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<\/p>\nSome seek treatment with oestrogen or testosterone, which feminise or masculinise their appearance to line up with their identity. Evidence suggests the treatment can significantly improve mental health, but it can also irreversibly affect fertility, hair growth or the voice.<\/p>\n
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Olivia Donaghy of Gender Health Australia.<\/p>\n
A Seahorse Collective spokesperson said that \u201call DIY HRT experiences in our collective have been positive\u201d, without detailing how many people had taken the treatment. \u201cEspecially in comparison to the HRT outcomes through GPs and other doctors\u2019 clinics, which can have a lot of drawbacks, including long waiting lists, transphobic behaviour from doctors, expense, being prescribed very low amounts of hormones for no reason.\u201d<\/p>\n
Evidence from long-term studies in gender clinics<\/a> and meta-analyses<\/a> of more than 26,000 people suggest trans women receiving hormone replacement therapy in particular have higher rates of stroke, heart attack or blood clots.<\/p>\n On the other hand, not providing gender-affirming hormone therapy also comes with risks. Young trans people have \u201cextremely high rates of depression, self-harm, attempted suicide and suicide\u201d, the Royal Australasian College of Physicians has said<\/a>. About one in three trans people attempt suicide<\/a> at least once.<\/p>\n A 2023 systematic review, published in<\/a> Nature Human Behaviour, found hormone therapy improved quality of life and mental health. In adolescents, providing hormone therapy halved suicidal<\/a> intentions, a 2020 study found.<\/p>\n In Victoria and NSW, most adults access gender-affirming hormone therapy through their GPs, who either prescribe directly or refer them to gender clinics.<\/p>\n Mental health support is not mandatory but is usually recommended. In people under 18, guidelines recommend a multidisciplinary team assess and care for the child \u2013 and the treating team, child and parents must all consent before treatment can begin.<\/p>\n Gender-affirming hormone therapy<\/p>\n People whose gender identity is different to the sex they were assigned at birth often experience intense distress, known as gender dysphoria. This can be alleviated through social, medical, or surgical transition.<\/p>\n Evidence suggests gender-affirming hormone therapy \u2013 using oestrogen or testosterone to align physical characteristics with gender identity \u2013 significantly improve mental health and wellbeing.<\/p>\n The therapy also comes with risks. It can increase the risk of stroke, heart attack or blood clots. Doctors say the therapy should be performed under medical supervision.<\/p>\n Source: Professor Ada Cheung<\/p>\n DIY HRT has long been a feature of the trans community, which historically struggled to access mainstream healthcare.<\/p>\n Some of those barriers have fallen away in the past decade amid the dramatic increase in the number of GPs able and willing to prescribe gender-affirming hormone therapy, and the establishment of public gender clinics, although Queensland has suspended public hormone therapy for people aged under 18.<\/p>\n \u201cI think the rest of Australia is right to be concerned \u2013 if they are doing it there, it could happen here. People are desperate for healthcare. They are not going to not get it,\u201d said Olivia Donaghy, clinical director of private practice Gender Health Australia and the statewide co-ordinator of the Queensland government\u2019s Children\u2019s Gender Service.<\/p>\n Loading<\/p>\n After Queensland announced its ban, the federal government set a review of treatment guidelines for trans young people, which is being led by the National Health and Medical Research Council.<\/p>\n Donaghy was also worried about people buying hormones online.<\/p>\n \u201cIf you\u2019re buying it on the internet, you don\u2019t know what\u2019s in the vials and you don\u2019t know the dosage,\u201d she said.<\/p>\n Loading<\/p>\n Trans Action Network spokesperson Amy, who has used DIY HRT and spoke under condition of anonymity, said Queensland\u2019s ban had worried people so much, they were pre-emptively organising DIY supply in case other jurisdictions followed.<\/p>\n \u201cWhich is really depressing, but that\u2019s the reality of it,\u201d Amy said.<\/p>\n They said do-it-yourself was becoming more popular as healthcare became more unaffordable.<\/p>\n \u201cI would say probably half, more than half of my friends are using that approach or at least supplementing with that approach,\u201d Amy said.<\/p>\n Waiting lists for Victoria\u2019s free public gender clinics run to two years. A private doctor with a shorter waiting time can cost between $20 and $120 a session, while the hormones are publicly subsidised<\/a> and cost between $6 and $40 a month.<\/p>\n Cheung, from the Trans Health Research Group, said not all areas had GPs who felt comfortable or confident providing gender-affirming care, particularly in the regions.<\/p>\n \u201cPeople still encounter quite widespread discrimination, even in healthcare. It\u2019s not perfect. But it\u2019s better than it was, say, five years ago,\u201d she said.<\/p>\n Unlike in the United States, Australia does not offer oestradiol injections, \u201cbut many trans people think that it is the best option. So, they often turn to DIY HRT\u201d, Cheung said.<\/p>\n
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