#hrt access

[zinniajones]

UPDATE 5/23/2023: There was a Joint Rules Committee teleconference meeting of the Board of Medicine, Board of Osteopathic Medicine and Board of Pharmacy this afternoon at 12:30 PM Eastern. (Meeting information, meeting agenda)

That means some of the members of the Florida Boards of Medicine - the same ones responsible for passing the trans youth care ban, at the behest of the ACPeds-ghostwritten AHCA report - were in attendance. (More on the AHCA report behind the Boards' trans youth care bans)

These members included: Hector Vila, who incorrectly asserted in November that about five traveling detransition campaigners had experienced the worst medical harm to happen in Florida over the last quarter of a century. (See section 10)

As well as Monica Mortensen of pediatric endocrinology at Nemours Jacksonville. She submitted a letter of support for the Board of Medicine's trans youth care bans in which she favorably referenced a case report of a trans teenager held in a psychiatric hospital for two years as conversion therapy. Then Ron DeSantis appointed her to the Board of Osteopathic Medicine.

During the meeting in a period of audience comment, I asked this brief and on-topic question relating to the issue at hand of pharmacists serving as prescribers in concert with physicians, specialists, case management and others:

"We’ve heard a lot about how important it is to find ways pharmacists can facilitate safe access to management of complex chronic conditions. And again, as it’s been said by Dr. Mesaros, sometimes that can be a matter of ‘bodies in the streets’ as he put it. And I appreciate that. My question is for the Boards of Medicine on prescribing practices and mental health, in this case a concern about the current implementation of practice standards.

I am a consumer advocate with Gender Analysis for the transgender community. We’ve previously had correspondence with the Boards of Medicine on related rule proposals last year. Trans people receiving specialist care for substance use are a part of the community of people in recovery. Last week’s passage of SB 254 immediately kept almost all trans people from refilling their hormone therapy when it was prescribed by nurse practitioners. We know patients being forced to physician-hop is a problem, but they cannot hop to anywhere now. Even MDs and DOs are not prescribing because they do not have the emergency rule consent forms from the Boards of Medicine yet.

Being taken off their stable medications abruptly for no reason can put people into a state of crisis, including people who are struggling with substance use. Our focus centers for the treatment of gender dysphoria with hormone therapy mostly can no longer provide that medication, and patients are already being harmed by this. This was not a medical decision in the treatment of their cases, this was an external decision that kept their providers, with ongoing relationships with them, from continuing to offer them that care. That was a long-running status quo that suddenly changed last week. And that entire therapeutic frame has been completely de-delegated from the providers and the patients.

We would like to ask the Boards of Medicine when MDs and DOs should expect the emergency rule consent forms for hormone therapy for adults. And in the interim while we wait for those rules, what best practices should our providers currently follow for prescribing this? Thank you for your time."

There were approximately 10 seconds of silence that seemed to stretch on and on. The chair said "Thank you for your comments" and waited about 20 more seconds for any others to respond. Only silence.

Then they moved on to another subject, never bringing up anything about this question or related issues again, but talking at quite some length about how pharmacists can get paid and make money from participating in community collaboration programs.

The meeting audio will be available later.

Text of thread at https://kolektiva.social/@zinnia/110418489814171631:

Yes - this is what is happening in Florida due to SB 254, which was signed into law on Tuesday 5/17/2023, taking immediate effect. This immediately cut off 80%+ of adult trans people in Florida from having their HRT refilled, because SB 254 uniquely prohibits only nurse practitioners from prescribing only gender-affirming medications.

This has already been in effect for 7 days now.

Trans adults in Florida have already been cut off from their HRT refills for a week now, including those of us who have been stable on these medications for years or decades.

This is VERY different from the general situation of trans youth care bans in 19 states, many still working their way through the courts.

This has *already* happened, to *all* of us: all trans adults in the third most populous state in the US.

The number of trans adults on HRT massively exceeds the sliver of the population that are under 18 and are prescribed puberty blockers or hormone therapy.

These laws, advanced under the pretext of 'protecting children', are now directly impacting a far larger group of people who are not children and are not subject to those pretextual concerns.

Other arguments about withholding public Medicaid funding for transition treatment also do not apply here: SB 254 does not even allow receiving this care through private insurance or paying cash out of pocket. The care isn't simply not covered - the care itself cannot be provided regardless.

What is happening in Florida requires special attention above the situation of trans youth care bans nationally. This is having a vastly larger impact quantifiably.

It will have worse impacts qualitatively as well: adults are responsible for taking care of and protecting trans kids and making sure they do not hurt themselves.

Whereas as a trans adult, we have no one standing guard at the brink but our own self and the void to which we are accountable.

These are the facts as they stand right now. These are the facts as they have stood for a WEEK and NO ONE nationally is putting any attention on this because there are 19 trans youth care bans all across the country going on, along with everything else targeting trans people and the LGBT community broadly.

This is a specific harm that is happening now and has been happening for 168 hours.

It is not a hypothetical issue to raise awareness of, as if it were at the stage of some proposal that needs to be fought back. This has already happened and is happening right now. Active harm is happening until this law is rolled back.

For all of Florida's history since the inception of the applicable regulatory and licensing bodies, nurse practitioners have been allowed to prescribe hormone therapy, testosterone blockers and other relevant gender-affirming medications.

That has been the case since I moved here in 2011. There was no reason why this wouldn't be the case. It's also the case in every other state.

This new law is a carveout of prescriptions when used for one purpose, gender-affirming care, from nurse practitioners specifically, in a way that has never been done before. It affects all ages.

It has immediately obstructed access to HRT prescription refills for more than 80% of TRANS ADULTS in Florida.

It has also prohibited first appointments for HRT via telehealth with in-state or out-of-state MDs or DOs - first appointments must be in person. This will require expensive and time-consuming travel that is beyond most trans people's means: driving to Georgia from Florida can take 8 hours.

This was an intentional targeting of almost all trans adults in Florida, and the means by which we have received our generic, FDA-approved medications for years. And it included closing every possible door that would let us find another way to keep taking the medications we have taken for...

Well, for me it was 3,891 days when the clock stopped

[monsterqueers]

Hey if people are thinking of 'stockpiling HRT' and you are doing it with Testosterone, be aware that is a controlled substance and doing this WILL GET YOU A FELONY CHARGE IF YOU ARE CAUGHT (and it would be very easy for this to happen through the way those posts reccomend).

Its your decision if you want to risk imprisonment (and then definitely losing hrt access), but be aware of the serious consequences- especially if you are recommending this to people!

If you do this with E, you get a slap on the wrist. If you do this with T its a felony. A felony charge deeply effects everything you do. Its not just hard to DYI T, its MANY TIMES LEGALLY RISKIER AND HARDER.

[cuntvonkrolock]

reminder that trans men also fought for your rights and refusal to acknowledge this is tantamount to denying historical fact

[trans-androgyne]

Remind yourself that this is temporary.

“This will mean I can’t transition” could be more accurately framed as “parts of my transition will have to be delayed.”

This won’t last forever. One day, your body is going to feel like a home. One day, you’ll have people who call you what you want to be called. One day, you’ll look in the mirror and see yourself. Please make sure you’re around long enough to see it. Sending you so much love.

[1982brucespringsteen]

some good news!! the spanish state's ministry of equality has finally passed one of the most progressive trans laws on the planet, shielded free and universal access to abortion and banned conversion therapy and genital surgery for intersex babies, among a lot of other feminist policies. the minister of equality irene montero gave a speech thanking spain's lgtb and trans associations for helping her draft these legislations. couldn't be more proud!!

[canidaezy]

how do transmascs not want to kill themselves all the time honestly

[koboldfactory]

if i were to guess... you are an enjoyer of 'woemn', yes?

what do you think

[so-i-did-this-thing]

Goals this weekend:

1) Passport packet completed

2) List more clothes on poshmark, books & nerd crap I haven't touched on various marketplaces

3) Hike a bit

4) Dinner & game night with queer friends

5) Pet a big boofer at the newfie training event at Mystic

6) Look hot AF with my partner

Next up:

1) Start legal processes for redundant shoring up of legal protections as a "same sex" married couple. Focus on power of attorney, transfer of house deed, healthcare visitation, first

2) Inventory house, make list of high-impact, sustainability-focused products to get before new tariffs hit (canning stuff & new sewing machine come to mind).

3) Bloodwork for Dec physical

4) List more stuff I don't need for sale (old video game collection, I'm looking at you)

5) Hike a bit

6) Visit queer friends

7) Look hot AF with my partner

[reputable-opportunist]

Slight expansion from this post as I chew on it further

[cavityinmybrain]

anti endos are circling back around to fakeclaiming more systems with CDDs, the ones they said they were trying to protect

[givelifetoaworld]

i think i’ve had just so much exposure to mask-off, self-righteous transphobic behavior online the last few days that i genuinely feel just like, this pit of fear in my stomach that we really could have a quick pivot into a persecutive culture. maybe im catastrophizing, because i always am, but its stupid to deny that the internet is now openly displaying a desire to publicly shut us down and condemn us for existing, and they are being fucking LOUD. the winning conservative candidates across the country RAN on hating us, and millions of people took the bait or completely ignored how dire that was, having not even an inkling of empathy to even consider us as humans.

and the overwhelming silence in response! have you fuckers forgot these are the people fighting for anti-drag laws and systemic denial of our existence??? and i’m sorry but every piece of advice of kind words from the liberal “allies��� who have spoken about trans people has felt stale and reused, assumes we are going to kill ourselves, there’s conditions to who gets grace extended to them based on identity for fucks sake, or it’s all pure pity instead of desire to help us. there needs to be quick, genuine moves to protect trans people legally. now.

[skunkes]

[nappingpaperclip]

after seeing the absolutely unbelievable conditions Palestinians and all of the other folks from the many places where US imperialism has laid its foundation have to cope with, the possibility of temporarily losing my (lgbt+) rights does not scare me and I don’t think it’s at all a good enough reason to deny any and all criticism of democrats and refuse to even THREATEN to withhold your vote ¯\_(ツ)_/¯

[foursaints]

if ev ever did get pregnant they’d have a romantic (kinky) night eating his placenta together

it's just that my evan would NEVERR be comfortable with being pregnant... however! pandora 100% ate her placenta!

the hc of the rosier twins both being trans is very important to me, and i think pandora's pregnancy is an empowering act that is incredibly meaningful. especially given the context of her role as magical inventor, pandora using her prodigious magical talent to carry a pregnancy to term (as a trans woman) is just something that i want to see. it is a triumph both as a mother and as a witch.

the fantasy genre is just so ripe with opportunity for stories centering trans joy... i want to decenter evan from the pregnancy headcanons (he would never bc he just. hates children. it's 100% a personality thing) and instead highlight a character who actually IS a mother. because that story could be so emotionally resonant!!

[ransomdemands]

yknow sometimes the way trans women talk about testosterone and being on estrogen is indistinguishable from the way terfs try to convince afab people not to start hrt

this is not a criticism mind you, their experiences are their own and completely legitimate, it's just a matter of competing needs - they need a safe space to talk about their dysphoria and how testosterone makes them feel and i need to not hear about how i am destroying my body with hrt

ordinarily these things are pretty insular to transfem circles but since instagram has been feeding me transfem content i'm seeing it more and more and yet again the algorithm is fucking me

[that-bored-aroace]

one of those. blushing bug eyes images. that's me waiting for the TARDIS to appear /j