This past week, an online directory that helped users access gender-affirming hormones through international pharmacies shut down.
HRT Cafe provided people with tips and points of access for DIY transition care, a process through which people access gender-affirming care without direct medical supervision. This often takes the form of receiving medication from international pharmacies, or informal networks of supply. HRT Cafe was the largest access point for DIY care in the U.K.
Over the years, the site had become a popular resource for people who were unable to get gender-affirming care through their mainstream healthcare systems due to factors like financial or geographic barriers, medical gatekeeping or interminable wait-lists.
The site disappeared suddenly and without explanation, leaving those who relied on it cut off from their healthcare. HRT Cafe had been facing scrutiny—namely in the form of reporting from right-wing news outlets spotlighting the practice of self-administered transition care—before it suddenly vanished.
But this story is bigger than just one site. Critics of DIY care have pointed out that the approach can be risky, and they’re not wrong—taking unregulated meds, or taking meds without monitoring, does carry risk. But for many, DIY care isn’t a first choice. It’s not an uncommon experience either: as Pink News pointed out, about a quarter of trans people in the U.K. have engaged in DIY care at some point.
Trans care—and by extension, the existence of trans people—is under undeniable attack, so it’s no wonder there are people trying to take care into their own hands. Which is why this sudden disappearance of a large provider matters.
If you’re trying to understand more deeply about the importance of this moment, Script columnist Kai Cheng Thom wrote about trans people’s long history with DIY approaches to care and why trans health belongs in trans hands.
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