“I’ve heard that people in the Bay Area are starting to make hormones. There’s stockpiling, and then there’s ‘oh, I’m manufacturing my own hormones’—respect to that.”
Assigned Media spoke with Shawn, a transmasculine person living in the Bay Area, and the subject was how trans people are safeguarding their access to hormone replacement therapy in the wake of threats posed by a second Trump Administration. Several sources were interviewed for this article, including Shawn, all of whom used pseudonyms to protect their identities.
“For all of human history in the United States, people have figured this out without the medical system,” Shawn continues, “so I draw on that and think that the long-term support for people is our community, whether or not the government accepts my gender.”
For the uninitiated, HRT is the bread and butter of gender-affirming care for trans people. It’s almost always the first step of a medical transition, and the standards of care laid out by the World Professional Association of Transgender Health still recommend a period of HRT before many gender-affirming surgeries. The 2022 U.S. Trans Survey found an astonishing 98% satisfaction rate with HRT, and for trans people who have had their gonads surgically removed, it’s a must for basic health and bodily functioning.
“It’s the thing that enables people to live their best lives,” says Quinn, a trans woman Bay Area tech worker. “If you take this away from me you basically kill me.”
Since HRT is such a lifeline for so much of the trans community, members have taken to building up stockpiles for various reasons at various times. While many have done this due to threats posed by a second Trump Administration, many were also doing so beforehand due to threats posed by a medical system that has often worked contrary to the best interests of its trans patients. Research and anecdotal reports have indicated that stockpiling is a tried-and-true part of life for many trans people.
The second Trump Administration has methodically worked toward cutting off access to medical transition for all transgender people. The Administration started with the comparatively easier task of cutting off services for minors, utilizing funding threats against children’s hospitals to effectively cut off access to HRT to many trans people under 19 years of age. These federal actions have limited access all across America, including in California, New York, Texas, Colorado, and they overlap with the 27 states that have already enacted laws cutting off trans youth from HRT.
Now states and the Trump Administration are increasingly encroaching on adults’ access to gender-affirming medical care. Access to HRT has been cut off for incarcerated trans people in federal prisons (later reversed by lawsuit), as well as in Florida and Missouri. The Trump Administration has also banned medical care for trans veterans, and 12 states have used Medicaid rules to cut off many trans adults from HRT.
With widespread speculation that these actions will continue to go further and further, many trans people are rightly frightened of a future where they won’t be able to get access to the hormones necessary for their survival.
After seeing a tidal wave of anti-trans legislation that started passing statehouses in 2021, Shawn was clear that even living in a queer Mecca like the Bay Area couldn’t protect him. “I started seeing these extreme laws getting tested and passing in other states,” he said, “and I knew that eventually this was coming to us. I don’t feel protected at all by living in the Bay Area. I have an awareness that there will be difficulties getting hormones in the future.”
To counteract the threat, Shawn, Quinn, and many others have built up stockpiles of hormones. Sources all shared that everyone they knew had stockpiles or wanted to do so—this practice was so universal among trans people that it was hard to find a single member of the community who hadn’t long ago built their own HRT nest egg for hard times to come.
Hard data on just how many trans people are stockpiling is difficult to come by. The re-election of Donald Trump in November 2024 was greeted with a flurry of pieces on fearful trans people building up stockpiles, and in 2023 Erin in the Morning reported on a thread started by Harvard law professor Alejandra Caraballo about stockpiling that received an outpouring of over 100 responses.
Individuals spoken to for this piece widely indicated that the impetus to begin stockpiling wasn’t threats posed by the Trump Administration but rather those of a medical system that often gatekeeps trans healthcare and that leaves many Americans out in the cold. Quinn shared that she was currently confronting shortages of injectable estrogen, not due to governmental bans but simply due to an undependable supply chain—her prescription refill had been delayed for 2 months and counting. She originally began stockpiling after a job loss left her without medical coverage in 2024.
Similarly, Shawn told me that he started stockpiling hormones “the first day I was on testosterone”—well before the re-election of Donald Trump—and he shared that even his current endocrinologist has encouraged him to create a backup, due to various threats posed to accessing testosterone.
Such self-management of medical care is not uncommon for trans people. A 2022 systematic review found two studies indicating widespread self-management of medical care by trans people in the United States. One indicated that roughly one-half of 314 respondents “reported taking hormones for HRT not prescribed by a clinician,” while a second study revealed that common routes of access were ordering online from international sources, sharing with friends, and stealing.
In spite of widespread negative experiences, sources for this piece all expressed a desire to work within the medical system for reasons of safety and accurate knowledge of their hormonal levels. They only felt compelled to take matters into their own hands due to gatekeeping and fears of purposeful government persecution.
For Adrian, a transmasculine person living in the Pacific Northwest and working for a national nonprofit, the ability to stockpile hormones while friends in other states are unable to do so induces guilt. They shared that a friend in Indiana had had his testosterone prescription cut off due to his provider pulling back access. “He’s been getting his stuff from other people,” Adrian told me, “and I thought about shipping him some of mine, but I’m afraid to do so because that’s probably a federal crime.”
Sharing communally is common, with both Quinn and Shawn at times dipping into their stockpiles to help out other members of the community. Quinn has shared with her partner, due to the latter’s endocrinologist gatekeeping access to injectable estrogen, and she also helped out a friend who had lapsed from estrogen for several months due to a job loss and a bout of depression. “One of our friends came to stay with us because they were in between places to live,” she told me. “My partner and I got really concerned and helped them get back on HRT. There’s something nice to feeling like you can do something about it.”
The most popular method for building up a stockpile is simply to not consume the full dose prescribed by a doctor, and in that way generate a reserve over time. Trans people interviewed for this article were uniformly hesitant to access grey market sources, such as international pharmacies online, for fear of being tracked or receiving inferior or even dangerous goods. “It would make me terrified and I think my wife wouldn’t be ok with it,” Adrian told me, adding, “I won’t even buy skin cleanser on Amazon, because who knows what you’re getting there, so buying testosterone over the Internet would definitely be risky.”
In the face of increasing threats from the Trump Administration, some states have taken actions to help trans people maintain access to hormones. Illinois recently removed testosterone from the Prescription Drug Monitoring Programs list, adding a layer of security for trans people accessing that hormone. Washington recently passed a law requiring medical plans to help trans clients build up a 12-month reserve of hormones, although it only applies to estrogen, as testosterone is still classified as a controlled substance in that state and thus subject to stricter controls.
Sources spoken to for this story indicated the presence of various mutual aid networks providing a more systematic means of organizing the informal communal sharing attested to by individuals like Quinn and Adrian, although none were willing to comment on the record. The possibility of community members brewing their own hormones is also not unheard of—particulary in the UK, where a mixture of governmental actions and extremely long wait times has left trans adults unable to access proper medical care, some have simply done their best to create their own hormones as necessary.
Sources consulted for this piece were uniformly outraged at the hypocrisy of trans people having to resort to informal sharing or even home-brewing of hormones at a time when cisgender patients are being encouraged to make use of exogenous estrogen and testosterone more than ever. “I find that really fucking weird that we’re intentionally transing the women in the military but we won’t let trans people in the military,” said Adrian, in response to reports that high-ranking Trump Administrstion official Pete Hegseth will now begin offering testosterone injections to both male and female members of the military.
Although trans people are proving resilient in the face of potential actions to prevent them from living their lives free of government persecution, living in a state of uncertainty and potential danger does leave its marks. Adrian shared that the constant threat to their livelihood has mounted steadily and taken its toll. “I’ve never not had to be pushing and pursuing for more bodily autonomy,” they told me. “It’s emotionally and mentally taxing.” They see their frequent trips to the gym for intensive workouts—as many as six per week—as a means of sublimating the fear of losing control of their body to governmental interference.
Shawn shared that an awful experience with his first endocrinologist—who gave him factually incorrect information about HRT, among other things—has cast a shadow over subsequent medical treatment. He also added that intergenerational trauma in his family has been stoked by actions taken by the U.S. government to, in the president’s words, eliminate transgender ideology.
“A lot of my perspective is that I’m half Jewish and I was raised with a foundational mistrust of the government,” he told me. “My father was very much like, ‘the Jews are safe for now, and there will be a time when we’re the villains in the story again.’” Unfortunately, he doesn’t find it difficult to draw connections between what happened to his Jewish ancestors and what’s happening now to trans people.
Veronica Esposito (she/her) is a writer and therapist based in the Bay Area. She writes regularly for The Guardian, Xtra Magazine, and KQED, the NPR member station for Northern California, on the arts, mental health, and LGBTQ+ issues.
