Waiting lists pushing trans teens to buy transition medicines online

Young trans people, sometimes as young as 14, are buying medicines online to start their transition themselves because the waiting times for official treatment in the Netherlands are so long. Some have been on waiting lists for more than three years, NOS reports after surveying over 700 trans people. Almost 300 of the respondents are on the waiting list to start transitioning. 

The long waiting times have major consequences, causing or exacerbating severe mental health problems. Over 90 percent of the respondents said they’ve considered suicide. Over a third have attempted to take their own lives, 14 percent more than once.

Joana, a 19-year-old trans woman whose been on the waiting list for hormone treatment for over three years, felt that despair. “It’s hopeless and made me suicidal,” she said to NOS. She eventually decided that self-medication was her only option. After some online research, she ordered two hormones to become more feminine and a testosterone blocker online. “I got breasts, noticed it in my body hair, and my libido changed. After all these years, I could finally look in the mirror and say, ‘Yes, I see myself now.’ It also made my depression go away.”

Two-thirds of respondents said they are considering self-medication. About one in seven already uses medication they ordered online. Most do so without medical supervision.

Christa van Bunderen, an endocrinologist at Radboudumc’s gender team, understands why trans people turn to self-medication due to the waiting lists but warned that this is not without danger. Hormone treatments are very person-specific, she said to the broadcaster. “Think of someone’s age, diseases that run in the family, or medication that someone is already taking. You really need a doctor who assesses from person to person what the best choice is.”

It is therefore essential to be open and honest about what you’re taking, Van Bunderen said. “We will never refuse treatment because someone has used self-medication. We can provide better guidance if someone says which medication they used.”

Minster Ernst Kuipers of Public Health acknowledged that the Dutch healthcare system does not have enough room for trans people wanting to make their transition. “Over the past twelve months, the capacity for hormone treatment has increased by about 50 percent. And that is still not enough,” he said to the broadcaster. He wants to open more outpatient clinics where trans persons can go and reduce the waiting time to months instead of years, he said.