10almonds Tells The Tea...

⏰ IN A RUSH?

Today’s Key Learnings:

Flying by? Here are some key take-away ideas from today’s newsletter:

• Hormones are powerful, and can produce changes all the way from skin to skeleton

• Gender-affirming surgeries are a lot more advanced than you may have thought from pop culture

• Trans healthcare is really hard to access, and often nearly impossible for under-18s

🏳️‍⚧️ TDoV

Today’s a special edition of Myth-Busting Friday!

Why? Because today is Transgender Day of Visibility, there are so many myths to bust that we couldn’t fit everything in... We've done our best, though!

(estimated reading time: 5 mins)

We'll be focusing on things about medical transition—we are, after all, a health and productivity newsletter.

Our normal format will be back tomorrow as usual!

👀 WATCH AND LEARN

What Gender-Affirming Care Is (And Isn’t)

This short (2:47) video by the Human Rights Campaign demystifies trans youth care:

Click Here If The Embedded Video Doesn’t Load Automatically

Runner-up videos for inclusion today were two short videos about gender reassignment surgery (GRS), busting myths and clarifying the reality:

• Samantha Lux demystifies GRS from a trans woman’s perspective

• Jamie Raines demystifies GRS from a trans man’s perspective

❗️ BEFORE WE GO FURTHER…

The Statistically Significant Others…

Trans people are estimated to make up about 1% of the general population. Why are we doing a main feature on something that affects so few people? The answer is, that’s actually quite a lot:

Put it this way, people with rheumatoid arthritis make up about 0.6% of the general population.

If you go to a large supermarket, there is probably a trans person there somewhere.

(If you’re a trans person reading this, then yes, there will definitely be a trans person there when you go, but we’re going to assume our readership is 99% cis)

Let’s quickly define some terms:

• Trans (transgender)—not identifying with the gender one was assigned at birth

• Cis (cisgender)—identifying with the gender one was assigned at birth

• Transmasc (transmasculine)—trans, transitioning in the direction of more masculinity

• Transfem (transfeminine)—trans, transitioning in the direction of more femininity

• Intersex—having been born with physical sex characteristics of more than one sex. May or may not also be trans, and/but face many of the same issues, often pertaining to bodily autonomy and healthcare.

• Perisex—having been born with physical sex characteristics of only one sex

• Top surgery—gender-affirming surgery on the chest. Most often refers to transmascs having a mastectomy. Can also refer to transfems having breast augmentation.

• Bottom surgery—gender-affirming surgery of the genitals. Most often refers to transfems having a vaginoplasty. Can also refer to transmascs having a phalloplasty.

Two quick notes on those:

Firstly: we’re going to occasionally use the terms “transmasc” and “transfem” rather than “trans man” and “trans woman”. This is because not everyone who is transmasc or transfem is a trans man or a trans woman, respectively. Some people do not fit neatly into either of the two genders that get assigned at birth.

As one illustrative example, there are a lot of non-binary transmasc butch lesbians who would not thank us for errantly calling them men... Even though they might take testosterone, bind their chests flat, or even have top surgery.

Secondly: let’s bust a myth real quick about Intersex people: they’re more common than you probably think. About 1.7% of babies are born Intersex. That doesn’t seem like a lot, until you realize it’s about as common as being a redhead… It’s just less visible.

It's especially less visible because surgeries are often performed neonatally... Doctors arbitrarily make a baby look perisex, one way or the other. Many people go through life not knowing they had this surgery, until something comes up later.

Read: Harmful Surgery on Intersex Children—Medically Unnecessary Operations Risk Lifelong Suffering (Human Rights Watch)

⚧ MAIN FEATURE

Let’s Bust Some Myths!

It’s too late after puberty, hormones won’t change xyz

While yes, many adult trans people dearly wish they’d been able to medically transition before going through the “wrong” puberty, the truth is that a lot of changes will still occur later... even to “unchangeable” things like the skeleton.

The body is remaking itself throughout life, and hormones tell it how to do that. Some parts are just quicker or slower than others. Also: the skeleton is pulled-on constantly by our muscles, and in a battle of muscle vs bone, muscle will always win over time.

Examples of this include:

• trans men building bigger bones to support their bigger muscles

• trans women getting smaller, with wider hips and a pelvic tilt

Trans people have sporting advantages

Assuming at least a year’s cross-sex hormonal treatment, there is no useful advantage to being trans when engaging in a sport. There are small advantages and disadvantages (which goes for any person’s body, really). For example:

• Trans women will tend to be taller than cis women on average...

  • ...but that larger frame is now being powered by smaller muscles, because they shrink much quicker than the skeleton.

• Trans men taking T are the only athletes allowed to take testosterone...

  • ...but they will still often be smaller than their fellow male competitors, for example.

Read: Do Trans Women Athletes Have Advantages? (A rather balanced expert overview, which does also cover trans men)

There’s a trans population explosion; it’s a social contagion epidemic!

Source for figures: The Overall Rate Of Left-Handedness (Researchgate)

Left-handed people used to make up around 3% of the population... Until the 1920s, when that figure jumped sharply upwards, before plateauing at around 12% in around 1960, where it’s stayed since. What happened?! Simple, schools stopped forcing children to use their right hand.

Today, people ask for trans healthcare because they know it exists! Decades ago, it wasn’t such common knowledge.

The same explanation can be applied to other “population explosions” such as for autism and ADHD.

Transgender healthcare is too readily available, especially to children!

To believe some press outlets, you’d think:

• HRT is available from school vending machines,

• kids can get a walk-in top surgery at recess,

• and there’s an after-school sterilization club.

In reality, while availability varies from place to place, trans healthcare is heavily gatekept. Even adults have trouble getting it, often having to wait years and/or pay large sums of money... and get permission from a flock of doctors, psychologists, and the like. For those under the age of 18, it’s almost impossible in many places, even with parental support.

Puberty-blockers shouldn’t be given to teenagers, as the effects are irreversible

Quick question: who do you think should be given puberty-blockers? For whom do you think they were developed? Not adults, for sure! They were not developed for trans teens either, but for cis pre-teens with precocious puberty, to keep puberty at bay, to do it correctly later. Nobody argues they’re unsafe for much younger cis children, and only object when it’s trans teens.

They’re not only safe and reversible, but also self-reversing. Stop taking them, and the normally scheduled puberty promptly ensues by itself. For trans kids, the desired effect is to buy the kid time to make an informed and well-considered decision. After all, the effects of the wrong puberty are really difficult to undo!

A lot of people rush medical transition and regret it!

Trans people wish it could be rushed! It’s a lot harder to get gender-affirming care as a trans person, than it is to get the same (or comparable) care as a cis person. Yes, cis people get gender-affirming care, from hormones to surgeries, and have done for a long time.

As for regret… Medical transition has around a 1% regret rate. For comparison, hip replacement has a 4.8% regret rate and knee replacement has a 17.1% regret rate.

A medical procedure with a 99% success rate would generally be considered a miracle cure!

🎤 PASSING THE MIC

We asked members of the trans community:

❝What transition-related thing(s) do you wish people knew / understood better?❞

Here are some of their answers not already covered in the information above (edited for brevity)…

• "Things a cis person might consider undesirable about hormones or surgery are desired effects by many. Just because you personally don't like an effect of transitioning doesn't mean everyone else feels the same"

• “I wish more people in general would acknowledge there’s a lot of joy to be found in being trans, and that gender euphoria is just as valid as gender dysphoria”

• “We didn't get trained for this. Nobody showed us how to be true to ourselves instead of mask we built trying to meet the world's expectations. Cis people have an entire society propping them up!”

• “It's not always about hating your body—it's a lot more about choosing to make your body your own”

• “It’s possible and okay to have a complicated relationship with your transition! I have zero regrets about getting top surgery, but I wish I’d never needed it because I would’ve been happier if I’d gotten hormone blockers first. Some aspects of T, I’ve not liked, either. But I feel like I have to put on this façade that I love everything about my transition. Otherwise, I feel like I give ammo to people who claim that transition regret is a much bigger issue than it actually is, and then use that against us”

• “Cis people who can’t understand what it’s like to be trans are usually trying backwards. You (dear cis reader) see yourself as the gender you are, and can’t imagine wanting to change that. Fair enough—I can’t imagine wanting to be a man! What you should imagine is: being the gender you are, but everyone around you has been treating you as the opposite. You may try to play along for a while, keen to fit in, but you can’t keep it up forever… You have your own one precious life to live, true to yourself!”

May your choices bring out the best possible you,

The 10almonds Team