Trying to choose between two hormone therapy options given history with self harm
I’m a trans person, and I’ve been struggling with self‑harm for a while. And I’ve had the recent realisation I shouldn’t trust myself completely in my own company. Most of the time, I can hold things together, but when I get really overwhelmed, especially during what I think might be mixed episodes (like depression and agitation crashing together) the urge can become very intense and I’ve hurt myself badly more than once. It sometimes needs a trigger or going past a stress threshold and sometimes it doesn’t. I’m working on it, but I’m not stable yet.
Right now I’m on a psychiatric medication (valproate) that was supposed to help, but honestly I’m far from feeling safe or okay. A few other psychiatric meds have failed before this. I’m still trying to find the right combination.
At the same time, I need to decide between two ways of continuing my hormone therapy, and this is where I feel really stuck and ashamed that I can’t just figure it out alone.
There is the Injection; It’s an 18Guage Injection in my belly every 3months; It shuts down my body’s own hormone production. It’s very effective. I’d be the one storing it and giving it to myself (I’ve done it a few times), which usually feels manageable. I don't have access to trans medical care so I can't deligate the injection to a medical professional. I have a friend who is sometimes with me, but they can get distracted, and there have been moments when I’ve been left alone and the self‑harm impulses took over (not with the injection, but through other means). I’m scared that if I have a bad episode around the time of an injection, I could do something bad.
I also have the choice of the pill; This is a daily tablet that blocks hormones rather than stopping their production. I haven’t tried it yet. But it might not be as strong as the injection
I feel so ashamed that I can’t trust my own judgment on this. I want to make the choice that keeps me safe. What would you choose if you were in my shoes?
@hotdogmiami
I dont really know. This issue is more of a practical one than an emotional one. I dont know how exactly your self harm manifests, triggers, etc, so its hard to suggest anything.
Could you take a page and list the pros and cons of pills and injections ? Maybe that would help ? Also pls discuss the nature of your self harm with people who have witnessed it in some way, maybe the therapists or someone else. I am possibly wrong but I dont think accurate judgement of it possible otherwise.
Also, if you get blocked by shame or embarrassment while trying to think these through, please do some work on the shame separately. From personal experience, it does wonders
