Estrogen: A Trip Report

The glass-is-half-full take is that no states have prohibited gender affirming care for adults. All the present bans in the U.S. only proscribe treatments for minors. But one would be forgiven for not knowing this because it's not how it's reported.

Point being, even the most conservative states haven't (yet) sought to limit treatment for trans adults.[1] Which is not nothing considering how many were so quick to ban abortion.

Also, it's not just the U.S.; plenty of "liberal" Western European countries have reversed course on care for minors. Even the Netherlands, the origin of the WPATH protocol, has pulled back on the reigns for minors, though they haven't yet instituted any prohibitions.

IMO, the trans advocacy rhetoric that equivocated hurdles to gender affirming care for minors as murder backfired. The fact there seems little motivation to limit treatment for adults suggests substantial openness to the issue among even conservative populations. And there are many in the LGTBQ community, include trans community, who share similar sentiments, at least regarding the rhetoric.

[1] Not sure about legislation dictating certain aspects, like waiting periods, but those were widespread as a practical matter in even the most liberal states.

From the point of view of a conservative and non us citizen, you have a good life there compared to the rest of the world.

Technically, most countries don’t allow people to be openly gay. In some countries, being gay even privately means you get beaten to death or your head chopped off.

Needless to say that transgender people are not even taken into consideration.

If I was gay or transgender, god knows I would rather be in the USA or maybe north Europe than any other country and especially not Africa, Arabia, South America.

That's one way to think of it, but the root of it (imho) is a mismatch between ones internal sense of inalienable gender identity and the embodiment of that identity physically - think clothing, bodily form, social perception, etc.

It might be difficult to imagine how those two things are separable if one has lived their whole life with them in congruence. If perhaps, you close your eyes and concentrate on your being, there is a part of you that feels that your sense of manness of womanness is part of who you are? What would you do if you retained that sense, and woke up in the body of the opposite sex and were expected to behave in congruence with that contrary to your internal sense of self? It can be a bit like that.

I haven't studied gender dysphoria but I've been diagnosed with it. In my experience, it's an incongruence between your idea of yourself and your perceptible form. In some ways it could be argued your body is "craving" it but not in the same way it may crave a specific nutrient. Instead, you're sort of surprised and often upset by the way that you are.

I'm pretty sure you're being transphobic, but for the life of me I can't understand what this statement is supposed to mean.

> I keep hearing people say "gender is a social construct" and those same people then go on to emphatically support transgender as a concept.

I say that "race is a social construct" but not "gender is a social construct", because gender has both social and biological components.

Gender having a biological component does mean that gender stereotypes that the average person learns are based on biology. The concept that pink is for girls and blue is for boys is social and cultural, not biological. Gender having a biological component is more complicated. A good book that explains this is Whipping Girl by biologist and trans woman Julia Serano:

https://en.m.wikipedia.org/wiki/Whipping_Girl

The first tenet of this model, the model's core that everything that follows is built upon, is the fact that "subconscious sex, gender expression, and sexual orientation represent separate gender inclinations that are determined largely independent of one another."

Just like cisgender women, not all trans women are "girly".

The fourth and final tenet of this model states that "each of these inclinations roughly correlates with physical sex, resulting in a bimodal distribution pattern (i.e., two overlapping bell curves) similar to that seen for other gender differences, such as height." This idea is what allows for the natural exceptions to gender expression to exist within the system without attempting to claim that they exist in as high of numbers as typical gender expression.

You are asking a good question (it reads to me like a good faith question that comes from a desire to learn more about how others think).

> Is it biological in basis, spiritual/metaphysical, or cultural?

Personally, I view it as cultural leading to physiological -- what does it mean to be a man? What is "manly"? I think everyone can agree that "manliness" is different globally. Is Bill Gates manly? He's very successful, but is that something that's manly? Is Tom Cruise manly? Or Kid Rock? What about George Takei? Manliness has some multi-axis definition that exists in each culture around the world.

We call that set of vectors "being a man", and we push people who are born with penises into it because it seems to fit most people who are born with XY chromosomes. Personally, I think it's useful to decouple the two ideas -- what my body is, and what the cultural expectations are in how I should behave because I have that body. This is what people mean when they say gender is a social construct -- they are saying, "The piece we call 'manliness' is a separate concept from the piece we define by bodies."

Now, say I experience anxiety, fear, and revulsion about the set of vectors that define "manliness". I have a penis, but absolutely all the vectors for "womanliness" line up with my understanding of how the world works. Clothing, presentation, speech patterns, interests, activities, etc. etc. etc. What do I do in such a case?

I could just live my life in pursuit of the 'wrong' set of vectors -- but socially that's quite dangerous. When people who are "supposed" to maximize one set of vectors try to live with another set, they tend to get bullied (if not violently attacked.) This puts me in a bind -- either live a miserable life pretending to be manly OR push my body to try and match the set of vectors associated with womanliness. (Or, change society to stop caring so much about people who fall outside of the traditional vector space, but that's a lot harder than either of the two other approaches.)

> is being transgender also just a social construct that can and maybe should be addressed by loosening up our tight expectations for gender roles?

For me, absolutely! That's the exactly the sort of ideal world I'd love to be in -- let people just... pursue what makes them feel happy. If someone with a penis wants to get way into makeup and the color pink, stop beating the shit out of them for it.

I think about it like this...

Fundamentally, I believe it's how they want to be treated culturally, but in our society, we tie gender and sex so closely together, that to be treated the way you want to be treated culturally in society, you need to change some of the sex based features you have.

In a better society, a medical approach wouldn't be needed. In our society, we _should_ accept that it is.

That's my opinion, and it's a pretty weakly held opinion, someone could dissuade me from it.

Kind of a tangent, but I think the cultural/social side is bigger and messier than your questions suggest, and I think boiling this down to "biological vs cultural" misses that.

> If gender is a social construct, is identifying as transgender the result of feeling pressure to conform to a cookie-cutter definition of what someone with male/female parts is meant to be like?

I suspect "identifying as" cisgender is the outcome of this kind of cookie-cutter pressure to much the same degree, if not more. This tends to go unnoticed even in conversations where people are directly engaging with the ideas. (Even though that's part of what "gender is a social construct" is meant to suggest.)

A rhetorical question for cis people: to what degree do you feel your cisgenderness is a result of feeling pressure to conform to a cookie-cutter definition of what someone with male/female parts is meant to be like? I suspect there's more meat to genuinely unpacking this than you might think. Trans people's answers to this might not be that different from cis people's.

"It's a social construct" is an invitation to peek behind (or at least recognize) an abstraction; but it's just a peek into a quite complex story.

"Social construct" doesn't necessarily mean something to rise above, or to dismantle, or to deny. Money is a social construct. Human rights are a social construct. Friendship is a social construct. Sure, one can usefully imagine oneself "above" those things at times, but it's unclear whether aspiring to that is a good idea, and realistically most people won't attain it even if they do. Culturally we must find some relationship to those things anyway, we cannot ignore them.

As I see it, gender is an aspect of a messy evolving cultural system. Yes, the concept of "transgender" is part of that system, though it certainly doesn't fit into that system in quite the same way as "man" and "woman". Trans people tend to challenge or pressure many aspects of this system in some ways that cis people tend not to, but that's not the same thing as denying the system in whole. (Some people do see "gender abolition" as an aspirational ideal; many don't.)

Broadly, I think "is being transgender also just a social construct that can and maybe should be addressed by loosening up our tight expectations for gender roles" vastly underestimates the scope and scale of this cultural system, the degree to which it's tangled up in our lives, and the difficulty of untangling it.

Can’t you just be a man that loves spending time with women instead of a woman ‘trapped’ in the body of a man ?

I have known several men, non gay, that just behaved more like women than men. that was fine, and as far as I know they didn’t swapped gender.

Like you can be a duck, happy when around dogs but still be a duck.

> many who have had both primary hormones prefer the feeling of testosterone.

This is super interesting! Do you know what they prefer about testosterone?

> One recurring theme I've heard from people going from majority testosterone to majority estrogen is a feeling like a continuous 'buzzing' sensation in their head had finally stopped

This is also fascinating. As a cis man is there a buzzing constantly that I don’t even notice, that none of the women in my life have?

It’s an extremely common pattern for alcoholic drinks, to the point that a man ordering a very sweet drink or a woman ordering neat whisky is likely to draw comments (not even necessarily negative ones, especially in the case of a woman preferring usually-masculine drinks). It’s also present in wine marketing—the lower end of the market has heavily feminine-coded marketing and tends to be very sweet (at least in the US), and in fact that aligns with actual preferences I’ve observed (I’m not sure I know a single woman who prefers dry wines?)

Chocolate (dark vs milk) and coffee drinks (heavy on milk and sugar versus light on them, or black) follow similar patterns in perception (and actual observed preferences, IME)

Of course, how much of that is nature versus socialization is another matter… but also, the kind of risk-taking and one-upsmanship behavior that might drive men to be more willing to acquire tastes for things that aren’t initially appealing and to so-expand their palates may itself be hormonal, so even one plausible “nurture” cause for this might actually be “nature” one step removed.

But either way, and even if data doesn’t bear any of that out (pretty sure it would, though), the perception that all that’s generally true is certainly common.

> I’ve never heard one that involves women liking sweet food more or less than men,

It's somewhat ingrained in (traditional) Japanese culture that women prefer sweet foods and men prefer spicy foods. Young boys enjoying sweets is seen as "funny" since they don't "know" it's a feminine thing yet (not necessarily in a "you can't do that" way, but more in a "cute that he hasn't picked up on it yet" way).

What? How in the world did I make that assumption?

Women (here I mean XX individuals) have two different alleles present for each of the green (OPN1MW, also the OPN1MW2 duplication) and red cones (OPN1LW), since these are found on the x chromosome. X-inactivation means that only one gets expressed in a particular cell, but this means individual photoreceptor cells can express either allele. The individual proteins and gene encodings of the cones can differ, and small variations shift the spectral sensitivity to slightly shorter or slightly longer wavelengths. It's possible, then, for a woman to express as many as five unique-ish cones in theory -- though there's only been one 'true' tetrachromat found so far. Still, having red and green cone variants that respond with a peak preference shifted 10-20 nm in addition to another unshifted cone (or, better, shifted the opposite direction) provides a biological basis to expect women (again, specifically XX individuals) to have finer color differentiation. This explanation, however, could not occur following a hormone replacement.

I was not prepared for my food tastes to change! I used to love candy. But now I’m rarely drawn to it, but I will absolutely INHALE fruit. It has so much incredible depth of flavor now!

> Some women are tetrachromats with an extra colour sense, while men are more likely to have red/green colour blindness.

If I'm not mistaken, red/green color blindness is more common in men because it's caused my a mutation on the X chromosome (which men tend to have fewer of). I would guess a similar thing about tetrachromacy.

So those are probably unrelated to color-perception changes due to exogenous estrogen.

No mention of a doctor or monitoring. I don't live in the USA - bureaucratic hoops sounds like what I go through to get my id renewed.

From the first few paragraphs of the article?

> and subsequently found myself cycling home from the pharmacy with a paper bag filled with repurposed menopause medication

and then no mention after of monitoring of health effects?

Ironically, testosterone in theory is harder to get. Since it is widely used for sports doping, it's considered an anabolic steroid, and is a scheduled substance in the US, and so has a bit more oversight to prescribe and dispense. (But I imagine there's probably also a larger black market for it for the same reasons.)