Seed Region Functional Connectivity Analysis
Using SPM, first, pretreatment group differences were tested by means of independent t-tests for each seed region, comparing cis controls with trans men, and using age as a covariate. In order to investigate the effects of the testosterone treatment, we then conducted paired t-test analyses for each seed region within the trans men group for time one versus time 2. Results are reported at a cluster-level threshold of PFWE< 0.05 and a minimal cluster size of k = 50.
Functional MRI data were available for 22 trans men and 19 cis controls. We did not carry out separate pretreatment comparisons between trans men and the cross-sectional control groups, because these data have already been reported in one of our earlier studies, and showed no specific gender interaction . There were technical problems during image acquisition in one trans man and one male control. Furthermore, there was a change of MRI head-coil before the follow-up fMRI data collection of the cis controls, and these data sets had to be discarded for the longitudinal aspects of the functional connectivity analyses, which were, therefore, restricted to 21 trans men. No coil effects were detected on the DTI data. This was tested by a post hoc TBSS comparison between 2 groups of age- and sex-matched persons investigated before and after change of the coil which showed no significant difference with PFWE< 0.05, F = 0.9, df = 1.
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Why It Is Used
As part of gender-affirming care, gender-affirming hormone therapy is prescribed to encourage physical changes in the body to help people live their authentic selves with respect to their gender identity or lack thereof. Research has shown that the gender-affirming care model improves health outcomes for trans people. In fact, it is considered standard of care and is supported as a medical necessity by nearly every major medical association in the United States, including the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association.
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Other Hormonal Health Concerns
Topical estrogen – sometimes taken for atrophy of the vagina/front hole. Being on testosterone can decrease the natural lubrication of the vagina/front hole, which can make that part of the body uncomfortable not only during sex, but everyday activities and other important things like cervical screens and sexual health testing.
A topical estrogen applied directly can help solve this problem, without estrogen finding its way into the rest of the body. Using a topical estrogen has no effect on masculinising.
Progesterone – sometimes taken to assist in stopping menstruation. A small amount of progesterone in combination with testosterone can help make sure you dont get a period.
Testosterone Will Increase Your Upper Body Strength Dramatically
This deserves its own section because it is so dramatic. Before T, I spent years working out in gyms, lifting weights, hiring personal trainers. Still I could not do one decent push-up. Within a year of starting testosterone, I could do 20 push-ups with ease. At the moment, I have not set foot in a gym for a year yet I can drop and give you 15 push-ups without breaking a sweat. And they feel light and easy! In short, my upper body strength has increased dramatically since starting testosterone.
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To Count Or Not To Count
Calorie counting is not going to drive healthier eating or give you a healthy weight and is a great thing to add to an MTF diet or FTM diet. If you count calories, you will think that an avocado and a doughnut are equal . But they are not.
A doughnut does none of the above!
a little dark chocolate.
I like to make a big frittata using 10 eggs and loads of vegetables. I then keep it in the fridge and have a slice for breakfast, lunch or dinner. Its a quick way of getting something healthy into your diet and helps to control blood sugar. It can last up to four days in the fridge.
Water is vitally important to our health. It helps regulate our blood pressure, helps concentration and detoxification. Aim to drink between one and two litres of water throughout the day.
Alcohol can disrupt blood sugar levels and hormones and make depression worse. Always moderate alcohol and try to keep to less than seven units per week.
How To Learn More
If you want to learn more about testosterone-based GAHT, the best place to start is by talking to your healthcare provider. However, if you dont have one, you can find a local gender-affirming provider near you by visiting the WPATH provider directory or checking to see if you live a state covered by Plume, a telehealth company providing gender-affirming care, made by and for trans people.
Plume offers a mobile app where you can consult with a provider, develop an individualized treatment plan, and have your prescriptions delivered to your door, all for a flat monthly fee of $99 . You can learn more about Plumes GAHT services on their website.
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Practical Guidelines For Transgender Hormone Treatment
Adapted from: Gardner, Ivy and Safer, Joshua D. 2013 Progress on the road to better medical care for transgender patients. Current Opinion in Endocrinology, Diabetes and Obesity 20: 553-558.
- In order to improve transgender individuals access to health care, the approach to transgender medicine needs to be generalized and accessible to physicians in multiple specialties.
- A practical target for hormone therapy for transgender men is to increase testosterone levels to the normal male physiological range by administering testosterone.
- A practical target for hormone therapy for transgender women is to decrease testosterone levels to the normal female range without supra- physiological levels of estradiol by administering an antiandrogen and estrogen.
- Transgender adolescents usually have stable gender identities and can be given GnRH analogs to suppress puberty until they can proceed with hormone therapy as early as age 16.
Hormone regimes for transgender men
- Testosterone enanthate or cypionate 50200mg/week or 100200mg/2 weeks
- Testosterone undecanoate 1000 mg/12 weeks
- Testosterone 1% gel 2.5 10 g/day
- Testosterone patch 2.5 7.5 mg/day
i.m., intramuscular.*Not available in the USA.
Monitoring for transgender men on hormone therapy:
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Specific Guidelines For Transgender Individuals For An Mtf Diet Or Ftm Diet:
To lower testosterone for transgender women
- Reduce meat but make sure you have protein from e.g. nuts, seeds, eggs.
- Reduce cholesterol by cutting back on saturated fats, processed food and deep-fried food .
- Increase soy from tofu, miso, soya sauce, edamame beans.
- Eat organic food.
To lower oestrogen for transgender men
- Increase fibre from vegetables.
- Increase foods with sulphur: eggs, meat, fish, nuts, seeds.
- Increase organic food.
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Supplements : Vitamin D
Vitamin D3 supplements may boost testosterone levels, especially in the elderly and people who have low blood levels of vitamin D.
In one study, zinc and vitamin B supplements increased sperm quality by 74%. Zinc also boosts testosterone in athletes and those who are deficient in zinc .
Other studies also suggest vitamins A, C and E can play a role in your sex hormone and testosterone levels, although more research is needed .
Out of all the vitamins and minerals available, the research on testosterone shows vitamin D and zinc supplements may be best .
Vitamin D and zinc have the strongest evidence as testosterone boosters. Other micronutrients may also have benefits, but require further research.
It may also have major effects on your testosterone levels.
The ideal amount of sleep varies from person to person, but one study found that sleeping only 5 hours per night was linked to a 15% reduction in testosterone levels .
One long-term study observed that those who slept only four hours per night had borderline deficient levels .
Other long-term studies support this. One study calculated that for every additional hour of sleep you get, testosterone levels rise 15% higher, on average .
Although some people seem to do fine with less sleep, research suggests around 710 hours of sleep per night is best for long-term health and your testosterone.
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