That's really interesting. I think people would be surprised at how much medicine is not evidenced-based -- not because doctors are bad at science, but because gathering medical evidence is hard. Randomized controlled trials are the gold standard, but declaring "We're going to gather up a bunch of trans men who expect to become pregnant and randomly assigning them to continue testosterone or not" is going to be logistically challenging and ethically complex.
The point that women with PCOS are not given androgen blockers is fascinating. I wonder if anybody has tried that and observed anything.
In the absence of evidence, doctors are forced to muddle through. It sounds reasonable not to alter the hormones when the body is doing something where the body is already setting up a specific hormone mix, even if imperfectly. But that's just caution in the face of ignorance, not a factual statement.
"Not evidence based" is the impression the motivated author aims for, but if read carefully, is not supported by the text of the article. E.g. the link in While testosterone is widely considered a “male hormone,” all people produce testosterone. is to a study [1] showing an average 10x difference in testosterone levels between men and women.
Later, talking about polycystic ovary syndrome, it tacitly admits excess testosterone is likely to cause:
developing intersex conditions, or having biological traits that do not fit binary definitions of male or female characteristics; [..] metabolic and cardiovascular dysfunction, such as obesity; and neuropsychiatric disorders, such as autism and attention-deficit disorder
This is excused by equating the desire for "normal" children with eugenics:
I became increasingly concerned that this focus on producing “normal” children fails to attend to both natural human diversity in cognitive processing, bodies and identities, and the mental health of trans and nonbinary parents. It may also echo eugenicist policies that attempt to eliminate human characteristics and communities that society deems inferior or bad.
Yeah, that last bit really bugged me. I get that there is a very fuzzy line between wanting your children to be healthy and forcing your own ideas of "normal". But it's reasonable to not take unnecessary risks, and then love whatever you get no matter what.
No sane parent would drink a lot of alcohol during pregnancy. Fetal alcohol syndrome is not a "community". I don't know what the effects of testosterone during pregnancy are, but it's reasonable to advise a parent not to take that chance.
If the parent would be badly harmed by ending testosterone then a balance would be struck and the experiment should be noted. Maybe it is safe enough. But I don't like the idea of saying that all behavior is automatically safe because any harm is merely diversity.
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[ 7.7 ms ] story [ 24.3 ms ] threadThe point that women with PCOS are not given androgen blockers is fascinating. I wonder if anybody has tried that and observed anything.
In the absence of evidence, doctors are forced to muddle through. It sounds reasonable not to alter the hormones when the body is doing something where the body is already setting up a specific hormone mix, even if imperfectly. But that's just caution in the face of ignorance, not a factual statement.
Later, talking about polycystic ovary syndrome, it tacitly admits excess testosterone is likely to cause:
developing intersex conditions, or having biological traits that do not fit binary definitions of male or female characteristics; [..] metabolic and cardiovascular dysfunction, such as obesity; and neuropsychiatric disorders, such as autism and attention-deficit disorder
This is excused by equating the desire for "normal" children with eugenics:
I became increasingly concerned that this focus on producing “normal” children fails to attend to both natural human diversity in cognitive processing, bodies and identities, and the mental health of trans and nonbinary parents. It may also echo eugenicist policies that attempt to eliminate human characteristics and communities that society deems inferior or bad.
[1] https://www.medicalnewstoday.com/articles/323085
No sane parent would drink a lot of alcohol during pregnancy. Fetal alcohol syndrome is not a "community". I don't know what the effects of testosterone during pregnancy are, but it's reasonable to advise a parent not to take that chance.
If the parent would be badly harmed by ending testosterone then a balance would be struck and the experiment should be noted. Maybe it is safe enough. But I don't like the idea of saying that all behavior is automatically safe because any harm is merely diversity.