diy isn't dangerous, dismissal of trans knowledge is.
Despite its long, autonomous history and proven efficacy, self-administered or DIY gender affirming care in the form of hormone replacement therapy (HRT) is heavily stigmatised nowadays. The opposition to DIY isn't just coming from transphobic bigots; many trans people and their allies also view it as a risk that isn't worth taking, even if it means enduring long wait lists and heavy medical scrutiny. DIY may seem sketchy, but for many, being denied the gender-affirming care they need is a much more pressing danger. In reality, self-administered HRT is only viewed as an excessive danger because it draws upon knowledge that trans people have uncovered for themselves---knowledge that is dismissed in mainstream settings. DIY is not nearly as dangerous as it seems, and any risks associated with it can be alleviated simply by making legal hormones more accessible.
More and more trans people have been opting for DIY as anti-trans moral panic sweeps across Canada and the United States, limiting access to gender-affirming care in some states and provinces where it had previously been accessible through formal pathways. According to historian Jules Gill-Peterson, this is nothing new. Trans people have been self-administering hormones and other gender affirming medical services for decades, forming networks to provide effective treatment for our communities.
Patients seeking HRT through formal avenues were---and in some places continue to be---denied care for failing to adhere to strict norms of what a "real transsexual" should look like. Trans women of colour and sex workers were particularly vulnerable to discrimination, so they took matters into their own hands. Instead of facing dehumanization from bigoted doctors; trans people gathered the medical knowledge required to administer HRT by and for themselves.
When I was eighteen, I told my mother that I wanted to start masculinizing HRT as part of my transition. I thought that she would be supportive. After all, it had been three years since I first came out as nonbinary. I had already socially transitioned, legally changed my name, and had the backing of my therapist. My medical records even stated that I was a verified real transsexual! I had checked all the boxes of things transgender people are expected to do before we pursue hormones and surgeries, and my mother had more or less gotten over her initial ignorant response to my transness.
To my surprise, her response was fearful. Testosterone can cause so many health problems, she said. Other members of her local support group for cis parents of trans children had also warned her about the supposed dangers of DIY HRT. The idea that I might want to follow in the footsteps of the most historically marginalized and revolutionary members of my community must have been frightening to her middle-class sensibilities, reflecting an attitude towards DIY that dates back to its initial prominence in the 1970s.
I quickly reassured her that I wasn't going to do DIY, and would instead go to an informed consent clinic where a cis doctor told me all the risks and benefits---things my trans siblings have known for decades.
As with any medication, it's true that HRT is not without risks. In extreme cases, estrogen can increase risk of blood clots, and excess testosterone can cause heart attacks. These risks are not exclusive to trans people; they also affect cis people who use HRT or have a naturally occurring hormonal imbalance. Luckily, the more serious risks are easily avoidable with proper dosage and diligent blood testing. Plenty of everyday over the counter medications are dangerous if used incorrectly, but are perfectly safe most of the time. Hormones are no different.
Thanks to the internet, it's easier than ever for trans people to share our knowledge with each other. We are perfectly capable of educating ourselves about the potential risks of HRT outside of a formal medical environment. The widely shared resources for DIY HRT place heavy emphasis on safety, including detailed instructions on proper dosage, side effects, and how to perform blood tests. In my experience, these guides provide more transparency and in-depth information about each available option than either one of the informed consent clinics I utilized. Informed consent and DIY are functionally providing the same service; the latter is simply dismissed for its independence from cis society.
Though the idea that trans people can't make informed decisions about our bodies without consulting formal and likely cis doctors is absurd, some concerns about DIY are more legitimate. There is some risk of contamination if hormones come from an unregulated source, not to mention scammers who promise a product that they have no intention of delivering. Hormones shipped from overseas can be seized at borders if they are controlled substances in their destination country, never reaching the person who needs them.
Still, the solution is not to restrict HRT even further. Gender-affirming hormones are widely understood to be life-saving care. Cis doctors even agree with us on this, if a trans person saying so wasn't enough. The informed consent model is certainly a step in the right direction, but clinics are not widespread enough outside of the US to be effective, and they still force trans people in need of care to jump through unnecessary hoops.
The only solution is to make safe hormones and blood testing available to all without a prescription. Restrictions might force DIY users to hide information from their doctors if they end up needing formal medical care, creating situations that are legitimately dangerous. It's time to stop ignoring the decades of medical knowledge that has been built by trans people. I've already undergone unwanted irreversible changes from the estrogen my body produces by itself---I don't need a doctor to tell me that changes from HRT may be permanent.