If you’re someone at higher risk due to the US election, I want you to know that I’ll do what I can to help and support you.

If you find yourself in Colorado and need a place to stay for a few days—or just need someone to talk to—PLEASE reach out. I’m sick to my stomach, but I’m trying to figure out how to keep things positive.

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Puberty blockers ban

As many of you may already be aware, as one of their last acts in power, the government has placed restrictions on new prescriptions (NHS or private) of puberty blockers for trans people under 18.

gov.uk/government/news/new-res…

The affected medications are ones that contain:

• buserelin
• gonadorelin
• goserelin
• leuprorelin acetate
• nafarelin
• triptorelin

It should be noted that that this is not a complete list of such medications, commonly referred to as gonadotropin-releasing hormone agonists.

• Gonadotropin-releasing hormone agonists
• Available forms

Additionally, there are similar drugs referred to as gonadotropin-releasing hormone antagonists. These have the same outcomes and low risk profiles of the banned medications, but have notably not been included in the ban.

• Gonadotropin-releasing hormone antagonists
• Available forms

Alternatives to puberty blockers

Whilst puberty blockers are considered the gold standard:

• They were mainly offered in place of gender-affirming hormone therapy in order to delay the medical transition of trans kids, in the hopes that they could be "persuaded" that they're not actually trans (i.e., conversion therapy).
• Other alternatives to these do exist and are commonly available.

Anti-androgens

One notable alternative for trans fem kids is bicalutamide. It's not a perfect drug, as it has a rare chance of causing liver issues, so needs regular monitoring, but it can stop masculinisation by blocking androgen receptors in the body. It also has comparatively few common side effects vs other medications like spironolactone or cyproterone acetate, which are less ideal anti-androgens.

Anti-oestrogens

There are alternative anti-oestrogens, but they typically have a lot of side effects and risks. As a rule, most don't come highly recommended.

Monotherapy

It's very notable that the ban does not ban any oestradiol (aka estradiol; estrogen) or testosterone prescriptions.

This means that there is nothing to stop supportive parents from helping their trans kids to get a private prescription for oestradiol or testosterone.

Furthermore, due to the way human bodies work, if you maintain a high-enough trough (lowest) level of either oestradiol or testosterone, the body will basically tell the gonads to stop producing that hormone.

For trans fems, monotherapy typically requires maintaining an oestradiol trough of around 750 pmol/L. It varies from person to person, so some folks might need as little as 350 pmol/L.

You'll know if their oestradiol trough is sufficient if their testosterone level is 2.4 nmol/L or lower, though up to 3 nmol/L is still considered within the high-end of female range.

For trans mascs, a testosterone trough of around 10-12 nmol/L is generally considered the aim when using prescription testosterone medications like Nebido or Sustanon, with a peak around 25-30 nmol/L.

You'll typically know if their testosterone trough is sufficient if their oestradiol level is under 150 pmol/L, though some folks may be up to around 180 pmol/L.

Monotherapy completely avoids the need for a puberty blocker, an anti-androgen, or an anti-oestrogen.

It also has the delightful side-effect of making your trans kid happy to be starting the puberty that they want to go through sooner, thus alleviating their feelings of gender dysphoria and allowing them to enjoy their lives, rather than continuing to wait on non-existent NHS healthcare.

For trans fems, monotherapy is most easily achieved by a daily high-dose of oestradiol in the form of oestrogel (oestrogen gel) applied to a high-absorption area, but could in theory be achieved by sufficient patches applied twice weekly. Injections and implants are sadly not available on prescription.

For trans mascs, monotherapy can be achieved by daily application of testosterone gel or cream, but is more easily achieved by testosterone injections (Nebido or Sustanon).

Blood tests

These can be done privately, completely avoiding the need for the NHS.

You can find more information here:

• genderkit.org.uk/resources/blo…
• transactual.org.uk/medical-tra…

Where can we find more information about gender-affirming care by experts who actually want to help trans kids?

Although far from perfect, arguably the best sources currently are:

• WPATH Standards Of Care 8
• UCSF guidelines for gender-affirming care

What if I'm still confused about all this?

Ask for help. We're all in this together. Some of us know a lot about how broken trans healthcare is on the NHS right now, not just for trans kids but for trans adults too.

The key thing to remember is that you are never alone. All you have to do is reach out and ask for help ​

Edits: Minor changes to language use and to add additional information.

#trans #transgender #enby #NonBinary #agender #genderfluid #genderqueer #transition #TransKids #TransKidsDeserveToThrive #ProtectTransKids #TransLiberation #TransLiberationNow #OpenHRT #TransRights #TransRightsAreHumanRights #queer #LGBTQ+ #LGBTQIA+ #PubertyBlockers #GnRH #GnRHAgonists #GnRHAntagonists #AntiAndrogens #AntiEstrogens #AntiOestrogens

New restrictions on puberty blockers

New regulations restrict the prescribing and supply of puberty-suppressing hormones to children and young people under 18.

^{Department of Health and Social Care (GOV.UK)}