Regardless of how they feel about transgender issues, most reasonable people agree that transgender people should have access to proper medical care. That expectation is a fundamental human right. However, advocacy for care and standards of care are two very different things. The former is rooted in civil rights, while the latter is based on medical science. And with the latter, the tools right now in the medical community’s arsenal almost always seem to be hormones – and, if the patients so desire, surgery. This raises the question: are hormones (and potentially surgery) the right course of action for everyone? When it comes to answering this question, state-of-the-art medical research is unambiguously clear about one thing – that estrogen is especially lethal for men (that is, those assigned male at birth).

Given all the evidence of immense iatrogenic physical and psychological harm that has been documented in the peer-reviewed research in the past few years (and, quite possibly, the absence of any upside at all), neither a medical nor a moral case can be made for administering estrogen for men with gender dysphoria. The published research also demonstrates that surgical interventions have astounding rates of postoperative complications, contributing towards reducing the expected lifespan of the patients by several decades. In this post, I will discuss this research.