Their information is going to come from their sisters and from the black market on 125th Street. Being identified by others as a gender, other than how you identify yourself, can be humiliating, embarrassing, and hurtful. This alone can keep many transgender people out of medical service providers' offices. Not all transgender people need to interact with the medical community around being transgender. Being HIV-positive makes each of these that much more difficult to obtain.
Hormone therapy can do the same thing for a transgender person.
The stress and turmoil of this imbalance in a person can be like poison. Producing testosterone because you have testicles producing male hormones creates tension. Ideally, all three forms of hormones should be prescribed by a physician. Insurance companies will not cover hormone therapy for transgender people because, according to them, it is an elective therapy, not a necessary therapy. Because of this, many transgenders are forced to get their hormones on the street.