04/09/2025 | Writer: Belgin Günay
According to the survey, intersex people face difficulties in accessing hormones due to problems with obtaining prescriptions and supply issues.
Inter Solidarity conducted a survey on access to and use of hormone replacement among intersex people. The study, aimed at examining the impact of recent restrictions on hormone medications used by trans+, non-binary, and intersex individuals, revealed noteworthy findings.
A total of 15 people, aged between 19 and 53, from different gender identities, cities, and economic groups, participated in Inter Solidarity’s hormone use survey among intersex people. Notably, 40 percent of participants over the age of 30 (6 participants) stated that they had stopped using hormones, even though they had previously been prescribed them. Meanwhile, 53 percent (8 participants) reported that they are currently using a hormone medication.
In response to the question “Which hormone do you use?”, where multiple options could be selected, 8 participants reported using estrogen and 7 reported using testosterone. One person stated that they also used progesterone, while another said they had never used hormones. Participants noted that due to restrictions, they were unable to obtain hormone medications in the desired dosage or had difficulty finding them in pharmacies. The survey revealed that the most common forms of hormone medication use were injections and tablets, while gel form was either not preferred or unavailable.
To the question, “Have you recently had difficulty accessing hormones? (Unavailability in pharmacies, difficulties in getting a prescription, etc.),” 8 participants responded “I have difficulty,” while 4 participants answered “I can obtain them without difficulty.”
In response to the question, “What kinds of difficulties or conveniences have you experienced in accessing hormones?”, the following points stood out:
“I need to take two doses a day, but the system doesn’t allow two doses.”
“It’s difficult to find hormones during certain months of the year because people who do bodybuilding also prefer them. Pharmacies often sell to them instead of to people with prescriptions, so I end up going from pharmacy to pharmacy to find hormones.”
“I have difficulty getting a prescription and can’t find them in pharmacies.”
“The pharmacy has managed to handle it for now, but I try to stock up just in case.”
In the survey question, “Are you able to ask your doctor the questions you have about hormones / do you receive satisfactory answers? Does your doctor tell you about different hormone use alternatives?”, 46.7 percent of participants (7 people) answered “No,” while the others selected “Partly.”
To the question, “Are you satisfied with the health effects of the hormone(s) you are using?”, 46.7 percent of participants answered “Partly,” while 26.7 percent answered “No.”
For the question, “Do you think the hormone you are using aligns with your gender identity?”, 7 participants answered “No,” 7 answered “Yes,” and 2 answered “Neither.”
To the question, “Did you request the hormone yourself, or was it directed by your doctor?”, 7 participants answered “At my own request,” 4 answered “At the doctor’s request,” 3 answered “Other,” and 1 answered “Neither.”
Dr. Ayşe Uğurlu: “It creates inequality in access to healthcare”
Public physician and forensic medicine specialist Dr. Ayşe Uğurlu, who was asked for her opinion on the survey results, stated that the Ministry of Health is not following a scientific protocol and said the following:
“Based on the responses given by participants in this survey, it is apparent that most experience difficulties in accessing hormones. The main reasons for this are difficulties in obtaining prescriptions and the unavailability of hormones in pharmacies due to other people using them for different purposes. Additionally, participants reported that they were not sufficiently informed by their doctors about the hormones they were using and alternative options, that they were only partially satisfied with the effects of these hormones on their bodies, and that satisfaction with the alignment of the hormones with their gender identity was split roughly equally. These results indicate that there is still no treatment protocol prepared according to scientific standards by the Ministry of Health regarding the use of hormones for gender-affirming processes or medications for puberty suppression. Furthermore, they show that health services are not fully accessible within the framework of social security, that patients are not adequately informed by doctors about their health issues as defined in patient rights regulations, and that even when individuals have the financial means, they cannot obtain hormones and medications due to market-driven conditions in healthcare. In this context, I would like to emphasize that age restrictions and other barriers imposed on the use of these hormones and medications are contrary to scientific and medical ethics. Leading national and international medical specialty organizations, such as the World Professional Association for Transgender Health, which covers multiple specialties, or the Endocrine Society, which focuses on hormone therapies, have long recommended that hormones and puberty-suppressing medications be used under specific conditions and under the supervision of expert clinical teams in the best interest of the individual. These restrictions create inequality in access to healthcare, as also defined in our constitution.”
What happened?
Access to hormones for trans people was restricted on November 20, 2024, the Transgender Victims of Hate Crimes Remembrance Day. The Turkish Medicines and Medical Devices Agency had imposed an e-prescription requirement for some of the hormone replacement therapy medications used by trans people in their gender-affirming processes.
In June 2025, the Ministry of Health, through a letter sent to the governorships of all 81 provinces, introduced an age limit of 21 for hormone medications used by trans people in their gender-affirming processes.
Although the Civil Code sets the age of 18 for undergoing surgery in gender-affirming procedures, the Ministry, in a directive titled “Misuse of Sex Hormone Medications,” restricted the use of testosterone-containing medications, gonadotropin-releasing hormone (GnRH) analogs, and estrogen medications containing 2 mg or more for individuals under 21. In its directive dated June 25, the Ministry cited the “Year of Family” as the reason for the restriction.
The role of hormone replacement in intersex medical care
Hormone replacement is a component of medical care in every intersex condition. In some cases, such as salt-wasting congenital adrenal hyperplasia, hormone replacement therapy is life-saving because it substitutes essential hormones (cortisol and aldosterone) necessary for survival. In other cases, the role of hormone medications is the opposite: to suppress excess unwanted hormones via negative feedback.
For patients living with hypogonadism due to various causes, gender hormone replacement may be prescribed to stimulate sexual development. This treatment also has equally important and highly beneficial effects on bone mineral density, particularly in intersex individuals who have had their gonads removed.
Hormone replacement can also be used in unborn babies. Over the past 20 years, prenatal dexamethasone treatment administered to pregnant women has been used to prevent ambiguous genital development in babies with 21-hydroxylase deficiency. Outcome studies generally show that this treatment is well tolerated and effective, but it also highlights that interventions on intersex bodies can extend as far back as the prenatal stage.
The medical management of intersex conditions is a sensitive issue because it can directly affect complex aspects of a person’s gender identity, sexual orientation, sexual functioning, and psychological well-being. Additionally, decisions made by doctors and parents regarding a baby’s sex are not always accurate; an individual may experience dissatisfaction with their gender identity or feel anger about their life and medical experiences when they reach adulthood. At that point, the person will likely have clear views on hormone replacement and will require guidance from a specialist.
In recent years, there has been intense discussion between intersex advocacy organizations and the medical community regarding the ethical dimensions of current medical practices for intersex conditions. Given the lack of research and the absence of a human rights perspective, this debate is expected to continue for the foreseeable future.
Tags: human rights, life, health, trans, lgbti, interseks
