An article just appeared on the news that GPs consider self-requested medical testing “concerning and unnecessary”. Of course, I think they’re wrong, but I’m going to outline some reasons.

Firstly, a question to those against this. Why do people feel the need to self-request medical tests?

Tests requested by a medical practitioner are free, when you self-request they are not, often costing more than a GP appointment. Clearly people feel they are not getting the care they need - I have had my health concerns completely dismissed by GPs with no follow-up so understand why someone would get tests done by themselves.

I’m sure there’s a lot of misinformation out there are people getting unnecessary tests, but we should not remove a service just because some people use it - at their own cost - when they don’t need to.

So, back to why people self-request tests, and I’m going to start with a transgender perspective.

Transgender healthcare is frequently poor. I know people who’ve been ignored, gaslighted and outright lied to by the people supposed to provide the medical guidance for their transition, so to keep GPs honest they get their own tests. This should not be necessary, but it’s a reality for a lot of us. Most often this seems to be providing menopausal levels of oestrogen and refusing to do any tests, so by getting these tests people can find out what’s actually happening and change GPs. Without the ability to do self-requested tests there’s no way to double-check a GP’s opinion.

Secondly, “DIY” therapy - that is obtaining hormones illegally without a prescription - is not uncommon. This is often because doctors have refused to provide care, or won’t provide care the patient wants. Self-requested testing is used by DIYers to monitor their own levels, ensuring that they’re not exceeding appropriate levels and actually have medication containing the hormones they want. Why do they DIY? Simply because specialists refuse to prescribe injected oestrogen or any sort of testosterone therapy so people take it on themselves to get the medication, and sometimes because they’re refused an increase in dosage. I explored some of this in a post on considering DIY therapy.

Lastly, because people modify their treatment regimes without consulting a doctor. Perhaps increasing or decreasing an anti-androgen, or altering the time of day medications are taken. Getting this done with GP approval can be very hard, especially if your GP sticks rigidly to the guidelines and does not take your wishes in to account. Self-requested testing can help show if you’re on the right track or not, and to ensure your levels are at the GP-expected ones before a test they’ll see.

None of these tests would be self-requested if people got the care they want, but that can be very hard and costly to do - even when the cost of tests is taken in to account.

And for non-hormone tests?

Also sometimes it’s easier than booking an appointment with your GP and taking time out of your day to see them for a five minute request. When GPs are booked out for multiple weeks in advance getting a test when you know what you need can take too long. Sometimes your request would be declined, then you just wasted the cost of the appointment.

Personally I’ve done self-requested tests for hormone panels (and once for a blood type test, because while interesting it’s not medically important to know in advance), mostly to get data on medication timing and drop-off for my own curiosity, but also to check levels while using DIY progesterone before I found a GP who’d prescribe it properly.

Is there a conclusion?

Not really. Just my opinion that restricting people from obtaining their own medical tests isn’t going to help trust in the medical profession.

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