We can phrase this even more distinctly
18-year-old with hypogonadism who is truly suffering but can’t receive treatment because his testosterone level of 250ng/dl is “normal”
vs
girl who wants to be a man
Who should be prioritised? Why have we ignored the former when this scenario is becoming unfortunately all the more commonplace… But the latter, which is very uncommon represents an issue we clearly need to alter the status quo over at the drop of a hat because… trans people are subject to inequality or whatever…
I agree with descheduling testosterone. Even if it can be abused we need to look at the drugs testosterone has been lumped in with. In Queensland/The Northern Territory in Aus testosterone/all AAS are lumped in with heroin, methamphetamine, crack cocaine. They’re essentially schedule I substances with a very narrow set of circumstances that allow them to be treated like schedule II substances (using American equivalents)
Elsewhere in Aus they’re lumped in with the likes of benzodiazepines, barbiturates, cocaine, ketamine (schedule 4 appendix D is more/less the same as schedule 8), fentanyl, morphine, amphetamines. I.e drugs that actually cause physical dependency and most of the above can be lethal within an acute context.
In America testosterone is lumped in with barbiturates, ketamine, benzodiazepine analogues, some benzodiazepines (most benzos are schedule IV), some opiates like buprenorphine and various formulations of low dose morphine, dihydrocodeine, LSA etc.
For the most part, there isn’t an equivalence. Testosterone is dangerous when abused, but in a manner that differs from contemporary drugs of abuse.
If one looks at why/how the USA schedules-controlled substances, you’ll see testosterone shouldn’t be schedule III, schedule V or unscheduled but RX only is more appropriate.
USA schedules drugs based on the potential for abuse, how prone a drug is to induce physical and psychological dependence and how wide (or narrow) the therapeutic margin for a substance is.
It’s actually a sticky one, because the abuse of anabolic steroids has become more commonplace over the past few decades. The prevalence of anabolic steroid use is likely higher than the prevalence of say… heroin or ketamine abuse, so this would warrant a SCH III classification from this regard.
However testosterone is incapable of inducing outright physical dependence akin to the withdrawal syndrome drugs like benzodiazepines induce, hence schedule III is heinous overkill. Psychological dependence is possible, but testosterone in itself isn’t abused as extensively as the synthetic derivatives that are largely responsible for eliciting that ‘look’ bodybuilders tend to have.
When prescribed appropriately, testosterone has virtually no penchant for inducing dependence. When prescribed appropriately, testosterone will not induce physical or psychological dependence akin to the way benzodiazepines, or opiates have the potential to induce.
I can tell you withdrawal from painkillers feels so much worse than dipping because you haven’t taken a shot in 14 days.