Opinion: Estrogen proposed as treatment for COVID-19, raising trans folks’ eyebrows everywhere


As many states, including Colorado, end stay-at-home orders and employees return to work, scientists and politicians are still looking for effective treatments for COVID-19. President Trump has touted hydroxychloroquine, which has been linked to seizures, blurred vision and deaths in COVID-19 patients. He has also suggested the (quickly discredited) use of “tremendous” light and injections of disinfectant.

Dr. Anthony Fauci, the White House health advisor, seems to have his hopes pinned on remdesivir, an antiviral drug. The LGBTQ community is already familiar with the pharmaceutical company behind remdesivir, Gilead, due to its history of ethically dubious business practices and profiteering off of its HIV-prevention drug, PrEP. But according to a recent report by The New York Times, doctors at Cedars Sinai Medical Center will soon be testing a new COVID-19 treatment — estrogen.

The proposal to give men infected with COVID-19 the female sex hormone has raised eyebrows among the trans community. Trans author Torrey Peters predicted a global plague that would essentially turn everyone trans in her 2016 novella Infect Your Friends and Loved Ones, but speculative fiction aside, there is a scientific basis behind this treatment.

Estrogen is known to have immune-boosting properties, which explains the “Man Flu,” or the way men suffer more from colds and flus. As someone who has switched from a testosterone-based endocrine system to an estrogen-based one, I can, anecdotally, attest to the reduction of cold and flu symptoms post-transition.

This immune-response disparity has also become apparent when analyzing mortality rates of COVID-19 victims. In Colorado, men make up about 56 percent of the state’s 1,215 COVID-19 deaths. A study by Dr. Zsuzsanna Suba on estrogen treatment for COVID-19, published April 22, notes that “among men, morbidity and fatality rates were markedly higher compared to women.” The study goes on to claim that “Premarin [an estrogen derivative] is capable of stopping the COVID-19 pandemic.”

However, there are indications that the disparity is not entirely due to hormones. The Times noted that “even elderly women with Covid-19 are outliving their male peers, and there is a drastic reduction in levels of hormones for women after menopause.” Julia Serano, biologist and author of Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity, said in an email that “if estrogen or progesterone were playing some kind of protective role in women, we would expect it to occur only in younger (pre-menopausal) women. But that’s not what’s being reported. Androgens [male hormones] could be responsible for exacerbating COVID-19 in men.”

So instead of treating men with estrogen, doctors could instead provide an anti-androgen, right? An April 7 Brown University news release notes that Dr. Carlos Wambier, an assistant professor of dermatology and clinician educator, has discovered that “male hormones that cause hair loss are linked to the vulnerability of patients to SARS-CoV-2.” According to Wambier, “The infection by SARS-CoV-2 seems to be mediated by androgens.”

However, Suba’s study, which used mice as test subjects, found that “treatment with an anti-androgen compound (flutamide) did not affect the morbidity and mortality rates following lethal virus infection…”

Meaning: We still don’t know what role hormones play in the vulnerability to and severity of COVID-19. But as a trans person, it is curious to see the medical community look to hormones as medicine and not simply products of a person’s biologically immutable “male”- or “female”-ness, especially since earlier this year Republican lawmakers across the country sought to ban estrogen treatments for assigned-male-at-birth (AMAB) people under age 18. Such treatments could lead to a greater understanding of the effects of estrogen therapy on AMAB people.

Concerns over health care plague the trans community; the Trump administration recently moved to rescind health care protections for LGBTQ people. It’s kind of ironic, as health professionals are looking for a population of AMAB people on which to study the effects of cross-sex hormone therapy on COVID-19.