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Counterpoint to those saying ‘biological sex’ is medically relevant information but gender isn’t: have you heard of [medically] transitioning?
If I were treated as female (what I was assigned at birth) in a medical context today, depending on the situation it could kill me. Never mind the distress of e.g. being in a female ward as a man.
The whole “gender is social; sex is biological” thing that’s cropped up in the past decade or so is straight transphobia made to sound woke.
Yes, for some people, transitioning only involves being called something else. This is not categorically true however.
Then again, I don’t use the term transgender for myself. I am transsexual.
Check it...
Our bodies possess everything needed to express any primary or secondary sex characteristics; our DNA contains literally all the blueprints.
The difference is hormones (and sensitivity to those hormones). Hormones are instructions.
So if a person is constantly showered in testosterone as a fetus, they're likely (not absolutely!) going to pop out and a doctor will probably decide that baby will grow up to be interested in baseball and fishing.
But here's the thing: that person who may be assigned male at birth still possess dna. Their cells are still dividing and using those blueprints. A lot of the structures are built, but everybody's different and likely a lot still aren't, probably over half aren't.
So you just insert disc 2 and play the other half of being human, and biology follows the instructions and builds me nice skin, less body hair, tiddies, round soft warm emotional plump curves long hair shining eyes and thirst.
My biology is changed.
And before the lizard brain speaks its ignorance, no, sex is not defined simply by anything. It never has been and never will be. You can take averages and groupings all you want, but those are still not digital assessments that define Jack Shit. Because that's not how biology or society or humanity or any animals or almost anything in reality works.
When I transitioned medically, I scientifically became biologically female.
I am socially a woman, sexually a woman, and biologically a woman. There are a few... Remnants, and you could consider them hormonal disorders, but hey let's be real, most women have some medical issues. Bigger forehead here, ovarian issue there, reproductive challenge here, little bit of hair there... That's part of being a real human in the real world.
There is no perfect.
Basically nobody is truly average.
Everything is a spectrum and wildly fluctuating.
And it doesn't matter.
I can't give a cis man a child. I'm sorry. But, there are millions of wonderful women just like me. Like, y'all welcome to try, but I just don't think it's gonna happen unless you're REALLY manly. Maybe the one true King... 🥵
Sorry. Got off track.
Anyway. Uhmmmm.... I forgot.
Yeah, people are ignorant and parrot hateful outdated rhetoric and it's super annoying because they all state it confidently incorrect and it's extremely prevalent and even when you do get somebody's ear, cognitive biases take over and it's like talking to a pigeon. Basically all trans people over 30 know this stuff but are just so gd tired of repeating it only to get drowned out by the uneducated masses. I wish education reform were in the works because we're actually fighting the ignorance of the world just to get people to not be shitty to us.
It was going okay for a while in the late 2010s, but we had to elect a tyrant and a fascist and set back all of society a hundred years. Maybe more. It always comes back to that. Always. Because politics are actually critical. It turns out.
To everyone: please vote. Please. You can keep doing whatever else it is you're doing, but for the love of having the best starting point to work from: vote. Please. It's just a number. Nobody notices you protesting except the acceleration of intensity of pain and misery upon the most vulnerable demographics. This isn't the way. Abstaining to get the worse immediate outcome elected won't end well. It doesn't make anything happen faster other than torturing underprivileged people who don't deserve it. It also really benefits evil people and entrenches their power more. This isn't the way. Please, vote. Please. I'm begging you.
Hi, cisgender man here, I have been on a personal path of enlightnenment and learning, I want to do my best and not be one of those parroting things I don't know about or understand. I do have a lot of preformed ideas and opinions that I am painfully aware nowadays can be full of … how to put it ligthly, stupid bullshit based on ignorant, biased and worse, bigoted social background.
I want to preface anything else saying, no matter what my opinion and knowledge is on biology, biological sex, gender, … what I say is unrelated to the most important fact. That I support fully the LGBTQ+ community and movement, their rights, and I will never stop being vocal about that or active in what way I can. Unfortunately (fortunate for me though as I don't live there) I cannot vote against the orange turd.
With that said I must acknowledge one of my biggest gaps in knowledge is about the trans community, which has been terribly annoying as lately it has been a topic so common in the news.
I have loved reading your comment, you have a way with words that tingle my brain. So I felt compelled to comnent, I wanted to let you know, there are those between which I hope I can include myself, with the lizard brain mostly, trying to escape the stupidity. I don't want to be confidently wrong, and I want to put effort on being better.
Sometimes it is hard, because by giving my opinion I am afraid to show the ignorance and make someone feel like they need to either correct me or once again ignore what must look like the same bullshit they deal with daily. You said perfectly:
And I don't want to be one more between those.
It is not your obligation to educate me, it is my obligation to learn though. And I must say it feels hard for a basic cis like me to find what is a good resource of trustworthy information, and not bigotry that sounds right to me. If I may, could I ask for one thing? I want to know if what next I write, feels like I am in the right direction, or if I am using some wrong term? Hopefully I won't say something terrible…
For me and my limited biology and genetics knowledge, we have the whole set up of what makes us biologically male or female. I am talking about our dna setting up how much of each hormone we are to produce, I am talking of our chromosomes (and now I will have to go do some reading to learn of how that actually affects us in growth an adulthood). I am aware it is not black and white either but let's not go too far on that right now. When people talk of biological sex that is what I imagine.
Then of course there's the whole spectrum of sexuality, I am not getting into that right now, it doesn't feel like it connects to this in any way.
And then there's the whole thing with gender. So, for your case, it seems you were born male, or with a genetic path towards maleness if I may say it that way?, but you are a woman (or identify as? Is that the wrong way to say it?). Do you say you have always been a woman? Or do you think of yourself as a man in the past that transitioned later? After the transition you say you are medically and biologically female. Does that mean you have only xx chromosome and no y chromonome left? Are those the remnants you refer to? Again I want to apologize for my ignorance. And you are not obliged to answer to any of my questions, like I said it is not your task to educate me or anyone. But I would be very grateful if you would want to share with me some more info.
More related to the post, I would imagine, medically it is very important not to know only the gender, but the full history. I am no doctor so I can be entirely wrong. Knowing someone was born with a certain genetic information that affects greatly growth and possible diseases and so on is as important as knowing they transitioned, even the age at which it happened could be super important. That would be my guess.
(I'm gonna be verbose here, since there's a lot to cover and I want to give you the care you did in your response. Other people, you can read this, but think of it more like a publicized 1v1 convo and not something you have to read. Feel free to participate, but warning, this might end up lonnnng. I apologize to others not interested in advance.)
Nobody was born a gender, and scientifically, the more you get into less elementary level sciences and more bleeding edge genetics, sociology, endocrinology, and other biology specializations, the less binary "sex" is or, really how dimorphic humans are.
When somebody says they were AFAB or AMAB, that is shorthand for an incredibly immense amount of information, and simplifying it for the masses.
I was not "born a man". I was born a baby, and a doctor looked at my genitals, mentally checked in with their outdated and imperialistic textbooks, and decided "looks closest to this". Nobody knows my chromosomes. You don't know yours. And like I already laid out, chromosomes mean a whole hell of a lot less than the blanket propaganda makes them out to be. They don't actually matter. No, they really don't. Conservatives that are spreading all of the misinformation are constantly finding out they're intersex and either shutting the fuck up from then on, denying it, or doing some other mental gymnastics to conform this new information to try to bend it around their existing world view.
Seriously. Even for most doctors, they're still practicing super transphobic medicine. A person medically transitioning by taking dominant estrogen now has dominant estrogen phenotype sex characteristics. It's why trans women have breasts, nipples, milk ducts, increased risk of breast cancer (equivalent of cisgender women's risk), and basically zero risk of prostate cancer, assuming they have a prostate at all. Because biology changes.
And EVEN THEN, that person could be a guy, a gal, or nonbinary, because surprise your secondary sexual characteristics don't define your gender, nor how you dress, nor your gender expression. I could be your auntie, but perform largely the role of an uncle (or, a genderless version of whatever role your parent's sibling is to you!).
Yup. That's exactly as intended. Did you know that before Nazi Germany rose to power, there was a queer research clinic in Germany that knew probably even more than we know now, but when the Nazis rose to power, they murdered tons of people and burned all of the books and research, and spread rhetoric and misinformation and criminalized it and made discussion and research basically illegal?
Did you know that a lot of the families currently in power and across the Republican parties and their supporters are Nazis, Neo Nazis, and other fascist adjacents?
When queer people call "Nazi!" (Rhymes with "Yahtzee!") we aren't exaggerating, it's the same exact insidious rhetoric and literal playbook. History is literally trying to repeat itself. We are literally fighting fascism, now, for real, REALLY, N O W. Like, RIGHT NOW. In real life. For real. This is not a drill. This is not a dream. Nazis and their values are in power. The United States is under literal and intellectual siege. Flag upside down, Warning! Distress.
We had our civil war where slave owners in the south United States literally went to war to keep having slaves. They lost, but the north was way too lenient on the south, made too many compromises, and that shit festered. Ohhhh boy, did it fester. And after World War 2, Nazi Germany lost, and for some reason, the United States decided to put high ranking Nazis ... In high ranking places in both the United States and all over the world??? Our ancestors literally spread the disease and allowed it to escape.
So, here we are, dealing with the outcome of that decision.
Dang. Thanks. It might be the ADHD hahaha. Keeps you on your toes or something.
Approach it like this, and you're doing great. Approach like you know everything or don't attempt to learn, and you'll annoy the fuck out of ANYBODY who's trying to teach or share information. Real respectfulness goes a long way. Even if your information shows a pattern of being a chode, good faith is good faith, and people aren't stupid, they can see good faith. And like the Golden Rule dictates, it has a high likelihood of coming back to you, hence this conversation 👍
Ehhh, almost. You are a cis what? Cis is an adjective, or a modifier. You can be cisgender, but you are not a cis. I know you were joking self deprecatingly, and that's okay, but try not to get into the habit of using slurs or titling people by a single descriptor. I just feel the need to point that out, even if you do know. It's how, even in some corners of younger or older trans communities people get called or call others amabs or afabs. Because that's just shorthand for male or female, which is toxic af and wolf-in-sheep's-clothing just as transphobic as calling a woman a man or a man a woman.
People who take hormones have their hormonal needs (receptors) filled. Their hunger is sated and their body stops producing endogenous hormones. So, much like the roided out guys that take testosterone to get huge, their balls shrivel up because they aren't needed anymore. Trans women just (sometimes. Most of the time? I dunno) don't give a fuck about that or maybe even want that because "ewww i don't want those".
Imagine suddenly being really, REALLY ugly (no offense, people who are convinced you're really ugly (you aren't)). Or, imagine suddenly having the lower half of your body cut off permanently. Gender dysphoria is like body horror, except with your gender. And then society tells you that, "no, you're wrong for wanting those legs", and criminalizes you and hates you and is super prejudiced against you or anybody who's gone through that. Research has been done on how to cure or help you cope or fix the horror, but somehow the worst human demographic gets into power and hates you, and does everything they can to make everybody else hate you and misunderstand you and the science about you, too. They're changing language, they're changing the post office, they're buying fucking Twitter, they're producing tv shows, ads, running entire multi election political campaigns, criminalizing doctors who help, calling you pedophiles for wanting to not feel this body horror or help others with the body horror...
~~Nazis, man. You can't talk about them, you can't try to solve them, but they're gonna do everything they can to ruin everything. We all know the solution. It's a horrible solution. It's inhuman. It goes against all of our beliefs and values.~~
~~But we have also never had to deal with actual Nazis before. It's cancer. Literal, actual, cancer. It would be nice to stop it in any other way, or even to minimize collateral. But deep down (not even that deep) we know how to stop it. It's a dirty, imperfect, dangerous, evil way. I wish there was another way. But I lack the power and resources to do anything alone, let alone a miracle. I can't.
I'm just me. My values are conflicted. There's a hostile force bearing down on me and many others on all sides. I know it's almost time to fight. I know it has been for a long time...~~
I'm a frog, boiling.
~
Whew. I had to take a break there. The darkness came calling.
Nope. ERRRRRRRR, wrong. That's the elementary understanding.
Yeah.... Sigh I know.
Yes! Correct.
[End of Part 1]
[Continued in Part 2, which I will make as a comment to this comment]
[Part 2]
We're getting pretty personal here, but that's... We'll make an exception because, yeah why not let's make an example out of my personal medical needs! Jk, no, actually, we won't! I'll continue to use a hypothetical person. I'll spare us all from my stuff and me being really uncomfortable. (Transitioning, you end up learning a lot about your own boundaries)
So, if a person were assigned male at birth, that could be HOST of different reasons and outcomes. They wouldn't necessarily have a path towards anything. But, on average, most people, currently in today's political climate and scientific "knowledge", would go on to be raised as what you may think of a boy, taught what that means by everybody around them, and that child would do what they were told, regardless of what they felt inside.
At some point of stumbling through life and wondering what that sneaking feeling is, that person may encounter another human or information that they're curious about, pertaining to something interesting. "Transed Genders. Hmmm, what is that? Oh, interesting. Oh... Wait, I'm interested in that. Why am I interested in that?" So it goes.
All manners of possibility can occur. Some people figure it out when they're children, some when they're elderly. Usually, it takes the longest to figure out in people the least exposed to the possibility or imbued with the most shame. But one thing we know for certain, you can't easily stop one's internal truths from being, especially if they conflict with an external lie. That's a long, slow, and awful torture.
Hormones do not change chromosomes that I know of. But chromosomes don't matter. As I previously briefly said, plenty of people have chromosomal variants and don't know. There are plenty of people who are XY and were assigned female at birth, and currently live as women, and have zero idea about any of that. There are butch cisgender women who are XX. There are butch cisgender women who are XY. There are butch cisgender women who are XXY. There are butch cisgender women who were assigned male at birth who are XX who have ambiguous genitalia and like it. There are those exactly like that who don't like it and decide to change it.
My point is, chromosomes don't really matter. You get chromosomes from your parents, and that's about it.
Then, there are hormones. People come in all shapes and sizes and mixes of hormones. Basically everybody has all hormones, in various mixes, amounts, and fluctuations, etc.
Basically all Cis men have estrogen. Basically all Cis women have testosterone. Different people, different amounts.
And then you have sensitivity to said hormones. People are receptive in different ways, in different amounts, at different types, at different ages to hormones.
There's a thing called "androgen insensitivity syndrome". It's just a single situation where you can have someone who is XY chromosomes, have fully testosterone dominant hormones, but be born with, and happily live as (or not!) a vulva having a woman. You wouldn't be able to tell the difference, and a lot of those people have zero idea about themselves.
It literally doesn't matter. Maybe some of them are sterile or have a genetic pattern predisposition for a disease or something. Some of those people have total androgen and sensitivity syndrome, others not totally insensitive.
Let people live their most authentic lives. Let them enjoy life and have fun and be happy.
Let people change their minds and experiment and maybe be wrong about themselves or maybe be partially right. It's okay.
I'm a bit deep in the comments weeds, here, and can't directly check previous comments while writing one. But if my memory serves me (it often doesn't), I was probably talking about retaining certain physiological structures, such as skeletal dimensions that have already set or macro genital structures or larynx size.
It's a lot easier to make things bigger than it is make them smaller. Things do get smaller and thinner or wider or softer or warmer or colder - changes do happen. But one unpleasant fact is that almost all things on the human body like to grow with age (like old peoples' ears and noses). Similarly, you cannot ungrow a penis or let set adult skin split and grow a uterus. Things will atrophy or perform differently for sure. A medically transitioning trans woman's penis will almost always lose certain masculine penis/genital smells (and feels), and arousal patterns, timings, and even behaviors will change. For example, many trans women, when really aroused, literally get wet instead of any erection, as their body prepares. Others do still experience erections.
Minus the erectile patterns, there's a quite entertaining but now older video on YouTube on the subject of the "feminine penis" by the old queen of trans women, Contrapoints. The video is titled "Are Traps Gay?" Easily found on YouTube, it currently shows as 3.3 million views. She's mostly retired, now, probably partially because of how much conservatives have attacked her. But, in the video, she goes over the obvious question, and splits the video into easily digestible chapters, notably, one of which talks about "the mouthfeel" (yes). She talks a lot of trash, is edgy and funny, and the video is a tiny bit outdated now. But most of it is still solid as steel. I suggest watching it entirely from start to finish, if not just to be entertained.
Edit (I missed a section):
A doctor checking if I have a cold or if I broke my hand has no medical reason to know my previous name that I no longer use.
A doctor checking for breast cancer has no need to know what's in my pants.
A doctor giving me a covid booster and a flu shot doesn't need to know anything that isn't pertinent to those shots.
Yes, epidemiology is a thing. No, most nurses and doctors are not epidemiologists and couldn't give a fuck.
Yes. Statistics are also totally valid. Unfortunately they are now used overwhelmingly for malice, neglect, and ignorance, treating trans women as weird men, rather than as women who may have hormonal disorders and a lot of recent trauma because of politics, poor treatment, harassment, and abuse.
[End]
I know males and females experience heart attack symptoms differently, and im pretty sure transitioning doesn't affect that. Friend of mine that transitioned suffered a heart attack but didn't have the classic chest pain symptoms so didn't know what was going on, and my SO had no idea female heart attack sysmptoms can differ from males and didn't even know what to look out for and she's female. Not sure if there are any other ailments that differ in expression between males and females and how transitioning affects them or not! Definatley an interesting field to talk about I think, and one most people aren't educated enough in.
There is one set of heart attack symptoms, but what differs between male and female populations is their relative incidence. For example, (cis*) women are over 2x as likely to experience pain between the shoulder blades, compared to (cis*) men, and ~33% more likely to experience shortness of breath.
HRT, as part of transitioning, impacts both cardiovascular physiology and pain processing, to become more aligned with the person's gender. This is of course dependent on the duration of treatment, and also on hormone levels actually being within the healthy range for males/females. Whether "more aligned" means "fully aligned" or just "closer to" is an open question and likely also depends on the specific metric. Whether there are sex-based factors that impact cardiovascular physiology and symptom presentation, that do not respond to hormonal treatment in transitioning adults , also needs further research. There are obvious conclusions to be drawn from the fact that feminising HRT in adulthood does not shrink bones to a more 'typical' female build for example, but at that point we'd really be talking about the impact of bone size & stature on cardiovascular health, rather than sex necessarily.
(And then, of course, we have some populations who started transitioning before completing the puberty associated with their natal sex, or who were fortunate enough to be put on puberty blockers before transitioning and so never went through the 'wrong' puberty.)
*: research around heart attack symptoms in men vs. women, like most medical research, has historically used data from cisgender patients
Absolutely! I found this meta study on the topic, although the main conclusion is that the studies it covers have various limitations be it in sample size, consistency of the inclusion criteria (some include nonmedical transitioners for example...), or simply the fact that trans populations experience minority stress and socioeconomic differences that have measurable impacts on health. tl;dr way more research needs doing.
This is a pretty strong claim to make with one data point, and unlikely simply based on the major physiological changes that happen with medical transition.
Male hearts are larger and have different proportions than female hearts, and the camber proportions also differ. There are also differences in the muscle texture itself. I know a LOT can change during transition, but I didn't think your heart would get restructured due to current gender reaffirming care. There's another reply to my comment where somebody much more educated than me offered some info! I did not intend to make a "strong claim" about this, I said im PRETTY SURE not that I know because I simply do not lol.
All of this may be true and still does not mean that HRT doesn't affect heart attack symptoms. For most things with average differences based on sex, we simply don't know when, how and how much gender-affirming hormone therapy changes things, because it hasn't been sufficiently studied. That's all I'm saying.
Facts, all these things are as clear as mud. At the end of the day, everybody is a walking sack of chemical reactions and things boil down to ur chemistry more than anything. Every single one is different!
Hey, I might have wrong assumptions and you certainly know more about this than I do so let me ask you. If I understand correctly you were born female and have undergone hormone therapy and plastic surgery to transition to male, correct?
If that's the case, first of all isn't it relevant to a doctor that you take hormones? One of the first questions most doctors ask is if you're on any prescription, and to a doctor wouldn't your genetics+hormones give a more correct picture than either male or female would?
When most people say sex matters to doctors I think they're talking about genetics and things derived from that, for example unless you had a hysterectomy uterus cancer is still a possibility, but prostate cancer is not. In that sense sex is important for doctors and helps them diagnose better.
It might be ignorance on my part but I can't see a situation in which being medically treated as a female would be life threatening, but I can see several where being treated as a male would. Hospital wards are split by gender not sex, so you should still be put into a male one.
Correct; FTM transition.
I absolutely agree with you here. A holistic understanding is infinitely more useful than any one-liner or discrete classification; this is true of everything, not just sex. However, the reason we have sex as a binary classification for patient data is because for 99% of patients this is more succinct (and therefore time-saving) for doctors, than going through a medical history to determine hormone profile and organ inventory. In an ideal world, these factors should be considered carefully for all patients, not just those they perceive to be 'outliers' in some way.
Reference ranges for blood testing is the most pertinent example. Interpreting the results w.r.t a female baseline would be misguided and cause them to miss certain anomalies, causing delays if not outright blocking diagnosis and treatment. That can be life-threatening depending on the specific condition. The opposite can happen too, i.e. a false positive, when the result is normal for men.
This is unfortunately no longer true in the UK as of yesterday.
Isn't both often relevant? Your hormones are probably the main thing usually, but unless you were lucky enough to only go through one puberty, your body has went through some irrrversible changes. And the duration of HRT would also be very relevant, not to mention that someone could for whatever reason not want HRT and still be trans.
Not to disagree that birth sex isn't any more medically relevant than gender though, and all of that should be part of your medical record and doesn't need to be elsewhere for that purpose.
Both are relevant, absolutely.
For transsexual men, the only irreversible change from first puberty is impact on bone structure/stature. Being smaller is not an exclusively female trait though, or 5'2" cis men would not exist.
Yep, this.