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Unbiased Trans Information?

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Fino

Fino

Alex
V.I.P Member
I'm not interested in starting a discussion on how people feel about trans people in general. I'm wondering what people know about the health implications of a person medically transitioning through hormones, surgery, or otherwise. It's not a political concern, and though I'm Christian, I am not anti-trans. It's a personal concern. My sibling is transitioning (male to female), and I'm constantly bombarded with views from both sides.

Since I do engage with Christians frequently, I hear a lot of arguments that it's dangerous, painful, risky, etc. to transition. Since I do live in LA, I'm equally faced with arguments that there is no health risk. I'm guessing the truth is somewhere in between.

I'm mainly just worried about my sister. She has been transitioning for years but still just sits at home 24/7, not working, not very happy, and taking large amounts of psychiatric medications in addition to the hormones. If someone doesn't necessarily have the answers, does anyone know of resources that would tell me about these sorts of things in as unbiased a way as possible?
 
Try looking up Fenway Health. They are based in my area but have a lot of resources for people who are transitioning, and it is an organization run by medical doctors.
Transgender Health - Fenway Health: Health Care Is A Right, Not A Privilege.

I will reiterate here to anyone who is thinking of commenting that the OP is not looking for a debate.

I wish your sister the best on her journey of self discovery and hope she can get some sound medical advice.
 
I have a niece/nephew who is trans. suspect there may be some unexpected consequences Thier usually is. probably hard to predict. Aso an Aspie, knew before diagnosis, takes one to know one.
 
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Fino said:
I'm not interested in starting a discussion on how people feel about trans people in general. I'm wondering what people know about the health implications of a person medically transitioning through hormones, surgery, or otherwise. It's not a political concern, and though I'm Christian, I am not anti-trans. It's a personal concern. My sister is transitioning (male to female), and I'm constantly bombarded with views from both sides. Since I do engage with Christians frequently, I hear a lot of arguments that it's dangerous, painful, risky, etc. to transition. Since I do live in LA, I'm equally faced with arguments that there is no health risk. I'm guessing the truth is somewhere in between. I'm mainly just worried about my sister. She has been transitioning for years but still just sits at home 24/7, not working, not very happy, and taking large amounts of psychiatric medications in addition to the hormones. If someone doesn't necessarily have the answers, does anyone know of resources that would tell me about these sorts of things in as unbiased a way as possible?
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I can understand your concern for your sister, especially as her mental health does appear to be suffering currently. I'm not in your area, so can't offer names of organisations, but would the practice that are helping her with her transition not have any services designed to help family members with such a significant journey?
 
I can answer your medical questions on transitioning, if you want. Whether in this thread or via PM.
 
Bolletje said:
I can answer your medical questions on transitioning, if you want. Whether in this thread or via PM.
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If you're okay with in this thread, that might end up being informative to others, as well. She has had minor things done, like hair removal with lasers of some sort, I believe, but she is considering more drastic surgery, which is when I started being a little more concerned. I've heard claims from Christians that patients are often not well informed when they do undergo these procedures so I'm worried about any long-term, unintended consequences if she does go through with anything like that.
 
Is there any surgery in particular you are worried about?

In general, gender affirming surgery is something that happens quite late in the transitioning process. By which I mean, a big team of healthcare professionals have been working with the patient on several aspects of their health before the scalpel ever touches the patient. It is a MAJOR decision and a major life event once the transition starts.

It’s not something doctors just jump into without making very sure this is what the patient wants. An oft heard complaint from people that want to transition is how many hoops they have to jump through before they can even get to the point where the subject of surgery is on the table. Because of the nature of the surgery, no doctor will want to perform these surgeries unless they feel like a patient is 100% on board with their decision. If they detect any doubt, the surgery will not happen.

If your sister is going to a reputable physician and has a healthcare team around for her transition (including a mental health professional) I think you can assume the pros and cons of surgery will be discussed thoroughly.
 
You mention your sister being depressed. That’s a tough situation. A question that might be asked in that situation is “what if she’s not thinking clearly right now?”

It’s a tough question and a daily occurrence in care for people somewhere in the transition process. Because there are several options (with their own outcomes)

1) they are depressed because of their gender dysphoria, moving forward with the transition should be therapeutic

2) they are depressed because of side effects of the transition (common, because hormonal changes can mess you up)

3) they are depressed for different reasons, ideally this is resolved before transitioning because it’s a taxing enough process as is.

And then obviously there’s the question: when someone is depressed and heavily medicated, are they capable of fully understanding the implications of the surgery they are consenting to? It’s an understandable, complex question. But that’s why there’s a team of healthcare professionals involved in trans care, to make sure all bases are covered before the green light is given for surgery.
 
I realize there are plenty of stories out there about “buyer’s remorse”, so to speak. It’s good to keep in mind that those stories are the reason transitioning is such a lengthy process and the waiting lists for gender reaffirming surgery are so long in most countries practicing Western medicine (I emphasize western here because I am not an expert on how things are done world wide).

Before being trans was something that could be discussed openly with a physician, before we had these multidisciplinary teams to help trans people work through the entire process, people were left to their own devices. Which meant that people would sometimes just travel abroad specifically for surgery. I’ve had several patients that traveled to Thailand in the 80’s or 90’s to get gender reaffirming surgery because they couldn’t get that here. In this situation, when you can just order a surgery a surgery without the lengthy process of assessments and counseling, and an added language barrier, being informed thoroughly and understanding the ins and outs of the surgery becomes more of a problem. I feel like many of the stories we hear these days about people that got the surgery and regret it afterwards stem from situations like these, where a trans person shops for an operation abroad (sometimes under sketchy circumstances) rather than a full transition care process, because the full transition care process wasn’t available to them (for whatever reason).

You can be sure your sister won’t be operated on unless her healthcare team feels like this is what she really wants.
 
I just wanted to say, I wish the best for her, and for you as well.

I know what it's like. How hard it is. But your support and love will go a long, long way.

Er... I dont really have anything useful to add. I wish I could help but there isnt anything I can do.

Bolletje said:
You can be sure your sister won’t be operated on unless her healthcare team feels like this is what she really wants.
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I'm curious: What sorts of questions and discussions are involved in getting to this point where everyone is sure on it?

Like, what's the process, what do they do... I hear about people going through transitioning all the time, but rarely do I hear about this aspect of it. The discussion and support that must come before transition. All I know is that it can be a very long process.
 
@Fino

It's not easy to get accurate information about the medical effects of some of the more important aspects of transitioning.

There's also a lot of politically motivated disinformation - from many different sources, because there are many "sides" in this discussion.

I suggest you ask more specific questions that can be handled in a simpler discussion.

One place to start is "puberty blockers". These are often described as being relatively safe in the medical sense, but there definitely (100%) has not been sufficient research to make such a claim.
Note that puberty is one of the most significant periods of change in human development - both psychological and physical. Regardless of the outcomes (we'll know in 10 years or so) it's irresponsible to use puberty blockers in this way without extensive testing.
 
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I think we need to take care not to head into the realm of speculation. I would also imagine that the path followed, and therefore any consequences and side-effects, would be quite specific to the individual.

To OP, I don't think anyone who hasn't experienced it first hand or been directly affected would be able to offer you many insights - and even then these would be one person's experience. Your best bet is really to reach out to a specialist who is likely better equipped and experienced to answer questions for you. A reputable place would be happy to do so I think.

To your original point of where in between those two opposing views reality lies, I would say likely not as close to the "it's nothing" view as to the "it's a serious and can have consequences" view. I don't think the question is about "how serious and significant a procedure is this?" though, it's about understanding that for some people the trade-off is worth it and brings greater value than the challenges it invariably presents. One group you speak to argues there is no need, the other argues there is no cost. Neither is the case. Why not try the link that @Luca gave where you'll likely get both sides with a little more honesty?
 
Misery said:
I'm curious: What sorts of questions and discussions are involved in getting to this point where everyone is sure on it?
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I have never been involved in the process personally, only in the briefest sense, before my autism diagnosis, when a psychologist wondered if my sense of wrongness could be down to gender dysphoria.

If you’d like, I can try and do a deep dive into local guidelines and see if I can fish up some more practical information.
 
@Bolletje

Thanks for the link to that Journal. I'll read the whole thing, but it will take a while.
So far it reads like it has been "over-tuned" to avoid offending anyone, so it's heavy going. The problem with that kind of writing is that it can be used to hide a political message - you have to read everything twice to figure out what's actually being said /sigh.
But I haven't come across anything unreasonable yet, which is quite good for this particular topic :)

IMO, if you have the time and energy, a review of local guidelines in European countries, with summaries of the guidelines, would be very useful.

Both of the countries I have close ties to "backed off" after re-analysis of the science (such as it is).
Several EU countries did the same, and since it's the EU there's good data available on their new policies and reasons for them.

Note that local guidelines are evolving, because there's not much good quality research that can be generally applied, and some of the early policy decisions turned out to be misguided.

The early Dutch study that was used as the basis for several countries' policies was taken out of context in several well-known cases (notably including the UK and the US). I browsed the original study (linked off an article I was reading) a while ago - IMO the study was very good, but the data was misused by some policy-makers.
 
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Hypnalis said:
So far it reads like it has been "over-tuned" to avoid offending anyone, so it's heavy going. The problem with that kind of writing is that it can be used to hide a political message - you have to read everything twice to figure out what's actually being said
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Having written medical articles and guidelines myself, I can assure you they are not written this way to hide a political message. This is simply the writing style taught for medical scientific writing. Also keep in mind this topic is explicitly not about politics.
 
From the early days, I remember a warning that the operations would make you feel five years older. From science, I know that a transition only ever gets half way in reality.
 
Hypnalis said:
These are often described as being relatively safe in the medical sense, but there definitely (100%) has not been sufficient research to make such a claim.
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Honestly, no medical treatment is 100% safe and no medical treatment is without risk of complications or side effects. That’s why medicine operates on the principle of informed consent: as a physician you’re obligated to inform your patient of the pros and cons of a treatment, and the patient has to give their consent for treatment to start, before it can actually happen.

That being said, true informed consent is hard to achieve, for several reasons. Some by choice, some by circumstance. But informed consent is one of the cornerstones of modern medicine, rather than the old outdated model where a doctor just tells you to take your pills shut up.

If a doctor calls something 100% safe with no possibility of adverse outcomes, I’d say you’re looking at a snake oil salesperson.
 
The only thing I know first hand from seeing a friend transition, is that the hormone pills really did a number on them, emotionally and caused sudden outbursts and some rage in some instances where they would normally just be a little bit frustrated at best. They apologized after every episode, and honestly it was only ever of issue to any of the rest of us because they were keeping it a secret from everyone. So, perspective and communication is something that I feel I can assume is important (if it can be established, of course), if anything, to those close or coworkers they see daily.
 
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