I am not a doctor so I cannot speak on this with authority or knowledge only from experience. I have congestive heart failure due to familial cardiomyopathy. I was diagnosed in my twenties in the early-oughts. I am not trans, but going through my cardiac issues is what made me open my eyes to the misinformation about sex and its consequential impact on cardiac function.
When I first started experiencing severe cardiac issues I was lucky that I had physicians around me that took the time to look at me, my medical testing results, and my family history without dismissal as I did not have many of the comorbidities associated with severe cardiac dysfunction. Over a period of several years I was titrated on and off several medications in an attempt to manage my condition. It was this process that was so enlightening. Many of the medications were designed and approved based on pharmaceutical studies of male patients. Some of the best had not been tested on women, and many that had, were not extensively tested on premenopausal women with my condition. Unfortunately many of the "best line" treatments did not work for me in a way that was expected. I experienced side effects that included a drop cardiac function-the exact thing we were trying to fix.
Midway through trying to find the right mix of medication I moved. I started seeing a different cardiologist who looked deeply into the medication I was on. This physician came to me after a continued decline in function and mentioned that one of the medications I had been prescribed was great, it really was transformational for cardiac health in patients with CHF and in particular the idiopathic cardiomyopathy I also had. The only problem, it was primarily tested in men and did not have a great deal of testing data in women and in the cohort of women my age the complications were significant. It was approved for women in my age group, but with several caveats and warnings.
In the end my doc pulled me off it and said something that has always stuck: "Women have different cardiac needs than men. Their hearts work differently because they need the capacity to support a pregnancy. They also work differently pre and post menopause, and we don't have a lot of testing data on the pre-menopausal groups. They are not part of trials because there are so many complications that influence the outcomes."
What that doctor emphasized was the long held medical bias against studying women with cardiovascular diseases. In the mid 2010s we started to more sensitive diagnostic tools that have had a massive impact on how doctors support female cardiovascular health. However it is still hard to find data on treatments for women who are pre-menopausal. One thing that we see now is there are very different medical protocols for females and males and in both these groups at different stages in their lives.
I share this now because I know from going through the medical system that if the clinicians do not have access to strong foundation of information on cardiac disease for women, and at different stages in their lives, then they certainly do not have that information for people who are trans.
I am a former teacher, I have worked with students who experience gender dysphoria. I was always told by students and families that trans healthcare is safe and the science is known. But, with cardiac health in particular my experience has led me to a place where I see a biological difference between males and females, and one that is consequential. I think the narrative that the only ways men and women are different is in their primary and secondary sex characteristics is incredibly misleading. We still do not know the degrees to which our many different characteristics are influenced and driven by sex. The notion that the science is settled in this or any area of health is inaccurate at best.
I feel and understand the uncertainty felt by the individuals in this podcast experiencing cardiac dysfunction. I can only say that more is unknown than known where women-especially females under 50-are concerned. My best suggestion is to find a doctor who can speak to, or is willing to look into, the differences in outcomes for men and women on medication regimes.
Finally, I want to say thank you for this episode. It was excellent hearing from these individuals about the complexities of care in this space. More research, communication, and knowledge sharing across the silos of medicine are required so that individuals get the care that is best for the bodies they have, not just the ones they want.
After many years of testosterone therapy, I had a hysterectomy. My uterus was the size of that of a full term pregnancy. It was a difficult surgery due to its size. I also had breast cancer twice after hormone use. No one knows if it was caused by testosterone. Haemocrit levels can be managed by regular blood donation. I assume that I have a higher risk of cardiovascular problems and possibly dementia - so I try to exercise and eat well. Doctors can never answerr my health questions. They similply don't know. It's experimental. It's a risk! Thanks for this important conversation.
And thank you for sharing your experience. Having these kinds of discussions will hopefully become more commonplace, not to derail transition, but to provide us with more information so we can truly make an informed decision to consent to our care.
This was a brilliant conversation. As a biological psychologist, I agree with the advice and thoughtfulness of the participants. There were some misunderstandings of the basic biology revolving around these issues (like women have two functional X chromosomes in every cell), but that is understandable given the complexity of biology, endocrinology, and genetics. Unfortunately, a lot of these conversations are not as thoroughly informed as the participants would like them to be. Nonetheless, the thoughtfulness and reasonableness displayed here was invaluable. Thank you. Sincerely, Frederick
I found this so interesting to listen to. Thank you to the panel for speaking if the unknowns surrounding healthcare for Trans people.
As a parent of a teen with ROGD , I struggle because I often wonder how to know if transitioning would truly make her happy as so many of you say it has done for you. I fear that it will not but I don’t know how to talk to her about this. She is so convinced that she’s trans , even though it makes no sense based on her childhood.
You're in a tough position. There's no definitive way to "know" if transition is the right path for ANYONE. That uncertainty is anxiety producing for so many parents AND trans people. If the four of us were speaking about our childhoods there might not be much overlap or a lot of overlap. That's probably not very consoling to hear. I am sending you grace and kindness.
Really I just read that is encouraging it’s been a rough I read this comment it was the perfect anecdote. It’s good to hear some sanity and common sense...and oh yes we know adult trans people who might actually know a thing or 2 about this...kids
Hi Frogmom...I’m in the same spot. I don’t think that teens listen to parents. I use to give my daughter articles, YouTubes of Detransioners etc. she can’t even handle that I have trans ADULT friends. She does not like any trans adults or any educated adults in general... unless it’s Harry Styles. If you figure things out pls us. I keep thinking if the MSM reported on this in an honest way she wouldn’t be able to ignore this scandal. I hate admitting this but at 14 she thought she could change her chromosomes to XY, until my 16 year old son broke it to her that it isn’t possible to change your chromosomes. My daughter is smart she must have learned that from TikTok or something. Idk 🆘
My dad was a PC doc for trans adults in the 1970s. He saw post-op Stanford patients. He was known as a kind and open minded doc who cared about these patients and he can’t believe this is happening to kids. He still sees trans adult patients. I don’t think he even knows risks I told him the side effects bc I researched them. He was writing scripts for T & E in the 80s. I don’t think research is adequate or much more advanced than it was 40 years ago. Imho
What an important conversation about the need for better adult trans healthcare jfc. They’ve been doing these interventions for 40+ years there’s been enough time to monitor side effects. Jamie Reed is right...these are NOT throwaway people. Everyone deserves excellent healthcare.
Thanks for this great interview...3 of my favorite smart guys and Jamie Reed! I really appreciate their POV and ability to be honest and public about their voices.
Now this prostate info should really be discussed by an oncologist or urologist. I want to know the medical implications.
Zander I listen to all your interviews. You are smart guy and I learn a lot from these conversations. We need more conversation and listening. ❤️ thanks Lisa Selin Davis.
the willingness to undo these very extreme "medical" interventions in the "wild west" of experimental medicine entails significant risks and hardships.
Of course tampering with your body in these extreme ways will cause difficulties and suffering. Not considering this beforehand is incredibly naive. It's like trying to cross a busy highway without looking at the traffic coming your way.
The whole trope of "transphobic" accusations against people who raise concerns is just vicious. People want you to wake up & consider the very real dangers.
Life entails risk. I accept that. However, my transition has not brought any "hardships." As a matter of fact, my life significantly improved post-transition. This is not the case for all who venture down this path.
The unknowns surrounding 'treatment' which is not so much prescribed as demanded and which is fueled by ideology rather than truth is hardly surprising.
So when people choose such self deforming, risky and purely elective protocols paid for by insurance I am not inclined to feel sympathetic much less supportive.
My hope is that legislation, lawsuits, and public awareness will put an end to 'transitioning' or at least very tightly restrict it w/ the understanding that those who have already transitioned will get proper care insofar as they can for iatrogenic problems practitioners are not trained to treat. No person should be allowed to be legally designated as the opposite-sex as that disrupts society too much--specifically because males pretending to be women cause too many problems regarding women's and LGB's sex-based rights and their safeguarding and privacy in woman-only spaces.
Building up the lesbian community of women will be a healthier, courageous, and more authentic alternative in my opinion than trying to opt-out of it w/ the myriad physical and psychological problems attendant to 'transitioning.' There is more than one way to be a women.
The 'helping professions' have been brought into disrepute by using humans as experimental animals; it is scandalous and shameful as both 'transitioned' and detransitioned people can attest. Thank you all for sharing your experience. I wish all of the women well as you navigate your respective situations.
Good that you haven't experienced problems but many have including loss of sexual functioning. The problems and losses are unfortunate enough in adults but minors who have not been in a relationship-including a sexual one-do not even know what they are giving up. Minors need to go through puberty and mature enough into teenhood to figure out who they are.
the willingness to undo these very extreme "medical" interventions in the "wild west" of experimental medicine entails significant risks and hardships.
Of course tampering with your body in these extreme ways will cause difficulties and suffering. Not considering this beforehand is incredibly naive. It's like trying to cross a busy highway without looking at the traffic coming your way.
The whole trope of "transphobic" accusations against people who raise concerns is just vicious. People want you to wake up & consider the very real dangers.
After many years of testosterone therapy, I had a hysterectomy. My uterus was the size of that of a full term pregnancy. It was a difficult surgery due to its size. I also had breast cancer twice after hormone use. No one knows if it was caused by testosterone. Haemocrit levels can be managed by regular blood donation. I assume that I have a higher risk of cardiovascular problems and possibly dementia - so I try to exercise and eat well. Doctors can never answerr my health questions. They similply don't know. It's experimental. It's a risk! Thanks for this important conversation.
Maybe the past decade of cautionary tales has conditioned scientists and those in the medical establishment to be afraid of any gender non-conforming patient. "Just give 'em what they want, and maybe they will go away." And "patient loss to follow-up" seems to be considered as more of a perk by most rank-and-file professionals, than as a problem to be solved. See Jesse Singal's 2015 article: https://www.thecut.com/2015/12/when-liberals-attack-social-science.html
I fear that LGBs have been duped, that those who feel or have felt unhappy w/ their bodies, have been used in an experiment that has caused many a lot of misery. And for what? To be an ersatz man or woman, a 'mutilated heterosexual,' someone who lives w/ knowing it's all a lie? It makes me sad and angry that LGBs don't have more integrity and self-respect b/c they are too too ashamed of who they are and therefore vulnerable to buying into a false promise resulting in self-harm.
But the 'transgender identity' con sure has helped the male, heterosexual, cross-dresser sexual fetishists, autogynephiles/tranvestic fetishists, the men w/ paraphilias who can boldly display their paraphilias in women's spaces (including lesbian spaces) and supplant women's and LGB's sex-based rights and opportunities.
And having forcibly attached the T to the LGB these men and their 'transmaidens' have brought a backlash onto LGBs b/c of their aggressive colonization of 'woman' and their bastardization of the language that specifically insults women and mothers; in addition, the promotion of 'gender identity' and 'transitioning' to minors. The patriarchy always finds a way to dominate and use women--this time it is in heels and a dress.
I am not a doctor so I cannot speak on this with authority or knowledge only from experience. I have congestive heart failure due to familial cardiomyopathy. I was diagnosed in my twenties in the early-oughts. I am not trans, but going through my cardiac issues is what made me open my eyes to the misinformation about sex and its consequential impact on cardiac function.
When I first started experiencing severe cardiac issues I was lucky that I had physicians around me that took the time to look at me, my medical testing results, and my family history without dismissal as I did not have many of the comorbidities associated with severe cardiac dysfunction. Over a period of several years I was titrated on and off several medications in an attempt to manage my condition. It was this process that was so enlightening. Many of the medications were designed and approved based on pharmaceutical studies of male patients. Some of the best had not been tested on women, and many that had, were not extensively tested on premenopausal women with my condition. Unfortunately many of the "best line" treatments did not work for me in a way that was expected. I experienced side effects that included a drop cardiac function-the exact thing we were trying to fix.
Midway through trying to find the right mix of medication I moved. I started seeing a different cardiologist who looked deeply into the medication I was on. This physician came to me after a continued decline in function and mentioned that one of the medications I had been prescribed was great, it really was transformational for cardiac health in patients with CHF and in particular the idiopathic cardiomyopathy I also had. The only problem, it was primarily tested in men and did not have a great deal of testing data in women and in the cohort of women my age the complications were significant. It was approved for women in my age group, but with several caveats and warnings.
In the end my doc pulled me off it and said something that has always stuck: "Women have different cardiac needs than men. Their hearts work differently because they need the capacity to support a pregnancy. They also work differently pre and post menopause, and we don't have a lot of testing data on the pre-menopausal groups. They are not part of trials because there are so many complications that influence the outcomes."
What that doctor emphasized was the long held medical bias against studying women with cardiovascular diseases. In the mid 2010s we started to more sensitive diagnostic tools that have had a massive impact on how doctors support female cardiovascular health. However it is still hard to find data on treatments for women who are pre-menopausal. One thing that we see now is there are very different medical protocols for females and males and in both these groups at different stages in their lives.
I share this now because I know from going through the medical system that if the clinicians do not have access to strong foundation of information on cardiac disease for women, and at different stages in their lives, then they certainly do not have that information for people who are trans.
I am a former teacher, I have worked with students who experience gender dysphoria. I was always told by students and families that trans healthcare is safe and the science is known. But, with cardiac health in particular my experience has led me to a place where I see a biological difference between males and females, and one that is consequential. I think the narrative that the only ways men and women are different is in their primary and secondary sex characteristics is incredibly misleading. We still do not know the degrees to which our many different characteristics are influenced and driven by sex. The notion that the science is settled in this or any area of health is inaccurate at best.
I feel and understand the uncertainty felt by the individuals in this podcast experiencing cardiac dysfunction. I can only say that more is unknown than known where women-especially females under 50-are concerned. My best suggestion is to find a doctor who can speak to, or is willing to look into, the differences in outcomes for men and women on medication regimes.
Finally, I want to say thank you for this episode. It was excellent hearing from these individuals about the complexities of care in this space. More research, communication, and knowledge sharing across the silos of medicine are required so that individuals get the care that is best for the bodies they have, not just the ones they want.
Thankfully you found a doctor who knew the difference. Thank you for listening and commenting.
After many years of testosterone therapy, I had a hysterectomy. My uterus was the size of that of a full term pregnancy. It was a difficult surgery due to its size. I also had breast cancer twice after hormone use. No one knows if it was caused by testosterone. Haemocrit levels can be managed by regular blood donation. I assume that I have a higher risk of cardiovascular problems and possibly dementia - so I try to exercise and eat well. Doctors can never answerr my health questions. They similply don't know. It's experimental. It's a risk! Thanks for this important conversation.
And thank you for sharing your experience. Having these kinds of discussions will hopefully become more commonplace, not to derail transition, but to provide us with more information so we can truly make an informed decision to consent to our care.
This was a brilliant conversation. As a biological psychologist, I agree with the advice and thoughtfulness of the participants. There were some misunderstandings of the basic biology revolving around these issues (like women have two functional X chromosomes in every cell), but that is understandable given the complexity of biology, endocrinology, and genetics. Unfortunately, a lot of these conversations are not as thoroughly informed as the participants would like them to be. Nonetheless, the thoughtfulness and reasonableness displayed here was invaluable. Thank you. Sincerely, Frederick
I found this so interesting to listen to. Thank you to the panel for speaking if the unknowns surrounding healthcare for Trans people.
As a parent of a teen with ROGD , I struggle because I often wonder how to know if transitioning would truly make her happy as so many of you say it has done for you. I fear that it will not but I don’t know how to talk to her about this. She is so convinced that she’s trans , even though it makes no sense based on her childhood.
You're in a tough position. There's no definitive way to "know" if transition is the right path for ANYONE. That uncertainty is anxiety producing for so many parents AND trans people. If the four of us were speaking about our childhoods there might not be much overlap or a lot of overlap. That's probably not very consoling to hear. I am sending you grace and kindness.
Waiting is always better. I managed to help my child out of this. And a dear friend who is trans also counseled to wait till 30’s.
Really I just read that is encouraging it’s been a rough I read this comment it was the perfect anecdote. It’s good to hear some sanity and common sense...and oh yes we know adult trans people who might actually know a thing or 2 about this...kids
Hi Frogmom...I’m in the same spot. I don’t think that teens listen to parents. I use to give my daughter articles, YouTubes of Detransioners etc. she can’t even handle that I have trans ADULT friends. She does not like any trans adults or any educated adults in general... unless it’s Harry Styles. If you figure things out pls us. I keep thinking if the MSM reported on this in an honest way she wouldn’t be able to ignore this scandal. I hate admitting this but at 14 she thought she could change her chromosomes to XY, until my 16 year old son broke it to her that it isn’t possible to change your chromosomes. My daughter is smart she must have learned that from TikTok or something. Idk 🆘
My dad was a PC doc for trans adults in the 1970s. He saw post-op Stanford patients. He was known as a kind and open minded doc who cared about these patients and he can’t believe this is happening to kids. He still sees trans adult patients. I don’t think he even knows risks I told him the side effects bc I researched them. He was writing scripts for T & E in the 80s. I don’t think research is adequate or much more advanced than it was 40 years ago. Imho
What an important conversation about the need for better adult trans healthcare jfc. They’ve been doing these interventions for 40+ years there’s been enough time to monitor side effects. Jamie Reed is right...these are NOT throwaway people. Everyone deserves excellent healthcare.
Thanks for this great interview...3 of my favorite smart guys and Jamie Reed! I really appreciate their POV and ability to be honest and public about their voices.
Now this prostate info should really be discussed by an oncologist or urologist. I want to know the medical implications.
Thank you for your kind feedback!
Zander I listen to all your interviews. You are smart guy and I learn a lot from these conversations. We need more conversation and listening. ❤️ thanks Lisa Selin Davis.
Thank You!
the willingness to undo these very extreme "medical" interventions in the "wild west" of experimental medicine entails significant risks and hardships.
Of course tampering with your body in these extreme ways will cause difficulties and suffering. Not considering this beforehand is incredibly naive. It's like trying to cross a busy highway without looking at the traffic coming your way.
The whole trope of "transphobic" accusations against people who raise concerns is just vicious. People want you to wake up & consider the very real dangers.
Life entails risk. I accept that. However, my transition has not brought any "hardships." As a matter of fact, my life significantly improved post-transition. This is not the case for all who venture down this path.
The unknowns surrounding 'treatment' which is not so much prescribed as demanded and which is fueled by ideology rather than truth is hardly surprising.
So when people choose such self deforming, risky and purely elective protocols paid for by insurance I am not inclined to feel sympathetic much less supportive.
Thanks for listening. May you be well.
Pax vobiscum as well..
My hope is that legislation, lawsuits, and public awareness will put an end to 'transitioning' or at least very tightly restrict it w/ the understanding that those who have already transitioned will get proper care insofar as they can for iatrogenic problems practitioners are not trained to treat. No person should be allowed to be legally designated as the opposite-sex as that disrupts society too much--specifically because males pretending to be women cause too many problems regarding women's and LGB's sex-based rights and their safeguarding and privacy in woman-only spaces.
Building up the lesbian community of women will be a healthier, courageous, and more authentic alternative in my opinion than trying to opt-out of it w/ the myriad physical and psychological problems attendant to 'transitioning.' There is more than one way to be a women.
The 'helping professions' have been brought into disrepute by using humans as experimental animals; it is scandalous and shameful as both 'transitioned' and detransitioned people can attest. Thank you all for sharing your experience. I wish all of the women well as you navigate your respective situations.
Thankfully not all transsexuals experience a "myriad physical and psychological problems." I know I have not.
Good that you haven't experienced problems but many have including loss of sexual functioning. The problems and losses are unfortunate enough in adults but minors who have not been in a relationship-including a sexual one-do not even know what they are giving up. Minors need to go through puberty and mature enough into teenhood to figure out who they are.
I agree that going through puberty is important.
the willingness to undo these very extreme "medical" interventions in the "wild west" of experimental medicine entails significant risks and hardships.
Of course tampering with your body in these extreme ways will cause difficulties and suffering. Not considering this beforehand is incredibly naive. It's like trying to cross a busy highway without looking at the traffic coming your way.
The whole trope of "transphobic" accusations against people who raise concerns is just vicious. People want you to wake up & consider the very real dangers.
After many years of testosterone therapy, I had a hysterectomy. My uterus was the size of that of a full term pregnancy. It was a difficult surgery due to its size. I also had breast cancer twice after hormone use. No one knows if it was caused by testosterone. Haemocrit levels can be managed by regular blood donation. I assume that I have a higher risk of cardiovascular problems and possibly dementia - so I try to exercise and eat well. Doctors can never answerr my health questions. They similply don't know. It's experimental. It's a risk! Thanks for this important conversation.
Maybe the past decade of cautionary tales has conditioned scientists and those in the medical establishment to be afraid of any gender non-conforming patient. "Just give 'em what they want, and maybe they will go away." And "patient loss to follow-up" seems to be considered as more of a perk by most rank-and-file professionals, than as a problem to be solved. See Jesse Singal's 2015 article: https://www.thecut.com/2015/12/when-liberals-attack-social-science.html
I fear that LGBs have been duped, that those who feel or have felt unhappy w/ their bodies, have been used in an experiment that has caused many a lot of misery. And for what? To be an ersatz man or woman, a 'mutilated heterosexual,' someone who lives w/ knowing it's all a lie? It makes me sad and angry that LGBs don't have more integrity and self-respect b/c they are too too ashamed of who they are and therefore vulnerable to buying into a false promise resulting in self-harm.
But the 'transgender identity' con sure has helped the male, heterosexual, cross-dresser sexual fetishists, autogynephiles/tranvestic fetishists, the men w/ paraphilias who can boldly display their paraphilias in women's spaces (including lesbian spaces) and supplant women's and LGB's sex-based rights and opportunities.
And having forcibly attached the T to the LGB these men and their 'transmaidens' have brought a backlash onto LGBs b/c of their aggressive colonization of 'woman' and their bastardization of the language that specifically insults women and mothers; in addition, the promotion of 'gender identity' and 'transitioning' to minors. The patriarchy always finds a way to dominate and use women--this time it is in heels and a dress.
Thank you for the link Heather, I had not read this excellent article Jesse wrote.