diff --git a/public/gdb/hormones.md b/public/gdb/hormones.md index 587d410..92ce89f 100644 --- a/public/gdb/hormones.md +++ b/public/gdb/hormones.md @@ -14,7 +14,7 @@ classes: # How Hormones Work -As we described in the [Causes of Gender Dysphoria](/gdb/causes) section, every human's DNA contains the genetic instructions for both male and female bodies, and which set of instructions gets used is controlled by what hormones your gonads produce. That differentiation occurs entirely based on if you happen to have an SRY gene which, in the 6-8th week of gestation, kicks off a chain reaction that produces testes instead of ovaries. From that point on, every sexual attribute of the human body (primary and secondary) is a result of the hormones that those gonads produce. +As we described in the [Causes of Gender Dysphoria](/gdb/causes) section, every human's DNA contains the genetic instructions for both male and female bodies, and which set of instructions gets used is controlled by what hormones your gonads produce. That differentiation occurs entirely based on whether you happen to have an SRY gene which, in the 6-8th week of gestation, kicks off a chain reaction that produces testes instead of ovaries. From that point on, every sexual attribute of the human body (primary and secondary) is a result of the hormones that those gonads produce. If they produce estrogens (primarily Estradiol) then the genitals form into a vulva, vagina and uterus. If they produce androgens (primarily Testosterone) then the genitals form into a penis and scrotum, shifting the [Skene's gland](https://en.wikipedia.org/wiki/Skene%27s_gland) downward and enlarging it into a prostate. Differentiation ends here until the onset of puberty, 9-10 years later, and we all know what puberty does. @@ -38,7 +38,7 @@ There are four main kinds of hormones: - [Amino Acids](https://en.wikipedia.org/wiki/Amino_acid) such as Melatonin which controls sleep, or Thyroxine which regulates the metabolism. - [Peptides](https://en.wikipedia.org/wiki/Peptide_hormone), like Oxytocin and Insulin, which are collections of Amino Acids. - [Eicosanoids](https://en.wikipedia.org/wiki/Eicosanoid) that are formed from lipids and fatty acids and predominantly affect the immune system -- [Steroids](https://en.wikipedia.org/wiki/Steroid), signaling molecules produced by various internal organs in order to pass messages to other organs within the body. +- [Steroids](https://en.wikipedia.org/wiki/Steroid) are signaling molecules produced by various internal organs in order to pass messages to other organs within the body. {!{
{{import '~/img' images.steroidogenesis className="card sideline" @@ -47,11 +47,11 @@ There are four main kinds of hormones: caption="All steroids are formed from cholesterols (top left) and are derived from other steroids. Progestins form into Androgens which form into Estrogens. This is a one-way exchange, and does not reverse, so don't believe it when someone tells you that too much estrogen will turn it into testosterone." }}
}!} -For the purposes of transition, this last category is what we care about the most, as all of the sex hormones are steroids. They fall into seven main categories. +For the purposes of transition, this last category is what we care about the most, as all of the sex hormones are steroids. They fall into seven main categories: - [Androgens](https://en.wikipedia.org/wiki/Androgen) - [Estrogens](https://en.wikipedia.org/wiki/Estrogen) -- [Progestagins](https://en.wikipedia.org/wiki/Progestogen)) +- [Progestagins](https://en.wikipedia.org/wiki/Progestogen) - [Glucocorticoids](https://en.wikipedia.org/wiki/Glucocorticoid) - [Mineralcorticoids](https://en.wikipedia.org/wiki/Mineralocorticoid) - [Neurosteroids](https://en.wikipedia.org/wiki/Steroid) @@ -64,9 +64,9 @@ The first three of these are what we care about most when it comes to Hormone Th There are nearly a dozen different androgens, but the ones we care about the most are [Testosterone](https://en.wikipedia.org/wiki/Testosterone) and [Dihydrotestosterone](https://en.wikipedia.org/wiki/Dihydrotestosterone). -Testosterone is the primary masculinizing hormone for the human body and is produced in the adrenal glands, the testes, and in the ovaries (where it is immediately converted into estrone and estradiol). It tells both muscle and bone cells to grow and in higher concentrations encourages larger muscle mass and thicker skeletal structure. This also means that Testosterone is critical for bone health, as it affects calcium distribution within the skeletal structure. Thus severe depletion of testosterone can result in osteoperosis and fragile bones. Testosterone also plays a major role in sex drive and libido, encouraging mating behavior within the cerebral cortex. +Testosterone is the primary masculinizing hormone for the human body and is produced in the adrenal glands, the testes, and in the ovaries (where it is immediately converted into estrone and estradiol). It tells both muscle and bone cells to grow and in higher concentrations encourages larger muscle mass and thicker skeletal structure. This also means that Testosterone is critical for bone health, as it affects calcium distribution within the skeletal structure. Thus, severe depletion of testosterone can result in osteoperosis and fragile bones. Testosterone also plays a major role in sex drive and libido, encouraging mating behavior within the cerebral cortex. -Dihydrotestosterone (DHT), which is converted from Testosterone in the prostate, skin and liver, plays a major role in the development of the male genitalia during puberty by inducing random erections, and the growth of facial and body hair. Paradoxically, DHT is also what causes male pattern baldness, as it chokes off blood circulation to the follicles on the top of the scalp (sorry, trans guys, it's a double edged sword). DHT binds to androgen receptors ten times stronger than testosterone, which is why it is critical to eliminate it for feminizing transition. +Dihydrotestosterone (DHT), which is converted from Testosterone in the prostate, skin and liver, plays a major role in the development of the male genitalia during puberty by inducing random erections, and the growth of facial and body hair. Paradoxically, DHT is also what causes male pattern baldness, as it chokes off blood circulation to the follicles on the top of the scalp (sorry, trans guys, it's a double edged sword). DHT binds to androgen receptors ten times more strongly than testosterone, which is why it is critical to eliminate it for feminizing transition. ### Estrogens @@ -83,9 +83,9 @@ New research is starting to suggest that the body may regulate total estradiol l **Why aren't AFAB trans people prescribed estrogen blockers alongside testosterone?** -There are two separate sources for estrogens within the female reproductive system. Ovaries contains thousands of follicles, cell structures which produce eggs. The pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which encourages the follicles to grow into luteal cells. Theca cells within the follicle produce testosterone, and granulosa cells produce the enzyme [aromotase](https://en.wikipedia.org/wiki/Aromatase), which converts that testosterone into estradiol. This is the first source of estrogen, but it is not the largest source. +There are two separate sources for estrogens within the female reproductive system. Ovaries contains thousands of follicles, cell structures which produce eggs. The pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which encourages the follicles to grow into luteal cells. Theca cells within the follicle produce testosterone, and granulosa cells produce the enzyme [aromatase](https://en.wikipedia.org/wiki/Aromatase), which converts that testosterone into estradiol. This is the first source of estrogen, but it is not the largest source. -Note: This is why PCOS causes ovaries to produce testosterone, the ovarian cysts disrupt the aromotase production, so the testosterone does not get converted. +Note: This is why PCOS causes ovaries to produce testosterone; the ovarian cysts disrupt the aromatase production, so the testosterone does not get converted. Two weeks into the period cycle the hypothalamus tells the pituitary gland to produce an LH and FSH spike three to four times stronger than earlier in the cycle. That surge causes the follicles to swell until one pops, releasing an egg, at which point the remains of the follicle become a structure known as the corpus luteum. That corpus luteum then begins to produce progesterone and significantly more estrogens in order to prepare the womb for a fertilized egg. This is the second source. @@ -97,13 +97,13 @@ Taking testosterone causes the hypothalamus to deactivate the genes that initiat ### Progestagins -The primary progestagin is [progesterone](https://en.wikipedia.org/wiki/Progesterone), which plays numerous roles in the body and has been found to be [an important component for feminizing hormone therapy](https://academic.oup.com/jcem/article/104/4/1181/5270376). +The primary progestogin is [progesterone](https://en.wikipedia.org/wiki/Progesterone), which plays numerous roles in the body and has been found to be [an important component for feminizing hormone therapy](https://academic.oup.com/jcem/article/104/4/1181/5270376). -One of the largest roles that the progestagin receptor plays is in the regulation of gonadal function (ovaries and testies). The hypothalamus is positively *littered* with progestagin receptors and responds strongly to their activation, downregulating the production of [GnRH](https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone), which then reduces the production of [luteinizing hormone](https://en.wikipedia.org/wiki/Luteinizing_hormone) by the pituitary gland. +One of the largest roles that the progestogin receptor plays is in the regulation of gonadal function (ovaries and testies). The hypothalamus is positively *littered* with progestogin receptors and responds strongly to their activation, downregulating the production of [GnRH](https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone), which then reduces the production of [luteinizing hormone](https://en.wikipedia.org/wiki/Luteinizing_hormone) by the pituitary gland. -LH is what tells the ovaries and testes to produce estrogen and androgens. LH and it's sibling hormone [FSH](https://en.wikipedia.org/wiki/Follicle-stimulating_hormone) both play central roles in ovulation, which is another large source of estrogen in ovary-havers. Thus, synthetic progestins, chemicals that fit into progestagin receptors, are often included in birth control in order to prevent ovulation. In AMABs, progestagins are a useful tool for blocking testosterone production. +LH is what tells the ovaries and testes to produce estrogen and androgens. LH and its sibling hormone [FSH](https://en.wikipedia.org/wiki/Follicle-stimulating_hormone) both play central roles in ovulation, which is another large source of estrogen in ovary-havers. Thus, synthetic progestins, chemicals that fit into progestogin receptors, are often included in birth control in order to prevent ovulation. In AMABs, progestogins are a useful tool for blocking testosterone production. -Another type of cell that is full of progestagin receptors is mammary tissue. Progesterone plays a major role in the growth and maturation of milk ducts within breast tissue. While little formal research has been conducted into progesterone's affect on breast development, anecdotally it has been seen widely across the transfem community to provide significant improvements in breast fullness. Progesterone has also been demonstrated to increase blood flow to breast tissue, and encourages fat deposits in the breasts, both of which increase breast size. +Another type of cell that is full of progestogin receptors is mammary tissue. Progesterone plays a major role in the growth and maturation of milk ducts within breast tissue. While little formal research has been conducted into progesterone's effect on breast development, anecdotally it has been seen widely across the transfem community to provide significant improvements in breast fullness. Progesterone has also been demonstrated to increase blood flow to breast tissue, and encourages fat deposits in the breasts, both of which increase breast size. Additionally, progesterone promotes better sleep, improves cardiovascular health, increases ketogenesis (reducing triglycerides), increases metabolic function, and has been found to reduce breast cancer risk. @@ -113,6 +113,6 @@ Mineralcorticoids play no role in transition, but they are worth mentioning beca Aldosterone is what instructs the kidneys to *stop* extracting water from the blood stream. It is produced by the adrenal glands in order to regulate body hydration. Why is this significant? -Because one drug that is very commonly used in trans hormone therapy is an extremely powerful aldosterone antagonist... Spironolactone. Spiro binds to mineralcorticoid receptors *stronger* than aldosterone does, but does not activate the receptor. It just clogs it, preventing the kidneys from receiving the signal to stop extracting water. +Because one drug that is very commonly used in trans hormone therapy is an extremely powerful aldosterone antagonist... Spironolactone. Spiro binds to mineralcorticoid receptors more strongly than aldosterone does, but does not activate the receptor. It just clogs it, preventing the kidneys from receiving the signal to stop extracting water. This is why spiro makes people pee so much. diff --git a/public/gdb/second-puberty-fem.md b/public/gdb/second-puberty-fem.md index 385f7a2..145ca8b 100644 --- a/public/gdb/second-puberty-fem.md +++ b/public/gdb/second-puberty-fem.md @@ -18,7 +18,7 @@ classes: This is a compilation of reported medical transition changes collected from testimonials of AMAB trans people taking estrogen based hormone therapy. This information is gathered from social media and chat rooms. Yes, that means this is all anecdotal, but historically, most of transgender medical study is anecdotal because no one wants to fund transgender medical research. -**Note that this is a list of _possible_ changes. There is no guarantee that every person on feminizing HRT will experience all of these. Your age, genetics, medical history, degree of masculinization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness, every body is different, and some things can take years to appear.** +**Note that this is a list of _possible_ changes. There is no guarantee that every person on feminizing HRT will experience all of these. Your age, genetics, medical history, degree of masculinization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness -- every body is different -- and some things can take years to appear.** ### Breast Growth @@ -98,7 +98,7 @@ This is an extremely subtle and slow moving process that takes years, and it is With the removal of androgens, blood flow to the scalp increases. Follicles that had been lost to male pattern baldness may reactivate, causing some return of the hair line and a filling in of bald spots. Scalp hair becomes thicker and follicles grow stronger, allowing hair to grow to longer lengths. -With this thickening, curliness may become more pronounced, and a change in hair color may also occur. You may come to have your mother's hair more than your fathers. +With this thickening, curliness may become more pronounced, and a change in hair color may also occur. You might find your hair taking on a texture more like your mother's than your father's. ### [Anterior Pelvic Tilt](http://en.wikipedia.org/wiki/Pelvic_tilt) @@ -178,13 +178,13 @@ People have also reported a tendency to be less prone to start arguments, an a d }!} -All genitalia are constructed from the same tissues, they are merely organized differently during pregnancy. Much of the behavior of these tissues is regulated by the hormones ones body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions. Which means that when you remove androgens and add estrogens, these tissues start acting like they are in the shape of a vulva, even though they aren't. +All genitalia are constructed from the same tissues, they are merely organized differently during gestation. Much of the behavior of these tissues is regulated by the hormones ones body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions. Which means that when you remove androgens and add estrogens, these tissues start acting like they are in the shape of a vulva, even though they aren't. ##### Increased Sensitivity The skin on the glans and shaft becomes much thinner and fragile, more prone to tearing and irritation, while also becoming *significantly* more sensitive to touch. The entire organ also becomes much more sensitive to pressure, and vibration becomes a better form of stimulation over stroking, which may become painful. -#### Moisture and Feminine Odor** +#### Moisture and Feminine Odor The skin along the shaft begins to secret the same fluids as the vaginal canal, particularly during arousal (yes, trans girls get wet). These fluids encourage the development of the same microbiome that develops within the vaginal canal. The combination of these factors means that odor (and taste) of the penis changes to align more to that of a vulva. @@ -234,7 +234,7 @@ The entire body becomes more responsive to touch, and with that unlocks stronger ##### Orgasm -Orgasm changes significantly, both in the way it builds and how it is experienced (see link above), but additionally if one is lucky they will gain the ability to become multi-orgasmic with no refractory period. The cost of this is that orgasm may become harder to achieve, and one has to re-learn how to reach it. It also becomes easier to reach with a partner, which may have been the opposite before. +Orgasm changes significantly, both in the way it builds and how it is experienced (see link above), but additionally, if one is lucky, they will gain the ability to become multi-orgasmic with no refractory period. The cost of this is that orgasm may become harder to achieve, and one has to re-learn how to reach it. It also becomes easier to reach with a partner, which may have been the opposite before. ##### Attraction @@ -242,11 +242,11 @@ It is [not at all unheard of](https://www.them.us/story/sexual-attraction-after- ### Cyclical Period-like Symptoms -Obviously we do not mean blood flow, that would be ludicrous. Symptoms vary greatly (just as they do in cisgender women) and typically last for 2-4 days, repeating every 26-32 days (tho some report experiencing it bi-weekly). This happens independent of medication dosing schedules. The use of a period tracker app like Clue can reveal the pattern. +Obviously, we do not mean blood flow, that would be ludicrous. Symptoms vary greatly (just as they do in cisgender women) and typically last for 2-4 days, repeating every 26-32 days (though some report experiencing it bi-weekly). This happens independent of medication dosing schedules. The use of a period tracker app like Clue can reveal the pattern. - Cramping in the intestine and abdominal muscles, ranging from a slight flutter in the gut to strong painful spasms. - Bloating and water retention -- Gas, Diarrhea and other intestinal issues. +- Gas, diarrhea and other intestinal issues. - Emotional instability, mood swings and irrational thoughts - Heightened depression and dysmorphia - Depersonalization or dissociation. diff --git a/public/gdb/second-puberty-masc.md b/public/gdb/second-puberty-masc.md index 4a64f6c..e00f4ff 100644 --- a/public/gdb/second-puberty-masc.md +++ b/public/gdb/second-puberty-masc.md @@ -28,7 +28,7 @@ tweets: This is a compilation of reported medical transition changes collected from testimonials of AFAB trans people taking testosterone hormone therapy. This information is gathered from social media and chat rooms. Yes, that means this is all anecdotal, but historically, most of transgender medical study is anecdotal because no one wants to fund transgender medical research. -**Note that this is a list of _possible_ changes. There is no guarantee that every person on masculinizing HRT will experience all of these. Your age, genetics, medical history, degree of feminization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness, every body is different, and some things can take years to appear.** +**Note that this is a list of _possible_ changes. There is no guarantee that every person on masculinizing HRT will experience all of these. Your age, genetics, medical history, degree of feminization from natal puberty, and hormone regimen can all have impacts on results. There is also just a degree of randomness -- every body is different -- and some things can take years to appear.** ### Voice Drop @@ -50,7 +50,7 @@ With the above shift in temperature distribution, this also results in a signifi ### Body Odor -Often once of the first things to change: Sweat and general body odor will become much stronger, especially during exercise. The smell will take on a sour, muskier smell. Tends to even out over time. +Often onc of the first things to change: sweat and general body odor will become much stronger, especially during exercise. The smell will take on a sour, muskier smell. Tends to even out over time. ### Body Hair, Everywhere @@ -60,13 +60,13 @@ Androgens significantly increase the presence of body hair on the legs, groin, b MPD is caused by [Dihydrotestosterone](https://en.wikipedia.org/wiki/Dihydrotestosterone) (DHT), an androgen which metabolizes from Testosterone. Having more T in your body means more DHT can form, and the gene that contributes to MPD causes the hair follicles on the scalp to receive less blood, choking them out until the follicles die. There will likely be *some* loss of hair line eventually, no matter what, but if there is a history of baldness among the men in your family, then you can expect to see that as well. Again, Rogaine can help with this. -The synthetic androgen [Nandrolone](https://en.wikipedia.org/wiki/Nandrolone) does not metabolize into DHT and may be a viable alternative in place of direct Testosterone if hair loss is a concern. However, DHT is important for genital growth, so this is a double edged sword. +The synthetic androgen [Nandrolone](https://en.wikipedia.org/wiki/Nandrolone) does not metabolize into DHT and may be a viable alternative in place of direct Testosterone if hair loss is a concern. However, DHT is important for genital growth, so this is a double-edged sword. ### Thicker and Oilier Skin -Testosterone promotes the thickening and toughening of the epidermis, causing skin to become more coarse. As estrogen levels fall the body will produce less collagen. This causes the skin to become tougher and drier (especially in the knees and elbows). Veins on the hands, arms, and legs may become more pronounced, but not varicose. +Testosterone promotes the thickening and toughening of the epidermis, causing skin to become coarser. As estrogen levels fall, the body will produce less collagen. This causes the skin to become tougher and drier (especially in the knees and elbows). Veins on the hands, arms, and legs may become more pronounced, but not varicose. -Expect your face and scalp to become oilier. Acne *will* be a problem, and not just on the face. This tends to be worst immediately after dosing. +Expect your face and scalp to become oilier. Acne is likely to be a problem, and not just on the face. This tends to be worst immediately after dosing. ### Larger Hands / Feet @@ -150,7 +150,7 @@ It's extremely common for trans people of all types to find themselves much more }!} -All genitalia are constructed from the same tissues, they are merely organized differently during pregnancy. Much of the behavior of these tissues is regulated by the hormones ones body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions. Which means that when you and add androgens, these tissues start acting like they are in the shape of a penis and scrotum, even when they aren't. +All genitalia are constructed from the same tissues, they are merely organized differently during gestation. Much of the behavior of these tissues is regulated by the hormones ones body runs on. Skin secretions, textures, sensitivity and erectile behavior are all hormonal expressions. Which means that when you add androgens, these tissues start acting like they are in the shape of a penis and scrotum, even when they aren't. ##### Bottom Growth