I am a 22 years old, and a college student that currently is not employed. I used informed consent to start HRT. A lot of people make assumption about those who use this route and their providers. Informed consent means that a person can sign a paper stating that they understand the dangers, benefits, and side effects of a treatment.
This option means that no note from a therapist is required to start HRT, testosterone in my case. I have seen people make horrible comments towards those who have done this route and about their providers. Informed consent has a stigma of being a lesser way to transition, more dangerous, reckless, and only done by people who are not well informed.
We need to stop shaming people for utilizing informed consent to pursue HRT and other gender affirming procedures.
The first myth is that everyone who is pursuing this route is in more danger.
Just like you can have a physician that is not the best for primary care the same goes for HRT. Not all doctors take the precautions they should or educate patients, but that does not describe the majority of physicians who do informed consent. An outside person would give a perspective that leads you to believe guys are getting T from shady back alley deals.
Instead, what you will find is that there are a lot of low cost clinics that offer this option. Their doctors are a part of a practice that is oriented towards education and cost effective care without gatekeeping. The doctor has to explain all the risks, benefits, and side effects of testosterone. Then they need to perform blood work to determine if you are healthy enough to start testosterone. Only if your blood work is good and you sign the paper after having everything fully explained are you prescribed testosterone.
No doctor that has a good reputation and practice is just throwing T at guys because they ask for it. Then my doctor for example, requires you to schedule your follow up appointment and bloodwork right after your visit or she will not send your prescription to the pharmacy. My levels initially were checked every 3 months. Now that my levels are stable we have moved to every 6 months, but my point is that my levels are being monitored. When my dose was too low she was concerned. I had extra blood work ordered to check on my heart and liver. The doctor is very detailed in her care.
The next myth is that people choose informed consent only because they are impatient or are uniformed on the side effects.
There may be some people that fall into these categories, but a lot of transguys do informed consent for four reasons:
- There is a therapist who has seen them for months or over a year that will not issue them a letter without good reason
- There are no trans friendly therapists in their area
- You have single practioners or small clinics doing HRT that usually do not provide the service because of population size or the conservative nature of the area
- Simply not having enough money to pay for seeing a therapist every two weeks for an unknown period of time.
Not everyone is privileged to have doctors and clinics that regularly provide treatment to trans patients. Some guys have either had to educate doctors or utilize smaller services than most are accustomed to utilizing. Then there are some therapists that take a while to give out letter without good reason. For some people that means giving a copay or paying full price for weekly or biweekly visiting for an undetermined piece of time.
Lastly, a lot of guys claim that those who chose informed consent are uninformed.
That simply is not true. I have seen guys who are following WPATH guidelines post basic questions about T that they should know from basic research. I have seen guys already on T that did not do informed consent complaining about changes that are basics that come with T. My point being that there are uninformed parties on both sides, but guys who do informed consent are not less informed. We need to stop placing a stigma on something because of a feeling of jealousy. I know some of these guys truly just want everyone to be safe and healthy during transition, but there are those that are simply jealous about someone getting on T sooner and in their opinion easier. How that person came to transition is not an attack on how you transitioned.
As a guy who did informed consent I feel isolated at times. If I bring up informed consent in a conversation I either find myself in an argument or not being taken seriously because I did not get on T in the “proper” way. Gatekeeping should not lead to the next trans suicide. Be kind and listen to others that have done informed consent. You would be surprised with how many that would not be here if not for that option.
By Quinten Bolden