Putting yourself on a medical leash in the name of bodily autonomy...
... and other half-baked ideas
New research in the International Urogynecology Journal raises serious concerns about testosterone use among trans-identified female patients. Researchers found that 94% of the patients they studied had developed pelvic floor dysfunction since starting testosterone. What’s more, 87% suffered from issues with bladder control; 53% reported sexual dysfunction, such as pain during intercourse; and 74% reported experiencing issues with bowel movements, such as constipation or faecal incontinence.
In an interview with the Telegraph, physiotherapist Elaine Miller warned that young adult females taking testosterone appear to be on “exactly the same trajectory” as women undergoing menopause — except that they’re encountering these issues 20 or 30 years ahead of schedule. Miller spoke about the toll complications like this can take on a person’s life: “Wetting yourself is something that just is not socially acceptable, and it stops people from exercising, it stops them from having intimate relationships, it stops them from travelling, it has work impacts.”
There’s a serious disconnect between emerging evidence of transition’s risks and harms, and the ways young people view these interventions. In the online spaces that I study, young people talk about their bodies using casual, often dismissive language, as though they were embarking on a do-it-yourself home-remodelling project. They talk about how they prefer their bodies to run on “T” (testosterone), not “E” (oestrogen). They deride puberty as “oestrogen poisoning” or “testosterone poisoning”. They are also startlingly alienated from their bodies’ natural functions, always seeking fresh euphemisms to hide uncomfortable realities, such as the young woman who wrote that she could only cope with the “dysphoria” her period caused by “seeing it in a[n] impersonal and logically [sic], usually thinking ‘The cycle is occurring to this vessel.’”
Young people and gender clinicians alike increasingly speak of detransition as no big deal — just another stop along an edifying journey of self-discovery. Jack Turban and Johanna Olson-Kennedy, two of the leading gender clinicians in the US, refer to “dynamic desires for gender-affirming medical interventions”. Others prefer the term “retransition”, which suggests a kind of equivalence between the initial decision to intervene on a patient’s healthy body and any subsequent interventions on an altered body. Olson-Kennedy has waved away concerns about potential surgical regret among her young female patients: “If you want breasts at a later point in your life, you can go and get them.”
But transition — and detransition — is nothing like customising an avatar or tearing out a kitchen. What hormonal and surgical interventions can offer to patients struggling with gender dysphoria is severely limited. When these interventions “succeed”, they imperfectly imitate physical features and functions that medical technology cannot, in fact, replicate. When these interventions go wrong, the complications can be life-altering, even fatal. Meanwhile, every intervention takes an unpredictable toll on the body. Over the coming decades, as this mass medical experiment plays out, I worry that we will see growing numbers of young people suffering from the kinds of diseases and disabilities that typically emerge only in old age.
To make matters worse, researchers also expressed concern that patients may avoid seeking help for transition complications, citing fear of encountering discrimination in healthcare settings, as well as discomfort and distress dealing with body parts and functions. Patients may also fear losing access to interventions they have come to believe are not just identity-affirming but life-saving. Discussions in online forums frequently turn to complications patients are reluctant to bring to their doctors’ attention, lest they lose access to hormones.
For all the trans community’s talk about bodily autonomy, there’s little focus on the ways medical complications can strip away the freedom to live one’s life as one pleases. Young people flocking to gender clinics today may not realise what life on a medical leash means. Too many will find out in the course of time.
I need a shorthand phrase to express the realisation that the light at the end of the tunnel - the cultural enlightenment from Dr. Cass, the WPATH Files, the increasing numbers of regretful detransitioners and other major revelations - is probably receding almost as fast as we approach it. One of these moments of realisation was reading, "researchers also expressed concern that patients may avoid seeking help for transition complications, citing fear of encountering discrimination in healthcare settings, as well as discomfort and distress dealing with body parts and functions." The whole sub-culture that believes in "trans people" (or pretends to) colludes not only in causing the harm and suffering it, but then in covering it up, thus failing to alert the next cohort of innocents climbing on the conveyor belt.
Contrary to my earlier hope, I imagine some will be even more determined to assert the reality of their transgender status, whether they really believe it or not deep down, because that will increasingly become the ticket to all the further care they will need. We house people in care homes for the elderly not so much on the mathematics of their age, but their incapacities, like incontinence, fragile skeletons, and dementia - at least some of which we know are likely to be increased by use of exogenous hormones and transgender surgeries. I'm not sure if dementia is related to these (is there any research on that?), but it's a reasonable guess they won't help mental function, for instance through the stresses of living with a damaged body and possible struggles to form long-term life partnerships and have satisfying sexual relationships.
I see the suicide rate increasing over coming years, and increasing efforts to blame the evil transphobes. We - by which I mean, society generally - owe a massive debt of care to all the victims, to help them understand that it wasn't their fault. I might surprise some by saying that's also true of the likes of Turban and Olson-Kennedy - everybody does things for "reasons", they almost always believe those are good reasons, and we all trap ourselves in dead-ends we can't back out of - some are just more damaging than others. Despite that, I can't help wanting all the TRAs locked up for a symbolic length time.... or a pound of flesh cut from each of them.
Great article, Eliza!
It really bothers me though that they’re describing insane and unnatural damage to women’s bodies via male-levels of testosterone (so much more than female bodies can function on) as “exactly the same trajectory” as…menopause?
Obviously taking the T sends them into something like an artificial, chemically induced menopause occurring at the wrong phase of the female lifecycle…but real menopause is a natural process, a winding down of estrogen, with testosterone levels remaining normal. This what the female body NEEDS at this phase in life in order to live into old age. Any unpleasant menopause symptoms can be treated with some pelvic floor PT and some topical estrogen cream.
TIFs take so much testosterone, they kill their organs. Like, it’s the standard to remove all their reproductive organs after 5 years on T because it deteriorates their ovaries, uterus, cervix and vagina to such a degree they can get cancer or infections and it can kill them.
That’s NOTHING like menopause. Post menopausal women both have and NEED their ovaries, uterus, cervix and vagina to be healthy, and have normal levels of female sex hormones. Women have functioning ovaries till the ends of their lives, they’re not f*cking castrated.
These rates of incontinence and sexual dysfunction are insane and don’t even remotely resemble the rates of these issues in post menopausal women. 70% fecal incontinence? Again, that’s not menopause. That’s chemical castration.
It’s just more pathologizing of the female experience and aging.
Notice how nobody says 50+ men who have erectile dysfunction and may need viagra to be capable of sexual intercourse again are “on the exact same trajectory” as TIMs who’ve chemically and or surgically castrated themselves.