"I don't know how to treat you”: Testosterone and gynecological care for transmasculine and gender diverse adults
the science direct article FULL STUDY. there is so much in this article that I don't even know where to start in pulling out highlights because the entire thing feels like it's made up of them.
So instead i'll just drop the "what did we learn?" portion of the summary that was released by the PRIDEStudy research. (links to the summary/press releases for all the pridestudy research since 2019. i suggest ctrl-f)
Participants most often discussed these topics as most important to them:
genital atrophy (thinning and dryness of genital tissue), and
repeat infections, such as urinary tract infections and yeast infections.
Many participants had doctors who didn't know how to help them because they were on testosterone. As one participant's doctor put it plainly: "I don't know how to treat you."
We found six connected patterns in what people told us:
1. Erasure – Healthcare systems, research, and providers often failed to recognize or account for transmasculine bodies and identities. This included:
experiences with systems not built for transmasculine patients,
a lack of research and provider training, and
providers making incorrect assumptions about participants' body parts or identity.
2. Authority of knowledge – Providers trusted test results over what patients knew about their own bodies. This left many participants feeling dismissed even when they had clear symptoms.
3. Navigating uncertainty – Confusion, for both patients and providers, about whether symptoms were caused by testosterone. There was also a lack of guidance on long-term effects of using testosterone.
4. Prolonged and fragmented care – Being sent through repeated referrals and rounds of testing, sometimes for years, without ever getting a clear diagnosis or explanation.
5. Cumulative exposure – The toll of these experiences built up over time and led to exhaustion, medical trauma, and, for some, avoiding care altogether.
6. Resistance and agency – Participants proactively used different approaches to try to receive good care, including:
advocating for themselves,
using community networks for trustworthy information, and
trying non-medical treatments.
Participants found real relief, validation, and joy when they did get good care.
(*the summary only discusses transmasculine, not everyone who needs gynecological care and is on testosterone hrt is transmasculine, not every trans person who was afab is transmasculine. there is more than just transmasc and transfem.)
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