Many transmasculine or nonbinary people require testosterone to help them transition. This is to align their gender expression with who they are and alleviate the distress of gender dysphoria. It’s a crucial step for the mental and emotional health of many trans people. Testosterone is also a controlled substance, which means accessing it can be fraught — and the restrictions can leave some without access to their prescriptions.
With this in mind, Sens. Sens. Elizabeth Warren and Ed Markey, both Massachusetts Democrats are pushing federal agencies for loosening restrictions on testosterone to make it easier to access the hormone by transgender people. In a letter shared for the first time with The 19thThe senators argue that testosterone should be completely delisted — no longer federally restricted — or categorized as a controlled substance with a lower potential for abuse.
“Across the country, trans people are being penalized and punished simply for being who they are,” Markey, who led the effort behind the letter, told The 19th. “Testosterone care is not a crime. It’s something that’s important.”
Camden Hargrove is the national organizing manager for the National Black Justice Coalition. He stated that loosening restrictions on testosterone could allow trans people to access it legally and safely.
“That would be a very, very useful thing and it could absolutely change many trans men’s lives,” Hargrove said. Many trans people rely on unsanctioned methods — like ordering from online pharmacies without a prescription — when the financial and transportation barriers to access gender-affirming care become too great, he said.
Quinn Jackson, a trans primary care doctor who practices in Kansas City, Kansas, believes that easing restrictions on testosterone would significantly reduce barriers for trans people — including his own patients.
“I have patients who can’t fill prescriptions before they go on vacation because it’s too many days before their next prescription is due. So then they go without doing their medication for however long it is before they can come back to the pharmacy,” he said.
Being forced to skip doses for too long can endanger a trans person’s health, especially if they have pre-existing conditions that put them at further risk. Hargrove has seen it firsthand. As someone with epilepsy, being unable to access his testosterone prescription for four weeks in 2020 — caused by a primary care provider refusing to continue prescribing the drug — caused him to have a seizure.
“It not being a controlled substance would give a lot more access to a lot more people and it would make the situations that I went through, the struggles, much less likely to occur,” he said.
Lowering the number of doctor’s visits needed to continue a testosterone prescription would also help Jackson’s low-income patients and those without insurance, who are paying visit fees and doctors fees multiple times per year that they otherwise wouldn’t have to pay, he said.
Testosterone can be used classifiedas a controlled drug with a moderate-low potential for psychological and physical dependence. Congress classified the drug in this manner as part of the Anabolic Steroids Control Act (90), after male cisgender athletes, and non-athletes. abusedAnabolic steroids. So, testosterone prescriptions cannot be filled or renewed six months after they were issued.
Descheduling the drug would cut the number of doctor’s visits needed to maintain care and lower fees for trans people, many of whom already tend to live in povertyAdvocates agree. It would also keep trans people away from having to interact with as many people as possible. health care systemThis often stigmatizes or mistreats them.
In their letter, Markey and Warren ask the Health and Human Services Department, plus the Justice Department and Drug Enforcement Administration, what steps, if any, they have taken to reclassify testosterone’s status as a controlled substance — and point out that doing so would align with the Biden administration’s goals to further LGBTQ+ rights and transgender Americans’ access to gender-affirming care.
The senators also urge U.S. Attorney General Merrick Garland to consider using his authority to adjust testosterone’s status within the Controlled Substances Act or remove it altogether.
Markey stated that states were introducing anti-trans laws across the country to ban gender affirming care for trans youth. This would primarily affect puberty blocking hormonals and treatment regimens of testosterone and estrogen.
“There’s clearly efforts that are percolating all across the country. And so I think it’s important for the federal government to stand up,” he said. “Classifying testosterone as a Schedule III drug means that trans people face unnecessary and burdensome restrictions.”
Logan Casey is senior policy researcher and advisor to the Movement Advancement Project, which tracks LGBTQ+ policies.
“The political landscape of these bills targeting transgender youth’s access to gender-affirming care has created an incredibly hostile environment for all trans people,” he said. Most state-level efforts to stop gender-affirming care have been directed at minors. FloridaRecent policy actions in one state have also affected trans adults. The state has joined eight othersBy banning Medicaid coverage of gender affirming care for people of all age,
Casey said that he wouldn’t be surprised to see other states trying to disrupt transgender adults’ access to gender-affirming care. But, if more attacks come, advocates are prepared to respond and “sound the alarm” — especially when states implement restrictions on care that have to go through a lengthy regulatory process.
Markey and Warren want a response from the DOJ/HHS to their letter that was sent on Thursday evening and acknowledged by them by the agencies.