Women are paying $350 for a testosterone pellet. The same hormone, in a men’s tube, can last a year for $86.
Texas Rep. Katrina Pierson (HD 33) — former Trump national spokesperson and chair of the House Subcommittee on Maternal Health, Menopause and Access to Evidence-Based Medicine — sits down with Brad Swail on Texas Talks to walk through her Texas Women’s Health Initiative: baseline hormone testing, HRT coverage, physician liability, iron and prenatal access, and why she says doctors now practice insurance instead of medicine.
Pierson spent 14 years in healthcare, including OB-GYN. She filed a menopause-coverage bill in 2025 that never got a hearing. After the FDA lifted the HRT black-box warning, she took a larger package to the Speaker and got interim charges. In this conversation she explains:
• Why she wants insurance to cover physician-prescribed perimenopause and menopause treatment — including testosterone when medically necessary
• The case for baseline hormone testing before women get labeled with depression or anxiety
• Prior authorization, compounding clinics, and telehealth HRT after the black box came off
• Why Medicaid still requires a prescription for prenatal vitamins, and why she wants physicians able to dispense iron and basics in the office
• What she heard in her subcommittee’s first hearing on prenatal nutrition and Healthy Texas Women
• The gap she flagged in HTW: enrollment is up, participation is down
• The next hearing (date TBD) on menopause and perimenopause, including patient testimony at the Capitol
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Chapters
0:00 If a doctor prescribes it, why can’t you get it?
0:55 Intro: Rep. Katrina Pierson
2:26 How the Women’s Health Initiative started
4:28 Baseline hormone testing
7:37 Physician liability and testosterone
8:51 The $350 pellet vs. the $86 men’s tube
10:04 Why women use testosterone
11:25 Telehealth HRT and prior authorization
13:34 Iron, folic acid, and standing orders
24:19 The black-box studies and starting HRT early
27:33 Yesterday’s subcommittee hearing
28:28 Physician dispense and rural access
31:32 What Healthy Texas Women actually is
33:04 Enrollment up, services down
35:59 How is women’s health in Texas right now?
37:22 North Texas Maternal Health Accelerator
38:42 Close
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