no more oestrogen?

[chrith]

my friends son is autistic and says he’s trans. He’s taken oestrogen for over a year but has recently been told that he can’t have it anymore. He’s 20. Friend is framing it as a bigoted GP service. I’m wondering if this is common, stopping a HRT service for very young people, in light of the Cass review? He’s a very young 20 too and very vulnerable with very poor mental health.

It might be that his prescription is from an unregulated provider and the GP will no longer accept it under a shared care agreement

Ah. I hadn’t thought of that. I wondered if it was in response to Cass. Mum doesn’t seem concerned about the health implications of her son taking oestrogen.

men should not be taking oestrogen

It’s not HRT. It’s a cross-sex hormone. Let’s not confuse it with prescribing to replace female hormones.

I wouldn't have thought it was an age thing at 20, but some Gaps have just decided to stop prescribing hormones for "gender affirmation" because they don't feel that it is within their competencies, which is fair enough IMO.

See eg www.reddit.com/r/transgenderUK/comments/1fz7qwa/hormones_being_discontinued/

It'll be exactly this

There are many possible reasons. Perhaps he was issued it as a 'bridging prescription' (i.e. GP initiated) and they have thought better of it. Perhaps he had initially been seen and assessed by GenderGP and the GP now no longer wants to do shared care with them due to LMC advice. Perhaps he had been seen by another, more reputable, private clinic and his shared care has lapsed, either because he stopped attending follow-ups with the private clinic or the GP who agreed to do the shared care has left. Perhaps his surgery has decided to do no more gender prescriptions at all, for anyone, as this is unfunded work, or due to a change in LMC advice.

Maybe his GP no longer wants to take the risk of supplying medications, unfunded, with no evidence base, and face the possibility of being sued in the future. Or maybe they are bigoted.

Cass covered children only. And although she was very concerned about vulnerable young adults, and recommended that services be reviewed for this section of the population, her recommendations did not apply to young adults.

yes, my mistake, words are important. I looked up the (many) side effects of men taking oestrogen and it’s shocking. And this is a lifelong thing for many: how can it be prescribed by a responsible doctor, it’s baffling?

Assuming too if its not part of the NHS care contract the Doctor would need private insurance and the risks of future cases must make any policy cover expensive.

he’s hoping for bottom surgery, which would absolutely terrify me as a Mum, but friend is very much taking the affirmative approach. He’s autistic, never goes out anywhere, has never had a relationship. It surprises me that any clinic or hospital would remove the genitalia of someone who hasn’t had a relationship because how do they know what they’re missing if they’ve had no experience of it? And obviously it means infertility, which I think friend thinks is reversible!

this is happening a lot across other areas of shared care eg adhd meds where people
have been diagnosed in a private company. Agree it’s likely to be this

I wonder if it’s worth sending her some of the blog posts by Ritchie Heron?

It will be stopped for his own good, thank God this country is coming to it's senses at last.

I do wonder; though wouldn’t ask her, about the long term effects of 17 months on oestrogen? Will he now be infertile? I know it can cause liver issues too.