Trans Women Are Dealing With a Pharma Nightmare

“Something like this can throw people to a bad place.”


Let our journalists help you make sense of the noise: Subscribe to the Mother Jones Daily newsletter and get a recap of news that matters.

A nationwide shortage of injectable estrogen has left thousands of transgender women without a medication that helps them physically transition—and that health experts have described as lifesaving.

Injecting estrogen is one of the most popular methods for trans women to appear more feminine. The medication is crucial, health experts say, because a mismatch between a masculine body and a female gender identity can cause trans women to experience a medical condition called gender dysphoria—extreme distress that sometimes leads to attempts at self-mutilation and suicide. Manufacturers previously suggested the drug would be back on pharmacy shelves in October, but last week the Food and Drug Administration announced a delay, saying the drug would not be available for at least another month.

Doctors have blamed the injectable-estrogen shortage on the FDA and manufacturers. The brand-name version of the drug ran out because its manufacturer, Par Pharmaceuticals, suddenly lost the supplier for its main active ingredient. The company has since contracted with a new supplier and is waiting for approval from the FDA. “The FDA recognizes this is an important drug, and is working with the drug manufacturers so that the drug may return to the market as quickly as possible,” Andrea Fischer, a spokeswoman for the agency, told BuzzFeed. Perrigo, a company that makes the generic version, did not respond to BuzzFeed‘s request for comment.

“Something like this can throw people to a bad place,” said Gina Bingham, a trans woman.

The shortage has left thousands of transgender women in a tough situation. “The drive and desire to be authentic, to live in the correct body, it’s so strong,” Gina Bingham, a trans woman in California, told BuzzFeed. “Something like this can throw people to a bad place.”

There are alternatives to injectable estrogen—doctors can prescribe the hormone in pill or patch form—but many trans women say these aren’t as effective. And they’re also less convenient: The patches can be prohibitively expensive. The pills must be taken daily and can affect the liver, since they’re processed through the digestive system.

Injectable estrogen isn’t just for transgender women: It comes in three doses (40mg, 20mg, 10mg) and the smallest one is often prescribed for post-menopausal women. But only the two larger doses—the ones transgender women use—have been affected by the shortage, though doctors aren’t sure why. Some say it would be extremely painful to give trans patients four injections of the smallest dose, since that would mean injecting four times as much liquid.

The shortage “speaks to the disparity of how we as a community understand the importance of hormones for trans people,” Anthony Vavasis, the director of an LGBT health center in New York, told Out magazine. “What if tomorrow we announced, ‘There’s no more insulin available for diabetics?’ How would that play?”


Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

payment methods

We Recommend