#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.

[s-exy-sapphillean]

All the shit going on is already upsetting enough but it rly is devastating to keep seeing posts bashing trans men for asking to be included in conversations about reproductive healthcare, trans safety and hrt right now, at a time where solidarity and community is so fucking important

And unironic posts along the lines of "don't forget to include trans men in your no-dating-men practice".

And a post about how trans men aren't safe to date either because they're rapists too with replies full of this

Gender essentialism will doom us all. The fascists don't even need to "divide and conquer" anymore because y'all are just doing that shit for them for free.

[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

[shidoutsukiomi]

I find it a bit strange how it's okay and normal to say trans men have 'afab privilege' but if you say trans women have 'amab privilege', that's bad and wrong and incorrect and also maybe you should kill yourself. strange stuff

somehow trans men were 'socialised female' and therefore can 'get away with being women' but trans women were not 'socialised male' and can't 'get away with being men' cos there's something inherently feminine, inherently queer about them.

though, i spent my whole life being called gay, getting asked if i was a butch lesbian, getting asked if i was a tranny, cos i wore pants [girls!] instead of skirts, cos i wore shirts [girls!] instead of blouses, cos i wouldn't wear dresses and would prefer [girls!] formal wear that weren't dresses, cos i liked bionicle instead of dolls, cos i played video games, cos i swore, cos i liked heavier music, cos my favourite colour wasn't pink, cos i wore caps. i would not say i fit into girlhood at all, actually.

but this masculinity was inherent to me, it still is, i couldn't and can not change it (despite trying, very hard, to my detriment) so i ALWAYS stuck out as being 'too masculine' for other girls. and then i come into queer spaces and i'm 'too masculine' for other queer people - but that's besides the point, currently.

so, currently, when i see people say 'trans women aren't "socialised male," that's not real, they always stick out as "other"' and then turn around and say 'trans men have afab privilege, they can be women to get away with things, they fit into girlhood so well' I can't help but become incredibly fucking frustrated. this is not true and actually it's something we have in common! neither of us were socialised 'correctly' cos we're both trans and raised amongst peers who were not trans!

everything from masculine girls to trans men do not fit into 'girlhood' cos masculinity is not what girlhood is meant to be. this shouldn't be hard to grasp. this is why the 'socialised' concept is bullshit cos it's founded on whatever was forced upon you as a kid and if you don't fit that standard you will not be socialised that way due to, in large part, being fucking ostracised from everyone else. and that doesn't mean there won't be things to unlearn, i know very many trans men who were very feminine for a long time and the opposite for trans women, but someone who clearly cannot fit what's being pushed onto them is going to come off as 'strange' and 'uncanny' to the people who can fit into what's pushed onto them.

but the way people talk about this really highlights to me that yous don't want to consider us trans in the first place - transness is for trans women and not for trans men, socialisation concepts are fake when it comes to trans women but real when it comes to trans men cos they're not really trans, 'amab privilege' would get you branded a TERF or radfem saying it to a trans woman but it's fine to say trans men, trans men have 'afab privilege' cos we're not trans, we're just women. you know until we get a little too rowdy and then we're not trans, we're just men.

maybe i'm just jaded and bitter. idk

[actualalivecreature]

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

[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.

[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.

[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.

[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

[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…

[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

[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.