transition on demand for free | a fragment of the day

for more on these matters, here are some past posts, with links to other past posts: from 2022 and earlier; from earlier this year.

i’ve just received a notice from Callen-Lorde Community Clinic (known to new yorkers as “big gay health”) asking me to sign a “SPECIFIC INFORMED CONSENT FOR GENDER AFFIRMING HORMONE THERAPY – ESTROGENS” form (pix/alt-text below).

i will not be signing it.

this is adapted from what I wrote to the Callen-Lorde leadership, and what i posted elsewhere:

this new “informed consent” form is either (1) pre-emptive compliance with the regime’s demand for a list of trans people receiving medical care; (2) an ill-thought-out and utterly useless attempt at ass-covering against the regime by creating exactly the documentation they want; (3) a scare tactic to push trans people off HRT.

the form’s list of side effects of exogenous estrogen is based on research that was not done on trans women, and is in many cases outdated. it is framed in ways that directly use the language and scare-tactics of the anti-trans far right.

this is a conscious and disgusting betrayal of Callen-Lorde’s trans patients. that’s true whatever the motives behind it, whatever imaginary game of fuck-you-dimensional chess the clinic’s leadership and lawyers think they’re playing.

you resist genocidal policies by refusing to do anything that even vaguely complies with them, not by doing what they tell you – and especially not by doing what they tell you and pretending it’s non-compliance.

here is where you can find a list of the people in charge at Callen-Lorde (though without contact information for any of them). the only person i found on social media (a very shallow search) willing to admit to their job at CL is Executive VP for Research & Education asa radix: @asaradix.bsky.social

give them all a piece of your mind.

tell them not to collaborate with the regime & its anti-trans allies. tell them to yell at our mayor (who has so far done nothing to protect trans health, despite specific policy and funding promises) to have their backs.

and remind them we can see them.

remember:

“informed consent” gatekeeping is just regular gatekeeping whenever the doctors and other “experts” in charge decide it is – including trans “expert” gatekeepers.

you can’t identify yr way out of a structural relationship.

you can’t 501c yr way out of a structural relationship.

this underscores why we (trans ppl, but also others) need full-scale autonomous healthcare structures to have secure, sustainable access to health care. and why it’s a damn good thing the starting point for that has been HRT compounding and redistribution.

if you want estrogen, there is a project near you who can hook you up. ask a trans woman who’s a punk, or an anarchist, or both. and remember: the fearmongering about sources of HRT is the same as the fearmongering against HRT. more on all that here.

take care of your sisters & siblings.

refuse to collaborate with the regime. as keguro macharia asks: “how are you imagining freedom today? how are you practicing freedom today?”

and as margaret killjoy writes: “love comes before tear gas like ozone comes before a storm.”

the state will not protect us. even your favorite politician.

the 501Cs will not protect us.

we will protect and free ourselves.

autonomous trans healthcare now! and nothing less.

and because we cannot be free unless all of us are free:

abolition now! and nothing less.

(edited to fit alt-text length limit)
CALLEN-LORDE

SPECIFIC INFORMED CONSENT FOR GENDER AFFIRMING HORMONE THERAPY - ESTROGENS

Hormone therapy is an important component of transition for some transgender and nonbinary people to change secondary sex characteristics to affirm a gender presentation that is consistent with their gender identity. Estrogens have been used for decades for this purpose, but its use in gender affirmation is still considered off label by the FDA). While there are risks associated with taking hormones for the purpose of gender affirmation, when appropriately prescribed they can greatly improve quality of life and psychological well-being. However, there is limited high-certainty evidence about the effects of estrogens used for gender affirmation on health outcomes such as bone health, fertility, and cardiovascular health. The goal of this consent form is to review the potential risks and benefits associated with the use of estrogen therapy and review the risks associated with its use.

A. The full medical effects and safety of estrogen therapy are not fully known. Potential adverse effects may include, but are not limited to:

Increased/decreased cholesterol which may increase risk for heart attack or stroke

Increased risk of the following:
◦ Blood clots (deep venous thrombosis, pulmonary embolism)
◦ Breast tumors/cancer
◦ Heart disease, arrhythmias, stroke
◦ Pituitary tumors
◦ Infertility while on treatment

Decreased number of red blood cells

Decreased sex drive and sexual functioning, including erectile dysfunction

Psychiatric symptoms: depression and suicidal feelings; anxiety; psychosis (disorganization and loss of touch with reality), and worsening of pre-existing psychiatric illnesses

Genital changes (i.e., smaller testes & penis)

Infertility

Cholelithiasis (gall bladder disease)

B. Some side effects from hormones are irreversible and can cause death.

C. The risks for some of the above adverse events may be INCREASED by

• Pre-existing medical conditions

• Pre-existing psychiatric conditions

• Cigarette smoking

• Alcohol use

D. Irreversible body changes (potential increases with length of time on hormones) resulting from hormone therapy may include, but are not limited to:

• Breast growth

• Possible lifetime infertility

E. Estrogens are usually given with androgen blockers. Potential adverse effects may include, but are not limited to:

• Increased levels of potassium in the blood, which may cause abnormal heart rhythms (if spironolactone is prescribed)

• Liver inflammation (flutamide, bicalutamide, cyproterone acetate)

• Decreased bone density (GnRH agonists, e.g., leuprolide, buserelin, histrelin, goserelin)

Medical Treatment with Estrogens

• 1. I have been told about the risks, benefits, and possible side-effects of treatment with estrogens. Initials:

• 2. I understand the likely physical changes associated with the use of estrogens. Initials:

• 3. I understand this treatment is voluntary and not required. Initials:

• 4. I understand some changes from estrogen are permanent and even if I stop estrogen treatment, some changes will persist. Initials:

• 5. I understand estrogens have been used for a long time to treat other medical conditions, but their use in gender affirmation is considered off label. Initials:

• 6. I understand that the long-term effects of estrogens in this context are still being studied. Initials:

• 7. I understand estrogens may affect future fertility. Initials:

• 8. I have been informed about the option of fertility preservation before starting treatment. Initials:

• 9. I understand that stopping treatment should be done with support and planning from the medical team. Initials:

• 10. I understand that I can ask questions at any time and receive support to make informed decisions. Initials:

• 11. I understand that I can withdraw consent at any time and stop gender affirmation treatment.

(to get a few things out of the way as a preamble)

what i want in the world is for folks (of all ages) to be able to make and put into effect any decision they want about what to do with their bodies – which means, practically, working for there to be more and more possibilities available to more and more people. in the realms of gender and sexuality that includes access to all kinds of body modifications, whether towards or away from any particular socially recognized gender position, and also access to all kinds of options for reproduction, from permanently or temporarily preventing it to actively facilitating it. what’s important to me is the possibility of real, meaningful choice, and the removal of restraints on that.

probably because of coming up right before and after the arrival of antiretrovirals, i think about most of the access-to-medical-transition stuff as a “drugs in bodies” question, through the analogy of AZT. in the absence of much actual decent research on HRT drugs (either to learn more about their longterm effects or towards making better ones), we already know they’re generally shitty, but bad drugs in living bodies is better than dead bodies.

(and here’s the meat of the post)

so: in the current conversations, mostly things are framed as a fight in which advocates for kids’ access to puberty blockers face off against advocates of “reparative/corrective therapy” to normalize kids to their assigned genders. that’s how, for instance, julia serano sets things up in her mostly useful piece on Med iu m last year.

and that’s generally how things play out among trans community activists, parents, TERFs, and other folks outside the medical institutions involved.

but here’s the thing: that’s not a divide that exists among the doctors.

the best-known puberty-blocker doctors and the best-known “reparative” therapists work together, publish together, and generally see each other as collaborators rather than opponents. kenneth zucker and peggy cohen-kettenis, for instance, co-wrote the chapter on “gender identity disorder in children and adolescents” for a 2012 “handbook of sexual and gender identity disorders”. and that’s not an anomaly: even a mild bit of googling finds the two of them as co-authors on papers all the way from the late 1990s to the past few years (with at least a few also including ray blanchard in the credits). and that collaboration isn’t just on the page: well-sourced gossip tells me that before zucker’s clinic was shut down (finally!), he was known to send so many kids who didn’t respond to his “conversion therapy” bullshit to puberty-blocker clinics that he was considered one of their biggest referrers.

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ראָזעלע זושוק האַלעװי

a fragment of the day

Tag Archives: transition on demand for free

Callen-Lorde to trans people: fuck you

all the doctors are friends (but not our friends)

(to get a few things out of the way as a preamble)

(and here’s the meat of the post)

ראָזעלע זושוק האַלעװי