Nov 20, 2023·edited Nov 20, 2023Liked by Jenny Poyer Ackerman
I found this post through an advertisement on another blog, so apologies if I'm intruding. But as a trans woman myself I can't in good conscience leave without giving my thoughts. Plus much of the information written here is plain wrong.
>Trans-identifying men are prominent among the ‘experts’ who hand down the guidance of care for all gender-questioning patients. This departs from the principle of clinical neutrality that governs good science.
This framing of this point implies that trans people cannot be experts in their own conditions. Cisgender people have a very hard time understanding what gender dysphoria feels like -- what better person to explain that than someone who actually lives with it? Trans people have suffered for decades trying to receive medical care to alleviate their dysphoria from doctors who don't understand their suffering and are often times forced to lie in order to conform to cis expectations of what trans people ought to be. "From a prepubertal age I always played with the opposite of my assigned gender's toys"; "I am only attracted to the opposite sex and would never enter a homosexual relationship post-transition"; "I enjoy putting on makeup and wearing dresses and heels and I strive to be as feminine as possible"; "I am disgusted by my genitals and want to have the body of my identified gender in order to have heterosexual sex". Fortunately the world is changing and with informed consent practices and trans-positive healthcare, trans people are able to be more truthful with their doctors.
>Children given puberty blockers followed by cross-sex hormones will reach adulthood without having experienced puberty at all.
This is not true. An AMAB child who takes puberty blockers and then estrogen will go through a female puberty. An AFAB child who takes puberty blockers and then testosterone will go through a male puberty. Even a trans person goes through their assigned gender's puberty, they can go through a "second puberty" when starting HRT. Speaking from experience, your body and emotions change in a very similar way as during your "first puberty", only... it's the other way around.
>Teenage girls may embark on a lifelong relationship with synthetic testosterone administered weekly or bi-weekly.
Why would a girl take testosterone? It only makes sense for trans men to take testosterone, not cis girls Misgendering the article's subjects is unhelpful.
>Known side effects include: elevated risk of heart attack, type 2 diabetes, thyroid disease, autoimmune disease, bone loss, premature menopause, impaired sexual function, cognitive impairments, and mood disorders including suicidality.
This is all true (I assume). But other effects may be: lowered risk of breast cancer, increased libido (which may be a good or bad thing), cognitive improvements due to increased happiness and reduced depression, and the cessation of suicidality due to alleviating gender dysphoria. It's a two-way street. Yes, hormones, especially testosterone, can have negative effects. But they are only prescribed because the positive effects are deemed to outweigh the negative effects.
>This treatment is not shown to resolve dysphoria.
Um, yeah, sure. It works for me. Sometimes transitioning can make dysphoria temporarily worse as people take a closer look at their bodies. But that most often is the hard part before it gets easier and hormones start having their intended effects. And the alternative is repressing it until..., I guess until you die? If you have a reputable study in mind that shows that HRT doesn't resolve dysphoria I'd be happy to look at it but my feeling is that no such study exists.
>Even when genital surgeries go as planned, female patients don't get a functioning penis, nor do male patients gain anything resembling a woman's internal genitalia, but rather an empty cavity. Common complications are severe and include anal or rectovaginal fistulas, severe bowel injuries, infections, inflammation and, of course, sterility.
Bottom surgery is a big deal. But no one undergoes it without knowing the risks, and rates of regret are surprisingly low compared to other "cosmetic" surgeries (nose jobs, liposuction, etc.). Again, misgendering your article's subject is unhelpful and disrespectful. This section is sensationalist and unconvincing to me. I will note that "functioning penis" and the subsequent description of vaginoplasty is subjective and many trans people are happy with their postop genitalia, even if they cannot get an erection, conceive a child, or menstruate. I don't think bottom surgery patients undergo surgery thinking they're about to get the vagina/penis of their wildest dreams. Our desires have to come up against the limits of current medical technology somewhere
>Testosterone will cause her female genitalia to atrophy.
In fact the opposite is true. Testosterone causes the clitoris to grow bigger. Many trans men feel euphoric from this and choose to think of it as a small penis rather than a clitoris.
>As her estrogen secretion is suppressed, early menopause ensues, and a hysterectomy may be indicated. Should she undertake these 'therapies', she will likely never experience an orgasm, much less bear a child. Image is, literally, everything.
...What? It doesn't really make sense to think of someone on testosterone as going through menopause. Women who experience negative symptoms from menopause do so because they have no significant estrogens *or* androgens in their body. As a result, many begin HRT, a perfectly natural remediation.... but that's besides the point. As for trans men being unable to experience an orgasm, I've never heard of anything crazier, and I can speak from personal (ok, strictly speaking secondhand) experience here, lol. Trans men can get pregnant as well, there are many breathless tabloid articles about it you can find with a quick google search.
>In fact, a closer inspection of the available research shows a much greater likelihood of suicide among post-op transgender patients than among youth whose desire for medical transition is postponed or denied.
Citation, please. My impression is the data shows the complete opposite.
I won't pick out any quotes in particular but the push to "drop the T" from LGBT makes me very sad. Cisgender gay and bi people will not make themselves more genuinely accepted by marginalizing trans people. They will achieve a veneer of acceptance from the right-wing but will quickly find themselves on the chopping block when it becomes politically expedient. It's true that trans people are different from cis gay people, but gay men and gay lesbians are also different, yet they have (for the most part) chosen to band together as political allies because they experience the same hatred and can find community with each other.
I hope you will take my response with grace and respect as I hope I have done the same for you.
Julia, I've read your comment carefully, and first I really want to thank you for writing it. I started to reply but found I wasn't able to insert links in this field. With your permission, I'd like to paste your whole comment, and my reply, and publish the conversation as a stand-alone post. It will take me a few days to make sure I address all your points, so maybe I'll post it on Thursday, with thanks for the possibility of honest, respectful discourse on such a fraught, polarized topic. Are you okay with that?
I found this post through an advertisement on another blog, so apologies if I'm intruding. But as a trans woman myself I can't in good conscience leave without giving my thoughts. Plus much of the information written here is plain wrong.
>Trans-identifying men are prominent among the ‘experts’ who hand down the guidance of care for all gender-questioning patients. This departs from the principle of clinical neutrality that governs good science.
This framing of this point implies that trans people cannot be experts in their own conditions. Cisgender people have a very hard time understanding what gender dysphoria feels like -- what better person to explain that than someone who actually lives with it? Trans people have suffered for decades trying to receive medical care to alleviate their dysphoria from doctors who don't understand their suffering and are often times forced to lie in order to conform to cis expectations of what trans people ought to be. "From a prepubertal age I always played with the opposite of my assigned gender's toys"; "I am only attracted to the opposite sex and would never enter a homosexual relationship post-transition"; "I enjoy putting on makeup and wearing dresses and heels and I strive to be as feminine as possible"; "I am disgusted by my genitals and want to have the body of my identified gender in order to have heterosexual sex". Fortunately the world is changing and with informed consent practices and trans-positive healthcare, trans people are able to be more truthful with their doctors.
>Children given puberty blockers followed by cross-sex hormones will reach adulthood without having experienced puberty at all.
This is not true. An AMAB child who takes puberty blockers and then estrogen will go through a female puberty. An AFAB child who takes puberty blockers and then testosterone will go through a male puberty. Even a trans person goes through their assigned gender's puberty, they can go through a "second puberty" when starting HRT. Speaking from experience, your body and emotions change in a very similar way as during your "first puberty", only... it's the other way around.
>Teenage girls may embark on a lifelong relationship with synthetic testosterone administered weekly or bi-weekly.
Why would a girl take testosterone? It only makes sense for trans men to take testosterone, not cis girls Misgendering the article's subjects is unhelpful.
>Known side effects include: elevated risk of heart attack, type 2 diabetes, thyroid disease, autoimmune disease, bone loss, premature menopause, impaired sexual function, cognitive impairments, and mood disorders including suicidality.
This is all true (I assume). But other effects may be: lowered risk of breast cancer, increased libido (which may be a good or bad thing), cognitive improvements due to increased happiness and reduced depression, and the cessation of suicidality due to alleviating gender dysphoria. It's a two-way street. Yes, hormones, especially testosterone, can have negative effects. But they are only prescribed because the positive effects are deemed to outweigh the negative effects.
>This treatment is not shown to resolve dysphoria.
Um, yeah, sure. It works for me. Sometimes transitioning can make dysphoria temporarily worse as people take a closer look at their bodies. But that most often is the hard part before it gets easier and hormones start having their intended effects. And the alternative is repressing it until..., I guess until you die? If you have a reputable study in mind that shows that HRT doesn't resolve dysphoria I'd be happy to look at it but my feeling is that no such study exists.
>Even when genital surgeries go as planned, female patients don't get a functioning penis, nor do male patients gain anything resembling a woman's internal genitalia, but rather an empty cavity. Common complications are severe and include anal or rectovaginal fistulas, severe bowel injuries, infections, inflammation and, of course, sterility.
Bottom surgery is a big deal. But no one undergoes it without knowing the risks, and rates of regret are surprisingly low compared to other "cosmetic" surgeries (nose jobs, liposuction, etc.). Again, misgendering your article's subject is unhelpful and disrespectful. This section is sensationalist and unconvincing to me. I will note that "functioning penis" and the subsequent description of vaginoplasty is subjective and many trans people are happy with their postop genitalia, even if they cannot get an erection, conceive a child, or menstruate. I don't think bottom surgery patients undergo surgery thinking they're about to get the vagina/penis of their wildest dreams. Our desires have to come up against the limits of current medical technology somewhere
>Testosterone will cause her female genitalia to atrophy.
In fact the opposite is true. Testosterone causes the clitoris to grow bigger. Many trans men feel euphoric from this and choose to think of it as a small penis rather than a clitoris.
>As her estrogen secretion is suppressed, early menopause ensues, and a hysterectomy may be indicated. Should she undertake these 'therapies', she will likely never experience an orgasm, much less bear a child. Image is, literally, everything.
...What? It doesn't really make sense to think of someone on testosterone as going through menopause. Women who experience negative symptoms from menopause do so because they have no significant estrogens *or* androgens in their body. As a result, many begin HRT, a perfectly natural remediation.... but that's besides the point. As for trans men being unable to experience an orgasm, I've never heard of anything crazier, and I can speak from personal (ok, strictly speaking secondhand) experience here, lol. Trans men can get pregnant as well, there are many breathless tabloid articles about it you can find with a quick google search.
>In fact, a closer inspection of the available research shows a much greater likelihood of suicide among post-op transgender patients than among youth whose desire for medical transition is postponed or denied.
Citation, please. My impression is the data shows the complete opposite.
I won't pick out any quotes in particular but the push to "drop the T" from LGBT makes me very sad. Cisgender gay and bi people will not make themselves more genuinely accepted by marginalizing trans people. They will achieve a veneer of acceptance from the right-wing but will quickly find themselves on the chopping block when it becomes politically expedient. It's true that trans people are different from cis gay people, but gay men and gay lesbians are also different, yet they have (for the most part) chosen to band together as political allies because they experience the same hatred and can find community with each other.
I hope you will take my response with grace and respect as I hope I have done the same for you.
Julia, I've read your comment carefully, and first I really want to thank you for writing it. I started to reply but found I wasn't able to insert links in this field. With your permission, I'd like to paste your whole comment, and my reply, and publish the conversation as a stand-alone post. It will take me a few days to make sure I address all your points, so maybe I'll post it on Thursday, with thanks for the possibility of honest, respectful discourse on such a fraught, polarized topic. Are you okay with that?
Yes, that sounds alright.
Great. I'll reply again where when it's published so you know.
Happy TG! The post is live now.