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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“Conveyer belt” fallacy against youth transition is missing a crucial piece: all the off-ramps before transitioning

Zinnia JonesAnti-trans advocates have spent years attempting to popularize a folk notion of the process by which trans youth pursue transition, a dramatic picture that scarcely resembles the clinical reality of evaluation and possible treatment for transgender children and adolescents. In this telling, the protocol of GnRH agonists to reversibly delay puberty prior to any decision about HRT is little more than a formality, with puberty blockers actually serving as a “conveyor belt” that universally leads those who take them to continue on to cross-sex hormone therapy. Because of this alleged inevitability, the choice of whether to continue or discontinue transitioning is painted as no choice at all in practice. Arch-transphobe Paul McHugh has long promoted the inevitability argument:

The lack of data on gender dysphoria patients who have withdrawn from puberty-suppressing regimens and resumed normal development raises again the very important question of whether these treatments contribute to the persistence of gender dysphoria in patients who might otherwise have resolved their feelings of being the opposite sex. As noted above, most children who are diagnosed with gender dysphoria will eventually stop identifying as the opposite sex. The fact that cross-gender identification apparently persists for virtually all who undergo puberty suppression could indicate that these treatments increase the likelihood that the patients’ cross-gender identification will persist.

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Posted in Gender dysphoria, Hoaxes, Trans youth, Transphobia and prejudice | Tagged , , , , | Leave a comment

Second report of trans man undergoing successful fertility preservation without stopping testosterone – this time producing a viable embryo and live birth

Zinnia JonesOver the past few years, several studies have explored how the use of testosterone as part of transmasculine transition can affect the potential for fertility in those who still have ovaries. These findings have represented a steady progression toward overturning much of the conventional wisdom on fertility in the context of HRT. Although it has long been known that testosterone is not an effective contraceptive for trans men and transmasculine people who still have a uterus and ovaries, and both intended and unintended pregnancies have been reported while on testosterone (Light et al., 2014), pausing HRT to undergo fertility preservation procedures such as oocyte (egg) retrieval has been a widespread practice. This pause can lead to undesired effects, such as worsening gender dysphoria and the resumption of physical feminization (Armuand et al., 2017).

Along these lines, researchers have examined how long of a pause in testosterone is needed for successful retrieval of viable eggs, and the findings have been promising: Among a group of trans men who had been taking testosterone for an average of 3.7 years and paused HRT for an average of 4 months, all were able to retrieve normal numbers of oocytes that later led to successful pregnancies. In another case report, one trans man paused testosterone for only 24 days and underwent successful oocyte retrieval and preservation during this time. And this year, clinicians reported that a trans man who had been on HRT for 18 months had successful fertility preservation of 22 oocytes while not pausing testosterone at all. Continue reading

Posted in Biology of transition, Endocrinology, Fertility and reproduction, Transmasculine | Tagged , , | Leave a comment

Additional data confirms 10mg of cyproterone acetate (CPA) is effective for testosterone suppression in trans women

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

Zinnia JonesThe antiandrogen cyproterone acetate (CPA), taken as a daily pill, is commonly used outside of the United States as part of hormone therapy to suppress testosterone levels in trans women and transfeminine people who still have their testes (Hembree et al., 2017). Although CPA blocks the action of testosterone at androgen receptors and reduces the body’s production of testosterone, it also strongly stimulates progesterone receptors, potentially producing undesirable effects.

In recent years, increasing attention has been given to the role of CPA in spurring the growth of meningiomas, brain tumors which are usually benign and frequently express progesterone receptors (Roser et al., 2004). While these tumors may have already existed at a very small size without any apparent symptoms, and in many cases may remain unnoticed indefinitely (Yano et al., 2006), the presence of a strong progestogen such as CPA can cause them to grow over time to a size that produces symptoms such as headaches, vision loss, and seizures. Meningiomas are also known to be responsive to the body’s own progesterone levels, with cis women being significantly more likely than cis men to develop meningiomas (Sun et al., 2015), but CPA’s progestogenic effect is substantially stronger than that of progesterone itself (Hammerstein, 1990), and numerous cases of meningioma in trans women taking CPA have been reported in the literature (Nota et al., 2018). Continue reading

Posted in Antiandrogens, Endocrinology, Oncology, Progestogens, Transgender medicine | Tagged , , | Leave a comment

Three decades and hundreds of transfeminine breast augmentations show rare regret and trends toward larger implants

Zinnia JonesTrans women and transfeminine people seeking breast augmentation as part of medical transition face certain concerns distinct from cis women who may receive this surgery. Our anatomical baseline is very different from that of adult cis women, with a recent study finding that 7 in 10 trans women developed breasts of less than an A-cup after three years of feminizing hormone therapy, and only 58% stating that they were satisfied with their breast size.

This surgery is also in heavy demand among trans women, as around 80% either received this surgery or desired to receive it, and 85% of recipients stated they sought the surgery because of insufficient breast growth on HRT. Given anatomical differences in our upper body shape and size, the Johns Hopkins Center for Transgender Health has published information on specific techniques and approaches to produce the best aesthetic results for post-pubertal trans women.

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Early use of masculinizing steroid oxandrolone in trans boys can add 2 more inches of height compared to testosterone

Zinnia JonesLast year, I briefly covered an abstract by gender clinicians at Children’s Mercy Hospital describing the use of oxandrolone rather than testosterone as a part of masculinizing hormone therapy for adolescent trans boys, with the intention of both producing physical masculinization while increasing their final adult height to be more similar to that of cisgender men. This represented a new kind of treatment, as typically increasing final adult height is a matter of making certain necessary tradeoffs in hormonal management of trans youth during puberty.

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