There is a current stockout of the hormone depo-testosterone, commonly known as T, widely used by transgender men and transmasculine people to increase testosterone levels in their bodies, to align the outside masculine presentation of trans men to their identity. It is taken by injection. 

‘Emotionally draining’

Seth (20) from Cape Town has been on testosterone for 10 months. He is currently searching pharmacies in the Mother City to see if any has stock. If not, he will see if he can get one or two shots from a friend. 

Like most people who are deprived of T, Seth says it has been a rollercoaster ride. “Other than my mood being affected by potentially lowering my dosage, it has also been emotionally draining to have participated in the march that took place earlier this year at the University of Cape Town and be in the same position later in the year.” 

Seth is referring to the outcry over the shortage of T that happened earlier this year, which was accompanied by a march. These stockouts date back to as far as December 2018, the Mail & Guardian reported in March.

A person using Hormone Replacement Therapy (HRT) usually experiences gender dysphoria, when one’s sex does not align with their gender physically and therefore many would opt to use sex-specific hormones to affirm their gender. When not taken, the stockout of T can have devastating effects because it can lead to mental health issues and in some cases, even suicide. 

As a chronic medication, the physical effects of not taking it can also be harmful and is immediately felt.  The crisis of the stockout is an emergency for trans people, but not to the rest of the country.

History repeating itself

Pharmaceutical company Pfizer manufactures this hormone. In March, pharmacies received stock again which was a welcomed relief across the South African transgender community. However, the joy was short-lived because it is happening again. 

People who use these injections are frustrated and disheartened at the lack of concern and the recurring problem. “My anxiety has definitely increased as I’m nervous to run out of T,” says Seth. “It has been a huge stress factor to try and find before all pharmacies run out.” 

There has been news about the shortage circulating on social media, mainly amongst the transgender community, but little coverage and awareness from the rest of South Africa, Seth says. According to him, there is also anger toward Pfizer for not recognising the seriousness of the shortage. 

“It’s honestly really disheartening that Pfizer has done nothing to help trans people as well as the fact that most people don’t even know that it’s happening especially since this happened not so long ago,“ he adds.

The short-term interruption of the supply of Depo-Testosterone injection in South Africa recently, Pfizer’s communication and media manager Charmaine Motloung told Health-e. “However, we resumed supply of the product to distributors from the 10th September and therefore expect pharmacies to receive stock upon request.”

Other challenges

There is a waiting list of 25 years to get gender reassignment surgery in the Western Cape, and HRT is not readily available everywhere the country. Wealth plays a big part in who can access HRT, with little effort to make HRT accessible to people who can’t afford to buy T. 

In an earlier statement, the #Unite4TransRights movement says. “We call on the National Department of Health to respond to this health care crisis and put pressure on Pfizer to uphold their commitment to providing health care to its clients, as well as ensure that gender-affirming hormones can be accessed at all primary health care facilities/clinics, including in rural areas.” 

“It makes me really nervous as a trans individual because I don’t have enough money to buy more than one vial at a time in order to stock up and that leaves me helpless if I run out,” says Seth. “The level of instability is so high that even if I could stock up, I’d feel guilty for those who don’t have when there is a shortage.” – Health-e News