The Medical Leash of Hormone Replacement Therapy
Gender medicine isn’t ‘experimental,’ because in an experiment someone is collecting data.
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A version of this article originally appeared on Corinna Cohn’s Substack.
Nearly everyone is born with healthy and functioning endocrine systems. The cells in our bodies depend on both testosterone and estrogen to some degree. Of course, men's bodies depend more on the former and women's on the latter. When a child is put on to puberty blockers, also called gonadotropin-releasing hormone agonist (GnRH), the child’s natural endocrine system is stopped. For a child about to enter puberty, this causes an indefinite delay.
According to WPATH SOC8, gender clinicians may exercise the judgment to start hormone blockers in children at Tanner Stage 2 in their development (i.e. the first signs of puberty). For girls, this may be age 9. For boys, age 11. Most children who start puberty blockers then proceed on to be prescribed cross-sex hormones, also called gender-affirming hormone therapy (GAHT). This whole protocol replaces and works in contradiction to the child’s natural endocrine system. At this point, irreversible changes have occurred.
Let’s talk about the drugs. The most common GnRH (puberty blocker) is Lupron. Lupron is not designed for children who identify as transgender—it’s more commonly used to treat cancer. It costs at least hundreds of dollars a month, but I’ve normally heard it costing thousands. Lupon can have devastating side effects, and even the gender clinicians are aware of this, which is why some suggest rushing children off puberty blockers and on to cross-sex hormones as quickly as possible.
As hormone replacement continues, permanent changes intensify. Girls who are put on this path inject testosterone, causing them to masculinize. Her body hair will become thicker, she will grow facial hair, her voice will deepen, and she will accumulate more muscle. Testosterone can act as a mild anti-depressant. Girls taking testosterone report having more energy. Testosterone is also expensive.
Boys on this path take estrogen. Their skin will soften and they will begin to develop breasts. At this point, the body’s natural endocrine system is suppressed and smothered by prescription drugs. Estrogen is sometimes used to treat sex offenders to reduce their sex drive. Estrogen is cheaper in oral form, but is associated with higher risk of stroke. From my own experience, I was not ready to handle male puberty, and estrogen acted like a governor on my sex drive. It helped me avoid learning about my body.
But no amount of “cross-sex” hormones, taken for any length of time, will cause a female body to become male, nor will a male ever become female.
Hormone imbalances can exacerbate anxiety, depression, and even suicidal ideation. However, gender clinicians do not monitor these symptoms from medical side effects. In fact, when these symptoms arise (which is common), they are attributed to minority stress, not the medication itself.
After a period on hormone replacement therapy, some of these boys will follow a surgical path that includes castration and the construction of a vagina-like orifice using the penis as material. Without testicles, a boy will become dependent on external hormones for the rest of his life. Girls on this path will experience vaginal atrophy from testosterone, and eventually her other sex organs will be destroyed as well. Because of this, a girl on testosterone will eventually require a hysterectomy, after which she will become dependent on external hormones for the rest of her life.
For boys and girls in this situation, and for people like me, maintaining our health is wholly dependent on the medical system. We must have regular blood tests (at least once a year), and we must report in to our providers to obtain renewals for our cross-sex hormone prescription. These hormone treatments are no longer optional: we have no gonads. Without these hormones our bones will become frail and we will experience other physical symptoms, including mental health problems, because hormones regulate our entire bodies.
I am permanently leashed to a medical provider. My only freedom is that I can pick who holds the leash. The children who are being transitioned are being needlessly put onto this leash. They typically start the process with healthy bodies, but then so-called medical professionals assist these children in deliberately—permanently—damaging them. Why? For aesthetics.
I’m unusual in that I’m vocal about my criticism of the system. I have heard from so many trans people that they would like to say something, but they’re terrified that the people holding their leashes will jerk on the reins.
Planned Parenthood is one of the most generous of the leash-holders. They will essentially let anyone sign up to get a leash, and they don’t ask very much from their pets. How does this sound? Maybe not so bad? What is the medical discipline that understands the endocrine system? It’s endocrinology! And yet nobody writing prescriptions at Planned Parenthood is an endocrinologist. My local gender clinic, which sees perhaps 1000 patients, has no endocrinologist on staff.
Not only are we on medical leashes, but the people who hold the leashes aren’t even experts in the field. They are learning as they go and then experimenting on us. However, as someone once pointed out to me, it’s not really an experiment, because in an experiment someone is collecting data.
It should never be considered normal or preferable to treat problems like autism spectrum disorder, anxiety, traumas, depression, or other social disorders by placing children on puberty blockers or cross-sex hormones.
It is not a treatment path. It is a collar and a chain.
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Women with cancer or fibroids etc who have hysterectomies early in life - mid 30s, 40s - suffer terribly from hormone use. The surgery and hormone care are extremely debilitating for mental health, social ease, dating, intimacy. How are children to ever be prepared for this?!
Great article, thank you Corinna. The metaphor of the "medical leash" is so powerful. I had not realized that medically transitioned adults are terrified to speak up against these horrible harms to kids because they fear their their leash to medically necessary hormones might be cut in retaliation. I so appreciate your bravery, clarity (and humor on Heterodorx!).