a combination of strength from inside and community subsistence.
I will never forget my sisters try. She pushed too fast, separating the barrel from the needle, leaving half in my arm and the estrogen across my face. Otherwise, shes a terrific registered nurse.
But last year, my pharmacy was abruptly unable to fill my prescription, which I depend on the same route those with diabetes, thyroid failure, HIV or countless other now-treatable conditions depend on theirs. It was on backorder, I was told, with no further explanation. This was over a year before Out magazine reported on “the member states national” shortage last week.
My pharmacy offered to request a replacing prescription from my doctor for a double dose at a lower concentration. This is necessary weekly shootings, each of which left my arm or thigh sore for a few days, so I opted instead for daily pills which dissolve under my tongue.
Switching to pills was an easier decision for me than for others. Pills must be taken daily, which is easy to forget. Their contents reach the bloodstream indirectly, instead passing medicine through the liver, which can be dangerous over time. Many trans females, myself included, feel that shoots and the cyclic nature of the estrogen levels rising and falling across bi-weekly dosages feels more natural, and more effective, than the continuous levels from daily pills.
In whatever sort we take them, hormones are molecules that signal cells in the body to do specific things, like lines of software code. The more often they seem, the more that command is accessed. Hormones like testosterone and estrogen control our sexuality characteristics, especially in the womb and through puberty.
Amazingly, everyones body has an ability to respond to both males and instructions, depending on which hormones are present. Nobody fully understands what makes a person identify as a different gender than their body has developed. But for those working needing them, prescription hormones change the software our bodies run on. We are hacking our bodies to match how we feel on the inside.
This helps trans people to not only survive, but thrive. But it only works if the narcotics are reliably available and affordable.
My pharmacists were likely aware last year that high-dose estrogen injections would be scarce for the 18 months and counting. Reportedly, Par Pharmaceuticals, its manufacturer, must wait on new Food and Drug Administration approvals following changes in material suppliers. The reasoning feels nearly irrelevant to those whose lives are affected.
Making myself more feminine stops me from feeling disgusted by my body. I always was a woman, simply one with a deficiency of a certain signalling hormone, which my body so comfortably responds to now. It is about being seen as my truest ego, and recognizing the effort it has taken to realize her.
Missing hormones, on the other hand, while not immediately lethal, will lead to anxiety, depression and the return of certain male featuressuch as spontaneous erectings, which trans women find uncomfortable and frightening. But taking female hormones treats the dysphoria above all, as if tweaking my brains coding alongside feminizing my body. It lifts many of us from the clutches of self-harm or darker thoughts.
Trans people have teetered long enough on the fringes of medicine that this shortage would seem to be yet another stumbling block against getting acceptable care. The FDA continually uncovers itself to be a body of bias over basis, as it doubled down on enforcing obsolete limiteds upon gay male blood donations and in effect considers trans females to likewise be men who have sex with men.
This regulatory issue pertains to US distribution merely, so some daughters may seek estrogen through other channels or countries. There are reputable US compounding pharmacies that fill prescriptions by mail, but going overseas or to black market induces it harder to be sure what you are buying. Plus, you have to pay out of pocket.
For decades, it was difficult to find doctors willing to discuss trans medicine, let alone insurance willing to cover it. It is endlessly frustrating to receive anti-retroviral drugs I will take forever by monthly dole, remembering to place refill orders quarterly, and sorting out the inevitable glitches therein, such as doctors who accidentally write dispense 30 when they entail 30 days worth.
The FDA could do well to fast-track this bureaucratic debacle and help us trans women us get on with our wonderful lives. Until then, were stuck in an uncomfortable holding pattern, never certain if well be able to feel like ourselves, a state most people have the luxury of taking for granted.
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