Monday, January 19, 2015

Testosterone Does Not "Work Better" than Estrogen

Hang around with trans people and you're bound to hear it. Testosterone, it's said, is more powerful than estrogen. It makes for a faster and more robust gender transition, while estrogen works a more subtle form of magic.

According to this reasoning, "trans men 'pass' better than trans women" because we win at hormones.

This is a load of hooey.

As trans people, we are fundamentally opposed to classic biological essentialism. According to classic binary sex essentialism, a person born with XX chromosomes is ever and eternally female, and a person born with XY chromosomes immutably male.  (Biological essentialists tend never to consider nonbinary genotypes like XXY or intersex people generally, because they're all about the ideology of the sex binary.)

Those who gender transition must reject chromosomal sex essentialism.  We live by the tenet that it is gender identity that determines who we really are, not our chromosomes.

But a fair number of binary trans people actually cling to a variety of sex essentialism--specifically, a biological essentialism that centers hormones, not chromosomes or genitals.  Hormone-replacement therapy is the most common medical transition service we access, and we are raised in a culture that treats biological sex as "more real" than gender identities or gender expression.  So many find comfort in framing both their bodies and their psyches as rewrought in nature by testosterone or by estrogen and testosterone-blockers.  Obviously, HRT has visible effects. Our body hair grows more robust or more fine.  Voices drop or breasts bud.  Our faces are gently transformed by the loss or addition of subcutaneous fat and the bulking or shrinking of facial musculature, rounding the cheek of the estrogen-employing, and chiseling the jaw of a person using testosterone. When you've been living with gender dysphoria, these physical changes are very welcome.

I've met my share of people who overgeneralize from the celebrated physical changes of hormone therapy into hormonal essentialism, attributing every change they experience to sex hormones. "Testosterone has made me less interested in talking, talking, talking." "Estrogen has made me a lot better at matching colors."  But sex hormones don't make us more or less verbal, or improve or deaden our color vision.  Those are social effects, and they are culture-bound.

That doesn't make them any less "real," mind you.  Just like hormones, socialization is a powerful thing.  Living as a woman in our society means receiving constant cues about appearance that unconsciously shape behavior, just as living as a man in our society means receiving social deference that makes a person act more boldly.  And these things affect us even if, consciously, we challenge them.  Estrogen doesn't make a person a better parent, nor testosterone make a parent a less-engaged one.  But caring behavior is so intensely socially reinforced in people living as mothers, while those of us living as fathers receive so many messages that we're not expected to know how to braid our kids' hair and should prioritize work obligations over family ones, that we are inevitably shaped by these socializing messages without our realizing it.  We can resist those pressures of which we are conscious, and socializing forces are experienced differently when one's gender identity conflicts with one's perceived sex, but nonconscious socialization is a real and powerful and ongoing process. From the moment we begin a social transition, our behaviors and inclinations are impacted strongly by socialization, which changes our perceptions and our behavior.  (This is one of the things that transphobic radfem "gender crits" get all wrong.  They treat socialization as something that happens when you are young, and then stops, rather than something that is happening to all of us, every day of our lives.)

But taking a shot or a pill seems much more real and concrete to people in our society than does being (re)shaped by social cues.  And one way this manifests that I believe is particularly damaging is in the belief held by many people that "testosterone works better than estrogen."

Here's the thing about gender transitions: it's indeed true that most trans men transition more smoothly and swiftly than most trans women.  But this isn't because testosterone "works better" than estrogen.  It's because of how gender policing works in our society.  Our culture values masculinity and the male while it devalues femininity and the female.

Let's examine how this works through the lens of facial hair.  I've often heard people use as "proof" of the greater efficacy of testosterone the fact that taking T makes a person grow facial hair, while taking E doesn't make a beard go away.  But it would make just as much sense to say that estrogen is more potent an agent of transition, because it makes a person grow breasts, while taking T doesn't make breasts go away.

Let's consider facial hair and transition in greater depth.  Often before even starting hormone treatment, transfeminine individuals seek facial hair removal via electrolysis and/or laser treatments. And many experience ongoing anxiety because some hair may be left behind by these procedures, leaving a trans woman constantly worried that she may have some stubble, as the social consequences of being seen as a trans woman with a beard shadow are high. Those who transition using testosterone, on the other hand, have a much less anxiety-ridden experience in the facial hair arena. Sure, most trans men wait anxiously for their peach fuzz to materialize, and for some, peach fuzz is all they'll ever grow.  But every whisker is celebrated--and not just by us, but by society.

Think about it.  For a trans woman, a few whiskers are seen by a cissexist society as belying her gender identity, and the stubbly trans woman is a figure of mockery. Meanwhile, for a trans man, a few whiskers are all it takes to get a pass from the gender police.  If there were actual parity in treatment, the gender police would be imposing some sort of 50% standard on either side of their gender binary.  But instead, a trans woman must remove 100% of her facial hair to avoid harassment, while a trans man only needs to be able to grow 10% of a full beard to be treated as one of the brotherhood.

It's not testosterone that is working so well to benefit trans men.  It's patriarchy.

Our society trains people, especially cis males, in patriarchal binary-gender-policing from an early age.  Here's how we can imagine the "logic" of this system as operating: (1) immediately upon seeing a person, classify them as male or female.  (2)  If you can't immediately do that, this is a PROBLEM and must be addressed.  (3) When your initial glance leaves you in doubt, always treat the person as male.  Calling a man "she" is a terrible insult--and is dangerous, since a man whose masculinity has been insulted may feel compelled to prove his masculinity by doing violence to your person.  Calling a woman "he" is actually a sort of compliment, since it confers status.  And if a woman is insulted or has her feelings hurt, it's not likely that she's going to punch you in the face as a result, because that would make her look even less feminine.  Anyway, she should work harder to appear feminine and attractive to men.  (4) Now that the immediate snap judgment about whether to say "sir" or "miss" has been made (when in doubt, say "sir"), study the person to figure out what's wrong with them.  Not being instantaneously classifiable into an M or F box is an affront, but maybe it was the last thing the person wanted (it's some really short cishet guy who is sensitive about his height).  Maybe it was "negligence" (a straight cis woman who isn't doing her duty to be attractive).  Or maybe it was intentional (the individual is an "effeminate" gay man, a butch lesbian, a genderqueer "he/she" weirdo, a transsexual).  Intentionally breaking the binary rule of the gender police means that the offender should be punished with disdain, mockery, harassment, or even assault/sexual assault.  And the harshest punishment is to be directed at those who could have had male honor, but are traitors to the brotherhood--the "swishy faggots" and "trannies" and "shemales"--dishonorable freaks all.

So those are the rules of gender-policing engagement.  Now, combine them with what we discussed earlier--the high standards for inspecting the suspected transfeminine body combined with the low standards of inspecting the suspected transmasculine one. Interactively, they produce a situation in which gender policing affects those assigned male at birth much more strongly than those assigned female at birth. Of course, this is counterbalanced by the fact that people perceived as female or feminine (whatever their gender identity or physical status, really) win as a prize the joy of being catcalled and sexually harassed. But think about it.  This means that for a trans man, once you've crossed that scraggly chinpatch threshhold, chances are good you get to avoid both catcalling and gender-policing harassment. The path to male privilege is pretty short. For trans women, the path to freedom from constant misgendering is much longer, much more fraught with danger, and doesn't end with the prize of relative freedom.

I know that nobody is safe from male street violence, even those deferred to as masculine men, but there's a huge difference in the regularity of the onslaught.  And believe me, I understand that the safety experienced by trans men is conditional, and that if we are discovered to have breasts and/or a vagina, the best outcome is usually disgust, and the worst assault or reparative rape.  But most of the time, these body parts are not seen.  Transmasculine individuals just need to show up sporting that minimal evidence of beard stubble (or its inverse, the receding hairline), wearing moderately standard guy clothes, with chest bound or bundled under a sweatshirt, and the gender policing inspection stops. Not for us the unavoidable requirement that every body part be inspected for "questionable" hand size and foot size, adams apple or hairline.

So, please, let's stop spreading the lie that testosterone works better than estrogen, and that this explains trans mens' advantage over trans women.  Patriarchy and the male privilege it produces explain the transmasculine advantage.  And as long as we naturalize this transmasculine advantage, we do our transfeminine siblings a disservice. What we should be doing is fighting gender policing, not treating it as a fact of nature--and doing that fighting from a position that acknowledges it affects trans men less severely.


  1. Brilliantly stated. So glad that you're blogging regularly again.

    My one quibble is with "...if we are discovered to have breasts and/or a vagina, the best outcome is usually disgust, and the worst reparative rape." The worst would be murder, as we've seen in the case of Brandon Teena (who of course was also raped) and others. But yes, trans women are still more likely to be victims of "trans panic" violence.

    1. Ok, funcrunch, I hear your point and I've edited the sentence in the post.

  2. This is an excellent argument. It will change how I train clinicians. Thank you!


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  6. Cis, white, christian, male, living along the west coast if that matters, which i don't think it should.

    First I would like to ask you about (middle-aged, middle-income, non-disabled, white)male privilege. It is a concept I am familiar with only by testimony and perhaps some observation, but not one which I have any recollection of being guilty of enforcing, or enjoying.

    I know what you are thinking. "Of course you don't observe it; your mind has no benefit to observing it," or perhaps just "This person is a sociopath," but I have taken the time to read (and learn from) your blog, so I hope you have time to hear me out.

    When I introspect all the major points in my lifetime. School, job interviews, or even common points, like straightening out billing errors (which seems to be becoming a rite of passage for any adult in the first world), I found that while my appearance and title may have had some effect on the outcome, far more potent results came from stance, body language, and words.

    While I empathize with cracking voices (having been a preteen trying to sound manly once) is there some physical or mental inhibition for a female or intersex person from assuming an assertive stance, posture, and tone?

    I can tell you from experience, that a slouch, stammer, and an infirm stance ("maybe I don't deserve this job, i don't know....") is too heavy a disadvantage to be carried by this "male privilege" force, so would it not also stand to reason that having assertiveness and confidence on your side is not only stronger than privilege, but also has the potential to make that privilege inconsequential?

    I'm not so sheltered to suggest racism or sexism or cissexism is non-existent. But, tagging and swearing by a concept like "male privilege" instead of taking action to dissipate it's power is like a climate-change researcher who doesn't recycle.

    Second, (if you're still reading) I'd like to suggest that your rejection by your students is less based on their religion, upbringing, and identity, and more based on a notion that their youth of mind grants them pride in opinions that they feel don't need testing.

    A person of respectable academic prowess (as you yourself appear to be) knows that even if an opinion is convenient, adopting it without its being tested, ESPECIALLY if it's a strong opinion, is irresponsible.

    But let's be a 19 yo student here for a moment. Testing opinions takes WORK. And screw that.

    So, while I've come to reject the notion that "boys will be boys" I think short of an evolutionary leap, "kids will be kids." And, if you've managed to maintain eye-rolling vigilance, I encourage you to keep it up.

    I wish you luck in your newly aligned body, and specifically solidity of your career. While I may not wholly believe that what you have to teach is the naked truth, I think it is a closer truth than many adults enjoy today, and I hope the adults of tomorrow are smarter than me.

    GE 3S

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