Given the dearth of medical research on trans people, there’s a broad and dangerous lack of understanding of how everything from life-saving medication to vitamins (should I be taking daily supplements for men, or…?) interact with trans bodies that have undergone one or more medical interventions. Baked into that, though, is an even more pressing issue that I and the rest of my trans brethren need answers to, stat: How am I supposed to know if taking a gas-station dick pill will give me an erection, kill me or both? (For the sake of clarity here, let’s assume we’re talking about men who haven’t had a phalloplasty.)
Per usual, there are a few sparse Reddit threads on the topic, but they serve as better testimonials to the adage that “experience does not equal expertise” than they do as legitimate field studies. To wit: A user on r/ftm, responding to the question, “Anyone ever used male enhancement pills?” replied, “They have the opposite effect. They stimulate your gonads to produce hormones and we don’t have male gonads, so… they’re female enhancers for us.”
What this user could possibly mean by “female enhancers” is unclear to me and to medical experts, which I’ve now confirmed as fact because that phrase was so ominous-sounding that I had to email a doctor about it.
“There are no agents that stimulate gonads in a generic way [and act] as ‘female enhancers’ for individuals with ovaries,” explains Joshua Safer, the executive director at the Center for Transgender Medicine and Surgery. “There are pills that block estrogens, and that would be true for transgender men and for cisgender men equally.”
In another reply to that same Reddit query, the inconspicuously named user “pillkings” leaves a lengthy comment, stating, “I’m not 100 percent sure if a trans person would be affected any differently, but otherwise, [male-enhancement pills] do work, just be mindful that there are many fake or poor quality products out there, and as always, check with your doctor before starting any new supplement.”
Pillkings then goes on to direct the user to his company’s website, which “only sells products that have met our quality standards.” And though pillkings apparently spends their time searching terms like “male-enhancement pills” on Reddit so they can promote their own gas-station-less, gas-station dick supplements, pillkings does have a point about their similar efficacy on both trans and cis men.
“There would be no reason to think that they’d act differently for transgender men relative to cisgender men,” says Safer. “The tissue of the penis and of the clitoris have common origins.” Put in plainer terms, pillkings was right — dick pills, be they from gas stations or gynecologists, will give whatever you’ve got a little erection. Dick pills don’t discriminate, I guess. Print it on my tombstone.
Unfortunately for him, though, knockoff male-enhancement pills are also sometimes cut with sketchy weight loss drugs, diabetes medicine and other weird shit you definitely don’t want in your boner. And so, if a gas-station dick pill actually does what it claims to do vis a vis boner-summoning (which isn’t always the case), the pill’s contents would probably be extremely dangerous to consume, no matter your gender. Because if the gas-station dick pills do work, they’re probably full of the same things that are in legit ED drugs like Viagra and Cialis — but at what dosages, and mixed in with what other chemicals, is anyone’s guess. (Actually, the FDA has a pretty good guess, but we’ll get to that in a minute.)
And when you consider the potential side effects of regulated versions like Viagra and Cialis include vision loss, constant erections, heart attacks and strokes, taking a knockoff drug that potentially contains the same active ingredients at preposterously high doses seems perilous and something that should involve a doctor.
But what if, like many trans people, you don’t have access to a primary-care physician at all, let alone one as knowledgeable about trans people as Safer? Or better yet, what if you ask the boner pill companies themselves?
To find out, I contacted a wholesaler of male-enhancement pills and asked if they’d be just as effective for cis men as trans men, and received an underwhelming “I would think so” from a customer service representative. Another company rep, this time for a specific male-enhancement pill brand, assured me the pill “works the same way” for cis and trans men, though he admitted there was no testing or evidence to support that claim. In fact, he didn’t even think that kind of data was necessary, because the pill works by increasing blood flow to help “achieve the results.” Okay, then!
With confirmation from both a medical doctor and suspiciously confident customer service representatives that I could take a gas-station boner pill and expect to “achieve the results,” I followed up with the FDA to see if I should. Perhaps unsurprisingly, the answer wasn’t exactly encouraging. Remember that thing Safer noted about male-enhancement pills having a problem with contamination?
“Products marketed as dietary supplements to treat erectile dysfunction or for male sexual enhancement could be potentially hazardous to consumers,” the FDA wrote in a statement. “These products can contain undisclosed prescription drug ingredients found in FDA-approved drugs used to treat erectile dysfunction. In some cases, the products have contained active ingredients at 10 to 30 times the normal prescription dose.” (Emphasis mine.)
Ingesting a pill with 30 times the standard ED medication dosage sounds more like an origin story for a boner-based superhero than a cure for erectile dysfunction; or as the FDA put it in their statement, taking a gas-station dick pill “can cause serious side effects and interact in dangerous ways with drugs that a consumer is already taking.” There’s even a dedicated tracker for tainted sexual enhancement products on the FDA’s website, a list longer than the mega-erection one of these pills could cause shortly before causing your blood pressure to plummet to life-threatening levels.
But though the FDA is doing its best to list as many contaminated over-the-counter male-enhancement pills as possible, it rarely has the authority to actually yank the pills off the shelves, even the ones it’s identified as potentially dangerous. It can inform the public about a contaminated product and urge the company and its distributors to institute a voluntary recall, but that’s about it.
So while there are still serious research gaps when it comes to trans health, we can probably close the books on this one: Gas-station dick pills are just as risky for trans men as they are for cis ones.
In this one area, at least, we’ve achieved equality.