this document is awsome
so give her hearts
STREET MONES IDENTIFICATION CHART
IS A DOWNLOADABLE PDF POSTER
FOR IDENTIFYING DIFFERNT ESTROGENS commonly available in north america
MADE WITH LOVE AND SWEAT BY anneTAGONIST
is a collective gardening quilting outreach worker trans health care specialist former ambulance driver who enjoys gardening.
STREET MONES IDENTIFICATION GUIDE is an ongoing document that she laboriously researched and prepared while working at a trans health clinic in filthydelphia. as detailed below, tagonist has been unable to find anyone who wants to print off mass copies of the poster, and unfortunatly has no plans to re-do this as a zine or pamphlete (but i might eventually).
also: there is not yet an IDENTIFICATION GUIDE to androgen and other boy stuff...
there has been lots of interest in us supplying one but neither of us are actively putting it together
so if you or your freinds have produced a T guide please contact trannypunk ASAP !!!
this document is subject to peridoic revision so check this page for new editions
any recomendations for changes or additions to the document can be sent to
or less reliably me: lilyButter
tagonist is really big in the underground and if you sleep on her stuff then you ain't shit.
...and she fuckin hates it when i say shit like that :)
anneTAGONIST~STREET HORMONES identification guide footnotes
Street Hormones - Need some help!|
Hi! ... Since January I've been working on a "harm reduction" poster containing information on street hormones- how to identify different pills, how much to use, how to do so safely, etc. The final version, which has been done since June or so, is a double-sided color .pdf, 12"x24". The front is pictures of the hormones most commonly sold on the street in Filthydelphia, with identifying info (pill stamps etc.) and safe dosages. The back is general information in text form, explaining how to find, identify, and use the different meds safely, along with injection instructions.
Anyhow, the non-profit I work for isn't going to print the poster as a poster. I took it to Kinko's to get a single laminated copy for a training I'm doing, and it cost me $60. My friend here, however, has agreed to host the .pdf on her website.
Here is my request to everyone- could you go to the website, download the file, and find a way to print a few? If you have a Kinko's Connection (I know some of you do) or a color printer (again, some of you do) could you print out, say, a few hundred and see that they get distributed? I want it to go into the public domain anyway. I don't do enough travelling these days to distribute stuff like this.
Thanks, and the URL is:
reader mail001: progesterone?|
Why no Provera (medroxyprogesterone) or other progesterone tablets? Seems like an important omission...
does anyone know if there is a similar sheet for t?
i'm starting to mke a little notebook of pub health stuff + harm reduction resources that i come across like this. if you know of one floating around, could you tell me? or if you know of resources to help me make one, could you give me a heads up?
oh! and tagonista! thanks for posting this. is it allright if i draw from it to make some changes? like, i want to make it all bigger so it can be on 8 1/2 by 11 but a bigger font and i want to include short descriptions of effects. it's a really, really rad resource and i'm excited to have it. thanks, thanks!
<b>I work at the filthydelphia CLINIC!!!!</b>
(geez, nerds! :) )
(but this isn't a CLINIC publication because they didn't want their name on it)
(oh and no progesterone because I couldn't find any non-anecdotal evidence that it has a beneficial effect, and plenty of non-anecdotal evidence that it has a fairly high risk profile. no T because in Philly there isn't much of a thriving T black market except between close friends. A steroid poster has been suggested, since some guys juice up, but I'm not close enough to that scene to know what people are using. There are definitely a bazillion forms of generic spiro and I'd love it if you could direct me to authenticatable photos of them. Sorry about the typeface and information density, but posters reach people who don't read flyers and zines. No source code just 'cause. The format is the largest area printable on my friend's color poster printer, which is finicky about file format.)
my CLINIC is both a good and frustrating job. Good because I get paid to do good work, and people are invested in facilitating it for me. Frustrating because the standards are higher and little slips, like scheduling people under the wrong name are a big deal. Also frustrating because the patients keep dying or going to prison.
With all due respect, this is precisely the problem with anecdotal evidence. With a poll we could, and probably would, prove that it is possible to have round breasts with and without a progesterone history, and also that it is possible to have tubular breasts with and without a progesterone history. What we could not demonstrate, with a self-selecting, self-evaluating, non-blinded poll, is whether there is any correlation. I'm sorry, I'm going to stand by this, I don't care how many people you've known.
The risks of progesterone- which include several lethal events as well as more cosmetic factors like hello, it causes an increase in body hair- I will leave to you to research.
(Although I thank you for bringing my attention to the plastic surgery term "tubular breasts." What do surfer trannies grow?)
reader mail 003: P in me|
I think the issue us not whether or not progesterone is a good or necessary part of HRT, but whether or not there are transwomen out there who seek to buy progesterone and need to know whether the progesterone they're buying is legit. I mean, "I think P is dangerous and unnecessary, thus I will not include it" is not so far removed from "I think DIY HRT is dangerous and unnecessary, thus I refuse to hang this poster in my office." These are both personal opinions informed by the personal beliefs of gatekeepers and not the needs of the community. I mean, harm reduction, right?
Is this supposed to be a harm reduction approach? Then progesterone should be included, because there are plenty of women who take it, plenty of women who have had beneficial side effects -- which can be totally individual and very personal as to what is beneficial -- and some studies that I believe show that risks of progesterone are mitigated when taken in conjunction with an estrogen.
You know, we have had people on this board who have tried to get this kind of information about progesterone because they got a bad batch of something that was supposed to be progesterone, and maybe was, but this kind of pill guide information was not available and I really wish it had been. Just deciding based on your own research that progesterone is not a good idea and therefore the best advice to everyone is basically not to take it... can't say I think it covers all the bases.
I really do applaud the idea and the work that went into it though, it's great.
Re: P in me|
I think its important to clarify the goals of harm reduction and medicine here. This poster is not "stuff I've heard" or "things I see in my friends." The information (barring at least two typos) is citable, every draft of every part of the poster had to go through the clinicians and the medical director and yes, they did read it. This is why I can't just give out the source code so people can "adjust" it for their region or whatever. If I went to them and said "here are some changes from someone from the internet who swears by the holy google that progesterone makes breasts less tubular" they would ask me to prove it and... I couldn't.
There are several things that transwomen take because they don't have access to hormones, some of which (prenatal vitamins) are listed on the poster and some of which (raw mammary extract- what the hell is that anyway? unpasteurized milk?) are not. These, pardon me, don't work. Sometimes (the vitamins) because there's no earthly reason why they should and sometimes ("bovine ovarian tissue") they just don't. I include progesterone in this, even though, like prenatal vitamins or B-12 shots or what have you, there are people who swear it helped them or their friends.
The point of this poster is for people who have street access to hormones, but not to medical supervision, to know what is a safe way to take them and what to take. Period. So yes, it absolutely does say "take this and not this" and in no way does this counteract the harm reduction message. If you ask for me to tell you how you can transition with only progesterone, I will tell you it isn't demonstrably possible. If you ask me to tell you how you can transition with Penicillin G, I will tell you it isn't demonstrably possible. Part of the point is knowing what to look for in the first place. There's no contradiction between harm reduction info about heroin and not mentioning banana peels.
Furthermore, let me tell you what a well-controlled study would be. You would have to have a broad sample, in terms of age, time on hormones, time on progesterone, body weight, and ethnicity. You would have to take pictures of their breasts in a standard way (no self-submitted snapshots, anyone with photography skills can pose their breasts into a tube, an a-cup, d-cup, etc) and code these pictures somehow. You would have to send them to a panel of plastic surgeons to identify tube-ness or not, and then you would have to do a rigourous statistical analysis. Before you sneer, I want you to consider two things:
1) This has already been done for the *risks* of progesterone. Including the "anecdotal" side-effects people have been citing here.
2) The idea that "there's no oversight anyway and trans women should be happy with anything they can get" is exactly what doctors are thinking when they fuck us over. And its a cultural thing so anybody from the same ethnic/class background is going to feel the same way.
Evidence-based medicine is not some bourgeois after-the-revolution luxury. Evidence-based-medicine is what got rid of DES and methyltestosterone. We deserve it now.
I would be happy to discuss the history of including progesterone in non-trans women's HRT (it lowers the incidence of endometrial cancer) or the differential risk profiles from the WHI studies of estrogen+hysterectomy vs estrogen+progesterone if you're interested, but that isn't the point.
Point by point:
1) Estradiol valerate is an injectable medication. However, there are several oral estradiol pills. The valerate is the particular salt added for injection. Other hormone salts include cypionate, proprionate, benzoate, enanthate, etc. In the bloodstream the salt dissociates into the component estradiol (over time, which is why different salts have different dosing schedules) Many pills are estradiol combined with an ethinyl group (ethinyl estradiol) which is the most persistent (estinyl was the one everybody used to have, though I don't see it very often these days) Conjugated estrogens (premarin) are a combination of estradiol, estriol, and estrone, all three of which are estrogens. Estradiol (well, 17-b-estradiol) is the strongest of the three, and most oral meds are just plain, unsalted 17-b. I haven't yet come across a non-ethinyl salt of estradiol in tablet form.
2) generics- especially generic spiro, which has been off-patent for a very long time. Absolutely, you're right. I wish I had images of all the forms of generic spiro. I don't. Other than the potassium effect (which bumped me off spiro about ten years ago) it is safe and reliable, and also cheap, so it would be great to get that info out there. In the meantime Mylan, which makes generic spiro in the US, uses the following identifiers:
25mg - M146
50mg - M243, scored on back
100mg - M431, scored on back
(all pills are white and round)
If you come across an M41, don't take it- it contains spiro mixed with HCTZ and will cause severe blood pressure fluctuations (if you aren't hypertensive.)
3) Progynon- again, my bad. I'll verify this and add it to updates. Primogyn is a cheap mexican injectable that comes in 10mg ampules. So while I'm thinking of this I should add "how to open an ampule without injecting broken glass" to future versions as well.
4) Proscar that looks different- I assume (I hope?) you're talking about Fincar from Cipla. In the US Merck still holds the patent for finasteride. I haven't had a lot of contact with Indian generics (though occasionally Brazilian HAART makes it up to Philly) If I can get my hands on an unopened package, I'll add it. In the meantime, it should come in a blister pack of 10 with the chemical name (finasteride) and an expiration date.
5) Again, I work at a clinic where something like 40% of patients are or have used street hormones. When possible I ask people to bring samples in for this project, and ask detailed questions about the rest. I have a collection from my own history and from empty containers patients donate. I know there are literally books worth of meds available worldwide, so I'm trying to stick with what shows up frequently in the population here.
Much as I would love to get my hands on Aerodiol.
Estrogen nasal spray.
Don't get me started on silicone. I have strong opinions on silicone that are probably not what you're expecting. Actually, I have strong opinions about silicone public health campaigns that take the form of (trans) white lawyers telling (trans) sex workers of color that they're ugly and going to die. Actually, do get me started on silicone someday but not in this thread.
Back to progesterone. I think its very strange that trans women have been taking progesterone for a long time with no research. Generally, I think, doctors prescribe it because they've heard other doctors prescribe it for trans women, and because it is a standard protocol for menopausal women with uteruses as a preventive for endometrial cancer. The only other rationale I've heard is that non-trans women also produce progesterone, and if bringing a persons hormone profile as close as possible to that of a non-trans woman is the goal, then pro is necessary. Beyond that, Beth Elliot has made an excellent case for using progesterone for trans women whose sex drive is flagging and want a non-T way to restore it. And there is persistent hearsay about breast size/shape.
And you're right, use by medically trained people does separate it from madame bovine ovary or whatever. However, I know the name of the doctor who started the B-12 thing (he's a twit.) Its important to realize that most doctors go on tradition and hearsay as well, only they call it protocol. Protocols change all the time, and what changes them is research, and the research for estrogen is solid and the research for progesterone's affect on breast growth is non-existent. I'm not going to trust people's health to an untested "tradition."
I'd love to know for certain one way or the other, by the way, but I just can't go on first person accounts, especially of something as subjective and loaded as breast shape.
Actually, I want to back up a bit. Progesterone is part of the lactation cocktail. I guess that should go up a few paragraphs.
Drugs used for inducing lactation in trans women. Its been a while since I looked into this so I can't remember if you increase estrogen (I think so) but you add a high dose of progesterone, continue for a few months, and then cut all hormones suddenly (being on pills helps) and switch to domperidone. This is way on the whacky end of trans medicine with absolutely no well-controlled trials (domperidone isn't even legal in this country) and you sure won't catch me putting it on a poster. Still, makes me happy to think about some times.
Oh, after you do it, you need regular breastfeeding or pumping to maintain lactation.
Please, for god sake nobody quote me on this.