Ordering hormones via internet yourself
Using hormones acquired through the internet is sometimes called self-medication. Many websites don’t ask any questions, or if they do, the screening is done a lot less thoroughly than how a gatekeeping psychologist would do it. Warning: this route can be dangerous. Although we know several people who have had positive experiences, there are also people who have had very negative experiences. Make sure you get comprehensive information about what hormones do and what dosages are normal in advance. For instance see the pages about hormone therapy in male to female transgender persons and hormone therapy in female to male transgender persons on the VUmc gender team site. Also find places where you can have your blood hormone levels and your bone density checked in advance.
There are several important dangers and disadvantages to self-medication:
1) Sometimes the dosage isn’t accurate. The quantity of active medicine may match what is announced on the package, but it doesn’t have to be. Sometimes it contains more, sometimes less. There may also be other ingredients than announced on the package. Also see the report by Transvisie for the implications this can have.
2) The pills may also contain different active ingredients or contaminations. This isn’t visible to the naked eye. Medication may have the same packaging, the same labels, the same shape, the same blister strips as medication from the pharmacy... and yet contain pills with different active ingredients and/or contaminations. We once saw a German documentary in which pills from England were supplied via South America and produced in India. They were produced in pitiful circumstances by people working at home.
3) Importing medication from abroad is not allowed in the Netherlands, the customs office can confiscate the packets. For more information look at the customs office website.
4) Because this way to acquire medicine is illegal, there usually is no reimbursement by the health insurance. The costs can be quite substantial. For example: testosterone for men costs about € 100 per month.
5) Patients have to find a place to have the hormone levels in their blood tested. (In the Netherlands this is now possible at VUmc, but also at http://www.bloedwaardentest.nl/). Some patients choose not to have their blood levels tested (maybe because they cannot afford it). Patients who get their medicine prescribed by a doctor usually get their blood tests free of charge.
If you want more information about hormones via internet, ask your questions in the Facebook-groups mentioned under "suggestions and contact". There is always somebody who can give good answers to your questions.
Why do people order hormones via the internet?
Many care providers just condemn acquiring hormones through the internet. This is understandable, considering the risks and the fact that this solution can be illegal. But there is another side to this: if it is so reprehensible, why do transgender people sometimes choose this route anyway? Several answers are possible:
1) Transgender people may want to experience themselves what it feels like to take hormones, before they start a formal route to "ask for permission" to do this. By starting earlier on their own initiative, they can be (more) certain that this step is necessarily for them. They feel this will help them to convince a gatekeeping psychologist.
2) They may be in a route with a gatekeeping psychologist, but the waiting lasts too long (both the waiting list and the duration of the diagnostic process). The prolonged waiting time may give rise to all sorts of mental complaints. The gatekeeping psychologists often oversee or underestimate these. Starting earlier, in whatever way possible, is a necessity then.
3) They may have negative experiences with gatekeeping psychologists and/or do not recognize the authority of the gatekeeping psychologist, which makes them search for a route without a psychologist. In the Netherlands we unfortunately don’t have care providers who work according to the Informed Consent-model yet, so there is no regular way here to get hormones or operations without seeing a gatekeeping psychologist.
Where to order?
If we would put links to companies who can supply you with hormones on this page, these companies might get into trouble with overzealous gender teams who want to nip these initiatives in the bud. Because we are convinced that in the current situation Dutch transgender care cannot do without hormones from the internet, we will give these addresses only to people we know. See the page "suggestions and contact" for ways to get in touch with us.