What is natural? An indictment of the vitalist resurgence

by Heather McNamara

Our globe is warming. Polar ice caps steadily drip into the ocean and wash up on the shores of Miami. Beijing’s air quality is so poor that its non-smoking citizens develop lung cancer at nearly the same rates as smokers. Human beings are increasingly dependent upon technology – the production of which increasingly harms our environment and by proxy, ourselves. The desire to eschew unnecessary luxuries like plastic grocery bags, processed foods, straws, paper cups, etc. is an understandable one. Unfortunately, this distrust of technological progress has come hand in hand with a distrust of science and has led to a resurgence of vitalist thought. This resurgence sometimes manifests in a mostly harmless fashion: leading people to paleo dieting and unpasteurized milk. Unfortunately, however, it has also wormed its way into medical discussions and anti-trans discourse. Continue reading

Posted in Philosophy and language, Transphobia and prejudice | 1 Comment

Real solutions for self-medication: Expanding access to transition care via family physicians and informed consent protocols

If you’ve perused the British press lately, you’ve probably noticed that mixed in with the daily barrage of cookie-cutter anti-trans opinion pieces was this alarming headline: “Cowboy chemists are selling ‘DIY trans’ pills to teenagers as more and more are ‘risking their lives’ by taking black market drugs”. This subsequently led to the closure of the online pharmacy QHI. The issue of self-medication via online pharmacies by trans people, particularly trans youth, is not new: the Independent published a similar investigation in 2016, and I’ve received plenty of outraged tweets from transphobes who were unhappy with my own post collecting studies of generic medications that have been used as a substitute for puberty blockers in clinical practice.

I trust that these people recognize and value the importance of access to safe and competent gender-affirming care – and so do I. No one should be placed in a situation where this is their only means of obtaining timely transition treatment. Fortunately, if you’re worried about trans people and youth self-medicating unsafely, there are already many known ways to reduce the prevalence of this phenomenon. It’s simple: just meet the needs that aren’t being met for them. Continue reading

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Book review: “My Dinner with Andrea” by Jen Durbent

by Heather McNamara

Overall: 4/5 

Trans Narrative: 5/5

“My Dinner With Andrea” is mostly a love story. Faith is a transgender woman who is trying out dating for the first time in a while. Since coming out and starting hormones, Faith’s marriage to her wife, Michelle, has remained rich in love but no longer involves physical affection. Both parties have turned to others to meet this need for them, but until now, only Michelle has had success. Then Andrea showed up. Continue reading

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New clinical findings from Dr. Will Powers: Role of estradiol/estrone ratio in the efficacy of feminizing HRT

(Epistemic status: Extremely tentative.)

Dr. Will Powers, an HRT provider in Michigan who has possibly the coolest name ever, has recently posted a slideshow outlining findings from his practice on the most effective approaches to feminizing hormone therapy for trans women. Briefly, Dr. Powers has observed that inadequate feminization may be related to imbalances in levels of estradiol (E2) and estrone (E1), a form of estrogen which also binds to estrogen receptors but is much weaker in its effects than estradiol. Readings of total estrogen may indicate that overall levels are in the desired clinical range, yet within this total measurement, E2 may be too low, while E1 is too high. Powers notes that E1 “competes with estradiol for effect” at estrogen receptors, and because of the relative weakness of E1, this imbalance may slow the process of feminization (p. 24). Continue reading

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A new critical analysis of desistance research

Newhook et al. (2018) have recently published a review in the International Journal of Transgenderism of the state of the research on “desistance”, the finding that a possible majority of children diagnosed with gender dysphoria will no longer be dysphoric by adolescence. The authors identify numerous issues with desistance-related studies published since 2008 and how these findings have been used to inform clinical care for trans and gender-nonconforming youth. Key points include: Continue reading

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