Category: Males • Page 2
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Suppressing sex hormones in males, using treatments like those prescribed as puberty blockers, is linked to an increased risk of dementia
A 2025 systematic review and meta-analysis1 found that men receiving androgen deprivation therapy (ADT) for prostate cancer had an increased risk of dementia, with a 26% higher likelihood for all types of dementia and a 9% higher risk specifically for Alzheimer’s disease, compared to men not receiving this treatment. ADT reduces the effects of male sex hormones (androgens) such as testosterone and dihydrotestosterone (DHT). This is achieved using medications, including GnRH agonists (which initially stimulate and then suppress hormone production via the pituitary gland), GnRH antagonists (which directly block hormone receptor activity), or through other pharmaceutical and surgical approaches. Notably, some of the same medications used for ADT—GnRH agonists, GnRH antagonists, and certain antiandrogens—are also employed as “puberty blockers” to delay puberty in children and adolescents.
- Ma, L., Tan, E. C., Goudey, B., Jin, L., & Pan, Y. (2025). Unraveling the bidirectional link between cancer and dementia and the impact of cancer therapies on dementia risk: A systematic review and meta‐analysis. Alzheimer’s & Dementia, e14540. [Link] ↩︎
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Long term use of anabolic-androgenic steroids (synthetic testosterone) is associated with brain ageing and a decline in cognitive processing
One study suggests that long-term use of anabolic-androgenic steroids (AAS) may cause accelerated brain ageing in certain regions, which could lead to cognitive abnormalities.
A 2021 study by Bjørnebekk et al1. aimed to investigate the effects of long-term anabolic-androgenic steroid (AAS) use on brain ageing. The study included 229 male participants, 130 of whom were long-term AAS users and 99 were non-users. The participants underwent T1-weighted magnetic resonance imaging (MRI) scans to assess brain ageing. The results showed that long-term AAS use is associated with accentuated brain ageing in certain regions, particularly the frontal and cingulate regions. The study highlights the need for further research on the long-term effects of AAS use on brain health and cognition.
- Bjørnebekk, A., Kaufmann, T., Hauger, L. E., Klonteig, S., Hullstein, I. R., & Westlye, L. T. (2021). Long-term anabolic–androgenic steroid use is associated with deviant brain ageing. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6(5), 579-589. [Link] ↩︎
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60% of males and 70% of females attending the world’s largest gender clinic (GIDS) are same-sex attracted
In the 2015 statistics from GIDS, approximately 60% of the youth seen there who were biological males and 70% who were biological females reported attraction to the same sex or to both sexes1.
The 2015 Gender Identity Development Service (GIDS) statistics revealed a notably high rate of same-sex attraction among the youth seen at their clinic. Over half of the biological females reported same-sex attraction, about 20% were attracted to both sexes, and a quarter to the opposite sex, with the remaining identifying as asexual. Among biological males, approximately 30% reported same-sex attraction, another 30% to both sexes, 30% to the opposite sex, with the last 10% identifying as asexual or reporting no sexual attraction.
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It is not true that 1.7% of the population is ‘born between the sexes’. The proportion of people with DSDs (‘intersex’ conditions) is 0.018%
Conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female, occur in 0.018% of the population1.
The claim that 1.7% of the population is ‘intersex’2 includes conditions which most clinicians do not recognize as intersex, and is often wrongly used to back up the ideological assertion that ‘sex is a spectrum’, or that biological sex is not dimorphic.
The philosopher Kathleen Stock points out that she would be considered as “intersex” under Fausto-Sterling’s “preposterously over-demanding conditions on sex category membership”, as she lost an ovary in early adulthood3, which would count as “intersex” according to Fausto-Sterling.
- Sax, L. (2002). How common is intersex? a response to Anne Fausto-Sterling. J Sex Res. 39 (3): 174-8. [Link] ↩︎
- Fausto-Sterling, A. (2000). Sexing the Body: Gender Politics and the Construction of Sexuality. New York: Basic Books. [Link] ↩︎
- Stock, K. (2021). Material Girls. Little, Brown Book Group: p.56 [Link] ↩︎
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There are 2 sexes: male and female. Biological sex is not a spectrum
According to an Endocrine Society Scientific Statement1,
Sex is dichotomous, with sex determination in the fertilized zygote stemming from unequal expression of sex chromosomal genes.
Sex differences in baseline physiology and associated mechanisms form the foundation for understanding sex differences in diseases pathology, treatments, and outcomes.
The erroneous claim that biological sex is a spectrum, or non-dichotomous, is often used to justify the ideological assertion that all humans are ‘assigned sex at birth’. In fact, biological sex is encoded in every cell of the body2.
- Bhargava, A., Arnold, A.P., Bangasser, D.A., Denton, K.M., Gupta, A., Hilliard Krause, L.M., Mayer, E.A., McCarthy, M., Miller, W.L., Raznahan, A. & Verma, R. (2021). Considering Sex as a Biological Variable in Basic and Clinical Studies: An Endocrine Society Scientific Statement. Endocrine Reviews 42 (3): 219-258. [Link] ↩︎
- Shah, K. McCormack, C. & Bradbury, N. (2014). Do you know the sex of your cells?’ American Journal of Physiology – Cell Physiology, C3-C18, 306, 1. [Link] ↩︎
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In one study of detransitioners, males were three times more likely than females to have transitioned for erotic reasons
In a study1 of 100 detransitioners, 38.7% of males identified with the comment “I had erotic reasons for wanting to transition”.
The figure for females was 13%, around one-third of the male rate.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. [Link] ↩︎
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A systematic review of 32 studies involving 3,463 patients found urinary complications in 21% of male-to-female and 25% of female-to-male patients after genital surgery. A later study reported urinary incontinence or post-void dribbling in up to 79% of patients after phalloplasty.
A systematic review by Nassiri et al. (2020) examined 32 studies involving 3,463 patients and found urinary complications were common after transgender genital surgery.
Male-to-female surgery: Urinary incontinence was reported in 21% of patients. Meatal stenosis (narrowing of the urethral opening) was also common, with reported rates ranging from 4% to 40%, often requiring further surgical treatment.
Female-to-male surgery: Urinary incontinence was reported in 25% of patients. Urethral strictures and fistulae were among the most frequently reported complications. Although 19–54% of urethral fistulae resolved spontaneously without further surgery, many patients required additional procedures.
Another study by Kuhn et al. (2011) reported stress incontinence in 23% of post-operative patients, the vast majority of whom were male-to-female. More recent research focused specifically on phalloplasty shows even higher rates.
Complication rates are even higher after phalloplasty. Liu et al. (2022) found that 50-79% of patients experienced urinary incontinence or post-void dribbling after phalloplasty with urethral lengthening. Many of these patients need to manually squeeze or “milk” the neourethra after urinating. These complications can be long-lasting and have a major impact on daily life.
Nassiri, N., Maas, M., Basin, M., Cacciamani, G. E., & Doumanian, L. R. (2020). Urethral complications after gender reassignment surgery: a systematic review. International Journal of Impotence Research. https://doi.org/10.1038/s41443-020-0304-9
Kuhn, A., Santi, A., & Birkhäuser, M. (2011). Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertility and Sterility, 95(7), 2379–2382. https://doi.org/10.1016/j.fertnstert.2011.03.029
Liu, J. L., Chuang, Y. C., Lee, Y. H., Chen, Y. C., Chen, K. C., & Jhang, J. F. (2022). Postphalloplasty urinary function test: an observational study. Asian Journal of Andrology, 24(5), 498–503. https://doi.org/10.1016/j.jsxm.2022.01.168
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Around 1 in 5 vaginoplasty surgeries lead to corrective surgery
A systematic review1 of neo-vagina surgeries found a re-operation rate of 21.7% for non-esthetic reasons.
A Brazilian paper2 found a somewhat lower, but similar, reoperation rate of 16.8%.
- Dreher, P.C., Edwards, D., Hager, S., Dennis, M., Belkoff, A., Mora, J., Tarry, S. & Rumer, K.L. (2018). Complications of the neovagina in male-to-female transgender surgery: A systematic review and meta-analysis with discussion of management. Clin Anat. 31 (2):191-199. [Link] ↩︎
- Moisés da Silva, G.V., Lobato, M.I.R., Silva, D.C., Schwarz, K., Fontanari, A.M.V., Costa, A.B., Tavares, P.M., Gorgen, A.R.H., Cabral, R.D. & Rosito, T.E. (2021). Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique and Surgical Results. Frontiers in Surgery 8. [Link] ↩︎
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Vaginoplasty can result in fistula, stenosis, necrosis, prolapse and even death
Male-to-female genital surgery (vaginoplasty) is associated with significant long-term complications: there is a 2% risk of fistula, 14% risk of stenosis (abnormal narrowing), 1% risk of necrosis (tissue death) and 4% risk of prolapse1.
One systematic review2 found an overall complication rate of 32.5%.
A Dutch study3 of 55 (out of an original 70) adolescents treated with puberty blockers, cross sex hormones, and genital surgery, showed that among 22 male-to-female patients who underwent vaginoplasty, one adolescent died as a result of necrotizing fasciitis after the surgery.
- Manrique, O., Adabi, K., Martinez-Jorge, J., Ciudad, P., Nicoli, F. and Kiranantawat, K. (2018). Complications and Patient-Reported Outcomes in Male-to-Female Vaginoplasty—Where We Are Today. Annals of Plastic Surgery 80 (6): 684-691. [Link] ↩︎
- Dreher, P.C., Edwards, D., Hager, S., Dennis, M., Belkoff, A., Mora, J., Tarry, S. & Rumer, K.L. (2018). Complications of the neovagina in male-to-female transgender surgery: A systematic review and meta-analysis with discussion of management. Clin Anat. 31 (2):191-199. [Link] ↩︎
- de Vries, A., McGuire, T., Steensma, E., Wagenaar, T., Doreleijers, P. & Cohen-Kettenis, P. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. [Link] ↩︎
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Feminizing hormones reduce sexual function in males
Feminizing hormonal treatments lead to a lessening drive, erectile dysfunction, and shrinking of testes and penis1, significantly compromising sexual function.
A Belgian doctoral thesis study2 found that 69.7% of transwomen reported a decrease in sexual desire — while the opposite effect is found in transmen.
- Levine, S. (2018). Informed Consent for Transgendered Patients. Journal Of Sex & Marital Therapy, 45(3), 218-229. [Link] ↩︎
- Elaut, E. (2014). Biopsychosocial factors in the sexual desire of contraception‐using couples and trans persons. Doctoral thesis, University of Ghent. [Link] ↩︎
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Genital surgeries tend to reduce the capacity for orgasm in males, and may do so in females
One study showed that around 30% of male-to-female genital surgeries result in the inability to orgasm1.
Figures on female-to-male transitioners are less clear. However, a clinical follow-up study2 of 38 transmen – 29 of whom had received phalloplasty, and 9 metoidioplasty – found that reported loss of orgasmic capacity was more marginally common than reported gain of orgasmic capacity.
The negative intrapsychic and interpersonal consequences of anorgasmia (the inability to climax) is well-documented, and applies equally to transgender individuals3.
- Manrique, O., Adabi, K., Martinez-Jorge, J., Ciudad, P., Nicoli, F. and Kiranantawat, K. (2018). Complications and Patient-Reported Outcomes in Male-to-Female Vaginoplasty—Where We Are Today. Annals of Plastic Surgery 80 (6): 684-691. [Link] ↩︎
- van de Grift, T., Pigot, G., Kreukels, B., Bouman, M., & Mullender, M. (2019). Transmen’s Experienced Sexuality and Genital Gender-Affirming Surgery: Findings From a Clinical Follow-Up Study. Journal Of Sex & Marital Therapy 45 (3): 201-205. [Link] ↩︎
- Levine, S. (2018). Informed Consent for Transgendered Patients. Journal Of Sex & Marital Therapy, 45(3), 218-229. [Link] ↩︎
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In one survey, 50% of transwomen who tucked were concerned about negative health effects
A survey1 of transwomen who tucked (the process of reducing the visible male crotch bulge) reported that half were concerned about the health effects of tucking.
Their reported symptoms included itching (28%), rash (21%), testicular pain (17%), penile pain (14%), and skin infections (12%).
In addition, patients may be reluctant to seek medical care for testicular complaints and when they do, it may be already late to salvage the testis.2
- Poteat, T., Malik, M., & Cooney, E. (2018). Understanding the health effects of binding and tucking for gender affirmation. Journal of Clinical and Translational Science 2 (Suppl 1), 76. [Link] ↩︎
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
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One case study suggests that tucking can cause testicular torsion
A case study1 found that one transwoman had testicular torsion as a result of tucking.
Testicular torsion – the rotation of the testes and subsequent arterial constriction – can present as severe acute unilateral scrotal pain, nausea, and vomiting. If permanent ischemic damage results, delay in treatment may be associated with decreased fertility, or may necessitate orchiectomy2.
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
- Sharp, V. J., Kieran, K. & Arlen, A. M. (2013). Testicular Torsion: Diagnosis, Evaluation, and Management. Am Fam Physician 88 (12): 835-840. [Link] ↩︎
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While long-term study is lacking, one case study suggests that tucking can affect fertility
In a case study1 of one transwoman, tucking resulted in oligospermia – an abnormally low sperm count – affecting fertility. Elevation of the testes because of tucking may contribute to heat stress and consequent impairment of spermatogenesis.
After cessation of tucking and the provision of a new sperm sample, the sperm count in the patient was improved, and the semen had increased opacification.
A further study2 found that tucking could create a suboptimal environment for spermatogenesis.
- Trussler, J. T., & Carrasquillo, R. J. (2020). Cryptozoospermia Associated With Genital Tucking Behavior in a Transwoman. Reviews in urology, 22 (4), 170–173. [Link] ↩︎
- Debarbo, C.J.M. (2020). Rare cause of testicular torsion in a transwoman: A case report. Urology Case Reports 33. [Link] ↩︎
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Medical transition puts both males and females at risk of infertility
A wide-ranging study1 found that gender-related drug regimens place patients at risk of infertility:
Suppression of puberty with gonadotropin-releasing hormone agonist analogs (GnRHa) in the pediatric transgender patient can pause the maturation of germ cells, and thus, affect fertility potential. Testosterone therapy in transgender men can suppress ovulation and alter ovarian histology, while estrogen therapy in transgender women can lead to impaired spermatogenesis and testicular atrophy. The effect of hormone therapy on fertility is potentially reversible, but the extent is unclear.
On surgeries, the study noted that cross-sex surgery that includes hysterectomy and oophorectomy in transmen or orchiectomy in transwomen results in permanent sterility.
- Cheng, P.J., Pastuszak, A.W., Myers, J.B., Goodwin, I.A. & Hotaling, J.M. (2019). Fertility concerns of the transgender patient. Transl Androl Urol. 8 (3): 209-218. [Link] ↩︎
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The chances of developing osteoporosis and cardiovascular problems increase with feminizing hormones
A 2012 paper1 found that a quarter of the male-to-female transsexuals it studied had osteoporosis at the lumbar spine and radius.
In the same study, 6% of male-to-female transsexuals experienced a thromboembolic event (a blood clot causing obstruction), and another 6% experienced other cardiovascular problems. These effects were observed after only 11.3 years of hormone treatment on average.
A further study2 found that long-term bone mineral density decreases in transwomen who take cross-sex hormones in the long term.
- Wierckx, K., Mueller, S., Weyers, S., Van Caenegem, E., Roef, G., Heylens, G. & T’Sjoen, G. (2012). Long-Term Evaluation of Cross-Sex Hormone Treatment in Transsexual Persons. The Journal of Sexual Medicine 9 (10): 2641-2651. [Link] ↩︎
- Delgado-Ruiz, R., Swanson, P., & Romanos, G. (2019). Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy. Journal of clinical medicine 8 (6): 784. [Link] ↩︎
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One study showed that, without social transition, nearly two-thirds of pre-teen gender-dysphoric males grow up to be gay or bisexual
A University of Toronto study1 found that 63.6% of boys with early onset gender dysphoria, who received ‘watchful waiting’ treatment and no pre-pubertal social transition, grew up to be gay or bisexual.
Only 12% of the study participants continued to identify as transfeminine.
- Singh, D., Bradley, S.J. & Zucker, K.J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder. Frontiers in Psychology 12. [Link] ↩︎
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The profile of people seeking transition has shifted drastically, from overwhelmingly middle-aged males to predominantly adolescent females
A 2017 paper1 notes that “in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females.” By contrast, over 90% of transsexual adults in the 1960s were male2.
In fact, there was hardly any scientific literature before 2012 on girls ages 11 to 21 ever having developed gender dysphoria at all. Yet of the young people described in Lisa Littman’s 2018 seminal paper on young people3, 82.8% were female.
The data for the UK’s Gender Identity Development Service4 show that 138 children were referred in 2011, and most of those children were boys. By 2021, however, a complete sex ratio reversal had occurred, and the clinic saw 2383 children that year, with almost 70% being female.
A 2017 article by Lisa Marchiano5 collated data from different clinics around the world and found international evidence for this shift in distribution.
- Zucker, K. J. (2017). Epidemiology of gender dysphoria and transgender identity. Sexual Health 14 (5): 404-411. [Link] ↩︎
- Barrett, J. (2015). Written evidence submitted by British Association of Gender Identity Specialists to the Transgender Equality Inquiry. data.parliament.uk [Link] ↩︎
- Littman, L. (2018). Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. PLOS ONE, 13 (8). [Link] ↩︎
- Gender Identity Development Service (2021). Referrals to GIDS, financial years 2010-11 to 2020-21. [Link] ↩︎
- Marchiano, L. (2017). Outbreak: On Transgender Teens and Psychic Epidemics. Psychological Perspectives 60 (3): 345-366. [Link] ↩︎