#he likely has PCOS or CAH

[battry-acid]

logan is trans and intersex to me. when i draw logan he is trans and intersex. he is also bisexual (staying true to canon in that regard) and polyamorous. thank u for ur time

[ielectrica]

Controversial headcanon?

This may be a controversial headcanon of mine, but I believe that Lilia may have a smaller than average penis or a micropenis. I've seen headcanons of characters in this fandom having larger penises and whatnot, but what about smaller than average penises? What about micropenises? What about some characters being intersex? Clitoromegaly? CAH (Congenital Adrenal Hyperglasia)? PCOS? Klinefelter syndrome? Any of those? Hell, let's even include ambiguous genitalia!

All I'm basically saying is that Lilia Vanrouge should either have a smaller than average penis or a micropenis and still be just as loved, cherished, treasured, and treated as wonderfully as the rest that do HC him as having a large penis.

I even saw some posts that basically had Lilia as a virgin; as someone who didn't have that much sexual experience due to having been in the war against human and Fae for so long and having had to raise Malleus in the best way that he could (damn the Senate to hell for basically taking Malleus away from him and Malleus having had to live such a lonely existence) on top of Briar Valley possibly not having the best materials (IF AT ALL) for sex education, he wouldn't be able to really pinpoint how to pleasure anyone until after retirement at the very least.

You know what? Fuck it. Yes, I'm HC'ing the LITERAL FUCK out of Lilia having a micropenis. He doesn't need a big dick to satisfy others and HE KNOWS IT. Hell, he probably has some epic oral and hand game along with throat game because sex isn't all about penetration like some people like to claim it is!

If people want to have Lilia Vanrouge have the penis that is above average or massive, that's fine too! But micropenis and smaller than average penis havers need not to be ashamed!!! They need love too!

So there's that! That's all, folks!

[intersex-questions]

Hello! I was afab and I've been iding as tranmasc for a while. I've had friends and family assume that I'm on testosterone but I never thought much of it I do have solid sideburns, am def hairier than my sister, and my voice reads as p androgynous, but it makes me happy so I never thought much of it. However, I recently started the process to get on hrt and I found out that my testosterone levels are already notably higher than is typical for cis women, if still below the standard male range-- my doctor actually assumed that I'd been diying. He told me that there isn't any point of looking into specific conditions unless I have symptoms that are causing issues, so I don't have any sort of diagnosis. Could I be considered intersex? Is there any point to thinking abt it if I'm abt to start testosterone anyways? (also-- are there any conditions that just cause androgenisation? Bc I don't have any of the other symptoms of pcos)

Hi there! I’ve sorted this ask into sections for organization and easier reading. Since this regards whether being intersex or not, I will make it clear here and several times within the post that I am very inclusive in what intersex is.

Are you intersex?

Immediately, I’d say yes, you are, fullstop. Hyperandrogenism is an inherently intersex condition (which is an opinion of mine that I believe is true). There is definitely a vocal minority of intersex (and especially perisex people too) who think that you need more “qualifications” to be intersex. However, I don’t think that to be true. There is a large number of people in the intersex community who will welcome and accept you as you are and understand and truly see you as another intersex individual. To those who don’t agree, ignore them the best you can.

I also saw that you mentioned that it’s not something you can self-diagnose which can be true, but one does not necessarily have to go through medical processes to figure out you’re intersex. It’s okay if you decide you aren’t inherently intersex because of your hyperandrogenism or that you don’t want to label that way, but you are absolutely welcome to. If you feel like something additional might make you count as intersex,

Many individuals learn they’re intersex without having gone through any diagnoses or hidden altering of their body by medical professionals and find out on their own time throughout their own life. For example, if someone had ovotestes with a formed vagina and penis, but this was missed throughout their life and they grew up as and were raised as female, they might one day begin to question if they are perisex or intersex, and it would be completely fair of them to decide being intersex describes their life experience without going to a doctor who can test to see if they have ovotestes.

How are you intersex?

You are experiencing hyperandrogenism, which is an intersex condition of excess androgen hormones. This leads to increased “masculinization” of the body based on traditional views of masculinization vs feminiziation. This is a condition that does not need a diagnosis to know that one has. Hyperandrogenism is not to be confused with the mazculinizing effects of testosterone HRT as many trans+ individuals who go on testosterone HRT develop features that those born with hyperandrogenism already developed without it.

Potential diagnoses

I see that you mentioned LOCAH in your second ask, which is a great start. Before you sent that, I was going to say you could potentially have NCAH/LOCAH as my main recommendation. If you’ve done your own research, you might know this already, but I’m going to explain again just in case.

CAH stands for congenital adrenal hyperplasia and it is a group of genetic disorders affecting the adrenal glands. Adrenal glands control cortisol, mineralocorticoids, and androgens. CAH is split into two categories–classical and nonclassic(al).

The chances of you having classical CAH are extremely low as it can be life threatening and is almost always diagnosed at birth. Classical CAH (usually just referred to as CAH) is split into salt-wasting CAH and simple-virilizing CAH/non-salt wasting CAH, the latter often being less deadly. Both of these produce too little cortisol and produce extra androgen. Salt-wasting CAH has an extremely low aldosterone count, which is necessary for processing sodium, hence “salt-wasting”. Non salt-wasting CAH is like salt-wasting CAH but with a less severe aldosterone count.

The symptoms of classical CAH include but are not limited to:

Ambiguous genitalia for those who were assigned female at birth (often with genitalia looking like a penis but having internal female sex organs)/clitoromegaly

Larger penis at birth for those were assigned male at birth

Premature puberty

Androgenization/masculinzation of those who were assigned female at birth (like the things you described, deeper voice, facial hair)

Infertility

Benign tumors

Nonclassic/nonclassical CAH, or NCAH, is a far more likely candidate. NCAH is also less commonly known as LOCAH, the “LO” standing for late onset. The symptoms of NCAH include but are not limited to:

Ambiguous genitalia for those who were assigned female at birth(less frequent and severe than classical)/developed clitoromegaly

Early puberty

Androgenization/masculinzation of those who were assigned female at birth especially during and after puberty

Larger penis with smaller testicles in those who were assigned male at birth

Irregular periods

Infertility

Hormonal disorders/issues with individuals with NCAH are significantly lower but not insignificant. Those with NCAH often have issues with the synthesis of hormones like cortisol that are associated with the adrenal gland are often asymptomatic or unrecognized in tests.

It’s totally possible you could have another intersex condition, or not this at all. Regardless of why you experience hyperandrogenism, you do, and that alone makes you intersex.

You could also have PCOS. Ironically, you can have PCOS without having cysts. Symptoms of PCOS include:

Hyperandrogenism

Irregular periods

Large ovaries

Cysts on ovaries

Clitoromegaly

Skin tags

Hyperandrogenism can be a symptom of an adrenal gland disorder, those of which include but are not limited to:

Cushing’s syndrome

Addison’s disease

Adrenal gland tumors

CAH

Adrenal gland cancer

Pheochromocytoma

Diagnosis advice and testing/screening

Whether or not seeking a diagnosis is worth it is up to you. Because you have to outward health concerns because of your hyperandrogenism, it can be hard to qualify for testing. Being diagnosed with an intersex condition can lead to medical mistreatment, malpractice, and abuse, as well as difficulty in transitioning. I don’t want to say what you should do because I don’t want you to make your decision based off of anyone but yourself.

It can be difficult to test for NCAH once you have gone on HRT as tests for NCAH are usually done via checking the hormone levels in your body. I was actually in a nearly identical situation to yours when I was questioning if I was intersex, so I totally relate to you on pretty much everything! I was already on T by the time I was questioning if I was intersex, which meant testing would involve me going off of T (which triggers my dysphoria) and could be difficult because of the effects T had on my body.

Based on my knowledge, there IS a genetic test for NCAH, but I’m not sure how easy it is to get. If you want to be screened for NCAH, ask your doctor about it.

You could also be screened for PCOS, but the screening for PCOS can be very dysphoria inducing if things regarding your genitals or genitalia being inspected triggers that if you have dysphoria, as well as the fact that many gynecologists aren’t trans+ friendly or intersex friendly. Gynecologists can also be tough because many gynecologists aren’t required or refuse to give patients things that reduce pain during procedures or inspections. It can be tough to find one, but don’t be discouraged!

Going on HRT

Any trans+ patients starting testosterone should be starting with microdosing and have various things in their blood checked before they start HRT (things such as red blood cell count, bone density, testosterone count), etc. After you start, especially since you have hyperandrogenism, it’s really important to have your blood drawn at least once a month to check various levels. (Or modified based on doctor recommendation.) Starting HRT must be closely monitored in order to know and ensure your body is healthy and to figure out if you should increase or decrease a T dosage.

When I started T HRT, my testosterone wasn’t checked before hand or the records of it were inaccessible to my doctors, so I went from having an above average T count for a person who was assigned female at birth to a person with a T count ABOVE the average for cis men regardless of body size. And you must consider I am a tiny person (I was 4’11 and ~95 lbs at the time). My doctors ALSO thought I was dying, haha. They called all freaked out! Turns out I was fine.

Trans+ health doctors don’t usually think to check for potential intersex conditions that could affect HRT in my experience.

Make sure you advocate for yourself during your transition. It can be difficut but it is necessary!

Final notes

I saw you mentioned that you’ve been IDing as transmasc and the phrasing sorta makes it sound like you’ve been questioning that, so just in case–if you’re are questioning if you’re transmasc or not because you’re potentially intersex, you can still be transmasc! Generally speaking, transmasc is used to be synonymous with FTM and means someone who was assigned female at birth and then later identifies as/realizes they’re masculine-aligned or male*. I’d also like to say just, gender wise, label wise, you can do whatever you want, always. It doesn’t matter what people think. If not, ignore me and my little soapbox because I just wanted to make sure you know that!

And thank you for the kind words about this blog, I hope I can reach more and more intersex people on Tumblr and help as many people out as I can. And don't worry about "spamming", you didn't spam but even if you did I love spam so no worries. If you want to chat further you can DM me on here or on my Discord (which I can give via DM or via an ask off of anonymous and then I'll answer you privately)

If you have any other thoughts, questions, comments, concerns, etc., please let me know! Even if it’s just that this helped! I love getting to answer asks and help people out.

If I accidentally skimmed past any of your questions or concerns, let me know and I’ll edit this post to include any information.

And to anyone, if you see any false information, typos, grammar mistakes, formatting issues, etc., please let me know and I will change it.

*I’d like to make it clear that I fully support people who use this term otherwise. There is a significant number of intersex people who identify as transmasc because it describes part of their experience even if they were assigned female at birth. The terms transmasc/fem/neu(tral), FTM, MTF, FTNB, and MTNB are often used differently or used in a way that doesn’t fit the traditional expectations of many other queer people by groups such as: intersex people, bigender, multigender people, genderfluid people, genderflux people, genderqueer people, genderfucked people, and more. I absolutely support genderfuckery but also acknowledge that understanding of the term in how it’s usually used is necessary for understanding many individuals or conversations when the term is used.

[doberbutts]

Well, PCOS can do that. That's why most intersex orgs say if you have PCOS and consider yourself intersex due to the effects of high androgens on your body, it's okay to call yourself intersex. I have a trans guy friend who BEFORE HRT had a full beard and deep voice and masculine build, I actually didn't believe he hadn't had T at all yet when I first met him. And he, same thing for me. Actually me mentioning that he could be intersex because I was pretty sure *I* was intersex at the time is what led him to discover that he has PCOS. So it is very possible that that *is* the correct answer for you.

PCOS is truly the worst-named diagnosis on the planet because 1: it is not a requirement to have polycysts on your ovaries 2: like me, you can have cystic ovaries (well... apparently I only have the one 😅) and not have PCOS 3: it is not a requirement to have ovaries at all because cis men (and, presumably, transgender people who were assigned male at birth) have alllll of the various markers including genetic markers and assorted symptoms EXCEPT the period stuff, because they don't have the organs to have the period stuff with 4: it's so underdiagnosed AND misdiagnosed that it's possible what we're calling PCOS is actually 4 or 5 different things with similar symptoms. A lot of people with CAH and NCAH get misdiagnosed with PCOS and then re-diagnoaed as the correct one when treatments aren't working or if their body goes into a crisis.

Good luck to you and your quest for answers! I hope you can find a doctor that you can really trust.

question 4 intersex people, i know cis men with micropenises are considered intersex so my question is, can a trans man call their bottom growth from hrt a micropenis or is that like, stealing intersex terminology. like if someone were to say they have a micropenis when they arent intersex would they be misrepresenting themselves as intersex or can they use that word too

[hazel2468]

Alright. I said I was going to rave about every good doctor I have, so y’all get to hear about it.

I have a new endocrinologist. I left my old one after he gave me shit about my weight and not working out in the middle of a fucking pandemic, when I am HIGH RISK. He then diagnosed me with obesity for the first time, despite me having been technically in that category for... Years, at this point, after I called him out for being ridiculous and informing him that I was more concerned about not dying of fucking COVID than gaining a few pounds over two years.

Well. I saw my new doctor, and she was AMAZING. She asked me, at the start if our appointment, if I was interested in talking about weight management or not. I said no. She said okay. She brought it up once more, with regard to some conditions that I am being tested for, but she stated that it COULD help, but there was no pressure on me to talk about it if I didn’t want to. So that was awesome.

She was super friendly. Asked me a lot of questions, made no assumptions about anything. She explained everything she wanted to test (and, as a bonus, all my bloodwork so far has come back totally normal! I’m in good shape) and also did some tests that I’ve never had before- things that, honestly? Other doctors should have fucking noticed. She is the FIRST medical professional to want to test me for PCOS, ever, and she seemed surprised when I told her that, seeing as I meet some of the criteria. She’s also testing me for something that I had never heard of, CAH, so that’ll be interesting.

Basically, she’s the first person to look at me, listen to my concerns, and decide to test me for a condition that I probably should have been checked for years ago. Two of them, although CAH is apparently rarer? IDK much about it.

Anyway. She was awesome, and I will 100% be keeping her and dropping the appointment I had with my other endo, which I only took so he would keep refilling my meds until I got someone new. My new doc even gave me some recs for primary care doctors that she knows and likes, so I’ll get to finally look into that as well!

[kissimirrit]

I loved your rating for Kanata No Astra and I was wondering if you have any other ratings for intersex characters in shows? I only know of Stevonnie.

omg thank you so much!! 

unfortunately i don’t have any other ratings, intersex characters in any form of media are rare and virtually unheard of in majorly published forms. they’re easier to find from content creators who self-publish online— but that’s still pretty rare and hard to find. 

the only intersex characters that i know about in animated or drawn media is:

IS: otoko demo onna demo nai sei (INTERSEX: the sex that is neither male nor female) — a manga entirely about an intersex character and how his intersex variance shapes his life, sexuality, and gender identity. which is a very real a true experience.

stevonnie from steven universe

luca espocito from astra lost in space

yoite from nobari no ou (i haven’t read it, since it’s only revealed later in the manga; so i can’t attest if he’s good representation or not.)

astra lost in space has an AMAZING intersex character, and it wasn’t until i finished watching it, twice, that i realized stevonnie actually isn’t really that great of intersex representation (from my own intersex perspective, that is! many other intersex people feel differently). 

what i love about stevonnie is that they’re many people’s first introduction to intersex characters (and being intersex in general) in a major franchise. they were MY first intersex representation, and genuinely i cried when it was canonized they were intersex. i love and do whole-heartedly appreciate stevonnie and what their character means to many intersex people around the globe. i have never seen perisex folk talk about intersex bodies and struggles until stevonnie came into existence, (despite that still being a pretty rare occurrence.) and for that, i am so so thankful. 

so for stevonnie? i’d personally rate them a 6/10 in terms of intersex representation. their mere existence has already done a lot and made a huge impact, but their intersex variation just doesn’t feel real and i feel like it just serves as a way to make them “biologically nonbinary” or to further reinforce the fact that they’re nonbinary, which doesn’t sit right with me. it leaves a lot to be desired, and could further add to the misinformation and ostracization that we’re some mythical “third-sex” or “hermaphrodites”. 

i really love stevonnie, despite how much i might rant and rave about them. i just have a lot of feelings upon seeing “my first ever representation!!” and then finding other and better representation, then having to face the fact that, oh, huh.. stevonnie isn’t that good actually?  maybe if stevonnie’s variation mimicked an actual intersex variation i might feel otherwise. CAH/nCAH, androgen excess PCOS (which is a debate in-of itself, but i stand by any person with PCOS who wishes to call themselves intersex), ovotestes, or, well, literally anything. but that would sorta require stevonnie to have a “biological sex” i guess, which also doesn’t sit right with me considering that they’re most likely meant to be “biologically nonbinary” which... also doesn’t sit right with me if they’re supposed to be intersex. i just have a lot of feelings about it, i guess. 

so like. shrug. that’s my 2 cents.

[dyemelikeasunset]

you mentioned jay is intersex and now im wondering; do you have any other intersex ocs? (and, if you do, what are their intersex variations?)

Yeah I’ve been planning on it for a while! I’m still doing my research but at the moment my 3 for-sure intersex ocs are Jay, Jacki, and Erin

I’m still debating between Non-classical CAH or PCOS for Jay. I actually think Jay and her family don’t quite know themselves what her condition is either, but the symptoms are probably more like NCAH. Like I said in a previous post, the effects of being intersex affected how she was able to connect with other girls around her age, but she really embraces who she is now. She mainly identifies as a cis girl and uses she/her pronouns, but occasionally he/him and calling herself a “boy” happens.

Jacki (who used to be my pangoro gijinka and is now homed in Un!Lucky) has classic CAH. I’m not quite sure how it really works seeing as he’s an inanimate object now… lol, but I’d always planned on Jacki to be designated male at birth but with XX chromosomes. They use he/they pronouns and are generally on the androgyne/masc spectrum

Erin from Starless will be getting an updated visual design since he’s going to be an alien now. But his race of aliens have very similar genetic makeup to humans, so his intersex condition is still rare. I’m not sure if it’ll have the same name, but their condition is Klinefelter’s syndrome (sorry if there is a better term for it, but essentially they have xxy chromosomes). Erin is very genderfluid and likes to change up her presentation often. She uses he/they/she pronouns depending on the day(edit: i forgot to credit @beedalee for this colored bust of Erin!! thank you baby boo!)

At the moment all 3 of them have gender-flux identities, so I wanna make sure to expand my horizons and eventually make intersex ocs that are more binary cis or trans

[iamthestrangerinmoscow]

my thoughts on the ‘are genital preferences transphobic’ controversy

[warning! includes discussion of reproductive anatomy and may cause dysphoria in some people]

I don’t want to spend four paragraphs on the introduction so I’ll just say it now - no, I don’t think genital preferences are transphobic because it is not a trans only thing. (However, making generalizing statements like ‘I would never date a trans person’ is definitely transphobic, and I’ll explain why in a minute’).

When people say they wouldn’t date or have sex with a trans person, they are making a generalizing statement which they think makes sense - but it actually doesn’t. What they actually mean is ‘I wouldn’t date or have sex with a person whose anatomy doesn’t match societal norms of what their anatomy is supposed to be like’. And the problem with that switch is that it is profoundly inaccurate.

So let’s say a cis straight man doesn’t want to date a trans woman because she doesn’t have a vagina. Well, first of all, he is already making a categorization mistake because some trans women have vaginas! Bottom surgery is a thing. Sure, it is not accessible to all trans women, and some trans women don’t want it (and that’s okay!), but it is still a categorical mistake. Same goes for trans men since they also can get bottom surgery. ‘No trans woman has a vagina’ is an incorrect statement, just like ‘no trans man has a penis’.

And the second categorical mistake here is ‘all cis women have vaginas’ or ‘all cis men have penises’. And this one is rarely mentioned in the debates, and I don’t know why, because it is probably the more important point. Not all cis men and women have the same reproductive anatomy because of many different reasons and it seems like nobody is aware of that.

Some women are intersex. For example, women with CAIS (complete androgen insensitivity syndrome) are born with external genitalia that isn't in any way ambiguous, but with no uterus, no ovaries and internal testes. And women with partial AIS might have a small or narrow vagina and an enlarged clitoris that resembles a small penis. Women with CAH (congenital adrenal hyperplasia) can also have an enlarged clitoris, a small vagina, even labia minora that resemble testicles, and a uterus and ovaries at the same time. There are a lot of possibilities.

Some cis women aren’t intersex, but still have anatomy that doesn’t match our societal ideas of what biosex female bodies are supposed to be like. Some women just have a really small vaginal canal that makes penetrative sex impossible. Some have high testosterone levels due to conditions like PCOS (polycystic ovarian syndrome) which can also cause an enlarged clitoris (up to 5cm!) and labia minora, and fragile vaginal walls that make penetrative sex very uncomfortable and potentially dangerous. Hell, 1 in 20 000 biosex females is born with a cloaca! Nature isn’t binary!

Some cis men have micropenises, for various reasons - intersex conditions, hormonal differences, physical trauma to the testicles, etc. Some cis men have no penises - due to accidents or cancer. Some cis men have persistent erectile dysfunction that makes penetrative sex tricky or impossible. Some men just have small penises, for no reason other than natural variation in the human species, but it might still make penetrative sex difficult.

So what I am saying here is that if a cis woman were to tell you ‘hey I have CAH so my clitoris is really big and vaginal sex is very uncomfortable for me’, would you immediately dump her? If a cis man were to tell ‘hey I am an army veteran and I lost my penis in an accident’, would you immediately dump him?

Maybe you would. I’m not saying you wouldn’t, or that it is necessarily a bad thing (though you have to agree, it is a little bit shallow). What I’m saying is, you are making a semantic mistake by equating ‘I wouldn't date a trans person’ with ‘I wouldn’t date a person if I can’t engage in penis-in-vagina sex with them’ or any other similar statement.

It’s simply an incorrect logical argument. It’s like if you didn’t want to date someone with red hair and made a chain of conclusions like this: I don’t like people with red hair; there are many people with red hair in Ireland; therefore I don’t want to date Irish people. And the problem with this is that not all Irish people have red hair, and not all people with red hair are Irish. See my point now? And if you made a video titled ‘why I would never date an Irish person’, what point would it achieve, apart from making Irish people feel bad?

And like, I get it. Maybe you really don’t want to date a woman with a penis, so you exclude some trans women and some intersex women and some other women as well, and that’s fine. You can’t change your preferences. Maybe you only want to date a man who has a large biological penis, so the first thing you ask them on Tinder is ‘how big is your dick?’ - I get that. Some people only want to date people who will beat them with a baseball bat and keep them on a leash - that’s fine! As long as it’s safe and consensual. None of those preferences are inherently bigoted.

It all kinda goes to hell when you start making generalizing statements based on ignorance, misinformation, and stereotypes. When you say ‘I would never date a trans person’ and then run to us to ask if that’s okay so that we can validate your preference and make you feel better. When you make a video after a video telling us again and again how unlovable and undesirable we are and expect us to not react to that. That’s when it gets transphobic.

And look, it’s fine. We all have transphobic ideas to unlearn, even trans people. If you really, really don’t want to ever date a trans person, for whatever reason, I’m not saying you have to change it. Is that transphobic? Yes, but that’s fine, because those are just your thoughts that you can’t control or fix. What you can fix is what you say and how you act. Just don’t go around telling everyone about your preferences and how you have a right to have them. Of course you do! You also have a right to, I don’t know, eat pine cones. Doesn’t mean you should eat pine cones just because you have a right to.

(Also, who cares? If you enjoy eating pine cones, do it, but don’t make videos yelling about how you are so oppressed because of your preference for eating pine cones...)

If you are dating someone and then you find out they are trans, or intersex, or infertile, or whatever, you have every right to break up with them for any reason - but you can be nice and civil about it. Instead of saying ‘I’m breaking up with you because you are trans’, try ‘I’m breaking up with you because sex is important to me and I need a partner who I can do certain things with’. Yeah, exactly - it’s that easy!

And finally, if you just, you know, really want those juicy views, try making videos titled ‘why I would never date a guy with a tiny penis’ or ‘why I would never date a girl who has facial hair’ or something like that. I’m sure you will get much more views and comments and will make much more than 2% of the population feel bad, and at the end of the day, isn’t that what you really want?

End of conversation.