Use Caution When Taking Medical Advice
If you are transitioning today, the online transgender community is one of the most powerful tools at your disposal. But the power of the community comes with a major blind spot. I frequently watch interactions in trans spaces that go like this:
New Person: "I just started HRT, and my doctor put me on
<xyz>dose. I'm worried it's too low and my transition is going to stall."
Helpful Internet Stranger: "Oh, you should absolutely push to switch to
<abc>method/dose! I was on your dose for a year with zero changes, but when I switched to<abc>, I saw massive results in three months. Don't let them string you along!"
New Person: "Wow, thank you! I'm going to change my meds immediately."
This isn't malicious; it is a genuine attempt at helping. The internet stranger is trying to save the new person from the pain of a stalled transition. But there's still a good chance that their advice isn't helpful, and could actually be harmful.
Navigating your transition today means acting as your own strongest medical advocate. Taking charge of your healthcare doesn't just mean knowing when a doctor is wrong. It also means knowing how to spot bad science, and treating your body like a unique ecosystem rather than a community science experiment.
What to be cautious about when you're offered medical advice on the internet
- The Illusion of Expertise - Using complex terminology does not make a person's advice clinically sound. People claiming to be experts on the internet are actually less likely to be experts the more they insist. Experts won't give out medical advice to people without a complete understanding of the person and the situation, and without making sure the recipient is informed of the risks.
- Upvotes are not peer reviews - Social media platforms (Reddit, Discord, etc) are designed to reward engaging, popular, or emotionally resonant content, not scientific accuracy. Just because a piece of advice has 500 upvotes or dozens of heart emoji reactions does not mean it is medically true or safe.
- Hormone levels are only a fraction of the picture - Your body is one of the most complex things on planet Earth! Someone insisting on a course of treatment with minimal information is ignoring this fact. Proper transgender care means monitoring a wide array of health indicators.
- Your body is unique - Just because a specific dose, medication, or delivery method worked for someone else (or many people) does not mean it will work for you. Prescribing and dosing medication requires comprehensive training and knowledge of your body that none of us have.
- Beware of absolute certainty - Because transgender healthcare is still evolving, the most honest, scientifically accurate answer to many HRT questions is, "We don't have enough long-term data yet." If a stranger claims to have the definitive, "perfect" answer to a complex medical question, the burden of proof is on them to provide legitimate sources.
What you should do instead
Start by learning the basics
- What medications are available to you? Depending on your desired gender and where in the world you live, this can vary. Try to know the key hormones and blockers, especially.
- What methods of delivery are available to you? There may be pills, patches, gels, injections, and more. Understand what the advantages and disadvantages are. Do you have preferences between them?
- What routes to care do you have? Do you have access to a medical professional to help? If not, what level of risk are you willing to take?
I put together a page of resources for transfemme HRT in particular that I've found to be trustworthy. Just remember to evaluate my sources for yourself, and watch out for the issues I've mentioned above. While I've done my best, I'm still human, and I'm not an expert in this area.
Recognize that while community information sources are vital to help us close the transgender knowledge gap, they are prone to weaknesses and biases.
Ask questions of the people who offer you care
If you have access to a medical professional
If you have access to a medical professional, know that not all of them are trustworthy. You may encounter a transphobic doctor, or one that is well-meaning but underinformed.
When you meet with them, try to learn more about them:
- Do they see a lot of transgender patients?
- What are their views on transgender issues?
- How long does it tend to take their patients to see results?
- What does their treatment plan entail?
- Do they allow you to be an active participant in your treatment?
I myself have encountered bad professionals - doctors who encouraged self harm, or refused to treat me. If you have choices, don't settle!
If you don't have access to a medical professional
You may have to wade into reading standards, studies, papers, etc and interpreting them, or trusting others to interpret them for you. Be careful about who and what you trust - your health is on the line!
Be wary of the issues I mentioned in the first section. To recap, watch out for people who consider themselves to be experts, giving you authoritative-sounding advice based on minimal information about your body.
When presented with medical advice, the most important question to ask is "What is the source of this information?" Watch out for sources that don't have a grounding in science. The more layers between "you" and "things that have been verified," the more likely that the message has been distorted.
Conclusion
I hope that you will carefully consider the advice you are given and its source - and keep in mind the bad patterns that plague most online medical advice. Don't let hot takes, social pressure, and the false sense of urgency/panic rule. Make the most rational, well-informed decisions you can.
I sincerely hope that everyone who reads this - whether they agree with it or not, and regardless of how they get their HRT or medical advice - meets their transition goals.