Don't Take Medical Advice From Internet Strangers
Hey, you're asking a medical question to a group of random Internet Strangers! If they haven't already, someone will be along shortly to give you an ill-advised hot take. While you're waiting (or while the panic they've instilled in you is rising), you might want to consider the following:
You Shouldn't Take Medical Advice From Strangers on the Internet
... or, 10 things to watch out for when someone tries to give you some.
- Demand real qualifications (Appeal to False Authority) - Hold internet strangers to the same standard as your medical professionals. Before taking advice from either, ask: What is your clinical background? What treatment guidelines do you follow? How many patients have you successfully treated? If the answers aren't sufficient, seek help elsewhere.
- Confidence and jargon do not equal competence (Style Over Substance Fallacy) - Someone using complex endocrinology terms with absolute certainty on the internet does not make their advice clinically sound. It is incredibly easy to read a few studies, learn the vocabulary, and succumb to the Dunning-Kruger Effect.
- Upvotes are not peer reviews (Bandwagon Fallacy) - 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 (Fallacy of Oversimplification) - Adjusting doses based purely on your E/T levels ignores the rest of your body. Doctors must also monitor a wide array of other health indicators. Prescribing and dosing medication requires comprehensive training and knowledge of your body that none of us have.
- Beware of absolute certainty (Burden of Proof) - 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.
- Fringe regimens lack safety nets (Appeal to Novelty) - Medical science moves slowly for a reason: to do no harm. Unproven, experimental, or DIY regimens might promise faster or better results, but assuming "newer/alternative is better" is a fallacy.
- Puberty is a marathon, not a sprint (False Cause Fallacy) - Biological changes take years. Many people falsely believe that higher hormone doses or adding other drugs will cause faster feminization or masculinization. In reality, excessively high doses can stall progress or cause harm. As much as we would all like to get instant results, you cannot rush this.
- Your biology is highly unique (Anecdotal Fallacy) - Just because a specific dose, medication, or delivery method (pills, injections, patches) worked wonders for an internet stranger (or many internet strangers) does not mean it will work for you. Everyone’s body metabolizes medications differently based on genetics, age, weight, and receptor sensitivity. Generalizing one person's success story to everyone is dangerous.
- Strangers have zero accountability (Asymmetry of Risk) - If a medical professional gives you bad advice, they can lose their medical license, face malpractice suits, and ruin their career. If an internet stranger gives you advice that causes severe harm - even if they had good intentions! - they have no liability whatsoever.
- Dysphoria makes us vulnerable (Confirmation Bias) - When you are desperate for physical changes, facing medical gatekeeping, or dealing with intense gender dysphoria, you are highly susceptible to believing what you want to be true. It is easy to ignore the risks of a stranger's advice when they are promising you exactly what you want to hear.
Let's Reframe
Say you're going on a trip, and you've just boarded the plane to take you to your destination. The connection is tight, and if you miss this flight, there will be major impacts to your vacation.
Looking out the window, you notice smoke rising from one of the engines. The pilot comes on over the intercom and says that there will be an hour or more delay while a mechanic comes and fixes things.
One of the other passengers stands up. "Hey, I can fix it faster. I'm not a mechanic, or a pilot - those guys aren't trustworthy. They're liberal plants trying to use socialism to keep us grounded. I've watched hours of YouTube videos and read hundreds of tweets on X that confirm it. I can tell what's wrong with it just by the noise it's making. It's the airstream carburetor manifold, it's not getting the right fuel/air mix. Let me take a look at the engine instead."
What's your reaction?
As far as I'm concerned, I wouldn't want this person looking at the engine and trying to fix it.
Does it matter what the politics of the person are?
I portrayed them as right-wing, which is often anti-transgender. But would it matter if they were left-wing or explicitly pro-transgender? It makes a small difference in how receptive you may be to the message, but the message is the same... right?
When we get HRT advice from the internet, we're often getting it from pro-transgender sources, which can make it feel like it's more reasonable or reliable than it really is. On top of that, the source of the social media data they're basing their opinion on doesn't matter either - Discord, Reddit, Facebook, X, TikTok, YouTube - they're all not good sources of information this critical.
Does their use of engineering jargon make them seem more trustworthy?
Certainly those are words involved in the process of engine maintenance, so it's possible that they know something about the topic. Despite this, they are rejecting experts and science that conflicts with their worldview.
When it comes to HRT, don't ascribe additional weight to people's opinions just because they use technical endocrinology terms.
You're in a rush - isn't having this passenger look at it faster?
Did you remember that part of the story? You're trying to get somewhere quickly. Having this passenger look at the engine is a faster option. Still, delaying and deferring to an expert is still the smart choice.
Remember that this is your health you're putting into someone else's hands. Have high standards for the people you trust with it, and stick to those standards, even if another route seems easier or quicker in the short term.
What if the mechanic is wrong?
Did you consider that there's a non-zero chance that the mechanic who would come later to look at the engine could make a mistake? Mechanics are human, and there are certainly times when they screw up.
But the mechanic has a higher probability of getting things done right - they've got training and expertise. They (at least should) be following guidelines for safety and reliability. Everything that they do is documented and signed off on. While there's a chance they screw up, ignore all the safety signals and warnings, and something bad happens... they're still better than the passenger - who knows and does none of these things.
Unlike the mechanic, when it comes to medicine, you get to talk to your doctor. You can ask questions, and educate yourself about the medications, treatment plans, side effects, etc. You get to be your own advocate and safety coordinator.
I'm not suggesting that there are no bad doctors, or that you should blindly trust what experts tell you. Still, you're starting from a very different place when you get their advice.