4 ms·

What’s interesting to me about transgenderism is how much of a potential revenue stream it presents for the big healthcare and pharmaceutical companies. Has an

What’s interesting to me about transgenderism is how much of a potential revenue stream it presents for the big healthcare and pharmaceutical companies. Has anyone tried to quantify this? Besides the expensive transition itself, there’s also an extended period of hormonal therapy. What would a lifelong subscription like this mean for a corporation like Pfizer? It seems like widespread acceptance of transgenderism would present a positive impact on the share price. If they can monetize, say, 15% of the world’s population, how much does that affect their top line revenue?

throwaway23236 4y ago
Hello! I just wanted to comment from the views of a transgender person. Transgenderism is not really verbiage we use and seems to be used by mostly anti-trans people, same with the word transgendered. Hormone Replacement Therapy (HRT) are life long, though they are not super expensive compared to other drugs. Surgery is expensive, though if you have good insurance it is not that bad. Mine costed around 5k USD. Currently only about 2% of the population in the US identifies as transgender and while most of us expect the number to be higher, I doubt we would see anything over 5 percent.
- sn0w_crash 4y ago
  Thank you this was helpful. I was not aware that HRT is a lifelong commitment. Is there any concern that a major pharmaceutical company is essentially charging a lifetime subscription for you to be who you identify as?
  - NoraCodes 4y ago
    > I was not aware that HRT is a lifelong commitment. To provide a bit of nuance: this is only true if you get surgery that removes your body's ability to produce sex hormones. Every human needs _some_ sex hormones to prevent osteoporosis; that's why non-transgender people sometimes have to take hormones (and, in fact, more non-trans women take estrogen than trans people do!) If someone starts HRT and decides that they hate it, it's generally possible to just... stop. There are some more permanent effects, but they take a while to develop. > Is there any concern that a major pharmaceutical company is essentially charging a lifetime subscription for you to be who you identify as? This is a super interesting question! The obvious solution is that socialized medicine would completely obviate the problem, but that's a huge, sweeping solution, has its own issues, and is unlikely to happen. My perspective is that estrogen, in particular, is really quite cheap. Compared to, for instance, insulin, it's a very safe, abundant, and inexpensive maintenance drug. Testosterone is also pretty cheap, but is harder to access because it's more heavily controlled. In my opinion, it only really becomes a problem when politicians decide to try and remove these drugs from insurance coverage, which we've seen in several places in the United States.
- jelliclesfarm 4y ago
  > Transgenderism is not really verbiage we use and seems to be used by mostly anti-trans people, same with the word transgendered.[..] What is the word to use?
NoraCodes 4y ago
> What would a lifelong subscription like this mean for a corporation like Pfizer? Honestly, very little. As an example, 120x 2mg oral estradiol, which is a common dosage prescribed to both trans women and cis (that is, non-trans) women with endocrine disorders, costs about $35/mo to insurance in my area, which isn't much of a margin. It's also fully genericized, so it's very unlikely that any one manufacturer could profit by pushing that margin up; there's just too much competition. In fact, in the hormone space, the real scandal is vaginally administered estrogens for cisgender women. There have been massive, unjustified price increases in the last decade.
jelliclesfarm 4y ago
I looked up the cost of puberty blockers and this turned up : https://www.nytimes.com/2021/05/11/well/family/what-are-puberty-blockers.html https://www.nytimes.com/2021/05/11/well/family/what-are-pube... [..]“It depends a lot on what is obtainable through a patient’s insurance,” Dr. Kremen said. Insurance companies are reluctant to cover off-label drug treatments, and implants can run up to approximately $45,000 per implant out of pocket, while shots cost can cost thousands of dollars per dose.[..] https://www.pbs.org/wgbh/frontline/article/when-transgender-kids-transition-medical-risks-are-both-known-and-unknown/ https://www.pbs.org/wgbh/frontline/article/when-transgender-... [..]The Endocrine Society’s guidelines suggest starting puberty blockers for transgender children when they hit a stage of development known as Tanner stage 2 — usually around 10 or 11 years old for a girl and 11 or 12 years old for a boy. The same guidelines suggest giving cross sex hormones — estrogen for transgender girls and testosterone for transgender boys — at age 16. However, doctors caution that estrogen and testosterone, the hormones that are blocked by these medications, also play a role in a child’s neurological development and bone growth. [..] Another area where doctors say there isn’t enough research is the impact that suppressing puberty has on brain development. “The bottom line is we don’t really know how sex hormones impact any adolescent’s brain development,” Dr. Lisa Simons, a pediatrician at Lurie Children’s, told FRONTLINE. “We know that there’s a lot of brain development between childhood and adulthood, but it’s not clear what’s behind that.” What’s lacking, she said, are specific studies that look at the neurocognitive effects of puberty blockers. [..] Most of these treatments are still very expensive and often out of reach for people without the help of insurance. The cost of puberty blockers is approximately $1,200 per month for injections and can range from $4,500 to $18,000 for an implant. [..] NPR article is 2015. The first NYT article is 2021. So I guess prices are going up! I suppose there are a lot more opportunities for revenue after the puberty pause. Profitable racket.

throwaway23236 4y ago

Hello! I just wanted to comment from the views of a transgender person. Transgenderism is not really verbiage we use and seems to be used by mostly anti-trans people, same with the word transgendered. Hormone Replacement Therapy (HRT) are life long, though they are not super expensive compared to other drugs. Surgery is expensive, though if you have good insurance it is not that bad. Mine costed around 5k USD. Currently only about 2% of the population in the US identifies as transgender and while most of us expect the number to be higher, I doubt we would see anything over 5 percent.

sn0w_crash 4y ago
Thank you this was helpful. I was not aware that HRT is a lifelong commitment. Is there any concern that a major pharmaceutical company is essentially charging a lifetime subscription for you to be who you identify as?
- NoraCodes 4y ago
  > I was not aware that HRT is a lifelong commitment. To provide a bit of nuance: this is only true if you get surgery that removes your body's ability to produce sex hormones. Every human needs _some_ sex hormones to prevent osteoporosis; that's why non-transgender people sometimes have to take hormones (and, in fact, more non-trans women take estrogen than trans people do!) If someone starts HRT and decides that they hate it, it's generally possible to just... stop. There are some more permanent effects, but they take a while to develop. > Is there any concern that a major pharmaceutical company is essentially charging a lifetime subscription for you to be who you identify as? This is a super interesting question! The obvious solution is that socialized medicine would completely obviate the problem, but that's a huge, sweeping solution, has its own issues, and is unlikely to happen. My perspective is that estrogen, in particular, is really quite cheap. Compared to, for instance, insulin, it's a very safe, abundant, and inexpensive maintenance drug. Testosterone is also pretty cheap, but is harder to access because it's more heavily controlled. In my opinion, it only really becomes a problem when politicians decide to try and remove these drugs from insurance coverage, which we've seen in several places in the United States.
jelliclesfarm 4y ago
> Transgenderism is not really verbiage we use and seems to be used by mostly anti-trans people, same with the word transgendered.[..] What is the word to use?

NoraCodes 4y ago

> What would a lifelong subscription like this mean for a corporation like Pfizer? Honestly, very little. As an example, 120x 2mg oral estradiol, which is a common dosage prescribed to both trans women and cis (that is, non-trans) women with endocrine disorders, costs about $35/mo to insurance in my area, which isn't much of a margin. It's also fully genericized, so it's very unlikely that any one manufacturer could profit by pushing that margin up; there's just too much competition. In fact, in the hormone space, the real scandal is vaginally administered estrogens for cisgender women. There have been massive, unjustified price increases in the last decade.

jelliclesfarm 4y ago

I looked up the cost of puberty blockers and this turned up : https://www.nytimes.com/2021/05/11/well/family/what-are-puberty-blockers.html https://www.nytimes.com/2021/05/11/well/family/what-are-pube... [..]“It depends a lot on what is obtainable through a patient’s insurance,” Dr. Kremen said. Insurance companies are reluctant to cover off-label drug treatments, and implants can run up to approximately $45,000 per implant out of pocket, while shots cost can cost thousands of dollars per dose.[..] https://www.pbs.org/wgbh/frontline/article/when-transgender-kids-transition-medical-risks-are-both-known-and-unknown/ https://www.pbs.org/wgbh/frontline/article/when-transgender-... [..]The Endocrine Society’s guidelines suggest starting puberty blockers for transgender children when they hit a stage of development known as Tanner stage 2 — usually around 10 or 11 years old for a girl and 11 or 12 years old for a boy. The same guidelines suggest giving cross sex hormones — estrogen for transgender girls and testosterone for transgender boys — at age 16. However, doctors caution that estrogen and testosterone, the hormones that are blocked by these medications, also play a role in a child’s neurological development and bone growth. [..] Another area where doctors say there isn’t enough research is the impact that suppressing puberty has on brain development. “The bottom line is we don’t really know how sex hormones impact any adolescent’s brain development,” Dr. Lisa Simons, a pediatrician at Lurie Children’s, told FRONTLINE. “We know that there’s a lot of brain development between childhood and adulthood, but it’s not clear what’s behind that.” What’s lacking, she said, are specific studies that look at the neurocognitive effects of puberty blockers. [..] Most of these treatments are still very expensive and often out of reach for people without the help of insurance. The cost of puberty blockers is approximately $1,200 per month for injections and can range from $4,500 to $18,000 for an implant. [..] NPR article is 2015. The first NYT article is 2021. So I guess prices are going up! I suppose there are a lot more opportunities for revenue after the puberty pause. Profitable racket.