Susan's Place Transgender Resources

One of my friends recently told me that apparently he had found articles that said that the average age of a transgender person (factoring out suicide and murder rates) was around 50, because of how much hormones depleted the body. Is there any truth to those claims? I'm a little surprised my endocrinologist wouldn't mention anything if hormones could reduce my life expectancy by 30+ years.

thirty years is an alarming amount, though. I personally don't buy it, but still.

I'd be dead a long time ago if I hadn't taken hormones and transitioned.Not from suicide but accident,I regularly got wasted on weed and booze and often set pans on fire or fell asleep in the bath.

This person claims to have found numerous studies showing that people on hormone therapy live to be about 50 on average. If he ever links me to such studies, I'll post them here.

I am with others here if I didn't start hrt/transition/have surgery I'd be dead already.....  I don't care about said studies, no offence. imo well... I'll keep it my opinion

I might just link to an old thread which discussed this particular topic:

https://www.susans.org/forums/index.php?topic=91783.0

Take it from a real life medical student. There is no truth to this whatsoever.

Someone is probably trying to use faux medicine to scare you away because they secretly disapprove of what you are doing.

If you look after all other aspects of your health properly there is no reason why being on HRT should shorten your life.

I probably should add that anti androgens are not the best things to take on a very longterm basis so anyone thinking of being completely non op might not be making the best choice from that point of view.

You also need to realise that all studies that deal with averages are only valid if the sample size is large enough and truly random. In the case of TG population neither of those conditions is likely to be the case. Furthermore you CANNOT equate the results seen in natal females with those seen in transwomen because there are measurable differences in the effect of hormones due to the lack of endogenous production sites (simply put you will have no ovaries and uterus and that makes a difference).

Thanks. This kind of helps alleviate some concerns. I don't know if he secretely disapproves of what I'm doing. His sister is transgender and he apparently loves and supports her. He said that he and his mother had found numerous articles stating that transwomen lived much shorter lives due to adverse effects of hormones.

In addition, I've found a lot of articles (Including one on this site, I believe it's called "Hormones: Goal or Time bomb?") that seem to indicate both some very serious and very undesirable effects of therapy.

This all just makes me feel ridiculously conflicted. Is it bad that I would probably try to find some alternative to hormones if the side effects are really as bad as they say? I feel like that somehow makes me less trans*, but I don't know. It just frustrates me a lot that the one thing that I've heard over and over again will go the farthest in making me both look and feel like a regular woman could shorten my lifespan by up to 30 years and have all these horrible effects on my mood and body! It feels like being stuck between a rock and a hard place. I don't want to be this way, I want to look, feel, and be as female as I possibly can, but at the same time, I don't want to experience all these horrible side effects of hormones!

I agree with the medical student!

here is no solid evidence to support this. This fairy tale appears with remarkable regularity from parents etc who try to convince someone that taking hormones for gender dysphoria is bad for them.

It isn't.

Being on HRT and being monitored by competent medical providers gives you no more risk of an early death.

Mmm I should have died 10 years ago if it was true!

Yes I think the one thing to add here is that there is a world of difference between doing DIY HRT - which is VERY dangerous - and doing under proper medical supervision and monitoring.

I know you're thinking, well she would say that wouldn't she, but honestly, in the unlikely event that things do go wrong, wouldn't you rather find out before any damage was done?

HRT dosages are NOT as simple as many transpeople think and paradoxically if you take too much it can actually have the reverse effect because estrogen and testosterone are chemically related and one the bodies defence mechanisms is to convert one into the other - which is why male anabolic steroid misusers often end up with impressive breasts!!!

Your dosage is YOUR dosage - what works for you may kill someone else, or simply be completely ineffective.

So please do it properly folks, with medical supervision, and stay healthy.

Quote from: Doctorwho? on September 05, 2013, 02:36:46 AM
Yes I think the one thing to add here is that there is a world of difference between doing DIY HRT - which is VERY dangerous - and doing under proper medical supervision and monitoring.

I know you're thinking, well she would say that wouldn't she, but honestly, in the unlikely event that things do go wrong, wouldn't you rather find out before any damage was done?

HRT dosages are NOT as simple as many transpeople think and paradoxically if you take too much it can actually have the reverse effect because estrogen and testosterone are chemically related and one the bodies defence mechanisms is to convert one into the other - which is why male anabolic steroid misusers often end up with impressive breasts!!!

Your dosage is YOUR dosage - what works for you may kill someone else, or simply be completely ineffective.

So please do it properly folks, with medical supervision, and stay healthy.

I was not planning on doing HRT DIY. I have actually started anti-androgens under the care of (I think) a good endocrinologist (I would say names but I believe that's against the rules) and have had blood work sent (as well as some more later this month) It's just very disheartening to hear a lot of these things. I know that hormones can't be a "miracle cure" that'll do everything, but I was already depressed enough about the fact that they weren't going to do a lot of things (Changing bone shape, breast growth being slow and most likely fairly minimal, etc) and now on top of this there are a TON of adverse side effects? (Or so it seems like I'm told by everyone and every article I read)

It's just really, really frustrating, because it's like watching the already bad hand of cards I was dealt get progressively worse.

Quote from: Stella Lunaris on September 05, 2013, 02:41:03 AM
I was not planning on doing HRT DIY. I have actually started anti-androgens under the care of (I think) a good endocrinologist (I would say names but I believe that's against the rules) and have had blood work sent (as well as some more later this month) It's just very disheartening to hear a lot of these things. I know that hormones can't be a "miracle cure" that'll do everything, but I was already depressed enough about the fact that they weren't going to do a lot of things (Changing bone shape, breast growth being slow and most likely fairly minimal, etc) and now on top of this there are a TON of adverse side effects? (Or so it seems like I'm told by everyone and every article I read)

It's just really, really frustrating, because it's like watching the already bad hand of cards I was dealt get progressively worse.

I'm not sure how I can put this anymore clearly.

There are no significant side effects from taking hormone therapy while under the care of competent medics. My qualifications for this? I am a medic, I am on HRT I am looked after by an endocrinologist who has had over 20 years experience in treatment of trans*people. She is also a trans*woman and she is in her 70's.

Yes I have an increase chance of breast cancer, but I have a decreased chance of prostate cancer. I have an increase chance of blood clotting disorders if I take the wrong doses.  My HRT has reduced my blood pressure that I was on medication for, down to normal. I am no longer clinically depressed. I am happy, I am more productive than ever and my life expectancy has if anything increased.

People try very hard to scare trans* people from therapy because they do not believe the condition exists. They are wrong. It is an accepted medical condition, it is widely treated. It is treated very successfully.

We are now putting 9 year old children onto hormonal therapy for gender dysphoria, that we had to go though the legal system to prove that the therapy was not going to harm the child or decrease their life expectancy. This has been accepted in Australia and gender therapy can be used on children without court approval.

Honestly, I dont care if this is true or not. Dying after 15 years because of hormones or keeping things as they are and retiring as an old, balding man.... ewwwww, no please, not that one! I dont dont dont wanna become one of those grumpy men... Life is short anyway and I have lost my teenage illusions about immortality years ago. I am not afraid to die and when the Grim Reaper will come, I will be ready.
I just hope that there are other lives and I will be able to experience the joy of teenage girlhood, that caressing touch of that white princess dress and my translucent veil being lifted up and saying those words ,,I do" softly... Getting pregnant... Or, if the Lady Fate will decide for me – the rough and tumble games of boyhood, being strong, warm and confident to hold in Your arms and protect Your beloved one, to lead her before the altar and see Your reflection in her shining eyes... Whatever - but please without that feeling that whatever I did, there was something inherently wrong and I just could not understand way.

I dont think there is anything to it. I can see three potential issues with that. One is that maybe they looked at transpeople on all types of HRT and just took the day of death. In that case, one has to know that suicide rates are rather high among TG people, even after HRT. I almost lost a friend who was 12 months into HRT because of issues with still not being passable. If that counts into the stats, of course you would have lower numbers. (This is by the way why "people in medieval times died at 40" - they put in the high child mortality rate. Once you got to puberty, you most likely got 60-something years old)
Another issue is that they may draw evidence from non-trans women who are on HRT. In that case the cause of them getting HRT may be the real cause for the problem.
In any case if there are studies done on this, I would like to see them. Articles can tell you anything like "the center of the Earth is made of gold!" [sic] - the grain of truth is that 99% of the gold is really in the Earths core but so is most of the iron and other stuff - cherrypicking results to scare people is something the media is really good at.
I personally believe that with proper screening by an endocrinologist, HRT is fine. If desired one can eventually stop at the time other women get their menopause, but that may cause all the issues these women also have. Don't overdose and it will be ok, I think. My endocrinologist never told me anything like that and I think it would be his duty to say it before handing out pharmaceuticals. But even if it is so, I agree with the others here that a shorter life lived is better than a longer life wasted (or cut short by suicide).

I found an article once on the internet that said sheep's bladder can be employed to prevent earthquakes.

The endo probably didn't mention anything because that study is full of crap.

Quote from: MaidofOrleans on September 05, 2013, 04:21:34 AMThe endo probably didn't mention anything because that study is full of crap.

Exactly!

By the way I read that older thread linked above. It was funny to read that almost all people reported to generally be seen as younger. I can confirm that again - just was taken to be 28 - that is about 10 years off ;) - Keeps happening to me, everyone seems to think I am in the late 20ies not in the late thirties. As if I aged only 5 years or so since transition. Pretty neat. I wonder if that is just a visual effect or if actually transitioning and HRT improves some aspects of health and aging...

Quote from: anjaq on September 05, 2013, 04:26:35 AM
Exactly!

By the way I read that older thread linked above. It was funny to read that almost all people reported to generally be seen as younger. I can confirm that again - just was taken to be 28 - that is about 10 years off ;) - Keeps happening to me, everyone seems to think I am in the late 20ies not in the late thirties. As if I aged only 5 years or so since transition. Pretty neat. I wonder if that is just a visual effect or if actually transitioning and HRT improves some aspects of health and aging...

Its the skin, I believe. It gets smoother, tighter and clearer - the male skin roughens up after the puberty, so the rougher one looks, the older his assumed age would be. Its been the same with me - people do comment that I am suddenly looking younger, but I just tell them that it is the loss of weight (lost about 12 kg since I started the HRT).

Should have been pushing up daisys 6 years ago according to this.I'm soon 56 and look 40

I started hormones (officially) when I was 17, had SRS at 24, and am now 64 and I am still kicking!

Without SRS/HRT I would have been dead by 25!

I had some complications when my GP discontinued HRT in my late 40s (osteoporosis) but asked to be referred to a knowledgeable endocrinologist in my 50s and have been back on hormones for 10 years now. The osteoporosis is gone and I feel younger and more vibrant than I have in YEARS! I asked my endo how long I can/should remain on HRT and she said "For as long as you want!" She said that being without "primary hormones" has known and predictable consequences but the risks from being ON HRT are only statistical and they are small so the plan is to continue until I am a little old lady and ready to grow old LOL!

Nice post Northern Jane....

Anyway, an acceptable study for this conversation http://jcem.endojournals.org/content/93/1/19.full.

Patients: From the start of the gender clinic in 1975 up to 2006, 2236 male-to-female and 876 female-to-male transsexuals have received cross-sex hormone treatment. In principle, subjects are followed up lifelong. (That's a lot of data there.)

Conclusions
It is now clear that sex reassignment of transsexuals benefits their well-being, (33) although suicide rates remain high (7). Regrets are rare (0.5–3.0%). Cross-sex hormone administration to transsexuals is acceptably safe in the short and medium term. However, potentially adverse effects in the longer term are presently unknown. The data, although limited, of surrogate markers of cardiovascular disease and the reports of cancer in transsexuals leave room for a cautious optimism. But true insight can only come from close monitoring and thorough reporting of adverse effects in the literature.

OK –  They don't know.  It means not enough data to say it is bad but also not enough to say there isn't an effect.  That's very different from saying it's bad.

My Read -  There is some conflicting data, particularly from trans folks treated in the 70's and 80's, where the doses and types of treatment were varied.  Treatment is much more developed now and presumably, adverse effects will be lessened. 
Comparing the effects of antiandrogens on prostate cancer patients with healthy trans women is very error prone.  At best it can lead to an insight and cannot be definitive.  At worse, it can lead to erroneous conclusions.  Antiandrogens may pose a risk – this is unknown.
 
For the trans men, the once proposed increases risk for ovarian cancer is actually much less that thought and up regulation of androgen receptors is expected.  However, there is no data to show this is a problem.  It's an observation.  Our bodies up regulate all kinds of receptors in response to a number of exposure scenarios such as medication and diet. 

The breast cancer risk for a MTF – appears low but might be more than if there were no treatment.  The data cannot support an increased risk vs. natal females.  We need to have regular mammograms, they don't hurt that much.

However, there still may be a risk for FTM's as some breast tissue may still remain after surgery (guys, should be informed about that before, during and after top surgery.) 

Cardiovascular risk – life style has a big impact and has not been controlled in the studies.  Adopt a healthy life style.
A slightly different read from me:  No measurable effect from HRT on transgender people.  Lifestyle plays a bigger role.

I HATE, HATE, HATE bad science and people who promote bad science to support a preconceived bias.  If someone doesn't like trans folks, well, they can be stupid if they want to be stupid.  But don't scare people by spreading manure disguised as scientifically valid studies.   

Quote from: Stella Lunaris on September 05, 2013, 01:43:38 AM
This person claims to have found numerous studies showing that people on hormone therapy live to be about 50 on average. If he ever links me to such studies, I'll post them here.

That would be nice, because I do not think any credible scientific studies exist to support that contention.

Agreeing with JLT1, above, I find bad science to be the Devil's workshop!

Let's clear up one thing here.

Yes, the testosterone and estradiol molecules are very similar.

Testosterone can convert to estradiol via the enzyme aromatase.  This is a one-way trip though.
There is absolutely no way any estrogen can convert to testosterone.  It's just not chemically and biologically possible.  Estradiol can convert to the less active estriol and back.

Quote from: Doctorwho? on September 05, 2013, 02:36:46 AM
HRT dosages are NOT as simple as many transpeople think and paradoxically if you take too much it can actually have the reverse effect because estrogen and testosterone are chemically related and one the bodies defence mechanisms is to convert one into the other - which is why male anabolic steroid misusers often end up with impressive breasts!!!

Quote from: Doctorwho? on September 05, 2013, 02:36:46 AM
Yes I think the one thing to add here is that there is a world of difference between doing DIY HRT - which is VERY dangerous - and doing under proper medical supervision and monitoring.

I know you're thinking, well she would say that wouldn't she, but honestly, in the unlikely event that things do go wrong, wouldn't you rather find out before any damage was done?

HRT dosages are NOT as simple as many transpeople think and paradoxically if you take too much it can actually have the reverse effect because estrogen and testosterone are chemically related and one the bodies defence mechanisms is to convert one into the other - which is why male anabolic steroid misusers often end up with impressive breasts!!!

Your dosage is YOUR dosage - what works for you may kill someone else, or simply be completely ineffective.

So please do it properly folks, with medical supervision, and stay healthy.

Partly True, Excess testosterone, is converted into estrogen but not the other way around.
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.gfmer.ch%2FBooks%2FReproductive_health%2FImage171.gif&hash=1558a165b2ac4baba40ce266faad1197f96669cf)

While I'm forbidden from endorsing DIY hrt, I will say the following.

I self medicated, But I'm not dead. I have no regrets.
Doing your research essential this is true in almost all pursuits.

Emily - I was actually talking about more long term post-transition "age guessing", but yes of course, initially HRT certainly makes one look younger because of skin and fat changes. Especially for those who partially remain in the male social role - feminine features that are promoted by HRT are often read as being younger if they are looked at in people perceived as male.

You can choose to believe all manner of things and find corroboration from a study or two.  Dueling studies and opinions do not make your unique life worthwhile or long lasting.  Live well by your own standards and recognize that you can find support for HRT treatment and for staying where you are.

I've been on hormones half my life (I'm 69) I don't think it has shortened my life.

And I'm not the oldest member here.  Just make sure your doing hormones under a doctor's care.

By the way just FYI - this sort of topic was NEVER a topic with any transpeople I talked with here in Germany. Is it possible that it is an american thing? Like UFOs and 2012 and some of the other things that we Euros find weird about the US? ;)

We now specialize in fear and takeover maneuvers.  Yes, be afraid, very afraid, we have drones and bombs and OH puke!  We are the weird refuse other countries didn't want come back to bite you!