An image that purports to show a screengrab from a medical journal was featured on a tweet that gained traction on January 15 2020.
The tweet contains a capture of this citation:
Hormone replacement therapy has many nicknames among transfeminine people, including titty pills, titty skittles, smartitties, chicklets, anticistamines, mammary mints, life savers, tit tacs, breast mints, femme&m’s, antiboyotics, trans-mission fluid, and the Notorious H.R.T.
“oh fuck this was in an actual medical journal I’m gonna cry lmao,” the user wrote.
While it is legitimate, many of the users sharing it may not be aware of the context behind it. The citation was included in an article published by the McGill Journal of Law and Health, a publication covering healthcare-related law. The story itself is a first-person account by activist Florence Ashley regarding their experience seeking medical care both pre-and post-gender transition.
Their listing of the nicknames for hormone replacement therapy (HRT) appears alongside a passage covering the temporary effects from stopping the treatment prior to reassignment surgery:
I had to stop taking the hormones three weeks before surgery, give or take a few days. I was ill-prepared for this endeavour. Because hormones regulate emotions, amongst many other things, changes in hormonal regimen can have a heavy impact on mood stability and mental health. In my case, the fluctuations were large enough that I had to raise my dosage of antidepressant.
A few months after surgery, my reflection in the mirror elicited an emotional reaction I had not yet grown accustomed to. After over a year on hormone replacement therapy, my body had changed in ways that finally began feeling comfortable. After decades of discontent, I was finally feeling at home in what I had previously described as a flesh prison. It had only taken a few weeks without hormones to lose what I estimated as six months of progress, noticeable in terms of fat redistribution, breast tissue loss, and changes to sexual functioning. The mirror served me a cruel reminder of this loss of self.
In their paper, Ashley argues that current regulations covering disclosure of information between medical providers and transgender patients rely “on overly narrow conceptions of informed consent and underestimates the role that communal knowledge should play in health care.”
Their own surgeon, for example, did not mention what the side effects would be of stopping HRT prior to surgery.
“I would not have changed my mind about having surgery, it is true, but I could have done more to prepare had I known about the impact of ceasing hormone replacement therapy,” they wrote:
Knowing in advance is crucial to psychological preparation and adaptation. Armed with knowledge, I could have scheduled appointments with my therapist, warned my loved ones about my increased need for support and softness, and refrained from in-person commitments. I did the latter two of those for a subsequent surgical procedure.