Frustration, stress and fear are among some of the emotions felt by those losing consistent access to Sustanon
WORDS AND ILLUSTRATION BY LUAN MORRIS
Sustanon is a testosterone injection commonly used by trans masculine people during a medical transition, as a type of hormone replacement therapy (HRT).
However, as the UK faces a shortage, the impact is greater than just frustration, especially in the context of a broken trans healthcare system, where fighting to have access to life saving HRT is commonplace as young people are forced to wait at least three years for an appointment with GIDs.
Oscar, a 19 year old trans man from the South-East, stated being unable to get hold of Sustanon has caused a spike in gender dysphoria; consequently, worsening his mental health.
Oscar describes emotional and physical exhaustion due to constant admin and the additional stress of visiting numerous pharmacies to seek out Sustanon to no avail; while balancing university, a job and managing a chronic health condition.
The sudden withdrawal of HRT causes a fluctuation of hormone levels and the effects of testosterone – which are reversible, to revert, such as fat redistribution. For trans people going through this unwillingly, it is traumatic.
Elijah, age 17, from Scotland, described feeling like he’s losing progress made by transitioning, as well as having to cope with additional stress from losing secure and consistent access to Sustanon. He stresses that his t-shot is more than a medical process; “it feels emotionally healing to be able to have consistent access to my shots and I feel more comfortable within myself.”
Having access to gender affirming health care is vital for the wellbeing of trans people; a survey from TransActual highlighted the overwhelmingly positive impact of transitioning on the mental, physical and emotional wellbeing of respondents, with one transmasculine person stating HRT “has completely changed my life. My lifelong chronic depression and anxiety disappeared”.
Some NHS providers have been advised to help patients switch to a different type of testosterone during the shortage. However accessing a GP is a challenge both in terms of the NHS crisis and the fact that 45% of trans people state their GP does not have a good understanding of their needs as a trans person, and, according to a report by charity Mermaids, one in three young people report needing to visit more than one GP to access support relating to gender identity.
This is felt by Oscar – he’s increasingly worried that the shortage will impact his access to HRT, and “while my GP is supportive, they are cautious when dealing with trans healthcare and I feel that this shortage will challenge their support.” He is due a Sustanon injection every 3 weeks, however, it has been 8 weeks since his last dose.
The emotional toll goes beyond the Sustanon shortage. Living and growing up in a hostile, transphobic environment has left many trans young people in fear of the future; from the UK Government blocking Scotland’s GRA reform to scarring reports that there’s no replacement ready for the closure of the only gender identity development service (GIDS). Loosing access to life saving medication, even if it is short-term, mobilises fears of increased restriction to trans healthcare.
Elijah reiterates that the shortage has made him “feel unsure about his future especially combined with GIDS closing. It’s made me scared that my access to HRT is being limited rather than just a shortage.”
Similarly, Oscar fears that the rush to other forms of testosterone “will create a vicious cycle of shortages which the NHS and government will fail to recognise and act on.” Systemic change is needed to address the inequalities of trans healthcare across the UK. A welcomed start would be ensuring all GP’s have access to training around caring for trans and gender diverse people, to ensure all trans people have access to an alternative source of HRT in times of shortage.
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