Yes, Estrogen is really bad for men

When NPR aired the “How to Raise a Girl” podcast in 2017 on gender transition (think Jazz Jennings, but over the radio), I told my family that I doubted that there were any long-term studies of the effects of puberty blockers and cross-sex hormones. Gender transition seemed a mad experiment. Years later, when my son began taking cross-sex hormones, I tried to learn about estrogen’s effects on males.

Estrogen is prescribed to trans-identified males off-label to feminize the body through breast growth, fat redistribution, and softening of the skin – cosmetic enhancements of secondary sex characteristics. Because estrogen is prescribed off-label, it has not been subject to FDA approval, nor are outcomes closely monitored. Informed consent forms list some adverse effects, but the risks are quickly minimized by statements like “The risks are rare”, which appears in Planned Parenthood’s informed consent form. The following sentence on the form, “There may be long-term risks we don’t know about,” is truer, albeit because medicine has not asked the question, monitored patient outcomes, or does not want to know the answer.

In my research, I came across ML’s Substack article "Estrogen is really bad for men," where ML summarizes observational studies reporting the adverse effects of estradiol, the synthetic form of the hormone, in men. Two years later, Discover Mental Health published the peer-reviewed Emerging and accumulating safety signals for the use of estrogen among transgender women by Schwartz et. al.

Science is slow. WPATH did not do science, so they move fast.

Listening to DIAG’s interview with the paper’s authors, I became discouraged as Dr. Carrie Mendoza outlined the road ahead to educate doctors and change medical practice, as was done to combat the opioid crisis.

This is taking too long! My son is having symptoms now, and the medical community and patients need to understand the adverse side effects before his next ER visit.

Are doctors too arrogant, lazy, or ideologically captured to learn about estrogen’s adverse effects on males? Who will educate our brilliant sons, who are naïve and believe that doctors know best?

How could I tell the story of the harms in a succinct way, so that doctors and patients can’t look away without escaping the truth of the medical harms of estrogen? I summarized the study in this visual, and before I finished writing it, a new study came out on the increased risk of kidney stones.

Note: I use the language of the article, so transgender women mean trans-identified males or natal males.

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