Question for writing about HRT

L. OBrien said:

As a result of in-story politics that are irrelevant to the question, he eventually runs away and is, presumably, trying not to be found. For someone who is packing their things and leaving their home quickly, what is the likelihood that they would have the necessary supplies to continue HRT on hand, how long would this be likely to last, and once they ran out how difficult would it be to acquire more without a proper prescription?

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Disclaimer: I'm trans femme, not trans masc.

We'd likely grab our hormones first thing in an emergency. Since I take my estrogen via pills, I admit I'm not sure how often injections are typically re-filled, and testosterone is usually taken via injections. Injections are usually applied every 1-3 weeks, depending on the dosage. It really totally depends on how much more he has on hand, and you have some creative freedom to give him as much or as little as appropriate for the story. It can be difficult to stock up on hormones due to insurance issues, but many of us are fairly paranoid about situations exactly like this, so many of us tend to keep some emergency hormones around.

Unlike estrogen, testosterone is a controlled substance, so it could be much more difficult to obtain without a valid prescription. However, there is a huge underground market for testosterone (created mostly by sports doping), so it would not be impossibly difficult for him to obtain illegally, if he knows the right channels. The consequences for an illegal prescription will be higher than for estrogen, though, since it's a controlled substance.

It's discouraged but not unheard of for transmasculine people to get testosterone without a valid prescription. One method is to get it from another trans person who's willing to share. The danger with this is that 1) you can't accurately tailor the dose to your body and 2) trans people taking testosterone are supposed to have blood work done occasionally to make sure their hormone levels are appropriate and they're not experiencing potential health issues that can occur.

Injectable testosterone would probably be easiest to get, but testosterone can also be administered via gel/cream that's applied to the skin. That's a possibility if it's difficult for them to get needles.

This question's a few days old, so I hope I'm still relevant. I'm a pharmacy technician with a large trans patient base, so here's my wisdom.

I would assume your character would grab their supplies before leaving. As previously mentioned, testosterone is a controlled substance. The laws will differ from state to state; in Washington, a prescription for testosterone would be valid for 6 months. Most insurances will only allow a 1 month supply to be dispensed at one time, and because testosterone comes in a vial, a patient may not get exactly 30 days supply at a time. Many pharmacies will not allow you to refill your rx more than 3 days before you run out (so if you get a 28 day supply, you can refill at day 25.) This does vary, but most pharmacists have some kind of rule.

Is your character an adult or a child? Because an adult would have more options for a) refilling a valid prescription, whether at their current pharmacy or by transferring it to another pharmacy or b) getting a new rx with a new doctor or calling the old one. Yes, they might be running away, but medical staff is bound by HIPAA.

There are plenty of perfectly illegal ways to get prescription meds, of course. Sharing with a sympathetic trans friend is probably the safest bet -- it's still heartily illegal but harder for authorities to find out and, provided the friend is getting testosterone through legal prescription, the drug is almost guaranteed to be safe.

I can give you more nitty-gritty if any of this is useful. Shoot me a line if you need.

Not trans, but had a short bout with testosterone HRT for other reasons so the regimen would probably be different than for a trans person. My injections were every two weeks, 0.5 ml if I recall correctly, and the testosterone came in a 5 ml ampule. So, enough for 10 injections or 20 weeks. That sounds like a long time now that I write it, so I might be wrong on that. I never refilled the script because the testo did bad things to me (although I'm male) and a second opinion determined the first doc shouldn't have prescribed it (and many people gossip he was dosing guys just to keep them coming back at $100 per visit).

I suspect someone on the run could get testosterone on the black market supplying athletes.

I'm FtM so I'll try to answer this more clearly. It depends on how long he's been on T, I for the first year I only received 3 month's script at a time because my dose would rise 50 mg each time and I had to have a blood test every 3 months. It's fairly tough to carry that much around though. You need syringes, the glass vial of T, a container to put used syringes in that's thick enough not to puncture, isopropyl alcohol to disinfect everything, cotton balls/pads, and bandaids. Not something easily shoved into a backpack, but could reasonably fit in the car.