A transguy recently complained that it was absurd how much easier it was for him to get a prescription for a medication he needs at most once every six month than to start testosterone, which would improve his health every day. He is frustrated that he must twirl his thumbs during a waiting list over 2 years long. It does not add up but he does not know the full extent of the ridicule likely ahead of him when he finally does have a prescription.
Here is a small selection of my growing collection of horror stories. In the days prior to learning how to self-inject, one of my shots fell on a week my GP was away. The substitute doctor denied my shot on the account that I was balding too fast. All of the blood work I have had to date puts my testosterone count within the medically preferred range, my red hemoglobin count has always been fine ditto with my blood pressure, cholesterol and liver functions. Based solely on the speed of hair loss, which in my case is due to genetic predisposition, I could not access my previously doctor sanctioned dose from a vial already prescribed. This incident coupled with bad experiences with trans-ignorant nurses motivated me to learn how to self-inject. That way I could avoid future dilemmas. Or so I thought.
Long waiting lists and trans-ignorant staff were the tip of the iceberg. Pharmacies are the true beasts I wrestle. I’m assured they are well meaning and “just doing their jobs.” They make it hard to appreciate the “good will” or believe they’re “following protocol.”
I am bound to hormone replacement therapy (HRT) for the rest of my life. Given my stellar blood work history, my GP writes scripts with many refills. Pharmacies do not approve of this. I have tried a dozen pharmacies, including the one that probably deals the most with trans people in Toronto. That one has been the site of the worse headaches. Every pharmacist reminds me that testosterone is a controlled substance. As such, it is closely monitored when inspectors come to evaluate pharmacies. At least, that’s what I’m told. This is the excuse used to explain why they cannot dispense more than one vial at a time even though I have no history of abusing my medication. These claims started to reek the summer I was finally able to prove a pharmacy had filled three vials for me but withheld them on site, one of them for over a year! I don’t know how often pharmaceutical inspections occur but I went from being forced off T for months to having three vials in a week. The inspectors don’t care if pharmacies fill the script and keep them lined up ready for pick up? Even when pick ups are denied for months on end, sometimes over a year? I’m missing logic here.
I only got the vials, after many threats that I would no longer be served, because my doctor sent a fax of script granting records following numerous phone calls where he confirmed that I was legitimately requesting more testosterone.
I have faced humiliation as various pharmacists raised their voices to paint me to others around as a ’roid rage junkie. Not to be outdone, one doctor did the same based on her wrongly reading the dates on my electronic records. After enduring an hour of displaced reproached and accusations, she did a 180 lecturing me on the need to adhere to a regular dose schedule when she realised I was late in getting the refill. Sometimes I wonder if these people hear themself as they issue their condescending hypocritical and wholly displaced crap.
Getting the prescription written is the easy part. If I go in and a pharmacy’s records show I have more than 1 shot left, then I am ineligible for a refill. I explain calmly and politely that I travel a lot and I’m busy working multiple jobs so I’m not able to come back before I run out but to no avail. I’d chalk some of this to being relatively young and transphobia but…
For three years I took very strong medication for chronic pain management. This drug has significant (and well known) side effects on certain brain functions. None the less, every time I went in for testosterone and was denied, they would “consol” me by handing me an unrequested refill of the brain altering pain med. Mind boggling. Another med I had to take briefly has a documented history of potentially causing dependence was issued without anyone batting an eyelash and more than was approved by my doc! Pharmacists don’t mind that I become a junkie after all, as long as it’s with medication that scrambles my brain instead of the stuff that improves my mental health.
And I haven’t touched on inconsistencies in the product make-up (and more importantly, the futile attempts to bring this to pharmacists’ attention). Or the trials and tribulations of getting injection supplies. Or specialists and surgeons’ twisted take on trans people’s HRT. Or why I prefer injections to alternative forms of absorbing testosterone. But those are posts unto themselves. It is clear to me there needs to be more clinics with trans knowledgeable GPs so trans folks stop waiting years to improve their mental health. But just as much, we need pharmacies that don’t override GPs ‘scripts for no good reason.
