Hey all,
I've noticed a lot of our patients are using DIY oestrogen enanthate injections and I'm not necessarily opposed to this idea at all but I would like to understand better about what resources patients are using, what doses they are taking, if they are dosing subcutaneously or intramuscularly, where they are sourcing their product from etc for patient saftey purposes.
Some of my patients are just taking what their friends give them and can't give me reliable answers so I thought who better to ask than the community.
Any input is welcome and thank you in advance.
ETA: In particular I'm curious if anyone can tell me why it seems to be so popular at the moment? I feel like all my patients are talking to me about it and I'm just wondering why now?
I believe DIY is a response to inadequate medical care by professionals.
Rule 8: Do not discuss how to obtain unregulated medicine.
No need to discuss that. Only interested in health information for our patients. Certainly not at all interested in gatekeeping laboratory testing.
Generally we keep DIY discussions limited from the subreddit since we don't want to open it up to having a discussion misused by terfs or opening ourselves up to legal issues. However seeing as you're a medical facility, we are more likely to allow this post.
That being said, I will ask that you send us a message. Either directly or as a mod mail to confirm that you are actually the medical service please.
Thanks u/AbbieGator for moderation and confirmation that this account represents stonewall medical centre.
Can confirm that this is indeed an account from someone who represents Stonewall Medical Centre. We have a note on our mod side to indicate as such in the future.
In addition to my prescribed medication, I am also self-administering hormone therapy. However, due to the current medico-legal and political climate affecting transgender patients, I am not comfortable discussing this in detail, as disclosure could also result in discontinuation of my prescribed treatment by my GP. I have been on feminising hormone replacement therapy for approximately 40 years and have no history of significant adverse events, including thromboembolic complications. Clinically, I have found that maintaining serum estradiol levels slightly above the typical cisgender female reference range is associated with optimal psychological well-being and the most favourable physical outcomes for me, including breast development and body shape..
Most patients will be taking injections provided by people that use safe methods, they rarely, if ever, make it themselves, contaminants are extremely rare. Community testing has been done on the major suppliers that either ship to Australia or reside in Australia. Resources typically educate on avoiding coring and looking for any contaminants. IM and SubQ are both common and differ based on preference. I suggest you always offer to do blood tests for patients, as most people DIYing do not get them done as a referral is typically needed. Typical recommended dosages are about 4-5mg/7d or 7-8mg/10d for EEn. Some may do higher if it's not adequately suppressing testosterone without AA's.
DIY in Australia is typically cheaper than any other method of HRT unless they have concession PBS, which is why many do it (aside from easier access than through doctors). A lot of the community believe injections are "more effective" than tablets or gel due to people experiencing much better changes on them, though this is typically because their dosages on alternative methods were too low, and taking injections was just the first time they achieved adequate levels.
I will not be naming any suppliers not directly linking to informational websites due to your position, for the safety of the people running them.
Great answer. Just to expand one of your points though, the 'cheaper' is 1/3 to 1/4 the price when you include doctors visits . So, in a lot of cases it's an important amount cheaper. On 'why now', people are watching the US and UK and getting ready for when HRT is made illegal or much harder to access.
Thanks for your reply this is very helpful
A further aspect that played into my own decision to go diy injections was the convenience. Having been on gel for 8 months prior, the routine was very inconvenient, and always led to either me crashing end of day (before next dose), or applying in the morning, which means I'm spending a long time daily waiting for it to dry.
Implants require a level of trust in doctor because they last so long, which, having been underdosed in the past, I'm not willing to look into currently (until I have a consistent relationship with a doc I feel I can trust). Doc trust is another reason diy injections are very popular rn, especially with international political rising antitrans sentiment.
ALSO, the reason to diy injections VS get thru doc (beyond the insane price diff) is that EEn generally offers far more stable levels that EV (which you can technically get compounded). Lower peaks and higher troughs, which means less likely to have end of week crashes. EUn is another alternative that some people going diy may acquire, which can tentatively be considered equivalent to reandron in terms of dose freq (due to it being the same ester).
Thanks for this informative and useful response. Much appreciated
Why does this feel like phishing by police or anti-trans groups...
Coming from the same practice that records all calls for training an unnamed ai platform on our medical data? And then ignores any inquiries about it, and refuses to provide an opt out? Yeah I'd be suspicious too.
😢
You may be genuine in your questions but we have to think about our safety in this current political hellscape. Attacks on trans folks have been on the rise again so knowing who to trust and how far they can be trusted is really, really important.
Understandable with everything that has been going on.
I can reassure you stonewall medical is owned and operated exclusively by members of the community in which we serve. Always have been. For over 30 years.
EEn is not difficult to obtain, injections are on a weekly schedule due to it's regular cyclical peak at around 3.5 days, making scheduling simple and worry-free. It can be administered subcutaneously with a disposable 29G 12.7mm diabetes syringe. A high enough dosage*, while still falling within AUSPATH recommendations is plenty for monotherapy - which a lot of people like because spironolactone is horrid - and if androgen requires further suppression then a standard dose of microgenised progesterone can be added too.
*There is quite a lot of helpful information floating around this site on how much and what to use. Most suppliers seem to recommend a too-high dosage of around 6-7mg when 2-4 is probably plenty.
Thanks for this reply. Definitely helps my understanding
I don’t understand how you can claim to specialise in serving our community, be unaware of the political situation, history, and patients’ treatment-seeking context around the medical treatment you offer, and when somebody criticises you for requesting information that would compromise the security of our community and our access to necessary medication, you respond “😢”. You people are such a joke. What a disgrace.
Stonewall medical centre started operation in response to the AIDS epidemic when it was largely a palliative care service. We’ve been serving the LGBTIQA+ community for over 30 years.
I’m absolutely sad to see people responding as if we are policing gender.
As far as I know we are the only practice with expertise in gender affirming care offering new patient appointments in Brisbane under an informed consent model.
Again, your politics are so off base that the only frame you have to interpret this criticism is that i’m accusing you of “policing gender”. You interpret a material point in terms of identity.
You can’t lean on your history as an organisation to obfuscate the actual material basis and politics of your organisation, which is ngo-poisoned beyond belief and to the point where it has no connection to the needs and class situation of the population that needs the service.
It was u/evilicious_evil that made the point about gender policing, not you. You seem very committed to you being the main character in this story though.
I’ve made no mention of my politics.
Stonewall medical is not a non-government organisation.
We have plenty of connection to the community that we serve. Indeed we are that community.
No, evilicious evil made a comparison with the actual police. Exactly to my point.
And what do you mean made no mention of your politics? This is politics. You’re a political organisation. Your politics run through everything your organisation does, and is incredibly apparent in your every statement here.
🙂
Do not talk to the gender cops, people.
I'm not sure what to say to this except that Stonewall Medical Centre has a long history of providing gender affirming care to the community it serves and that this account has been verified by the moderating team.
I understand, but I have know way of knowing any of that. And I'm sure as someone who provides healthcare to trans people, you understand why we might be wary of accounts we don't know digging for information on something very important that many transphobes want to destroy.
Least personally pills/gels are obnoxious in quantity and frequency, patches are eh especially given the availability issues.
E enanthate let's you do weekly injections and is nominally less peaky than cypionate.
Makes it easier to do monotherapy too, Spiro is pretty annoying and cyproterone is eh especially long term
Exactly weekly injections. Easy to remember.
Makes a lot sense I agree
Because it works best for anyone without fail, it's cheaper and it's convenient.
Totally fair
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Your post/comment was removed due to a violation of Rule 8: Do not discuss how to obtain unregulated medicine.
Don't talk about how to obtain medication unless it's from a regulated pharmacist within Australia.
Rule 7 and 8:
They aren’t breaking rule 7 as they aren’t offering or selling meds and they aren’t discussing how to obtain so not rule 8 either. It’s a post about the safety information used by users when navigating DIY it’s important that safety is prioritised and understood by healthcare professionals that support us. Whether you see them or not you might one day and it’s important that they understand your position and can accurately inform the community.
I don't even think op is cleared with mods for one.
remove wrong place wrong time