The Estrogen Shortage Isn’t Just a Supply Issue—It’s a Political One

Last weekend I sat in my car crying, phone in hand, calling pharmacy after pharmacy.

"We’re out of stock."
"We don’t know when we’ll get more."
"Try another location."

I did. Over and over again. Each call ended the same way. No estrogen. No timeline for restocking. No alternatives offered.

I wasn’t calling for gender-affirming care. I wasn’t a trans woman trying to refill my prescription in a state that had decided to legislate my body. I am undergoing IVF.

Eventually, I found a fertility pharmacy that had stock, but it was a drive away and required an insurance override to bypass retail fill restrictions. The extra steps, the stress, the uncertainty—it was frustrating, but it worked. Unlike trans people, I wasn’t battling discriminatory laws, medical gatekeeping, or systemic barriers designed to deny me care—in fact, they were willing to reopen on a Sunday just for me so I could get my medication.

The only thing standing in my way was a shortage.

But the reason for that shortage? That’s where our stories connect.

The Same Medication, Two Radically Different Realities

The estrogen I needed was no different from the estrogen prescribed to trans women. Oral estradiol and patches—same medication, same dosages (in fact, mine were higher).

But here’s the difference:

• No one is trying to pass laws to stop me from accessing it.

• No one is accusing my doctor of pushing an "ideology."

• No one is protesting fertility clinics for prescribing these medications.

• No one is claiming I’ve been "brainwashed" into taking hormones.

• No one is concerned I will regret this or change my mind

For fertility patients, estrogen is simply medicine—a tool to prepare the body for pregnancy. For peri-menopausal women, it’s just hormone replacement therapy. But when trans people need it, the exact same medication suddenly becomes a political battleground.

The Estrogen Shortage That No One Is Talking About

One undeniable piece that often gets overlooked is the disproportionate impact on trans people—many of whom are being forced to secure extra medication in anticipation of losing access due to legislative attacks on gender-affirming care.

With anti-trans laws accelerating across the country, many transgender individuals are securing as much of their treatment as possible, preparing for a future where their care may be restricted or banned altogether. A Guardian report from 2024 highlighted how trans people were already scrambling to protect their healthcare amid rising threats to gender-affirming care (The Guardian)—and those threats have only grown more urgent.

They’ve watched states ban gender-affirming care, strip away rights, and threaten doctors for simply providing evidence-based treatment. So they’re doing what any of us would do in their position: they’re trying to survive.

And yet, despite this shortage, there is no national outcry. No emergency response. No widespread concern.

But imagine if fertility clinics suddenly couldn’t access estrogen. Imagine if thousands of expensive and carefully timed IVF cycles were put at risk because pharmacies were running out. The reaction would be immediate. Pharmaceutical companies would be pressured to act. Insurance companies would be up in arms. Politicians would push for solutions. The public would demand that no one lose their shot at building a family due to a supply chain failure.

But because the people most affected are trans, the silence is deafening.

Who Gets To Have Unquestioned Care?

I have to take estrogen twice per day, every day. So do many of my clients' peri-menopausal mothers. So do countless fertility patients. Yet, none of us have to fight for it the way trans people do.

When I finally got my prescription filled, I felt relief—but also guilt. I knew how many trans people were struggling to access the same medication, and I wished I could share it. My experience, frustrating as it was, was still nothing compared to the systemic barriers they face every day just to get the care they need.

Because for me, estrogen was never in question. It was never debated. It was never something I had to prove I deserved.

But for trans people, the simple act of accessing their medication is a battle. A risk. A fight against a system that sees their care as optional, their bodies as political, and their lives as expendable.

The estrogen shortage isn’t just a supply issue. It’s a political one. And it’s time we start treating it that way.