AUSTIN (KXAN) – An Austin man said he was denied his hormone prescription by a northwest Austin pharmacist.

Hayden Martin said she would pick up her husband Tristan Martin’s medication while he was working. The Walgreens cashier said the hormones were ready, but the pharmacist said they were uncomfortable filling the prescription because of how the hormones were prescribed to be injected, Tristan recalled. 

There are two types of self-injections for gender-transitioning hormone therapy: intramuscular and subcutaneous. Intramuscular injections involve delivering the medication deep into the muscle tissue – usually shot into the thigh or buttocks. While subcutaneous, or sub-q, injections deliver the hormones into the fatty tissue just under the skin. Doctors recommend injecting into the abdomen or back of the arms for subcutaneous shots, according to Fenway Health. 

“The pharmacist told [my wife] that she was not comfortable filling the prescription because of the way it was being injected, which is subcutaneous,” Tristan said. “As far as I know, all diabetics use that form,” he continued.

Tristain said that subcutaneous injections are less painful than intramuscular ones. He said when he started taking testosterone, he injected the medication into his thigh, which caused scar tissue to build. 

But the more he and Hayden talked with the pharmacist, the less it seemed to them that the injection method was what the pharmacist was actually uncomfortable with, Tristan said. 

“She was refusing to even just fill the actual medicine, without any of the needles,” Tristan said. “The reaction was that it was because I was transgender,” he said. 

Tristan said this has never happened to him in the several years he has been receiving gender-transitioning care. 

“It was pretty crappy. And it made me feel like another human has the right to decide whether I am allowed the basic human right of just getting a medicine filled,” Tristan said.

They contacted another Walgreens in the area and got the hormones within an hour of calling, this time with no pushback at all. 

Walgreens response

We are reviewing the matter and continue to be focused on providing the best care possible for our patients.

Marty Moloney, Senior Media Manager for Walgreens

Can a pharmacist legally deny medication if it violates their values? 

Yes, they can. 

In 2017, the Texas Legislature passed House Bill 2562, giving pharmacists the authority to refuse patients who might be abusing certain medications. Former House Rep Matt Krause filed an amendment to the bill that extended the authority to refuse people medication if it violates their religious beliefs, per reporting in the Dallas Morning News. 

Further, Walgreens tweeted in 2018 that it’s their policy to allow pharmacists to “step away from filling a prescription for which they have a moral objection. At the same time, they are also required to refer the prescription to another pharmacist or manager on duty to meet the patient’s needs in a timely manner,” the tweet read.

KXAN spoke to a pharmacist from Tarrytown Pharmacy about the incident. She said that while she would not have denied Martin the medication, testosterone is typically prescribed to be administered intramuscularly.

The pharmacist said that administering testosterone subcutaneously is not unheard of but not the typical way it is prescribed. She went on to say that if she ever disagreed with a prescription, she would confer with the doctor and patient to find a solution that works for all parties rather than refusing to fill the prescription.