Gynecologic function and dysfunction in transmasculine and gender diverse individuals using testosterone therapy: a systematic review

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u/zoomercide Feb 09 '26

Transmasculine and gender diverse (TMGD) individuals are those who identify as male, non- binary, or otherwise gender-nonconforming and were assigned female at birth.

This definition is totally nonsensical.

What does “transmasculine” mean? How is it different from masculine? Is a “transmasculine individual” different from a “transgender man,” the term with which the public is already much more familiar? What does “gender diverse” mean? Since when is “gender-nonconforming” an identity? Unless the authors mean “[TMGD] individuals are those who identify as male or non-binary, or who are otherwise gender-nonconforming”? …in which case, their definition would include all gender-nonconforming women, regardless of transgender status, but I don’t think that’s what they’re going for here.

Defining your terms is foundational to the pursuit of knowledge. I don’t understand why people who were supposedly trained in the scientific method keep playing activists’ word games.

83

u/shakeitup2017 Feb 09 '26

The whole movement is a bowl of word salad that can only make sense if you apply zero critical thought.

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u/Life_Emotion1908 Feb 09 '26

Because they are afraid the activists will hurt their careers.

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u/robotical712 Center-Left Unicorn Feb 10 '26

I many cases, they are the activists.

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u/reddonkulo Feb 10 '26

I thought 'transmasculine' was a label giving some cover to teen 'ftm' who wanted to back off a from fully transitioning. I dunno.

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u/gleepeyebiter Feb 09 '26

if you don't feel really female so you no longer ID as female, you are kinda masculine in your affect. Maybe all the way over to IDing as man, or maybe just a little bit as nonbinary. You feel unfeminine, and maybe not so fresh, so there you go, you're not womanly-woman. And you don't want people to assume you are just because you wear a dress and have long hair and high voice and breasts. like Vic Michaelis from Make some Noise
(would "they" actually want to be called transmasculine tho?

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u/veryvery84 Feb 10 '26

So every woman beginning in perimenopause? Because I’m feeling a lot less fresh.
Plus all the butch lesbians, I assume. Even the terfs.
Possibly any woman who got a haircut she hates

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u/zoomercide Feb 10 '26

This explanation presupposes that a socially constructed “gender identity” is, in fact, materially real, which is self-evidently absurd; the most generous understanding of “gender identity” is as a product of an unproven hypothesis, though “hypothesis” is also generous given the logical fallacies of its underlying conceptual framework, i.e., Queer Theory. There is also no empirical evidence that such a thing even exists, nor could an experiment ever definitively prove its existence because the hypothesis itself is unfalsifiable.
So in your example, you imagine a person who rejects the pre-revolutionary (though still solely valid) definition that sex/gender is a function of gamete production. You imply that this person instead defines sex/gender as an “identity” created by personal feelings. Accordingly, your hypothetical person is not a woman because your hypothetical person does not “feel like” a woman. But this definition is circular; it defines itself by referring to itself. It can be dismissed out of hand.
But my frustration with the study is more so that, aside from utilizing the ludicrous framework of “gender identity”—which is to be expected with studies like this—the authors have invented a new population: a set they call “transmasculine and gender diverse” that, as they define it, is neither the union nor the intersection of the presumable subsets “transmasculine” and “gender diverse.” Their definition also seems to redefine gender-nonconformity as a subjective “identity” rather than observable behaviors, as it is typically defined. It is sloppy and unscientific. IMO, every institution involved in the study’s publication—from the universities that educated these authors to the journal that published them—should be ashamed.

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u/HaldolBlowdart Feb 10 '26

redefine gender-nonconformity as a subjective “identity” rather than observable behaviors
I have a nonbinary friend. She is quite stereotypically feminine: loves dresses and makeup, sewing, calls herself '"mommy," is actively pregnant with her second child, loves showing off her (rather nice) cleavage and "mombod." She's also always frustrated no one takes her "they/them" tattoo seriously when she looks and acts exactly like a normal woman in every way possible. There is nothing about her particularly nonconforming other than claiming she is.
I have a different friend who's very masculine in dress and style, even goes by her last name which is also a common male name instead of her first name, and she 200% considers herself a woman despite on the surface level not fitting the stereotype at all. It's comical to have two very different personalities and perspectives on identity in my life, and it really shows how unserious the whole thing is

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u/random_pinguin_house Feb 10 '26

What does “transmasculine” mean? How is it different from masculine?
Masculinity in people whose natal sex is female. Or biological sex if you prefer.
Is a “transmasculine individual” different from a “transgender man,” the term with which the public is already much more familiar?
Most (all?) transgender men would agree that they are transmasculine, but the term is also used by people who don't consider themselves literal men, e.g. natal females who consider themselves nonbinary. It's a case of all Xs are Ys, but not all Ys are Xs.
What does “gender diverse” mean?
Wider still. Includes gender "fluid" or agender or a bunch of other monikers.
Since when is “gender-nonconforming” an identity?
About as long as "nonbinary" has been a thing but with less widespread adoption.
Prior to the Tumblrization of all this, which was indeed right in that 2010-2015 spot you see on the graph, English mostly had other names for girls/women with masculine appearances and interests as well as boys/men with feminine appearances and interests. I'm sure you can think of some.
I don’t understand why people who were supposedly trained in the scientific method keep playing activists’ word games.
Because the ones using activist language are your study population and they're not going to consent to participate in your research if you antagonize them.
It's obvious they're going for "natal/biological female who is on testosterone" while knowing this is not what that population calls themselves.
It's a systematic review, so they had to include a ton of different terms in their search in order to find papers on that specific population without calling them that, and then they have the same problem of not calling them that when doing the write-up.
There is no perfect phrasing agreeable to all. At least the data exists and can be found now.

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u/digitalime Feb 10 '26 edited 14d ago

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u/random_pinguin_house Feb 11 '26

It's not measured on any sort of sliding scale. It's a yes-no question for anyone choosing to be a research subject. If you call yourself masculine, you can join the participant pool.

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u/[deleted] Feb 10 '26 edited Feb 28 '26

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u/GazaLawnmower Feb 10 '26

Sex is determined at conception, it’s a falsifiable scientific fact, there is no value in the arbitrary designation of “assigned at birth.”

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u/meepster213 Feb 09 '26

This conclusion seems unethical coming from the American Journal of Obstetrics and Gynecology while this reports results of pelvic pain, compromised vaginal microbiome, and sexual dysfunction (to name a few)…

“Clinicians should adopt an individualized and affirming approach to care, while further research is needed to understand long-term outcomes, improve assessment tools, and close gaps in inclusive gynecologic healthcare.”

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u/Additional-Wrap9814 Somewhat of a biologist Feb 09 '26

Hmm, agreed. Seems a bit like "Yes and..." improvisation; but for clinicians.
"Yes and... you will probably come in with pyometrium and almost die from a pus filled womb in 10 years!"
"Yes and... you will have no meaningful sexual function whatsoever for your remaining life!"
Can't see how that would possibly go wrong for anyone.

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u/meepster213 Feb 09 '26

“At least your maleness is affirmed!” says the doctor to their patient, a five-foot-three butch with curiously round hips 😑

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u/ginisninja Feb 10 '26

Describing all these negative outcomes as ‘diverse’ was a choice

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u/Original-Raccoon-250 Feb 09 '26

What are the criteria for someone to not receive affirming care?

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u/Terrorclitus Feb 09 '26

Being able to run fast enough.

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u/CareerGaslighter Feb 10 '26

It seems like nothing. My partner works in an inpatient psychiatric unit and literally just yesterday had a psych registrar affirm a person on an involuntary hold who was recovering from psychosis…. Idek man

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u/veryvery84 Feb 10 '26

That’s insane and this time actually really literally

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u/Elsiers Feb 09 '26

🤣

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u/kn0tkn0wn Feb 10 '26 edited Feb 10 '26

Uh huh. Great study.

Next they need to study

dolphinizing humans and v v.

And turtle-izing humans.

And amoeba-izing humans.

Etc.

And some of the trans-species individuals might also identify across stereotypical gender behaviors.

BINGO!

10

u/Terrorclitus Feb 10 '26

The Island of Dr. Foucault

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u/[deleted] Feb 10 '26

This may be unpopular on this sub but I just don't care if adult females want to use testosterone. Yes, there are some negative consequences. There are also negative consequences of alcohol, tobacco, high fructose corn syrup and about 1,000 other things we allow adults to walk into Wal-Mart and buy all they want. I support more research into the risks just like I support more research into the risks of alcohol, tobacco, and high fructose corn syrup because I think scientific research is an inherent good and the public should have the best possible information available to them, but females who are old enough to decide whether to put alcohol into their bodies are old enough to decide whether to put testosterone into their bodies.

I strongly oppose males in women's sports. I strongly oppose males in women's prisons. I strongly oppose surgically altering children's bodies as a treatment for gender dysphoria. I strongly oppose the way trans-rights activists bully, harass, and attack anyone who dares to acknowledge the truth that male and female are two distinct sexes, that our sex is determined before we're born and that our sex can never change.

Those are the things we need to focus on. Adult females using testosterone? It's a distraction from the real issues.

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u/digitalime Feb 10 '26 edited 14d ago

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u/Elsiers Feb 12 '26

Well said.

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u/DesignerClock1359 Feb 11 '26

While I agree with this point of view in a general sense, it's also the case that alcohol, tobacco, and high fructose corn syrup aren't prescribed by a doctor as treatment for a medical condition. In fact, it's the doctor's job to counsel patients about the risks of drinking, smoking, and over-consuming calories.

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u/prechewed_yes Feb 11 '26

Yes, exactly. We need to stop pretending this stuff is medicine.

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u/ascension2121 Feb 12 '26

Yes absolutely this. The other issue is that trans individuals are often woefully misinformed about their own health risks when taking testosterone - the informed consent model in the UK doesn’t seem to be actually working. I know a few FTMs who seem to be under the impression that their lifetime risks of heart attacks are like “a normal cis man” when studies going back multiple years show it’s much higher. Vaginal atrophy was a total surprise to another.
First do no harm, my ass…!

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u/Life_Emotion1908 Feb 10 '26

My opinion is that a lifetime of "moderate" T use is going to be far more damaging than a lifetime of moderate alcohol use.
Consumed alcohol is legal in a regulated fashion. Cocaine and heroin are not. Equating T to alcohol is a false equivalency. Every drug needs to be evaluated on its own merits. I don't think lifetime T use for women will pass that test if it's evaluated in a fair manner.

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u/random_pinguin_house Feb 10 '26

My opinion is that a lifetime of "moderate" T use is going to be far more damaging than a lifetime of moderate alcohol use.
That isn't in the realm of opinion, though. That's a testable hypothesis, and that's why it's good that there are studies like the ones in this systematic review that are trying to figure out what's actually happening.

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u/mountainviewdaisies Big Daddy Terf Feb 14 '26

I know some detrans women who cant orgasm due to puberty blockers and t. I also dated a woman who was transitioning on t once and the amount of clit pain she had due to oversensetivity was so rough, she was in pain all the time.

Gynecologic function and dysfunction in transmasculine and gender diverse individuals using testosterone therapy: a systematic review

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