Healthcare providers report unprecedented demand for reproductive and gender-affirming medications: ‘We’ve never seen this before’

When the presidential election results were handed down on Wednesday, Rebecca Gomperts, the founder of Aid Access, the No 1 supplier of abortion pills by mail in the United States, was huddled in a Paris apartment with her team of eight American physicians and 15 support staff. The group – which usually operates remotely, shipping out more than 9,000 abortion pills a month – had convened in person before the election, knowing they might have to spring into action.

They were right: as news of Trump’s victory spread, the website received more than 5,000 requests for abortion pills in less than 12 hours – a surge even larger than the day after Roe v Wade fell. “I can see all the new requests ticking in as we’re talking,” Gomperts said in a phone call on Wednesday afternoon. “We’ve never seen this before.”

The scenario repeated itself across the country as news of Trump’s victory broke, with women’s and trans health providers getting inundated with requests for services that their patients feared might be banned in a Trump administration. The telehealth service Wisp saw a 300% increase in requests for emergency contraception; the abortion pill finder site Plan C saw a 625% increase in traffic.

“Clearly, people are trying to plan for the reproductive apocalypse that we anticipate will be happening under a Trump presidency,” said Elisa Wells, the co-founder of Plan C.

For Gomperts and her team at Aid Access, the moment did not come as a shock: they’d been preparing for it since the last Trump administration, when Gomperts, a Dutch physician, expanded her international abortion pill service into the United States. Since then, Aid Access has devised a system in which physicians in states where abortion is legal prescribe and ship abortion pills to patients in states where it is not. The non-profit eventually expanded to the team of eight physicians in four states, along with a help desk that is available 24/7.

But the scale of the demand on Wednesday – five times more than a usual day – was shocking even to them.

“We have an extremely streamlined process and we are capable of dealing with all the requests really fast,” Gomperts said. “But it’s much more [than usual]. And I think the reason is people are now much more aware – people are aware of the possibility of the abortion pill and aware of the threat it will be taken off the market.”

Trump has flip-flopped on the prospect of a national abortion ban, at one point saying women who obtain abortions illegally should be punished, and at others saying the decision should be left up to the states. But his supreme court appointments paved the way for the overturning of Roe in 2022, and his appointments to other, lower courts have held up even the strictest of abortion bans in red states like Texas. There are also multiple ways he could go after the prescribing and shipping of abortion pills, which now account for the majority of abortions in the US.

The panic didn’t just extend to abortion pills. The online women’s health provider Wisp told the Guardian it had already tripled its usual daily sales of emergency contraception by 11.30am on Wednesday. It also saw a huge increase in orders of bulk Plan B packs, which went from about 30% of their emergency contraceptive orders earlier in the month to nearly 90% on Wednesday. New patient requests for Plan B also soared from 50% of their orders to 70%.

The telehealth site Hey Jane said requests for birth control had doubled, and Winx, a similar women’s health service, said it had sold six times as many doses of Plan B by Wednesday afternoon as it had in the past seven days combined.

“Women are smart,” Winx co-founder Cynthia Plotch said. “We see what is coming, and we are protecting ourselves.”

Dr Crystal Beal, meanwhile, was dealing with an influx of emails on Wednesday from trans patients concerned about their access to hormones and hormone-blocking therapy. Beal runs a site called QueerDoc, which provides estrogen, testosterone and hormone-blocking drugs. Trump is hostile to trans rights, vowing to punish doctors who provide gender-affirming care to minors, and Beal’s patients wanted to know how to protect themselves from a second Trump administration.

By early on Wednesday afternoon, QueerDoc had already received more messages that day than it would in a typical week.

“Some of it is ‘How can I safeguard my access to medication?’” Beal said. “Some of it is ‘Should I change [the gender on] my legal documents back so I’m safer? Should I stop taking medication so I’m safer?’”

Beal said the service was advising patients to stock up on as much of their hormone treatment as state law and their insurance coverage allowed, and even suggesting trans men reuse single-use vials of testosterone to make them stretch farther. When it came to stopping medication or changing paperwork, Beal said, that was a more personal question.

“I have to tell people I ultimately can’t predict the future or make that choice or decision for them, and I certainly can’t give legal advice,” Beal said. “But changing your documentation or stopping your medication does not make you any less of a man or a woman, or any less trans. Who we are is not designated by what our documents say or what medications we take.”

QueerDoc sent a message to its patients on Wednesday morning reminding them that while they were worried about the future, “trans people have always been here, and we will continue to persist”, Beal said. And all of the providers who spoke to the Guardian urged patients not to panic and said they would keep providing services until the day they legally could not – and in some cases, even after that.

“Someone gave us a donation today with the message ‘Don’t let the bastards get you down,’” said Wells. “Politicians are not going to stop access, and they’re not going to stop us.”