The de-transition movement has reached Germany

[Callisto]

Estro claimed it was just endos.
Amd before you tell others to get their facts straight make sure your own are straight. Psychiatrists can prescribe more than psychotropic meds (inckuding hormones). It's a psychologist who is restricted to that, and even that depends on a few things because it's not a universal given that psychologists can write prescriptions.

I think what may be confusing things on what a psychiatrist can or can't prescribe is that while they are medical doctors (i.e., went to medical school, had to choose a specialty, must be state licensed as a physician), they're not in the business of prescribing medications for anything other than those that relate to mental healyh. E.g., you wouldn't want your psychiatrist prescribing heart medication or countering the recommendation of your cardiologist for whom that is their specialty and is the one who did the actual tests and diagnosis. The psychiatrist has to know about interactions between medications but they'd either have to prescribe a second choice or have you address the conflict with the cardiologist to see if that prescription could be adjusted to allow for the mental health prescription.

 

[Jimmy]

Thank you for your sympathy.
I know.

You should probably mind your own business. Nobody’s influencing anyone. When someone reaches legal age they make their own choices. They maybe right or wrong choices but they make them anyway. People make bad choices when their younger from eating habits, smoking etc. not saying being trans is wrong but what I’m saying is it’s hard enough to change oneself, What makes you think you’re going to change anybody else? So like I said you’re better off staying quiet and minding your own business. Plus no one likes a preacher.

 

[Shadow Wolf]

I think what may be confusing things on what a psychiatrist can or can't prescribe is that while they are medical doctors (i.e., went to medical school, had to choose a specialty, must be state licensed as a physician), they're not in the business of prescribing medications for anything other than those that relate to mental healyh. E.g., you wouldn't want your psychiatrist prescribing heart medication or countering the recommendation of your cardiologist for whom that is their specialty and is the one who did the actual tests and diagnosis. The psychiatrist has to know about interactions between medications but they'd either have to prescribe a second choice or have you address the conflict with the cardiologist to see if that prescription could be adjusted to allow for the mental health prescription.

The confusion is all these people not knowing what a psychiatrist does. They can, and do, prescribe more than psychotropic medications.

Prescribe Oxycodone With Caution | Psychiatric News

PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.

psychnews.psychiatryonline.org

Psychiatrists who prescribe oxycodone,

Should Psychiatrists Prescribe Gender-Affirming Hormone Therapy to Transgender Adolescents?

In referring transgender patients for medical transition, clinicians should be guided by harm reduction, respect for autonomy, and continuity of care.

journalofethics.ama-assn.org

While psychiatrists have long prescribed estrogen

It was true that Dr. Lao was considering becoming trained to administer hormone therapy. Many of Dr. Lao’s transgender patients and families have complained about the lack of physicians in their rural community who are trained in hormone therapy administration. Dr. Lao thought he might play a role in reducing this resource disparity for his patients by becoming trained himself.

 

[SomeRandom]

@Saint Frankenstein for some reason it’s not letting me quote you. But anyway

I don’t know how it works in the US, honestly. I keep finding different answers when I search for it. I assume that’s due to different states having differing laws? But I don’t know.
I think here psychiatrists can prescribe all sorts of drugs. Because they are fully qualified doctors as well as shrinks. A psychologist probably can’t though, since they lack that specific training. But don’t quote me on that

 

[Callisto]

The confusion is all these people not knowing what a psychiatrist does. They can, and do, prescribe more than psychotropic medications.

The ABCs of Cardiac Screening and Electrocardiography

This comprehensive approach for assessing and addressing potential cardiac complications before prescribing psychotropics can enhance care.

www.psychiatrictimes.com

Prescribe Oxycodone With Caution | Psychiatric News

PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.

psychnews.psychiatryonline.org

Should Psychiatrists Prescribe Gender-Affirming Hormone Therapy to Transgender Adolescents?

In referring transgender patients for medical transition, clinicians should be guided by harm reduction, respect for autonomy, and continuity of care.

journalofethics.ama-assn.org

I'm not sure how much of your post is directed at me beyond your first sentence. As I said they can prescribe other medications because they're licensed physicians, and part of that includes being aware of medicinal interactions; but that the majority of the time they are prescribing medications for mental health (since psychiatry is their specialization) and they don't act unilaterally to replace specialists in other fields (like a patient's cardiologist who will also be familiar with the same interactions associated with mental health medications).

 

[SomeRandom]

I can't feel "eh" about people who are detransitioning which can be a devastating ordeal to go through, especially if it comes about after hormone therapy and/or surgeries.

I didn’t mean to suggest that I felt “eh” about folks detransitioning. Obviously such folks deserve nothing but empathy
Merely that medicine in general isn’t always foolproof. That’s unfortunate to be sure. But it’s a reality nonetheless. Obviously we should try our best to minimise this fact. But we can’t use this reality as an excuse to demonise or negatively impact others seeking the same treatment all the same.
If you get me?

I think this plays a sizable part in the process and is a major contributor for the advent of detransitioners. "Informed consent" doesn't seem to be very informed and leads to people to making significant decisions without accurate diagnosis, not truly having GD, or understanding the longterm impact of their decisions (which can be irrevocable).

I’m not American so I can’t comment either way.
But I’ll take your word for it

 

[Estro Felino]

The confusion is all these people not knowing what a psychiatrist does. They can, and do, prescribe more than psychotropic medications.

Prescribe Oxycodone With Caution | Psychiatric News

PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.

psychnews.psychiatryonline.org

Should Psychiatrists Prescribe Gender-Affirming Hormone Therapy to Transgender Adolescents?

In referring transgender patients for medical transition, clinicians should be guided by harm reduction, respect for autonomy, and continuity of care.

journalofethics.ama-assn.org

But the rule is that they cannot prescribe synthetic hormones.
They are not specialized.
As they cannot prescribe birth control pill.

 

[Callisto]

I didn’t mean to suggest that I felt “eh” about folks detransitioning. Obviously such folks deserve nothing but empathy
Merely that medicine in general isn’t always foolproof. That’s unfortunate to be sure. But it’s a reality nonetheless. Obviously we should try our best to minimise this fact. But we can’t use this reality as an excuse to demonise or negatively impact others seeking the same treatment all the same.
If you get me?

I get you. I agree medicine is not foolproof but (in the US) people are not getting the level of professional evaluation they used to and that's just opening the door for far more unnecessary mistakes to be made. Case in point, the growing number of detransitioners.

The people I see being demonized are detransitioners. If you're trans, you're encouraged and have the community championing your needs, your very existence. But if you detransition, there's little empathy or support to be found. Suddenly you're a pariah and shunned. Somehow your suffering is nothing but a "movement". Like it or not, detransitioners are a part of the trans community and no less important than and in need of support as someone whose journey was successful.

I’m not American so I can’t comment either way.
But I’ll take your word for it

It's a whole discussion in itself. So,

 

[SomeRandom]

I get you. I agree medicine is not foolproof but (in the US) people are not getting the level of professional evaluation they used to and that's just opening the door for far more unnecessary mistakes to be made. Case in point, the growing number of detransitioners.

The people I see being demonized are detransitioners. If you're trans, you're encouraged and have the community championing your needs, your very existence. But if you detransition, there's little empathy or support to be found. Suddenly you're a pariah and shunned. Somehow your suffering is nothing but a "movement". Like it or not, detransitioners are a part of the trans community and no less important than and in need of support as someone whose journey was successful.

The international news paints a slightly different picture. Referencing all manner of laws targeting such treatment. But that could just be the world being puzzled at how the US regulates their medicine, so
But I can agree that we shouldn’t be demonising anyone who detransitions. Such folks should ideally be supported and helped through such a tough time in their lives.

I’ll offer a different perspective as to why their numbers are increasing.
As society starts to open up on trans issues, the number of folks who identify as such will naturally spike. It happens with every phenomenon that was once demonised. Left handedness spiked once society stopped demonising them. It wasn’t due to the number actually increasing, merely a more accurate display of their numbers. Since folks were more willing to be honest with themselves due to being more supported by society.
As you say, detransitioners are part of the trans community. I won’t pretend to know the reasons behind their process. Maybe they weren’t diagnosed properly or maybe they fit into a different category gender expression wise and were stuffed hastily into the trans box. I sincerely don’t know.
The way I see it, as we explore more of the nuances of gender expression, gender identity and such, we will naturally find such hurdles as well. People are more complicated than merely being cis or trans. Society still seems a bit anxious regarding that facet of humanity.
But I have faith that eventually we will figure it all out. Not sure how long it will take lol but still

 

[Callisto]

The international news paints a slightly different picture. Referencing all manner of laws targeting such treatment. But that could just be the world being puzzled at how the US regulates their medicine, so
But I can agree that we shouldn’t be demonising anyone who detransitions. Such folks should ideally be supported and helped through such a tough time in their lives.

IMO, the cruxes of the controversy is you have 2 extremes colliding: rightwing nuts and radical activists on the left with regular transgender people (i.e., not wanting controversy or attention, just wanting to live their private lives) the collateral damage between them. Neither extreme is beneficial to the people caught in the middle. And within the trans community, detransitioners are often left to fend for themselves.

I’ll offer a different perspective as to why their numbers are increasing.
As society starts to open up on trans issues, the number of folks who identify as such will naturally spike. It happens with every phenomenon that was once demonised. Left handedness spiked once society stopped demonising them. It wasn’t due to the number actually increasing, merely a more accurate display of their numbers. Since folks were more willing to be honest with themselves due to being more supported by society.
As you say, detransitioners are part of the trans community. I won’t pretend to know the reasons behind their process. Maybe they weren’t diagnosed properly or maybe they fit into a different category gender expression wise and were stuffed hastily into the trans box. I sincerely don’t know.
The way I see it, as we explore more of the nuances of gender expression, gender identity and such, we will naturally find such hurdles as well. People are more complicated than merely being cis or trans. Society still seems a bit anxious regarding that facet of humanity.
But I have faith that eventually we will figure it all out. Not sure how long it will take lol but still

I agree there would be a slight spike but not in the numbers we're seeing, especially among children and teens. This is why there's an ever-growing number of detransitioners, something unheard of previously and that has to do with the lack of in-depth evaluation and the speed at which people are pushed forward toward cross-sex hormones and surgery.

I agree that eventually much of it will get sorted. Unfortunately, I fear there is a great number of lives that will be ruined before that happens.

 

[SomeRandom]

IMO, the cruxes of the controversy is you have 2 extremes colliding: rightwing nuts and radical activists on the left with regular transgender people (i.e., not wanting controversy or attention, just wanting to live their private lives) the collateral damage between them. Neither extreme is beneficial to the people caught in the middle. And within the trans community, detransitioners are often left to fend for themselves.

Perhaps. I won’t pretend to have inside knowledge of such a phenomenon.
The closest I come is that I like paling around with non binary folks.

I suppose like most things in this world the moment politics enter the equation all hell breaks lose lol

I agree there would be a slight spike but not in the numbers we're seeing, especially among children and teens. This is why there's an ever-growing number of detransitioners, something unheard of previously and that has to do with the lack of in-depth evaluation and the speed at which people are pushed forward toward cross-sex hormones and surgery.

I agree that eventually much of it will get sorted. Unfortunately, I fear there is a great number of lives that will be ruined before that happens.

This may be something of an “over correcting” phenomenon as well. People are now mostly aware that the trans community was treated poorly by society. When something like that happens, some people tend to be quite enthusiastic to “make up for past mistakes.” Which isn’t always a good thing lol
This may contribute to the somewhat eager diagnosis of trans identities in the youth that you’re seeing.
Just speculating though.

I wish I could offer a solution. But as I am mostly ignorant of the transition process, I fear that all I can really do is look to the medical profession to sort this all out.

 

[Shadow Wolf]

But the rule is that they cannot prescribe synthetic hormones.
They are not specialized.
As they cannot prescribe birth control pill.

I just quoted that some do.
Do you have reading comprehension issues?

 

[Shadow Wolf]

I'm not sure how much of your post is directed at me beyond your first sentence. As I said they can prescribe other medications because they're licensed physicians, and part of that includes being aware of medicinal interactions; but that the majority of the time they are prescribing medications for mental health (since psychiatry is their specialization) and they don't act unilaterally to replace specialists in other fields (like a patient's cardiologist who will also be familiar with the same interactions associated with mental health medications).

Yes, they mostly prescribe psychotropic meds. That is a far cry from the claims they don't and can't prescribe other things.

 

[Heyo]

Yes, they mostly prescribe psychotropic meds. That is a far cry from the claims they don't and can't prescribe other things.

Oh, and hormones are psychotropic. Estrogen and testosterone can have positive effects on mood and are prescribed against depressions.

 

[Estro Felino]

Oh, and hormones are psychotropic. Estrogen and testosterone can have positive effects on mood and are prescribed against depressions.

They cannot be administered, unless one's blooodwork shows they cannot affect the cardiac system or the liver.
They are not vitamins.
So an endocrinologist asks you for a complete bloodwork first.

Whereas a psychiatrist can prescribe you a Xanax without bloodwork,

By the way: German pharmaceutical companies are the best in the field of synthetic hormones.

 

[Shadow Wolf]

They cannot be administered, unless one's blooodwork shows they cannot affect the cardiac system or the liver.
They are not vitamins.
So an endocrinologist asks you for a complete bloodwork first.

It doesn't have to be an endocrinologist. Seriously, I haven't even seen one in years. Lots of providers send a patient elsewhere to get bloodwork drawn, that goes to an independent lab that does those in bulk, and the ordering clinician gets the results. From there it's just knowing where the numbers are supposed to be.

 

[Estro Felino]

It doesn't have to be an endocrinologist. Seriously, I haven't even seen one in years. Lots of providers send a patient elsewhere to get bloodwork drawn, that goes to an independent lab that does those in bulk, and the ordering clinician gets the results. From there it's just knowing where the numbers are supposed to be.

How can one get the right dosage of estradiol, unless one has a bloodwork done, first?

 

[Heyo]

How can one get the right dosage of estradiol, unless one has a bloodwork done, first?

The same way they get the right dosage for other psychopharmaca, making a guess and adjusting if necessary.

 

[Shadow Wolf]

How can one get the right dosage of estradiol, unless one has a bloodwork done, first?

They have someone like one like me stab em in the vein and make em bleed. The same thing any providers do when they need blood.

 

[SkepticThinker]

They just prescribe psych drugs. It's funny how people want to jump you at times when they don't even have their own facts straight.

They also prescribe estrogen for things like premenstrual dysphoric disorder and postnatal unipolar depression, for example.