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[-] TheLeadenSea@sh.itjust.works 11 points 5 days ago

Guess what also permanently changes a body's appearance - natal puberty

HRT just changes it in the other direction, a preferred direction, that doesn't cause dysphoria, and blockers (which are demonstrated to be safe enough that cis kids with precocious puberty can use them) just prevent any changes until they're stopped/HRT is started

[-] prettybunnys@piefed.social 4 points 5 days ago* (last edited 5 days ago)

Ok so ethically the whole thing puts doctors in a situation where it’s tough.

A doctor worth their oath will have a hard time ethically, for the same reason your GP should refer you to a psychiatrist for psychiatric meds. The appropriate medical professional needs to be looped in for ethical reasons.

Simply because they are unable to quantify the harm being done, but a therapist can. So in order to uphold their oath they must have proof from a medical professional who can affirm harm is being caused.

Yes, there are assholes who are pushing their transphobia or hatred. But also the other thing.

Now whether or not gender affirming care should be considered “medical” care is another story altogether BUT this is the reality.

[-] TheMuffinMan@piefed.world 10 points 5 days ago

It absolutely is medical care. Here for the 'other story'. What are the counterarguments?

(Context: am transsexual, HRT did for me what 7 years of antidepressants could only dream of and quite literally saved my life.)

[-] prettybunnys@piefed.social 2 points 5 days ago

I meant insomuch as I’ve heard people say it ought not be kept behind the gate of a medical professional, not that it isn’t medical in nature or somehow unnecessary

[-] TheMuffinMan@piefed.world 3 points 5 days ago

I think there is some nuance to that, and IMHO it largely depends on the model of healthcare we are talking about.

In the case of paying out of pocket for treatment, all that's needed is informed consent. E.g. you see an endo, they inform you of the process and all effects, desirable or otherwise. They cannot bar you from treatment, nor are they responsible if the treatment turns out not to be right for you. Once consent is provided, they are responsible for monitoring your hormone levels and adjusting the dosing if needed.

When it comes to socialised medicine, gatekeeping is inevitable. This is for the same reason that someone whose teeth are ever so slightly crooked, to an extent that is only noticeable under close inspection and has no oral/jaw problems, would not be entitled to braces/invisalign. It isn't a medical need, and that person is free to pursue that privately. Attitudes towards gender and transitioning have changed over the years, and there are people these days for whom HRT is an aesthetic choice/body mod (and is partly why I distinguish by describing myself as 'transsexual'). Power to them, but I would not claim that cases like this are the best use of tax revenue. This is where the tattoo analogy has a bit of weight to it.

tl;dr medically necessary for some, and just a form of self-expression for others. That difference can matter to the taxpayer.

this post was submitted on 26 Oct 2026
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