Understanding the Complexities of Hormonal Intervention in Gender Transition

Many transgendered people will seek out ways to transition from their birth gender to the opposite gender.  Whether or not transgendered persons actually pursue sex reassignment surgery, it is not uncommon for some individuals to engage in hormone therapies.  With more acceptance of GID and educational and mental health organizations promoting that these individuals pursue transgender lifestyles, children prescribed hormones to block their gender specific puberty (GnRH analogs), and those to increase opposite sex characteristic (estrogen or testosterone) are on the rise.  Some medical providers make the sympathetic case that since GID children are at high risk for suicide, running away, and using “black market” hormones, medically supervised treatment should be made available.

The use of GnRH analogs will suppress menses in girls due to lack of estrogen and in boys will block the development of fertility due to lack of testosterone.  This is an extreme form of biology intervention for children whose brains are not fully developed.  While decision-making centers in the child’s mind are not matured, parents fulfilling desired opposite-sex want-a-be childhood fantasies through invasive hormonal intervention equates maniacal.

 And what are the potential consequences of hormonal intervention?  Actually they are multifaceted and complicated.  To interfere with the natural biological direction of one’s body and chemistry cannot go without consequence. Girls who are prescribed GnRHa are at a great risk for bone growth delay, which then will require the administration of growth stimulating drugs to help assist in achieving an acceptable male height (Delemarre-van de Waal & Cohen-Kettenis, 2006).  However, growth-stimulating drugs also have consequential side effects. For those who begin cross hormones as adolescents, exposure to hormone-dependent tumors is greatly increased over the course of a lifetime (Gooren, Giltay, & Bunck, 2008).

 Studies of male-to-female (m-to-f) transsexuals on estrogen and GnRHa treatment revealed a statistically significant increase in weight, total body fat, and visceral fat, decrease in insulin sensitivity, and in some cases increases in blood pressure.  Female-to-male (f-to-m) transsexuals on testosterone and GnRHa treatment also resulted in a statistically significant increase in body weight and body mass index (BMI).   

Other statistically significant changes that negatively affect cardiovascular health in f-to-m transsexuals are increased HDL cholesterol, triglycerides, and decreased insulin sensitivity (Gooren, et al, 2008).  In men, abnormally low levels of testosterone are associated with insulin resistance, which eventually can result in Type II diabetes.  In one study, the occurrence of venous thromboembolism (blood clots) increased 20-fold in m-to-f patients treated with estrogens and antiandrogens (Van Kesteren, et al, 1997).

Cardiovascular disease is also a concern.  Oral estrogen therapy has been shown to increase levels of the inflammatory and hemostatic markers interleukin-6, C-reactive protein, and factor IX, all of which may be predictive of future cardiovascular disease (Knezevich, et al, 2012).

Cancer and cancer risk is associated with hormonal therapies. Cases of breast carcinoma in m-to-f patients on estrogen treatment have been reported, as have breast fibroadenomas.  Breast cancer has also been reported in a f-to-m transsexual post-bilateral mastectomy while on testosterone treatment. The ovaries of f-to-m transsexuals receiving testosterone treatment look similar to polycystic ovaries, which are more likely to develop malignancies (Gooren, 1999; Gooren et al., 2008).  A high prevalence of endometrial hyperplasia has been noted in a study of transgender men undergoing hysterectomy (Futterweit, & Deligdisch, 1986).

Hormones are common mood interferes.  For example, research shows that some transgender individuals report mood swings, increased anger, and increased aggressiveness after starting androgen therapy (Israel & Tarver, 1997).

As stated earlier, to interfere with the natural biological direction of one’s body and chemistry does not go without consequence. With research indicating hormonal therapies contributing to bone problems, lipid disorders, mood disorders, cardiovascular disease, malignancies, and other pathologies, it appears hormonal interventions are not a safe course for individuals, especially children, to take. I leave you with the reminder God is the One you, I, and our loved ones need that caught up in the snare of the enemy, Satan.