A Quick Update And A Trans Male Injecting PSA

I haven't updated here in a while.  I've also been kind of off the paleo wagon for a while.  I've hit some "life snags" so to speak that have made maintaining any sort of motivation difficult.  I suffered a neck injury in a car accident that led to a lot of physical therapy and don't-give-a-fuck, and in addition I'm living in an environment filled with wheaty, sugary foods that are constantly being pushed onto me, complete with nagging guilt trips.  And if you're reading this right now thinking about one of those insufferable "No Excuses" Facebook posts, you just might be the kind of person I originally wrote this blog to combat.  Just saying.

Quick update: I wound up going to the doctor for various irritating symptoms and found out that I legitimately have a wheat allergy.  So far it hasn't helped with the nagging guilt trips, but that's a subject for a different thing I'm planning on writing (and have been planning on writing since long before I was diagnosed with any allergies).  I also almost passed out during a phlebotomy, which is directly related to my poor diet and weight problems.  Will these factors be sufficient motivation to continue?  I hope so, but I've had some damn good motivational triggers go sour before.

Anyway, enough of that, because I have something important to talk about that's relevant to trans men as well as anybody who injects testosterone: Please don't tell people it's safe to reuse your syringes and drawing needles.

I'm mentioning this because I'm reading a forum thread meant for trans men in which multiple people are talking about re-using syringes and drawing needles like it's no big thing.  At least one has said that his doctor told him that reusing the drawing needle is OK "because that needle never goes into you."

First, let me mention that I understand sometimes people do these things out of necessity.  Sometimes pharmacies are ridiculous and don't give you enough syringes, not everybody lives in a place where they can legally just buy extra syringes, not everybody even lives in a place where they can get testosterone legally.  People make do with what they have.  If the choice is really between re-using a drawing needle or syringe and not getting the medication you need, I'm not going to bother you for it.  Harm reduction is important, even when it's not popular.

But I need you to stop acting like it's no big deal or carries no risk.  Re-using products that are meant to be sterile always carries a risk.  And the explanations people are giving are quite frankly horrifying and miss the entire point of sterile injection supplies to begin with.

When you have a needle, syringe, or set of both in the original package, that package is sterile.  The testosterone itself is also sterile.  That equipment has been kept out of the elements so that it can't be touched by any of the random crap floating around in our air supply.

Once you have opened a package, it's exposed to the air and can't really be considered sterile anymore.  It needs to be used before the aforementioned random crap in the air supply attaches to it.  From that point on, everything that needle touches also needs to be sterilized.  That's why you take an alcohol prep pad to the top of the T bottle, and it's why you use the same on the injection site.  Everything that needle touches that is not sterilized is a contaminant.  If your needle taps into your desk before it goes into your T bottle or before it goes into you... that's a contaminated needle now, and ideally you will change it.  If you take that contaminated needle and then punch it into your T bottle, that T is also contaminated. This is why needles and syringes are one-time-use.  They even say this right on the package, so don't act like it's a huge surprise.

When it comes to users of illegal drugs especially, there are instructions available on how to clean them for reuse and sharing.  This is a harm reduction technique.  It's very risky, but it's better than not cleaning them for people who are going to reuse their needles and syringes no matter what you tell them.  These techniques typically don't work for testosterone.  Testosterone is usually carried in oil... sesame or cottonseed... and cleaning them is just not reliable.

To make matters worse, it's clear that a lot of trans men who reuse syringes and drawing needles are either just letting them sit in the air for a week or rinsing them with regular tap water.  Leaving these supplies in a non-sterile environment compromises that sterility (otherwise there would be no need to sterile package them to begin with).  Regular tap water isn't sterile, either.

I know some of you probably have heard people say--or are one of the people who continues to say--that you reuse syringes all the time and haven't gotten an infection.  And you know, it's true that if you reuse a syringe it's not an automatic guarantee you're going to get an infection.  This is a risk that grows over time as you continue to make these decisions.  Several years of testosterone injections are bound to result in some mistakes made... accidentally dunking your needle in an artery, injecting air into yourself, having to stick yourself three times in a row because you screwed up the first two times.  It happens... we just need to make sure it happens less by taking all possible precautions.

Finally, what can you do if you go through syringes too quickly or are broke?  First, you can contact your doctor.  Syringes are extremely inexpensive, and there's always a chance your doctor will just give you some spares if you're in a tight spot.  If money isn't the issue but you just find yourself running out of supplies (maybe you drop them a lot or your dosing has been a bit weird), I recommend you order--if it's legal where you live--bulk needles and syringes so that you don't run out.  There are also needle and syringe exchanges, some of which specifically cater to transgender participants.  When I buy syringes and needles combined, they're usually about $25 for a hundred of them including shipping.  If you have some trans friends you can even split that cost (on a related note, if I'm the trans friend, you can just ask me for some because I have dozens extra--again, mentioning for clarity that it's totally legal here to do that).  There are also, of course, needle and syringe exchanges, some of which cater specifically to transgender people.

Again, I don't mean to write this to shame people who legitimately feel they have no option.  The inability to get safe injecting supplies isn't necessarily a failure, it's a human rights and medical accessibility issue.  Because it's an accessibility issue, it's important that we don't act like the need to reuse these things is normal and safe.  It really isn't.

Natural Transitioning for Trans Men is a Crock, and Here's Why

I've already written about the subject of Natural Transitioning for Trans Men (NT), but this was a long time ago, and since then... well, my opinions on it have changed, slightly.  When I say "slightly" I mean I went from "this is crap" to "this is crap and I'm really, intensely offended by it."  This was driven partially by the fact that it is now only available as a $20 book, rather than for free as it was originally presented... but mostly by the feelings that come from watching friend after friend wind up sorely disappointed.

Anyway, what is NT?  It's a program designed for trans men to increase the amount of testosterone the body makes in order to masculinize a person's appearance.  It involves taking over-the-counter supplements, a rigid exercise program, and dietary changes.  And although I don't see it around so much anymore, every so often a friend or acquaintance of mine will decide to try it for some reason or another.

The top reasons?

1. Inability to get hormones due to lack of access to local prescribing doctors.
2. Desire to not be actually diagnosed with gender dysphoria.
3. Lack of interest in going to therapy and lack of access to informed consent programs.
4. Wants to avoid "shocking" their bodies.
5. Are non-binary and/or only want some of the effects of higher testosterone.
6. Contraindicated from using testosterone injections.
7. Attracted to the concept of "naturalness."
8. A few were trying it because they are vegans and wanted to avoid animal-tested and animal-ingredient-including pharmaceuticals.

I'm not judging the reasons people choose to use it.  I am also not questioning that in people who have barriers in place preventing hormone therapy, there may be a psychological reward in doing something until they can attain that.  So this essay is in no way intended to disparage people who have tried or are intending to try NT.  It's also not meant to be a cut on the other, extremely important projects Tristan Skye has founded and maintained.

But I think it's really important that trans men who are considering it are aware of the issues surrounding it.  And it really is your choice, but I'm not going to sit here and say I don't think it's a crock, because I absolutely believe it is.  Here's why.

1. Honorable Mention: Attempting to trademark "Natural Transitioning" when that was already a well-known term for something else.

First off, I don't think I've ever actually found reference to NT while looking for it in a trademark search, so I have a feeling he didn't actually trademark it and is just using the ^TM mark because... I don't know.  Maybe he doesn't know what it means?  There's also the chance I'm just not looking hard enough.  Anyway, it doesn't matter.

Long before people were peddling programs promising FTM transition with herbs and vitamins, "Natural Transitioning" was a term used for black people--usually black women--who were going back to their natural hair texture after having straightened or permed it.  It's worth a major eye-roll to me that this person has decided to try trademarking a term without even so much as a Google to make sure it's not already used by a marginalized group to refer to something personal and important.  Just a thought.  I mean, even when I create a new blog I always at least do a cursory search of the title just to make sure I'm not accidentally stealing a name.  And while that's not always a perfect solution, this was something that would have shown up in even a cursory search.

But even if you totally don't give a shit about that, there's still a lot of other stuff to discuss.

2. The person who invented this had a metric fuckton of help from good old biology as well as training.

When you see a picture of a bearded dude with a reasonably deep voice hawking an herbal/nutritional regimen to people as an alternative to pharmaceutical transition, it gives the illusion that NT is practically as good as intramuscular injections or other methods of taking testosterone through conventional medicine.  If you read more of this person's work, though, you learn that his voice is largely due to vocal training lessons.  Even more importantly, he already had facial hair before he decided to transition, and used minoxidil (Rogaine) as well.

Now, NT will if done properly cause changes in things like body fat and muscle, which can be extremely masculinizing.  But if you think you're going to come out of it looking like Tristan Skye, you're probably going to be sorely disappointed.  It wasn't just pills, exercise, and diet that made him look the way he does.

3. The effects of Natural Transitioning are usually miniscule and not worth the costs for most people.
 
YouTube is culturally extremely important to trans men, and loads of us have posted videos there talking about our struggles and displaying the changes we go through while transitioning, whether hormonal or not.  So of course there are people on there who are attempting NT.

Watch them.  Seriously.  The last time I did this, what I saw were a lot of guys talking about how many changes they were going through, who swore up and down that their voices were changing and their peach fuzz was slightly fuzzier.  Most of them wind up giving up very quickly once they realize just how little the regimen is actually helping, especially when doing a cost/benefit analysis between it and conventional testosterone.

NT doesn't just make your transition more gradual so your body has time to adjust or whatever other woo you choose to use to justify it... it does practically nothing you won't get from just taking care of yourself.  But I'll get to that later.

There are two main costs that make NT a poor choice for most trans men.  They are...


4. Natural Transitioning is ridiculously expensive in comparison to testosterone.

All of the supplements required on this program are very, very expensive.  Testosterone isn't that expensive, and it would be much more cost-effective to use the money you would be using to buy this crap to go to a therapist and a doctor instead (which is where the real costs of T come in; a bottle of testosterone for me costs around $60 and lasts six months, it's the bloodwork and therapy that is expensive).

But this more literal cost isn't even the worst part...


5. Natural Transitioning is a hell of a lot of effort to get a little of what cis men need basically no effort to achieve.

There's a pseudo-moralistic reasoning among quite a few trans men who attempt NT, as if they'll value transition significantly more because they worked so hard for it.  This is ludicrous, though:  Trans men shouldn't feel obligated to work hard to change our hormone ratios to those more similar to cis men's.  A cis man who has a serious hormone deficiency doesn't need to feel like bodybuilding and paying GNC worker salaries is a more worthwhile option than a weekly shot, why should we?

And this takes a lot of effort and time.  This is supplementation morning, noon, and night, as well as more exercise than most average people have the ability to do.  And they aren't even that effective.

6. Most of these supplements are useless.

To do the whole NT program you will need to buy and consume over a dozen different supplements, mostly supplements that are advertised to bodybuilders with a few extras for general health.  DebGod from Skepchick has a nice article in which a natural bodybuilder is queried and explains that most of these supplements are not necessary with good diet and exercise.  She also explains that cis women who do natural bodybuilding, while they may gain more "stereotypically masculine" muscle structures, do not typically get deeper voices or facial hair.  These are things you see when they use steroids; they don't just happen from bodybuilding.  But for this sort of thing, and much more, you should really just read that article, which has more information on this particular subject than I have.

Basically, you're taking these supplements just to piss them out.  You can achieve most of the real, tangible effects of NT just by going on a diet and exercise program... and you don't need this book for that.

7. Testosterone isn't that bad.

Testosterone has side effects.  So does NT.  Testosterone requires a doctor.  Ideally, so does NT.  Testosterone has contraindications that make it inaccessible for people with certain medical conditions.  Most of them also make the supplements on NT more dangerous.  We don't really have that much information about the risks of long-term testosterone use in trans men.  But it's been studied a lot more than NT.  Testosterone shocks your system.  So does... you know... puberty.  And most importantly, testosterone works for what trans men typically need.