Welcome to Gender Analysis

Gender Analysis is a web series launched in 2014 exploring transgender science and life experiences in depth, and revealing the many insights to be found at their intersection. We take a closer look at fields such as sociology, public health, psychiatry, cognitive science, and more, weaving these diverse perspectives into a deeper understanding of gender-related phenomena. Gender Analysis goes beyond the 101s to educate both trans and cis viewers on some of the most fascinating dimensions of our lives – and the pressing issues we face in society.

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New episodes of Gender Analysis are published several times a month and are backed by our generous supporters on Patreon. Want to learn more? Check out our instant index for a quick introduction to the wide range of topics we cover:

Curious about…?

Gender dysphoria Self-discovery
How hormones work Bathroom bills
Finding a doctor Treatments for trans youth
Passing Sexuality
Transness and autism Paul McHugh
Regret and detransition Sex chromosomes
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Twice in a million: Heather McNamara on surviving two rare CVST strokes

By Heather McNamara

The first intelligible words I remember speaking when I woke up were “I wish I hadn’t…” 

My mother answered from beside me “Wish you hadn’t what?”

“I don’t know? Drank so much? Eaten so much?”

“It wasn’t one of those,” she said. “The doctor told me. It was a CVST. It’s a very particular kind of stroke that happens because your blood is clotting in your veins.”

“What should I have done differently, then?”

“There wasn’t anything you could do. It was just going to happen.” Continue reading

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AstraZeneca or not, cerebral venous sinus thrombosis is a complex and potentially fatal emergency. Is the world prepared?

Disclaimer: I am not a medical professional and this is not medical advice. The COVID-19 pandemic and investigations into the Oxford-AstraZeneca vaccine and blood clots are rapidly evolving situations. This information may be superseded by later findings. This article was last updated on March 31, 2021.

Zinnia JonesOver the past month, several European nations have halted, resumed, then once again halted their use of the Oxford-AstraZeneca COVID-19 vaccine upon several reports of serious and fatal blood clots in those who received the shot. Initial responses to these reports focused on comparing the rates of occurrence of blood clots as a broad category between populations that had received and had not received the vaccine. Blood clots, discussed generally, can refer to such conditions as deep vein thrombosis, pulmonary embolism, or arterial (ischemic) stroke.

However, additional information soon clarified that these reports of blood clots after the AstraZeneca vaccine were not distributed among these various types of conditions in the same way that is seen to occur in the general unvaccinated population. Instead, blood clots following AstraZeneca have much more frequently been in the form of cerebral venous sinus thrombosis (CVST), a blockage of the veins draining deoxygenated blood from the brain, or disseminated intravascular coagulation (DIC), in which numerous blood clots form throughout the body’s vessels. These patients were also often seen to have a paradoxical severe depletion of platelets, which produce blood clotting, similar to that seen in a rare reaction to the blood thinner heparin.

A key signal involves the rarity of cerebral venous sinus thrombosis (CVST) under normal conditions: CVST is estimated to occur in only 2 to 5 out of every million people every year (Devasagayam et al., 2016). Within the German population given AstraZeneca, over the time period following vaccination, only one CVST would be expected to occur; instead, there were seven, resulting in three deaths. Frustratingly, even if a one-in-a-million condition becomes ten times more common, it may still not be common enough to appear at all in trials of merely tens of thousands of participants – so it might not be possible to detect these rare side effects before one has already administered a treatment to tens of millions. Continue reading

Posted in COVID-19, Personal, Statistics and demographics | Tagged , , | 2 Comments

Additional details on the connection between transgender HRT and migraine headache patterns

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

Zinnia JonesA migraine headache is an astonishingly miserable experience, ever surprising in not only its intensity but its diversity. This is not the milder tension headache or such a common headache but stronger and longer, this is a complex neurological syndrome that can affect us in many disabling or sheerly unpleasant ways. An affliction passed from my maternal grandfather to my mother down to me, since age 3 I’ve had some of the most memorable experiences of my life thanks to frequent migraines. Vomiting so profusely I’d need to be taken home or miss school at least once a week, laying for countless hours in the dark able to do nothing but wait for it to pass, I became intimately familiar with lengthy periods of unbearable, intractable, inescapable pain from a young age.

As I’ve grown, I’ve racked up more and more of the comprehensively bizarre symptoms of migraines: the occasional visual aura of apparent static in the center of my field of vision, the far more subtle feelings of abnormally higher or lower energy or inability to focus in the days preceding it, the near-hallucinatory racing thoughts that I can’t shake as I writhe around the bed fruitlessly trying to get any respite, the euphoria or simple exhaustion that comes when it finally remits. I’ve experienced a range of treatments over time as well, from Motrin that barely touched it, to Excedrin truly making a dent in it for the first time, to triptans that could free you from this in an hour but must come from a pharmacy whose schedule your body has no regard for, to the rebound headaches that make it seem like there can never be such a thing as a free lunch here. I’ve not yet needed some of the other treatments for migraine sufferers, such as facial botox injection, older antidepressants like amitriptyline, anticonvulsants like Topamax, long-acting preventative CGRP inhibitors or short-acting abortive CGRP inhibitors.

One key experience at the nexus of migraine symptoms and medical treatment over time is the way that sex hormones, including masculinizing puberty at a normal age and later feminizing HRT at 23, have shaped and altered these experiences. The wave of testosterone in my early teens acted within less than a year to bring my frequent migraines down to merely a couple times a year. And when I started taking estrogen and antiandrogens, it was a matter of days before I had one of my worst migraines in years, which have since become a once- or twice-monthly occurrence during the eight years I’ve been on HRT. Continue reading

Posted in Biology of transition, Endocrinology, Trans youth, Transfeminine, Transgender medicine, Transmasculine | Tagged , , , | Leave a comment

The Gayest Generation: Trans-hostile interpretations of changing LGBT demographics are baseless and backwards

Zinnia JonesIt’s fantastic news by any measure: Gallup’s latest poll reports that 5.6% of U.S. adults now identify as gay, lesbian, bisexual, or transgender, compared to only 4.5% just a few years ago. And Gen Z (defined here as those born from 1997 to 2002) has emerged as the least heterosexual, least cisgender generation ever recorded, with 15.9% identifying as LGBT compared to 9.1% of millennials (1981-1996) and 3.8% of Gen X. Specifically, Gen Z adults are vastly more likely than millennials to be gay, more likely to be lesbian, more likely to be bisexual, and more likely to be transgender – a rising rainbow tide. Continue reading

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Study of entire French population offers further data on cyproterone acetate and meningioma risk

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

Zinnia JonesCyproterone acetate (CPA) is widely used as an antiandrogen for trans women and transfeminine people outside of the United States, lowering testosterone levels as part of feminizing HRT. In addition to blocking androgen receptors, CPA is also a strong synthetic progestin, acting on the progesterone receptor more powerfully than bioidentical progesterone itself (Hammerstein, 1990). Long-term use of CPA has been established as a risk for developing meningiomas, a type of usually benign brain tumor that expresses progesterone receptors and is stimulated to grow by strong progestins such as CPA (Korhonen et al., 2006). Many of these tumors would otherwise be small and asymptomatic; CPA may not produce them, but it can cause them to grow larger and become symptomatic, requiring treatment with surgery or radiation.

Meningioma has been found to occur more often in those assigned female, who as a group tend to experience higher progesterone levels over their lifetime than those assigned male (Wiemels, Wrensch, & Claus, 2010). Multiple studies of large cohorts of trans women taking CPA have found that they are more likely to develop meningiomas than the general population (Ter Wengel et al., 2016; Nota et al., 2018), and studies of cis women and cis men revealed that high doses of CPA were linked to a greater likelihood of meningioma (Gil et al., 2011). Weill et al. (2019), examining a cohort of 131,485 cis women in France, established that greater cumulative exposure to CPA over time was associated with a steadily increasing meningioma risk, and the European Medicines Agency subsequently stated that any dose of 10mg or more should only be used “once other treatment options, including treatment with lower doses, have failed”. Continue reading

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