Stockout of testosterone injections used by transgender people

By GroundUp 7 February 2019

There is a nationwide stockout in South Africa of Depo-testosterone. By Elsabe Brits for GROUNDUP.

First published by GroundUp

Depo-testosterone is the brand name for testosterone cypionate injections manufactured by Pfizer, a pharmaceutical company. This is the hormone replacement therapy used by transgender people who are medically transitioning from female to male. The therapy has to be consistent and taken for the rest of one’s life. It is not known how many transgender people in South Africa need this therapy.

The hormone is also given to men who do not produce enough natural testosterone. It is sometimes given to boys to cause puberty when it is delayed.

Depo-Testosterone 200 mg per ml injection Testosterone cypionate

The hormone, commonly known as “T”, is important to the well-being of transgender people. Stock has not been available nationwide for more than a week.

Elliott Kotze, a psychologist and researcher, who also needs the product, told GroundUp that Depo-testosterone is a weekly injection and the majority of those who need it use this particular product. A vial costs him R500 and lasts about 10 weeks. The next available option in South Africa is Nebido, which costs R2,400, and has to be given every 10 to 14 weeks. The other option, Sustanon, is not available in South Africa.

I work with many people who struggle and not having access to medication creates severe anxiety, depression and dysphoria. It is a huge psychological issue. People are already struggling, because transitioning is not easy – it is seen as an elective or cosmetic procedure, which it is not,” said Kotze.

The product is available in the state sector, but to explain the medical basis to doctors is difficult, due to a lack of knowledge and no standard protocol, he added.

Germaine Gabriel de Larch, who works for Pan Africa ILGA, a human rights organisation, told GroundUp, that he will run out within a week. To switch to Nebido has huge implications.

Switching testosterone types is not an option for most. It comes with a host of problems. It controls moods, and with a large number of transgender people struggling with depression, this has serious health implications.

Then there are the effects on masculinity: we would begin to menstruate again (if you have not had a hysterectomy), lose muscle, have fat redistribution occur – all things that cause us unbearable dysphoria,” he said.

The issue is that switching from one to the other causes hormone imbalances, especially as there’s nothing you can do to alter your dose while you wait for the next shot in 10 to 14 weeks. This can also result in testosterone levels that are too high. This has the same result as going off testosterone completely. It could take up to three months to get on to the correct dosage and frequency of shots,” De Larch said.

Pfizer did not answer questions about why the product is out of stock, for exactly how long there has been a problem, or if rumours are true that it has stopped producing it.

The company issued this media statement: “There is currently a short-term interruption of supply of Depo-testosterone in South Africa due to circumstances outside of Pfizer’s control. We are expecting to resume supply by the end of February 2019.

We fully recognise the importance of the consistent availability of Depo-Testosterone to patients and are actively working with the Regulatory Authority to meet any urgent medical needs.

We recommend that patients speak to a healthcare professional about alternative treatments.” DM


In other news...

The South African economy is choking harder than the Proteas. Although to be choking you have to actually be eating and the Proteas seem to be on some sort of juice cleanse-like fast…*

Back to the economy: In the first quarter the GDP dive-bombed by a whopping 3.2%. The sense of futility can paralyse us into inaction and moaning. But it’s times like these that call for effort and action, no matter how small. Yes, South Africa is hurting. Yes the ravaged economy is evident everywhere you look. But you can make a difference, in your own personal way and by supporting independent media like Daily Maverick. We’ve pledged to continue the fight through producing incisive and impactful investigations and analysis, the same way we have done every day for the last decade.

By becoming a Maverick Insider you can help us keep doing what we do, so that you and others who can’t afford it, can keep reading the truth. For whatever amount you choose, you can support DM and it only takes a minute.

Support Daily Maverick→Payment options

*Proteas, you know we love you. We’d just love you more if you won occasionally...

Comments - share your knowledge and experience

Please note you must be a Maverick Insider to comment. Sign up here or if you are already an Insider.


Video Surveillance and Cybersecurity (Part Two): Chinese cyber espionage is a real threat

By Heidi Swart

A medium popcorn & soft drink combo is the nutritional equivalent of three quarter-pounders and 12 pieces of butter.