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

[Startinganew07]

Article in today’s Times curiously addresses possible risks of long-term HRT, including long-term use of testosterone for women, but ignores the possible impact on transwomen and transmen. Does anyone study long term impact of estrogen on men (transwomen) or of testosterone on women (transmen). Shouldn’t recommendations regarding impact of hormones on women be extended to consider impact on trans people. Or is the fiction going to be prolonged that HRT is natural for trans people because it allows them to live as their true selves and therefore doesn’t carry the same risk as for women?

I can't see the article but it sounds crazy - surely 'super high' would actually be a lower dose if its a cross sex hormone?

it would be transphobic to mention the health risks associated with this, obviously! 🤣

Does anyone have a share token?

On another forum a poster is advising a transwoman to take 10x their regular dose of oestrogen. The reason? Pregnant women get a huge increase in oestrogen during pregnancy which show the body can handle it!

Yes, yes, a male body is exactly the same as a pregnant female body. Honestly, they really don't help themselves.

If the article had focused on trans people I think posters would be complaining that the focus was solely on them.
It's very rare that menopausal women get a look in. I think the focus of this article is a good thing.

Wallace, why? What does that amount of estrogen deliver in permanent changes? Surely they wouldn’t also think that long term that would be healthy.

Archived version: https://archive.is/N36yR

@Helleofabore the OP was being sectioned and was concerned about not being able to take their unprescribed oestrogen so the poster recommended taking a massive dose before going in.

Fuck. That is very sad.

That's a good article. Dr Kaye's specific expertise is in the menopause. The menopause is something that most women, and only women, will experience. I'm glad she hasn't squandered any of her word count on commenting, possibly outside of her expertise, on the much more niche subject of the use and misuse of cross sex hormones in trans identified people. This article is just for women. Please don't begrudge it to us.

I like to think that those who make a living from providing trans identified adults with cross sex hormones are keeping detailed information which will allow the development of robust evidence-based advice on safety and dosage in the future.

But surely the article could focus on all patient groups receiving HRT, if it’s about medical risks to human bodies. It doesn’t need to focus on one group to the exclusion of another. In fact it would be better if all groups who might take HRT - for whatever reason - had evidence-based, ideologically-uninformed information about the particular risks to their particular bodies posed by hormone therapy.

ETA: I haven’t read the article. But I absolutely agree with a PP that menopause specialists should speak to the risks to menopausal women, and specialists in cross sex hormones should speak to risks to those patient populations. Nobody benefits from one-size-fits-all medical advice, or advice that doesn’t consider their particular biological circumstances.

Sharetoken link

www.thetimes.com/article/aa5fe868-8f04-475e-843a-ffbaf88ca39b?shareToken=470ecfc56ddc00450e3e2220622a1aa

I think it's fine that it's a piece focussing on women!

The 'curious' thing is perhaps that we don't hear moaning about lack of 'inclusion' from transactivists when it's something like hormone treatments where the outcomes may not be good.

RethinkingLife thank you very much for the link.
I think it’s a useful article and that it’s fine to write an article about HRT just for women. The effects of high oestrogen on female bodies will be different to the effects on male bodies.

Doesn’t mean that the effects on men shouldn’t be researched, they should. Just that they don’t need to be reported on in the same articles. Also in the interests of accessible language- HRT used by women and Cross sex hormones used by men are working to do different things in female and male bodies.

It would get confusing to routinely report on them in the same articles even though in both cases there may be common messages for patients- like that there could be risks to taking high doses.

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.

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.

Sorry — I didn’t express myself well in the first post. I think it is, of course, fine and also helpful to have articles about HRT and its affect on women (or other health questions related to women). The article just made me think yet again about the fact that hormones need to be taken carefully, under guidance, and ideally not for long term because of various risks. Yet teenagers are allowed to begin hormones to attempt to change their bodies with seemingly little warning of the possible long term consequences. I agree the impact of hormones on people with dysphoria is not the point of the Times article. It just seems whenever I read about health care for trans people, there are just throw-away lines about “begin hormone treatment” without reference to risks.

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?

@JellySaurus as I tried to explain above, I DO NOT wish men had been mentioned in the Times article. I think it is useful and refreshing to have women’s health addressed in a serious and helpful way. I only wanted to make the observation that, 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. All I meant to do wi the my post was share a thought inspired by an article. Clearly I did not explain myself well — and probably still haven’t.

Moving on now.

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.

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.

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

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.

Thanks for clarifying what you meant.

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.

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