The Missing Half of the Story: Why Testosterone Shortages Rarely Make the News

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When hormone shortages make the news, the focus is almost always on estrogen. In August 2025, for example, CBC ran a national feature about “worldwide hormone replacement shortages” that covered estradiol products in detail, complete with expert interviews and patient stories. Testosterone shortages — which had already been ongoing for months — were reduced to a single sentence near the end.

That’s not unusual. Over the past decade, coverage of testosterone shortages has remained sparse, even as Canadian pharmacies continue to face recurring supply problems. The result is a skewed public understanding of what’s really happening and who’s affected.

National Shortages Quietly Ignored

Injectable testosterone has gone in and out of shortage in Canada for over a decade — sometimes for months at a time. But when it’s covered at all, it’s often treated as a side note, or folded into stories about gender-affirming care, rather than recognized as a broader supply problem.

This isn’t a niche issue. It’s a recurring national problem.

Who Relies on Testosterone

Testosterone is prescribed in Canada for a wide range of medical reasons, across different patient groups:

  • Primary or secondary hypogonadism: where the body fails to produce sufficient testosterone.
  • Age-related deficiency: which can cause fatigue, mood changes, muscle loss, and low libido. Sometimes called “andropause,” though doctors more accurately refer to it as late-onset hypogonadism.
  • Post-cancer or post-surgical recovery: especially following prostate, testicular, or pituitary treatment.
  • Chronic illness or HIV-related suppression: where long-term disease or medication lowers testosterone production.
  • Low testosterone in women: sometimes prescribed in specific cases, such as after surgical menopause or for sexual health concerns, though less commonly than in men.
  • Gender-affirming therapy: for trans men and some non-binary people as part of ongoing medical care.

While testosterone therapy is an essential part of gender-affirming care, trans and non-binary people represent only a small portion of those who use it. Census data from 2021 show that transgender Canadians make up less than one per cent of the population. Testosterone is also prescribed to some women in specific clinical contexts, though much less commonly. Taken together, these groups represent a minority of overall use, with the majority of testosterone prescriptions going to cisgender men being treated for medically diagnosed hormone deficiency, recovering from cancer or chronic illness, or managing age-related testosterone decline.

Public perception hasn’t caught up. Testosterone is still often associated with bodybuilders or performance enhancement, even though it’s a tightly regulated prescription medication. Health Canada classifies testosterone as a controlled substance, available only with a prescription and used to treat well-established medical conditions.

The Media’s Blind Spot

Health coverage tends to follow what’s getting attention. In recent years, menopause and women’s health have gained long-overdue attention, highlighting gaps in access to care. But that shift has had an unintended side effect: testosterone shortages are often overlooked or treated as a niche topic.

This imbalance creates two false impressions:

  1. That testosterone therapy is primarily a specialized or controversial treatment.
  2. That shortages only affect a small group of people.

In reality, testosterone therapy is common, clinically established, and medically necessary for hundreds of thousands of Canadians. The lack of coverage doesn’t mean the problem is smaller — it just means it’s less visible. It reflects cultural discomfort around men’s health, persistent stereotypes about masculinity, and the mistaken idea that testosterone use is elective rather than essential.

A Shared Supply Problem

Estrogen and testosterone products in Canada share the same vulnerabilities: limited manufacturers, fragile supply chains, and long production timelines. The difference lies in the narrative, not the medicine.

When estrogen products are scarce, it’s framed as a women’s health crisis. When testosterone is scarce, it’s often seen as an isolated inconvenience or a trans health issue. Both framings miss the truth: that these shortages are part of the same fragile pharmaceutical system in Canada that affects all hormone therapies.

If Canada is serious about addressing chronic drug shortages, it needs to look at the full picture. That means recognizing testosterone therapy as essential and mainstream, as a standard part of hormone therapy and overall health care, not a niche treatment. Raising awareness about testosterone shortages ensures that everyone who relies on hormone therapy is included in the national conversation.

Testosterone shortages are not fringe events. They affect a wide range of people across Canada, from cancer survivors to those managing chronic illness, HIV, or age-related hormone loss. They deserve the same level of visibility, empathy, and urgency that other hormone shortages receive.

Appendix: Media Coverage of Testosterone Shortages

Coverage of testosterone shortages in Canada has been limited and fragmented. The few available examples illustrate how rarely these shortages are addressed in mainstream media, and how coverage is often concentrated in specific contexts rather than treated as a wider public health issue.

Most sustained coverage has come from LGBT-focused publications such as Xtra Magazine, where shortages are typically discussed in the context of gender-affirming care. While this reporting is important, it represents only part of the broader population affected by testosterone shortages in Canada.

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