New data on trans women’s estradiol/estrone ratios for different routes of administration of HRT

Disclaimer: I am not a medical professional and this is not medical advice.

I’ve previously covered anecdotal reports from HRT provider Dr. Will Powers on the role of relative levels of different kinds of estrogens in producing effective physical feminization in trans women. Estrogen is not one thing; estradiol (E2), the most common estrogen used in trans women’s HRT, is just one kind. Another form of estrogen, estrone (E1), binds to estrogen receptors but is much weaker in its effects than estradiol, and excessive levels of estrone compared to estradiol can crowd out estradiol at these receptors, inhibiting its feminizing effects. However, lab tests for trans women’s estrogen levels often only measure estrogen as a whole, rather than estradiol and estrone separately. Because of this, what appear to be adequate levels of estrogen may in reality consist mostly of less effective estrone rather than estradiol. Continue reading “New data on trans women’s estradiol/estrone ratios for different routes of administration of HRT”

Unsolved mystery: Trans women have significantly lower semen quality than cis men – before starting HRT

Sperm banking is the recommended method of fertility preservation for trans women prior to medical transition (Coleman et al., 2012), as cross-sex hormone therapy can impair fertility, and gonadectomy (removal of the testes during vaginoplasty or orchiectomy) results in permanent sterility. Semen cryopreservation before starting hormone therapy is a precautionary measure, as the impact of HRT on fertility can be highly variable between individuals – contrary to certain myths and misconceptions, taking hormones does not reliably produce permanent or even temporary sterility in trans women. In a literature review, Schneider et al. (2017) reported:

Whereas three publications described a marked reduction of the spermatogenic level in all patients examined, eight publications reported inconsistent results. Histological analyses showed highly variable outcomes from qualitatively normal spermatogenesis and undisturbed Leydig/Sertoli cell morphology to full testicular regression with severe cellular damage and hyalinization.

This wide variation in the effects of HRT on sperm production makes clear why trans women cannot rely on cross-sex hormones as a method of birth control; trans women engaging in sexual activity that could result in pregnancy should still use an appropriate contraceptive method. Continue reading “Unsolved mystery: Trans women have significantly lower semen quality than cis men – before starting HRT”

How trans youth and their parents decide to start medical transition

The process by which trans adolescents seek out and access medical transition treatment, including puberty blockers and/or cross-sex hormones, is one of the most widely misunderstood subjects in the public imagination. Initiating treatment is frequently depicted as something capricious, a decision made rashly by youth who may simply be experiencing a “phase”, with little or no in-depth consideration of its significance and impact; their parents are portrayed as either going along with this under the coercion of threats of suicide, or swept up in an alleged “trend” themselves; trans-supportive clinicians are in turn maligned as reckless enablers who supposedly allow immediate access to these treatments on the basis of mere adolescent whims. This bizarre caricature is the image of adolescent transition most commonly promoted in alarmist and sensationalist media outlets today. Continue reading “How trans youth and their parents decide to start medical transition”

What is transphobia made of? Perception of deception predicts transphobic prejudice

To the frustration of trans people, allies, and other generally reasonable individuals, transphobic attitudes continue to exist and inflict harm on innocent people. We know all too well that far too many people are transphobic – but why? What motivates this hostility, and in what beliefs and attitudes is it rooted? Previous studies have identified correlations between negative attitudes toward trans people and endorsement of homophobia, benevolent sexism, religious fundamentalism, discomfort with sexuality generally, and a lack of any personal contact with trans people (Rye, Merritt, & Straatsma, 2019).

These associations between transphobia and attitudes in other areas of life are well-established. But what is it about trans people specifically that inspires disapproval? A recent study looked more closely at one manifestation of prejudice, distrust toward trans people, as well as what beliefs are linked to this mistrust and what separates this antipathy from disapproval of other sexual minorities. Continue reading “What is transphobia made of? Perception of deception predicts transphobic prejudice”

Evidence of increases in homophobic bullying linked to anti-gay political measures

Referenda against marriage equality, and the accompanying public debates which inevitably surround them for months or years, have been among the ugliest episodes in American politics. In the heyday of these measures, campaigners against marriage equality routinely promoted some of the most brazenly scaremongering political ads, events, and materials, crafted to stir up significant public hostility against any recognition of the legal equality of same-sex couples. These campaigns attempted to convince voters that if marriage equality were not stopped at the ballot box, all manner of terrible fates would befall not only them but their children as well, evoking the perennial libel of gay people as an inherent threat to kids. Continue reading “Evidence of increases in homophobic bullying linked to anti-gay political measures”