When Donwell Mpofu started using testosterone for hormone replacement therapy last year, he felt good about himself and his body for the first time in his life.
Mpofu, 33, has lived with his wife and for years his two children in a township in the far east of Johannesburg would only photograph themselves from the shoulders up. “[Transition], it was amazing,” he said, sitting next to his wife Doreen, 31, on the couch.
“It’s the best feeling ever. Because for the first time I was able to take a picture of myself, the complete picture of myself. Because usually when I take a picture I sometimes only take half of it or from here, ”he said, pointing to his shoulders. “You know, I’ve never felt comfortable enough. I was never satisfied with what I saw. ”
Access to testosterone and hormone replacement therapy was a life- and gender-empowering experience for Mpofu. But despite having a successful top surgery in early November, he is concerned for his health and wellbeing.
The source of Mpofu’s anxiety is the current shortage of Pfizers Depot testosterone, the hormone replacement therapy used by many transgender people to switch and then maintain their testosterone levels. Many will use this drug for the rest of their lives.
Effects of Covid-19
Pfizer confirmed that it is increasing its range of Covid-19 vaccines to a temporary shortage of several of its other drugs, including depot testosterone.
Pfizer spokesman for East and South Africa, Willis Angira, said the drug company was unable to provide patients with alternative treatment recommendations, and advised them to consult their doctor experts.
“To respond to the urgent need to vaccinate more people with our Covid-19 vaccine, we have committed to increasing its range. This was made possible by the efforts of our manufacturing department to increase sourcing of raw materials and to prioritize our vaccine on additional filling and finishing lines.
“As a result, production for a small part of the Pfizer portfolio will be temporarily affected . We recognize the importance of each of our medicines to patients and doctors around the world. We are actively working to mitigate any disruptions in supply and we have made sure that there are available therapeutic alternatives to the drugs involved, ”Angira responded to a series of questions.
In a separate communique, the one to medical A Pfizer representative confirmed there was a shortage of depot testosterone in the country. The statement said the shortage would last from October 31 through the second quarter of 2022.
A shortage of testosterone and other drugs is not uncommon. There was a brief interruption in delivery of Pfizers Depot testosterone in 2019 when the company said it was due to circumstances beyond its control.
It’s a bigger problem < / strong>
B Camminga, co-founder of the African LGBTQI + Migration Research Network and postdoctoral fellow at the African Center for Migration and Society at the University of the Witwatersrand, said depot testosterone deficiency is treated like the current one as a shocking topic, although they actually point to major structural health problems in South Africa.
“This is part of a broader issue of drug stockpiling in South Africa. We know we ran out of HIV drugs not long ago, “they said.
” There are many people who are taking more than one type of medication and more than one type of health care, and the fear of one type of drug shortage leads to fear of stockpiling another drug. Often these are drugs for intensive care medicine.
“Even the rumor of a shortage of supplies immediately leads to symptoms such as an increased feeling of anxiety, followed by some kind of internal communication [within the community] about who? has a little more or can give someone a chance from their own supply to help someone. ”
Camminga said that this is not just a problem that affects the trans community in South Africa, it is a problem a broader problem with health care. “Of course, this is life-threatening in a particular way for transsexuals, but it’s also part of a larger, systemic problem.
” We often seem to phrase it as if we weren’t thinking about it, or him State doesn’t care, or we won’t be accepted by the Ministry of Health. But I think this is a worrying and broader topic than something that only affects a small community. ”
A collaborative approach
Camminga said the current one Scarcity points to a greater need for coalition politics. “We should look broader and say: OK, HIV organizations have problems with stock shortages, TB organizations have problems with stock shortages. We all need special health care, so how can we work together?
“As far as we know, the shortage this time around is a direct result of Covid-19. And we know that Covid-19 has seen funding reorganize and prioritizing the vaccine has had an impact on the community on a wider scale. We have seen organizations shut down across the continent and LGBT organizations are the # 1 employer for LGBT people, class differences in the transgender community as wealthier and better-off people would still have access to testosterone. “But there is a way that some kind of pay-it-forward or mutual help system should be fully possible. And I think that’s more than just saying, ‘I want to share my recordings with you this month,’ “they said.
” That part of the community that can more easily afford health care to confirm and pay for private health care should also consider: “What can we do for the rest of the community?” Because this is an extension of our community. “
A health professional who works in the public health sector said that the most immediate impact of the shortage on transgender people would be psychological.
“Dysphoria and incongruence cause a lot of psychological distress and obvious to people whose experienced gender identity does not match their perception … it creates a lot of psychological distress.
“Knowing that this is the crucial drug that you are using to maintain secondary gender characteristics going to be gone for months, it also creates suffering, “he said, adding that the return of certain symptoms or experiences due to a lack of testosterone in the body would be extremely traumatic.
” For many transgender men, for example, that is Menstruation is very stressful. I have one or two patients who, because they have no access to testosterone, restricted their food intake, starved themselves because this was the only way to alleviate or stop the severity of menstruation, which of course is very unhealthy and very harmful to your body. “
Nino Maphosa, 27, a transgender man who describes himself as a reference work for other people in transition and recently appeared in an ad for Lil-lets-tampons and said he was inundated with messages from other transgender men asking him if he knew where to find testosterone.
Maphosa said he had his last dose of testosterone in the end of September and couldn’t find anything since then. “So I was trying to research how to navigate that. It is frustrating. Now my sex level is low and you keep asking: ‘What the hell is wrong with me?’
“You fall into depression easily because you say: ‘Is this all reversible now?’ Example of building more muscles. You lose your hips, you lose your fat arms. If I don’t take testosterone now, I’m afraid that all of these things will be reversed, “he said.
” I can’t believe my whole thing There’s life in this little bottle … If I can’t take it, I’m grumpy, depressed, biting, irritable. I can’t even look at myself. I am always afraid that I will come back. I was so excited that my mustache was growing, now I’m afraid it’s going back. ”
Maphosa said he knew people were selling testosterone vials on the black market, and if he couldn’t, soon after To access testosterone, he would consider buying it there. “I’m going to do my research … I’m not just going to do stupid things without … talking to my doctor. But go to the black market? I’ll consider it, yes. ”
‘I’m not me’
Thomars, a transgender man from Zimbabwe and founder of the Fruit Basket , an organization that creates a safe space for the LGBTQIA + community, described testosterone deficiency as “really scary.”
“The fact that this is indefinite makes it worse. This is the brand I know and trust and have been using for two years. My life and livelihood depend on getting my injections every two weeks. I cannot function fully without my hormones. I’m not me, ”he said.
Thomars said hormone replacement therapy helped him overcome most of the body dysmorphisms that he had experienced all his life before his transition.
“Just the thought of going back to this place scares me and discourages me. I don’t want to go back there – I can’t go back there. ”
This article was first published by New Frame.