Give Trans People Their Hormones

As a person pursuing a career in health and medicine, often I am confronted with the question: if there is anything about healthcare you would change right now, what would it be? In fact, in my interview for pharmacy school, I was asked something to this effect. If there is anything about healthcare I would change right now, what would it be?

My first answer has always been that I would make it affordable. Free for all. I don’t believe that impoverished populations need to be subjected to life-threatening diseases simply because they don’t have the money to afford care. I don’t believe that impoverished populations need to die in the name of class differences.

But lately, I’ve been pondering a less conventional answer. More and more articles are being written about the anti-transgender sentiments of pharmacists and doctors when it comes to hormonal therapy. Many doctors refuse to even participate in prescribing and managing this treatment, and many pharmacists refuse to fill these prescriptions at community or retail pharmacies on the occasion that a doctor is willing to help a transgender person in their transition.

If I could change one thing about healthcare right now, I would make it a more accepting and socially cognizant field.

Almost every person I’ve met who wants to be a medical professional has a similar answer as to why they want to pursue this career: they want to help people. This is a nice, flowery, dreamy answer. It’s saccharine. It’s ephemeral. When push comes to shove, in this industry, there are loads of policies and laws policing people’s bodies. In Utah, a biological sex law has been proposed in which gender and sex are equated, which prevents trans individuals from pursuing the care they need.

Pictured above are Merrill Nelson (top) and Ralph Okerlund (bottom), who are the respective representative and senator in the Utah House and Senate that are the two primary sponsors of the Utah Vital Statistics Act Amendment (HB 153), which effectively erases the identities of trans individuals. Vote them out!

 

This systemic oppression leaks into the individual interactions we have. Doctors and pharmacists have shared prejudice against trans individuals. In July of 2018, a pharmacist working in a CVS in Arizona refused to fill the hormonal prescription of a trans woman and to return the prescription to the patient so that she would be able to fill the prescription elsewhere. Even though this prescription was complete and not filling it would go against company policy, the pharmacist acted unjustly against this trans woman because she was an agent of the larger systemic oppression against trans people.

Many will say that trans individuals don’t need to present as their gender or attempt to attain the conventional form of a woman or man or androgynous person. As a person in science, I am astounded at this ignorance. Treating a person with dysphoria is no different than treating a person who shows signs of aging and feels poorly. Literally. They are treated in the same way: with hormones. In my time as a pharmacy technician, I have filled countless prescriptions of estradiol (the most common form of estrogen in a non-pregnant cisgender woman) for both trans women and cis women who are fighting old age. Both of these populations suffer from the mental deficits of not feeling like their body is their own to claim. Why is the cisgender woman more valid in fighting old age than the transgender woman fighting dysphoria?

Even if a pharmacist, pharmacy intern, or pharmacy technician chooses to fill the hormonal therapy, it is essential for the team as a whole to be conscientious of their own prejudice. I cannot express the number of times I have heard casual transphobia amidst conversation. It is important to remember that even if you think someone is cis, they might not be. Comments against trans people further degrade their morale in coming out and feeling free to be who they are.

This is especially important to keep in mind in healthcare, as medical professionals' first and only priority is to take care of the patient, whoever they may be and no matter their background. Our job is not to criticize or project our own beliefs onto any person, but rather to assist them in their journey to wellness. The epidemic against trans folks is one that needs to be taken seriously and talked about freely if there is going to be any change. I believe this change should start now.