My Trans Decade

Zinnia JonesIt’s a common refrain: being trans isn’t the only thing we are, or even the biggest or most important thing we are – it’s just one thing among many. Yes, we’re trans, but we’re so much more than that; we’re people, with families and careers and hobbies and interests, with personalities and likes and dislikes, with all the complex fullness of any individual.

But at the same time, I can’t pretend that being trans hasn’t been a massively influential theme in my life ever since I came to embrace it. My transness, my womanhood, has been a defining factor in so many ways over the past ten years, touching on nearly all of my most significant personal and professional experiences. It’s changed my life to the extent that I can’t even imagine what the last decade would have been like for me without it. Sometimes, in some ways, it is a big deal. And I think it’s worth acknowledging all the ways that accepting and celebrating this has made my life so much better. Continue reading

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More on the relationship between hormone therapy and migraine in trans people

Zinnia JonesI’ve previously written about how feminizing or masculinizing hormone therapy can affect migraines in trans people with this condition. It’s something I’ve experienced myself: as a child, I had frequent migraines with severe pain, nausea, and sensory sensitivity, which almost entirely abated at the onset of puberty and then made a reappearance once I started estrogen at age 23. The association between sex hormones and migraines is well-established, with Pringsheim & Gooren (2004) finding that trans women on HRT had approximately the same prevalence of migraines (26%) as cis women, and a much greater prevalence of migraines than cis men. Cis men have been found to be “more likely to have longer-lasting periods of migraine remission after childhood” (Jamieson, 2017), and cis men who experience migraines tend to have higher levels of estradiol (van Oosterhout et al., 2018).

A chapter in the recent volume Gender and Migraine  offers further details on the mechanisms behind the increased occurrence of migraine in trans women on HRT, the kinds of migraines that trans people experience, and when trans people are most likely to experience them. Continue reading

Posted in Endocrinology, Health care, Transgender medicine | Tagged , | 1 Comment

The anti-trans lie of “just autistic”

Zinnia JonesWhen it comes to media coverage of transgender topics, the Daily Mail reliably provides stark examples of what not to do. Fresh on the heels of a non-story about one person’s claims that numerous unnamed individuals regret their transitions but will not come forward for lack of bravery, the Mail on Sunday’s health correspondent Stephen Adams has offered his peculiar interpretation of the intersection between transness and autism: “A quarter of youngsters being treated at transgender clinics may just be autistic, new research claims”.

Does new research claim any such thing? Adams continues: “Those attending gender identity clinics are many times more likely to show signs of autism than the population at large, doctors found.” Continue reading

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Recent progress in height management for trans adolescents

Zinnia JonesThe widespread adoption of puberty-blocking medications for transgender youth has been life-changing, for the first time allowing trans people who are aware of their gender at a young age to avoid the need to reverse the unwanted and damaging changes of an inappropriate puberty, and instead acquire their desired secondary sexual characteristics directly. With this treatment, these youth experience an alleviation of their gender dysphoria with improved psychological functioning and overall well-being (de Vries et al., 2014), in contrast to the many psychosocial comorbidities commonly experienced by those who do not begin transition until adulthood.

However, even as puberty blockers have provided substantial benefits to trans youth, one area of physical development continues to pose challenges: height. Continue reading

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Quantifying changes to hair and skin from HRT

Zinnia JonesHair is one of the most common areas of concern during transition: hair length, facial hair, and body hair are often important aspects of desired self-image for trans people, and these visible features are seen by others as strong signifiers for the purposes of gender classification (or “passing”). However, key publications on medical transition protocols and outcomes, such as the Endocrine Society’s clinical guidelines (Hembree et al., 2017), still describe the effects of cross-sex hormone therapy on hair and skin only in vague and general terms. Within these guidelines, trans men are stated to be likely to experience skin oiliness, acne, facial hair and body hair growth, and scalp hair loss (Table 12), while trans women are conversely likely to have softening of the skin, decreased oiliness, a decrease in the growth of terminal hair (thick, long, and dark hairs), and “variable” changes in scalp hair.

While these broad descriptions encompass the wide variation between individuals in the changes experienced from HRT, they’re lacking in specifics. How great is the extent of these changes? What might the results actually look like? These questions matter greatly to trans people who are looking to acquire certain physical features and be rid of unwanted ones. Continue reading

Posted in Dermatology, Endocrinology, Outcomes of transition | Tagged , | 1 Comment