The reason vaginal atrophy in HRT is rarely discussed isn’t because some nefarious boogeyman wants to transgenderficate all your pretty lesbian crushes into chronic pelvic pain it’s because people don’t give a shit about transmasculine reproductive health and you hijacking the topic for your detransition propaganda will only make things worse as you discourage transmascs from researching the subject and learning that it’s treatable
“You’ll live with chronic pain for the rest of your life is it worth it” casual ableism aside you’re saying that as if vaginal atrophy doesn’t happen to half of all postmenopausal people, what makes you think you’re immune
Because I am on a mission to make sure everyone knows this and every time vaginal atrophy comes up, I will bring it up:
Vaginal atrophy is easily preventable and treatable. if YOU are on T and you’re experiencing it, PLEASE let your gyno/HRT doc know. They can prescribe topical estrogen which will treat the issue without interfering with your HRT!
I’ve looked into it a LITTLE and over the counter phyto-estrogen creams seem to have an effect but IDK if I’d 100% trust them.
Sorry, this is just super fucking important to me and literally everyone on T needs to know about it because when I was doing the research NO ONE brought up how easily it was treated until I looked into vaginal atrophy itself and found out because of how it’s treated in menopausal women.
When I talked to the doctor at planned parenthood she echoed this, too. That if vaginal atrophy starts to develop, I should just let her know so she can prescribe me topical estrogen to help!
the fact that we aren’t fucking told this is PART of the problem. The fact that we’re told it’s inevitable and untreatable is part of the problem. You don’t *have* to deal with that pain and discomfort.
!!!
Topical estrogen won’t affect your T levels either, from what I know. It will just affect the vagina, so you don’t have to worry that your transition will be impacted if you do get vaginal atrophy treated. If you are worried about topical estrogen affecting your transition talk to your doctor! There’s no reason trans people should suffer out of fear and misinformation.
This is true! Be aware that whether you can get effective treatments over the counter will depend on the exact pharmacy laws in your area – for example, in NZ it’s a prescription-only medicine (but prescriptions are subsidised so this isn’t too bad).
This matters because there’s a bunch of products out there that claim to treat vaginal atrophy, including lube and “vaginal moisturisers”, which don’t have the estrogen in them that makes it work properly. You’ll probably get some relief from the moisturising but it won’t be reversing the atrophy. These products are available over the counter and one is directly shilled by Buck Angel lmfao so it can be tempting to go for them rather than going through the hassle of getting a script, but please, if you can, get the prescription stuff that works the best ^_^
(Un)Related Trans Healthcare: PICC Line and SASH Method
I go through my new home healthcare routine of administering IV meds to myself while also discussing unexpected connections between trans healthcare and non-transition-specific procedures.
NYT phallo article disclosed info about trans bucket leading to a huge influx of white nationalist traffic resulting in the creator(s) of trans bucket deciding to take the site down until further notice.
I’ll post about it more tomorrow
I’m literally still so upset with this. But here’s what happened:
For context, the New York Times recently published an article about a trans man named Ben’s phalloplasty journey with ALT phallo under Dr. Rachel Bluebond-Langer & Zhao. The article was written by a non-binary theythem author that is presumably not seeking phallo.
Here is what the article did well: Gave in-depth descriptions of phalloplasty, scrotoplasty, urethroplasty, and glansplasty; discussed the history of phalloplasty starting with Lawrence Dillon Francis (the first trans man to get phallo); mentioned the customizable nature of phalloplasty
Now here’s what the article did WRONG:
in a time of rising transphobic violence and especially transphobic legislature restricting access to transgender biomedical care, the article went out of its way to describe phalloplasty as a half-baked dangerous procedure with “high complication rates” (what do complications mean exactly) that is essentially only worthwhile if you would rather die that not get this surgery.
The language around post op penises was often callous and disrespectful.
The article named specific inter community resources (Transbucket, phallo Facebook groups) as well as naming surgeons outside of Ben’s specific practitioner. TRANSBUCKET had to be taken down as a result of a huge influx of white nationalist web traffic with no restoration date in site.
The article even quoted RBL saying basically “well phalloplasty uniquely kinda sucks and in other contexts we wouldn’t accept such complication rates but it’s for transgenders so whatever”. Which, what the fuck kind of attitude is that for a popular surgeon??? Fuck all the ppl who have had phallo with you I guess.
Made the correct assertion that the small patient sample Pool makes it difficult to come to consensus on overall all best practices. BUT did go into any description whatsoever about the extensive research being done by surgeons around the world to improve safety. (Assuming there even is a One True Best Practice). Basically didnt discuss at all how various surgeons /researchers are actively trying (and succeeding) in optimizing their methods
Glossed over the fact that phallo has like a 96/97% satisfaction
Gave a really graphic description of urethroplasty for shock value (“slicing open the underside of the penis”) without mentioning that this technique is unique to Dr RBL’s ALT urethroplasty only.
& the biggest thing: DID NOT EVEN DISCUSS THE INSANE BARRIERS TO ACCESS!!!!! Getting phallo is an unfortunately expensive, time consuming, and heavily involved surgery from prepping for surgery to recovering from surgery and beyond. Somehow this was actively ignored instead choosing to briefly mention “more demand = more new inexperienced surgeons” (who are trained by the very experienced surgeons btw)
HOW the FUCK are you, as a non-binary journalist & trans contributor/subject going to back handedly dunk on phallo the entire article IN THIS CURRENT CLIMATE and also COMPLETELY IGNORE HOW DIFFICULT PHALLO ACCESS CAN BE. Trans ppl across the US are having their rights restricted for medical transition, RvW is eroding people right to privacy & bodily autonomy yet the focus was “uhhhh phalloplasty kinda shitty but I guess if you’d rather die it’s worth it”.
Are you fucking kidding???? The same climate that the UK bottom surgery crisis left phalloplasty patients without care for nearly 2 years & effectively pushed back the over 5 year waitlist for the single (1) phallo team for the entire region?
The same time many states are actively putting forward legislature that makes biomedical transition increasing illegal for minors and potentially even ADULTS????
What the fuck is wrong with the both of you????? How as a non-binary/trans journalist could you even for a second think this was ok?????? I literally hope they rot in hell.
& that 1% regret rate is almost entirely “Yes I’m still trans but the surgery was bad, or the transphobia i encounter is so much worse than anticipated, or I was pushed towards a specific treatment by my binary-oriented doctor when I wanted a non-binary transition” etc.
Actual ‘whoops, I don’t identify as trans anymore” cases are closer to 0,02%.
[Image caption for original post: tweet by @EVeracite reading: “I like how in the context of trans affirming care, successful treatment in 99% of cases is treated as dangerous, whereas in all other areas of healthcare a 99% success rate would be treated as an absolute miracle.”
This is quote-reteweeted by @aster_disaster_ with the following addition: “Having a child has a 7% regret rate. A knee replacement has anywhere between 6-30% regret. Across all types of surgery, the regret rate is 14%. Transition and trans related surgeries have a 1% regret rate.” End caption.]
[Image caption: excerpt from the linked article above, as follows.]
But to dig deeper, Olson and her team focused on more than 300 children who had undergone a social transition.
About two-thirds were transgender boys, meaning boys who had been assigned a female gender at birth; about one-third were transgender girls.
All were enrolled in the TransYouth Project between 2013 and 2017. The project tracked transition experiences over a five-year period, with children being between the ages of 3 and 12 when first socially transitioning.
Though Olson’s focus was on social transitioning, she noted that some of the children had embarked on a medical transition as well, though she emphasized that was only the case among the oldest kids, given that “youth are not eligible for medical transition until after the onset of puberty.”
Specifically, nearly 12% had begun taking puberty blockers during the study period. (After the study period ended, however, 190 kids ultimately began taking blockers; nearly 100 of those children also started taking gender-affirming hormones, Olson noted.)
Solely on the social transition front, Olson noted that over five years only about 7% of the children transitioned back at least once.
By the end of the study period, 94% of the kids continued to identify as the gender they had embraced when first socially transitioning. (That figure includes the just over 1% who had at one point re-transitioned back to their birth gender, before then returning back again to the gender to which they had initially transitioned.)
Of the 6% who did not stick with their initial transition, a little more than 3% described themselves as non-binary by the end of the study period, while just under 3% said they identified with their birth gender. (Identifying with one’s birth gender was notably more common among kids who had socially transitioned before the age of 6.)
“Interestingly, we are not finding that the youth who re-transitioned in our study are experiencing that as traumatic,” Olson noted. “We’ve been finding that when youth are in supportive environments — supportive in the sense of being OK with the exploration of gender — both the initial transition and a later re-transition are fine.”
Remember that people who aren’t women also need and want abortions. Include and protect trans and intersex people in this conversation. Keep watch for terf rhetoric and dogwhistles. Terfs will use this as ammunition.
And when we push for gender-inclusive language in legal and healthcare contexts, it’s not just because being called the wrong word makes us feel bad. If the language of a healthcare law or regulation uses specifically gendered language, that creates a loophole that can be used to deny trans people coverage. Ask any trans man who’s had to try and find gynecological care, or any trans woman who has ever needed a prostate exam. Yes, it is difficult and often humiliating to be called the wrong words, but what we’re mostly worried about is losing our access to the healthcare we need alltogether.
& that 1% regret rate is almost entirely “Yes I’m still trans but the surgery was bad, or the transphobia i encounter is so much worse than anticipated, or I was pushed towards a specific treatment by my binary-oriented doctor when I wanted a non-binary transition” etc.
Actual ‘whoops, I don’t identify as trans anymore” cases are closer to 0,02%.
Comic about trans men in the health care system I made for magazine Ottar last autumn! Please note that it presents a Swedish perspective unless stated otherwise, as it is mostly based on Swedish studies. I would however argue that it has implications on the state of healthcare for trans people in other places as well. Thank you so much Hedvig for translating this!
im really fucking upset rn. ive been on spiro since i was 16 and reading the list of potential side effects in this article was like reading a walkthrough of all of the worst health problems ive been dealing with for the majority of my adult life. digestive issues, fatigue, medication resistant depression. all of it is shit thats been making my life hell for years.
im fuming. not once did anybody in all the years ive been seeing doctors about this shit bring up that it couldve been spiro. not once!!!! FUCK!!!!!
“Spironolactone, but not finasteride, use was associated with impairment of obtaining desired 17-β estradiol levels. Spironolactone did not enhance testosterone suppression, and finasteride was associated with higher testosterone levels.”
There’s a new update on our GoFundMe right as we hit 75% funding! THANK YOU and spoiler alert: maybe we’re getting a car??? Which is great, because K’s old meds source got cut off and it’s. Well. Check out everything here!
I had a patient this week who was a transgender man who was beginning the process of starting testosterone therapy, and I got to have a conversation with him about pap smears and cervical cancer screening, so I thought that as your friendly Tumblrhood doctor, I’d share some of that information, as well as general screening guidelines for all individuals who own a cervix.
1)Trans men who still have a cervix and have not undergone hysterectomy should continue to get pap smears. Cervical cancer is still possible due to HPV infection, and according to current research the guidelines for men with cervixes is the same as those for cisgender women with cervixes. This could always change in the future as more research is done, because that’s how science works, but for now these are the recommendations.
2) Transgender medical care is still not broadly taught at most medical schools and residency training locations, so be aware that not all providers will be versed in how to take care of you specifically. Hopefully they’re not douches and will respect you as their patient and do their proper research if they haven’t encountered care for LGBTQ+ individuals before, but… I’ve run into a lot of douches in my training, so please take care of yourselves. If you have transgender friends or know of LGBTQ organizations near you, reach out to them to see if they have recommendations for particular providers that are LGBTQ friendly.
3) Transgender men on testosterone tend to have a higher rate of unsatisfactory pap test results due to cervical changes and atrophy caused by testosterone, and are recommended to have repeat paps for a better sample. Don’t be discouraged - a lot of time this can be mitigated by the provider making a notation for the lab that the patient is on testosterone and whether or not they are amenhorreic (not having menstrual cycles). Hopefully your physician will know to do that, but considering point 2 above, it never hurts to pointedly ask them if they’ll tell the lab that.
4) Insurance bounce-back/non-coverage can sometimes be an issue if your documentation has you labeled as male. If this happens, simply ask your physician to help you appeal this by either reaching out to your insurance to clarify the issue, or having them write a letter addressing it for your appeal. It should be covered once that’s cleared up.
Now, for general pap screening guidelines (keep in mind, these are for the USA, and other countries may/will have different guidelines):
Start at 21 years old (unless you have HIV, in which case speak with your doctor about when you should start, because it may likely need to be earlier).
Ages 21 to 29, pap smears for routine screening are every 3 years if your results return normal.
Ages 30 to 65, pap smears can be every 5 years if they return normal IF it is done as cytology with co-testing for HPV. If HPV is not tested, then it’s still every 3 years.
If you have never had vaginal (penetrative or oral) intercourse, you may not need a pap. There is still a very low risk of cancer development based on things such as smoking, family history, etc., but overall the vast majority of cervical cancer is caused by HPV, which is sexually transmitted. If you’ve never been exposed to HPV through sex, your risk of developing cancer is very low.
You still need pap smears even if you’ve had the HPV vaccine.
If you’ve had a hysterectomy in which your cervix was also removed (which is the standard way of doing it these days, but wasn’t always in the past), and your hysterectomy was not due to cancer (and you’ve never had a significantly abnormal pap), you do not need to continue getting pap smears.
I could say more, but I’ll stop here. Overall, please discuss pap smears with your doctor if you currently have (or have had) a cervix to see if you need to have them and when.
Also, if you have had experiences with pap smears as a transgender individual, please add on with any advice you’ve found! I was never formally taught transgender care in my medical training and had to learn it through my own research, so I’m always curious to see how other providers who may be more experienced than me with it practice.
HI AGAIN TUBMLR sorry for not being active! im posting my top surgie fundraiser again bc i’ve been having some bad dysphoria days lately.. if anyone could share or donate I would really appreciate it!!
love to figure out trans male health stuff by searching through Reddit threads because there are so few sources of information and the doctor only had vague guesses. it’d be great if we could actually have, like, detailed medical guides for doctors and trans patients–with visuals of actual trans bodies and not ones labeled or depicted as female! with references to (recent) medical studies! and not just ones that stop at going on T/having surgery. we keep having medical needs after we “complete” transitioning (and some trans guys don’t take hormones or get any surgery! or take T and later stop!).
