Flying With Testosterone HRT

This post is in partnership with Upaway, an app with auto-organization travel tools and on-demand (human!) trip support. The Upaway team is familiar with the challenges the LGBTQ+ community faces while traveling, so they’ve provided some information about specifically traveling with gender affirming testosterone therapy.

As the holiday season approaches, we know some FOLX members may be traveling with their testosterone prescriptions. Since testosterone is a controlled substance under the Controlled Substances Act, it’s important to plan ahead and travel with your prescription drugs correctly.

In partnership with Upaway, we’ve compiled some tips to help you fly on a plane with testosterone replacement therapy.

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What is a controlled substance?

Testosterone is a federally controlled substance. A “controlled substance” refers to any drug listed in the Controlled Substances Act (CSA). Passed in 1970, this federal law created five categories of drug scheduling that every controlled substance falls into. In most states, Testosterone falls into the Schedule III category with other anabolic steroids; however, in New York state, it’s classified as Schedule II).

Note that estradiol, as well anti-androgens, are not controlled. Testosterone is the only medication offered by FOLX that is a controlled substance.

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Why is testosterone a controlled substance?

Testosterone cypionate is classified as an anabolic-androgenic steroid. “Anabolic” refers to muscle building while “androgenic” to increased sex characteristics culturally associated with masculinity. Much like this definition explains, testosterone can be used as a steroid to enhance physical performance in sports and other athletic activities.

Synthetic testosterone has been used for gender affirming hormone therapy for nearly a century. In 1939, the first documented prescription to a transgender man was obtained by Michael Dillion. However, by the mid-20th century, cisgender men began using synthetic testosterone to enhance their athletic performance. By the 1980s, it was being used among amateur and professional cis male athletes. In 1990, in efforts to combat recreational testosterone use by cis male athletes, the Anabolic Steroids Control Act categorized testosterone as a federally controlled Schedule III criminalized substance.

Because of its status as a controlled substance, those traveling with testosterone vials and supplies may need to practice more care and planning ahead of time to avoid any complications with TSA.

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What to know about security screening policies and testosterone

When it comes to TSA (Transportation Security Administration) security screening policies, they must comply with civil rights laws, regulations, executive orders, and policies. Likewise, the TSA must not discriminate against those traveling based on basis of race/ethnicity, skin color, national origin, sex (including pregnancy, sexual orientation, gender identity, and parental status), religion, age, disability, and genetic information.

However, with that said, per TSA regulations, the final decision—about where your testosterone prescription is allowed through the checkpoint—comes down to each individual TSA officer. Most people report not having any problems when flying with testosterone.

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TSA medication regulations

The TSA allows larger amounts of medically necessary liquids, gels, and aerosols in reasonable quantities for your trip, but you must declare them to security officers at the checkpoint for inspection.

It can be helpful and convenient to carry your medication and supplies together in one bag, like a pouch. For instance, people with diabetes traveling with their medication and supplies often carry everything in a small pouch. Stealth Bros carries a similar product, specifically designed for people traveling with testosterone. Additionally, while it's not required for liquid medication to be placed in a liquids bag, some find this helpful to make their medications easily accessible within their medication supply bag.

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Liquid medications

Injectable prescriptions medications are permitted on flights. You must declare these items to security officers at the checkpoint for inspection. We recommend, but do not require, that your medications be labeled to facilitate the security process.

• Carry On Bags: Yes (Less than or equal to 3.4oz/100 ml allowed)
• Checked Bags: Yes

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Unused syringes

Unused syringes are allowed when accompanied by injectable medication. You must declare these items to security officers at the checkpoint for inspection. We recommend, but don't require, that your medications be labeled to facilitate the security process.

• Carry On Bags: Yes (Special Instructions)
• Checked Bags: Yes

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Used syringes

Used syringes are allowed when transported in a sharps disposal container or other similar hard-surface container.

• Carry On Bags: Yes (Special Instructions)
• Checked Bags: Yes

For more information on TSA guidelines not mentioned in this guide, visit TSA.gov.

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Note about sharps disposal while traveling

Traveling with sharps can be confusing because sharps can't be disposed of just anywhere. While many airports have sharps disposals in restrooms, not all of them do. Plus, traveling with a sharps disposal container can be bulky, especially if you're traveling light.

Stealth Bros also sells sharp shuttles, which are specific tube-shaped containers designed to hold sharps waste on-the-go. Each container holds approximately 20 needle tips. Once filled, the container can only be locked once. Other retailers sell similar tube-shaped containers to help you dispose of syringes safely without the need for accessing public sharps disposals.

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Screening

TSA officers may test liquids, gels or aerosols for explosives or concealed prohibited items, even if they’re meds or supplements. If officers are unable to use X-ray to clear these items, they may ask to open the container and transfer the content to a separate empty container or dispose of a small quantity of the content, if feasible.

Inform the TSA officer if you don’t want your liquid medication to be screened by X-ray or opened. Additional steps will be taken to clear the liquid and you will undergo additional screening procedures including a pat-down and screening of other carry-on property.

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Travel Tips 

• Carry a copy of your prescriptions in your carry-on, purse, wallet, etc. when traveling.
• You cannot carry syringes without proof of their use. Keep injectable medications like insulin or testosterone physically on you when going through TSA (at least a small quantity, ok to check more if needed) 
• Keep syringes and medicines in the original packaging with the manufacturer's information. This helps airport security identify them easily. 
• It can be helpful to verbally explain to the TSA agent that you have the prescription. Something along the lines of, “I have some medical supplies in here including syringes and testosterone.” Or “I have a prescription in this plastic bag.” 
• Label items associated with your liquid medications such as freezer packs, IV bags, pumps, and syringes. Keep all of your medical items together separately from the rest of your belongings for seamless access. 

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What to do if something goes wrong

• Download the Upaway app in advance, before you leave home: www.upaway.app/download 

• Auto-organization for every trip confirmation, no matter where or how you booked.
• Real-time trip risk and safety information alongside your trip plans, for every destination.
• On-demand (human!) trip support to assist at any point of your trip.

• File a Complaint for those subjected to discrimination - Upaway would be happy to do this on your behalf. 
• Another helpful tip is filing for a Redress Number. This is a special TSA program created for folks who suffer from frequent security delays when traveling or generally experience more hassle than other travelers. It helps TSA immediately know who you are, without being confused by anyone on the no-fly list, so you can be on your way safely and seamlessly.

FOLX is proud to offer LGBTQ+ specialized care as a virtual healthcare provider. If you’re interested in starting testosterone with FOLX, learn more information about the different dosages (including low testosterone doses) and routes offered here. Additionally, learn more about physical changes on testosterone, getting your testosterone levels checked by blood work and more in the Library!

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FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!

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