In many men who receive ADT, the symptoms of depression often are severe enough to warrant clinical intervention. Thus, it is reasonable for all men who receive ADT to be screened for depression and, if they screen positive, to more fully assess them and intervene accordingly.
Also:
A patient's sense of his masculinity may be impacted in different ways by ADT. Some patients may conceptualize their masculinity in a more physical sense and, thus, may be affected more by changes like bodily feminization, infertility, or loss of muscle mass. For other men, masculinity may be impacted more by social factors, including changes in relationships and roles, or by psychological factors, including changes in body image, loss of sexual function, and emotional lability.
It is important to note that there may be other potential explanations for changes in a man's sense of his own masculinity during ADT. The same study that documented an increase in loss of masculinity over time also demonstrated that depressive and anxious symptomatology was predictive of lower perceived masculinity. In addition, lowered sexual desire may be symptomatic of depression, which is also strongly associated with ED.
Yes, they (LHRH agonists - usually in the UK known as GnRH agonists) are powerful drugs. No wonder their use as puberty blockers is controversial.
It's only "controversial" when used to treat trans people. No-one bats an eyelid otherwise.
In many men who receive ADT, the symptoms of depression often are severe enough to warrant clinical intervention. Thus, it is reasonable for all men who receive ADT to be screened for depression and, if they screen positive, to more fully assess them and intervene accordingly.
Also:
A patient's sense of his masculinity may be impacted in different ways by ADT. Some patients may conceptualize their masculinity in a more physical sense and, thus, may be affected more by changes like bodily feminization, infertility, or loss of muscle mass. For other men, masculinity may be impacted more by social factors, including changes in relationships and roles, or by psychological factors, including changes in body image, loss of sexual function, and emotional lability.
It is important to note that there may be other potential explanations for changes in a man's sense of his own masculinity during ADT. The same study that documented an increase in loss of masculinity over time also demonstrated that depressive and anxious symptomatology was predictive of lower perceived masculinity. In addition, lowered sexual desire may be symptomatic of depression, which is also strongly associated with ED.
Yes, they (LHRH agonists - usually in the UK known as GnRH agonists) are powerful drugs. No wonder their use as puberty blockers is controversial.
It's only "controversial" when used to treat trans people. No-one bats an eyelid otherwise.
I think we'll have to disagree about that on another thread!
In many men who receive ADT, the symptoms of depression often are severe enough to warrant clinical intervention. Thus, it is reasonable for all men who receive ADT to be screened for depression and, if they screen positive, to more fully assess them and intervene accordingly.
Also:
A patient's sense of his masculinity may be impacted in different ways by ADT. Some patients may conceptualize their masculinity in a more physical sense and, thus, may be affected more by changes like bodily feminization, infertility, or loss of muscle mass. For other men, masculinity may be impacted more by social factors, including changes in relationships and roles, or by psychological factors, including changes in body image, loss of sexual function, and emotional lability.
It is important to note that there may be other potential explanations for changes in a man's sense of his own masculinity during ADT. The same study that documented an increase in loss of masculinity over time also demonstrated that depressive and anxious symptomatology was predictive of lower perceived masculinity. In addition, lowered sexual desire may be symptomatic of depression, which is also strongly associated with ED.
Yes, they (LHRH agonists - usually in the UK known as GnRH agonists) are powerful drugs. No wonder their use as puberty blockers is controversial.
It's only "controversial" when used to treat trans people. No-one bats an eyelid otherwise.
I think we'll have to disagree about that on another thread!
But it is a fact. Using puberty blockers is not at all controversial when it comes to treating precocious puberty. That is their other use. Do you have any sources saying that using puberty blockers to treat precocious puberty is controversial?
Insulin is a powerful drug - and is also a form of hormone replacement therapy, just not sex hormone replacement therapy). Nobody uses this kind of tabloid-esque language to describe insulin. However, people do use this kind of language in talking about GLP-1 drugs (Ozempic etc) and it hasn't been lost on me that the rhetoric around weight loss medication ramped up once the puberty blocker issue was at least temporarily off the table.
In a previous life I wanted to explore the theology of eunuchs in the Bible as the intersection of gender and disability, and I think this thread is demonstrating why disability and gender are so linked to discussions of eunuchs. It very much seems to be a discussion about Good Bodies and Bad Bodies (and Good Marginalised People and Bad Marginalised People) - and I had forgotten until just now that fatness was very much part of the historical eunuch stereotype, so really coming full-circle with GLP-1 medication taking the place of puberty blockers in the tabloids (for the avoidance of doubt, I am a fat person who has been involved in fat activism since my teens, as well as trans and disabled).
I think cis people being able to have gender affirming surgery and destigmatising it is a good thing. I don't think that painting self-identifying eunuchs that desire an orchiectomy as being responsible for trans people having fewer rights is helpful to trans people - the people at fault are transphobes, not NHS Scotland being too inclusive. I don't have an issue with a cis man getting an elective orchiectomy, it's their body and it doesn't affect me. Cis people can have gender dysphoria too, likewise not all trans people do have gender dysphoria.
As I recall there is some evidence for orchiectomy being associated with longer, healthier life in mammals. It's fascinating just how culturally significant testicles are vs ovaries. Hysterectomies and ovarectomies are talked about pretty openly and there is nothing like the same connotation of being de-sexed. I don't know whether it's simply internal vs external or that female loss of fertility is considered natural in a way that male loss of fertility isn't.
As I recall there is some evidence for orchiectomy being associated with longer, healthier life in mammals.
That's what vets tell us about dogs and cats.
It's fascinating just how culturally significant testicles are vs ovaries. Hysterectomies and ovarectomies are talked about pretty openly and there is nothing like the same connotation of being de-sexed. I don't know whether it's simply internal vs external or that female loss of fertility is considered natural in a way that male loss of fertility isn't.
Testicles mean masculinity for a lot of people, and to lose masculinity is to lose power in society.
Women's reproductive organs don't mean femininity to a lot of people the way women's breasts do. The connotation of women being de-sexed comes more with unreconstructed mastectomies, partly because the effects of removing the ovaries come to women sooner or later anyway, but having breasts removed is an intervention, frequently a very visible one. People don't typically tell a woman who needs a hysterectomy that she shouldn't have one, but women who don't get breast reconstruction after mastectomies say some people are shocked at this decision.
Edit: In addition, women who lose femininity also lose power, but they were starting from a lower level of power than men.
Maybe not to the same extent but I think there are some familiar themes...
There is strong sexist resistance to and disapproval of young women and those perceived as women having hysterectomies "because some day you might meet a man and want kids' (which can seriously endanger their health). Plus some of the anti-trans rhetoric boils women down to our reproductive functions/ gametes so much that women without certain reproductive organs seem to get erased and excluded from their idea of what women are. So there is social pressure and stigma around women and reproductive organs from some quarters.
And then if we look at secondary characteristics, there's the whole 'healthy breasts being cut off' fetishisation and nonsense from transphobes about elective mastectomies - as well as the surprisingly common medical assumption that women who've had mastectomy for cancer MUST want reconstruction to feel feminine ( a friend of mine in that situation who didn't want it was startled by the pressure she came under to have it, as if it wasn't OK for a woman to be flat chested if she wanted)
So there is body policing of reproductive and sexual characteristics accompanied by stigma for women who do not want/ have the sexual/ reproductive anatomy that the body police think they should have.
I suppose it's not a surprise to find female transphobes sticking their nose into male sexual anatomy and trying to police that - I think they're at some level just against bodily autonomy for everyone.
I think it maybe doesn't crystallise around external genitalia in the same way- perhaps because so much in general about women's bodies is policed very strongly, so you're right that it's different.
I think though there are some similarities too with gender and body policing by those who want to enforce gender binaries and who aren't comfortable with gender fluidity?
Following on from Ruth - who has good points about power - I wonder if more of a female equivalent to a eunuch would be the sexist historical concept of the 'crone' - the older infertile stigmatised woman who doesn't please the male gaze, who hasn't got access to the relative power that a younger fertile woman might have been able to access from her fertility and femininity in a patriarchal society - and who could be seen as de-sexed in historical stereotypes.
There have also been modern moves to re-appropriate and reclaim the identity of crone but remade as a powerful identity. Though in our current sexist society older women can and do still lose power as they cease to fit stereotypes of femininity.
@Pomona and @Arethosemyfeet , on reflection I think it was not a good idea of me to raise the issue of puberty blockers on this thread.
I actually think that the type of discussion I would like to have with many knowledgeable people on this thread (and with other Shipmates not currently on this thread) cannot take place on any on-line discussion forum, including on this Ship. The potential for accidently 'saying' (ie typing) something that offends or gets misunderstood is just too great -for me at least.
This thread already has a lot of 'heavy' issues and I will continue to follow it and learn a lot. But I doubt I have anything further to contribute that would be helpful.
@Merry Vole while of course you can follow your own preferences with regards to involving yourself in discussion or not, it seems like a shame to:
1) not actually give a response to mine and @Arethosemyfeet 's replies - that seems like a bit of a cop-out, especially when "Do you have any sources saying that using puberty blockers to treat precocious puberty is controversial?" is a simple yes/no question;
2) frame meta discussions of disagreement within this discussion around offence or misunderstanding, when disagreement is neither of those things.
Also personally as an ND person I find online discussions MUCH less prone to misunderstanding than offline discussions, particularly as I have sensory processing issues which make taking in spoken information more difficult than taking in something I've read. For a lot of trans people - ND or not - discussing these things online also feels much safer than having a more personal offline discussion, even if that means experiencing more offence. It's much easier to escape if it does become too much, for one thing!
@Merry Vole while of course you can follow your own preferences with regards to involving yourself in discussion or not, it seems like a shame to:
1) not actually give a response to mine and @Arethosemyfeet 's replies - that seems like a bit of a cop-out, especially when "Do you have any sources saying that using puberty blockers to treat precocious puberty is controversial?" is a simple yes/no question;
2) frame meta discussions of disagreement within this discussion around offence or misunderstanding, when disagreement is neither of those things.
Also personally as an ND person I find online discussions MUCH less prone to misunderstanding than offline discussions, particularly as I have sensory processing issues which make taking in spoken information more difficult than taking in something I've read. For a lot of trans people - ND or not - discussing these things online also feels much safer than having a more personal offline discussion, even if that means experiencing more offence. It's much easier to escape if it does become too much, for one thing!
@Pomona , it's a fair cop: the answer to the simple question is 'no' I don't have any sources. My 40 years working in the NHS suggests to me that precocious puberty is very rare. I think it can overlap with short stature and I was involved in the case of a boy who was particularly short and puberty blockers were considered as a help to enable his long bones to grow more before puberty 'locks' that height. But in the end no treatment was decided on and he is now an adult and his short stature is not an issue for him. One might wonder whether there are subtle social expectations involved in such a case; ie 'men are expected to be taller than women'? But I think you'll agree medications shouldn't be used just to manage perceived problems with social expectations.
Apart from the above, forgive me but I'm out of my depth here.
Whereas in my very small circle of people who I have knowledge about medical conditions there's one who had precocious puberty treaty with puberty blockers. Which is far too small a sample to be statistically significant, and indeed I expect only those who specialise in treating adolescence and their development would have the experience necessary to give an answer to the question of how rare, or otherwise, precocious puberty is. A quick literature search produced results that aren't very clear to me, in part because there seems to be quite a bit of variation in what signs are taken to indicate the onset of puberty, and variation in how early such onset would be to be classed as "precocious". I admit I don't have the scientific background to assess the papers I found, but it does seem that precocious puberty is more common in girls, with rates of 1-5 per 1000 quite commonly quoted (some studies seem to suggest that more than 1% of girls experience precocious puberty).
Whereas in my very small circle of people who I have knowledge about medical conditions there's one who had precocious puberty treaty with puberty blockers. Which is far too small a sample to be statistically significant, and indeed I expect only those who specialise in treating adolescence and their development would have the experience necessary to give an answer to the question of how rare, or otherwise, precocious puberty is. A quick literature search produced results that aren't very clear to me, in part because there seems to be quite a bit of variation in what signs are taken to indicate the onset of puberty, and variation in how early such onset would be to be classed as "precocious". I admit I don't have the scientific background to assess the papers I found, but it does seem that precocious puberty is more common in girls, with rates of 1-5 per 1000 quite commonly quoted (some studies seem to suggest that more than 1% of girls experience precocious puberty).
We had a neighborhood girl that developed way too fast. She came to mind when the discussion turned to puberty blockers.
Just in passing: Is there a female counterpart to the male eunuch? I am not asking about trans questions.
The first thing that came to mind was The Female Eunuch (Germaine Greer, published in 1970), part of the premise being that that women are disempowered sexually (and politically and socially) by societal norms.
Another thing that comes to mind are the masculinising effects of anabolic steroids, which can be prescribed for a number of medical conditions.
...
Testicles mean masculinity for a lot of people, and to lose masculinity is to lose power in society.
...
Edit: In addition, women who lose femininity also lose power, but they were starting from a lower level of power than men.
As you also point out, the emasculated man is stigmatized as effeminate and less powerful. If the effects of masculinisation were at all similar for men and women, a woman could potentially be empowered through being masculinised.
In practice, rather unsurprisingly, there typically appears to be an analogous stigmatisation experienced by women who take anabolic steroids for medical conditions. The situation appears to be more complex for female body-builders and power-lifters (for example).
In other words, it could be that masculinisation is not empowering in itself, but only in relation to sociocultural norms, and to our internalised expectations regarding gender performativity.
Just in passing: Is there a female counterpart to the male eunuch? I am not asking about trans questions.
When I read this, my first thought was Rome’s Vestal Virgins. Their status, which as best I recall was involuntary (chosen by lot before puberty), gave them legal rights and privileges most women didn’t have.
I don’t really know if it’s a valid comparison, though, or if it is, if it’s only valid to a point. After all, there was no physical change.
@Merry Vole I'm rather puzzled by your comment to @Arethosemyfeet then. As puberty blockers are either used for precocious puberty or some other hormonal disruption in cis children or to delay puberty in trans and nonbinary children, and only one of those uses is controversial, I'm puzzled as to what bit you disagree with. Pointing out that puberty blockers are uncontroversial when used in cis children seems like a pretty neutral and factual statement to me.
With regards to short stature, stunted growth in terms of height can cause actual medical problems - particularly for joints and for exercise purposes. It's also, frankly, annoying to be short (speaking as someone who is 5'2) just for practical reasons.
Just in passing: Is there a female counterpart to the male eunuch? I am not asking about trans questions.
When I read this, my first thought was Rome’s Vestal Virgins. Their status, which as best I recall was involuntary (chosen by lot before puberty), gave them legal rights and privileges most women didn’t have.
I don’t really know if it’s a valid comparison, though, or if it is, if it’s only valid to a point. After all, there was no physical change.
Just in passing: Is there a female counterpart to the male eunuch? I am not asking about trans questions.
When I read this, my first thought was Rome’s Vestal Virgins. Their status, which as best I recall was involuntary (chosen by lot before puberty), gave them legal rights and privileges most women didn’t have.
I don’t really know if it’s a valid comparison, though, or if it is, if it’s only valid to a point. After all, there was no physical change.
Also, they could retire!
Yes. Like I said, maybe not a valid or straight-up comparison. But it does seem to me that there are some similarities.
I think wrt women eunuchs, it's important to remember that eunuch status came about because of eunuchs doing specific jobs eg guardians or chaperones of royal women. It was very much a social role more than a biological one. The closest to the historical role of eunuchs that I can see is something like the professed virgins in I think Armenia? who take on a male role socially in their village. The whole point of eunuchs historically was that they were not subject to the restrictions placed on women while also not being a threat to powerful men's dynasties - I don't think there is a female equivalent to that.
In the google / YouTube hole I fell down after the assertion about Chinese female enuchs - if I have understood correctly - it boiled down to: the emperors had concubines, the concubines had their own palaces. The emperor would got to whichever palace for the night. Concubines who felt they might lose his favour - perhaps they were getting older or whatever - would supply young pretty women from their entourage, “maids”, to service the emperor. Provided that he kept visiting their palace regularly, they kept their status within the court.
CW: Torture.
However, they absolutely did not want their servants potentially providing the emperor an heir. So, in some circumstances they would have such a maid strung up and beaten around the abdomen until she bled profusely, in such a way, that they believed she could no longer become pregnant.
Some of these women survived this, and they were the female eunuchs.
I am unclear how historically accurate this is though - or whether it’s just speculation.
Comments
It's only "controversial" when used to treat trans people. No-one bats an eyelid otherwise.
I think we'll have to disagree about that on another thread!
But it is a fact. Using puberty blockers is not at all controversial when it comes to treating precocious puberty. That is their other use. Do you have any sources saying that using puberty blockers to treat precocious puberty is controversial?
Insulin is a powerful drug - and is also a form of hormone replacement therapy, just not sex hormone replacement therapy). Nobody uses this kind of tabloid-esque language to describe insulin. However, people do use this kind of language in talking about GLP-1 drugs (Ozempic etc) and it hasn't been lost on me that the rhetoric around weight loss medication ramped up once the puberty blocker issue was at least temporarily off the table.
In a previous life I wanted to explore the theology of eunuchs in the Bible as the intersection of gender and disability, and I think this thread is demonstrating why disability and gender are so linked to discussions of eunuchs. It very much seems to be a discussion about Good Bodies and Bad Bodies (and Good Marginalised People and Bad Marginalised People) - and I had forgotten until just now that fatness was very much part of the historical eunuch stereotype, so really coming full-circle with GLP-1 medication taking the place of puberty blockers in the tabloids (for the avoidance of doubt, I am a fat person who has been involved in fat activism since my teens, as well as trans and disabled).
I think cis people being able to have gender affirming surgery and destigmatising it is a good thing. I don't think that painting self-identifying eunuchs that desire an orchiectomy as being responsible for trans people having fewer rights is helpful to trans people - the people at fault are transphobes, not NHS Scotland being too inclusive. I don't have an issue with a cis man getting an elective orchiectomy, it's their body and it doesn't affect me. Cis people can have gender dysphoria too, likewise not all trans people do have gender dysphoria.
Testicles mean masculinity for a lot of people, and to lose masculinity is to lose power in society.
Women's reproductive organs don't mean femininity to a lot of people the way women's breasts do. The connotation of women being de-sexed comes more with unreconstructed mastectomies, partly because the effects of removing the ovaries come to women sooner or later anyway, but having breasts removed is an intervention, frequently a very visible one. People don't typically tell a woman who needs a hysterectomy that she shouldn't have one, but women who don't get breast reconstruction after mastectomies say some people are shocked at this decision.
Edit: In addition, women who lose femininity also lose power, but they were starting from a lower level of power than men.
Maybe not to the same extent but I think there are some familiar themes...
There is strong sexist resistance to and disapproval of young women and those perceived as women having hysterectomies "because some day you might meet a man and want kids' (which can seriously endanger their health). Plus some of the anti-trans rhetoric boils women down to our reproductive functions/ gametes so much that women without certain reproductive organs seem to get erased and excluded from their idea of what women are. So there is social pressure and stigma around women and reproductive organs from some quarters.
And then if we look at secondary characteristics, there's the whole 'healthy breasts being cut off' fetishisation and nonsense from transphobes about elective mastectomies - as well as the surprisingly common medical assumption that women who've had mastectomy for cancer MUST want reconstruction to feel feminine ( a friend of mine in that situation who didn't want it was startled by the pressure she came under to have it, as if it wasn't OK for a woman to be flat chested if she wanted)
So there is body policing of reproductive and sexual characteristics accompanied by stigma for women who do not want/ have the sexual/ reproductive anatomy that the body police think they should have.
I suppose it's not a surprise to find female transphobes sticking their nose into male sexual anatomy and trying to police that - I think they're at some level just against bodily autonomy for everyone.
I think it maybe doesn't crystallise around external genitalia in the same way- perhaps because so much in general about women's bodies is policed very strongly, so you're right that it's different.
I think though there are some similarities too with gender and body policing by those who want to enforce gender binaries and who aren't comfortable with gender fluidity?
There have also been modern moves to re-appropriate and reclaim the identity of crone but remade as a powerful identity. Though in our current sexist society older women can and do still lose power as they cease to fit stereotypes of femininity.
I actually think that the type of discussion I would like to have with many knowledgeable people on this thread (and with other Shipmates not currently on this thread) cannot take place on any on-line discussion forum, including on this Ship. The potential for accidently 'saying' (ie typing) something that offends or gets misunderstood is just too great -for me at least.
This thread already has a lot of 'heavy' issues and I will continue to follow it and learn a lot. But I doubt I have anything further to contribute that would be helpful.
1) not actually give a response to mine and @Arethosemyfeet 's replies - that seems like a bit of a cop-out, especially when "Do you have any sources saying that using puberty blockers to treat precocious puberty is controversial?" is a simple yes/no question;
2) frame meta discussions of disagreement within this discussion around offence or misunderstanding, when disagreement is neither of those things.
Also personally as an ND person I find online discussions MUCH less prone to misunderstanding than offline discussions, particularly as I have sensory processing issues which make taking in spoken information more difficult than taking in something I've read. For a lot of trans people - ND or not - discussing these things online also feels much safer than having a more personal offline discussion, even if that means experiencing more offence. It's much easier to escape if it does become too much, for one thing!
@Pomona , it's a fair cop: the answer to the simple question is 'no' I don't have any sources. My 40 years working in the NHS suggests to me that precocious puberty is very rare. I think it can overlap with short stature and I was involved in the case of a boy who was particularly short and puberty blockers were considered as a help to enable his long bones to grow more before puberty 'locks' that height. But in the end no treatment was decided on and he is now an adult and his short stature is not an issue for him. One might wonder whether there are subtle social expectations involved in such a case; ie 'men are expected to be taller than women'? But I think you'll agree medications shouldn't be used just to manage perceived problems with social expectations.
Apart from the above, forgive me but I'm out of my depth here.
We had a neighborhood girl that developed way too fast. She came to mind when the discussion turned to puberty blockers.
Another thing that comes to mind are the masculinising effects of anabolic steroids, which can be prescribed for a number of medical conditions. As you also point out, the emasculated man is stigmatized as effeminate and less powerful. If the effects of masculinisation were at all similar for men and women, a woman could potentially be empowered through being masculinised.
In practice, rather unsurprisingly, there typically appears to be an analogous stigmatisation experienced by women who take anabolic steroids for medical conditions. The situation appears to be more complex for female body-builders and power-lifters (for example).
In other words, it could be that masculinisation is not empowering in itself, but only in relation to sociocultural norms, and to our internalised expectations regarding gender performativity.
I don’t really know if it’s a valid comparison, though, or if it is, if it’s only valid to a point. After all, there was no physical change.
With regards to short stature, stunted growth in terms of height can cause actual medical problems - particularly for joints and for exercise purposes. It's also, frankly, annoying to be short (speaking as someone who is 5'2) just for practical reasons.
Also, they could retire!
In the google / YouTube hole I fell down after the assertion about Chinese female enuchs - if I have understood correctly - it boiled down to: the emperors had concubines, the concubines had their own palaces. The emperor would got to whichever palace for the night. Concubines who felt they might lose his favour - perhaps they were getting older or whatever - would supply young pretty women from their entourage, “maids”, to service the emperor. Provided that he kept visiting their palace regularly, they kept their status within the court.
CW: Torture.
I am unclear how historically accurate this is though - or whether it’s just speculation.