KEY POINTS

  • 70% of all COVID-19 patients who are at high risk and die are men
  • Estrogen might have an effect on ACE2 receptors that the coronavirus uses as an entry route
  • Progesterone has anti-inflammatory properties
  • Progesterone can potentially prevent harmful overreactions of the immune system
  • Trans people worry that the hormone patch testing might make them lose access to HRT

In an effort to quell the COVID-19 pandemic, an unexpected potential treatment for some patients has emerged. Researchers have started giving estrogen patches and progesterone shots to cis men diagnosed with COVID-19 in an attempt to ease the symptoms. But the fact that it is often difficult for transgender people to gain access to hormone replacement therapy is generating controversies.

A recent study conducted by experts at Italy has found that 70% of all COVID-19 patients who are at high risk of contracting the virus and undergoing fatalities are men. Also, several other studies have pointed out that cis men might be more likely to contract COVID-19 and die. It is still not clearly understood why cis men seem to be at an increased risk for COVID-19.

One possible explanation might be that the higher levels of the female hormones including estrogen and progesterone in cis women might offer protective health benefits.

Last week, health experts at Stony Brook University, New York started providing estrogen patches to COVID-19 positive- men and older women who might `have lower levels of sex hormones to find out if their symptoms improved.

Doctors at Cedars-Sinai Medical Center in Los Angeles have will soon be testing if administering progesterone patches might help manage COVID-19. Progesterone has anti-inflammatory properties and can help prevent harmful overreactions of a person’s immune system.

“There’s a striking difference between the number of men and women in the intensive care unit, and men are clearly doing worse. 75 percent of the hospital’s intensive care patients and those on ventilators are men. So something about being a woman is protective, and something about pregnancy is protective, and that makes us think about hormones,” the New York Times quoted Dr. Sara Ghandehari, a pulmonologist and intensive care physician at Cedars-Sinai in Los Angeles who is the principal investigator for the progesterone study.

While the world is trying to find a way to treat the deadly novel coronavirus, these kinds of trials have quickly raised eyebrows. Trans people who are struggling to get appointments for hormone replacement therapies are against these trials.

"If they find that estrogen helps men survive coronavirus trans women will once again be left in the dirt, with no consideration and no help because all our hormones will be used by hospitals to help men," Refinery29 quoted Lina Qutainah’s tweet.

Trans people are worried that the pandemic is causing shortages in the places where they purchase their medications and that there are also shipping delays. They are worried about being in the high-risk group.

“If researchers do prove that there's a benefit to giving cis men with COVID-19 estrogen or progesterone, it'll mean immediate access to medication that takes people like me months or years to gain access to legitimately. It's just a demonstration that any concerns about estrogen were always fake, and it's the result of institutionalized transphobia," Quntainah told Refinery29.

Hormone replacement therapy research.
Study finds link between hormone replacement therapy and breast cancer. Reuters.