Trans

I'm not as confident as you that drugs and hormones won't be prioritized - places like California are already stockpiling HRT, for example.

For context, our lives are fragile and there is not much we can do about that. Most of us are poor, many of us are homeless and/or unemployed.

Already under current conditions probably most of us struggle to ever get to the point of transitioning, let alone access to care. Many of us die before or after. It's definitely better than it used to be, but it's good to remember that the current conditions are still not ideal for most of us, so we don't despair or forget that all moments are times of adversity for us and that we have to figure it out no matter what changes (for better or worse).

So, for the privileged minority with the resources to do so, there are plenty of options:

• stockpile years of medication so that you can ride out a temporary shortage in HRT
• stockpile raws & buy the equipment for a home lab, so you can compound your own medication
• get access to surgery so that your body won't detransition without access to HRT
• get passports and citizenship status in other countries so you can move around the world as the geopolitical situation deteriorates
• keep up a social network so that you know where the diminishing pool of care-providers are, and ideally use social capital to get your care prioritized
• store your stockpile in various secure places so that it cannot be easily confiscated, stolen, or otherwise lost (e.g. in a single house fire)

We absolutely depend on industrial systems to manufacture the bioidentical estradiol and to compound it in a safe way.

I think the closest low-tech alternatives were using the urine from pregnant women, and I've heard of using pregnant horse urine (but I have no idea how healthy or effective that is). I think to separate the estrogen from the urine is tricky and probably requires industrial inputs, and getting that estrogen into a route of administration that isn't super wasteful and ineffective (like oral routes) again requires even more refinement and industrial tools.

So, realistically I would say a "primitivist" approach to HRT is not going to happen, in which case it's just about trying to ensure you have privileged access to a dwindling and scarce resource, and then trying to ensure you won't lose that access.

Again, this is all rather individualist in mindset and not relevant to pretty much anyone here - we are not the privileged minority, we are the desperate masses and we should remember that.