When a father in the city of Cixi in the eastern Zhejiang province of China discovered that his 13-year-old had been secretly self-administering androgen inhibitors and estrogen tablets for months, he told local media that he was aghast. His child, whom he referred to as his son, had developed breasts and was “ruined.” The father complained that the teen was able to buy these drugs without a real prescription, and the story made the rounds on Chinese social media. The incident reflects China’s pervasive black market for hormone replacement therapy (HRT) drugs, which is fueled both by the country’s troubled medical system and conservative societal attitudes around gender. [time-brightcove not-tgx=”true”] In the U.S., access to gender-affirming care, especially for minors, has increasingly been attacked, as the Republican Party has made rolling back transgender rights a touchstone of its so-called culture war.