how is it this bad?

endocrinological

natalie takes estrogen (tablets, 2mg, 3/day), spironolactone (tablets, 50mg, 2/day), and progesterone (gel capsuls, 100mg, 1/day) because it is transgender. here are the associated costs for the above medications:

estrogen: $14.05/month, $168.6/year
spironolactone: $6/month, $72/year
progesterone: $15/month, $180/year
total: $420.6/year

one will note that estrogen and an anti androgen are responsible for 57.2% of the yearly cost. this is ridiculous.
it did some calculations:
cost of diy estrogen injectable solution (estradiol enanthate, 40mg/ml, 10ml): $70-$100
necessary doseage for estrogen monotherapy: ~.13ml
injection timing: every 7 days
10ml/.13ml = 74.9 weeks of estrogen
52 weeks in a year.
100*1/(10/.13/52) = $67.6/year for estrogen (upper bound)
70*1/(10/.13/52) = $47.32/year for estrogen (lower bound)

why is diy cheaper than having healthcare? this does not account for cost of needles and alcohol wipes, but that is negligible.

neurological

the psychologist that did natalie's autism evaluation thinks that it is depressed. this is based on 0 evidence other than its consistently high score on the PHQ-9. it would like to contend that the PHQ-9 is not a useful tool of assessment for neurodivergent people.

apparently, it is somehow more conceiveable that this thing is autistic and depressed than it is that it could be autistic and have adhd. it is very clearly not depressed, in fact, it would say that other than the negative impacts of the very obvious and DSM-V compliant signs of ADHD it exhibits, it is doing quite well.