Trans Health Care

Places to get affirming care

MyTransHealth.com  allows you to search for service providers: medical, legal, mental health, crisis in Chicago, Dallas, Miami, New York City, San Francisco, and Seattle.  There’s also an easy option to search for sliding scale services if insurance is an issue/becomes an issue.

Trans-Health.com/clinics – A list of clinics with experience in trans healthcare.

RAD Remedy (Referral Aggregate Database) contains a sizable network of providers around the US and more that are trans (and queer) competent, including care related to transition/affirming.  Allows the option to search for sliding scale providers.

Financial help

If you need financial support in affording health care (or id documents!), please go to this Trans Assistance Request Google form for an intake form for community funding.

Accessing hormones

  • Planned Parenthood prescribes hormone replacement therapy (HRT) and can sometimes cover some of the costs on a short term basis. For more info, see their website (and scroll down to see a list of which PPs offer trans* care.)  Planned Parenthood of NYC just introduced sliding scale trans* care at their sites as of 11/2016.
  • Many states have health centers which prescribe hormones: http://www.trans-health.com/clinics/

Stockpiling/sharing hormones

Ok, you guys know the deal:  this is about harm reduction, and people making the best decisions for themselves with all the information available.   The official medical and legal route is to find a trans-affirming provider who can work with your finances to provide you the care you need.  Taking hormones not written for you for a medical provider who knows your medical history and can monitor your labs can be potentially harmful to your health.  But having an awesome affordable provider isn’t possible for everyone.  Here’s some info to guide you in figuring out what risks you might be willing to take to get hormones.

Medical guidelines and dosing info
http://www.transhealth.ucsf.edu/tcoe?page=guidelines-feminizing-therapy
http://www.transhealth.ucsf.edu/trans?page=guidelines-masculinizing-therapy

 
Sharing
Testosterone (T) is a tightly controlled substance and, as such, is hard to get prescribed without direct reason. Cis men may be able to get a prescription for testosterone for hypogonadism (not producing as much testosterone as is considered “normal” for men), and some doctors will also prescribe testosterone to AMAB (assigned male at birth) people who are aging and experiencing a related drop in testosterone, and to AMAB youth who have not experienced puberty as early as expected. You may be able get a prescription for T that you do not need to use yourself and share it. Trans men use T in a variety of forms, including injectable and transdermal.
Most trans women and transfeminine folks who take hormones use 25-200mg of spironolactone per day and 1-8mg of estradiol per day. Cis women and AFAB (assigned female at birth) trans people can consider getting a prescription for spironolactone for acne or blood pressure. It is not recommended to get a combination birth control prescription for trans women and other transfeminine folks due to the increased health risks associated with such pills for them.

Hormone medications frequently used by trans women:
Estradiol 2 mg tablets
Spironolactone 50 mg or 100 mg tablets
Micronized progesterone 100 mg or 200 mg capsules
Finasteride 1 mg or 5 mg tablets
Depo-provera 150 mg injection syringes

 
Some trans folks will sometimes be willing to obtain a second prescription and fill it at a different pharmacy; however, this prescription will rarely, if ever, be covered by insurance.

Online pharmacies
Online pharmacies might be an easier/cheaper option for getting hormones.   Here’s some places heard through the rumor mill to be a place trans folks have gotten hormones from.

Inhouse Pharmacy

Alldaychemist

Strohecker’s Pharmacy

The GoodRX app and website offers coupons/discounts on prescriptions, and shows the costs for different pharmacies around you. You can use this if you don’t have insurance or instead of your insurance if your copay is higher. You must have an RX from a doctor first. It works with all types of prescriptions. (A month’s worth of T at CVS in New Hampshire is about $16 with this app.)

Talk to your provider
Ask your health care provider to code your visit / hormone rx differently – this may be difficult but it may help with insurance companies that will not pay for gender-affirming care.

Getting syringes

It is understood that laws permitting sale of needles and syringes without prescriptions are at the state level, rather than federal, so it is possible they’re not in special danger from Trump gaining office. But it’s not a bad idea to buy some syringes, too, while you can get them without a prescription. Both intramuscular and subcutaneous may be useful for you, for a trans person, or for someone else who just needs a clean syringe. Needle exchanges may also be a good source of clean needles; your mileage may vary and each will have its own rules for getting needles. NASEN has a list.

For Healthcare Providers

Check out Cardea Services and their many educational tutorials on topics such as Providing Care for Transgender or Gender Nonconforming Patients (they even include prescriptive regimens, labs to draw, etc.)  The tutorials are all free and also count towards continual medical education and continual nursing education credits. http://www.cardeaservices.org/resourcecenter/introduction-to-gender-and-sexuality-in-a-health-care-setting
http://www.cardeaservices.org/resourcecenter/clinical-care-for-transgender-and-gender-nonconforming-patients

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