Contra “ROGD”: A recent cohort of youth evaluated at Amsterdam’s gender clinic does not have less intense gender dysphoria or greater psychological issues

Zinnia JonesAttempts to legitimize the lay anti-trans narrative-slash-conspiracy theory of “rapid onset gender dysphoria” as a genuine health condition are risky business, as specifying particular features of an alleged new clinical phenomenon places it in the dangerous realm of that which can be disproven. Littman (2018), in her extensively criticized paper on this supposed condition, claimed that “clinicians have reported that post-puberty presentations of gender dysphoria in natal females that appear to be rapid in onset is a phenomenon that they are seeing more and more in their clinic”, and cites parental reports that “clinicians failed to explore their child’s mental health, trauma, or any alternative causes for the child’s gender dysphoria.” Zucker (2019), commenting on “ROGD”, asserted:

Over the past dozen or so years, it is my view (and that of others) that a new subgroup of adolescents with gender dysphoria has appeared on the clinical scene. This subgroup appears to be comprised—at least so far—of a disproportionate percentage of birth-assigned females who do not have a history of gender dysphoria in childhood or even evidence of marked gender-variant or gender nonconforming behavior.

Littman, Zucker, and others have further implied that a shift in the sex ratio of adolescents presenting for evaluation for gender dysphoria toward those assigned female is itself indicative of the emergence of an entirely new kind of dysphoria. These assertions – that a clinically distinct new phenomenon has emerged over the past decade, and that this is embodied largely by apparently gender-dysphoric AFAB adolescents assigned female who experience serious psychiatric comorbidities that may be presenting only the appearance of gender dysphoria – are testable. And a recent study from Amsterdam’s VUmc gender clinic puts them to the test. Continue reading

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Study: Spironolactone with medroxyprogesterone acetate suppresses testosterone in trans women more effectively than spironolactone alone

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

Zinnia JonesWhile spironolactone is one of the most commonly used antiandrogens in feminizing hormone therapy, some trans women are still unable to achieve suppression of their testosterone levels into the desired female range with spironolactone. A recent clinical study examined the potentially beneficial effects on trans women’s testosterone levels from adding a medication whose use in feminizing HRT has been hotly debated: the synthetic progestin medroxyprogesterone acetate (MPA). Continue reading

Posted in Endocrinology, Progestogens, Transgender medicine | Tagged , | 1 Comment

Case series of trans women suggests HIV drug efavirenz may make oral estradiol less effective

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

Zinnia JonesTransgender women face a highly elevated prevalence of HIV infection, with Becasen et al. (2019) estimating that 14% of trans women in the United States are HIV-positive. Trans women of color are disproportionately affected: 44% of black trans women and 26% of Hispanic/Latina trans women have HIV, compared to only 7% of white trans women. A recent case series reported in Transgender Health highlights one way in which HIV medications may interact with cross-sex hormone therapy and require changes in the HRT regimen used. Continue reading

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So they finally got their straight pride parade

By Heather McNamara

Since the dawn of pride parades, homophobes have been demanding to know “why isn’t there a STRAIGHT pride parade, huh?” Many patient queers have articulated far better answers to that question than I ever could. Personally, I prefer just to respond with “Fuck off.” At least as far as I have always been concerned, it isn’t important how we respond anyway. The question has always been a mixture of an empty threat and a poorly laid trap intended to make some kind of point about how they, too, experience discrimination from queer people and we should all just “be equal” (read: shut up and get back in the closet so they would no longer have to acknowledge our presence). And for a long time anyway, it was an empty threat. At least until John Hugo, Mark Sahady, and Chris Bartley set out this past June to make all of our nightmares come true. Continue reading

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Zinnia’s continued college adventures: summer 2019

Zinnia JonesA couple months back, I went into some depth about my personal history as a student, my struggles with high school in adolescence, and my decision this year to go to college for the first time at age 30. I can hardly overstate what a big deal this has been: the college environment is a wholly new experience for me, and it’s been extraordinarily productive in directly addressing the longtime personal trauma of dropping out of high school at 14 and having felt massively inadequate and insecure about myself and my capabilities for most of my life until now. Continue reading

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