PORN VALLEY—One of adult's most popular genres is trans porn: Videos featuring women with penises and men with pussies interacting either with each other or cis members of the opposite sex. But according to a recent article on BuzzFeed, the ability of trans women to maintain their gender identities may be in danger, due to a shortage of injectable estrogen—a problem that's bad, and been getting worse for at least two years.
"The simultaneous shortage of the two injectable forms of estrogen—Delestrogen, the brand-name version, and estradiol valerate, its generic formula—has left clinics and patients scrambling for alternatives," wrote BuzzFeed reporter Azeen Ghorayshi. "Although the generic was supposed to be made available in October, this week the FDA announced that it was pushing its availability back yet another month, but even that date is no guarantee."
Injectable estrogen is the preferred method of using the hormone among many trans women. They could also take pills or use estrogen patches, but many find them inconvenient, and some have experienced side effects from taking the pills, including skin irritation, liver damage and the possibility of experiencing blood clots, as many cis women who use the hormone have found. Many also feel that injected estrogen provides stronger effects, allowing them to better maintain their female appearance and vocal tones. The shortage is making it difficult for some trans women to maintain their gender identities, and may even be causing extreme mental distress in some, a condition known as "gender dysphoria" (though some conservative groups have used that term to claim that transgendered persons are simply mentally ill).
"A few months ago I moved back to my hometown, and I’ve had difficulty finding a new endocrinologist," wrote "annamagda4christ" on the CatholicTrans website in mid-2015. "About two months ago I ran out of my hormone medication, and slowly my body has been reversing some of the effects of transitioning. As my bodily dysphoria has skyrocketed, I’ve been reminded of the difference between my intense, embodied, transsexual condition and the social discomfort of some transgender people I’ve talked to."
While there's been no shortage of blame leveled around this issue, much of it has fallen on Par Pharmaceuticals, the maker of Delestrogen, which suddenly lost its only supplier of the compound's main ingredient this past summer and had been struggling to find another. Although the company apparently has found one, before the new batches of Delestrogen can be made available, the compound must once again go through an approval process with the FDA due to the change in ingredient, and that takes time.
"The FDA recognizes this is an important drug, and is working with the drug manufacturers so that the drug may return to the market as quickly as possible," said FDA spokesperson Andrea Fischer.
Another problem is that the FDA has not approved the use of Delestrogen in trans women, so doctors who are willing to provide it to the trans community are doing so "off-label"—even though they've been doing so for more than half a century.
Finally, since the trans community makes up just one-third of one percent of the population, pharmaceutical companies haven't exactly been breaking down the doors to come up with new formulations, figuring it's not worth the expense.
"It’s disconcerting, to say the least, that we’re faced with this kind of national shortage," said Kimberleigh Smith, director for community health planning and policy at Callen-Lorde, a New York City health clinic that targets the LGBT community.
AVN has reached out to some members of adult's trans community to inquire if they have had difficulties in obtaining their estrogen needs, but none have yet responded.
