An interesting yet unexpected comment from my doctor

[sarahcsc]

Hi ladies and gents,

A chat with my endocrinologist revealed some interesting yet unexpected insights. She's been an endocrinologist for 14 years and seen more female to male clients than male to female! Also, male to female transgendered clients are often much older and much more difficult to pass as a lady compared to female to male trans. A lot of MTF are very conflicted and although FTM can be conflicted too, they are somehow less distressed because they are often younger easier to pass.

Of course these are just anecdotal experience from ONE endocrinologist in a tiny little city, but what do ya'll think?

Love,
Sarah

[Nigella]

Having seen the results of HRT in a F2M it is understandable why they can pass better than M2F, Testosterone does more to the body than estrogen.

Today's society has grown with the acceptance of a female who no longer looks like the "little housewife" and so there is less pressure on them to conform to societal norms.

By far though the biggest issue with any change of gender is a persons own fear.

[kimdl93]

From a biological perspective, I'd expect more MTF than FTM, simply because the fetus is essential female until various mechanisms begin and complete the gender differentiation. That's sheer speculation on my part.

I suspect that culture has a lot to do with when either MTF or FTM choose to transition, since western culture has been and remains arguably somewhat mysogynistic and it's only in the past decade or so that more accepting attitudes towards gender and sexual identities became more prevalent. So, people like me tended to stay hidden. We begin to emerge when the environment is more hospitable.

There may appear to be more older mtf transitioners in her practice for some time to come. Call it pent up demand. It may level off or shift younger once the backlog of us older people age out of the system. (Aging out sounds better than dying for some reason!)

[KellyJameson]

Historically women have been viewed by men as inferior to them. There are many reasons for this but I think part of it is that collectively men secretly fear women.

The fear may come out of their sexuality and the power it gives women along with feeling emasculated by her which probably partly comes out of his relationship with his mother and women in general when a child.

My BFF has two boys, four and six, and they have already communicated how they think their younger sister and the mother are somehow lacking because they do not have a penis so this starts young.

From the perspective of men and by extension the culture, it seems much more natural to move from FtM from wanting to be with the superior gender versus MtF and move toward the inferior.

It is interesting to see how some FtM struggle for status among men because usually they are smaller in stature with faces showing more typical feminine characteristics.

In general men are threatened when "one of their own" rejects his masculinity and is part of what makes being a transsexual so dangerous.

There are many more reasons a MtF will be scrutinized than a FtM and these reasons almost always have an element of fear wrapped up in them.

An example that is not related to MtF or FtM concerning women is how some men openly loathe those men who support feminism.

If you watch men from a distance and how they intereact with each other you can see how their world is divisive along the lines of women and equality.

[Kimberly Kael]

It's frustrating that statistics of anything involving self-identification are woefully inadequate. I suspect nobody has a really good handle on the relative frequency of FTM vs MTF without a strong coloring by social biases (even setting aside the argument that gender is a social construct to begin with and there is no such thing as an objectively transgender individual.)

It is worth noting that the two communities don't interact as much as we ought to. In contexts where the focus is legal rights or professional support I've found rough equivalence between the number of representatives. Socially, though? Events and outings tend to cater to one community or the other. After doing some research on CD/TG getaways early in my exploration I was impressed by the size of some of the events. Hundreds of us getting together for a shared experience. Then I learned about an FTM a equivalent in the city I was living in that dwarfed everything else I had been looking at for myself. Completely disjoint and relatively invisible from my limited perspective.

I've really liked the few trans men I've had an opportunity to chat with. Paradoxically, I'd say I felt more kinship with them than my own kind. I don't know if it makes any sense at all, but something about having been socialized female avoided the hyper-competitive, judgmental, macho crap that too many raised as male have internalized.

[SassySal]

I think the pertinent point being sorely missed is the following....

"A lot of MTF are very conflicted and although FTM can be conflicted too, they are somehow less distressed because they are often younger easier to pass."

Does this not raise some interesting questions ?

[Rianna Humble]

The only questions your quote raises in my mind is how statistically significant the sampling was and what the results were in the control group.

On the other hand, your last sentence does raise questions in my mind.

[Wildaboutheels]

"these are just anecdotal experience from ONE endocrinologist in a tiny little city, but what do ya'll think?"

An opinion from just ONE person which goes completely against the MOUNTAIN of EVIDENCE presented at this Forum for X # of years on a daily basis?

I like FACTS and evidence myself.

[Eryn]

Hi ladies and gents,

A chat with my endocrinologist revealed some interesting yet unexpected insights. She's been an endocrinologist for 14 years and seen more female to male clients than male to female!

I wonder if that is due to her first FTM clients simply referring more FTMs to her? Doctors tend to develop a "following" that might lean one way or the other.

Also, male to female transgendered clients are often much older

Not surprising, considering that it is much more stigmatizing for males to want to act female than it is for females to want to be masculine. Tomboys are generally tolerated, and male tendencies are even seen as an asset. Sissies are beaten up and nobody sees feminine tendencies in a male as an asset. In these conditions MTFs tend to focus on short-term goals and make the best of their birth gender until it finally becomes too much for them to ignore.

and much more difficult to pass as a lady compared to female to male trans.

Stature and build have a lot to do with this. Short, slight men do not raise questions in observer's minds, but tall robust women do, particularly as they pass six feet.

A lot of MTF are very conflicted and although FTM can be conflicted too, they are somehow less distressed because they are often younger easier to pass.

Society hammers in the message that males have it better than females, so it is natural that the FTM path involves fewer doubts and fears than the MTF path. The fact that the goal of being accepted as one's target gender is more certain for FTMs naturally leads to a smoother passage. Also, the fact that MTFs transition later in life means that they have that much more background to cause conflicts.

[SassySal]

I am interested in knowing just what, "this MOUNTAIN of EVIDENCE is that so certainly refutes this opinion of one individual that has 14 years of 'hands on/on the ground' experience working with gender conflicted peeps.

Also, this... "The fact that the goal of being accepted as one's target gender is more certain for FTMs naturally leads to a smoother passage." How do we know this? Is there some MOUNTAIN of EVIDENCE that shows this as well?

"...the fact that MTFs transition later in life means that they have that much more background to cause conflicts." Does this not, yet again, raise that same question as to why this is so? And is it so? Are there not those among us who transition young? I know that I did and as I have stated, there was much less "conflict" and social angst.

Just sayin'....

I admit that I am skeptical of some of these comments in that they seem so certain of their opinions as opposed to that opinion offered in the OP.

"

...the fact that MTFs transition later in life means that they have that much more background to cause conflicts.

[Michelle.M]

The only questions your quote raises in my mind is how statistically significant the sampling was and what the results were in the control group.

It's not, not was it intended to be. OP says "just anecdotal experience from ONE endocrinologist".

[Rianna Humble]

You got it, Michelle, apparently SS did/does not. She even questions what evidence we have had over the years without bothering to find out.

I think her motivation is beginning to become clear.

[SassySal]

"Motivation?" "Questions?" Hmmmm.....

[LeaP]

Of course these are just anecdotal experience from ONE endocrinologist in a tiny little city, but what do ya'll think?

I think it reflects the practice of one endo in a tiny little city. Do I think the pattern is plausibly extensible? Yes, in several ways. The rate occurrence of MTF transsexualism is known to be higher than FTMs. This has been reported ad nauseum, though the rates themselves are all over the map for, among other reasons, different approaches and methodologies. Easier transition? Perhaps, depending on what is meant by transition. Masculinization from an appearance standpoint is quite effective, voice changes, beards grow, skin coarsens. Social integration in the sense of passing is easier in some respects as a result. Psychologically, some FTMs are reported to struggle with emotional changes and isolation, however. [edit] FTM surgery is expensive and problematic. Older MTF transitioners? Maybe. It squares with my own experience meeting FTMs, who have invariably been young (late teens into their 30s when they transitioned). I know a lot of late MTF transitioners, but that's to be expected to a degree, as I AM one.

All in all, nothing remarkable about the observation.

[arbon]

An opinion from just ONE person which goes completely against the MOUNTAIN of EVIDENCE presented at this Forum for X # of years on a daily basis?
.

This website is for primarily for men who like to crossdress in womens cloths. Its not really for ftm people (though a few do come)

I am not surprised by what the doctor said really. There ARE a lot of ftm out there. On a support group I started they are the majority.

[Stephania]

In the small town I live in Central Texas, There are 2 FTM's to 1 MTF (me). Its all dependent on where your at. Go into Austin and the MTF is much larger than the FTM.

Stephania

[sarahcsc]

Your opinions are all very logical and plausible and there isn't any way to prove of disprove any of them due to paucity of any robust studies done on this topic.

This topic has been notoriously difficult to study because people aren't always forthcoming in their feelings (especially men) nor are they aware of their needs. It can also be more debilitating for some and less for others depending on an individual's strengths and weaknesses. Their culture, beliefs and values also factors strongly into the equation. Thus the prevalence is bound to vary between cultures and regions although there aren't many studies done so far.

My biggest conflict is not with passing, but rather convincing myself that "it is alright" to seek individuality. My culture promotes collectivism which means my actions will inevitably be perceived as "wrong" in the eyes of my very traditional and conservative family. I suspect I wouldn't have gone this far (to HRT) if I wasn't exposed to western culture and concepts. There is no right or wrong in this but it was just the way my life has unfolded. I am happy now, but I can't dismiss the possibility of another kind of happiness if I stuck to my culture and suppressed my needs. I could have been husband to a beautiful wife, father to a beautiful child, and at the same time would have done my family proud. All this, at the cost of my individuality. Is that a small price to pay? This idea may seem unfathomable to the West, but it was passed down to me from my mother who inherited it from her mother which have been passed down for many generations before.

I believe my conflicts aren't unique, except that we all internalize it differently. In the West, maybe men are afraid of being viewed as weak, but in the East, men are afraid of being viewed as unappreciative, unfilial, and irresponsible. Maybe instead of just having feminists, we need to have a group of "masculinist" (or something) fighting for our rights to be treated equally too. Lol. Why are men expected to hold positions of power? Why are they expected to be given more control and responsibility?

Anyways, my doctors comment did raise my eyebrows a bit but I can't say I'm too surprised. I take her words with a pinch of salt and it wasn't important to me anyway. I was just curious of what your thoughts are.

yours,
Sarah

[Marleena]

For what it's worth my endo has mostly MTF patients and a whole whack of late transitioners (according to him). Support groups within a 500 mile radius recommend him as being trans friendly. So I think word of mouth is a key factor. He told me I should have seen him when I was thirteen *sigh*. I told him there was no internet or support groups back then and I had no idea WTH was wrong with me.

[kimdl93]

Cultural expectations are pretty hard to shake loose...I suspect that most of us here have felt our share of internal conflicts between what we would choose for ourselves and the cultural norms.

One thing I'd like to challenge. It seems you have assumed that you can never have a wife and child one the path you've chosen. It's not true. You can. Many of us have and honestly Sarah, you're a lovely intelligent person. It may be a bit unconventional,but I have every confidence that you will meet an equally lovely and intelligent woman to share life with you.

[LeslieSD]

It is an interesting topic. I came from eastern culture too, and can resonant with some of your thoughts, but at the same time disagree with some.

The eastern culture is inherently discouraging individuality, and different from norm. I have gone through that struggle with the "guilt and shame" over years, and those are put upon me by the society. In the eastern culture, if one is different from the main stream value, s/he is to be laughed about and shamed. There is less respect of that fact that people may be different. That I can definitely agree.

In the West, maybe men are afraid of being viewed as weak, but in the East, men are afraid of being viewed as unappreciative, unfilial, and irresponsible. Maybe instead of just having feminists, we need to have a group of "masculinist" (or something) fighting for our rights to be treated equally too. Lol. Why are men expected to hold positions of power? Why are they expected to be given more control and responsibility?

I am not so sure about that. One thing happened in the last half century of China is that women are deemed to be 100% equal to men. All the tradition notion of men are the bread earner and women are house maker is thoroughly changed. It however did not make much noticeable difference. It seems the society's drive for everyone to confirm to norm is the strongest suppressing force.

[Michelle789]

I think there are an equal amount of FTM as MTF, but there appears to be more MTF since MTF's don't pass as well, on average. I think there are several reasons behind this.

1. Testosterone is a much stronger hormone than estrogen.

2. Society stigmatizes men acting feminine moreso than women acting masculine, causing MTF to transition later in life. Late transition causes two additional problems. See #3 and 4.

3. MTF have decades of testosterone poisoning, and T being stronger than E means that it's harder for E to erase years of T development, while for the FTM the T can erase the effects of E. #3 is a direct consequence of both #1 and #2.

4. MTF have decades of history as a male, which is harder to erase than an FTM who transitions at 23 and has his whole life ahead of him as a male.

5. Human civilizations essentially have decided that you either must bear children or fight war. Since gay men and MTF cannot bear children, they must fight war and therefore not act feminine. Lesbians and FTM can choose to get pregnant or fight a war. Femininity in human society has been given as a privilege to those who are physically able to bear children. The ultimate reason behind this was religion which wants to produce as many children as possible. They want more children to produce slave labor to make the rich happy, as well as to have males that die in the wars created by the rich.

6. In nature or ancient tribal societies, gay and feminine males, as well as MTF transgenders (even though they have no medical treatments for MTF) are accepted more because of the fact that a few males breed with all the females and have all of the children. The rest of the males are not needed in the reproduction process, as a few males can impregnate all the females and keep the species alive.

7. This is the dark side of male privilege. Male responsibility. It is generally easier to be a straight or even lesiban cis-woman than it is to be a gay or feminine male or MTF. I am convinced of this after talking with a lesbian woman who goes to my church who lives in the redneck town of Lancaster. She told me that in Lancaster, it is generally safe to be lesbian, but to be a gay male or a MTF means you risk being the victim of physical assault.

8. Male privileges are distributed unevenly among MAAB. Those males who are at the most feminine end of the spectrum (gay males, feminine males, and MTF) actually have less privilege and are treated more poorly than straight or even lesbian GG's.

9. The next time that a GG complains how it sucks to be a woman, I have only one thing to say to her. Try being a gay man or a transgender woman.

10. Due to male responsibilities, human society has decided that when it comes to gender cues, when in doubt the gender is male, so that there are more men to do slave labor and die in wars. This is actually opposite of how animals and tribal society works. In nature, when in doubt the gender is female. Basically when it comes to gender cues, if someone is 45% male and 55% female, they are still gendered male. In other words, the Senate Filibuster rule applies to how we gender people rather than a simple majority. If your gender cues are a simple majority female (51% female) you are still considered to be male. Your gender cues must be at least 60% female in order to be gendered female in our society. This is a huge reason why it is easier to pass as male than as female.

An FTM who reaches 41% male gender cues and is 59% female gender cues passes as a male. An MTF must be able to reach 60% female gender cues in order to be gendered female. My guess is the majority of transgender people, both MTF and FTM, will end up having between the 40-60% range, therefore in both cases being gendered as male.

Once again we can blame our society's screwed up rules on making you earn your right to pass as female.

[Aprilrain]

I'd love to see the science behind your theory Michelle.

[Cheryl123]

Interesting topic Sarah and it has certainly brought out a lot of interesting responses. I've found some background information. This past January the National Transgender Discrimination Survey was released. The sample size was 6500. The survey found that 41% of the respondents had attempted suicide. The national rate in the US is about 3%. Although the survey did not break down the results between MTF and FTM there is clearly a lot of stress in both groups. The survey did find that inability to pass was one factor causing an attempt at suicide. And since it is easier for a MTF to pass, your doctor's conclusion seems to have some support. The lastest estimate is that the ratio between MTF and FTM is about 1.4:1. But it's just an estimate.

[Kimberly Kael]

And since it is easier for a MTF to pass...

I've seen this stated several times in the thread and I find it utterly baffling. From what I've seen, FTM hormone therapy is extraordinarily effective. Facial hair. Male pattern baldness. Even changes in vocal pitch. All the direct result of testosterone and none of them as easily reversed. Our advantages are in the realm of GRS, not social passabiity.

I consider myself relatively blessed from a genetic standpoint, and I still set my sights on acceptance rather than passing without question. I think the only MTFs I've ever met who I would say are as passable as the FTMs I know were very early transitioners, taking corrective action before testosterone had time to make its unmistakable mark.

[LeaP]

1. Testosterone is a much stronger hormone than estrogen.

...

3. MTF have decades of testosterone poisoning, and T being stronger than E means that it's harder for E to erase years of T development, while for the FTM the T can erase the effects of E. #3 is a direct consequence of both #1 and #2.

No! This comes up again and again, but is wrong. Testosterone is actually a fairly weak hormone.

Take a woman with an estradiol level of 200 pg/ml and a man with a testosterone level of 600 ng/dl. Convert both to pg/ml. T converts to 6000 pg/ml - meaning that his blood levels have 30 times the volume of testosterone as the woman does estradiol. And that's the snapshot level, not a measure of production and consumption.

In fact, estradiol is appx. 100 times the potency of testosterone. The male body produces, consumes, and maintains relatively vast amounts of T to maintain testosterone dominance and androgenic effects over the relatively small amount of estrogens produced in the male body.

Estrogens don't erase the effects of testosterone.