How long should trans females be made to reduce their levels of circulating testosterone should prior to competing in the women competition?

Gooren found that during the first 12 months muscle mass (area) was decreased by 9.4% & hemoglobin levels by 14% in 20 transwomen (M2F trans) treated with an estrogen-based regimen that reduced circulating T concentrations from the male range to the female range.
Conversely, in 17 transmen (F2M transgender) treated for the first time with testosterone for 12 months (which increased circulating testosterone levels to a mean of 31 nmol/L), muscle mass increased by 19.2% and hemoglobin by 15%.
https://t.co/MOZtfh5Raf
The muscle mass findings remained stable between 1 and 3 years after initiation of treatment, although fat mass continued to change between 1 & 3 years of T treatment. although with disproportionately greater effect on muscle strength than on muscle mass.
https://t.co/8rMfUi4brV
This study did not report muscle strength, but other studies of T dose-response relationships for muscle mass and strength show consistently positively correlation,

https://t.co/0SqyneBjPZ…

https://t.co/pgyggiNG2u

https://t.co/0SqyneBjPZ…

https://t.co/A5AVkkShDj
Hence, the muscle mass estimates in these prospective treatment initiation studies in trans individuals likely underestimate the muscle strength gains from...
Elevated T levels where the circulating T markedly exceeds female range to be within the male range as occurs in severe hyperandrogenism of DSD females, poorly controlled transwomen (M2F transgender),..
or transmen (F2M transgender). These effects are also the biological basis of the ergogenic efficacy of androgen doping in women.
In both intersex/DSD and trans individuals, the developmental effects of adult male circulating T concentrations will have established the sex difference in muscle, hemoglobin, & bone, some of which is fixed & irreversible (bone size)....
.& some of which is maintained by the male circulating testosterone concentrations (muscle, hemoglobin).
The limited available prospective evidence from initiation of trans cross-sex hormone treatment suggests that the advantageous increases in muscle & hemoglobin due to male circulating T concentrations....
...are induced or reversed during the first 12mths & the androgenic effects may plateau after time.
This time course is much faster than the somatic effects of male puberty, which evolve over years and for some variables (e.g., peak bone mass) are not complete for up to a decade after the start of puberty.
However, the abrupt hormonal changes induced by medical treatment in intersex/DSD or transgender individuals may be telescoped compared with male puberty where circulating testosterone concentrations increase irregularly and incompletely for some years.
Additional data are available from the unique investigative model of men undergoing castration for prostate cancer. Just as androgen sensitivity to testosterone may differ between tissues...
https://t.co/S2yyg9Xq8j
The time course of offset of androgen effects following withdrawal of male testosterone concentrations may also differ between the major androgen-responsive tissues.
For example, circulating hemoglobin shows a progressive fall for 6 months reaching a nadir and plateau at 12 to 16 months in six studies involving 534 men undergoing medical castration for prostate cancer.
https://t.co/Bcg0PuNNu3
Although these studies of older men with prostate cancer must be extrapolated with caution, age, stage of disease, race, & baseline circulating T concentration did not affect the rate or extent of decline in hemoglobin.
https://t.co/Bcg0PuNNu3

https://t.co/2bii5lMZYy
Comparable longitudinal studies of muscle loss, strength, and performance following castration for prostate cancer are well summarized,
https://t.co/olda0NryXA
Showing progressive loss for 24 months (see Fig. 4).
Further clinical studies to define the time course of changes, mainly offset, in testosterone-dependent effects, notably on muscle and hemoglobin, are badly needed to determine the optimal duration for cross-sex hormone effects in sports.

End
@threadreaderapp please unroll

More from Kirsti Miller

Would having the testosterone limit for transgender women at 10nmol/L (5-10 times what’s considered “typical” for women) give them a massive advantage over their cisgender opponents?


Absolutely not, is recognized an XY chromosome body is seen as unhealthy <12nmol/L or less. A XY female as they lose the ability to produce natural occurring testosterone, falls into a range of 0.4nmol/L.

Which we know too, the individual falls into menopause at 9.6nmol/L, and due to complete androgen deprivation eventually into the position of that would equate a XX female = who had had a complete hysterectomy including her gonads.

We can be assured, one this is extremely unhealthy – Moreover, and most important, we can be assured that there are no women either XX and or XY competing internationally like this.

This is not for anyone a desired state and for the participation high performance sport eventually impossible to participate longterm.

More from Society

I've seen many news articles cite that "the UK variant could be the dominant strain by March". This is emphasized by @CDCDirector.

While this will likely to be the case, this should not be an automatic cause for concern. Cases could still remain contained.

Here's how: 🧵

One of @CDCgov's own models has tracked the true decline in cases quite accurately thus far.

Their projection shows that the B.1.1.7 variant will become the dominant variant in March. But interestingly... there's no fourth wave. Cases simply level out:

https://t.co/tDce0MwO61


Just because a variant becomes the dominant strain does not automatically mean we will see a repeat of Fall 2020.

Let's look at UK and South Africa, where cases have been falling for the past month, in unison with the US (albeit with tougher restrictions):


Furthermore, the claim that the "variant is doubling every 10 days" is false. It's the *proportion of the variant* that is doubling every 10 days.

If overall prevalence drops during the studied time period, the true doubling time of the variant is actually much longer 10 days.

Simple example:

Day 0: 10 variant / 100 cases -> 10% variant
Day 10: 15 variant / 75 cases -> 20% variant
Day 20: 20 variant / 50 cases -> 40% variant

1) Proportion of variant doubles every 10 days
2) Doubling time of variant is actually 20 days
3) Total cases still drop by 50%

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