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Dec 4, 2023ยทedited Dec 4, 2023Liked by Doc Impossible

This dovetails with something I say in response to trans brain discourse a lot, as someone who fell into it when I was first learning about trans people's existence and validity (before my egg cracked): why would we expect or want such a dimorphic difference in the first place? There's no way something as course as a brain scan could possibly find something as complex and multifaceted as an identity, even a neurologically predisposed identity, in the structure of your brain, just like we wouldn't expect brain scans to be able to tell whether you're a punk or a goth or a metalhead. That just isn't how it works. So if we're committed to saying that gender is a socially, culturally, and individually constructed and psychologically seated identity, which seems to be the most robust account of it for describing the world (and promoting good things) then why would we expect brain scans to find it? Plus, even if there was some average difference scans could find, there would always, always be exceptions โ€” cis women with more masculine brains and cis men with more feminine than we expect โ€” because that's just how biology and statistics is, and so we'd never want to rest our case on it lest that turn into a new gatekeeping mechanism.

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๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ

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Jan 9Liked by Doc Impossible

I'm a 67 year old trans woman. Since I was 4 or 5 I knew that I wished I was a girl but I also knew that it would always be my deepest secret. Why? Because way back then there it was have been intolerable by my family, friends, and society to come out. Basically, I was scared to death. Fast forward: I started my transition at 61 and am quite happily living my life as the woman I am.

What's my point? Trans people who were born, say, over 40-50 years ago want there to be something, anything, that biologically proves that what we feel is real. Science may never fully unwind characteristics of handedness, sexuality, gender... In the meantime โ€” as we witnessed with the general acceptance and love of gay people, the need to identify such biological differences by and large goes away.

Thankfully, society is slowly coming to awareness that we are what we are whether understood or not, we're not out to hurt anyone, and in the end we're just part of normal human diversity.

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Very much so, and I love that.

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Dec 4, 2023Liked by Doc Impossible

Thank you for this! In particular, the second illustration would have been handy to post any number of times I tried to point out why the latest craze didn't follow from the research as people thought it did. Remember the coconut oil craze? The author of the paper tried to point out what everyone was misinterpreting, but she was drowned out by advertisements from "Big Coconut." Before that it was oat bran...

I use a shortcut for finding the limitations in a paper. After reading the abstract, I skip to the discussion. Wherever the authors discuss a limitation--or, just as importantly, don't address a potential confounding factor--I go spelunking through the methods to see what they actually did. It doesn't give me a complete understanding of the paper, but it's usually enough to find the most significant limitations...especially since the author of the news article that led me to the journal article that led me to the paper probably only read the abstract.

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Honestly, one of the best ways to get a basic understanding of new research is to do exactly what you describe, Violet--read the intro, then jump to the discussion. Only then, if things seem worthwhile, do you settle in and actually read the whole thing.

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Dec 4, 2023Liked by Doc Impossible

this comment takes me back to my PhD days.

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People read the entire abstract?!!!!

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This post caused an interesting and heated discussion over at CDL: https://www.tapatalk.com/groups/crossdreamlife/your-brain-isn-t-different-because-you-re-trans-t4768.html

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Dec 18, 2023ยทedited Jan 9Author

Quite a discussion indeed. It's interesting how many incorrect assumptions they make about what I've said, and how many common terms they misinterpret, and how those basal misunderstandings cascade. For instance, "Lived gender," coined by Serano, means "the gender a trans person actually is, and not what they were assigned at birth." It's also interesting to see people readily admit that they don't like the article because they feel it invalidates the biological bases of their trans identities, when all it does is show a single (substantial) thing that isn't the cause of those identities.

I think some people over there might do well to read Whipping Girl and some other foundational transfeminine scholarship, to avoid such misunderstandings, as well as some deeper introspection about the sources of their responses.

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I will let them know!

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Dec 14, 2023Liked by Doc Impossible

Very interesting! This has definitely updated my knowledge. Before I read this my understanding was still that there were minor differences between female and male brains, and that trans brains did indeed align more with their identified gender. But this knowledge was based on a science book published before this meta-analysis and focused mostly on the female brain. I always wondered about the contents of this book because I identify as a non-binary femme but well Iโ€™m not an expert on brains, haha. The results of this analysis does feel more understandable to me from my experience living as a non-binary femme. ๐Ÿ™‚

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Dec 5, 2023Liked by Doc Impossible

Thanks so much for writing this! I've got to remember that I bookmarked it when I see this myth rear its head next.

I may be missing something, but I want to bring to your attention that when I read the summarized results, Marjoribanks et. al (2017) seems to say the opposite of what you said re: dementia, e.g. "Women over 65 years of age who were relatively healthy and taking continuous combined HT showed an increase in the incidence of dementia (after 4 years' use: from 9 per 1000 to 11 to 30 per 1000)."

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Dec 5, 2023Liked by Doc Impossible

Digging a little more, I found this: "Results

In the oestrogenโ€only HT arm, researchers noted no statistically significant differences between groups. In the combined HT arm, the incidence of probable dementia was significantly higher in the group taking combined continuous HT than in the placebo group (RR 1.97, 95% CI 1.16 to 3.33). At 4.2 years, absolute risk of probable dementia increased from 9 per 1000 in the control group to 18 per 1000 (95% CI 11 to 30) in the HT group (Analysis 1.35)."

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That's a fair citation. I'll have to go rooting around to double check my sourcing on prog and dementia; it's been a couple of months since I was reading up on it.

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Dec 4, 2023Liked by Doc Impossible

I'm really sorry for asking about what amounts to an aside in your article.. Progesterone.. As a trans girl, not yet on it, but could, (8 months) I struggle to find anything resembling certainty, on anything, regarding progesterone. Nevermind the breast development. The when to start. The more I dig into this the more conflicting information, especially word of mouth, and this completely wrecks me because on one hand I may be doing better by waiting until at this point who knows, one year, or screwing my development and maybe health in general too by delaying it.. (don't even get me started on progesterone being metabolized into DHT.. I don't even know anymore...)

I'm just so desperate to know anything for sure. Sorry for bothering. And thank you so much for the article as a whole.

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No worries!

So, bad side up front: there has been essentially zero study of progesterone on transfems. Everything we know, we know from how prog effects cis women. As a result, there are very few sensible, evidence-based guidelines.

Prog doesn't start up in cis women to any real degree until basically adulthood, so there's a sensible--NOT EVIDENCE-BASED--argument to wait a while before starting. 1 year of hrt is the general concensus for now, but that is NOT evidence based. I wouldn't worry drowsiness side effects on average. As an anal suppository, much more makes it to your bloodstream, but not everyone can tolerate that path. Some people observe Bad Emotional Responses through one method or the other, though, so that should be your main determinant if both are an option for you.

As for dosing? 200-400mg seems to be the consensus, but that won't get you to cisfeminine levels, in all likelihood. I know people doing up to 800 (I can't take more than 200/day). It's pretty safe medicine, though, so if you feel OK and don't exceed cisf ranges, you should be OK.

The main problem is that micronozed prog has an *extremely* fast half-life--only 90 minutes. That means that, after 24 hours, it'll have gone through 16 halvings. That 200mg dose will only have 0.003mg left in you, and a monster, 1600mg dose will be barely better, at 0.02mg in your bloodstream.

The important thing is to have *some* regularly available for your body to work with, at least until someone figures out how to make a safe, stable ester out of it (esters are what generally give us extended-release meds, especially in the estrogen family). There are zero prospects for that right now that I'm aware of, though, so it's kind of a make-do situation.

All this being said, I do think progesterone has an important role for trans women in supporting bone, blood vessel, and cognitive health *over the long run* (Remember: this is not evidence-based, because there really isn't any transfem-specific evidence!). Cis women don't get much of anything until they're more or less adults, so going a year or two shouldn't do you a lick of harm in the long run.

Hope this helps!

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Dec 5, 2023Liked by Doc Impossible

This helps.so much, I'm so relieved. Thank youuu soo much, really, thank you!!

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May 18ยทedited May 18Liked by Doc Impossible

As a trans man, before I transitioned, I was worried about what testosterone would do to this old body. I began when I was 58. What I found was that all my evidence-based research was merely fear disguised as research. I could not find evidence either way, so what did I do? I stopped playing games with myself and embraced what I am. I went from fear/skepticism to excitement almost overnight. I'm so glad I finally gave up 3 years of researching what I couldn't find and went for it. I've never been happier living as my authentic self.

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May 18Liked by Doc Impossible

Thank you! This was great to hear.. and it's probably the same for me. In the time since my comment I ended up adding progesterone to my regime (last month, at one year of HRT) and I don't know whether it's doing anything, but I finally did it.

And honestly, I experienced basically the same as you, the moment I just went for it it all turned into excitement.

Thanks for telling abour your experince. And congratulations on going for it!!

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May 18ยทedited May 18Liked by Doc Impossible

I didn't think I would get through this blog. Science was my worst subject, and anything related to it bores the heck out of me. But, I did read it all. I'm still glad I relied on my instincts, my heart, my past memories, and new ones to discover what I've known about myself since I was 6. I am a Black man who happens to be trans.

I am 66 years old, and when I first knew something was going on, it was 60 years ago. I had no language, I couldn't articulate anything, and I almost despise the word 'identity' right now, because it comes nowhere near what I thought back then. I didn't identify as a boy; I was a boy. There were too many things pointing to this fact, and I WAS who I WAS. I AM who I AM. I identify as Ray, and the rest of it is like mash potatoes.

Maybe it's a cultural thing that people try to find scientific evidence (or statistics) of this and that, but I could care less. I knew 3 months after I began my medical transition that my brain was wired as a male, while my body was wired as a female. I didn't need a scientist, doctor, friend, family, or loved one telling me this. I trusted myself enough to believe in me and do what I needed to do. Sh_t or get off the pot. Staying on the pot wasn't an option, because I tried sitting on that thing until my legs got numb. The only reason I was afraid was "society" and what it might do to me.

I guess I appreciate people trying to find answers outside of themselves, but my answer lied in me. I was in therapy and finally started talking about what I was thinking and it paid off. I also find it funny that science still hasn't figured out why some animals have sex with animals of the same sex. If they can't figure that out, they'll never figure out why humans can have brains one way and bodies another. I don't think it's the characteristics of the human brain; it's the way it works and nobody has studied that thoroughly about trans people. Perhaps they will; perhaps they won't. I didn't need all that to stop fighting who I am.

If we hadn't been thrown into the political arena and hung out to dry in society, people wouldn't be scrambling for all this. I truly believe that. There's something else that happened, but I don't want to offend trans women here. Something they did backfired and now the entire country is after us. There's no scientific research about why human beings react so badly about us, but they reacted this way towards Black people, then gay people. It's all bullshit.

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You might really enjoy "A Short History of Trans Misogyny," by Jules Gill-Peterson, which sets out to answer some of the gaps you observe and to speak to the intertwined nature of racial and gender-divers oppressions. ๐Ÿ˜Š

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May 18ยทedited May 18Liked by Doc Impossible

Now, why would I enjoy that? You'd have to know me to know why I don't care about words like that being thrown around this world ... to control men because of the mistakes of some. Does it also talk about misandry? If not, I probably wouldn't like it, because I'm not controlled by words like that which women like to bash over men's heads with them. I say this with all due respect, while at the same time, it's a disrespectful word, to say the least about it.

And, what gaps? I'm not confused in the least. I would use a word that you're probably not used to hearing, but will wait to see what you have to say about what I just said. I promise you, I'm a wise old Black man. Cantankerous too. lol

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Well, for one thing it attacks the idea that *anyone * can be trans misogyny exempt, and in particular that gay men aren't harassed and harmed because of it. For another, it speaks directly to the historical use of the global trans panic to dehumanize and exterminate not only trans folks of all genders in the global south, but as one of the central justifications for the global colonial dehumanization and genocide that's been stunning for the last few hundred years. Certainly, not all of it'll be of interest to you (skip the conclusion for sure), but the book is ultimately a criticism of feminist failures, and in no way shits on men.

But yeah, if you're not interested, no problem or pressure. Just seemed like you were interested in some of the central themes.

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Yeah, I definitely felt some sort of way by the word "misogyny" because of how it's being used to divide the genders. Of course it doesn't touch gay men, because they're men with men and don't place a high importance on it like women do.

As far as I'm concerned, they're using the same tactics towards trans people as they used towards Blacks for a very long time (slavery + Jim Crow). Used it against gay people in between. I often tell trans people, "Welcome to being treated like Black people." I've lived through all these variations and it was bullshit during slavery and Jim Crow, like it's bullshit now. I was born during Jim Crow and had to piss on the side of the car while we traveled cross-country, because of white-only bathrooms. They're headed towards that around trans people, and I'm livid to have to experience that again ... if I give into the fear of it. I won't, but it's the whole idea of it that strikes me as nonsense to the nth degree. It's all about control/power and that's what these GOP goons are after.

I have to be very careful what I read around here, because one can get lost in the sea of writings. I'm behind like 25 books right now, and must read them before I take off reading another one. Especially with that goofy word in it. Why goofy? To me, only misandrists & feminists complain about misogyny or write about it.

But, you brought up valid points. I just don't have time for 1 more book to read. Oh, and the word I was going to use was what we call 'whitesplaining' which is much like 'mansplaining'. There's absolutely no way someone who isn't Black can explain racism more than my lived experience of that word (wink).

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Apr 11ยทedited Apr 11Liked by Doc Impossible

First off, this article is lovely. I think a good bit about bad science communication (and bad statistics in science, and there's so much of that from the neuroimaging folks), and I've wondered for a while what a good, accessible explanation of all that would look like. This article. This is what it would look like.

A related topic:

Today I saw a Reddit post, one of many, of a young trans girl asking whether being trans is 'innate'.

I think I have a good intuition of how genetic and environmental factors _might_ play into gender. I'm a bit biased towards people not really being "born" trans. It's not that I don't think there's a biological component, just that that sort of pre-deterministic view of biology doesn't really jive with my own knowledge of biology.

So like, there's a whole perspective difference between me and I feel like the majority of the trans community, and I think I can make a strong academic argument about that, but I don't think I'd do a good job of communicating that perspective to most people.

Have you thought about writing an article along the lines of 'What makes someone trans?"? Is that just too amorphous of a topic to communicate well (is there such a thing?)?

Hopefully this comment makes some sense -- thanks again :)

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I have thought of such an article, and have even done legwork for it! The problem is is that we absolutely don't know right now. There's *very* strong evidence that a large portion of what makes a trans person trans is genetic and heritable, but it's also multifactoral--there is no one "trans gene"--and there's also a large section of transness that we just have no clue where it comes from. Womb conditions? Epigenetics? Social conditions? Culture? No research done to date has found strong, supportable, reproducible evidence to say.

In all likelihood, it's an "all of the above" thing, like most complex human behavior (like language!): it's nurture *and* nature, inseparable, each driving the other and bending our evolutionary biology around these changes. Problem is, that's really hard to untangle from the background noise of human existence.

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My field is Geoscience, not biological, but I'd like to think that I have a vague idea of how research, correlation, and presentation works.

And while it's tempting to believe theories that sound good. (The Aquatic Ape Theory in hominid evolution comes to mind), when the available data either doesn't prove or disprove it, or when multiple sources of information DISPROVE the theory, you have to go "yeah, that would have been nice, but it's not supported by. the available data.

Example: Out of a pool of 23 undergraduates and 15 graduate students in the geology program, 5

of us are transgender. A fact I can say is "13% of geology students in the 2023-24 school year at my university are transgender". HOWEVER, this doesn't mean that the same will be true next school year, nor does it mean that 13% of ALL geology students are transgender. Nor should it mean that "13% of those in the geosciences are transgender". Correlation does not equal causation, and junk science is more the domain of those trying to disprove or delegitimize our existance. It shouldn't be our domain.

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And side note, the main reason I take progesterone was more to equalize the highs and lows of the injectable estrogen I am using. Any other benefits are strictly a bonus. :)

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Dec 5, 2023Liked by Doc Impossible

Great article. I'd thought I'd heard that there wasn't much dimorphism in the brain, but I wasn't sure.

If you don't mind me asking (and if you haven't done it already), I would be interested in learning more about the pros and cons of progesterone. I hadn't heard about some of the things you said about it in this article.

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The main con is that there's essentially zero research on it and transfems; everything we know, we know from research on cis women.

But the nutshell is what I skimmed over in the article: it has important effects on bone strength, memory, and blood vessel flexibility for anyone running on estrogen.

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deletedDec 4, 2023Liked by Doc Impossible
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Check the citations on Eliot et al's work. It's in there. No sexual dimorphism.

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