Transgender Individuals Twice as Likely to Die Early as General Population(medscape.com)
medscape.com
Transgender Individuals Twice as Likely to Die Early as General Population
https://www.medscape.com/viewarticle/958259
12 comments
The idea that you need to mutilate and medicate away your dysphoria will hopefully be regarded the same way we look at 20th century lobotomies. Your body cannot be engineered into the opposite sex.
First, wow, I'm a little hurt by that. "Mutilation" is such a strong word for safe, sane, and consensual body modification. Are you so bothered by a body part that only 2 people and a few doctors will ever see?
Second, it depends what you mean by sex.
I know that I probably won't ever bear children, and I don't want to.
I know that I probably have XY chromosomes, and I don't care.
I know that my skeleton looks masculine, and the only people who matter don't mind.
But I also know that I enjoy having breasts, and I have wanted a vagina for years. The same way that anyone else wants to have a nice car, or be respected, or be loved, or be successful. There is no deep "why", I just want it.
I am not planning a vaginoplasty so that I will be a woman. I am planning a vaginoplasty because I want to be a person with a vagina. I only transitioned socially because it felt incongruous to present in a highly feminine way and still be called a man. I don't take estrogen so that I'll be a woman, either. I started taking it because I wanted to have breasts, and now I have breasts, and that makes me happier.
How do you think dysphoria works for people like me?
Do you think I could achieve enlightenment and stop wanting a vagina? I don't think I can. I think, in terms of time, money, and QALYs, a vaginoplasty is much cheaper than enlightenment. Good for you if you were able to achieve enlightenment and conquer dysphoria without medical intervention.
Second, it depends what you mean by sex.
I know that I probably won't ever bear children, and I don't want to.
I know that I probably have XY chromosomes, and I don't care.
I know that my skeleton looks masculine, and the only people who matter don't mind.
But I also know that I enjoy having breasts, and I have wanted a vagina for years. The same way that anyone else wants to have a nice car, or be respected, or be loved, or be successful. There is no deep "why", I just want it.
I am not planning a vaginoplasty so that I will be a woman. I am planning a vaginoplasty because I want to be a person with a vagina. I only transitioned socially because it felt incongruous to present in a highly feminine way and still be called a man. I don't take estrogen so that I'll be a woman, either. I started taking it because I wanted to have breasts, and now I have breasts, and that makes me happier.
How do you think dysphoria works for people like me?
Do you think I could achieve enlightenment and stop wanting a vagina? I don't think I can. I think, in terms of time, money, and QALYs, a vaginoplasty is much cheaper than enlightenment. Good for you if you were able to achieve enlightenment and conquer dysphoria without medical intervention.
Am I reading you correctly in that, at the end of the day, you simply just want breasts and a vagina? Or do you want something more broad here?
I broadly thought transgenderism was about a desire to be perceived and feel/identify on all levels as a man when assigned female at birth and woman when assigned male at birth, as opposed to just wanting particular sex organs.
I broadly thought transgenderism was about a desire to be perceived and feel/identify on all levels as a man when assigned female at birth and woman when assigned male at birth, as opposed to just wanting particular sex organs.
Take this all critically, because I can't speak for all trans people.
> I broadly thought transgenderism was about a desire to be perceived and feel/identify on all levels as a man when assigned female at birth and woman when assigned male at birth, as opposed to just wanting particular sex organs.
It depends. Most of us see gender as a buffet. There are medical, social, and legal ways to transition, and you can take what you want when you want it. A lot of us end up wanting some body modification, but it's not a requirement either way.
There are lots of non-binary people, so the trans umbrella also includes people who don't feel or identify as men or women. I feel kinship with them, because it feels a little hollow when I assert that "I am a woman". I don't know what it means to feel like a man or a woman. I don't think the non-binary spectrum is a space "between" man and woman, I think it's the entire space around and outside of man and woman. I won't mind if I find myself there somehow.
> you simply just want breasts and a vagina? Or do you want something more broad here?
I might have exaggerated. It will take a lot of words to clear it up.
For me, the medical transition definitely is the most important part.
I do want she/her pronouns, but they're secondary.
I'll emphasize again that I'm not speaking on behalf of all other trans people, because if I talked about other people the way I talk about myself, it would be exclusionary.
But in my case, the she/her pronouns are part of presenting as a woman, and I only want them as part of the whole package, if that makes sense.
I prioritized my transition based on a ranking of something like "What is the cheapest? What requires the least permission from other people? What am I least likely to regret?"
At a high level, this put the 3 pieces in this order:
- Medical first, because I have to live in my own body all day no matter what.
- Social second, because it would eventually be weird to look like a woman and still tell people that I'm a man, but I wasn't too upset about he/him pronouns back when I was still questioning my own gender.
- Legal last, because it's a big commitment and it didn't bother me that much to be legally male.
At a low level, they overlap a bit. I started laser hair removal and hormone replacement about a year before I changed my name and pronouns at work, but I am now waiting for COVID to clear up before I can even think about genital surgery.
And gender is just so weird that, the more I think about it, the less sense it makes.
But what I'm realizing is, I consider the pronouns to be part of my presentation. During that first year of HRT, I wasn't actually sure if I would be a woman at the end. I don't have an internal compass for gender, I had to try it out and see if I would like it. So I didn't mind being "he/him" when I was still questioning. It was a secondary priority.
But after a while, it got to be weird that my medical transition was going amazing and I was still "he/him" at work. I grew my hair out, I painted my nails and gradually wore more feminine clothes, and it got to feel like, in terms of the clothing and presentation, I had crossed from "Man with long hair" to "Woman with male pronouns". So then I came out to my coworkers, changed my name and email in the computers, and luckily everyone was okay with it.
In a world where everyone is an ally and pronouns are always respected, yes, I want to use she/her. I don't really know if people see me as a woman, I don't pass very well, but the pronouns are at least a green flag that people are being polite to me, regardless of what they think.
But in the real world, I was extremely reluctant to ask for something that could be trivially denied or could spark a politics debate around the office.
So... I hope that clears it up a little. For me transitioning has been first and foremost about reconciling my mind and my body. I spend a lot of time alone, and I spend a lot of time online where I don't need a gender, and I like that. In HN threads that aren't about gender, I'm not a woman who programs, or a woman who was assigned male at birth, I'm just a programmer who programs.
But out in the bizarre real world, "My pronouns are she/her" is an invitation to be invalidated, and "I'm buying a vagina and nobody can stop me" is a statement of fact. I let myself be a little macho sometimes. Even cis women do it.
> I broadly thought transgenderism was about a desire to be perceived and feel/identify on all levels as a man when assigned female at birth and woman when assigned male at birth, as opposed to just wanting particular sex organs.
It depends. Most of us see gender as a buffet. There are medical, social, and legal ways to transition, and you can take what you want when you want it. A lot of us end up wanting some body modification, but it's not a requirement either way.
There are lots of non-binary people, so the trans umbrella also includes people who don't feel or identify as men or women. I feel kinship with them, because it feels a little hollow when I assert that "I am a woman". I don't know what it means to feel like a man or a woman. I don't think the non-binary spectrum is a space "between" man and woman, I think it's the entire space around and outside of man and woman. I won't mind if I find myself there somehow.
> you simply just want breasts and a vagina? Or do you want something more broad here?
I might have exaggerated. It will take a lot of words to clear it up.
For me, the medical transition definitely is the most important part.
I do want she/her pronouns, but they're secondary.
I'll emphasize again that I'm not speaking on behalf of all other trans people, because if I talked about other people the way I talk about myself, it would be exclusionary.
But in my case, the she/her pronouns are part of presenting as a woman, and I only want them as part of the whole package, if that makes sense.
I prioritized my transition based on a ranking of something like "What is the cheapest? What requires the least permission from other people? What am I least likely to regret?"
At a high level, this put the 3 pieces in this order:
- Medical first, because I have to live in my own body all day no matter what.
- Social second, because it would eventually be weird to look like a woman and still tell people that I'm a man, but I wasn't too upset about he/him pronouns back when I was still questioning my own gender.
- Legal last, because it's a big commitment and it didn't bother me that much to be legally male.
At a low level, they overlap a bit. I started laser hair removal and hormone replacement about a year before I changed my name and pronouns at work, but I am now waiting for COVID to clear up before I can even think about genital surgery.
And gender is just so weird that, the more I think about it, the less sense it makes.
But what I'm realizing is, I consider the pronouns to be part of my presentation. During that first year of HRT, I wasn't actually sure if I would be a woman at the end. I don't have an internal compass for gender, I had to try it out and see if I would like it. So I didn't mind being "he/him" when I was still questioning. It was a secondary priority.
But after a while, it got to be weird that my medical transition was going amazing and I was still "he/him" at work. I grew my hair out, I painted my nails and gradually wore more feminine clothes, and it got to feel like, in terms of the clothing and presentation, I had crossed from "Man with long hair" to "Woman with male pronouns". So then I came out to my coworkers, changed my name and email in the computers, and luckily everyone was okay with it.
In a world where everyone is an ally and pronouns are always respected, yes, I want to use she/her. I don't really know if people see me as a woman, I don't pass very well, but the pronouns are at least a green flag that people are being polite to me, regardless of what they think.
But in the real world, I was extremely reluctant to ask for something that could be trivially denied or could spark a politics debate around the office.
So... I hope that clears it up a little. For me transitioning has been first and foremost about reconciling my mind and my body. I spend a lot of time alone, and I spend a lot of time online where I don't need a gender, and I like that. In HN threads that aren't about gender, I'm not a woman who programs, or a woman who was assigned male at birth, I'm just a programmer who programs.
But out in the bizarre real world, "My pronouns are she/her" is an invitation to be invalidated, and "I'm buying a vagina and nobody can stop me" is a statement of fact. I let myself be a little macho sometimes. Even cis women do it.
That all makes a lot of sense. And I think you've helped something 'click' for me (and hopefully others) in understanding some things here, thank you for your time writing all of this up! It's really appreciated.
A quick final questions on pronouns, if you have time: I'm contemplating the idea of just using they/them pronouns for everyone. I quite like the idea currently for a few reasons, and I can't imagine people being offended by it(?). But one negative I could see is that, when someone asks for others to use particular pronouns for them (e.g. she/her), using those pronouns I can imagine would be a nice acknowledgement/validation/show of support etc., which using they/them instead probably wouldn't give. Did you have any opinion on people making such a choice, given any insight you might have from your own experiences or an understanding of the LPGTQ+/etc. community? I'd definitely like to be able to reasonably justify it as a rule (even if someone's specified certain pronouns).
A quick final questions on pronouns, if you have time: I'm contemplating the idea of just using they/them pronouns for everyone. I quite like the idea currently for a few reasons, and I can't imagine people being offended by it(?). But one negative I could see is that, when someone asks for others to use particular pronouns for them (e.g. she/her), using those pronouns I can imagine would be a nice acknowledgement/validation/show of support etc., which using they/them instead probably wouldn't give. Did you have any opinion on people making such a choice, given any insight you might have from your own experiences or an understanding of the LPGTQ+/etc. community? I'd definitely like to be able to reasonably justify it as a rule (even if someone's specified certain pronouns).
I'm so goddamn sorry you had to read that response. It's a recycled argument but I was genuinely not expecting such an abhorrent comment on HN
Interesting to see that these are all wants, and that you can have them. It's a good time to be alive. Good for you.
Yeah. Admittedly for most trans people they are needs. I have it easy. Thanks!
Article has a paywall.
Any way to see actual paper or something?
Any way to see actual paper or something?
Interesting if true. There is a lot of hedging, like (to paraphrase) "This might be spurious", "This might be because we don't deny HRT to people who might have an increased risk of cardiovascular conditions on HRT."
I'm not going to do anything about it.
I think choice is an illusion. Until about 2018, I fully believed I was a cis crossdresser, so I still say that at the time, I really was cis.
So in a way I "chose" to transition in 2018. Some trans people feel an overwhelming urge to transition from birth, but I could have kept living as a cis man. But now in 2022, I don't think I can "choose" to go back to being cis. If the data comes back showing that I'm personally at a huge risk of death, maybe I would stop HRT, but I don't really want to be a man again. Somehow they are different kinds of "choice". One was "I have to try it, I can't keep wondering." The other is "I am happy where I am and I would need a lot of convincing to change it."
I don't have an exact boundary between "Being happy is worth losing 1 or 2 years off the end of my life" and "Being happy is not worth losing 20 years off the end of my life". Ceasing medical transition and living as a high-testosterone woman would be completely valid, but it's a judgment call, and I just don't feel like it right now.