Thread by @gabrielarkles

As Alabama's felony ban on puberty blockers, hormones, and surgery for trans people under 19 goes into effect, a couple of tips re self-managed gender-affirming care for trans people.

But first, remember, whether or not we get the care we need, our lives are glorious and precious, and we are who we know ourselves to be. Let's love and care for each other, and persist, whatever they throw at us.

1) While the law is in effect, providers in Alabama can't legally prescribe puberty blockers or hormones. But nothing in the law prevents them from monitoring. If you're getting hormones from another source, you can still ask your doctor to order blood work.

That labwork can help you figure out if your hormones are in the right range, if you might need more or less, or if you're having any side effects that might need attention.

Similarly, your own doctor may still be able to help you with post-surgical care or with complications from care you received elsewhere, whether it was self-managed or not.

Healthcare providers have no obligation to report you or your parents for getting self-managed care (or care in another state or country). In fact, they're not allowed to. But THEY may not know that. So you may want to ask them some questions before you disclose.

2) More hormones don't necessarily mean more or faster changes, or quicker relief from dysphoria. A bit technical, but these guidelines can help figure how much to take: academic.oup.com/jcem/article/1… Or try: folxhealth.com/category/hormo…

3) If you're injecting anything, you need to use new, clean needles to prevent HIV, hepatitis, or other infection. Unfortunately, Alabama and Mississippi have no syringe exchange programs. Georgia does. @AtlantaHarm @transneedles is also a great resource. transneedles.org

There are a bunch of guides online about how to inject safely. Here's one. plannedparenthood.org/uploads/filer_…

4) Think about types of treatment that aren't illegal where you are. Alabama's law doesn't reach voice coaching, electrolysis or laser hair removal, IUDs (a form of long-term birth control that also stops menstruation), tucking, binding, name changes, etc.

Tips on tucking safely: healthline.com/health/transge…
Tips on binding safely: ftm-guide.com/complete-guide…

If you need financial help with some of these forms of treatment, check out @pointofpride pointofpride.org and @translifeline translifeline.org/microgrants/.

5) Kind of obvious, but if you're traveling to another state or country to get treatment from a healthcare professional, look for forms of treatment that are longer acting. So for puberty blockers and hormones, consider implants, or at least longer-acting injections.

6) Carrying syringes or even hormones can be legally risky. It might be safer to leave it at home and out of sight if going somewhere with lots of cops (unfortunately, this includes protests, police precincts even if you are there to report a crime, and bus / train stations).

7) Think carefully about digital security too. Really carefully. ssd.eff.org

8) There is NO safe way to self-manage surgery. Silicone injections and self-surgery are extremely dangerous, and might kill you. If you decide to get a silicone injection anyway, remember less is more--every additional shot brings more risks, so don't get more than you need.

If you decide to perform self-surgery anyway, have someone with you who can get you to a hospital if needed, keep everything as sterile and hygienic as possible, and have supplies to hand to help stop bleeding. stopthebleed.org/media/x3jbyfkp…

9) As abortion criminalization also heightens, and as more trans folks face more barriers to care, it's also worth saying: self-managed abortion is very medically safe IF DONE WITHIN ~12 WEEKS. abortionpillinfo.org

For a variety of reasons, including bc many of us don't menstruate regularly or at all, many of us don't realize we're pregnant until much later. If you have any doubt about whether you could be pregnant, test right away so you have a full range of options.

10) And if this fucked up world is fucking up your mental health, there are a range of (still legal!) resources:
@fireweedHJ fireweedcollective.org
@TransLifeline translifeline.org [phone]
@QTPoC nqttcn.com
autistichoya.net/resources/cris…

You are beautiful.
You are magical.
You are loved.
They will never destroy us.