#priapism

Strangely enough, people of all genders and genital configurations can get this condition (painful erections that last too long). Cis women and trans men just get it way, way less frequently because of their anatomy.

(Re: this ask!)

We have no reason to suspect that T increases the risk of this. While it’s possible, there’s nothing to indicate that such a possibility is reality, and absence of evidence is not proof.

A good rule of thumb on if there will be studies for something is “can people make money off of knowing this”. Studies are hard to run and hard to fund; very few people devote months or years to a topic out of pure whim, and trying to secure funding is a difficult and extremely competitive process to the point where some people write grant proposals as their entire job. If you’re curious, this is a good breakdown of what’s involved in even getting from the initial idea to the proposal. It’s geared towards clinicians, but that’s applicable here; nobody’s writing their PhD english lit dissertation on incidence of priapism in trans people.

This is also why so much of our (general our) knowledge about medical transition and trans healthcare is hard to source. The absolute most basic things are easier—there are studies and meta-analyses of dosing for hormone therapy, for example, or the most basic effects of HRT. Sometimes trans people are included in examinations of mental health in LGBTQIA+ populations; even more rarely, we get our own examination. But something specific like, say, “how likely are trans people on T to go bald if they have a family history of doing so”, that’s something we can’t source for you.

We can root our answers in science we do understand—for example, we can look at inheritance in cis men and go okay, trans people still have genes, and to the best of our understanding T works in a similar way to how cis perisex men go through puberty, and the differences don’t seem like they’d apply here. We can also look at other people’s experiences; when I answer questions on here that I don’t know the answers to offhand, I usually spend 30 minutes to an hour going through support communities to see if I can find other people who experience what the asker wants to know about so that I can compare that information with what broad-stroke medical information I can find. Something like priapism, that has a variety of causes, many of which we can’t identify or don’t understand—that’s where it’s extremely difficult to even guess at if it could be influenced by HRT. I picked the baldness example because there’s 1) an established interest in the mechanics of inheritance 2) a large pharmaceutical market for preventing/treating baldness and 3) enough of a population of trans people on T who’ve experienced this for us to know that it can sometimes happen.

(This is also a good thing to think about when you’re evaluating studies. Authors are supposed to disclose conflicts of interest—like, say, funding from a company that makes a certain drug for a study where they just so happen to find that the drug is effective.)

While there’s an interest in treating priapism in a medical setting, the priority isn’t going to be trans people, it’s going to be cis men. I wouldn’t expect there to be any research on us until the causes of it in cis men are very well-explored, and I’m not aware of any current studies on it in us at all. I would love to be proven wrong in case I missed something, but I run through all of this post to give you and other people here some context as to why a lot of our answers boil down to “well, we think this could happen, but we’re not sure, and if it happens to you let us know”. Priapism is particularly hard, because we know a whole bunch of causes and risk factors for it (cancer, medication, sickle cell anemia, etc.) but a lot of cases are idiopathic, and it happens so uncommonly that there isn’t as likely to be a market for treating it—or enough cases to isolate trans people as a specific subpopulation to examine. Hence the first (second?) paragraph of this post—we don’t have scientific evidence to suggest it, but we also don’t have enough informal accounts of it happening in trans people to even begin to guess.