By Laurel Duggan
Medical professionals are prescribing cross-sex drugs to patients without in-person evaluations through several telehealth companies that boast of fast and easy access to hormonal drugs and other transgender-related care.
Several companies have cropped up in recent years offering cross-sex medical treatments, euphemistically referred to as “gender-affirming care,” through telehealth programs in order to facilitate and expedite the gender transition process. The companies are part of a push against so-called gatekeeping in the medical community that can delay patients’ access to cross-sex treatments like hormones and surgeries, but a growing cohort of medical professionals are drawing attention to the health risks of rushed transitions.
The transgender medical company Plume offers online appointments for individuals seeking cross-sex hormones and advertises that most patients get their drugs sent to a pharmacy the day of their appointment. Plume also offers medical letters of support, which can be used to obtain cross-sex surgeries and to persuade insurance companies to cover gender-related procedures.
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For a $99 monthly payment, Plume members can get digital video appointments, prescriptions for cross-sex medications, medical letters of support for surgeries and various other services, according to the company’s website. The company operates under “informed consent,” meaning practitioners can diagnose a patient with gender dysphoria without an assessment from a mental health professional and that a patient can begin a medical transition immediately at his or her own risk.
“Informed consent models of treatment that seek to minimize so-called ‘gate keeping’ are ideologically driven and attribute any potential co-existing mental health issues to ‘minority stress,’” clinical psychologist Dr. Joseph Burgo told the Daily Caller News Foundation. “From this perspective, the self-harming behaviors, eating disorders and elevated levels of depression and anxiety often seen in those who suffer from gender dysphoria are caused by being trans in a world that doesn’t accept you. Transition is pitched as the cure for all these mental health comorbidities and, for this reason, many informed consent providers consider a psychological evaluation to be unnecessary.”
Trans Clinique is a digital service operating under a similar model to Plume: the company prescribes HRT medications and offers “trans coaching” and letters of support for a host of transgender medical treatments and legal processes, according to its website. Its services range from $69.99 to $99.99 per month and, like Plume, the company bills itself as being led by transgender people.
A service called Folx Health offers letters of support for cross-sex surgeries and will ship cross-sex hormones directly to patients’ doors for $59 to $109 monthly. Planned Parenthood also offers cross-sex hormones through telehealth.
“The informed consent model for transgender healthcare, as currently practiced, fails to protect patients from the many potential harms of cross-sex hormones,” Burgo said. “How truly ‘informed’ are patients after a 30-minute video consultation? Do such interviews truly cover the physical and psychological risks as well as the limitations of hormone treatments? Do these patients understand just how little we know about the long term risks and benefits of hormone therapy? Is it actually possible for an adolescent or young adult to make an informed choice about a treatment that will likely make them sterile?”
Potential complications associated with cross-sex hormones include breast cancer, strokes, heart problems, blood clots, infertility and diabetes, according to the Mayo Clinic.
Folx Health, Trans Clinique, Plume and Planned Parenthood did not respond to the DCNF’s requests for comment.