If enacted, the Missouri rule will require people to have experienced an “intense pattern” of documented gender dysphoria for three years and to have received at least 15 hourly sessions with a therapist over 18 months or more before receiving puberty blockers, hormones, surgery or other treatment.
Patients also must first be screened for autism and “social media addiction,” and any psychiatric symptoms from mental health issues will have to be treated and resolved. Some people will be able to maintain their prescriptions while undergoing the required assessments, which aren’t affordable for many.
“Do-it-yourself hormone replacement therapy” has become an increasingly common way for trans residents of restrictive states to avoid involuntarily stopping hormone treatment.
This online marketplace, known as the gray market, is comprised of unregulated suppliers who sell legitimate medications, sometimes name-brand, outside the distribution channels authorized by the manufacturers. Some trans people in GOP-controlled states that have not yet enacted bans are buying from these suppliers to build an emergency stockpile.
But self-administering hormones without adequate supervision can be “extraordinarily dangerous,” especially for those taking testosterone, said Dr. Robert Lash, chief medical officer at the Endocrine Society, which represents specialists who treat hormone conditions.
Although taking testosterone can help trans men develop some desired physical features, it also increases their risk of a blood clot or stroke. Lash said doctors need to closely monitor a patient’s red blood cell count, lipids and liver function and adjust their dosage accordingly. Estrogen use can also increase risk of blood clots, he said.
Source: DIY trans care evades barriers in Missouri, other states