Transman Athletes’ Advantage: Testosterone Therapy - True or False?

Why don’t we consider them a part of the society? Who are they, why are the way they are, why these type of questions are raised in Indian society? In an interview with Aryan Pasha, he shared his views on this sensitive topic!

I have been always fervent to know about the transgenders, who are they, why are they the way they are, why in India they are actually considered as a source of Godly power, but at the same time condemned behind the closed doors; why on earth are they not considered a part of what we call as normal society; why don’t we consider them humans first, instead of calling them as abnormal, diseased or 3rd sex?

I had no idea of the meaning of terms like ‘gender dysphoria’, ‘sex reassignment surgery’, difference between transman and transwoman etc. It was through an interview with Aryan Pasha, India’s 1st transman (transitioned from female to male), for my channel ‘We R Stupid’, when I got to know about the existence of such terms.

The moment of pride came when he became India’s 1st ever transman to win a silver in a National Men’s Physique competition. I know how hard he had put in for the competition, as I was guiding him throughout his practice. But the apathy of the people, never left his side.

The most common query which arose was, “when he is on a hormone (testosterone) replacement therapy throughout, and will continue to do so, won’t that act as a straight advantage for him, as he is legally and medically taking anabolics?”

For a man who has a feminine or a masculine mind, it is impossible to even imagine, how he/she feels inside the body of an opposite sex. The social struggles one has to face in such a situation, despite of being a normal phenomenon is another story. But once, the person decided to take a bold step of revealing the world his/her true identity, he/she plans to take the next step i.e. a surgery called as the Gender Reassignment Surgery (GRS), also called as Sex Reassignment Surgery (SRS). But this is one of the most challenging steps the person could take, as in most cases it is irreversible.

Before a person plans to undergo SRS, there is an entire legal procedure to be followed, primarily of consent, but before that one has to ensure that the person is not suffering from Gender Dysphoria. Acc. to the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association, Gender dysphoria is a state where the individual shows a strong and persistent identification with the opposite gender. The individual has the belief of being born in the wrong sex.

Both the World Professional Association for Transgender Health (WPATH) and the Endocrine Society have created transgender-specific guidelines to help serve as a framework for providers caring for gender minority patients.

For female to male transition (what Aryan underwent), testosterone therapy is administered. The therapy used resembles hormone replacement regimens used to treat men with hypogonadism and most of the preparations are testosterone esters.

Acc. to the American Medical Association, the most common testosterone derivatives given are testosterone enanthate and testosterone propionate, via intramuscular injections. These are usually administered weekly, but if higher doses are needed to reach adequate physiologic levels, the dosing interval can be extended to every 10 to 14 days. Testosterone undecanoate is a long-acting testosterone that can be administered every 12 weeks and was approved by the FDA in 2014 for treatment of male hypogonadism, and it can be used off-label to treat gender dysphoria in transgender men. Transdermal& pellet options are also good alternatives for some patients.

What research by American Medical Association saw was that, the goal testosterone levels (male physiologic range) are 300–1,000 ng/Dl. Within six months of initiating therapy, higher doses are no more effective than lower doses

The general maintenance dose of testosterone is around 100-250mg every 14-21days. AMA suggests that, many trans men seek maximum virilization, while others desire suppression of their natal secondary sex characteristics only. As a result, hormone therapy can be tailored to a patient’s transition goals, but must also take into account the risks associated with hormone use.

Within three months of initiating testosterone therapy, the following can be expected: cessation of menses (amenorrhea), increased facial and body hair, skin changes and increased acne, changes in fat distribution and increases in muscle mass, and increased libido. Later effects include deepening of the voice, atrophy of the vaginal epithelium, and increased clitoral size. Male pattern hair loss also can occur over time

Other esters like test propionate or depot, are very short acting testosterone derivatives, so need frequent administration within 1-3 days, so are avoided in the case of hormone therapy.

Now, any person who has been remotely associated with the sport of bodybuilding or physique championships, knows that anabolics form a strong part of the competitive preparations. They work, and they work wonderfully well, that’s why they are used, and that’s why they are banned. However, if talk about the average doses used for a novice to advance athletes for different testosterone derivatives, then it ranges somewhere from 300-1000mg/week.

However, for a transman, who has undergone the SRS, a dose of 100-250mg test, every 14-21 days, just helps them in combating the female characteristics and maintain the male characteristics. In simple terms, this little test level, just makes them normal men.

So, there is simply no question of them getting any anabolic advantage whatsoever. For them to move on to the top level, even they would have to take a much higher dose of anabolics, which will just bring them to the same level as other male athletes. Winning depends on their persistent efforts, not their testosterone doses.

About The Author

Akshay Chopra

AKSHAY Chopra is a graduate from the prestigious National Defence Academy and the Air Force Academy. He was commissioned in the Indian Air Force as a pilot and has been the capt.... Read More..

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