pustluk:

Yesterday morning I got a call from a nurse at my doctor’s office to tell me my most recent round of lab results. I was surprised when the call was cheerily punctuated with, “Remember, too much estrogen converts to testosterone and undoes your changes!”.

Countless transgender women have been told the same thing by their HRT prescribers, usually in the same breath as instructions to lower their dosages. Because statements like this leverage anxiety and gender dysphoria, they are extremely persuasive, especially when coming from a place of perceived authority. They have caused many trans women I know personally severe distress and contributed to a feeling of futility in their biomedical transitions, as well as the potential harm of questionably low-dose hormone regimens.

Unlike most transgender women, however, I’m lucky to have had enough education to know this for what it is: not accurate medical information, but a scare tactic meant to dissuade people from deliberate overdose or self-medication.

There is no known pathway for testosterone biosynthesis from estrogens.

Put simply, this just does not occur. We know of no enzyme that “converts” excess estradiol to testosterone.

The opposite process, biosynthesis of estradiol from testosterone, does occur in people regardless of birth assignment through the enzyme aromatase, also called estrogen synthase. This raises the question of whether an abundance of exogenous estradiol could force the reaction to proceed in reverse. This does not, however, appear to be the case.

Aromatase functions through a three-step mechanism involving successive oxidations of testosterone’s C19 methyl group, followed by eliminative aromatization to estradiol [1][2]. 

A detailed mechanistic study found that, while some steps of the catalysis occur in equilibrium even at typical concentrations, aromatase cannot effectively catalyze the reverse reaction even in an abundance of product; while the estrogenic product binds weakly to aromatase, the rate constant of the reverse reaction was too small to be measured and the conversion from androgenic to estrogenic product may be considered one-directional [2]. I would speculate that this owes partially to aromatization energy (in essence, estradiol is a more stable molecule than testosterone), but that’s just a guess.

So, while it is demonstrably false that estrogen can be “converted” to testosterone, we might still assume that practitioners who tell this to patients are acting in good faith, and merely simplifying a different process. This raises another question:

Can estradiol overdose increase testosterone synthesis? Maybe. Should trans women be concerned? No.

It’s been known since the mid-’70s that high levels of endogenous estadiol (E2) exert positive feedback on the release of gonadotropin-releasing hormone (GnRH) [3]. This is, in fact, a major part of the ovulation cycle. Additionally, through the hypothalamic-pituitary-gonadal axis, these GnRH pulses trigger the release of luteinizing hormone (LH), which in turn regulates testosterone synthesis in the Leydig cells of the testes.

It’s possible, then, to imagine a scenario in which highly elevated levels of exogenous serum estradiol—in the case of, say, an accidentally-doubled intramuscular dose—engage the positive feedback loop of the HPG axis, triggering a surge in testosterone production. As best I can tell, this is speculative and has not yet been clinically observed in transgender women on HRT. Similar phenomena called ‘testosterone flares’, however, have been observed during the administration of GnRH and LH agonists for prostate cancer [4]. These flares last only 1 to 3 weeks [4], however, because sustained engagement of the HPG axis positive feedback loop desensitizes the system [5].

None of this, however, should present a concern for trans women on HRT. This is because testosterone flare will not affect anyone under androgen-receptor blockade by cyproterone acetate or bicalutamide [4], nor will it affect anyone whose testosterone biosynthesis has been externally suppressed by drugs like spironolactone [6] or by surgery like orchiectomy.

Moreover, because LH only regulates Leydig cell testosterone secretion, HPG axis positive feedback will have no effect on adrenal testosterone synthesis—a separate process regulated by corticotropin and CRH.

Practitioners who repeat this myth to trans patients might actually believe it, but their patients shouldn’t have to!

[N.B. I am not an endocrinologist. I am a trans person and former research chemist, primarily trained in chemical biology. This post contains information gathered from the biochemical literature, and does not constitute medical advice.]

References

[1] Yoshimoto FK and Guengerich FP (2014). Mechanism of the third oxidative step in the conversion of androgens to estrogens by cytochrome P450 19A1 steroid aromatase.

J Am Chem Soc; 136, 15016−15025.

[2] Sohl CD and Guengerich FP (2010). Kinetic analysis of the three-step steroid aromatase reaction of human cytochrome P450 19A1. J Biol Chem; 285(23): 17734–17743.

[3] Lasley BL, Wang CF and Yen SSC (1975) The effects of estrogen and progesterone on the functional capacity of the gonadotrophs. J Clin Endocrinol Metab; 41,820–826.

[4] Thompson IM (2001). Flare associated with LHRH-agonist therapy.

Rev Urol; 3(Suppl 3): S10–S14.

[5] Magon N (2011). Gonadotropin releasing hormone agonists: Expanding vistas. Indian J Endocrinol Metab; 15(4): 261–267.

[6] Corvol P (1975). Antiandrogenic effect of spirolactones: mechanism of action.

Endocrinology; 97(1):52-8.

gothpeasley:

squided:

lenkagamin-e:

squided:

It’s almost fall you know that means we will all be needing some

dont bring this back

I waited an entire year to make this post.  It’s coming back.

@stantzler @bladeknight

wccpaafttabf:

defilerwyrm:

defilerwyrm:

othersidhe:

defilerwyrm:

Ya boi just took some asshole for a ride. Some schmuck called me from a (spoofed) DC number with some cockamamie story about how he’s with the Federal Government and they’ve randomly selected me to receive a $7000 grant, oh and I’ll have to go pick it up at any of several chain grocery stores. Keeps using these “check-in” phrases that are meant to prompt you to say yes.

But see, joke’s on him: I’ve heard of this scam, and I don’t talk like most people. When I answer the phone and someone asks for me by name, I say “Speaking,” not “Yes.” So every single time this assclown tried to get me to say “Yes” I’d say something like “Understood” or “Go on.”

You see, the scam is, they trick you into saying “Yes,” and bonus if they can get you to repeat numbers (esp. 0-9) and/or “I agree.” What these low-lives do is record your voice and then use the sound bytes to make fraudulent charges in your name.

So fuck this guy right off the bat.

The more I dicked him around, the more frequently he started trying to goad me into saying the y-word. The funniest part came when he was going to “give me a confirmation number.”

Him: The confirmation is seven, one, three…

And he just STOPS. The “three” was pitched up to indicate there’d be more. I wait. He waits. I say, “Go on.”

And this bitch goes, “Yes, the confirmation number is seven, one, three…”

And he STOPS AGAIN. I wait. He waits. I say, “Go on,” again.

And he STARTS! OVER! AGAIN! He did this TWO MORE TIMES before giving me the “full confirmation number” and a “number to call,” which together JUST HAPPEN to include all ten digits, 0 through 9.

This entire time I haven’t said a single word that could be construed as agreement. So he asks me to repeat the numbers back to him. I decide I’ve had enough at that point. I tell him to get a better job, hang up, and block the number.

Another “DC” number immediately calls me. I reject & block it.

And then I filed a report with the Federal Trade Commission. :3

BE WARY. Get yourself on the National Do Not Call Registry. If a number you don’t recognize calls you, DON’T REPLY “YES” OR ANY OTHER GENERIC AFFIRMATIVE TO ANYTHING THEY SAY OR ASK.

The original scam is a robocall that starts off with “Can you hear me?” The most correct response is to hang up and report it to the FTC. The second best is “I can hear you,” if you’re not sure or if you forget. But get into the habit of using responses other than “Yes” on the phone. These fuckers are everywhere.

It gets worse, OP. Your voice can be spliced to sound like you agreed to something. You may have given them enough to do that with. Like those Microsoft Windows people that call and want your ‘important numbers off your computer’ I talked to them for far too long and only found out after the fact that they could make fraudulent charges just by splicing some of your words together. They were after something different, but it amounts to the same thing in the end. Also there’s the common ‘press 1′ people as well. It’s best to just hang up. The Attorney General says to get an answering machine and they can’t really do anything about them because they’re constantly spoofing numbers. Neither can the phone company, and they Charge You Money for reporting them!

Oof. Reblogging for additional warnings. I’ve already made my report to the FTC, so I’ll just be keeping a close eye on my finances for a while. (Like I’m not already given my situation.)

I’m trying not to be annoyed by this

but I’m annoyed

I understand that this is tunglr dot hell and people love to make up wild shit but llllllook boys girls and others this literally happened to me, personally, exactly as I described it. Here’s the screenshot of the two “DC” numbers that called me—the one I answered at 12:35, dicked around, and hung up on, and the one that called me immediately after which I rejected.

Here are some news articles about the “yes” scam:

https://abcnews.go.com/Business/fcc-warns-consumers-phone-scam/story?id=46405703

https://www.usatoday.com/story/tech/talkingtech/2017/03/27/dont-say-yes-when-robocall-scam-rings/99709634/

https://www.freep.com/story/money/personal-finance/susan-tompor/2017/02/01/mystery-phone-calls-dont-say-yes/97237592/

Here are some articles about the fake $7000 grant scam:

https://www.usatoday.com/videos/news/2014/12/14/20401343/

https://www.consumer.ftc.gov/blog/2013/05/fake-government-grants-real-refunds

https://www.youtube.com/watch?v=KW6zh3GJZ98

https://www.scam-detector.com/article/government-grant-scam

On reflection I do partway suspect that it might have just been the fake grant scam, but I still gotta say, super fucking fishy that he kept trying so very hard to get me to say yes and repeat numbers.

I’m on the level, fam.

Reblogged on 10032018

karnalesbian:

frankly speaking i think kids doing the fortnite dances at any given opportunity in public is genuinely hilarious and im glad they’re having a good time anyone who complains because someone is enjoying themself in a completely harmless way like that and not inconveniencing anyone just hates fun