DIY Transition: Informal Hormone Use and Transgender Community Care in The Netherlands

Abstract

Nowadays, gender affirming hormone therapy for transgender people is available in hospitals in the Netherlands. However, many transgender people use hormones informally at some point during their transition. This practice is believed to be the result of the long waiting times for trans healthcare, but little is known about how self-medication is organized in the trans community.

In this thesis, I record self-medication practices among trans people in the Netherlands from the perspective of people who engage in them. Using seven semi-structured interviews, I show some of the organizational structures shaping self-medication, as well as people’s motivations for making use of it.

In Chapter 1, I follow one person’s transition path, to show that they have often relied on the trans community for care that was unavailable through the conventional healthcare system. In Chapter 2, I give a more general outline of what types of information and care are exchanged within the trans community: from online forums where people share experiences to organized groups who give practical transition help. I also show how trust is formed in these different contexts. In Chapter 3, I describe the ideal trans healthcare system as envisioned by my interviewees. I argue that they are mainly looking for care as defined by Annemarie Mol, which the current healthcare system is ill-suited to provide. A strong informed consent model could be an alternative worth exploring.