Facing hormone shortages, South Africa’s trans men try black market
He was looking forward to starting a new chapter until he discovered that testosterone supplies often ran short – an issue that has worsened during the COVID-19 pandemic – pushing him and other desperate trans men to seek risky, black market hormones. “These shortages mess with our sense of self,” 29-year-old Stols told the Thomson Reuters Foundation in a phone interview from Johannesburg. “It is like someone with mental health issues not being able to get their meds. (Testosterone) is what we rely on to look in the mirror and see ourselves – without it, it’s like walking around blind.
The risk of not getting this is suicide.” In South Africa, trans men and doctors say that widespread testosterone shortages began around 2015, and can last for a few months at a time.
Similar shortages of the male hormonal drugs have been seen from Canada to Spain, health reports say, leaving a trail of derailed transitions in their wake. “Without testosterone, breast tissue can form again, fat redistribution could return to more female areas and periods can start again,” said Stols, all of which carry devastating mental health impacts as trans men see their new bodies sliding away.
Reasons for disruptions include shortages in the compounds that form the medication, transport issues such as shipping container shortages, or lack of manufacturing capacity due to heavy demand for other products such as COVID-19 vaccines.
