THE transgender community is facing a dire shortage of testosterone hormone therapy treatment and fear many could resort to the black market. The shortage of Pfizer’s testosterone has been attributed to restricted production and the prioritisation of COVID-19 vaccines.
A Sea Point-based medical doctor, who has many transgender patients, described the shortage as “serious” and said Pfizer had indicated it would only be able to restore stock in the second quarter of 2022. Testosterone is a hormone replacement therapy that many transgender people use to transition and maintain testosterone levels, reports the Cape Argus.
Gender Dynamix, an organisation advocating for transgender rights, said it had been inundated with concerns over the shortage as the situation exacerbated the already limited gender-affirming heathcare access available for trans and gender-diverse people. Spokesperson Savuka Matyila warned that the shortage placed people at risk of using expired testosterone or accessing medication on the black market.
However, Dr Anastacia Tomson believes that the medication shortage could also be related more to supply chain issues as the previous shortage occurred before the COVID-19 pandemic. “The (current) shortage is a serious one, since the communication from the company anticipates stock to be restored only in or after the second quarter of 2022,” she said.
Tomson said many patients who were reliant on testosterone were now without treatment, and while there were alternative options for patients with financial resources, those who could not afford the alternatives, or accessed their medication in the public sector were being forced to go without medication “that is essential and often life-saving”.
When news of the latest stock shortage came out in August last year, Tomson contacted a “responsible pharmacist” and a ramp-up of the production capacity for an alternative treatment, called the testosterone cypionate, to ensure ongoing access to hormone medication.
“We have made this available to patients all over South Africa, and have guided other providers and practices in prescribing it,” she said.
Previously Tomson led a project aimed at developing South Africa-specific guidelines to aid practitioners in providing gender-affirming care, and these were released recently. “The goal was to make access to competent care easier. Many still face long waiting periods, or are subject to judgement and discrimination by healthcare providers due to entrenched stigma and prejudice,” said Tomson.
She also approached a multinational compounding pharmacy to make injectable oestrogen available in South Africa, since the medication had never been sold here. This led to the injectible oestrogen becoming the most affordable option for gender-affirming care for assigned-male-at-birth patients and trans women in South Africa.
She said the average cost of treatment per patient decreased from R1 500 to approximately R250 per month, and the oestrogen had since moved into widespread use.
However, activists said for many who relied on public healthcare facilities, it was not easy even to part with R250 for the medication they required.
See more from MedicalBrief archives: