In the US, as in much of the world, trans people are often unable to access the healthcare they need. For many people transitioning, finding a doctor willing or able to help, let alone a clinic that offers hormonal treatment, can be costly and difficult.
Ryan Hammond, an artist and tactical biologist based in Baltimore, wants to make the process easier using genetically modified plants. He plans to engineer transgenic tobacco plants to produce gender hormones like estrogen and testosterone, allowing anyone to grow their own supplements at home.
To do this, Hammond is attempting to crowdfund $22,000, which would cover the costs of his training, lab access, and living costs for a year at Pelling Lab in Ottawa, Canada. Hammond has a background in art and has been working in a community biohacking lab in Baltimore called BUGSS, where he been exploring Synthetic Biology and learning new techniques in the field.
He chose to manipulate tobacco for this project because because a lot is known about the plant's capacity for producing pharmaceuticals. In the past, tobacco plants have been made to produce collagen, hemoglobin, and Ebola vaccines. For his first round of plant products, which will not be distributed, Hammond will use plant pathogen Agrobacterium to insert genes into the tobacco. Once the prototype is developed, he will work to refine the process and make the plants safer for human use.
The artist said it is unlikely he can fully develop a transgenic tobacco system to produce these hormones in his one year residency, but his ultimate goal is to lay the groundwork to create a network of care outside of the realm of the healthcare industry, which has traditionally marginalized queer and trans people.
"I am trying to bring these tools into the hands of people who are actually consumers of the product," he told Motherboard.
Nick Gorton, an openly trans physician who treats transgender patients at the Lyon-Martin Clinic in San Francisco, said there are many accessibility issues for people transitioning in the US.
"Most trans people in the US can get hormones with varying degrees of difficulty," he said. "A lot of people will have to drive 200 miles to the trans clinic, which is not ideal. For general health care it's good to have your provider somewhat close so you are not long-distance managing this."
He said while some doctors might be outright transphobic, many of them just lack the experience and skill to assist patient needs, which is why his clinic works with medical consultation service TransLine to help physicians provide better care.
"A primary care doctor in Texas, for example, may have not ever seen this before, so you are still having to deal with that discomfort of them not knowing what to do," he said. "There are a lot of people who opt for DIY hormone treatments."
These DIY treatments include borrowing birth control prescriptions from friends or partners, or ordering hormones online. While purchasing hormones online is technically illegal, the drugs are fairly accessible from foreign mail-order pharmacies in places like India. Estrogen, which unlike testosterone is not a controlled substance in the US, is particularly easy to access for trans women. However, there is always a risk when ingesting medications not cleared by the USDA.
Hammond said he wants to provide an accessible alternative without pushing trans and queer patients into situations similar to these back-alley solutions of the past. To do this, he wants to consult with other people in the synthetic biology field on how to make the process as safe as possible.
"In order for it to be safe and actually a viable way for people to receive hormones there are additional things that need to be developed," he said. "There are ways to test them for quality and purity, and for people to test their hormone levels by testing their blood while they're on the hormones."
There have already been some concerns in this realm: Hammond said after launching the project he received a barrage of messages from people concerned about the plausibility and safety of the endeavor. However, he has consulted with government entities, including FBI agents, who say this kind of at-home biohacking is perfectly legal.
Josiah Zayner, a bioengineering scientist and research fellow at NASA Ames Research Center, said engineering these DIY hormones is "totally plausible." "The hardest part would be extraction and purification of the hormones," Zayner added.
Similarly, Gorton said there is no reason to believe the hormones themselves would be unsafe. There are many plant-based hormones, most notably estrogen found in some soy products.
"This could totally work," he said. "The easiest way to this is to genetically modify the organisms, and there are certain organisms more amenable to this. There is a ton of research about tobacco, so I can see why he would pick this."
Although the chemicals produced by tobacco plants would not be inherently unsafe, Gorton said often trans people take a variety of different hormones and supplements as part of their transition, so taking exclusively estrogen or testosterone may not be the best solution. For example, many trans women take anti androgen to lower testosterone levels into the normal female range in addition to estrogen.
It is also difficult to quantify the hormones in plants like these. "Knowing what you are getting is an important thing," Gorton said.
To address this, Hammond said he envisions a broader system, in which trained care providers help trans people using these hormones test their own blood levels.
"This is where the project gets interesting to me," he said, "because then it becomes the job for me and queer people who get involved to have workshops with people to kind of visualize what this would look like: to have a pharmaceutical system where you have community hubs where people can grow the plants and hormones and there are specialists who have knowledge and can pass it along to trans people in the community."
Hammond is raising funds for the project until January 14, 2016. As he works on Open Source Gendercodes, he plans to make a website cataloguing his work and a creating network of others' research that he encounters on the way.
"I'm not expecting avid success in a year, that would be really naive, but I'm looking at myself as a connective tissue in this whole process," he said. "I am looking at myself as someone who can connect people in the DIY bio community, and researchers, and queer people who have a space here and whose lives are affected by the availability of hormones. I'm trying to create a broader dialogue."