#testosterone and women

[coochiequeens]

This article is from last year but since I posted about detransitioners earlier this week I think this is relevant

Testosterone Therapy in a Transgender Male Patient as a cause of Acute Ischemic Stroke (P2-5.011)

Christina Tan, Lauren Kim Sing, Ron Danziger, Alex Aw, Chae Kim, Stephen Avila, Vilakshan Alambyan, Angud Mehdi, Michael Gezalian, Maranatha Ayodele, and Shahed ToossiAuthors Info & Affiliations

April 25, 2023 issue

Objective:

To share an intriguing case of a young transgender male patient receiving testosterone therapy who developed locked-in syndrome due to an acute ischemic stroke and to highlight potential risk factors for stroke in the LGBTQI+ community

Background:

There are many studies identifying risk factors for stroke in racially and ethnically diverse populations. However, there is little existing data for stroke risk factors in the LGBTQI+ community. Prior research has shown testosterone therapy in cis-gender men with initially low levels of testosterone increases the risk of stroke, especially in the first 2 years of use1. While testosterone therapy has been shown to increase the risk of venous thrombosis, its role in arterial thrombosis is unclear2. A proposed mechanism for thrombosis with testosterone replacement includes erythrocytosis, but the potential contribution of an independent pro-coagulant effect is yet to be determined3.

Design/Methods:

Literature review and case report.

Results:

An otherwise healthy 23-year-old transgender male on one year of testosterone therapy presented in an obtunded state. Examination revealed complete quadriplegia with sparing of vertical eye movements, consistent with locked-in syndrome. Imaging revealed complete occlusion of the basilar artery with distal reconstitution at the superior cerebellar arteries, and a large bilateral ischemic infarct of the pons. Computed tomography angiography did not demonstrate other large vessel disease or structural vascular abnormalities. Unfortunately, the patient was out of the time window for any acute stroke interventions. A hypercoagulable workup was performed but results were unrevealing and hematocrit was normal. Further investigation with transthoracic echocardiogram, transesophageal echocardiogram, and telemetry were negative for thrombus, patent foramen ovale, and atrial fibrillation.

Conclusions:

Acute ischemic stroke may be an under recognized complication of testosterone therapy in transgender males independent of degree of erythrocytosis. Further research is needed to establish a safety profile of testosterone therapy in this understudied population.

Disclosure: Dr. Tan has nothing to disclose. Mrs. Kim Sing has nothing to disclose. Dr. Danziger has nothing to disclose. Mr. AW has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Avila has nothing to disclose. Dr. Alambyan has stock in Teleflex. Dr. Alambyan has stock in Natera. Dr. Alambyan has stock in Labcorp. Dr. Alambyan has stock in Veracyte. Dr. Alambyan has stock in Vicarious Surgical. Dr. Alambyan has stock in Unity Biotechnology. Dr. Alambyan has stock in Scynexis. Dr. Alambyan has stock in Stryker. Dr. Alambyan has stock in Eli Lilly. Dr. Alambyan has stock in DaVita. Dr. Alambyan has stock in Invitae. Dr. Alambyan has stock in Pfizer. Dr. Alambyan has stock in Bristol-Myers Squibb. Dr. Alambyan has stock in Johnson and Johnson. Dr. Alambyan has stock in Merck. Dr. Alambyan has stock in Medtronic. Dr. Alambyan has stock in AbbVie. The institution of Dr. Alambyan has received research support from Albert Einstein Healthcare Network. Dr. Mehdi has nothing to disclose. Dr. Gezalian has nothing to disclose. Dr. Ayodele has nothing to disclose. Dr. Toossi has nothing to disclose.

[genderkoolaid]

we need more stories about high femme prom queen types who become weird faggy guys. you haven't seen Behaviors until you've seen a repressed closeted tboy holding on to socially acceptable heterosexual femininity by the skin of his teeth

[canidaezy]

how do transmascs not want to kill themselves all the time honestly

[actualalivecreature]

stop associating testosterone with only men and estrogen with only women. thanks.

[antiyourwokehomophobia2]

I wish women did not feel so strongly about the fact men, on average, are physically stronger than them. I feel like women have such negative feelings about this that it drives them to ridiculousness. Listen, I get it. I get it, I get it, I get it. The fact men are stronger is frightening. It’s scary to know that if a man decided to physically attack you then you are probably fucked. The USWNT, women who have spent years honing their skills on the field, lost to teenage boys who—when compared to the women—were basically just beginning to develop their talents. I understand how demeaning that can feel to every woman who hears this fact. I can imagine how demeaning it was for the USWNT. I’m sure every woman has been in a situation, playful or threatening, where they have tested their strength against a man and lost miserably. I’ve seen videos where women hit and slapped men with genuine rage and fury and the man barely even flinched. I understand how embarrassing and scary it can be to come to terms with the strength disparity between men and women, but you simply must come to terms with it. Far too many women have taken to pretending that it's not there—this is not a good approach.

Women choose to pretend it's not there because acknowledging that it's there makes them feel inferior. I ask women to remember that this world was built with the ideals of men in mind and to cater to their specific strengths. Men value strength and violence so of course the world is going to seem like those two things are all that’s valued in it. It's no coincidence that many male heroes are physically strong/easily able to cause harm—such as Naruto or John Wick or the Avengers. Of course it feels shitty, as a woman who inhabits this world, to have to acknowledge that your biology generally prevents you from being able to have the ‘can beat anyone in a fight’ type of strength that gets constantly praised.

However, I implore women to consider that men being physically stronger than them is no more of a significant fact than women being able to give birth while men cannot. Women also have biological advantages over men but when was the last time you saw a man calling himself inferior because of them? Imagine if the world was built with female advantages in mind. Imagine a world where the ability to give birth was seen as some sort of pinnacle of human worth. I mean, the ability to give birth is crazy. You are literally creating a whole new life. The female body is capable of providing the necessary tools to bring about a whole new person. Every brain that has thought of something life changing and every hand that has built something new was brought into existence by a woman’s reproductive system. Every single person that has ever so much as breathed was brought to life by a woman, but men never think women are superior for this fact.

Oh, but women couldn’t get pregnant without men, right? No. IVF exists. But even without it, the correct thing to say would be that women cannot get pregnant without sperm. A woman can get artificially inseminated. She never has to go out and find a man to have sex with. Is that not an advantage? Because, I mean, what can a man do if he wants to have a child but no woman is willing to give him one? Hire a surrogate? That comes with a list of complications, is far more intimate than artificial insemination, and is incredibly expensive. How is that not a disadvantage of being male? You may be thinking that you, as a woman, never want to become pregnant, but that is not the point!  The point is that it's arbitrary to look at biological advantages as anything other than completely neutral.

Women also survive famine better and live longer than men. Imagine a world where women held this over men’s heads? But we don’t live in that world. In this world, I’m certain a man would say that they die sooner because of being braver, taking more risks, and doing dangerous jobs. However, if it were women putting themselves in danger and dying as a result, men would not be quick to call us brave; they'd call us the opposite. Idiotic. Foolhardy. Too stupid to take the necessary precautions to keep ourselves alive.

It is just so painful to see women lamenting over the physical disparity between men and women. Let it go. Consider being neutral on the subject of biological advantage. Consider that male strength isn't something to pretend doesn't exist and isn’t something that proves women are inferior.

I understand that acknowledging vulnerability is against the survival Instinct—I get it—but come on. How can we let this get to a point where we’re saying it’s okay for males to enter female sports and beat the absolute crap out of/wipe the floor with women? Them being stronger is neutral! It does not mean anything! But it’s fact. Pretending it’s not only serves to put women in a losing position. Pretending it’s not only serves to make women into a laughing stock. Men will gladly collect medals that belong to women—they’ve been doing that forever. If there was no reason for male and female leagues then there wouldn’t be any. You cannot deny your way into something being true. I also wish it were true that the average woman was evenly matched against the average man, but it’s simply not reality. In the same way that it’s not reality that the average woman is taller than the average man.

I am begging women to think neutrally about this topic instead of being in such deep turmoil over it that they open the door for men to walk all over us.

[anarcho-catboyism]

"You don't need HRT to be valid, you are just as valid without HRT" Is 1000% true, and yet Cis people really love saying that to trans people specifically seeking out HRT.

Like we get it you don't want us on those scary hormones.

[scramratz]

Occasionally I’ll accidentally check the reblogs on my trans comics and be met with some of the stupidest pseudoscience known to man

[uncanny-tranny]

I'm going to be real, I've been on testosterone for multiple years and my levels have been very consistently high and whatnot, and yet I haven't gotten to the point where my testosterone "makes" me act in possessive, creepy ways toward women. Not even the women who are drop-dead gorgeous to me!

And that's because it's not about testosterone. It's about the way you choose to interact with women. When you devalue them already, no amount of testosterone is going to influence you further.

[transpolling]

saw this on instagram and figured i’d repost here. be careful everyone.

[funhouse-mirror-barbie]

JK Row-Row straight up said “I can excuse a child-rapist being allowed to compete in the olympics, but I draw the line at letting a cis woman that doesn’t fit into my hyper-specific idea of what a woman should be compete!!!”

[unlimitedbutchworks]

i know it’s bitchy and kinda unfair but id be lying if i said it didnt irritate the hell out of me as a trans woman seeing tme lesbians treat the idea of lesbians being with trans men and still identifying as lesbians as some kind of forbidden lost knowledge of magical hybridities and perspectives, rather than the common standard female4female bioessentialist and transphobic set of norms they often are. like ive never seen lesbians get shit for this irl, meanwhile trans women and lesbians who stand with us are routinely excised and alienated from spaces for ‘enabling poor behavior’, ‘taking too much space’ and ‘dangerous proximity to maleness’, but now i gotta listen to you go on about how you’re reclaiming maleness femalely safely? something’s not adding up…

[genderkoolaid]

the thing that's so annoying about the state of the Trans Discourse here is that anti-transfem transmisogny and anti-transmasculinity both contribute to making trans people unwelcome unless we are deemed close enough to cis women. countless trans men & mascs & FTX people have had the experience of being alienated or directly kicked out of queer spaces for being too male/masc. but people have this absolutist perspective that this must be an experience ONLY had by trans people assigned male & that trans people assigned female are only ever read as feminine and female in the exact same way cis women are. because if we acknowledge that then maybe we'd have to acknowledge how trans (& intersex & GNC) people are demonized in relation to our real or percieved masculinity and maleness

[gendiebrainrotreceipts]

So many people (including jkr) are calling imane Khelif a biological male/TIM when as far as I can find out she’s a intersex woman

[pinbones]

There's two types of people who use transandrophobia to decribe transmascs' and trans mens' experiences:

- Simply specificity, language used to hone in on a specific way being trans affects people who just happen to be men

- As both the above and as a springboard to discuss how societal misogyny, radical feminism, gender stereotypes, and bioessentalism affect all people who can be pecieved as men or masculine by others, and how bigotries compound in meaningful ways with stereotypes and bigotry surrounding maleness and manhood

Like. Half of you are saying "maleness is a hollow experience which is standard, and exists in opposition to gendered oppression, and transandrophobia is therefore when dudes experience misogyny and transphobia"

and half of you are saying "Being percieved and/or transitioning towards male uniquely affects how I am treated, because, for example, how people perceive my blackness or mental illness or kinkiness or femininity is compounded with my manhood in ways that don't usually happen to gender conforming cisperi women"

Which are two fundamentally different approaches to transandrophobia as a concept. One suggests that maleness is a simple downy layer of privilege that coats a person through their male life, and the other acknowledges that a man (or somebody perceived as masculine/male) can experience oppression in ways that those NOT perceived male may not.

Only one of these interpretations is intersectional. Black individuals who are policed more hashly when interpreted as masc know they are risking dangerous experiences when transitioning to male, as has been discussed before on here (to no avail). Male or percieved male people with personality disorders are treated as more dangerous than women with similar symptoms, and are sometiems diagnosed with different disorders entirely based on percieved gender differences. This affects transmascs too, especially considering the already dire state of queerness in psychiatric institutions. Being a male birthing parent is a whole shitshow of transphobia because men are not supposed to give birth, and transmascs are lucky to access related healthcare at all, let alone access it without being ceaselessly misgendered and treated as a stigmatised 'other' to deleterious affects on parent and baby. These are just a few examples, there are many more ways maleness can screw a person over. And that's not to say that female privilege is a thing instead of male privilege, but rather to emphasise that men are not supposed to be minorities. Men are not supposed to be assaulted, men are not supposed to be outliers, men are absolutely not supposed to be trans.

When a man is autistic, he's not just autistic, he's an autistic male, and that makes him more likely to be killed by cops (especially if black). When someone says "you claim you're not ableist but you're scared of the homeless x on a bus talking to xself", they always say the person is a man, because that sounds more significant (and cops think so too). Consider when a person's rape/abuse is considered to not be all that serious due to the victim being male, or when a man's attraction is considered to be more exploitative than a woman's, or when a fat man is considered more creepy/sexist than a thin man or a fat woman. Consider why so many caricatures of evil and creepiness are men with deformities. Consider the fact that men's bathrooms don't have baby changing tables, and that a man may get less support from others after their child's death than the mother might. Maleness can negatively compound with things like minority status, vulnerability, aggression, sexuality, etc. in ways that screw that person over, both in social spaces (such as queer communities that dislike/distrust maleness and masculinity, or how isolation affects men harder), and in more tangible ways, like their rates of suicide and being murdered.

There are tangible ways in which transitioning to male can negatively affect a person's life even if you remove (hypothetically, not really possible) the transphobia element, and these also constitute as worthwhile topics of discussion. If you think maleness is the lack of gendered oppression, then you're not intersectional in your feminism at all. If your life as a male is genuinely sunshine and rainbows (apart from the transphobia if trans), then good for you, genuinely that's great, but not everyone lives in a radfem fantasy world.

Being unable to tell the difference between men talking about mens issues/liberation, and right wingers talking about oppressing women more, isn't feminist. It's ignorant and antifeminist. (MRAs don't care about actual mens lib, and are actively worsening it because they are sexist and opposed to gender lib. You guys know that, right? That male and female liberation aren't oppositional or binary, but the same gender liberation that is entirely oppositional to patriarchy?)

These men and mascs talking about issues facing men aren't ignorant womanhaters who deny misogyny and want ultraprivileged men to be coddled, they are good faith members of your community with experiences just as varied and valid as yours. Treat them like it.

[theworldisoursblog00]

Can’t say what I’m going through

I smile a lot but it’s what I have to do to live…

Pain!

[anarcho-catboyism]

"Hey, there are risks to DIY HRT that need to be discussed and addressed" is NOT fearmongering.

"DIY HRT is always dangerous and you will have bad things happen to you!" Is fearmongering. Making sure trans people have INFORMED consent about MEDICAL PROCEDURES is not!!

DIY is amazing, it saved my life and is my preferred method, but I'm a white trans guy in America with a normal hormone balance. I do not fit everyone's experiences, and it's important to talk about even the shitty risky stuff so trans people who want this can partake in it SAFELY and be PROPERLY EDUCATED.