Thank you for putting this valuable information together!
Since you mentioned Carta Monir, in case you weren't aware, she mentioned on Gender Reveal that her girth increase discussed in Napkin occurred while she was on T cream, and that her physician subsequently diagnosed her with an intersex condition. This additional context was helpful for me since without it her outcome was very difficult to understand.
I am 100% convinced atrophy is caused by estrogen. I was on only on Estrogen for roughly 8 months before my penis shrunk so that it was hidden inside. It tends to stay buried now. For me this is not a bad thing
"Indirect cause" isn't "cause," though--it's the reduction in testosterone levels that is what we've documented as causing this effect. It'd be like saying spiro did it--no, not directly. It's the reduction of testosterone that, yes, spiro caused that did it. It's misleading, as a result, to say that either estrogen or spiro does it.
I have a question - if it’s the reduction in testosterone that causes shrinkage of the penis, is this something that is to occur regardless of maintained erections? I ask this because, on the wiki for feminizing HRT, it links a study to the isolated effects of ADT on penile size. Because it seems that both medications used in feminizing HRT and medications used in ADT aim to lower T to (oftentimes) castrate levels, then wouldn’t we observe shrinkage in patients undergoing feminizing hrt, just like their ADT counterparts? The study the wiki links is one that says potency plays no significant preventative measure to atrophy/shrinkage, which seems to confound some of your conclusions thus far.
So, there's something really important to know about working with research: the results of a single standalone study may or may not be accurate, especially a smaller one, like the one you're referencing--andnthis is doubly true when dealing with biology, medicine, or human psychology, all of which are very chaotic. A good illustration of this is the fact that something like 93% of all research says that transition significantly improves the mental health of trans people. What about the 7% that found mixed or no results? Well... statistical noise is a thing. Some studies are going to miss an effect where it's present, or find one where there is none in reality. This is why it's so important to reproduce research.
So, to get more directly on topic: there's very very very little research on transfeminine people's penile health over the long term, and what little there is is of very low quality. Because of this, I don't feel confident relying on it to say anything, especially when there's a much larger body of research on cis men's penile health under very similar conditions. Now, could I be wrong by preferring that research body? Absolutely! But given the quality of the research into transfem penile health, I kind of feel it's rely on that larger body of research or throw my hands up and say "we know nothing reliable."
This regimen seems to work for most people. That's the best we've got right now, unfortunately. Hopefully that'll change in the future.
I understand you when you speak in scientific terms but I think others don't get the distinction. I've never been able to get my non-science friends and customers to understand the concept of how vapor pressure in a vessel can remain constant while the volume inside changes. Sometimes the only way to go is to take liberties with the scientific definition in order to get a point across in layman's terms. I know it's messy. I constantly encourage people to just Google it but the curiosity that burns inside of us isn't always shared with others.
To be frank: I have a doctorate in technical writing with a specialty in biomedical communications. What you're describing is both wrong and would be considered to be unethical conduct in my field.
We don't distort the truth. Period. We don't condescend to our users. Period.
My healthcare provider responded with surprise and disbelief to my worry about atrophy, having never heard of that being a thing before nor seen it happen. The sources linked only seem to cover the case of prostatectomy, could you link the sources for "research on cis men with similarly reduced testosterone" so I can take that back to them? I've tried looking myself for a bit but with little success.
To be honest, you should be able to take the prostatectomy-focused articles to your doc, because the cause is insufficient testosterone/penile use. The cause is irrelevant.
And if your doc won't listen, maybe it's time for a new doc.
Having gone from atrophy to " restoration" myself over a period of years I am glad to see a discussion going, they are far and few between. I have to say from just this essay the lack of mention of orgasm quality or ejaculation hopefully is covered elsewhere.
~everyones body and experience can vary widely, all HRT is not the same ~ BUT much can be gained by sharing and comparing.
One of my rules for SGW is that I don't get into gory detail when I have to touch on NSFW stuff. Secondly, the stuff you talk about isn't exactly explored in the research literature, so I'd have nothing to back it up.
I don't know if you still update this document but I would do some research on testosterone gel a study done by "Doctor Powers" I know a handful of trans women that have reported this also helps with the atrophy pain that may happen and regaining size if they lost any. but it does seem the longer you let it go without those nightly erections the more you loose.
Thank you for putting this valuable information together!
Since you mentioned Carta Monir, in case you weren't aware, she mentioned on Gender Reveal that her girth increase discussed in Napkin occurred while she was on T cream, and that her physician subsequently diagnosed her with an intersex condition. This additional context was helpful for me since without it her outcome was very difficult to understand.
Also, none of the "buy it" links on the Goodreads page you linked to work for Napkin, but readers can get a digital copy through Carta's press: https://diskettepress.com/collections/harder-disk/products/napkin
Thanks!
Thanks for this 🙏 much appreciated
Sorry about the dumb question but should I take Viagra every night if I have bottom dysphoria? Or is 3 days a week enough for that situation too?
Three a week *should* be enough, but listen to your body and lay attention for pain!
I am 100% convinced atrophy is caused by estrogen. I was on only on Estrogen for roughly 8 months before my penis shrunk so that it was hidden inside. It tends to stay buried now. For me this is not a bad thing
I mean, you're allowed to think as you please.
That position not backed by medical science, however.
That’s because estrogen itself blocks out testosterone at a sufficient dose. That’s why monotherapy is a thing
It's my understanding that If your estrogen use causes a reduction in available testosterone it's an indirect cause of atrophy.
"Indirect cause" isn't "cause," though--it's the reduction in testosterone levels that is what we've documented as causing this effect. It'd be like saying spiro did it--no, not directly. It's the reduction of testosterone that, yes, spiro caused that did it. It's misleading, as a result, to say that either estrogen or spiro does it.
I have a question - if it’s the reduction in testosterone that causes shrinkage of the penis, is this something that is to occur regardless of maintained erections? I ask this because, on the wiki for feminizing HRT, it links a study to the isolated effects of ADT on penile size. Because it seems that both medications used in feminizing HRT and medications used in ADT aim to lower T to (oftentimes) castrate levels, then wouldn’t we observe shrinkage in patients undergoing feminizing hrt, just like their ADT counterparts? The study the wiki links is one that says potency plays no significant preventative measure to atrophy/shrinkage, which seems to confound some of your conclusions thus far.
That's a good question!
So, there's something really important to know about working with research: the results of a single standalone study may or may not be accurate, especially a smaller one, like the one you're referencing--andnthis is doubly true when dealing with biology, medicine, or human psychology, all of which are very chaotic. A good illustration of this is the fact that something like 93% of all research says that transition significantly improves the mental health of trans people. What about the 7% that found mixed or no results? Well... statistical noise is a thing. Some studies are going to miss an effect where it's present, or find one where there is none in reality. This is why it's so important to reproduce research.
So, to get more directly on topic: there's very very very little research on transfeminine people's penile health over the long term, and what little there is is of very low quality. Because of this, I don't feel confident relying on it to say anything, especially when there's a much larger body of research on cis men's penile health under very similar conditions. Now, could I be wrong by preferring that research body? Absolutely! But given the quality of the research into transfem penile health, I kind of feel it's rely on that larger body of research or throw my hands up and say "we know nothing reliable."
This regimen seems to work for most people. That's the best we've got right now, unfortunately. Hopefully that'll change in the future.
I understand you when you speak in scientific terms but I think others don't get the distinction. I've never been able to get my non-science friends and customers to understand the concept of how vapor pressure in a vessel can remain constant while the volume inside changes. Sometimes the only way to go is to take liberties with the scientific definition in order to get a point across in layman's terms. I know it's messy. I constantly encourage people to just Google it but the curiosity that burns inside of us isn't always shared with others.
To be frank: I have a doctorate in technical writing with a specialty in biomedical communications. What you're describing is both wrong and would be considered to be unethical conduct in my field.
We don't distort the truth. Period. We don't condescend to our users. Period.
My healthcare provider responded with surprise and disbelief to my worry about atrophy, having never heard of that being a thing before nor seen it happen. The sources linked only seem to cover the case of prostatectomy, could you link the sources for "research on cis men with similarly reduced testosterone" so I can take that back to them? I've tried looking myself for a bit but with little success.
To be honest, you should be able to take the prostatectomy-focused articles to your doc, because the cause is insufficient testosterone/penile use. The cause is irrelevant.
And if your doc won't listen, maybe it's time for a new doc.
Having gone from atrophy to " restoration" myself over a period of years I am glad to see a discussion going, they are far and few between. I have to say from just this essay the lack of mention of orgasm quality or ejaculation hopefully is covered elsewhere.
~everyones body and experience can vary widely, all HRT is not the same ~ BUT much can be gained by sharing and comparing.
One of my rules for SGW is that I don't get into gory detail when I have to touch on NSFW stuff. Secondly, the stuff you talk about isn't exactly explored in the research literature, so I'd have nothing to back it up.
I don't know if you still update this document but I would do some research on testosterone gel a study done by "Doctor Powers" I know a handful of trans women that have reported this also helps with the atrophy pain that may happen and regaining size if they lost any. but it does seem the longer you let it go without those nightly erections the more you loose.
I do keep these things updated!
I'm not comfortable with Powers' research methodology, historically speaking. As a result, I do not use his work.