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Even after you've decided to take estrogen replacement therapy ERT, the decision-making isn't over.

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But when she arrived, the people at the counter said her prescription was not available. And no, they didn't know why. Not for her, not for anyone, because of a nationwide shortage of injectable estrogen. As of a few days ago, the drug deficit appears to be recovering. But the US government regulates estrogen for trans women using weird, wonky rules, so while injectable estrogen might be available now, the supply is unstable. For trans women, estrogen treatments are essential for developing and maintaining a feminine body that is more closely aligned with their internal sense of self. A sudden loss of the hormone can result in emotional and physical trauma.

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The anaesthetic is injected near to a nerve trunk where it reversibly prevents conduction along many of the nerve fibres in the trunk.

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