Pandemic Telehealth Flexibilities for Prescription of Testosterone Remain in Place
Recently, the Drug Enforcement Agency (DEA) announced that it will be temporarily extending pandemic flexibilities for the prescription of controlled substances, including testosterone, via telehealth. Howard Brown Health commends the DEA for understanding the importance of telehealth in expanding access to care, especially for transmasculine people who need continued access to testosterone. We will continue to provide gender affirming care, including prescription of testosterone, via telehealth for TNB patients who need this critical and life-saving medical care.
Specifically, this temporary extension allows for the full set of telehealth prescribing flexibilities to remain in place until November 11, 2023. Additionally, for any patient-provider telehealth relationship established on or before November 11, 2023, the full set of pandemic flexibilities around prescription of controlled substances will remain in place for a one-year grace period through November 11, 2024.
The DEA regulates certain controlled substances used to make medications, which are classified into five categories (Schedule I-Schedule V). Throughout the COVID-19 pandemic, patients have been able to access DEA-regulated controlled substances via telehealth, with no requirements for patients to see a doctor in person. With the ending of the public health emergency, the DEA released a proposed regulation to end these pandemic telehealth flexibilities. Under the proposed regulation, patients would only be able to use telehealth for an initial 30-day supply of Schedule III-V medications before being required to see the provider in-person to continue care.
This proposed regulation was especially concerning for transmasculine and non-binary people because testosterone is a Schedule III drug that would be subject to the DEA’s rule change. This means that patients who need testosterone for gender affirming care would only be able to receive a 30-day supply via telehealth before being required to see a doctor in person to continue care. This creates unnecessary barriers to care, and it undermines all the ways that we’ve been able to use telehealth to expand access to gender affirming care. Unfortunately, finding providers who are affirming and knowledgeable about transgender health is challenging for many patients. The 2015 U.S. Transgender Survey found that respondents were three times more likely to have to travel more than 50 miles for trans-related care compared to routine healthcare. Pandemic telehealth flexibilities helped to address some of these barriers by allowing patients to access gender affirming care, including testosterone, without the unnecessary burden of arranging travel, requesting time off from work, arranging childcare, and other logistical barriers to see a competent provider in person. This has become especially important lately as many states across the country begin enacting bans on gender affirming care.
As the DEA continues to revise its regulations, we will urge the agency to ensure that it is considering the needs of TNB patients who rely on telehealth to access life-saving care. This should include the possibility of de-scheduling or rescheduling testosterone to loosen restrictions and improve access overall. To stay up to date on our advocacy activities on this and other LGBTQ+ health priorities, you can subscribe to our listserv or visit our webpage. You can also check out these resources to learn more: