WEBVTT - Hormone Replacement Therapy: Part Two 0:00:05.200 --> 0:00:08.479 Welcome back to It Could Happen Here, the podcast about 0:00:08.480 --> 0:00:11.120 things falling apart and sometimes how we can put things 0:00:11.160 --> 0:00:15.720 back together. I'm Garrison Davis, aspiring Rebus, and this is 0:00:15.800 --> 0:00:18.480 part two of my little two part series talking about 0:00:18.560 --> 0:00:23.520 trans hormone replacement therapy. Last episode, we discussed what HRT is, 0:00:24.079 --> 0:00:28.080 it's various benefits as gender affirming treatment, and the informed 0:00:28.080 --> 0:00:32.280 consent model of receiving hormones. Before we continue on with 0:00:32.280 --> 0:00:35.000 my discussion with Dr Grieve, I would like to talk 0:00:35.040 --> 0:00:38.560 a bit more about informed consent. So the informed consent 0:00:38.600 --> 0:00:41.680 option can be great for many many people as it 0:00:41.720 --> 0:00:46.120 attempts to bypass some of the red tape around receiving 0:00:46.200 --> 0:00:49.159 gender reforming healthcare. For its form of consent, all you 0:00:49.159 --> 0:00:51.839 gotta do is set up an appointment, signed the forms, 0:00:52.159 --> 0:00:54.360 maybe get some blood work done, and then pick up 0:00:54.360 --> 0:00:57.360 your hormones. Right. You don't need to live as trans 0:00:57.480 --> 0:01:00.360 for like two years or have letters from therapyest s. 0:01:00.640 --> 0:01:03.319 It's it is. It is just up to you, so 0:01:03.360 --> 0:01:05.600 it is it is really convenient if you can get 0:01:05.600 --> 0:01:08.440 that option. Some places even let you do it via 0:01:08.600 --> 0:01:11.639 telemedicine appointments, so you can just sit at home holding 0:01:11.640 --> 0:01:14.360 your little, I kea shark and then get your hormones, 0:01:14.400 --> 0:01:18.400 which does sound very very nice. Planned Parenthood offers informed 0:01:18.400 --> 0:01:21.200 consent trans health care in many states, and in the 0:01:21.200 --> 0:01:23.800 show notes I will link a Google map of the 0:01:23.840 --> 0:01:28.240 informed consent clinics from across the country. Depending on your insurance, 0:01:28.319 --> 0:01:30.720 you can get hormones for a little to no extra cost. 0:01:30.840 --> 0:01:34.360 This way it can be really convenient. The biggest asterisk 0:01:34.520 --> 0:01:38.040 for informed consent is that since it's based on you know, 0:01:38.280 --> 0:01:42.720 informed consent, it often is just for humans age eighteen 0:01:42.800 --> 0:01:47.400 and older, or sometimes teens a few years younger, but 0:01:47.560 --> 0:01:51.760 only if their parents or guardians signed the forms. Obviously, 0:01:51.800 --> 0:01:54.640 this is not ideal for a sixteen year old with 0:01:54.760 --> 0:01:58.000 transphobic parents, who would really be helped by receiving like 0:01:58.120 --> 0:02:01.960 hormone blockers or something right. Another potential drawback is that 0:02:02.000 --> 0:02:05.400 the clinics can sometimes have quite the wait list. I 0:02:05.480 --> 0:02:08.320 started off with the informed consent model because it was 0:02:08.560 --> 0:02:11.760 the easiest, but by the time I needed more blood 0:02:11.800 --> 0:02:15.320 work done and my prescription refilled, setting up more appointments 0:02:15.320 --> 0:02:18.680 that Planned Parenthood became kind of a nightmare. I was 0:02:18.720 --> 0:02:22.600 continuously having appointments being canceled on me last minute. And 0:02:22.600 --> 0:02:26.000 just getting pushed back months and months into the future. Eventually, 0:02:26.080 --> 0:02:28.800 I just resorted to getting hormones through my regular doctor 0:02:28.840 --> 0:02:32.080 instead of just continuing on with informed consent. Now, this 0:02:32.160 --> 0:02:34.880 is obviously a regional issue, right I. I don't know 0:02:34.919 --> 0:02:37.880 what it's like in Florida, for example, but the COVID 0:02:37.919 --> 0:02:40.880 andeen pandemic has stressed a lot of the medical infrastructure 0:02:40.919 --> 0:02:43.920 here in the States, and scheduling some appointments in these 0:02:43.960 --> 0:02:48.320 clinics can be still quite challenging. And as you know, 0:02:48.680 --> 0:02:51.160 a big theme of this show is that maybe we 0:02:51.160 --> 0:02:55.560 shouldn't assume the structures that hold up our society are concrete, 0:02:55.639 --> 0:02:59.520 permanent fixtures. The term the crumbles that we used to 0:02:59.520 --> 0:03:03.080 describe the slow deterioration of the systems that we rely on, 0:03:03.600 --> 0:03:06.560 was initially coined in reference to our medical system by 0:03:06.600 --> 0:03:08.959 a friend of the show who works in the medical field. 0:03:09.440 --> 0:03:12.160 Listen to the first five episodes of The Daily Show 0:03:12.280 --> 0:03:15.800 talking about climate change for more on that. But a 0:03:16.000 --> 0:03:19.480 part of the Criminal's idea is trying to learn how 0:03:19.520 --> 0:03:22.040 to become less reliant on the systems that we take 0:03:22.080 --> 0:03:25.080 for granted, right, trying to solve for the fallacy of 0:03:25.160 --> 0:03:29.799 misplaced concreteness before it's too late. On that note, back 0:03:29.800 --> 0:03:33.480 to my discussion with Dr Victoria Luna Brendan Grieve, Assistant 0:03:33.520 --> 0:03:37.520 professor at the University of Pittsburgh School of Pharmacy. For 0:03:37.840 --> 0:03:40.760 places that are getting uh, you know, all of these 0:03:40.800 --> 0:03:44.480 anti trends bills criminalizing all of this stuff for miners, 0:03:44.520 --> 0:03:47.440 and then you know, eventually maybe even you know, my 0:03:48.000 --> 0:03:49.839 big fear is that, you know, first off, they're gonna 0:03:49.840 --> 0:03:52.400 criminalize it for minors, and they're gonna say the brains 0:03:52.440 --> 0:03:54.880 not fully developed, your twenty five, and they're gonna criminalize 0:03:54.880 --> 0:03:56.720 it until you're twenty five, and they're just gonna criminalize 0:03:56.760 --> 0:03:59.800 it for everyone after that. Um So, for all of 0:03:59.800 --> 0:04:02.600 these places that are making access to healthcare is so 0:04:02.680 --> 0:04:06.080 much harder, what what is what is one to do? 0:04:06.280 --> 0:04:08.839 Like if these if there's these kids and then even 0:04:08.840 --> 0:04:10.760 adults who are like just find it so much harder 0:04:10.760 --> 0:04:14.360 to get stuff. Like I know there's the informed clinics, 0:04:14.400 --> 0:04:16.400 but there there's like there's like a few in Texas, 0:04:16.440 --> 0:04:18.840 but I don't even know what they can even offer anymore, right, 0:04:18.880 --> 0:04:22.840 Like it's really unclear. Yeah, well, I'll tell you some 0:04:22.920 --> 0:04:25.839 of that fear is already becoming reality here in Pennsylvania 0:04:25.960 --> 0:04:30.040 just two days ago. HB. I think it was HBO 0:04:30.160 --> 0:04:34.640 passed by the House in don in Harrisburg that prevents 0:04:35.279 --> 0:04:38.640 it's a ban on trans people playing sports up through 0:04:38.680 --> 0:04:43.919 the college level, not just high school in grade school, 0:04:43.960 --> 0:04:48.719 it's all the way up through you know, secondary education. Uh. 0:04:48.800 --> 0:04:51.360 And even though our governors like has failed to vito it, 0:04:51.440 --> 0:04:53.719 like who even knows what's going to happen, but they're 0:04:53.760 --> 0:04:57.960 already taking taking aim at this higher level kind of thing. 0:04:58.040 --> 0:05:01.520 And there's a lot of president for that. What my goodness. 0:05:01.680 --> 0:05:05.839 If there's a long and storied history of d I 0:05:06.040 --> 0:05:10.400 Y hormone therapy and it's easier for the trans feminine 0:05:10.400 --> 0:05:15.080 individuals because testosterone is actually a scheduled to control I 0:05:15.080 --> 0:05:18.760 think it might be a three I think it's scheduled 0:05:18.760 --> 0:05:21.839 three steroid. I'll write a little thing about it and 0:05:21.839 --> 0:05:24.200 I'll say in the episode. And it's such a funny 0:05:24.240 --> 0:05:27.320 reason too, because it's just you can use it to 0:05:27.480 --> 0:05:32.200 dope for endurance based like like cycling and running, because 0:05:32.240 --> 0:05:35.760 it will increase your red blood cell account that's a like. 0:05:36.080 --> 0:05:38.480 And so it's a controlled substance because people can use 0:05:38.520 --> 0:05:42.040 it to dope for for exit, for for sports. So 0:05:42.080 --> 0:05:43.960 it's that's a little bit harder to get ahold of 0:05:44.520 --> 0:05:46.880 in like a meaningful way. But there are a lot 0:05:46.920 --> 0:05:50.159 of different Allegedly, there are a lot of different places 0:05:50.200 --> 0:05:54.799 online that you can acquire estrogen or estra dial relatively easily. 0:05:55.200 --> 0:05:59.000 Now I'm gonna actually pause the discussion with me and 0:05:59.160 --> 0:06:01.760 Dr Grieve to talk a little bit about d I 0:06:01.960 --> 0:06:05.799 y h r T or for those anti acronym people 0:06:05.800 --> 0:06:10.400 out there, do it yourself hormone replacement therapy. Again, I'm 0:06:10.400 --> 0:06:14.279 not a medical doctor. Unless you have a problem regarding parapsychology, 0:06:14.680 --> 0:06:17.520 I cannot offer you any expertise, but I can talk 0:06:17.560 --> 0:06:20.120 about d I y h r T as it's existed 0:06:20.160 --> 0:06:23.680 for trans people for the past two decades. Because an 0:06:23.760 --> 0:06:26.760 unfortunate truth is, although it's gotten much easier to get 0:06:26.760 --> 0:06:29.479 gender affirm and care and hormones the past few years, 0:06:30.080 --> 0:06:32.600 even in states that aren't facing this wave of anti 0:06:32.600 --> 0:06:36.320 trans health care bills, the medical establishment hasn't been the 0:06:36.360 --> 0:06:41.360 most trans friendly place in general. A recent Center for 0:06:41.400 --> 0:06:45.119 American Progress report found that nearly half of transgender people 0:06:45.560 --> 0:06:50.080 and six of transgender people of color reported having experienced 0:06:50.160 --> 0:06:54.240 mistreatment at the hands of a medical provider, including refusal 0:06:54.279 --> 0:06:58.160 of care and verbal or physical abuse just in the 0:06:58.279 --> 0:07:00.600 year before the survey, which took place in June of 0:07:01.000 --> 0:07:02.719 twenty so this is this is still very much an 0:07:02.760 --> 0:07:06.280 ongoing issue. One in two trans people reported that their 0:07:06.320 --> 0:07:10.880 access to gender affirming healthcare was curtailed significantly during the pandemic, 0:07:11.320 --> 0:07:14.160 and nearly one in two transgender adults have had insurance 0:07:14.200 --> 0:07:19.240 providers denying them coverage for gender affirming care, and very 0:07:19.280 --> 0:07:23.480 often doctors don't even know how to properly treat transgender patients, 0:07:23.600 --> 0:07:26.000 and often it's up to the patients to educate the 0:07:26.040 --> 0:07:30.080 doctors on trans healthcare issues. The Center for American Progress 0:07:30.080 --> 0:07:33.480 survey from last year found that one in three trans 0:07:33.560 --> 0:07:37.239 people report having to teach their doctors about trans people 0:07:37.360 --> 0:07:41.720 to get them appropriate care, and reported having been asked 0:07:41.800 --> 0:07:45.480 innovasive or unnecessary questions about being trans which were not 0:07:45.600 --> 0:07:48.840 related to the reasons for them visiting the doctor. The 0:07:48.880 --> 0:07:51.440 report cited a twenty eight team brief from the Kaiser 0:07:51.480 --> 0:07:54.640 Family Foundation that found that more than half of medical 0:07:54.680 --> 0:07:58.960 school curriculums lack information about unique health issues the LGBTQ 0:07:59.160 --> 0:08:03.440 community faces, and doesn't cover treatment beyond HIV prevention and care, 0:08:03.960 --> 0:08:06.480 so obviously that leaves a lot to be desired for 0:08:06.560 --> 0:08:11.520 people wanting to receive transgender health care. Between medical mistreatment, 0:08:11.600 --> 0:08:15.320 insurance complications, and doctor ignorance, many trans folks have taken 0:08:15.320 --> 0:08:18.000 it upon themselves to get the drug necessary for hormone 0:08:18.040 --> 0:08:21.760 replacement therapy because the alternative is often just having to 0:08:21.800 --> 0:08:24.040 face not being able to receive the health care that, 0:08:24.080 --> 0:08:28.360 in many cases makes it possible to live. The Center 0:08:28.400 --> 0:08:31.320 for American Progress survey found that twenty eight percent of 0:08:31.400 --> 0:08:36.280 trans folks report having postponed or not gotten necessary medical 0:08:36.320 --> 0:08:41.480 care for fear of discrimination. Taking your endochronology and hormone 0:08:41.480 --> 0:08:44.760 treatment into your own hands has a lengthy history and 0:08:45.040 --> 0:08:46.880 used to be much more common in the days before 0:08:46.880 --> 0:08:51.240 informed consent. In a survey of trans people in Washington, 0:08:51.320 --> 0:08:55.199 d C. Circus two thousand, over half of the respondents 0:08:55.320 --> 0:08:58.840 so that they had used non prescribed hormones also known 0:08:58.880 --> 0:09:02.280 as d I y h RT. So information on how 0:09:02.280 --> 0:09:06.360 to go about d I yng your HRT spread via 0:09:06.520 --> 0:09:09.680 online forms and websites in the early two thousands, and 0:09:09.760 --> 0:09:13.120 after some trial and error, the information is kind of 0:09:13.160 --> 0:09:16.760 consolidated into a few main information hubs that being the 0:09:16.840 --> 0:09:19.880 d I y h r T Wiki, HRT dot Cafe 0:09:20.320 --> 0:09:25.480 and d I y HRT dot get hub dot io. Now, obviously, 0:09:25.520 --> 0:09:29.320 when you're getting into taking drugs from online sources, you 0:09:29.320 --> 0:09:31.800 need to be extremely careful and cautious about what foreign 0:09:31.840 --> 0:09:35.280 chemicals you're putting into your body, including and trying to 0:09:35.440 --> 0:09:38.720 only acquire drugs from trustworthy sources, doing drug testing if 0:09:38.760 --> 0:09:41.480 you can, and doing your own blood testing before and 0:09:41.520 --> 0:09:44.679 after to keep an eye on your testosterone and estrogen levels. 0:09:45.520 --> 0:09:49.320 It is possible to order blood tests via online and 0:09:49.720 --> 0:09:51.600 send it through a lab that you have to ship 0:09:51.640 --> 0:09:54.240 your blood too, but often it's just easier to do 0:09:54.280 --> 0:09:57.640 it by going through the medical system. Now, one massive 0:09:57.679 --> 0:10:00.840 caveat with d y h r T is although it's 0:10:00.840 --> 0:10:04.520 more straightforward to acquire extra dial and antiandrogen's like spiro 0:10:04.640 --> 0:10:09.240 from online sources, getting to stosterone for masculinization therapy is 0:10:09.320 --> 0:10:12.480 much more tricky because in most places it's a restricted drug. 0:10:12.600 --> 0:10:14.800 Here in the States, it is a Schedule three substance, 0:10:15.280 --> 0:10:18.640 so technically buying it without a prescription would be a 0:10:18.640 --> 0:10:21.880 felony um So for this reason, most d I O 0:10:21.960 --> 0:10:25.120 y h r T stuff focuses on feminizing hormones since 0:10:25.160 --> 0:10:29.319 that is less legally complicated. Now, obviously you know steroids exist, 0:10:29.520 --> 0:10:32.760 so it is possible to get them, but I will 0:10:32.760 --> 0:10:35.120 not be giving out guides on how to do that 0:10:35.160 --> 0:10:37.360 here on the pod, but you know you can you 0:10:37.400 --> 0:10:41.280 can look into it if you so desire for feminizing hormones. 0:10:41.360 --> 0:10:44.679 The main way of going about it requires obtaining bioidentical 0:10:44.800 --> 0:10:48.040 extra dial. It can come in a few forms pills, 0:10:48.120 --> 0:10:50.600 which are not difficult to acquire, and assuming you get 0:10:50.640 --> 0:10:52.880 the dose right, it's pretty easy because it's just a 0:10:52.920 --> 0:10:56.400 process of dissolving the little pill tablets under your tongue, 0:10:56.960 --> 0:11:00.640 and that's kind of it right. Dosed is its own thing, 0:11:00.640 --> 0:11:03.400 which you can figure out if you do reading, but 0:11:03.880 --> 0:11:08.079 the actual taking of it is pretty straightforward. Transdermal estrogen 0:11:08.240 --> 0:11:12.000 or transdermal estra dial is kind of the new hot thing. Uh. 0:11:12.120 --> 0:11:16.400 Usually this has you taking weekly estra dial patches which 0:11:16.400 --> 0:11:18.960 you just switch out every week um or you can 0:11:19.000 --> 0:11:21.880 also do daily gels, which you just rub out your body, 0:11:21.920 --> 0:11:25.680 although unfortunately for dosing gels it can be more tricky 0:11:25.760 --> 0:11:27.600 if you go d I Y because it's hard to 0:11:27.880 --> 0:11:30.240 know what concentration just the jela is. If you're just 0:11:30.320 --> 0:11:33.720 rubbing a sav on yourself. It's not already prepackaged, but 0:11:33.800 --> 0:11:37.320 the patches are pretty good. And lastly, the classic method 0:11:37.480 --> 0:11:41.360 is injectable estradial at various concentrations in the form of 0:11:41.440 --> 0:11:46.040 some oil solution. This can usually be the cheapest option 0:11:46.200 --> 0:11:49.360 if you can figure out how to buy estradial, and 0:11:49.559 --> 0:11:52.200 needles and syringes can be bought at any pharmacy just 0:11:52.280 --> 0:11:55.760 over the counter in most countries without a prescription. For 0:11:55.840 --> 0:11:59.200 feminizing hormones, some people also take antiandrogen's a k a. 0:11:59.280 --> 0:12:03.560 Testosterone lockers like spiral lactone, which can be acquired online 0:12:03.800 --> 0:12:06.760 and are almost always taken orally in the form of 0:12:06.760 --> 0:12:10.520 a pill. Now, when getting these drugs online, there are 0:12:10.559 --> 0:12:15.120 two main categories of purchase. There's pharmaceutical grade and home brewed. 0:12:15.520 --> 0:12:19.840 Pharmaceutical grade refers to HRT produced by legitimate pharmaceutical companies 0:12:20.240 --> 0:12:23.200 that are licensed and subject to regulation. They should be 0:12:23.280 --> 0:12:26.040 of the same quality as those found in your local pharmacy, 0:12:26.160 --> 0:12:28.960 and they can be ordered without a prescription from websites 0:12:29.000 --> 0:12:31.680 based in countries that allow for the legal exportation of 0:12:31.720 --> 0:12:35.800 certain medications. These will almost always carry less inherent risk 0:12:36.120 --> 0:12:40.600 versus receiving and taking home brewed hormones, which leads us 0:12:40.640 --> 0:12:43.880 to the second version that you can buy, which is homebrewed. 0:12:44.600 --> 0:12:48.240 This refers to HRT produced by individuals by sourcing raw 0:12:48.280 --> 0:12:51.680 extradial or whatever other chemicals you're taking in the form 0:12:51.720 --> 0:12:55.320 of a powder and then compounding the medication themselves. They 0:12:55.360 --> 0:12:58.280 do not synthesize or current from scratch these hormones, but 0:12:58.400 --> 0:13:01.160 they do use the powdered vers of them, and they 0:13:01.200 --> 0:13:05.720 get them from sources from drug manufacturing companies to synthesize 0:13:05.800 --> 0:13:09.200 it into their own extra dial or whatever arther drug 0:13:09.240 --> 0:13:12.320 you're taking. You know, in the antiandrogen list. There's there's 0:13:12.360 --> 0:13:15.040 too many, too many to name now. While this this 0:13:15.120 --> 0:13:18.360 concept does sound scary and it can obviously go wrong 0:13:18.400 --> 0:13:21.560 if someone's not synthesizing it correctly. Uh, there are a 0:13:21.559 --> 0:13:23.800 couple of well respected members of the community that have 0:13:23.880 --> 0:13:26.760 been known to produce high quality and safe HRT medications. 0:13:27.360 --> 0:13:29.719 But before anyone decides to take drugs that you get 0:13:29.720 --> 0:13:32.560 on the internet, please, please, please please do lots of 0:13:32.600 --> 0:13:38.160 reading beforehand on on dosage effects, side effects, and be 0:13:38.360 --> 0:13:41.360 very cautious with your drug sourcing. Right, you should know 0:13:41.440 --> 0:13:43.280 who you're buying it from. You don't want to just 0:13:43.400 --> 0:13:45.439 buy from whatever it's get your website. You should make 0:13:45.440 --> 0:13:48.720 sure that what you're doing is other people are backing 0:13:48.800 --> 0:13:50.320 up on this decision and make sure that it's there. 0:13:50.480 --> 0:13:54.040 You can cross reference information here because there's a lot 0:13:54.040 --> 0:13:56.320 of information out their online and not all of it 0:13:56.440 --> 0:13:59.960 is good information, obviously, but really try to cross reference 0:14:00.040 --> 0:14:04.480 information on any drug sources, on hormone dosage, on any 0:14:04.559 --> 0:14:07.280 possible drug interactions. If you're taking multiple drugs or you 0:14:07.320 --> 0:14:09.960 already have prescriptions now I should I should note that 0:14:10.000 --> 0:14:13.520 supply chain issues that affect the medical system can even 0:14:13.520 --> 0:14:15.280 extend out to d Y A h r T. There's 0:14:15.320 --> 0:14:19.120 no true escape. There's no true other. One of the 0:14:19.160 --> 0:14:22.920 main pharmaceutical grade online sites to source HRT from is 0:14:22.960 --> 0:14:27.080 currently out of estradial pills, so there there is there 0:14:27.160 --> 0:14:31.120 is no true escape sometimes, but to learn more about 0:14:31.240 --> 0:14:33.520 d I Y h RT, you should check out d 0:14:33.560 --> 0:14:37.520 I Y HRT dot get hub, dot io or HRT 0:14:37.680 --> 0:14:40.880 dot cafe and the d I Y trans dot wiki 0:14:41.400 --> 0:14:43.720 and keep in mind not everything you read on those 0:14:43.720 --> 0:14:46.880 sources is necessarily good advice or up to date with 0:14:46.920 --> 0:14:49.880 the current information on how these drugs work. Recently, I 0:14:49.920 --> 0:14:52.040 was reading a guide I found via one of those 0:14:52.040 --> 0:14:56.040 sites on how to homebrew my own estrogen by buying 0:14:56.440 --> 0:14:59.520 the powdered version of it than synthesizing it myself to 0:14:59.760 --> 0:15:03.360 level up my alchemy stat um, and I found the 0:15:03.560 --> 0:15:06.240 guy that I was reading contained quite a bit of 0:15:06.280 --> 0:15:10.640 outdated misinformation about progester around. So don't take everything you 0:15:10.680 --> 0:15:13.760 read as gospel, but those resources are at least a 0:15:13.760 --> 0:15:17.720 good place to start. Anyway, Now back to the interview, 0:15:18.440 --> 0:15:20.640 the problem that you might run into with the I 0:15:20.880 --> 0:15:22.560 y NG is you might not be able to get 0:15:22.920 --> 0:15:26.200 the bioequivalent estradial in some form. You might have to 0:15:26.200 --> 0:15:31.440 settle for conjugated estrogens or even something like an ethanol ESTRADIALE, 0:15:31.520 --> 0:15:36.280 which is like hormonal birth control, which because they are synthetics, 0:15:36.280 --> 0:15:39.920 they actually have a much rougher time on your body. 0:15:40.040 --> 0:15:42.720 And that's where a lot of the side effects quote 0:15:42.760 --> 0:15:46.520 unquote like come from. Like all of the worry about 0:15:46.600 --> 0:15:50.280 like blood clots and things from taking estrogens comes from 0:15:50.680 --> 0:15:56.320 conjugated estrogens. Est Yeah, the actual study, uh that a 0:15:56.360 --> 0:15:58.480 lot of that is citing goes all the way back 0:15:58.520 --> 0:16:01.440 and it was studying the rate of plotting in cis 0:16:01.560 --> 0:16:06.440 gender women taking hormonal birth control, and it's just like, Okay, 0:16:06.440 --> 0:16:11.000 so this is the wrong population with the wrong medication. Yeah, 0:16:11.040 --> 0:16:13.720 that seems like not a great scientific study, right, what 0:16:13.760 --> 0:16:15.640 do we do? I mean, it might be great to 0:16:15.680 --> 0:16:21.200 talk about for the rate of yeah, right for trans women, 0:16:21.560 --> 0:16:26.440 or doesn't really right? It doesn't it doesn't really help 0:16:26.560 --> 0:16:29.640 so much. Um. And what I think is also pretty 0:16:29.640 --> 0:16:32.760 wild too. I mentioned the progesteran thing earlier. A lot 0:16:32.760 --> 0:16:35.280 of that controversy comes from the fact that the original 0:16:35.280 --> 0:16:37.520 studies on whether or not it could be beneficial. We're 0:16:37.520 --> 0:16:42.280 done with medroxy progesterone, a synthetic progesterone that has a 0:16:42.360 --> 0:16:45.200 really nasty side effect profile in a lot of different ways. 0:16:45.440 --> 0:16:48.040 And now that we have micronized progesterone, where the evidence 0:16:48.080 --> 0:16:51.800 suggested not only is it safe, it actually makes estrogen safer. 0:16:52.960 --> 0:16:55.040 And now they're like, no, we can't give that. That's 0:16:55.080 --> 0:16:58.120 just that's just crazy talk. I will say, I have 0:16:58.240 --> 0:17:01.240 heard from people with more experienced hormones and be that 0:17:01.320 --> 0:17:07.160 progesterone does make you way too hoardy. Um. The heads 0:17:07.200 --> 0:17:13.800 up for for side effects ASHTAG can confirm. But um, well, 0:17:13.800 --> 0:17:15.480 but but progesterone can have a lot of other really 0:17:15.480 --> 0:17:18.680 beneficial side effects. It can really increase the fat deposition 0:17:18.680 --> 0:17:20.439 to various places. It can help with your mood, it 0:17:20.440 --> 0:17:23.199 can help with your sleep. It actually reduced the period 0:17:23.280 --> 0:17:27.160 symptoms that I was having because I because there's a surprise, 0:17:27.440 --> 0:17:31.320 people on estrogen can also have periods. Uh. And because 0:17:31.359 --> 0:17:33.600 your body again knows what it's doing, it's going to 0:17:33.680 --> 0:17:36.080 modulate it through the E one, E two, E three pathway, 0:17:36.200 --> 0:17:38.479 like throughout the month in a sixical fashion, and you 0:17:38.520 --> 0:17:41.480 can get bloating and cramps. And I had really bad 0:17:41.520 --> 0:17:44.840 morning sickness like for for three days every twenty eight 0:17:44.920 --> 0:17:49.240 days for months, until eventually I started micronized progesterone and 0:17:49.320 --> 0:17:52.760 those symptoms alleviated, Which makes a kind of sense if 0:17:52.800 --> 0:17:57.480 you know that progesterone only birth control reduces periods. So 0:17:57.560 --> 0:17:59.399 like there's a there's there's a lot of precedent, a 0:17:59.440 --> 0:18:01.119 lot of makes a out of like sense that it 0:18:01.160 --> 0:18:15.639 would work. God, I it's I need to tell you 0:18:16.040 --> 0:18:20.480 have have you ever heard of the Powers method of 0:18:21.720 --> 0:18:25.960 no Oh Garrison. I am so excited to introduce you 0:18:26.040 --> 0:18:31.320 to this person. Like doctor Powers is a fascinating grifter 0:18:31.800 --> 0:18:36.119 in the trans health care space because He is a 0:18:36.560 --> 0:18:39.719 he's a physician who like has has made it his 0:18:39.920 --> 0:18:43.840 duty to to to make sure that trans people, especially 0:18:43.840 --> 0:18:45.879 trans women. He actually doesn't like really have anything to 0:18:45.880 --> 0:18:48.800 say about trans men because the the therapy is so 0:18:48.920 --> 0:18:53.520 like easy to to to do that. He has a 0:18:53.920 --> 0:19:00.000 wild postulation as to like better ways to give hormone, 0:19:00.600 --> 0:19:03.480 and he he has things worths like we don't need antiandrogens. 0:19:03.680 --> 0:19:06.959 You just give really high levels of injectable estrogen, which, like, 0:19:07.119 --> 0:19:10.879 I mean that'll probably work because for some people, but yeah, yeah, 0:19:10.960 --> 0:19:13.800 but but also estrogen is like really safe and so 0:19:13.920 --> 0:19:17.440 like you can give it to an unbelievably high level, 0:19:17.560 --> 0:19:20.720 it's not really going to speed things up exactly, Like 0:19:20.800 --> 0:19:23.960 it will maybe a little bit, but not that much. 0:19:24.359 --> 0:19:27.240 And any of the side effects you might experience, which 0:19:27.280 --> 0:19:30.600 could also come from the the excipients, the non active 0:19:30.600 --> 0:19:33.200 elements of it, like you can be allergic to those 0:19:33.280 --> 0:19:36.879 if you ever really high dose can be a real problem. Um. 0:19:36.920 --> 0:19:39.240 But the big thing for him is he pushes that 0:19:39.440 --> 0:19:43.359 micronized progesterone is not only necessary and good especially for 0:19:43.400 --> 0:19:46.480 breast size, you should also stick the oral capsules in 0:19:46.520 --> 0:19:50.440 your butt. Oh I were we are we are officially 0:19:50.480 --> 0:19:54.399 boothing estrogen. Now, yes, yes, okay, well I'm I'm switching 0:19:54.400 --> 0:19:58.879 back to pills. This sounds very exciting. Well so well, 0:19:58.880 --> 0:20:03.159 oh my gosh. So the idea is his line is 0:20:03.520 --> 0:20:07.720 um that you know that the oral capsules you only 0:20:07.720 --> 0:20:10.760 get a tiny fraction of the total progesterone, and you 0:20:10.760 --> 0:20:12.320 get a lot more if you stick it up You 0:20:12.320 --> 0:20:15.080 get the whole dose if you stick it up your butt, which, 0:20:15.160 --> 0:20:18.520 like if you know literally anything about pharmacology is both 0:20:18.640 --> 0:20:23.159 right and entirely insane because anything that you take orally, 0:20:23.680 --> 0:20:28.560 there's a bioavailable like level of it. Like so oral uh, 0:20:28.680 --> 0:20:31.040 micronized progesterone has a bioequivalence of I think like two 0:20:31.119 --> 0:20:33.280 or three percent, which is why when you take like 0:20:33.280 --> 0:20:36.440 a hundred milligram capsule, you get like a certain blood level. 0:20:37.160 --> 0:20:40.479 If you take it rectally, it's like a twelve. It's 0:20:40.520 --> 0:20:43.880 still not the whole thing, which is why the the 0:20:44.560 --> 0:20:49.240 micronized progesterone rectal suppositories are twenty five milligrams to give 0:20:49.240 --> 0:20:53.879 you the same exposure, so it's four times the systemic absorption, 0:20:54.320 --> 0:20:59.120 which means that if you are boofing a micronized progesterone capsule, 0:20:59.440 --> 0:21:03.280 you are geting three to four times the dose that 0:21:03.320 --> 0:21:09.359 you should be getting. And uh, the I pulled because 0:21:09.359 --> 0:21:11.359 I get into fights with people all the time about this. 0:21:11.640 --> 0:21:16.240 I pulled the original FDA filing for Mike and Ice progesterone, 0:21:16.560 --> 0:21:19.679 and they suggested that three hundred milligrams is basically getting 0:21:19.680 --> 0:21:22.639 to what like a cis gender person's maximum progesterone levels 0:21:22.640 --> 0:21:25.679 would be, meaning that if you're boofing one or two, 0:21:26.000 --> 0:21:29.880 as some of his regimens suggests, like, you might be 0:21:30.080 --> 0:21:34.680 essentially overdosing on progesterone for no reason, like there's no 0:21:34.840 --> 0:21:37.960 real reason to do that, and it is just crazy. 0:21:38.359 --> 0:21:40.600 When what I started this call today, I did. I 0:21:40.680 --> 0:21:45.720 did not think we would get boofing progesterone. It is 0:21:45.760 --> 0:21:49.520 a weird, like a weirdly large part of my Twitter 0:21:49.560 --> 0:21:54.280 interactions have been fighting people to stop boofing progesterone. UM, 0:21:54.440 --> 0:21:57.840 so I wanted to Unfortunately just exposed this idea to 0:21:57.960 --> 0:22:01.399 millions of more people. Know I'm saying talk do it 0:22:01.680 --> 0:22:04.439 well and so, but you know, you know, you know 0:22:04.520 --> 0:22:06.840 that's not how that works. I do know that's not 0:22:06.920 --> 0:22:09.280 how that works. But I mean, I I tell you, 0:22:09.640 --> 0:22:13.159 if if your your friend Robert Evans for here, I 0:22:13.160 --> 0:22:15.480 could pitch a hole behind the bastards on this doctor 0:22:15.520 --> 0:22:19.959 powers guy. Um so he sounds fascinating. He has a subreddit, 0:22:20.119 --> 0:22:23.159 like all good physicians do. I love the doctor has 0:22:23.160 --> 0:22:27.280 a subreddit, and my my favorite post other than recently, 0:22:27.320 --> 0:22:30.000 he's been pushing this like miracle hair tonic that he made, 0:22:30.080 --> 0:22:33.200 which is like, come on, buddy, like like now, and 0:22:33.280 --> 0:22:38.680 it's just obvious. He calls it, yep, yep, the verbon 0:22:38.880 --> 0:22:41.160 he might call it. He might even call it an elixir, 0:22:41.240 --> 0:22:45.280 which is very funny, but all from a magical hand 0:22:45.280 --> 0:22:48.760 tonic exactly. It's so funny because one of the components 0:22:48.760 --> 0:22:51.000 of it, I think is finasteride. Like I I looked 0:22:51.040 --> 0:22:52.720 at the and I'm like, yes, that is something for 0:22:52.760 --> 0:22:56.000 bald for male pattern baldness. It will probably work. Congratulations, 0:22:56.040 --> 0:23:01.280 you just remade rogaine. Uh. But the the single post 0:23:01.400 --> 0:23:06.119 that I feel like perfectly encapsulates this guy's mentality. Um is, 0:23:07.560 --> 0:23:09.960 There's this big post that went around through like cis 0:23:09.960 --> 0:23:13.560 gender like kind of like centrist spaces that every trans 0:23:13.560 --> 0:23:15.960 person I saw was just like, excuse me, what the fuck? 0:23:16.680 --> 0:23:21.919 Where this guy was secretly micro dosing injectable estrogen that 0:23:21.960 --> 0:23:26.160 he prescribes himself, which sounds kind of illegal. Not gonna lie, uh, 0:23:26.200 --> 0:23:29.679 and messed up the dose by a thousand percent, by 0:23:29.680 --> 0:23:33.959 a thought, by a times thousand yeah, yea yeah, And um, 0:23:34.000 --> 0:23:35.800 like I can give you the link. I I can. 0:23:35.640 --> 0:23:37.320 I know exactly where it is. I can give you 0:23:37.359 --> 0:23:38.760