Hormone Replacement Therapy … All the Flavor!

 

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Hormone Replacement Therapy … All the Flavor!

HRT can bring unexpected changes

Originally Published in "Prism & Pen", July 30, 2022

Photo by amirali mirhashemian on Unsplash

I recall one summer evening out for dinner with my former wife. I had come out to her as transgender several months prior but had not made any social transition changes over the intervening months. I had started hormone replacement therapy (HRT) about six weeks before that evening, at a low dose to see if it would improve severe gender dysphoria. My starting HRT had been the cause of a bit of distress, but that was mostly past us at this point.

We were dining at one of our favorite steakhouses, a place famous for its excellent cuts, pleasant setting, and superb service. We had a nice table for two, in a fairly private part of the dining room. I was looking forward to this dinner, as it both got to be a break from kitchen duties at home and I expected to have an enjoyable meal, my first night out in a few months.

We both ordered the prix fixe dinner, each picking different side dishes that we would share. This menu started with an appetizer, a soup or salad, the main course with sides, and a dessert. I ordered the house salad, a rare New York steak, asparagus for a side, and the dessert for that night, an apple cobbler. My partner got the house salad, a medium filet mignon, and the mashed potatoes, with the cobbler for dessert.

Now, there were additional sides on the main menu that were not part of the prix fixe dinner options, and that night these included a candied sweet potato dish. Now, I love sweet potatoes and asked the waiter to add this side dish to our order. We could share them, I thought, along with the other sides. I also ordered a glass of a favorite wine, a merlot to enjoy with my dinner.

The merlot tasted a bit different somehow, a little sharper than I expected, but with a nice velvety finish. The wine was quite good, with enjoyable flavors, so I certainly wasn’t going to complain. Shortly after that, the salad was served. This looked like the regular salad with the basil dressing that I had expected, but the flavor of the dressing had more bite than I remembered, and the basil flavor was quite strong. It was still good, but I thought it might just be a normal variation, perhaps some changes back in the kitchen in how things were being prepared.

We relaxed and chatted about inconsequential things in our lives after the salad, and a bit later the steaks and sides were served. The steaks were sizzling on their iron platters, dripping butter and steam rising, smelling quite delicious. The sides looked good as always, and that sweet potato dish, with butter, hints of brown sugar and cinnamon wafting from it, and crushed pecans glistening with sauce over the top, had me salivating.

The steak was perfect, with a hint of charring on the edges of a bit of the fat, that delicious butter and the meat almost melting in my mouth. The flavor was perfect, I could not have asked for anything better. I think this was the best steak I had ever had to this point in my life. The asparagus was quite good, that sort of “greens” flavor present and the hollandaise sauce spot on.

Then I tried the sweet potatoes.

Everything else had me primed by this point. I dipped my fork into that lovely sweet potato casserole, lifting out a fork-full of potatoes, glaze, and pecans. I raised it to my lips, catching that lovely cinnamon scent overlaying the rich buttery yams. I tasted it.

I paused. I couldn’t believe what I was tasting. This was so very, very good. A pulse of heat rippled through my body, radiating outward. I shuddered. I managed to set down my fork before I dropped it. That flavor rested in my mouth, on my tongue, and my body responded, repeatedly.

Yes, I think I was enjoying this meal very much.

My spouse was looking at me, head tilted slightly as she examined me, wondering why I was suddenly so quiet and almost frozen in place. I tugged at my napkin and tried to explain how very good I was finding this meal, and how particularly good the sweet potato dish was. She tasted a bit of this. “Yes, it’s pretty good.” Pretty good? I tried another fork full. Yes, damn good. Oh, not as surprising on the second tasting, no interesting orgasmic side effect, but damn good.

I tried to explain how the flavors I was experiencing seemed so new, more intense, and somehow brighter than the last time we had been there. I was starting to quietly wonder if perhaps my hormonal changes were involved, but wasn’t about to mention that out loud. I likely carried on a bit too much about how things tasted, in retrospect. This little conversation ended with the remark, “You’re weird.”

I enjoyed the rest of the dinner but kept quiet about the flavors and other aspects of the dining experience that might have caused a bit of distress.

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I know. I’m weird. I also know I’ll never forget that dinner.

Fun with Definitions — Woman: Adult Female Human, not Adult Human Female

 

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Defining “Woman” in Three Words

Words matter. Understanding the meaning and implications of a phrase matters, too

Originally Published in "An Injustice!" July 28, 2022

Photo by Waldemar Brandt on Unsplash

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Let me make this perfectly queer. We are all, first and foremost human beings, people with inherent worth and dignity. Whether straight or queer, lesbian, gay, bisexual, transgender, intersex, ace, two-spirit, or any of the other myriad variations of gender orientation and identity, we are human beings, people, all in this world together. I believe that each and every person is important and that people should be treated fairly and kindly. Sadly, not everyone believes this, and I’ve seen language and words twisted in very odd ways in what appears to be an attempt to construct harmful ideas.

Words have meanings, of course. Words form our expressive map to describe and interact with the world around us. As we discover more about our world, we have added new words and extended the meaning of existing words incorporating new things we have learned about our world. This has added some complexity to our language as we have to interpret words in the context in which they are used. “Charm”, for example, may refer to the power or quality of giving delight or arousing admiration, may refer to a small ornament worn on a bracelet or necklace, or may denote a variety of unstable quark having an electric charge of +2/3.

We interpret the word in the context in which it is used. Should someone complement my charm, I am unlikely to believe that they admire my collection of unstable quarks. Our interpretation necessarily depends on the context and setting in which it is used. Social interactions are unlikely to be using meanings of language normally confined to laboratory and scientific papers. Definitions and descriptions similarly use words in the sense that best relates to the common usage of the words being defined and the things being described.

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Defining a woman

“Woman” is a word, with three consonants and two vowels, the English translation of the Proto-Indo-European word “*gʷén-eH₂”. The word is generally used to describe an adult human being who presents a set of observable characteristics or traits, the phenotype, corresponding to what the culture using this term considers to be in the female range.

Note that the term is typically used by other humans who lack any inherent capability to immediately examine alleles, karyotypes, or details of anatomy concealed by clothing or internal to the body, and is generally used without requiring detailed medical examination or medical laboratory analysis.

The word “woman”, like other words in English and other languages, does not predate the existence of the entity being described. The word is simply a symbolic mapping of the actual referenced entity. Words, like maps, are useful references but should not be confused with the actual entities or terrain.

One can erase or alter a map, yet the actual terrain remains unaffected. Similarly, one can attempt to alter the definition of a word in various ways, create new words, or try to erase words from the language, but the actual entities will persist.

I, for example, have a phenotype typical of an adult human being, and am typically referred to as a “woman” by others, who rather cavalierly apply the term without even insisting on genetic testing or a computer-aided tomography scan! It’s mind-boggling, I know, but some humans don’t overthink and agonize over the words they use in their everyday speech!

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“A woman is an adult human female” is a problematic definition and sentence.

I see t-shirts with this statement or a variant styled as a dictionary entry, which I understand has even appeared on billboards. It sounds obvious to many folks, at first glance, but that predicate has an interesting structure. I cannot help but wonder if it was deliberate.

In English, sentences can be built from a subject and predicate. The subject, “woman” is followed by a predicate consisting of a verb, along with a direct object and modifying or qualifying adjectives. In this sentence, “adult” and “human” are placed as qualifiers before the direct object, “female”.

The sentence reduces to a statement that a woman is a qualified form of “female”, which is used as a noun here. The words “adult” and “human” are here used as qualifiers, adjectives illuminating or qualifying the following noun. Why is this problematic?

I avoid female in my own writing because it feels disrespectful, as if I’m treating the people I’m referring to as mammals but not humans. — Deborah Tannen, professor of linguistics at Georgetown University

If we examine the dictionary we can gain a sense of why using “female” as a noun in this definition of woman is troubling.

female - noun

a female animal or person:

The kitten was actually a female, not a male.

Females (= women) represent 40 percent of the country’s workforce.

used to refer to a woman in a way that shows no respect:

I suspect the doctor thought I was just another hysterical female.

When used as a noun, “female” connotes a biological category, while a “woman” is a whole human person. Emphasizing the biological category rather than their being human beings has a subtly deprecating effect. This is nothing new, of course. People have deliberately referred to women as “females” for comedic or condescending effects for a long time.

What these females have to understand is…

Why would we go to so much trouble over a female?

Oh, females are always doing that sort of thing.

These sort of phrases seem to be making misogynistic statements and use “females” deliberately rather than “women” to emphasize this. No, female as a noun referring to a person just doesn’t cut it outside of a narrow scientific or technical scope.

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“A woman is an adult female human”

Here, the direct object is “human,” and I am more comfortable with that. The words “adult” and “female” are used as qualifiers and adjectives to illuminate and further define humans.

I know that I am a human being, first and foremost. Let’s look at how these qualifiers fit me in my everyday life and interactions with others.

Adult as an adjective is defined by the Merriam-Webster dictionary as “fully developed and mature” This word describes a broad category that I likely fit within, as a downright overdeveloped and certainly mature senior citizen.

Female is another adjective describing broad categories, with several definitions in the Merriam-Webster dictionary.

• “of, relating to, or being the sex that typically has the capacity to bear young or produce eggs.”

In my day-to-day social interactions, the topic of my ability to produce eggs has never come up. It might conceivably matter if I were being considered as a donor for in-vitro fertilization procedures, but that is something I would never be discussing with strangers or casual acquaintances. I have the appropriate gross phenotype, blood chemistry, and such, but atypically yet not uncommon at my age, I am out of the gamete production business. This is one of those laboratory or scientific definitions that don’t work well in common daily use.

• “having a gender identity that is the opposite of male.”

I certainly do not have a male gender identity and certainly feel that I am at the far end of the gender spectrum from male, so this applies.

• “made up of usually adult members of the female sex: consisting of females.”

This definition seems to be a bit circular and applies to groups or sets of people, so I’ll just pass on this one.

• “characteristic of girls, women, or the female sex: exhibiting femaleness.”

Well, yes, I do present pretty typical characteristics of an older woman, so this would seem to apply. This definition also has a hint of being circular and appears to be all about gender performance and roles.

• “designed for or typically used by girls or women.”

Well, no, I’m not an object, so this doesn’t apply to me.

• “engaged in or exercised by girls or women.”

Yes, I engage in some female pursuits and activities, but, this feels a bit stereotypical, another reference to gender roles.

• “Having a quality (such as small size or delicacy of sound) sometimes associated with the female sex.”

I suppose so. I’m moderately small compared to many of my friends. I’m not sure my ancient voice is all that delicate anymore, and the choir director is likely to agree!

As I am neither a rhyme nor a hose coupling, the remaining definitions certainly don’t apply, either.

The noun “Human” seems appropriate enough, as we are first and foremost human beings. Human as a noun is defined as

• “a bipedal primate mammal (Homo sapiens): a person: MAN sense 1c — usually plural.”

Man in this reference is defined as:

• “a bipedal primate mammal (Homo sapiens) that is anatomically related to the great apes but distinguished especially by notable development of the brain with a resultant capacity for articulate speech and abstract reasoning, and is the sole living representative of the hominid family.”

This is also a broad definition intended to identify a category of beings. While it does exclude some folks I know who are not bipedal and others who have a great deal of difficulty with articulate speech and abstract reasoning, as a category, we recognize that some individuals may not fully conform to the definition. As with other words that broadly describe categories, it is possible to see past the limitations of the dictionary and grant others the benefit of the doubt concerning membership in the category of “man.”

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In the social environment

Within our normal social activities out in the world, the details of our zygote production capabilities do not typically come up. I know that the topic has never come up when ordering breakfast, and even in as intimate and personal an activity as using a restroom, I have never had to explain such details of personal biology to anyone else. Certainly, I have never had to provide a cheek swab and blood sample to a random stranger on the street before they would regard me as a woman.

In the social environment, we rely on the same interpretations for ‘woman’ and ‘female’ as we have used for millennia in categorizing people we encounter, estimating by gender performance, the gross physical appearance, wardrobe, and movement a person presents. We have no real insight into whether or not other individuals have a functioning SRY gene or a particular karyotype. We don’t have access to an inventory of organs for every other person, nor do we pull a medical case history from every individual we meet. We rely on the social definitions of these words in describing ourselves and the world rather than the variations we might use in the confines of the laboratory.

Woman? Very simple, say those who like simple answers: She is a womb, an ovary; she is a female: this word is enough to define her.

— Simone de Beauvoir, “The Second Sex”, 1949 (2011 translation)

This is a simple answer. It is also effectively useless in the social environment unless one chooses to leave a trail of outraged people in their wake. This sort of reductionist answer, limiting the concept of a woman to reproductive function, offends when actively applied in the social environment. It assumes a degree of intimacy hardly warranted for casual social interaction.

From a man’s mouth, the epithet “female” sounds like an insult; but he, not ashamed of his animality, is proud to hear: “He’s a male!”

- Simone de Beauvoir, “The Second Sex”, 1949 (2011 translation)

Confining the definition of a woman to her sex is insulting. A woman is, first and foremost, a human being with all the glorious incongruities, foibles, and majesty that come with being human.

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“Woman: adult female human.”

For those who must have a simple answer, who are capable of understanding that we all live within a social environment and not a laboratory and thus should use socially oriented definitions of these words, this becomes a marginally acceptable definition. It is also similar to the definition the linguists at Merriam-Webster have come up with, “an adult female person”, and the Oxford definition of “an adult female human being.” These dictionary definitions of “woman” as a category are necessarily terse and broadly descriptive yet limiting. They hardly constitute a checklist for who does or does not qualify.

I don’t care for the simple sound-bite-sized definitions. Humans are amazing complex, and the vast category of women within humanity holds a world of variations and differences. There is far more to any woman than a few words can describe, from our paths through life, our particular lived experiences, our associations with others, to our deepest thoughts and desires. We are none of us the same, and none of us can be held in toto by a few words in a dictionary entry.

We always have to keep in mind that words form our expressive map to describe and interact with the world around us. As we discover more about our world, we have added new words and extended the meaning of existing words to incorporate new things we have learned about our world.

Further reading

Simone de Beauvoir, “The Second Sex”, Editions Gallimard Paris 1949, Vintage Books May 2011 (English Translation by Constance Borde and Sheila Malovany-Chevallier, 2009)

Alex Byrne, “Are women adult human females?”, Springer Nature B.V. 2020, published online: 6 January 2020 https://philarchive.org/archive/BYRAWA

Maggie Heartsilver (pseudonym), “Deflating Byrne’s “Are Women Adult Human Females?”, “Journal of Controversial Ideas”, published: 25 April 2021. Deflating Byrne’s “Are Women Adult Human Females?”https://journalofcontroversialideas.org › pdf

Mikkola, Mari, “Feminist Perspectives on Sex and Gender”, The Stanford Encyclopedia of Philosophy (Fall 2022 Edition), Edward N. Zalta (ed.) https://plato.stanford.edu/archives/sum2022/entries/feminism-gender/

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An Injustice!
A new intersectional publication, geared towards voices, values, and identities!aninjusticemag.com

Yes, Gender is a Social Construct, and…

 

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Yes, Gender is a Social Construct, and…

Originally Published in "An Injustice!", July 20, 2022

We’ve all heard this phrase. There is an assumption that anything which is a social construct is, therefore, artificial, which ignores how social construction works

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Image by the author; text from Arroyo v. Rosselló (2018)

We’ve all heard this phrase. “Gender is a social construct” is a catchy little phrase, only five words, practically tailored for a bumper sticker or campaign button. It’s simplistic, easy to understand, and problematic when used as an ideological foundation element. There is an assumption that anything a social construct is, therefore, artificial, ignoring how social construction works.

Social construction is simply the joint development of understanding the world that forms our shared assumptions about reality. We socially construct meanings that we attach to words to communicate. The fun starts when one party alters the meanings behind a word without communicating that fully to others, breaking the shared assumptions and producing communication failures. This may occur by accident or with malicious intent.

I view gender as the social construct by which we perform a part of our identity which we wish ourselves and others to see. There are two pieces to this, the performance and the identity.

Breaking Down Gender: Gender Performance and Identity

The idea that gender is purely performative, that we ‘do’ gender solely for others, is a persistent oversimplification of a complex matter. It makes constructing philosophical cloudscapes much easier, but it is not reality.

We all know that our assigned sex at birth comes from what folks observe between our legs, the shape of bits of tissue that originate way back in the first few weeks of fetal development. A complex dance of messenger proteins and genetic origins is involved to produce this. There is a tremendous range of possible outcomes in measuring and describing these bits of tissue. Collections of such measurements from a population of humans will produce a “bimodal distribution,” a range of outcomes with two distinct peaks or normative values.

Bimodal Distribution — This file is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.

We, humans, love our dichotomies, binary classifications, and Either/Or choices. In the case of sex at birth, the social agreement is to ignore all the measurements that aren’t quite close enough to those normative values and pretend there are precisely two results. We are assigned one of these two socially constructed labels.

Many folks do not realize that much evidence points to a nugget of gender identity that is also formed, many weeks later in fetal development, deep in the structures of the brain that interface with the body. Again, a complex dance of chemistry and biology drives the production of the bits of neural tissue that hold this nugget of gender identity.

Sexual Differentiation of the Bed Nucleus of the Stria Terminalis in Humans May Extend into Adulthood

Almost all of the brain is essentially identical across male and female persons. There are several dimorphic regions with overlapping but slightly different average characteristics, mostly related to regions of the brain that handle body regulatory functions, olfaction, and visual-spatial skills. It’s also worth noting that very few people have measurements close to the normative values for their sex for all of these regions. We are all, it seems, a bit of a mixed bag.

The bed nucleus of the stria terminalis, a bit of the brain involved in reflexes and body movement control, is one of these dimorphic regions. Curiously, this region varies across gender identities. In the small number of samples dissected to date, the region appears similar in both natal and transgender men and is different in both natal and transgender women. This similarity between natal and transgender persons is present before any medical transition is done by the transgender person. Now, this is a correlation, not causation. Correlation doesn’t imply causation, but it waggles its eyebrows suggestively and gesture furtively while mouthing ‘look over there’.

This biological nugget of gender identity is problematic for much of Western philosophy and theology. For centuries, it has been widely argued that there is a Cartesian duality, a split between mind and body. This argument is a handy way to construct theological cloudscapes of the mind or spirit somehow being detachable or independent of the body, which in turn permits the argument that the mind is infinitely flexible in its independence, able to overcome any limits or issues of the body.

The popular interpretation of gender as purely a social construct is related to this mind/body duality. It enables the claim that gender arises from the infinitely flexible mind, and therefore gender is merely a socially imposed thing. Oh, and since the mind is infinitely flexible and separate from the body, it should be possible to apply conditioning to alter the mind’s idea of gender identity to match the body.

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I argue that there isn’t a mind/body duality, but rather that the mind is part of the body, a sort of emergent phenomenon that arises from the operations of the brain, capable of learning and adjusting, indeed, but bound to the capabilities and characteristics of the brain and not infinitely malleable.

While I would agree that gender roles and gender presentation are certainly social constructs, I argue that gender identity is not but rather arises from the brain, a deeply seated phenomenon impacting the mind that develops in the brain.

If gender identity itself were merely another aspect of an infinitely malleable mind, then psychological persuasion or coercion techniques should be able to alter that gender identity. So-called “conversion therapy” would work, rather than simply terrifying the subject into concealing their gender identity. I know from personal experience that it does not work.

If gender identity was not seated in the depths of the brain but imposed from without, then changes in the imposing stimuli should cause the gender identity to change over time. Dr. John Money attempted this, most notably with the involuntary gender reassignment of the child David Reimer, which despite his initial claims, failed miserably.

John Money (8 July 1921 — 7 July 2006) was a New Zealand American psychologist, sexologist and author… (link to wikipedia.org)

David Reimer (born Bruce Peter Reimer; 22 August 1965 — 4 May 2004) was a Canadian man born male but reassigned female… (link to wikipedia.org)

Dr. Milton Diamond refuted Dr. Money’s claims that males and females were psychosexually neutral at birth, and that nurture could alter gender identity.

The John/Joan case was the unfortunate story of a set of normal identical male twins. They developed a penile condition called phimosis, which is a closing of the foreskin, so it becomes difficult to project the head of the penis. It can make it difficult to urinate and the closed foreskin can accumulate dirt and gunk. To correct this condition the boys were sent for circumcision. Instead of the circumcision being done with a knife and bell clamp as is typically done, it was done with a cautery, a device that basically uses a hot wire to cut. Surgeons often like to use such an instrument in surgery because the heat also closes off any cut blood vessels. In any case, there was an accident and the penis of the first twin was burnt off. For privacy sake, in our publication, we called him John when living as a boy and Joan when living as a girl. The parents anguished about the decision of “What to do now with John?” What could be done for a boy without a penis? The local physicians they consulted recommended he have later cosmetic surgery to fashion a penis. However, they saw Dr. John Money on television telling how a male (transsexual) can have surgery to live as a contented female. He was then consulted. His solution, with the basic idea that males and females were psychosexually neutral at birth, and any male without a penis would be better off living as a girl and then as a woman, led him to recommend that the child be given appropriate sex reassignment surgery and raised as a girl.

The parents followed Dr. Money’s advice. This sex reassignment included removal of the child’s testicles and scrotum, and preparing him, to have a vagina. The parents did the best they could to raise the child as a girl we called Joan. As the child grew up, however, Joan began to look around and say, “Well, they’re calling me ‘girl’ yet I’m more like my brother than I am like the girls around here.” “My parents are calling me girl and I have a girl’s name but I’m not like any girl I know. I think more like a boy and prefer to do boy things.” But there was a long transition stage before Joan would come to refuse to live any longer as a girl. First off, not only did Joan realize something was amiss, so did her school mates. They teased her for the incongruities between her male-like behaviors and her female-dress and appearance. They called her Gorilla since they saw the male in her behavior and demeanor. Finally, despite the absence of typical male genitalia and the administration of female hormones to induce breast growth and feminine hips and fat deposits, Joan decided she could no longer live as a girl. She had to live as a boy. After the switch she was called John instead of Joan. After the switch Joan was eventually received better as John than as the girl she had been led to believe she was.

With psychiatric help and hormone therapy in addition to the surgical removal of his breasts and construction of a penis, John developed into a mature man, married in his twenties and adopted his wife’s children.

— “A Conversation with Dr. Milton Diamond”, Dean Kotula, Pacific Center for Sex and Sexuality (2011)

Unfortunately, at age 38, David Reimer committed suicide after suffering from severe depression.

Gender identity can reassert itself despite social pressures. If not congruent with the gender role or presentation imposed by society, it can result in considerable discomfort, as some of us have experienced.

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Yes, gender is a social construct, and gender performance is the socially agreed upon means I use to express my gender identity. This fragment of my identity is informed by a few bits in my brain near the hypothalamus formed late in fetal development.

I perform my gender not to please society or to please others, but to be in alignment with my persistent gender identity. I have built a gender role and presentation for myself that removes my discomfort and better aligns the elements of my gender.

While I have gone to some lengths to explain my conceptualization of the origin of my gender identity, how I come to be this way is far less important than understanding that I am, that I exist, and that the identity that I hold and express is valid, my truth, and dwells as part of the core of my identity.

As one social construct to another…

I see no reason to hide my truth, to pretend to be that which I am most emphatically not, simply to live my life in this world. I expect to continue living and loving my life far into my future.

An Injustice!
A new intersectional publication, geared towards voices, values, and identities! aninjusticemag.com