Does anyone here want advice on DIY MTF HRT? I'm pretty much the best at the financial, medical and legal aspects of hormonal transition and my doctor gives out advice when I ask her about mones for other people, so I can answer most of the questions you have.
>>5277273
>Is 24 too late to start?
>How do I avoid fast breast growth (want it slow)
>Can I indefinitely present as male till I gain the confidence to present as female?
>What is the best website for UK dwellers?
>How risky is self medding?
>Is it true it makes you more attracted to men?
>Does it make your head hair grow longer?
>Does it change your head hair texture?
>Does it get rid of facial hair or at least prevent further growth?
>Is it true it makes you shorter?
>Is this legal?
>>5277291
>Is 24 too late to start?
No, but (barring above-average genetics) you won't pass in your personal life without surgery or makeup. You WILL pass to strangers as long as you work on your voice, and I've heard that having the right hormones gives trans women an inner peace that makes it worth it no matter how old you are.
>How do I avoid fast breast growth (want it slow)
Eat less, perhaps. Consider, however, that breast growth rates will almost always be genetically determined, and starving yourself may permanently retard their growth. It's not worth it.
If you're 24, it's most likely that you don't have that much breast growth left in you anyway, however.
>Can I indefinitely present as male till I gain the confidence to present as female?
Usually. Especially for late transitioners.
>What is the best website for UK dwellers?
I've heard Inhousepharmacy works good for Europeans, but I prefer Alldaychemist for the per-unit prices. Their estradiol valerate is
>How risky is self medding?
As much as hons, bitter in their lonely ugliness, will try to persuade you into going through the same mare piss hell they went through, it's not very dangerous at all, assuming you do not present any of the contraindications for spironolactone or estradiol.
If you do, it may still be worth it; not transitioning earlier will ruin your life for you.
Cyproterone acetate, a progestin, is said to be 'better' somehow than spironolactone due to its non-diuretic nature, but though it has certain other effects there remains a risk of depression, liver damage and other potentially heinous shit. Start off with spironolactone, as it is the safest anti-androgen that exists.
>Is it true it makes you more attracted to men?
Some people experience orientation changes on hormones.
[cont.]
>>5277291
>>5277317
>Does it make your head hair grow longer?
Some people have experienced hair regrowth, but hair doesn't have a preset 'growing length'; length is determined by the length of the anagen phase, which is genetically determined. Consider a dosage of biotin if you're interested in improving the health of your hair.
>Does it change your head hair texture?
See above.
>Does it get rid of facial hair or at least prevent further growth?
No. You will need electrolysis to get rid of your facial hair, as the follicles have already formed.
I'm uncertain about what you mean by preventing further growth. If you mean the formation of new follicles, yes. If you mean the death of current ones, no.
>Is it true it makes you shorter?
No.
>Is this legal?
Yes, but who gives a shit regardless?
>Want to go full time gril mode
>I'm 29, should I just say fuck it?
>>5277331
That depends where you live, anon.
>21 but I get mistaken for being 15-17 often. Would I need surgery or could pills do it? I don't have really strong features.
>What do I take? How much? (160lb 5'11")
>Is it even worth it? I've had these thoughts on and off for at least 10 years but I don't want to be a living meme.
>>5277273
Is it possible to take hormones to be more feminine but not transition fully?
I don't think I can deal with my social life and family relationships being destroyed right now.
>>5277415
You'll grow boobs in the process. It's unavoidable, but you can wear a binder.
>>5277386
>21 but I get mistaken for being 15-17 often. Would I need surgery or could pills do it? I don't have really strong features.
Pills usually do it, even for people who have supposedly 'strong' features.
>What do I take? How much? (160lb 5'11")
The standard dose is 100/2 mg spironolactone/estradiol. Due to its pharmacokinetic properties, spironolactone is generally taken twice a day. Estradiol timing doesn't matter, since its half-life is 18 hours sublingually.
>Is it even worth it? I've had these thoughts on and off for at least 10 years but I don't want to be a living meme.
Yes, it's worth it. It's like zero to forty bucks a year if you're poor in America on a prescription, depending on which state you live in, or around thirty bucks a month (iirc) for DIY.
>>5277415
Yes. Bitter hons will tell you otherwise, but without a doubt yes. Hormones are unlikely to completely transform you, and it will take months to years for the effects to become undeniable. Tits are the real dealbreaker.
>>5277425
Wearing a binder will fuck your tits up, especially if you do it while they're growing. Do not do it if you ever want to come out.
>>5277431
>Wearing a binder will fuck your tits up, especially if you do it while they're growing. Do not do it if you ever want to come out.
Aww, shit. But I'm not ready to present female. I'll stick to chunky sweaters and shit I guess.
>>5277434
If things get bad just say you have gynecomastia or whatever lol
>>5277439
The sudden gyno will be fun explaining to my family.
Where do you buy things? How to make packages look secret?
>>5277470
Inhousepharmacy or alldaychemist.
You should probably give them a note, but either way ADC gives you your meds in a plain, small brown box.
Any info on medroxiprogesterone acetate? Can i combine it with spiro and finasteride, or is there no need for it?
Hey friendos, prospective MTF. Dysphoric as heck for 5-6 years, ready to finally act on it. I'm from Vancouver island and the process to even get a foot in the door is pretty difficult. The only psychs/way in is in Victoria and I'm in Nanaimo (As far as I know). My hometown, Calgary is pretty shitty right now too.
tl;dr considering self medicating. What the heck does it even look like? I know you need anti-androgens and ofc estro but what's the deal. I know I'm asking for alot, but the resources here are so lackluster I feel really frustrated.
Is there a Canadian website to get the drugs online?
>>5277431
>Tits are the real dealbreaker.
Can I prevent tits by staying underweight? My appetite is already next to non-existent anyway.
I've started on 2 mg E valerate (so oral, not sublingual), total per day, for 3 month. Should I increase it to 4 mg ?
Most article I've found use "pure" oestradiol as basis, but I don't want to switch.
>>5277665
I'm pretty sure inhouse & alldaychemist ship to Canada, my friend who lives in Alaska as an example, gets her stuff from alldaychemist. Basically if they let you ship there, it'll most likely work. I.e. they don't ship to Norway as it'll get stopped at the border, being shipped from outside of Europe.
http://www.slideshare.net/roger961/hormone-replacement-therapy-for-transgenders-dos-and-donts
http://taimapedia.org/index.php?title=Hormones
https://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/TransGendprotocols122006.pdf
http://www.gires.org.uk/assets/DOH-Assets/pdf/doh-hormone-therapy.pdf
These all tell you what they do and what you can get.
I personally recommend 10mg/1ml progonon depot once a week.
http://www.alldaychemist.com/progynon-depot.html
And 25mg+25mg cypro, up to 50mg+50mg.
http://www.alldaychemist.com/androcur.html
^ For most potent feminization ^, though going for i.e. what's said in this https://docs.google.com/spreadsheets/d/1zZQyrinhLsl2FWY9XI_bk3RtqSP94a8h-ZFvYBzcfIE/edit#gid=0 is fine, but not as potent.
All transgirls who have went from pills to injections for estrogen all have had more feminization, accelerated breast growth and so on and so forth, compared to pills.
Which AA you take is up to you, if you don't have a lot of issues with dry skin or dry mouth, stay well hydrated, Spironolactone is totally fine, but Cypro is more potent and will not cause liver issues unless you're a 50 year old prostate cancer patient taking quadruple or higher dose than you'd take.
>>5277817
I think you should move to as far as 8mg a day. I personally had good results with 6mg. 4mg is fine.
>>5277273
Hey I'm >>5277291 again, I don't want to start HRT until I lose weight (currently 220 down from 255, don't laugh) but time is ticking seeing as I'm 25 in January so I was thinking of starting anti androgens right now until I slim down which will be hopefully next year summer. How long is it adviseable to stay on anti androgens without estrogen? What will the effects of just anti androgens be? Will it stall my weight loss?
>>5277980
I've gone from 320 to 230 in 8 months, 50 of those pounds were lost while on hrt. You can start it now and still lose weight.
>>5278251
it won't just move the 220 lbs to my tits right? im so fucking scared of that
>>5278266
I'm 230 lbs and 11 months in- It's moved a bit from the waist/belly both up to the tits and down to the hips. We're talking 3 inches off the waist and 2 inches each extra top and bottom.
>>5278266
I don't think so, not at your age. That said I'm 19 and I've pretty significant shifts going on. Hiding tits is easy, hiding hips isn't.
>>5277716
Yes, but again - you'll stunt your growth permanently.
>>5277665
>>5277845
The regimen here is extremely high-dosage and not what most American doctors would recommend. 100/2 mg spironolactone/estradiol per day should be enough in the majority of cases for the first three months, by which point you ought to get your blood tested. Taking the amount of estradiol stated there sublingually could outright kill you.
Honestly, a lot of this seems to be tranny folk wisdom. No responsible doctor would suggest you step up to 8 mg estradiol within three months without testing confirming your need for it.
>>5277273
If you're still there, I was wondering:
I've seen a few guides recommend having the first month or so be just AA and no E. Is that just so people can "test the waters" and decide if it's right for them, or is there a reason beyond that? Because I don't have any doubt at this point.
I've also seen people recommend you not do injections unless a doctor teaches you how. Do you agree with that? I'm fairly confident that I could learn it from online tutorials alone, since I'm always very careful and meticulous about this kind of thing.
(I don't know if this matters, but I was planning to do pills for the first couple months and then switch to injections.)
My hairline is very masculine-looking, and even though I'm not balding per se, I was thinking of trying finasteride or dutasteride to fix it. Should that wait until I've been on regular HRT for a while, or is sooner better than later?
What are your thoughts on progesterone? I've seen some say it does nothing, while others say it really helped their boob development.
>>5278837
>Hiding tits is easy, hiding hips isn't.
Hooray! So there's a plus side to having repressed myself so hard for so long! Since I put off starting HRT until just short of age 23, I don't have to worry about those pesky hard-to-hide hips! Now I can spend as long as I want having everyone around me think I'm not a tranny, but just a skinny guy that got fat and grew his hair way out!
hahaha... yeah...
>>5279345
>I've seen a few guides recommend having the first month or so be just AA and no E. Is that just so people can "test the waters" and decide if it's right for them, or is there a reason beyond that? Because I don't have any doubt at this point.
There's some argument that the presence of testosterone interferes with female puberty, but I don't think it's really significan t if it exists.
>online tutorials
Remember that almost all tutorials oriented specifically for this purpose are tranny folk wisdom. Try to generalise as much as possible when you do these - if you're self-administering injections, search up 'intramuscular injections', not 'injecting estradiol valerate'.
>My hairline is very masculine-looking, and even though I'm not balding per se, I was thinking of trying finasteride or dutasteride to fix it. Should that wait until I've been on regular HRT for a while, or is sooner better than later?
You may see some minor regrowth on estradiol, but if it's purely genetic and not a result of DHT, not even finastaride is likely to do much about it. You may need hair transplants.
>progesterone
I've heard very good things about it, but it's a steroid hormone present in both men and women and can cause masculinisation. You should be consulting with a doctor by the time you start on progesterone.
>23
You'll be relatively okay.
Need some advice on 2 questions:
1) http://www.alldaychemist.com/progynova-5687.html
Can this be taken under the tongue? One of the reviews mentions:
>doesn't contain micronized 17β-estradiol. It contains estradiol valerate, an esterified prodrug with differnt pharmacokinetics.
2) If I have to stop DIY for a while (rocky finances and live in UK so informed consent style treatment is hugely expensive) would I damage any future growth, or will it be ok if I have to miss a month/2 and restart? I realise this is far from ideal, but if it comes to it I want to know if I'm going to fuck up my chances by stopping/starting.
Thanks
>>5277273
>financial
Can we have some financial advice.
>>5279345
There's exercises you can do for your hips, google them. It'll help you out if you start now. You want a high protein, decent fat and low calorie diet. Between that, your exercise and hormones you could get some hips going. And not to give you false hope but you may be surprised what you find under the chub, I had no idea I actually had decent hips until I stopped being such a fatty. Good luck anon!
>>5279389
>There's some argument that the presence of testosterone interferes with female puberty
Oh, so then the idea behind it is "make sure all the T is gone before starting E"? Sorta makes sense.
> but I don't think it's really significan t if it exists.
Ok then, guess I can start E right away
>Remember that almost all tutorials oriented specifically for this purpose are tranny folk wisdom. Try to generalise as much as possible when you do these - if you're self-administering injections, search up 'intramuscular injections', not 'injecting estradiol valerate'.
Yeah, I actually meant more along the lines of what you're talking about. As in, I'd look up "how to self-administer drug injections", not "how to inject tranny HRT".
>You may see some minor regrowth on estradiol, but if it's purely genetic and not a result of DHT, not even finastaride is likely to do much about it. You may need hair transplants.
Damn. ;_;
Guess I gotta learn to love bangs.
>You should be consulting with a doctor by the time you start on progesterone.
Ok, will do.
Thanks for your responses.
>>5279616
>you may be surprised what you find under the chub, I had no idea I actually had decent hips until I stopped being such a fatty.
I should clarify: I'm skinny now, and I have the hips of a 12-year-old boy. When I said "skinny guy that got fat", I meant that if I were hiding boobs then I'd look fat.
Unless I'm the one who misunderstood, and you meant that I'd get fat on HRT and go down again, and it'd be like a cocoon of fat.
That seems like it'd be kinda cool though, if I could go from skinny guy to fat androgynous thing to average girl.
Hell, maybe I should get fat on purpose, so that when I go back down, I'll be surprised at how different I look from before.
OP what are your thoughts on perlutal/ algestone? does it really make your ass and tits huge
>>5279749
Oh I'm sorry I did misunderstand, what you're describing is actually the GOAT method of doing this. 3-6 months on hrt start to bulk up then slim down. It's around that point that you put on new mass in a feminine pattern.
>>5277273
From reading your posts, you are clearly not a pro of any sort. Stop giving out shit advice and acting like you know what you're talking about. Some of your advice is sound advice, but youre no pro.
For one, injections are vastly superior to pills - nobody who has switched to injections from pills will tell you otherwise.
t. 1 year pills 6 years injections pro
Anyone have any experience with Europe, particularly Ireland?
I'm trying to figure out if DIYing it is easier.
(I am 17 now, for information purposes)
>>5277273
where can i get the pills?
pls
I'm getting my hrt from my gp here in the USA.
I just got insurance from my job.
My insurance specifically excludes anything trans related including hrt.
That's fine cause honestly I can easily afford it.
However despite that all the pills I'm taking (finasteride, estradiol, and spironolactone, and progesterone)
are coverd by my insurance.
That's being said when I go pick up my pills at the pharmacy would it be possible to get them coverd by my insurance?
Like do they have a way of finding out why I'm taking them?
I do I just hand them my card and they swipe it and I pay 5$ copay per script?
>>5280573
ADC, QHI or Inhouse.
>>5277317
my endo says low dose (10mg/day) cypro is superior to spiro . . .
i think she's right. i mean all the countries with multiple choices never choose spiro. just america.
>>5279783
I personally don't like the risk factors associated with synthetic progestins.
>>5280623
>My insurance specifically excludes anything trans related including hrt.
Doesn't matter. Almost every policy tries to have a blanket exclusion for trans shit. Doesn't hold up in court.
>That's being said when I go pick up my pills at the pharmacy would it be possible to get them coverd by my insurance?
Yes.
>Like do they have a way of finding out why I'm taking them?
They'd need to ask your GP.
>I do I just hand them my card and they swipe it and I pay 5$ copay per script?
Yes.
If they try to raise a fuss, you can sue them and win easily, depending on your state.
>>5280746
It's not as safe, regardless, and is associated with depression.
I'm 17, nearly 18 and I'm thinking about self medicating until I can get seen by a clinic. I'm wondering what a good starting dosage/what drugs I should look out for to start off with. Also, is there a way to work out how much I should be trying as a starting dosage? Do you recommend a certain form of taking HRT or any you wouldn't recommend?
Thanks in advance if you respond
- Ashley
>>5281069
In general, the most financially sound option is 100 mg of spironolactone split into two taken orally twice a day, and 2 mg of estradiol taken sublingually once a day. Start off with 50 mg spiro a day, just to ensure that you're not allergic to it or something.
I do not recommend taking estradiol orally (you'll require a larger dose to make up for the reduced bioavailability) or taking premarin ever. Injections are good if you can do them safely and if they're cost-effective for you. Patches are good too.
>>5281127
Thanks for the info, the only thing is that i'm really worried about jabbing myself with a needly in the wrong place and injecting it somewhere it shouldn't. I have anxiety and I would be in constant fear that I would just drop dead because of a clot or something. Can this happen? Also, how much does it hurt to inject yourself (haven't had an injection since flu jabs when I was much younger) and do you always have to do it in the same place (as i've heard this can make you very sore)
- Ashley
Been taking full dose spiro + progy for 4 months but i panicked and quit therapy and never saw a doctor for blood tests or referrals and now i'm just here... I tried stopping the hormones for a couple weeks and i started getting anxiety a lot more, like i used to. I felt uglier and body hair started coming back. Could've been coincidental, but i'm scared of stopping, and i don't think i'm strong enough to come out in the near future.
How fucked am I? Is my health going to get blasted from this? No adverse effects so far, except from I have to wear a jacket at all times.
I'm 22 and hit male puberty pretty softly but now I'm concerned that I should be trying to get to a reasonable female dose asap. I'm one month in taking 50mg and 2mg estradiol (I do under the tongue) twice daily. Should I at least increase my spiro? I don't know if body type counts but I am pretty small.
>>5280782
Thank you for giving me clear answers.
I live in Texas.
Sooo idk conservative state?
But I'm not too worried cause even with the 4 pills i only pay like 40 a month out of pocket, but with insurance Itd be 20.
>>5281181
I have little experience with injections. If you're afraid of doing stuff yourself, I suggest doing it sublingually until you can get a doctor to do it for you.
>>5281209
Just keep going. Try and see a doctor nonetheless. Since you've already been on it for a while, quitting it would obviously affect your health more than going on.
>>5281239
Stay on that dose for at least three months. You should be trying to get tested and see a doctor before then anyway.
>>5281323
If your income isn't over three times the poverty level (or even if it is, they don't check), consider RxOutreach. You'll get 180 days of estradiol and spiro for $40.
>>5277273
I have 2 Questions
1. How long should you be on spiro and oestrogen before taking progesterone?
2. Do you take progesterone with spiro or without?
when should you increase estradiol doses?
>>5280714
what all am i ordering? im really dumb and need things broken down into bits
>>5282562
Spironolactone and estradiol. Go for as much as you can afford at a moment, since shipping costs are identical (unless you go over 95 with adc, I think).
>>5277561
Only add progesterone 1.5 to 2 years after starting estrogen, or have reached tanner stage 4.
>>5282562
Order 2mg pills of progynova, estrofem, or estrace, and 100mg pills of spironolactone or 50mg pills of cyproterone acetate.
Hey I'm wondering how can I get hormones and where?
I live in Alabama
>>5283378
From doctors or online? If doctors, do you have insurance?
>>5279454
Dont take valerate sublingually. Not dangerous but you don't need to, and the pill is not designed for that so you'll have to wait a lot. It is a slightly modified estradiol that slowly converts back to "true" estradiol once in the blood.
To get into details, it's a chemical trick so that the dose curve does not have a peak at the start (contrary to sublingual unmodified E); it stays relatively constant. You may have to take more than sublingual (4 or 6 mg) to get adequate levels, due to degradation by digestion. Do blood test to check. IMO as a pharmacology student and MtF, that is the best option if you don't want/can't inject.
As for the financial aspect, can't you just stockpile 2 or 3 month before starting ?
>>5280074
I'm in western europe, QHI works fine for me. Not sure for Ireland specifically.
what drugs can i take if i just want to be a femenine boy
help me
>>5283432
Yes; however I'm 16 and yet to come out to my family.
I shouldn't have to worry. I just need to find the right time to tell my dad
>>5283471
So I guess you mean doctors. What's your insurance company? Do you think your family will see the bill from seeing a doctor?
>>5280782
>>My insurance specifically excludes anything trans related including hrt.
>Doesn't matter. Almost every policy tries to have a blanket exclusion for trans shit. Doesn't hold up in court.
oh my god bullshit.
Mtf here. Pretty new into hrt. Noticed some breast soreness the other day and when I applied some light pressure to them clear fluids started coming out. Is this common? I've already made an appointment to get blood tests I'm just wondering if I'm dying from high prolactin levels?
>>5283481
Blue cross blue shield of Alabama
I have nothing to worry about from my family.
Except some disappointment from my dad. He'll still love my after all I am his only son from my mom
>>5283511
I'm having some trouble finding people to help you since I don't know all the facts. I did find about 13 people with experience with trans people within 100 miles of Birmingham. However, that may not apply to you.
Go to http://provider.bcbs.com and select search by specialty and select the letter B. There you'll find Behavioral Health - Transgender Issues then you enter the rest of your information. After that, you can search for an endocrinologist. Though your counselor may know someone who treats trans people if you're not sure who it's safe to pick.
>>5283616
thank you for listening
>>5283503
Don't panic, but you're probably dying. See a doctor.
>>5280714
trying to order of QHI but its asking for Indemnity & Disclaimer forms?
>>5284745
They sent you them by email right? Just email or fax them. I decided to email, since I didn't know if my parents would get charged extra for fax. You'll need a scanner.
>>5287483
ahh okay, thank you dearly
>>5281181
There are four areas great for injecting. Both thighs and both buttocks. I alternate between the left thigh, right buttock, right thigh, left buttock on a weekly basis, so I only hit the same injection site once a month.
OP, in case you're still here. Any information on progynon depot regimen? I was only able to find article comparing pharmacokinetics of 2 intramuscular drugs, but I'm not that good at calculations plus measurements are based on tests from biological post menopausal women which will put some bias, I guess.
P.S. If someone have clue on how to deliver injectable estradiol to Russia I ask for it.
Currently on 4mg of estradiol, how long until I up the dosage?
>>5294062
That's considered the standard dose, senpai. Unless your estradiol level isn't where you want it (some trans girls aim for ovulatory, and it seems some endocrinologists would rather have it a bit lower, in follicular). If it is lower than you would like, I think the standard time is at two weeks, maybe a month.
>>5277317
>>5277321
Thanks chen
>>5277273
What's the average time for fat redistribution to *start*? I lost weight before HRT but I don't want to put it back on until I'm sure it'll go to the right places and not my stomach. But also at the same time I don't want to harm my early boob development.
>>5277273
Hey OP I've been on 200mg spiro 4mg e for around 6 months. What sort of changes should I be expecting to see by now? My nipples have grown quite pointy which is to be expected I guess but other than that I've had no changes to libido, body hair, mood etc.
I'm underweight but I've been eating like a normal person - two decent meals a day and stuff - ever since I started the meds but my weight has not gone up. I'm not sure if the spiro is just not kicking in or what. I've heard that you need to drink to make spiro effective but is that just for the diuretic effect or does it also help block T?
Oh and I cant get bloodwork done because selfmedding.
Is 17 still gonna be OK to not be a hon? I'm fairly twinky
>>5283467
QHI?
Also, thanks
>>5296838
Quality Health Inc
Im scandinavia and it works great
>>5283448
Thanks for replying, how much more risky is swallowing a pill vs patches/injections in terms of blood clots? Should a non-smoker, average weight 23 year old not have much to worry about assuming they're not sitting down all day every day?
>>5296956
Nothing to worry about for healthy people.
>>5296884
Thanks very much
I have started getting lightheaded a lot more often when playing sports. I think I get enough water, but maybe the spiro is exacerbating it? Is this possible?
I wanna do this but my mom died from breast cancer, I heard if that's the case you shouldn't do HRT. Anyone know about this? ;-;
>>5299571
Having a personal history of estrogen-sensitive cancer is an absolute contraindication for HRT. Having strong family history is a relative one, so it will be something you and your doctor should watch extremely closely, but it won't stop you from starting.
>>5299589
I am not that person but breast cancer doesn't seem to run in my family (can't recall anyone who has ever had it) but I'm still worried. How do I know for sure? To complicate matters I am self medding.
>>5300024
You could try a screening for the mutations. It's not really clear about prices, but apparently it can run from $99-$599. https://www.counsyl.com/price/
Alternatively, perform breast self-examination. I think you would be fine unless you're taking premarin for your estrogen.
http://www.nationalbreastcancer.org/breast-self-exam
>>5277273
What's the safest dosage and type of estrogen cream for an mtf who's already got low T and is being forced by their endocrine to take drugs for that?
I don't want it to be too obvious on the blood tests, that's why I'd prefer something not ingested. Plus I already look like a flat chested 12 year old so there's that.
>>5300769
Why the fuck are you being forced to take testosterone supplements? If your doctor doesn't know you're trans, TELL HIM. If he does know, find yourself a new endocrinologist immediately.
At the very least, you don't have to accept his treatment.
