Once again we see discussions in the media of young people with gender dysphoria resorting to ‘DIY-ing’. This is a concept I had not come across before working with transgender patients. The idea that someone would ‘buy’ medicines off the black market to treat their medical needs would never have occurred to me given the dangers involved and the fact that the NHS prides itself on free, unbiased, accessible healthcare for all.

Some trans teens are self-medicating and buying hormones online

There has been much discussion about excessive waiting times for gender care. Clearly, we have seen a rising demand for services as more people understand gender issues and are brave enough to come forward for help. In addition, recruitment in the NHS is at an all time low. When I first qualified as a GP, there would have been 40 applicants for each GP partnership post, and competition for the top jobs in prime locations was high. These days, GP practices and hospitals struggle to retain and recruit doctors, and Golden Hellos and recruitment from abroad is commonplace.

If waiting lists are high and doctors working in the field are sparse, surely the priority should be on the education and training of GPs and paediatricians so that they can deliver gender related healthcare to patients in their locality.

The media would have us believe that youngsters are lining up to have ‘Sex Change Surgery’. In reality there are a large number of young transgender patients who are just desperate to press pause on puberty while they wait for NHS services to give them access to the help they need, be that medical or psychological.

Puberty can be paused with simple injections, called puberty blockers, which stop transgender teenagers developing the secondary sex characteristics of the wrong gender. If these were more readily accessible through the nhs, I would argue that much of the self harm and suicide that is so sadly discussed, would be avoided. Well-informed, adequately trained GPs and local paediatricians could easily prescribe and monitor these for younger patients, and stop the need of them resorting to illegally purchased Internet drugs.

Online pharmacies selling medication without a doctor’s prescription are thankfully being squeezed out as regulations get tougher. We are seeing more and more people coming to GenderGP for advice as their online, unsafe source has dried up. Medicines bought without a prescription are not regulated. There is no guarantee of the dose, strength, quality or composition of the medicine that will arrive through the post. And the message couldn’t be more clear: anyone taking such medicines is putting themselves at risk.

This is far different from a medicine that is dispensed by a pharmacist from a prescription written by a doctor who understands your medical history and the condition being treated.

For so long members of the transgender community have felt that self-medication was the only option and forums were their only source of information. But this is no longer the case.

There is so much more to gender care than reading advice in the forums and ‘giving it a go’. Ask your doctor to help you, arm yourself with your knowledge and share it with your GP. Campaign for better medical education at a local level so that the pressure on the only specialised service in the NHS that treats children, can be able to do so in a timely fashion. If you are feeling desperate, ask for legitimate help.

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