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title: "Trans care - access to hormones"
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If a pharmaceutical company makes more money from selling a given medicine in one country rather than another, it is inclined to sell the total amount required by both countries to the more profitable market.

The unavailability of certain medicines is one of the many factors limiting the possibility for transgender people to access safe pathways for hormone intake, as it encourages the production and sale of testosterone of dubious origins. Indeed, in Italy and in most of the other countries, this type of drug is only prescribed as therapy for hypogonadal cisgender people (that is, people who feel that their birth-assigned sex and gender match their gender identity). Therefore, so-called "gender dysphoria" (when people feel their birth-assigned sex and gender do not match their gender identity) is not among the authorised conditions for using hormone-based medicines.

Transgender people are thus trapped in a paradox. On the one hand, the recent depathologisation of gender dysphoria can be seen as a cultural and civil victory. On the other, it has left a definitional void that needs to be filled to guarantee access to medical care to everyone. In fact, this void pushes people who take hormones for gender transition to do so "under the counter", because for official healthcare systems they are non-existent.

Trans communities often advise and support each other via social media and other online channels to reduce the risks associated with purchasing and taking unauthorised hormones.

All the while, estrogens are not as much in the spotlight as testosterone; indeed, since they are not used for sport (and war), there is no such a lucrative black market for them. Open Source Estrogen, a collaborative project led by the artist Mary Maggic, stands between citizen science and speculative design and has the ambition to develop DIY/DIWO (do-it-with-others) protocols for the "domestic" synthesis of estrogen hormones as a response to the strong control by governments and institutions over human bodies.

_Note based on Rebelling with Care (WeMake, 2019)._