Sunday, July 22, 2012

Transmale Health and HIV

This link gives a balanced account of what trans females can expect from taking testosterone, from how it can change their sexuality (lesbian to straight), increase or decrease their sex drive to suddenly wanting to have their vagina's penetrated by a penis or wanting to suck a penis. And given the latter, it contains some good info on how trans females can protect themselves against HIV and other STDs that having sex with men they run the risk of contracting.

I also think it gives some good visual representations of various trans females and what females considering transition can expect from dosing themselves with testosterone. Clearly even after years on testosterone, the feminine body remains firmly intact. See images below:


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  1. No offense to these guys, but I've got 10 better-looking, more masculinized transdudes within 1 square mile of my house. These pictures aren't very representative. Howvever, transition is a calculated risk and one should not expect to get rid of a giant ass, love-handles, or really wide hips. Likewise, if you are not a muscular person already , don't expect a damn miracle. If you are not attractive beforehand, you are not likely to become more attractive.

  2. Really, 10 'better' transman within a square mile? Guess everybody really IS doing it these days. That's a lot of 'born in the wrong body,' innit?

    1. oh sorry I mean transDUDES of course

  3. Anon@6:40, And we're told transition is all about feeling "better in your own body", apparently to some its a competition of-Who can harm their female form "better".


  4. OKay, two square miles. Maybe we should campaign to get the word "trans" changed to "none of your fucking business" so that old schoolmarms don't think they can weight in on other people's lives. After all, I'm not donna tell you not to wear a suit just because it looks really stupid on your female "form". But I guess that's because I have better personal boundaries than you all do.

    1. it's interesting that you think everybody who questions the theories and values behind transsexualism is of the 'old schoolmarm' variety (which strikes me as both 'ageist' and sexist)

    2. A suit looks stupid on ur female form? What kind of ignorant statement is that? Would you make that same statement if it were a lesbian wearing a suit? Sounds to me, you're stuck back in the time where only men wore pants. Tell all the butch women they have to get married in a dress and see how well that goes.

  5. Donna, (I'll assume a Freudian slip) you were the one "weighing in", with pure misogyny I might add. Given you hate yourself because you're a woman, your comments toward any woman (trans females or not) arent surprising. You dont need "T", you need feminism.


  6. "No offense to these guys, but I've got 10 better-looking, more masculinized transdudes within 1 square mile of my house."

    I know ten better looking butch lesbians who are far more masculine, strong, independent, self-aware, and proud than Chaz Bono, Thomas Beatie the pregnant FTM, or Buck Angel the FTM porn star.

    "However, transition is a calculated risk and one should not expect to get rid of a giant ass, love-handles, or really wide hips."

    To me, it's so strange how the term "transitioning" came about. Isn't this just another name for elective masectomies for healthy young women,a life time of testosterone, and the possibility of surgically altering one's healthy female genitalis. At least this individual has the sense to state that transition is "a calculated risk."

  7. When we are forced to live in this Orwellian trans fantasy, I don't know whether to laugh out loud or cry.

    (1.) Transmen still need to be reminded that they also have a cervix. If they still have a cervix, they need a pap smear just like all other biological females. Testosterone and the removal of both healthy breasts only give the OUTWARD appearance of male. Well, isn't a cervix a female organ? Transmen, you are still male, but don't forget the pap smear. It makes sense to me.

    (2.) Transmen have to be reminded to ALWAYS use a condom if they have sex with men. While nearly every butch lesbian I know wouldn't have sex with a gay man under any circumstances. Butch lesbians don't like penis. Some transmen, however, do have sex with gay males.

    By the way, none of these transmen look all that masculine to me.

  8. To me, it's so strange how special health care books have to be produced just for transmen. Why is this? Perhaps this is true because in order to remain outwardly masculine they are essentially wedded to the health care industry for the rest of their lives.

  9. Anon@1:54pm, Unless a Butch is on T, she isnt "masculine". Butches are women with feminine bodies, simply because we carry our bodies differently, doesnt make us "masculine" or less female.

    Please try to stop looking through the lens of the Gender Straight Jacket.


  10. Dirt, I'm sorry. You are right when you say butches have feminine bodies because they aren't men, or even try to be men, or claim they are men. Yes, butches do seem to carry our bodies differently, and we do things that femmes usually don't do. Butches have a swagger. It's not male, but it certainly isn't femme. I was trying to make the point that some transmen I've seen don't appear that masculine to me. For example, I've never thought Chaz Bono was masculine at all.



    Increased red blood cell (RBC) count

    Higher-than-normal numbers of RBCs may indicate congenital heart disease, cor pulmonale (failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle), polycythemia, or kidney disease with high erythropoietin production. For more on polycythemia, see below.

    Increased hemoglobin (HGB)

    Higher-than-normal hemoglobin may indicate congenital heart disease, cor pulmonale (failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle), polycythemia, or increased RBC formation associated with excess erythropoietin. For more on polycythemia, see below.

    Increased hematocrit (HCT)

    High HCT may indicate dehydration, erythrocytosis (excessive red blood cell production), or polycythemia. For more on polycythemia, see below.


    Testosterone usage has been shown to increase "erythropoiesis," or red blood cell production. "Polycythemia" is an abnormally high level of red blood cells. An excess of red blood cells thickens the blood, impeding its passage through small blood vessels and causing a number of potential health problems. There are a few different types of polycythemia: "polycythemia vera," "relative polycythemia," and "secondary polycythemia."
    It is important to understand the differences between the three types of this condition, because polycythemia as a result of testosterone usage would probably best be categorized under secondary polycythemia. Of course, if your doctor diagnoses you with polycythemia, it is still important to determine which type of polycythemia you have and proceed with the proper treatment-- one should not automatically assume that an initial elevated RBC or HCT reading is necessarily secondary polycythemia simply based on testosterone use alone. Family history and other factors (listed below) should be considered.

    Polycythemia vera (or "primary polycythemia") is a rare myeloproliferative disorder, meaning that the bone marrow cells (which produce red blood cells) proliferate uncontrollably. In polycythemia vera, the RBC count increases without being stimulated by the red blood cell stimulating hormone, erythropoietin (EPO). Risk factors include exposure to radiation, some cancer therapy drugs, and familial history of polycythemia vera. In the case of relative polycythemia, an individual has an excess of RBCs due to a loss of volume in the plasma (the liquid portion of the blood). This can be due to dehydration, use of diuretics, burns, stress, or high blood pressure.

    Secondary polycythemia is defined as an absolute increase in RBCs caused by an increase in the RBC stimulating hormone, erythropoietin (EPO). Potential causes include low blood oxygen caused by heart disease, prolonged carbon monoxide exposure caused by smoking, hereditary disorders producing an abnormal hemoglobin or an overproduction of EPO, or kidney disease.

    Complications that can arise from polycythemia include thrombosis (blood clots that can cause stroke or heart attack), hemorrhage, and heart failure.

    The objective of treatment is to reduce the thickness of the blood due to the increased red blood cell mass and to prevent hemorrhage and thrombosis.
    Phlebotomy is one method used to reduce the high blood viscosity (blood thickness). In phlebotomy, 1 pint of blood is removed weekly until the HCT is less than 45%, then phlebotomy is continued as necessary.

    For relative polycythemia and secondary polycythemia, treatment must also address any underlying risk factors, such as smoking.


    Elevated liver levels & potential liver conditions

    Testosterone therapy can cause alterations in liver function tests, cholestatic jaundice, hepatocellular neoplasms (rare), and peliosis hepatis. Specifically, the use of orally-administered C-17 alpha alkylated testosterone has been associated with such complications, in addition to being associated with hepatocellular carcinoma and hepatic adenomas. Oral use of C-17 alpha alkylated testosterone is therefore generally discouraged, as injectable, transdermal, buccal, and pellet delivery methods are thought to significantly lower such risks. No matter which testosterone delivery method is being used, it is prudent to screen the user with liver function tests to monitor the overall health of the liver.
    Cholestatic jaundice
    Jaundice is a yellowing of the skin and other tissues due to excess circulating bilirubin. Mild jaundice is usually detectable when serum bilirubin reaches 2 to 2.5 mg/dl (milligrams per deciliter). Cholestatic jaundice is due to a biliary obstruction (a condition where bile excretion from the liver is blocked, which can occur either in the liver or in the bile ducts).

    Hepatocellular neoplasms

    Hepatocellular neoplasm is a general term for abnormal new tissue which has grown on the liver (neoplasm means "new growth"). These growths may be benign or cancerous.

    Peliosis hepatis

    Peliosis hepatis is a condition in which multiple blood-filled cystic spaces develop throughout the liver which may lead to congestion and necrosis.

    Hepatic adenomas

    Hepatic adenoma (HA) is a rare benign tumor of the liver. Two types of HAs have been identified, including tumors of bile duct origin and tumors of liver cell origin. HAs may rupture and bleed, causing pain. Although they are benign lesions, HAs can undergo malignant transformation to hepatocellular carcinoma (HCC). Although malignant transformation is rare, surgery is advocated in most individuals with presumed HAs.

    Hepatocellular Carcinoma

    "Hepatocellular carcinoma" (HCC) is a term for a malignant (cancerous) tumor of the liver.
    Suppression of clotting factors
    Testosterone has been reported to suppress clotting factors II, V, VII, and X. For those also taking anticoagulent medication such as Warfarin, testosterone may increase the effects of such medication. Caution should be exercised by those taking such medication, or those with bleeding disorders. Consult with your doctor about possible dosage adjustments.

    Elevated lipid profile/High cholesterol

    The higher an individual's level of cholesterol, the higher their risk of coronary heart disease. The lower your LDL cholesterol, the lower your risk of heart attack and stroke. It is also important to maintain a high enough level of HDL, or "good" cholesterol. Excessive total cholesterol contributes to atherosclerosis and subsequent heart disease.

    Atherosclerosis is a condition in which fat, cholesterol and other substances are deposited along the walls of arteries. This fatty material thickens and hardens, forming "plaques" that diminish the elasticity of the arteries and may eventually block them. Clots can form around plaques, posing an additional danger if they break off and travel to the heart, lungs, or brain.

    High triglyceride levels may be associated with a higher risk for heart disease and stroke. People with high triglycerides often have other conditions that increase the likelihood of developing cardiovascular disease, such as diabetes and obesity. High triglyceride levels may also indicate cirrhosis, hypothyroidism, high carbohydrates in diet, poorly controlled diabetes, or pancreatitis.

  13. All I see in these photos are happy, confident people.


    High Blood Pressure

    High blood pressure, or "hypertension," directly increases the risk of coronary heart disease and stroke, especially along with other risk factors. Testosterone therapy can contribute to raised blood pressure levels. Because of this, and because of other potential risk factors for heart disease such as increased lipid profile or polycythemia, it is wise to monitor blood pressure levels throughout testosterone therapy.


    Edema refers to the abnormal buildup of fluid in the ankles, feet, and legs. It is usually painless. Testosterone is known to cause water and electrolyte retention (i.e., sodium, potassium, calcium, and inorganic phosphates), which can contribute to such swelling. Sometimes increasing daily water intake can reduce or end the problem.


    Acne is a skin disorder (characterized by whiteheads, blackheads, and pimples) that effects the pilosebaceous units (PSUs) of the skin. PSUs consist of a "sebaceous" gland (oil-producing gland) connected to a canal called a "follicle." The follicle contains a fine hair, and the hair grows out through the open end of the canal at the skin's surface. This open end is usually called a "pore." There are numerous PSUs on the face, upper back, and chest (where acne problems often are worst).
    The sebaceous glands produce an oily substance called "sebum" that normally empties onto the skin's surface through the pore. Trouble begins when the follicle becomes plugged, thereby preventing the normal draining of sebum. If a follicle becomes blocked for some reason, the mixture of oil cells within allows the bacteria "Propionibacterium acnes" (P. acnes), which is normally present on the skin, to grow inside the plugged follicle.
    The P. acnes bacteria inside the plugged follicle causes the body to send white blood cells to that follicle, which in turn causes the area to become inflamed and painful. This leads to a variety of skin lesions.

    Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks. Acne can be triggered by hormonal changes; stress; oily facial, body, or hair products; humidity; sweating; and irritation. Testosterone therapy increases activity of the sebaceous glands, and so may increase the presence of acne..


    Seborrhea, or "seborrheic dermatitis," is a skin condition characterized by loose, greasy or dry, white to yellowish scales on the skin, sometimes with accompanying redness. It may involve the skin of the scalp, eyebrows, eyelids, nose, lips, behind the ears, the external ear, and the skin of the trunk, particularly over the sternum and along skin folds. This side effect of testosterone usage can be temporary or a more long-lasting condition that may flare up due to contributing factors such as stress, fatigue, weather extremes, oily skin, infrequent shampoos or skin cleaning, use of lotions that contain alcohol, skin disorders (such as acne), or obesity.

    Miscellaneous other side effects
    Also listed as potential side-effects of testosterone use are: nausea, headache, anxiety, depression, or generalized paresthesia.


    Paresthesia refers to an abnormal burning or prickling sensation which is generally felt in the hands, arms, legs, or feet, but may occur in any part of the body. Many describe it as a "pins and needles" feeling.


    Yeast infections and bacterial vaginosis

    Hormonal changes can cause changes in the vaginal environment. This can bring about two common types of vaginal infections: yeast infections and bacterial vaginosis. In order to treat these infections properly, it is important to properly diagnose which type of infection you may have by seeing your doctor.
    A yeast infection is caused by the overgrowth of a naturally occurring yeast, Candida albicans, in the vagina. If there is a change in the vaginal environment due to hormonal fluctuations, injury, a compromised immune system, increased pH, increased heat and moisture, allergic reactions, elevated sugar levels, or reductions in the populations of bacteria that are normally present, Candida albicans will multiply rapidly and cause the symptoms of a yeast infection. Symptoms include itching and/or a burning sensation around or inside the vagina; a white, clumpy discharge that may look like cottage cheese (discharge can also be thinner and faintly yellow or nearly clear in color); and a smell that is similar to bread or beer.

    Treatment of a yeast infection can range from over-the-counter or prescription treatments such as Diflucan or Monistat to natural home remedies such as inserting plain, unpasteurized yogurt into the vagina, drinking unsweetened cranberry juice, or consuming acidophilus. Check with your doctor for advice if yeast infections continue to occur. They may be more common in the beginning of hormonal transition.
    The yeast infection should not be confused with bacterial vaginosis (BV), another kind of vaginal infection. BV occurs when certain types of bacteria (such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis) outnumber the normal Lactobacillus bacteria due to a change in the vaginal environment. The primary symptom of BV is an abnormal gray-white vaginal discharge that often has a fish-like odor. There may also be itching and/or a burning sensation around the vagina.
    Bacterial vaginosis is usually treated with antibiotics. Check with your doctor for advice if BV continues to occur. It may be more common in the beginning of hormonal transition.

    PCOS and ovarian and endometrial cancers

    Some physicians recommend hysterectomy (surgical removal of the uterus) and oophorectomy (surgical removal of the ovaries) within the first 5 years of starting testosterone therapy. This is because there is some concern that long-term testosterone treatment may cause the ovaries to develop similar symptoms as those seen in polycystic ovarian syndrome (PCOS). PCOS has been linked to increased risk of endometrial hyperplasia (a condition that occurs when the lining of the uterus (endometrium) grows too much) and thus endometrial cancer, as well as ovarian cancer.
    It should be noted that it is difficult to know whether the risk for such cancers is increased by testosterone therapy in trans men. Female-to-male transsexuals are a small population to begin with, and many undergo hysterectomy/oophorectomy early on in their hormonal treatment, thus making the study of long-term testosterone effects on the uterus and ovaries difficult. Also, some trans men may have suffered from PCOS before beginning testosterone treatment, making it difficult to know if PCOS-like symptoms may have originated before of after T therapy.

  16. Anon, I know where you were coming from and I wasnt trying to be an ass. But as women who have been shamed from our feminine bodies (which hurts us and our relationships) we have to reclaim what has been stripped from us long before we ever had a say.

    And in this new day of queering, we MUST embrace our femaleness and reject the nonsense of "female masculinity" that the scared and insecure so desperately cling to.

    Butches are WOMEN first!


  17. Do I have to stay on T my whole life?

    Generally, most trans men remain on a maintenance level of T for their whole lives, even after they have gone through significant masculinization. There are a number of reasons for this, both health-related and emotionally-related.

    First, if your ovaries are still present and functional, the cessation of testosterone may cause the return of certain feminine body characteristics, including monthly periods. Second, if your ovaries have been removed or are no longer functional and you stop taking testosterone, your body will not be able to produce a "normal" amount of either estrogen or testosterone by itself. This would cause a menopause-like state, which could include hot flashes, loss of bone mass, and other considerations. Maintaining a level of testosterone within a healthy range over the lifetime of a trans man can protect against those potential problems. There are differing medical opinions as to the benefits and drawbacks to hormone replacement therapies-- be sure to speak to your doctor if you are considering stopping testosterone therapy for any reason.

    (Notice in this FTM health guide, it says…”your ovaries twice”…
    Aren’t ovaries female organs?)

    Some women have had to stop testosterone because of side effects.

    Perhaps the female body wasn't designed for that much testosterone. Indeed, I don't think this is seen anywhere among the primates. Of course, females naturally produce small amounts of testosterone, but never the amount that biological males produce naturally. In many ways, it seems as if one grand experiment is going on.

  18. What NEVER gets discussed by doctors or the trans community is the impossibility of a measuring a proper or correct level of testosterone to inject into aa female body by comparing that body to that of a male for which those level are designed!

    If the female body was meant to have higher levels of testosterone she'd be born with it!


  19. @Dirt How do you know that it never gets discussed? Have you ever sat through an appointment with a doctor or attended a medical conference on trans-health?

  20. Dirt, I had feminism for many, many years. It failed to shame the trans out of me. You will find that many of us come from feminist backgrounds. I reject the feminism that polices, interferes, judges, and talks out of it's ass without knowing people's experience. Real feminism would be embarrassed to have you among it's ranks.

  21. Yes, there are risks with transition, real medical risks and it could cost your life.

    If you do not need transition so bad that you would face death to have it, you are not Trans. If you are not Trans and you transition, you will become trans by virtue of what you have done to yourself.

    From the perspective of a trans person I am seeing so many younger folks transing that I worry.

    Hold off until you are older. See if you can make a go of it in your birth gender. And I mean make a real go of it and try to accept your body.
    If you cannot handle it and there is no choice but to kill yourself or transition; then you might want to consider transition.

    Far too many young lesbians (and gay males) I meet in the community have convinced themselves they are men (or women) or been convinced by the Trans catechism. I am seeing far too many young homosexuals eagerly embracing a curse as if it is a life style.

    Dirt is right in the majority, and wrong in the minority. There is a definite trendiness in the transition of many of the new crop of transitioner. Try to find the self-hate derived from internalized misogyny and delve deep into your psyche' before you go the transition route. Dirt is not right however in the assertion that ALL transition is wrong. We can never resort to absolutes. There are some, who for right or wrong cannot function without transition. Those who would rather face certain death than remain as they are born are the only logical candidates for transition. All other transitions should be off the table.

    Young transitioner I implore you; weigh your options faithfully. Engage in to the deep work of delving into your psyche and find the real root of your issues. Be real honest with your therapists. Do not spout the trans accepted lines that will guarantee you transition. Tell them the truths in your heart. Because I promise you:

    If you are not transsexual before you transition, you will be a transsexual when you do transition. You will be a medically created transsexual, by your own hand. You will regret it, hate life, and wish with all your heart you could go back and fix it all. I have seen it a number of times.
    Special snowflake? not really, just an extremely rare bird that has some copycat species

  22. "Donna, (I'll assume a Freudian slip) you were the one "weighing in","

    Oh Dirt, don't give me shit about a single typo when you can barely string two sentences together without making some huge grammatical error. Sometimes I wonder if you are drunk when you post here.

  23. "it's interesting that you think everybody who questions the theories and values behind transsexualism is of the 'old schoolmarm' variety (which strikes me as both 'ageist' and sexist)"

    But if there is no gender, then certainly anyone can behave like an old schoolmarm. I see it as more of a shitty-personality problem than a gendered insult.

    1. anyhow, I am not an 'old schoolmarm' type; I'm a Manhattanite in my 30's in the fashion/music world- don't assume trans-skeptics are all alike or are all 'butch dykes'

  24. Donna, if I'm that difficult to understand, that I suggest you read elsewhere rather than find yourself so obviously bothered.


    ps hope that makes sense to you

  25. Me being "wrong in the absolute" anon, is an absolute. It is a physical impossibility by the properties of nature to be "born in the wrong body".


  26. 7:38, thank you for some clear thinking!

  27. I knew one of the people photographed. They are one of the reasons I got out of the trans community and ideology. This person woke me up to the fact that people with severe psychiatric illness are being misdiagnosed with GID.

  28. "Real feminism would be embarrassed to have you among it's ranks."

    Women compromise approximately half the population on earth. The fairly recent interest in all things trans related appeared approximately the same time as feminism was declining in the 1990s.

    I can't speak for all feminists because, in all honesty, this would be extremely arrogant of me. However, I do believe most feminists would be embarrased by Buck Angel, the FTM porn star, or Richard Masbruch (aka Sherri). Along with the increased interest in transgender, there has been an explosion in pornography. At the annual Philadelphia Trans Health convention, there was even a workshop for FTMs in the sex industry. One of the reasons that trans activists have more power and clout than lesbians is because they have backing of both the medical establishment (cross gender hormones are for life) and the sex industry. Transgender, does indeed, support patriarchy. It always has and it always will. If this is feminism, I don't want to have anything to do with it.

  29. I look at these photos and think, of course, Dirt wouldn't put up pictures of transmen that didnt have something noticeably feminine about them. That wouldnt do much to prove the point she's trying to make. For someone that speaks about how you don't have to conform to gender stereotypes, why do these transmen have to look like a stereotypical males? I've known many biological men that have large hips and even those that have large amounts of breast tissue. Even biological women that have facial hair and very little breast tissue. When you, Dirt, look at these pictures, you're looking for a stereotypical male. For someone that doesn't conform to stereotypical female looks, that seems a bit hypocritical.

  30. I didnt "look" for anything, merely reposted what was presented. If you have some kind of female shame when you look at these women, than thats an issue you need to address.