Border Hormones: Miro's Story

Wednesday, 23 February 2011 16:43

Every day hundreds of people cross over the Arizona-Mexico border gates by foot, in search of groceries, goods, craft items and sometimes–pharmaceutical supplies. Some project that our nation's health care is pushing them there: those who cannot afford to buy their prescriptions in American pharmacies turn towards the less-regulated and cheaper Mexican alternative. For transgendered individuals, this reality is especially appealing. With only a handful of health care practitioners in the Southern Arizona area specializing in transgender health, it is a long and difficult process to gain access to hormone therapy. Mexican pharmacies offer up the chance to purchase hormones at a  fraction of the U.S. price, and the freedom to self-administer.

For some, like Miro Gutierrez, 29, this opportunity seemed ideal. Growing up in a working-class family with no health insurance, Gutierrez could have never afforded hormones or the supervision that comes with the prescription. He took a route that many have before him–a choice that put his body and his life in danger.

The Danger of Transitioning

With the border so close, the temptation exists for those in need to cross to seek out the drugs they wish to acquire. For transgendered people, this need is more than just sustaining their physical health. It is the need to get out of the situation they were born into. For Miro Gutierrez, it was more than that.

"Identifying and passing as a male was so much easier with hormones. To find a job and apply as a male instead of a female. I got better jobs. I got paid better. I did better things.  I could make more money when I was passing as a male," Gutierrez said. "Coming from working class from where my brothers were getting good jobs, not according to educated people but according to working class people, a good job you can live off of.  And not be be a waitress, like the typical shit, like the typical jobs for a person of low income who was a female."

As few choices as people like Gutierrez felt they had, hormone therapy is still a treatment that is capable of causing great harm if not regulated by health care professionals.

Maria Crawford is a certified nurse practitioner and a registered nurse first assistant for Southwestern Surgical Associates. She sees the decisions of many to buy hormones in Mexico as a harmful and potentially fatal move.

"I think that it is very unsafe. It is kind of scary because they have to do three months of psychotherapy prior to even receiving any of the drugs to make sure that they are a good candidate and that they are mentally able to go forth with this process. So, for them to take it into their own hands because they don’t want to go to a therapist, they feel as though they might be deemed ineligible to receive the therapy or it is just too expensive, they are going about it in a very dangerous way. The rules are put in place for a reason," Crawford said.

The major problems lie in the source of the hormones as well as the dosage it's suppiled in. Many believe that there is a standard dosage considered "safe" for each hormone when in fact, it is different for each individual.

Crawford said, "In the U.S., when they are given the hormone therapy, they are actually taking what's called  peak and a trough levels, looking at the amount of hormones in that person's individual system and they are prescribed based on those levels versus just taking the amount it says on the box. They are administered a certain amount of milligrams per what is in their blood stream and what is being absorbed."

Failure to take the right dosage can result in blood disorders, renal failure, cardiac arrest, epileptic seizures, hypertension and even death.

Crawford does acknowledge that sometimes the rules can be walls. With so few practitioners versed in the science of transgender health, even if someone was able to afford hormone therapy, they may not be able to gain access to a doctor or be able to stick it out through the psychotherapy sessions.

"There are actually not many people that practice or take care of transgender hormone therapy and I think that is a huge reason why people are going across the border because there are really not a lot of people dealing with this specific area and not just any practitioner is going to prescribe for this," Crawford said. "They do have to seek out a very specialized practitioner to do this for them.  I think that is a big reason that they get deterred to the border." 

This is an audio recording of Miro recounting his experience using hormones he obtained from a pharmacia in Nogales, Mexico. Pictures are not included to protect the privacy of the individual.

Written by Emily Bowen You are reading Border Hormones: Miro's Story articles