Shortages of the estrogen medication estradiol valerate, used for injections, have been disrupting the lives of trans women for years, and there doesn’t seem to be an end in sight. Adding insult to injury, these shortages are usually unexplained and come with little information for when they will pass. Women are left waiting for unknown lengths of time until they can get their medication again or forced to consider switching to far more expensive nongeneric versions, like Delestrogen.
The shortages have led many women left without viable options, with no access to the resources to get the estrogen they need. Some have looked into alternatives, but not all of these are safe. It's never a good idea to take drugs from other countries that don't have any screening process or share prescription drugs from unknown sources.
The use of estrogen can help trans women in a multitude of ways. The hormone can help control and stabilize moods, which means the unknown and ongoing nature of the shortages creates issues with mood control. The hormone can help with creating a more stereotypically typical feminine body, with rounder faces, and fat deposits moving toward the hips and breast. In addition to the mental issues presented by the mood changes, the loss of these side effects can cause body dysphoria to flare up.
The cause of the shortages is unknown. The Food and Drug Administration’s website is kept up to date on when the drug is and isn’t available but is lacking details of just about everything else, including when it may be available again. There has been speculation about the cause of the shortages, though. Perhaps researchers are looking into a new ingredient, or the increase in trans people’s acceptance is creating more demand for the dug than suppliers can keep up with. The Human Rights Campaign has reached out to the FDA about the shortages, posting to their website in 2016:
"HRC reached out to the U.S. Food and Drug Administration (FDA) officials to express concern about the shortage and to learn what the agency is currently doing to address the ongoing problem. In addition, HRC partnered with the National Center for Transgender Equality on a letter to FDA Commissioner Dr. Robert Califf urging that the agency expedite review of information necessary to approve the drug and bring the shortage to an end."
That said, 2016 was a while ago, and the issue is still ongoing. The National Institute of Minority Health and Health Disparities is the organization in charge of research for minority communities, including the trans community, and those affected can contact it to express concern.