The Times “Why HRT is safe — but super-high doses might not be”

That might have been the document I was sent in my referral pack (several years prior to actually getting an appointment). I'm pretty sure the actual consent to treatment form was different.

@MissingLynks
https://ncth.nhs.uk/download.cfm?doc=docm93jijm4n10817.pdf&ver=19967

Would this be the list if side effects?
Thanks.

A brief search finds breast cancer in males being described as more common in those taking oestrogen for prostate cancer or gender based reasons - but the reference for the latter is from 1968 so I assume there is very little research with transwomen (otherwise there would be a more recent publication referenced)
Interestingly males with Klinefelter's (XXY) have a greatly increased risk of breast cancer, likely due to hormonal reasons (but that's more complex than just taking oestrogen as an adult)

https://pmc.ncbi.nlm.nih.gov/articles/PM

To be honest I don't see what gains trans people with a penis have from taking oestrogen- it would be expected to cause weight gain, reduce libido and increased risk of blood clots. No idea what the medium to long term impact on breast cancer risk is - might see an increase, doubt if there are any stats available. Genuinely, what benefits are there?

I initially got a diagnosis with Gendercare, Gendercare follow the same process as the NHS, only without the several years long wait.

God that is so dumb.

It’s good to hear Nottingham are being thorough and useful to hear your experience. Do you have friends who have gone down the private route? If so, do you have any insight to how closely their experience matches yours?

I was seen at Nottingham. But that is the standard pattern of care across the UK GICs, there is no one who won't have been told what testosterone does and what the risks are, no one who wouldn't have signed a consent form to that effect, and no one who wouldn't be having follow-up bloods. I don't think even detransitioners like Keira Bell try to argue they literally weren't told what testosterone would do (probably because that would be extremely easy to disprove by producing their signed consent form), the argument has been around capacity to fully understand. Again, I can only speak for the UK, and I understand people here would like it to be true that GICs give hormones out like skittles with barely a conversation, but that isn't what happens.

Indeed! When FM declared that they were not warned that having a double mastectomy would mean that they could not breastfeed, that was a bit of a light bulb moment for me. For several reasons.

And we have enough other personal reports from others stating they were not told that we know that in the past, such statements about making sure that consent is more comprehensive would seem to more of an exception.

It’s a good, informative article about using HRT for menopause.
its not an article about using cross sex hormones.
🙄

I'm sure that'll be a relief for you all to hear given your great all-encompassing and ever present concern for the health and wellbeing of trans people.

Yes, I'm concerned when people with as high a profile as Freddie Mc( who has had substantial input to policy in some areas) claim to have been ignorant of the consequences of some of the realities of transition-related interventions (NHS England, afaict).

I, too, would be pleased to learn about the clinics that demonstrate good practice in this area although that would be useful on a separate thread, as it's not the emphasis of this one.

HRT prescribed to menopausal women without muddying the waters.

It is refreshingly novel to see a woman-focused account of something that affects women. I'd hope to see something like this forming the basis of continuing attention to women's health in the NHS Consultation.

@MissingLynks would you mind sharing which of the UK clinics it is? I'm trying to understand which ones give information in the most ethical way, and which ones gloss over the side effects.

Thanks for the post MissingLynx the comparison in the care you have received is interesting.

Good article, said what it needed to say about HRT prescribed to menopausal women without muddying the waters.

I can't speak for other countries, but I can tell you as a trans man my experience of accessing testosterone on the NHS

I had a very long list of the effects and potential risks of taking testosterone spelled out to me, including what is and what isn't reversible, including impact on fertility, including some stuff which isn't even a proven side effect but might possibly be. I had this explained to me in two separate appointments with two different clinicians - both of whom then asked me to explain the effects and risks back to them to ensure I had heard and understood. I then had the same conversation all over again with an endocrinologist. I was then asked to read and sign a consent to treatment form which spelled out the risks and side effects again.

Oh, and before I even had a first appointment I was sent an information pack which also spelled out what testosterone does and what the risks are.

I am monitored with blood tests every six months, and my prescription would be stopped if I didn't comply with this. I also have follow-up appointments roughly every 6 months to check my general wellbeing and that I'm happy with the changes (these won't continue indefinitely but are routine for the first few years of treatment and won't stop until I want them to). I can also contact the GIC for medical or psychological support in between these follow-ups should the need arise.

I can compare this with the experience of taking oestrogen HRT which I was on before starting testosterone (since cancer stole my ovaries) - had a ton of horrible side effects no one ever warned me about, no monitoring of bloods, had to chase and chase to get any support, and the only advice I got from my GP was to keep increasing the dose (with the results that when I finally did get a blood test my oestrogen levels were through the roof).

So yeah. Can confirm gender clinics are way better at prescribing hormones than GPs are. I'm sure that'll be a relief for you all to hear given your great all-encompassing and ever present concern for the health and wellbeing of trans people.

Thanks for clarifying what you meant.

A WHRC webinar in 2021 included a presentation Kajsa Ekis Ekman who reported that she had been contacted by a Swedish infertility clinician who claimed to be seeing increasing numbers of women in their 20s who (after testing) have atrophy of their reproductive organs. These were women who had been affirmed with puberty blockers and cross hormones at a young age (Dutch protocol) and gone on to have (to them, unexplained) difficulty with conception.

Discussion of issue here.

In late 2020, I interviewed a physician in the IVF sector who reported having noticed the effects in his field of treatment for gender dysphoria over the course of the previous year. One of his patients was a woman in her 20s who had been unable to conceive. Tests revealed her ovaries contained a higher than expected proportion of connective tissue including several small cysts. Blood tests showed ovarian activity was extremely low and it was unlikely that she would ever be able to conceive. On hearing this, the woman broke down and disclosed she had been treated with puberty blockers and testosterone as a teen at the Anova clinic of Stockholm’s Karolinska University Hospital. She had subsequently decided to return to living as a woman and had been informed by the clinic that the treatment she had undergone would not result in any risks to her fertility.
The physician asked Avona about their follow-up procedures for patients and was told they undertook no long-term tracing at all. “It is completely illogical,” he said. “A drug with equally drastic side effects would not be prescribed without long-term follow-up of patients under any other circumstances. Gynaecology and oncology departments remain in contact with their patients for five to ten years post-treatment. It cannot be claimed that the treatment is harmless when no attempts are made to ascertain whether this is the case.”

https://www.genderclinicnews.com/p/hormone-hoax

As ever, there's an unmet need for appropriate data collection, over time.

Apologies to OP, I've realised I'm off-track for the actual topic of this thread.

The experience of several high-profile desisters or de-transitioners might argue that this is far from universal.

This chimes with the reports that even Freddie Mc claimed (in some stories) not to have understood that nipple placement after a double mastectomy compromised the ability to breastfeed an infant.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9936190/#:~:text=As%20an%20example%2C%20the%20prominent,%E2%80%9D%20was%20retained%20(52).

Scott Newgent's interviews and talks indicate that SN hadn't anticipated the full consequences and impacts of transitioning. A particularly poignant observation is this:

The point is that, as Scott writes, "trans health doesn't really have a justiciable baseline." If a surgeon botches your gall bladder operation, there are criteria by which to judge him or her…
…The risks associated with these surgeries is something the "affirming" community should be—but are not—communicating to parents of dysphoric children. Instead, parents are led to believe that the lifelong medical interventions they are guiding their children toward (it is well known now that virtually all children who take puberty blockers go on to cross-sex hormones) are a benign sidebar to the holy grail of gender transition.

https://thepostmillennial.com/transman-twitter-banned-for-speaking-against-gender-transition-of-children-fights-back?s=04

Trans people are given hormones under guidance and monitoring and they are absolutely advised of long term risks and have to sign bits of paper to that effect - perhaps you shouldn't be believing everything you read or assuming a "throwaway line" is all there is to it. Perhaps you could even try asking a trans person or two what their experience of accessing treatment is.

given we women need to think carefully about how and when and for how long and at what dose to use HRT because of known risks , why are medical professionals allowed (and even encouraged) to prescribe hormones to confused teenagers seemingly without evidence of long term impact.

You are absolutely correct.

It is an article about women. What have the desires of fetishistic or confused men to do with treatment for a condition that only occurs in women, a condition that is a normal part of being female?

This is not an article about the toxicity of exogenous hormones. That would be a different subject, one in which discussion of the use of cross-sex hormones would be relevant.

But this is an article about women's health. And posters on the Feminism board want men to be mentioned in it. For Goddess' sake! Even here, can we not have anything just about us, without including Them?

Does anyone study long term impact of estrogen on men (transwomen) or of testosterone on women (transmen)

Yes of course they do, there are multiple studies looking at exactly this, which you easily could have discovered by googling.

Men taking oestrogen and women taking testosterone in high doses are not receiving HRT they are receiving cross sex hormones.

An article about women receiving HRT doesn't need to consider other people on cross sex hormones.