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Transgend Health. 2018 Mar 1;3(1):42-44. doi: 10.1089/trgh.2017.0025. eCollection 2018.

Advocacy for Gender Affirming Care: Learning from the Injectable Estrogen Shortage.

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Department of Health Policy Research, The Fenway Institute, Fenway Health, Boston, Massachusetts.
HIV and HCV Programs, Treatment Action Group, New York, New York.
Community Health Planning and Policy, Callen-Lorde Community Health Center, New York, New York.
Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts.
Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts.


Hormone therapy is medically necessary for many transgender individuals. The U.S. Food and Drug Administration (FDA) and pharmaceutical companies' failure to guarantee a supply of injectable estrogen in 2016 and 2017 for transgender individuals is a violation of their right to comprehensive medical treatment, free of discrimination. A series of advocacy actions eventually led to all formulations of injectable estrogen being restored to market; however, long-term solutions to supply interruptions of injectable estrogen are needed. Long-term solutions should address the lack of federally funded research and, consequently, evidence-based practice on hormone therapy for gender affirmation.


clinical care; gender dysphoria; gender transition; public policy and advocacy; transgender

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