Just out: Study of trans adolescents confirms puberty blockers and HRT are associated with improved mental health

Zinnia JonesThe use of puberty blockers and cross-sex hormone therapy for trans adolescents is not a new or recent development, and this protocol has been in use since the mid-1990s. Clinical data on outcomes in this population is abundant: numerous studies of trans youth who’ve taken puberty blockers have shown significant reductions in gender dysphoria, depressive and anxious symptoms, self-harm, and suicidality, along with improvements in body satisfaction and overall psychological functioning and quality of life. Despite uninformed depictions in the press as an untested treatment fraught with unknowns, adolescent transition has consistently been found to have strong beneficial effects for gender-dysphoric youth, and major medical and pediatric organizations endorse this as a suitable and necessary treatment for appropriately evaluated youth.

This is hardly so new that nobody knows what it does. So the latest study of this treatment by Tordoff et al. (2022) simply adds further confirmation to a large existing body of evidence that clearly points in one direction: adolescent transition helps trans youth. Continue reading

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Beckman Coulter Access Sensitive Estradiol test, subject of FDA adverse event reports, may give falsely low readings for trans women on oral HRT

Zinnia JonesHRT for trans women and transfeminine people is intended to lower testosterone levels and raise estrogen levels to those typically seen in cis women, which is confirmed through observed clinical effects and laboratory measurement of hormone levels. Guidelines such as those offered by the Endocrine Society recommend monitoring hormone levels at least annually, maintaining estradiol levels between 100-200 pg/mL and testosterone below 50 ng/dL (Hembree et al., 2017).

Estradiol, taken via different routes such as oral or sublingual tablets, transdermal patches, gel, or intramuscular injections, can differ in how it is metabolized and how effectively it raises estradiol levels. This is reflected in studies of estrogen levels in trans women taking various types of estradiol: transdermal patches may produce lower levels than tablets or injections, while tablets taken either orally or sublingually produce far higher levels of the metabolite estrone than patches or injections. Continue reading

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Contra social contagion: Why online community among trans people saves our lives and terrifies our enemies

“Trans vlogs made me feel like I wasn’t a problem.” “It just makes me feel that it’s okay to be this way.”

Zinnia JonesThe “rapid onset gender dysphoria” hoax proposes that large numbers of apparently trans adolescents are actually misguided cis adolescents mistakenly taking on a transgender identity based on misinterpretation of personal experiences and difficulties, and it invokes the notion of a broad “social contagion” to explain how this is happening. In this narrative, these supposedly cisgender youth happened to meet trans people or encounter trans resources and support communities online, and the availability of this social contact or community resources somehow caused them to believe they should adopt an erroneous trans identity. Julia Serano has documented the apparent first uses of “social contagion” in this context and its spread across right-wing and anti-trans media throughout 2016, prior to its use in the published “rapid onset gender dysphoria” study which overtly pinned the blame on any social contact with other trans people (Littman, 2018): Continue reading

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The Matrix Resurrections analysis: More trans than ever, this bold and messy dysphoric nightmare will thrill and unnerve (part 2)

< Continued from Part 1.

Assigned roles and binaries fracture easily and often.

These conversations and moments of dysphoric self-recognition and trans self-actualization are repeatedly shown as tipping-point epiphanies that can happen at the speed of an egg cracking. Bugs, the absolute breakout captain of Resurrections, redpills a programmed Morpheus out of his assigned role as Agent Smith in under three minutes simply by sharing and comparing their experiences of the matrix, before directly asking him: “Who are you? What do you have to do?”

Neo’s boss, a sharply dressed young businessman who loves standing at the window of their skyscraper and reciting Smith’s lines, stumbles into a set and setting that resonate with something deep within him: Neo trying to escape from an office flooded by sprinklers, Morpheus gunning down police, the signature Desert Eagle laying at his feet. He steps into the vivid bright red light, and has an intensely physical and transformational experience of embodiment and emergence, slowly throwing his head back as if in imitation of Agents possessing bluepills, while resembling nothing more than the prom scene in “Carrie”. In seconds, he is right back in his element, screaming “Mister Anderson!” and opening fire at Neo.

Much like Neo’s experience with Smith in the first Matrix, Trinity being repeatedly, obnoxiously deadnamed is the last straw for her: she realizes she cannot live a fake life defined by someone else who’s holding her hostage, and she knows she has to rebel against this and live as herself no matter the cost. She announces herself as Trinity, and proceeds to pursue this life immediately and with beautifully rewarding violence. Continue reading

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The Matrix Resurrections analysis: More trans than ever, this bold and messy dysphoric nightmare will thrill and unnerve (part 1)

Spoilers/prerequisites: All of The Matrix Resurrections.

Up front, I really liked The Matrix Resurrections and I think you should watch it, but whether the movie was good or bad isn’t my focus here. Even if you don’t enjoy it, I still consider it to be a significant work and worthwhile to study and discuss as a text. These are notes and observations on my experiences as a trans woman watching the first new Matrix sequel by an out trans woman, and what I saw as possible meanings and interpretations of it.


This movie made me uncomfortable, and it succeeded in expressing something meaningful through that discomfort. Shortly before the release of Resurrections, I went over several points of comparison between the events and style of the original trilogy and the dissociative experience of depersonalization-derealization disorder. This disconcerting sense that the world or oneself feels essentially “unreal” often begins in early childhood or at puberty, is unusually common among trans people, and often goes away after transitioning. Neo’s experience in The Matrix has long been understood as a metaphor for transness. Part of that transness could be the all-encompassing faded green of a false-seeming reality with no depth, the flat backdrop to your meaningless and empty self simply going through the motions of life, constantly tormented by the inescapable and unbearable “splinter in your mind” feeling of “something wrong with the world”.

Resurrections does not seem to be primarily about feeling one’s way through an uncomfortable sense of unreality. If the trilogy was about having gender dysphoria and depersonalization-derealization, Resurrections is about even more severe expressions of dissociation such as extreme absorption and amnesia, including apparent episodes of actual loss of contact with reality, hallucinatory flashbacks, and having no memory of periods of time. Whereas depersonalization disorder is notably associated with experiencing emotional neglect from one’s parents or family, this extreme dissociation is the result of the prolonged severe trauma of physical, emotional, or sexual violence and abuse, typically during childhood. Continue reading

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