The Impact of Stopping Estrogen Supplements on Trans Women

It is essential to understand that all humans with functional gonads, whether they identify as biological women, trans women, or other gender identities, produce estrogen. Estrogen is a crucial hormone involved in the development and maintenance of secondary sexual characteristics, bone density, and cardiovascular health. This article will explore the effects that discontinuing estrogen supplements may have on trans women, who often rely on hormone replacement therapy to manage their gender identity.

Human Estrogen Production

ALL humans with functioning gonads, whether it is ovaries (in biological women) or testes (in biological men), produce estrogens. However, both men and women also produce small amounts of estrogen through other tissues, such as fat cells, bone cells, cartilage cells, blood vessel endothelial cells, and brain cells. This indicates that estrogen is not exclusive to either gender and is a universal hormone with multiple sources of production.

A significant reduction in estrogen production occurs naturally in biological women as they age, a phenomenon known as menopause. This usually starts in their 40s and 50s, when the ovaries cease to function effectively. In contrast, trans women may also face a similar decline in hormonal levels, often needing to stop taking estrogen supplements around the same age phase.

The Importance of Hormonal Balance

Trans women who stop taking estrogen supplements in their 40s or 50s (a period often marked by natural hormonal changes) may experience significant health repercussions. Estrogen plays a vital role in various bodily functions, including maintaining bone density, cardiovascular health, and mental well-being. Discontinuing estrogen supplements can lead to several health issues, including heart problems, brain issues, and severe physical weakening.

Additionally, it is important to note that most trans women who have undergone surgical castration (castrated males without testicles) and ceased estrogen supplementation may experience a dramatic increase in body fat. This is because the body may attempt to produce estradiol through an alternative pathway involving estrone, which is produced in fat cells. However, this compensatory pathway may not be sufficient, potentially leading to adverse health effects.

Complementary Hormone Therapies

In such scenarios, it is often necessary for trans women to supplement other hormones, such as progesterone and DHEA. Progesterone can help with mood stability and reproductive health, while DHEA (Dehydroepiandrosterone) supports overall hormonal balance and can alleviate some symptoms caused by the lack of estrogen.

A personal example of these hormonal changes can be seen in individuals who have undergone medical treatments, like chemical castration. Testosterone levels can plummet, leading to severe physical and emotional challenges, particularly in the immediate aftermath, as the body rapidly adjusts to the new hormonal landscape.

Understanding Hormonal Variability

It is crucial to recognize that estrogen production in biological women is not exclusively or fully dependent on the ovaries. Many women also produce small amounts of estrogen through other tissues within their body. Similarly, men produce estrogen, and women produce testosterone, indicating that sex hormones have a reciprocal balance. The degree to which a person's hormones exceed those of the opposite sex often determines their perceived gender identity.

For instance, a woman might have higher levels of testosterone but still identify as a woman due to higher levels of estrogen. Conversely, a man could have high levels of estrogen but still have a prominent male identity due to higher testosterone levels. This reciprocal balance helps in understanding the complexity of gender and hormonal identity.

Conclusion

The decision to stop taking estrogen supplements is a complex healthcare choice for trans women. The potential health implications of such a decision highlight the necessity of well-informed, multidisciplinary care. Healthcare providers must consider the individual's overall health, hormonal balance, and psychological well-being before making such recommendations. It is also crucial to recognize that hormonal changes can profoundly affect the physical and emotional wellbeing of individuals who identify as trans and are managing their gender identity.