( s to afford black market hormones. ...)Making Change: The Cost of Being Transgender,Health

s to afford black market hormones.

She has criss-crossed the country and bought illegal hormones in California, New York and Texas.

"Just go into any transsexual bar and someone there will be selling," she said.

The only time she ever received hormones by prescription and at regulated doses was at a county jail in San Francisco. After being raped in another prison, she contracted HIV.

On the black market, she said, 1 cc of estrogen costs around $15. A physician might charge more than five times that amount.

She has also spent $800 on laser hair removal and at one time considered pumping industrial silicone into her breasts.

Dr. Ward Carpenter, a physician at the Callen-Lorde Community Health Center who works with transgender patients, said there were numerous risks associated with both silicone injections and unregulated hormone use.

"Silicone is a huge health problem & One patient has had 20 surgeries to remove all the silicone injected into her hips 30 years ago. It solidifies, becomes very hard, and clumps into rocks," he said.

"Silicone has a tendency to migrate in the body," he added. "It can be injected in the hips and then you end up in the emergency room with silicone in the lungs."

There are also health risks associated with illegal hormones. Progesterone has been linked to breast cancer and estrogen can cause deadly blood clots in the "lungs, legs, heart and brain."

Class Matters

Low income "trans men" also face challenges in their transition from females to men.

Born Raquel Samantha Hall, 20-year-old Kels never felt comfortable in his body.

"My body never felt right to me," he said. "I always wanted to dress boyish and do boyish things. The body I'm in, I hate. I don't like my breasts or my voice.

"I want to chop off my breasts, but that will cost $8,000. I don't even have good enough credit to get
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