Report Finds Pfizer, AbbVie Among Top Players in Transgender Hormone Market

Some of the world’s largest pharmaceutical companies have a financial stake in the market for hormone products used in gender-transition treatment, according to an American Principles Project report by the group’s president, Terry Schilling.

The report, “The Gender Industrial Complex,” examines the market for transgender-related hormones and surgical procedures in the United States. American Principles Project commissioned Grand View Research to conduct the underlying market analysis, which estimated revenues, market shares and costs associated with drugs and procedures used for medical transition.

Among the report’s findings: Pfizer, AbbVie, Endo International, Novartis and Eli Lilly were identified as five of the leading pharmaceutical companies selling hormone products that may be used in gender-transition care. The analysis estimated Pfizer held a 4.6 percent share of the hormone market examined in 2022, followed by AbbVie at 3.2 percent, Endo International at 2.9 percent, Novartis at 2.1 percent and Eli Lilly at 1.8 percent.

Those figures do not represent the companies’ total revenues, nor do they necessarily represent drugs developed specifically for transgender patients. Many of the medications included in the analysis have other medical uses. Pfizer, for example, sells estrogen, testosterone and puberty-blocking products included in the market analyzed by Grand View Research. The report estimated that Pfizer generated $48.21 million in estrogen revenue, $18.54 million in testosterone revenue and $7.42 million in puberty-blocker revenue in 2022.

AbbVie was estimated to have generated $30.96 million in estrogen revenue, $12.9 million in testosterone revenue and $7.74 million from puberty blockers during the same year. Endo International, Novartis and Eli Lilly also appeared in the report’s pharmaceutical market analysis. Endo was estimated to hold 2.9 percent of the market examined, while Novartis held 2.1 percent and Lilly 1.8 percent.

The report also illustrates an important complication in calculating the size of the market: drugs used as part of gender-transition treatment often have other indications. Supprelin LA, for example, contains histrelin acetate and can suppress puberty. The APP report notes that the drug is used in cases of precocious puberty as well as gender dysphoria. Other testosterone products listed in the report are approved for testosterone-replacement therapy in adult men.

That means the report’s estimates depend in part on modeling how much of a drugmaker’s hormone business is attributable to the market being studied rather than simply counting all sales of a particular medication. Grand View Research said its market-share estimates considered companies’ market presence, product offerings, locations, overall revenue, strategic initiatives and state regulations. The analysis drew from investor presentations, annual reports and internally collected data.

Its broader methodology included financial databases such as Hoovers, industry databases including PitchBook, government statistics, company filings, analyst reports and academic publications. Researchers also conducted interviews with health-care practitioners and industry experts. The researchers then used several modeling techniques to estimate market size and future growth, including bottom-up analysis of company revenues and market shares, usage rates, regression analysis and interviews with practitioners, distributors and industry experts.

The pharmaceutical figures form one part of Schilling’s broader report, which argues that gender-transition medicine should be understood not only as a medical and political issue but as a sizable commercial market. APP said the full report estimated that the combined U.S. market for transgender-related drugs and surgeries exceeded $4.4 billion in 2023 and projected it could surpass $7.8 billion by 2030. Those figures are estimates produced from the Grand View Research modeling commissioned by APP rather than reported revenue totals from a single industry accounting system.

Schilling, whose organization advocates for restrictions on medical gender transition for minors, has argued that the financial dimension deserves greater scrutiny in debates over the practice. APP describes itself as an organization focused on family policy and has made opposition to pediatric gender-transition procedures one of its priorities.

Whatever conclusions are drawn from those policy debates, the report attempts to quantify a part of the issue that is often harder to see: the businesses selling the drugs and procedures, the revenue associated with them and the companies occupying the largest portions of that market. In the pharmaceutical sector, at least, the names are not obscure. They include some of the biggest drugmakers in the world.