Health risks of cross-sex hormones? Or can transition reduce risks?

As there are such strong differences in the appearance of the sexes and because cross-sex hormones bring about such radical physical changes, I can understand how some might think that doing something which appears so extreme to the body must be very unnatural and will cause it stress or even harm. But it’s not a completely alien thing that will cause all sorts of weird and wonderful things to happen. We won’t suddenly sprout a second head!

Think about the very beginning of our life, just after we’re conceived. At this point our bodies are gender-neutral and are capable of becoming either male or female, or occasionally even a mix of the two. What determines how masculine or feminine we develop are the levels of sex hormones running through our blood. This is initially from our Mother while growing in the womb. This step determines which genitals we grow. Then later our own genitals produce these sex hormones. They are a natural substance that the body is supposed to contain. As long as they are within the correct parameters for either male or female our bodies will be healthy.


HRT for all

A male with low testosterone will likely have many undesirable symptoms and may be prescribed testosterone (male HRT). Raising his testosterone to within the normal male range will have many benefits for him, helping his body and mind function healthily while reducing the unwanted symptoms.

This also applies to a post-menopausal woman on female HRT, but I am using the male example as he may be on lifelong HRT from a younger age. No one would bat an eyelid or question what the long-term implications are for him to take this drug for decades. I imagine simply because it seems to be ‘natural’.

It is no less safe for a transgender person to be on HRT. The fact it is cross-sex HRT has no health bearing on their body. The body will just react and grow according to the hormone it is receiving from the blood. It’s just a chemical reaction within the cells. As long as levels are within male or female ranges this is a very natural and healthy state for the body. This is unlike many other prescription drugs which the body wouldn’t usually have inside it. Again no one bats an eyelid about these because they feel ‘needed’. There appears to be something very emotive about treating for gender dysphoria, which causes some people to think something really bad will happen. I even had these feelings from my first GP, which made accessing treatment very difficult and stressful for me.


Side effects

As with any medication there are potential side effects but most feel the benefits outweigh the risks, and there may be no side effects at all. The patient would be monitored and any treatment adjusted or halted as required.


Real risks

As a transman myself I know one of the potential side effects when taking testosterone is polycythemia. This is an abnormally high red blood cell count, and it’s symptoms can be serious if not treated.

It is easily diagnosed via a blood test, and any male on testosterone will have their blood monitored regularly. It is very easily treated.

The risks, diagnosis and treatment of polycythemia is the same for both trans-men and biological men on testosterone treatment.


What about effects on gender specific organs receiving cross-sex hormones?

It is still unknown what the full implications and risks are to gender specific organs receiving cross-sex hormones. For example what might happen to a womb or cervix when receiving male levels of testosterone over a long period of time? This doesn’t mean there is greatly increased risk though. Very often these organs are removed meaning it’s not a concern, but if not then appropriate monitoring can be carried out to catch potential warning signs and allow treatment before problems develop.


Gender transition frequently results in reduced health risks

Cancer is a considerable threat to humans, with an estimated one in three people developing the disease. Some of the more common forms can be gender specific. E.g. prostate, testicular, cervical or breast cancer.

As a transgender person the risks of gender specific cancers are often reduced or even eliminated. A trans person will often have those organs removed, thus reducing or removing that risk, and of course they can’t develop cancers of their acquired gender because they don’t have those organs.


Desirable side effects of cross-sex hormones

The physical changes that happen on cross-sex HRT could potentially be considered a side effect. Of course these are very much desired, and can lead to a happy, healthy and contented life.


2 replies
  1. Margaret
    Margaret says:

    I thought it was the man whose input decided the sex of a baby?

  2. Matt
    Matt says:

    Yes the Father provides either an X or Y chromosome that genetically determines a baby’s sex, but it is the Mother, while the baby is in the womb, that provides the hormones for the baby to physically grow into that sex.

    There can be many variations, including different configurations of the X and Y gene (X, XXY etc) or possibly testosterone insensitivity. This is where a genetic male (XY) is insensitive to testosterone and therefore doesn’t respond to this hormone while developing. This can show up when going through puberty but in it’s extreme case a genetic XY male doesn’t respond to the testosterone in the womb and so may develop as physically female despite being a genetic male. See my short book for more on the genetic possibilities.

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