Hormone replacement therapy shortages ‘devastating’ for trans women

Hormone replacement therapy (HRT) shortages across the UK could have a “devastating” impact on trans women, according to an endocrinologist.

A “major and widespread” shortage of HRT in the UK was reported to be having an adverse effect on cisgender women in July 2019.

The drugs replace hormones in cis women going through the menopause, and the shortage means cis women are struggling with side effects including depression, anxiety and nigh sweats.

Now, the i reports that trans women are also feeling the effects of the shortage – with experts saying they don’t know the reasons behind the shortage or how long it’s expected to last.

HRT acts as gender-affirming treatment for trans women. The impact of HRT withdrawal varies depending on the stage of transition.

“If the woman hasn’t had gender reassignment surgery – so she still has testicles and is able to produce hormones – and she is not on an anti-androgen, like a GnRH analogue – which stops the testicles from working – then running out of HRT may result in a return of masculine features,” explains Dr Leighton Seal, a consultant endocrinologist at London’s Gender Identity Clinic.

“This would be really devastating for a trans woman,” says Mary Burke, a clinical nurse specialist in hormone therapy at The London Transgender Clinic.

“They would start to feel a lot more dysphoric, and that leads to feelings of depression, and huge social anxiety,” Burke said.

Liberal Democrat trans equality campaigner Sarah Brown told the i that she knows of trans women who are struggling to access their normal HRT prescription and she is concerned about the physical and psychological impact that the HRT shortage could have on the trans community.

“Transition is difficult to start with so – particularly if you’re early in transition – if you’re on again, off again, you can start having real problems emotionally,” Brown said.