“Biological sex”, empirical backfire: How transphobes gambled on COVID-19 – and lost

Posted on April 30, 2020 by Zinnia Jones

Zinnia JonesAs the pandemic coronavirus has spread around the globe, the growing numbers of infections have revealed a surprising pattern: from China to Italy to the United States, men are more likely than women to contract the virus. And among those infected, men show a consistently greater likelihood of suffering from a more severe course of the disease, and men make up a clear majority of COVID-19 deaths.

These trends in infections and disease severity offer an opportunity for fruitful research, as scientists and medical professionals investigate the factors that could provide greater protection from serious or fatal COVID-19 disease and whether this may point the way toward beneficial treatments. On the other hand, if you’ve made a career out of transphobia, then mass death and worldwide economic devastation offer something far more important: a chance to remind everyone that trans people don’t matter. Continue reading →

Posted in Biology of transition, COVID-19, Philosophy and language, Transphobia and prejudice | Tagged , , | Leave a comment

How likely are trans women to seek breast augmentation?

Posted on March 31, 2020 by Zinnia Jones

Zinnia JonesFeminizing hormone therapy induces the growth of breast tissue in trans women and transfeminine people, and this tissue is essentially identical anatomically and histologically to the breasts of cis women (Phillips et al., 2014). Although final breast size can be highly variable, trans women’s breasts generally tend to be smaller than those of cis women: de Blok et al. (2018) found that trans women reached a cup size of AAA or less after one year of HRT, Wierckx, Gooren, & T’Sjoen (2014) report the results of a study in which trans women reached a maximum cup size B after two years of HRT, and Seal et al. (2012) note that the apparent difference in size may be highlighted by the differing shape of trans women’s chests and shoulders and the positioning of breasts on the torso. For these reasons, many trans women desire breast augmentation surgery even after the effects of HRT.

A recent study from the VU University Medical Center gender clinic in the Netherlands presents a remarkably extensive analysis of breast augmentation among trans women, spanning 773 women who began receiving HRT at the clinic between 1972 and 2018. de Blok et al. (2020) examined how rates of augmentation surgery have changed over time, how soon trans women tend to have augmentation after starting HRT, and how many trans women want or don’t want this surgery. Continue reading →

Posted in Breast, Outcomes of transition, Surgery, Transgender medicine | Tagged , | 1 Comment

How long have you known you’re trans? Additional findings on gender identity development

Posted on March 31, 2020 by Zinnia Jones

Zinnia JonesThe process of coming to self-awareness of our gender and putting a name to our identity takes a different course for every trans person, and it’s rarely a simple matter. Realizing that you’re feeling something in the first place, noticing what that feeling is about, and understanding what it means for our selves and our lives – all of these are significant challenges for any adult, let alone a young child. There are trans people who’ve found true self-recognition for the first time in every decade of life, yet this achievement may follow decades of uncertainty, confusion, and untreated gender dysphoria.

A recent study seeks to quantify the extent to which this impacts our lives. I’ve previously looked at research showing that trans women aged 16-29 became aware of their trans identity at an average age of 9.9 years, but did not disclose this to others until an average of 15.8 years of age, and did not start HRT until an average age of 20.4 years. Another study of trans youth aged 6-17 similarly showed that trans girls recognized their gender at an average age of 9.9 years, and trans boys at 10.7 years. The most recent research, by Zaliznyak, Bresee, & Garcia (2020), looks into the identity development timelines of 210 trans women and trans men attending consultation for genital surgery at the Cedars-Sinai Medical Center. Continue reading →

Posted in Gender dysphoria, Statistics and demographics | Tagged , | 1 Comment

Why gender-questioning youth continue or discontinue puberty blockers

Posted on March 31, 2020 by Zinnia Jones

Zinnia JonesPuberty-blocking medications for trans or gender-questioning adolescents, which reversibly halt the production of sex hormones and prevent the development of undesired secondary sex characteristics for as long as the medication is continued, have long been the subject of unnecessary controversy and poorly-supported criticism. Those who oppose this gender-affirming medical care for adolescents have frequently claimed that the use of puberty blockers actually causes otherwise-cisgender youth to “become” transgender when they would have remained cisgender in the absence of this treatment (in reality, puberty blockers are widely used in cisgender youth with precocious puberty and do not appear to “cause” transness). Others have alleged that all trans or gender-questioning adolescents who use puberty blockers will go on to choose to transition via cross-sex hormone therapy and further medical treatment, and that this therefore proves puberty blockers must have caused them to continue being trans; as it turns out, a small proportion of gender-questioning youth on puberty blockers do go on to discontinue treatment and identify as cisgender, and the high percentage who continue transition is far more plausibly attributable to transness causing use of puberty blockers rather than use of puberty blockers causing transness.

A recent study of the outcomes of 143 trans and gender-questioning adolescents treated with puberty blockers at the Curium-Leiden University Medical Center gender clinic in the Netherlands provides further detail on how many of these youth go on to transition, how many elect against transitioning, and what motivates these key decisions. Continue reading →

Posted in Nonbinary, Outcomes of transition, Regret and detransition, Trans youth | Tagged , , | Leave a comment

Fact check: Spironolactone and COVID-19

Posted on March 31, 2020 by Zinnia Jones

Disclaimer: I am not a medical professional and this is not medical advice. Our understanding of the pandemic is evolving rapidly; this information may be superseded by later and more conclusive findings. This article was last updated on March 31, 2020.

Zinnia JonesAs the SARS-CoV-2 coronavirus, the virus that causes COVID-19, has cut a deadly path around the globe, many people have desperately sought out potential treatments that could reduce the severity of the disease or the risk of contracting it. From the apparently unsupported rumor that ibuprofen worsens COVID-19 in those who have it, to the startlingly weak evidence for the use of hydroxychloroquine to treat the infection, a vulnerable population – and right now, that’s every one of us – badly wants to believe there’s something that can be done in the face of a potentially lethal virus.

This has come to intersect with the trans community in the case of spironolactone, a blood pressure medication often used for its testosterone-blocking effects as part of feminizing hormone therapy by trans women and transfeminine people who have not yet undergone gonadectomy (orchiectomy or vaginoplasty). While other medications have been used to block the production or action of endogenous testosterone, spironolactone is among the most inexpensive and is widely used in the United States. Recently, concerns have been raised on social media and in beauty outlets that spironolactone may increase the likelihood of contracting COVID-19 or worsen the symptoms of the disease. Continue reading →

Posted in COVID-19, Endocrinology, News, Transgender medicine | Tagged , , | 2 Comments