Right now, we have a political problem in Ontario that bars trans males from much-needed access to testosterone coverage.

As a working trans male myself, trying to stay afloat in this economy and experiencing a range of coverage from private, to public, to employer health insurance, I can vouch firsthand how expensive testosterone can be, and how disappointing it is to hear that my financial situation can limit my access to gender-affirming care.

In Ontario, there are four options for testosterone administration that can be prescribed to trans men depending on their needs. Testosterone is covered under OHIP, but for individuals who have private or employer health insurance, this ceases to be the case.

Trans males have the option of taking it further and applying for the EAP (Exceptional Access Program) under the ODB (Ontario Drug Benefit), but by and large, this coverage is reserved for 50+-year-old bio men suffering from any of the ailments listed under Code 397 of the Formulary. Only one brand of Testosterone Cypionate is not listed as Limited Use.

This leaves any trans male prescribed ANYTHING else unable to access the coverage provided by OHIP, and rejected by ODB, having to pay for their testosterone, which in Canada can range anywhere from $40-$400 dollars a month. This is outrageously expensive for essential healthcare targeted toward an already oppressed and medically alienated group of people.

I was just told by my pharmacist that patients applying through the ODB are now getting their birthdates checked to ensure they meet the 50+ age requirement. This is in no way acceptable and removes financial surety and access for the many, many trans males that are below 50. To add to the problem, Hormone Therapy was delisted from the ODB in 2006. We are now approaching two decades of Ontario having limited-access healthcare for trans individuals.

Gender affirming hormone replacement therapy (HRT) can be administered in a variety of ways, like injections or a topical gel. The type of HRT someone chooses is a deeply personal choice and depends on their unique health circumstances, their personal preferences, and their goals.

As trans men, we should be in control of our bodies and how we choose to navigate our transition. Our community already faces significant marginalization and discrimination, especially in healthcare settings. We need better, easier access to life-saving gender-affirming care — not more barriers to accessing it.

The government shouldn’t be dictating what type of testosterone is available. Trans men should be able to choose HRT that works for them. True inclusivity is impossible when life-saving medicine is not accessible.

Cut the crap. Make a new code. Cover testosterone for trans males in Ontario.