Gender dysphoria, defined by the distress resulting from a misalignment between one’s gender identity and assigned sex at birth, has been a focal point in both medical and societal discourse for an extended period. Transgender men, individuals designated female at birth but identifying as male, frequently grapple with this distress, prompting some to contemplate gender-affirming surgeries. The irreversible nature of such surgical interventions highlights the importance of thoroughly exploring alternative options before committing to a permanent decision. A particularly compelling avenue for investigation is testosterone therapy. Recent research suggests that testosterone may exert an impact on the romantic proclivities of transgender men, potentially mitigating elements of gender dysphoria. Given that over 1.6 million adults and youth identify as transgender in the United States, with approximately 480,000 being transgender men, the implications of these findings are substantial. Could early testosterone therapy function as a decisive intervention, offering relief and clarity, and potentially reducing the necessity for irreversible surgeries? This article explores this question in depth. It examines the potential of testosterone therapy as a transformative force in transgender health.
Transsexuality
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Understanding the Basics
- Cisgender Man: Think of this as a man who was born male identifies as male, and is comfortable being male. He’s a man who loves being a man and has no desire to change that. This guy can be:
- Heterosexual (Straight): He’s attracted to women.
- Homosexual (Gay): He’s attracted to men.
- Or have any other sexual orientation.
- Cisgender Woman: This is a woman who was born female, identifies as female, and is comfortable being female. She’s a woman who loves being a woman and has no desire to change that. This woman can be:
- Heterosexual (Straight): She’s attracted to men.
- Homosexual (Lesbian): She’s attracted to women.
- Or have any other sexual orientation.
The study
The relationship between hormones and human behavior has long intrigued researchers, and a study titled “Testosterone and sexual risk among trans-men: A mixed methods exploratory study” from PubMed Central (PMC) offers valuable insights into this dynamic. Conducted with 122 trans men from San Francisco, of whom 81.9% were on hormone therapy, the study aimed to discern the effects of testosterone on sexual behaviors, attractions, and activity frequency. A significant finding was the marked shift in sexual attraction among trans men after testosterone therapy. Initially, only 3.3% reported having cisgender male partners, but this figure surged to 25.4% after starting testosterone. Additionally, there was an increase in trans men partnering with transgender women, from 4.1% pre-testosterone to 13.9% post-therapy. These findings suggest that testosterone might profoundly influence the sexual preferences of trans men, particularly towards cisgender men and transgender women. This shift in attraction and behavior has additional potential negative implications for HIV risk among trans men, especially in high HIV prevalence areas.
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The Role of Testosterone in Transitioning
Testosterone, a hormone primarily associated with male physical development, plays an important role in the transitioning process for many transgender men (individuals assigned female at birth but identifying as male). Beyond its role in physical transition, recent studies suggest intriguing behavioral effects:
- A study titled “Testosterone and sexual risk among trans men: A mixed methods exploratory study” found that some transgender men reported a shift in their sexual attractions after starting testosterone therapy. Before testosterone, fewer trans men had partners who were cisgender men. This number increased after testosterone initiation.
- The implications of this shift are profound. If testosterone can influence romantic and sexual inclinations, could it also impact the desire for gender-affirming surgeries? Theoretically, if an individual’s internal conflict or dysphoria is alleviated or changed through hormone therapy, the need or desire for surgery might also change.
The Reality of Post-Surgery Regret
While the majority of transgender individuals find relief and happiness after gender-affirming surgeries, there’s a subset that experiences regret. The reasons vary:
- Some feel that the surgeries didn’t achieve the desired results.
- Others face societal or familial pressures post-transition.
- A few might experience shifts in their gender identity after surgery.
The Mental Health Crisis
The mental health challenges faced by transgender individuals are staggering:
- Transgender individuals, especially youth, face significantly higher rates of suicidality compared to their cisgender counterparts.
- Factors like societal discrimination, familial rejection, and internal gender dysphoria contribute to these elevated risks.
- Post-surgery regret can further exacerbate feelings of despair and isolation, potentially leading to suicidal ideation or attempts.
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Testosterone: A Potential Lifeline?
Given the potential of testosterone to influence romantic inclinations and, possibly, the desire for surgeries, it presents a compelling avenue for exploration:
- Could early testosterone therapy serve as a “trial period” before permanent surgeries?
- If testosterone alleviates gender dysphoria in females wishing to transition to male or changes the desire for surgery, it could potentially reduce post-surgery regret and its associated mental health challenges.
- Offering an alternative or intermediary step might provide individuals with more time and space to understand their gender identity and make informed decisions about surgeries.
Final thoughts
The complexities of gender identity and the transition process are profound and multifaceted. Among these, testosterone therapy presents a particularly compelling area for examination. If testosterone can truly influence romantic preferences in transgender men, it raises an important question. Could this hormone therapy, when administered early, potentially ameliorate the dysphoria experienced by some individuals aspiring to be perceived as male while desiring relationships with other males or transgender women? While the term “cure” carries significant weight and every individual’s experience is uniquely personal, the undeniable potential of testosterone to influence romantic desires and possibly reduce the need for extensive surgical interventions cannot be overstated.
Disclaimer: This article presents findings from peer-reviewed studies and does not reflect the personal opinions or beliefs of the author.
References
Akira Tsujimura, Hiroshi Kiuchi, Tetsuji Soda, Kentaro Takezawa, Shinichiro Fukuhara, Tetsuya Takao, Yuki Sekiguchi, Atsushi Iwasa, Norio Nonomura, Yasushi Miyagawa, The Pattern of Sexual Interest of Female-to-Male Transsexual Persons With Gender Identity Disorder Does Not Resemble That of Biological Men: An Eye-Tracking Study, Sexual Medicine, Volume 5, Issue 3, September 2017, Pages e169–e174, https://doi.org/10.1016/j.esxm.2017.04.003
Dadasovich, R., Auerswald, C., Minnis, A. M., Raymond, H. F., McFarland, W., & Wilson, E. C. (2017). Testosterone and sexual risk among transmen: a mixed methods exploratory study. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 19(2), 256-266. https://doi.org/10.1080/13691058.2016.1216605
Williams Institute. (n.d.). How Many Adults and Youth Identify as Transgender in the United States? Retrieved September 24, 2023, from https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/
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