An introduction to Transfeminine Sexual Health: Why is nobody talking about it?
TW: Dysphoria, Medical Bias, Sexual Anatomy, Human reproduction.
I am placing a general warning for anyone not comfortable with talks of certain body parts. If you're a trans woman or transfeminine with bottom dysphoria, this may be uncomfortable. And I will be focusing more on the United States since that is where I live, but do comment on the status of trans health care in your country, especially if you are not from the U.S.
I was inspired to write this after hearing about trans men talk about their experience with gynecology and how cisnormative it is, and how medical institutions still conflate having a uterus and a vagina with being a woman, likewise they tend to the same with having a penis, prostate, testes, etc with being a man. Though a lot of doctors especially when dealing genitalia and reproductive parts are becoming more trans-inclusive.
I will be using transfeminine as an umbrella term for any transgender person that was assigned male at birth that is taking estrogen and/or anti-androgens as part of hormone replacement therapy for their transition. It is the most inclusive way I can think of without using AMAB as the term, and both are alternatives to saying "MTF" which is short for male-to-female. MTF is falling out of favor because we were never men. I am a non-binary person, not just a trans woman and I do want to include non-binary people. Of course, non-binary people transitioning away from masculinity might not be feminine. However, it reflects the nature of "feminization" due to how people construct feminity in both sex and gender.
Hormone Replacement Therapy for trans women and non-binary people.
Cross-sex HRT is to raise estrogen, the so-called female hormone, and also suppress testosterone, which is associated with males. The goal of HRT for transfeminine people is often to get one's hormonal and endocrine system to resemble a cisgender woman's body, though the standards for pre-op or non-op transfeminine people are different than those who are post-op, which had the testicles removed whether just that or along with a vaginoplasty. HRT can really feminize the body and can show some good results, though its variable.
For me, I am only on it at the time of publishing 11 months.
Why are trans women hated? Why do they experience misogyny?
Transphobes talk about so-called sex-based rights and define women's oppression by biological functions like bearing a child from a cis man's input and genetic material. Being incorrectly assigned male at birth, transfeminine people often have certain body traits and presumptions, but that does not make us free from "sex-based oppression" quite the opposite. We are "monster gender" because of that. Writer May Petersen in various twitter threads alludes to trans women being "monster sex" because of how trans women do not bear a genetic, biological child for cis men. She writes about transmisogyny and sexism. They are both connected. So, when you live in a society that misgenders and excludes transgender people, your healthcare needs especially relating to sexual anatomy may not get taken seriously. Medical research on transgender people is rare, though it often focuses on trans women at least, even then it is not complete, for example, researchers don't control for whether or not a subject is on HRT.
Womanhood and having a uterus are not the same thing. Abortion access effects trans men, transmasculine people, and any non-binary person with those parts. Conversely, framing abortion and reproductive justice as women's issues is both reductive and cisnormative, likewise for any issues for people with prostates, testes, a penis, etc. We are not men, a pair of testicles does not a man make.
What is the most puzzling thing about my transition? How do you know you are experiencing hormonal period symptoms? I really do not know. Of course, if we ask TERF twitter or "gender critical" subreddits, we are told that I am lying and that women don't experience periods like that, it is part of their constant goal shifting on defining womanhood away from transfeminine people. Even with periods in mind, I wonder if endocrinologists know that is possible? Do they hold cisnormative assumptions? Maybe, but I at least had HRT prescribed to me through informed consent.
What would a transfeminine "birth control" look like? Birth control as most people are designed with cis women in mind and even can be useful to transmasculine or AFAB trans people. There are some developed with cis men in mind in research trials, but I don't know how they would be for AMAB trans people, especially transfeminine people on HRT. Hormone therapy should not be relied on as birth control, as I am told. However, sperm production is lower or even stopped as the semen takes on a different character, it seems to have more in common with vaginal fluids than men's semen? Some transfeminine individuals choose to freeze sperm to have future biological children. I do not want any children so I did not do that and preserving fertility is no concern, in fact, I want to be infertile instead. Some do and that presents challenges, especially when some places require you to be sterile to be recognized as your real gender. There are so many challenges that I hope will be resolved eventually– legally, medically, socially, etc. Perhaps we can finish this story another time. I want to just start this conversation.
Thank you for reading!
-Brittany, the unicorn herself
Support me on Patreon!
Make a one-time donation on PayPal
I am placing a general warning for anyone not comfortable with talks of certain body parts. If you're a trans woman or transfeminine with bottom dysphoria, this may be uncomfortable. And I will be focusing more on the United States since that is where I live, but do comment on the status of trans health care in your country, especially if you are not from the U.S.
I was inspired to write this after hearing about trans men talk about their experience with gynecology and how cisnormative it is, and how medical institutions still conflate having a uterus and a vagina with being a woman, likewise they tend to the same with having a penis, prostate, testes, etc with being a man. Though a lot of doctors especially when dealing genitalia and reproductive parts are becoming more trans-inclusive.
I will be using transfeminine as an umbrella term for any transgender person that was assigned male at birth that is taking estrogen and/or anti-androgens as part of hormone replacement therapy for their transition. It is the most inclusive way I can think of without using AMAB as the term, and both are alternatives to saying "MTF" which is short for male-to-female. MTF is falling out of favor because we were never men. I am a non-binary person, not just a trans woman and I do want to include non-binary people. Of course, non-binary people transitioning away from masculinity might not be feminine. However, it reflects the nature of "feminization" due to how people construct feminity in both sex and gender.
Hormone Replacement Therapy for trans women and non-binary people.
Cross-sex HRT is to raise estrogen, the so-called female hormone, and also suppress testosterone, which is associated with males. The goal of HRT for transfeminine people is often to get one's hormonal and endocrine system to resemble a cisgender woman's body, though the standards for pre-op or non-op transfeminine people are different than those who are post-op, which had the testicles removed whether just that or along with a vaginoplasty. HRT can really feminize the body and can show some good results, though its variable.
For me, I am only on it at the time of publishing 11 months.
Why are trans women hated? Why do they experience misogyny?
Transphobes talk about so-called sex-based rights and define women's oppression by biological functions like bearing a child from a cis man's input and genetic material. Being incorrectly assigned male at birth, transfeminine people often have certain body traits and presumptions, but that does not make us free from "sex-based oppression" quite the opposite. We are "monster gender" because of that. Writer May Petersen in various twitter threads alludes to trans women being "monster sex" because of how trans women do not bear a genetic, biological child for cis men. She writes about transmisogyny and sexism. They are both connected. So, when you live in a society that misgenders and excludes transgender people, your healthcare needs especially relating to sexual anatomy may not get taken seriously. Medical research on transgender people is rare, though it often focuses on trans women at least, even then it is not complete, for example, researchers don't control for whether or not a subject is on HRT.
Womanhood and having a uterus are not the same thing. Abortion access effects trans men, transmasculine people, and any non-binary person with those parts. Conversely, framing abortion and reproductive justice as women's issues is both reductive and cisnormative, likewise for any issues for people with prostates, testes, a penis, etc. We are not men, a pair of testicles does not a man make.
What is the most puzzling thing about my transition? How do you know you are experiencing hormonal period symptoms? I really do not know. Of course, if we ask TERF twitter or "gender critical" subreddits, we are told that I am lying and that women don't experience periods like that, it is part of their constant goal shifting on defining womanhood away from transfeminine people. Even with periods in mind, I wonder if endocrinologists know that is possible? Do they hold cisnormative assumptions? Maybe, but I at least had HRT prescribed to me through informed consent.
What would a transfeminine "birth control" look like? Birth control as most people are designed with cis women in mind and even can be useful to transmasculine or AFAB trans people. There are some developed with cis men in mind in research trials, but I don't know how they would be for AMAB trans people, especially transfeminine people on HRT. Hormone therapy should not be relied on as birth control, as I am told. However, sperm production is lower or even stopped as the semen takes on a different character, it seems to have more in common with vaginal fluids than men's semen? Some transfeminine individuals choose to freeze sperm to have future biological children. I do not want any children so I did not do that and preserving fertility is no concern, in fact, I want to be infertile instead. Some do and that presents challenges, especially when some places require you to be sterile to be recognized as your real gender. There are so many challenges that I hope will be resolved eventually– legally, medically, socially, etc. Perhaps we can finish this story another time. I want to just start this conversation.
Thank you for reading!
-Brittany, the unicorn herself
Support me on Patreon!
Make a one-time donation on PayPal
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