Some example scenarios for each option (this is not exhaustive, just representative):

• Notably easier: HRT is available over the counter; DIY HRT is completely legal rather than grey market or significantly cheaper.

• About the same: an HRT prescription can be obtained via informed consent at Planned Parenthood or similar; DIY HRT is grey market but in practice is only infrequently confiscated.

• Notably more difficult: an HRT prescription requires long waits or the approval of several experts; DIY HRT is confiscated somewhat frequently or is significantly more expensive.

• Virtually impossible: an HRT prescription is essentially illegal; DIY HRT carries significant legal risk.

HRT is hormone replacement therapy, and includes various forms of estrogen/estradiol, anti-androgens, and progesterone.

In this question, blue states are loosely defined, but generally any state which consistently would have a relatively uncontested Democratic trifecta in fair elections for the duration of this question counts.

This market is specifically about feminizing HRT because I don't know much about the processes for obtaining masculinizing HRT. If someone else who knows more makes a market for masculinizing HRT, let me know and I'll link it here.

The question asks about adults in blue states because I have seen a lot of disagreement on trans twitter about whether blue states will remain a safe haven for trans people or if we will need to leave the country for our safety, and I would like a clearer answer to this question for my own planning. If you are also interested in the answer to this question, please subsidize this market.

Since this judgment has a significant amount of subjectivity, I will not trade.