Happy Thanksgiving

Today in the U.S. we celebrate a day of giving thanks for our blessings and the good things in our lives.  I give thanks for you, the readers, who still come to this blog even though I haven’t made a substantial post in almost three months.

During this recent period of work, travel and activism, I have failed to acknowledge one important aspect of this blog that you, the readers, have made possible:

You have broken the 100,000 views mark!
In fact, you’re only 54 views away from 105,000!

So thank you, readers, for your interest in American Trans Man!  May we have many more posts together.  (And I promise I will post again before the end of the year.)


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4 Responses to Happy Thanksgiving

  1. 65mm says:

    Hi ATM,

    Apologies for an off-topic comment. I’ve had a long-burning question about the use of synthetic testosterone. To my understanding, endogenous T in cis males follows a pulsatile pattern in the blood, due to the pulsatility of GnRH. But to my experience everyone who takes synthetic T, whether for transitioning or for other hypogonadal disorders, takes it in depot form. So the serum levels would be constant throughout a day. I even saw some data put out by the company making Androgel boasting how it provides constant levels.

    My question: is this really desirable, if we’re trying to achieve the same effects as cis males with pulsatile T levels? Or are we prescribed depot because it’s just easier? Could this mean a significant difference in the effects we experience? I have read there is buccal testosterone that can give pulsatile levels, but haven’t seen any research on a possible difference in effects.

    I have also heard here and there about changes that trans guys see on T that you wouldn’t expect in cis males. Emotional changes, inability to cry, and really early hair loss. Of course, these are anecdotal, and could be psychological in origin or not dosage-controlled. But could it be that they are caused by having bolus rather than pulsatile T?

    Sorry for the long question! If you have any knowledge on the matter I’d love to hear it.


    • Hello Sam. Thanks for the question and no need to apologize about it being off topic. I certainly haven’t posted anything on any topic in months so it’s good to get your comment.

      Regarding your question, I am not so sure that endogenous testosterone in peripheral blood of natal men is actually pulsatile. Yes, GnRH and LH secretion patterns are pulsatile, and if you take blood from the gonadal vein you can measure the pulsatile secretion of testosterone from the testes, but those pulses are not readily detectable in the peripheral blood system. So do the extremities or the brain actually experience pulses of testosterone? I’m not so sure, but if you have information that addresses that, please let me know because I am not aware of it.

      As for the changes you mentioned that trans guys experience such as emotional changes, the inability to cry and “early” hair loss, first, I think these are anecdotal, as you said, and even if they’re real, they may have a non-testosterone basis. Emotional changes could come to anyone from being more comfortable in their body, for example, rather than a direct effect of testosterone on the emotions. Regarding hair loss, even if it is “early” compared to non-trans men (and I’m not saying that it is), the reason may have nothing to do with testosterone and may have more to do with other genetic, cellular or physiological changes that occur in the scalp with age so that when testosterone comes along during transition, it only triggers a manifestation of the differences that are already there. However, bottom line for these “changes” is that not all trans men experience them and some non-trans men do experience them even though they have always had endogenous testosterone, so I don’t think any hard, fast conclusions can be drawn.

      Of course, injecting testosterone will result in a peak concentration of testosterone a some time post-injection and then a decline until the next injection, and that is still different than what natal men experience. Might that pattern of testosterone fluctuation in the blood of trans men have consequences that are different than what is seen in non-trans men? Sure, but without controlled studies looking at the question, we won’t be able to really know the answer.

      • 65mm says:

        Thank you, that is very helpful. I don’t know why I thought serum level would be pulsatile just because secretion is, maybe the way one of my profs talked about it once. It makes complete sense, serum would weakly pulsatile if at all due to half-life and especially due to SHBG.

        Looking forward to new posts from you!

        • Actually testosterone is pulsatile in other species like rats and even monkeys, but not as much in humans for some reason. I think the constant levels they advertise for the gel has more to do with the lack of spike in concentrations that you would get with the injectable kind.

          Thanks for the encouragement. I wish I had more time to write!

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