"Tejada managed to obtain the doses she needed, thanks to donations, but the uncertainty of not knowing if she will be able to access her monthly medication has become a constant. Some months, they give me injectable estradiol. Other months, pills. Every time they get a donation, they contact me, says Vasquez, 35. The problem is that I need a double dose of estradiol, because my [estrogen] levels are very low. And that makes everything more difficult."
"Estradiol is the most important female sex hormone, and is primarily produced in the ovaries. In trans people, it plays a crucial role in gender-affirming hormone therapy, which is used to induce feminizing physical changes, such as breast development, redistribution of body fat, decreased body hair and reduced muscle mass. Low estrogen levels in transgender women can lead to a lack of development or reversal of female characteristics."
Evanna Vasquez, a Peruvian migrant receiving gender-affirming care in Manhattan, has experienced inconsistent access to estradiol, sometimes receiving injections, sometimes pills, and relying on donations. Her social worker, Javier Tejada, has helped secure doses but uncertainty about monthly medication persists. Estradiol induces feminizing physical changes and low estrogen can cause lack or reversal of female characteristics in transgender women. Since late 2024, activists have reported shortages of gender-affirming medications and long clinic wait times. In July, the One Big Beautiful Bill Act prohibited federal funds for gender-affirming treatments and cut Medicaid, affecting people with humanitarian visas.
Read at english.elpais.com
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