More on Testosterone

Those people who use their public platforms to argue that the case is not proven for testosterone (T) being a performance enhancer (PE) for genetic females, are either several studies short of a valid opinion, and/or are beating an ideological drum with one hand and with the other,  conducting a chorus that loudly proclaims all those who have concerns about women’s sports are ignorant and / or bigots.

 

There has been loud condemnation of an Otago University study which calls for a weighting system to be introduced to allow transgender women (TW) to compete fairly in female sports events.  This has been attacked by various people – including some extremely problematic claims of incompetence and /or bigotry. Some people have allowed their ideological fervour to cloud their judgment to the point where, if I were them, I’d be worried about a libel suit.

 

Jack Byrne, a human rights researcher at Trans Action, in an RNZ piece, cited a 2014  study  (drawing on data collected in 2011) that was published in The Journal of Clinical Endocrinology and Metabolism.

 

Byrne claimed the study showed "no clear scientific evidence proving that a high level of testosterone is a significant determinant of performance in female sports," and he further claimed that a literature review in Sports Medicine found no direct and consistent research that transgender female athletes have an advantage in sport. (1)

 

Apart from the highly selective nature of that quote, the 2014 study claimed no such thing and it is worrying that RNZ, as NZ’s flagship of quality journalism, seems either not to have read the study, or chose to ignore both its purpose and its findings. 

 

The study was concerned with “establishing valid normative serum androgen values” –  i.e. a standard reference range (SRR) for elite female athletes – "to help develop the blood steroidal model of the Athlete Biological Passport and by so doing, to improve policies around hyperandrogenism in female athletes." 

 

It was not directly concerned with the issues around transgender athletes who compete in female events; it did not screen for a Y chromosome, and nor did it carry out specific  diagnostic tests for polycystic ovary syndrome (PCOS) an endocrine disorder which elevates T levels and has implications for female reproductive health. 

 

The statement Byrne was drawing on is :

“With the exception of data extracted from doping programs in female athletes in the former German Democratic Republic (GDR), there is no clear scientific evidence proving that a high level of T is a significant determinant of performance in female sports.”

That data has been used both to demonise the GDR and as the basis for sports governing bodies' and the World Anti-Doping Agency's (WADA) ban on all anabolic and androgenic substances.

 

If that data is now being claimed to not be clear scientific evidence proving that a high level of exogenous T is a significant determinant of performance in female sports- then all criticism of the GDR should cease immediately because it has been exposed as pure agit prop.

 

But, the truth is that exogenous T is a potent performance enhancer in genetic females – for evidence of that you only have to look at what happens to the strength related athletic performance of trans men (genetic females who transition) who are granted an automatic therapeutic use exemption (TUE) for exogenous T use, and for whom there are no limits on that use in competition. (Obvious health implications aside)

 

There is also strong evidence to suggest that higher endogenous T levels enhance performance, in power events especially. 

 

 A study of endurance athletes cited in the 2014 study reported that the: 

“hyperandrogenic subgroup (T concentration 1.9 ± 0.2 nmol/L) showed a more anabolic body composition, a higher total bone mineral density (BMD), and upper to lower fat mass ratio as well as the highest maximal oxygen uptake and performance values in general than did oligomenorrheic or amenorrheic athletes with normal androgen levels (1.1–1.2 ± 0.4 nmol/L).”

 

The researchers also cited other studies that have reported an almost 2 to 1 over-representation of women with PCOS in female Olympic athletes (37% vs 20% in the general population). Importantly,  "the PCOS subgroup showed a higher T concentration and free androgen index than those observed for regularly menstruating or non-PCOS Olympian athletes.”

 

They concluded: 

“This last recruitment bias supports the assumption that there is an ergogenic effect of T in high-level female athletes.”  (2)

 

Although the 2014 study was not designed to diagnose PCOS,   the researchers felt that several of the athletes in the study had this endocrine disorder.  (3)

 

“In our present cohort, the 99th percentile for T concentration is calculated at 3.08 nmol/L. It is close to the 2.78 nmol/L threshold proposed as one of the criteria for the diagnosis of PCOS and the 3.0 nmol/L cutoff proposed by others to detect hyperandrogenism.” 

 

They also noted that the calculated prevalence of athletes with a hyperandrogenic 46 XY DSD in their cohort gave them a ratio of 7.1 per 1000.  Because they did not screen for SRY, they note that the actual prevalence of 46XY DSD was possibly even higher. (4) 

 

In light of studies that have estimated a 46 XY DSD occurrence at a rate of 1 in 20,000 in the general population, this study’s reported prevalence is approximately 140 times higher than expected in the general population.

 

The researchers noted that the 46XY athletes in their study tended to be younger and showed a higher T concentration than the female athletes who were known to have been doping.

 

In summary: the researchers noted the significantly higher proportion of elite female athletes whose T level was at or above the diagnostic level PCOS plus, what appears to be a highly skewed representation of athletes with a 46XY DSD.  (5)

 

It may be argued that this study does not categorically prove T is a PE for genetic females but it provides strong evidence to suggest it is nonsensical to argue that it proves it is not. 

 

The fact remains - and this is an issue the Otago researchers have tried to grapple with - if there were not separate events for women and men - in most sports, women would never make the podium. 

 

The background to this is complicated.  The IOC and IAAF adopted a quick and arbitrary solution to the complex organisational and ethical problems posed by both athletes with 46 XY DSDs and transgender athletes competing in female sports, which was to set a limit for all competitors in female events of below 10 nmols/L ie the lower end of the male SRR - unless athletes were able to prove they had complete androgen insensitivity.

 

This arbitrary definition was chosen in the absence of normative statistics of androgen levels in an elite athlete female population – hence the 2014 study.

 

A study "Serum androgen levels and their relation to performance in track and field" was commissioned by the IAAF after its hyperandrogenism rule was challenged in the Court of Arbitration for Sport. The study which has been criticised for methodological flaws, found there was a performance advantage to female athletes with higher endogenous T level in several track and field events, ranging from 4.5%  to 1.2%.

 

The IAAF/IOC then complicated the matter further this year by lowering the level to 5 nmols/L for some track events only, which was perceived as targeting a specific cohort of African middle distance runners, Caster Semenya among them. (6)

 

There is a range of factors which enable people to reach elite levels of any given sport; some are naturally occurring physiological advantages, others are cultural and socio-economic.  Sports is not a level playing field but the single biggest divider is the performance difference between female and male athletes – averaging 10-12% and rising to 25% in power events like weight lifting.

 

Against the blithe and often spectacularly ill-informed or ideologically motivated assertions that testosterone is not a proven factor in female athletic performance, transgender athlete Kristin Worley, who surgically transitioned in 2001, successfully argued for an increase, on health grounds, in the amount of exogenous testosterone her sporting body (the UCI) permitted her to take. (7) 

 

Others, like Rachel Mackinnon, argue that any imposed limit on endogenous testosterone is a violation of trans women’s human rights, ie only TW should determine their levels of androgen suppression, if any.

 

Clearly for both of these cohorts of people who went through a male puberty - in which the average athletic advantage that males have over females is triggered by testosterone - the amount of androgens and ratio of male to female hormones that their genetically male bodies need in order to be able to perform athletically and to maintain general health, is of great concern. 

 

Having had an orchiectomy, athletes like Worley no longer produce any appreciable amount of T naturally and some want to increase the allowed exogenous level to enable them to compete at a level commensurate with their competitive drive  - which may be highly problematic if, as some have argued, exogenous T is a more potent performance enhancer than endogenous T.

 

Some TW athletes, like MacKinnon, who have not had an orchiectomy see any requirement to reduce TW’s endogenous T to be unfairly discriminatory given other women have no imposition on their naturally occurring T. 

 

The point in question here is whether higher T levels and going through a T triggered and fuelled puberty – and possibly even the possession of the Y chromosome itself  - confers an average performance advantage (PA) over 46XX women. 

 

We may all agree that performance advantage is complex and multi-faceted and that the PA of trans women and 46XY DSD women with partial androgen insensitivity will not be as great as that of genetic males, but it is highly likely to be enough to skew female sports significantly – especially in events in which power and strength are major factors.

 

 

Notes:

(1) Byrne is not the only person to misrepresent this study; sports writer Andy Brown made the same claims in 2015 and the statement that a literature review finds gaps in the research into trans athletes is hardly controversial or remarkable given everyone knows there isn’t enough  – yet – and there needs to be.

 

(2)  They discounted congenital adrenal hyperplasia as a possible cause of virilization in the study cohort. “Among our studied population, none of the 13 athletes with a 17-hydroxyprogesterone serum concentration above 8 nmol/L showed increased T or A4 (data not presented), ruling out the possibility of an untreated 21-hydroxylase deficiency, the most common form of congenital adrenal hyperplasia, as a cause of the high T levels.

 

(3)  PCOS is an endocrine disorder which, in severe forms, has implications for overall and specifically reproductive health. Women with PCOS are either more likely to enter/succeed in sports, or possibly there is something about training regimes for female athletes (most rely on male data) which affects endocrine health. Another big question is where the incidence and/or severity of this endocrine disorder is increasing as a result of increasing exposure to endocrine disrupting chemicals in the wider environment.

 

(4) Four had 5α-reductase deficiency and two had partial androgen insensitivity.

 

(5) The androgen sensitivity levels of those 46XY athletes is not known but as athletes with 46XY DSD with complete androgen insensitivity are over represented in elite female sports the question has been raised at to whether the possession of a Y chromosome itself confers a performance advantage.

 

(6)Caster Semenya has refused to take androgen suppressing drugs to lower her endogenous T level to the new level of 5 nmols/L – which is still well above the top of the level for natal women.

 

(7) Worley’s claim and the arguments underpinning it should be noted by all those who have enthusiastically embraced the medical and surgical transitioning of children. If a post-pubertal orchiectomy leaves a person unable to maintain a general level of health, let alone be competitive in a sport, without higher exogenous T levels than are permitted by a sports governing body, what might happen to the overall health and wellbeing of children whose genetic puberty is suppressed with drugs and who have a counter puberty induced with cross sex hormones, and whose endocrine health thereafter must be maintained by constant doses of a mix of synthetic male and female hormones?

 

Child Care for Councillors

The management-governance split in local government that accompanied the Neoliberal "reforms" of the 1980s, gives paid officers and central government (CG) enormous power over local government (LG) spending.  CG sets the rules – local governance and management have delegated oversight of centrally determined regulations and a range of delegated responsibilities. 

 

Take out the remuneration of the Mayor, Councillors, the CEO and staff, plus the costs of the delegated responsibilities and regulatory role imposed by CG and, in districts with a small rating base, there's not much left to meet other demands.

 

In the largely rural district in which I live, the council recently voted on the issue of councillors’ allowances. The Remuneration Authority sets rates of reimbursement for use of private car, phone and any childcare expenses. Local councils can decide which of these they will implement. 

 

When my council voted on this, they unanimously voted for the car and phone allowances, and unanimously voted against childcare allowance. The only councillor who would have voted in favour of reimbursement of childcare expenses, was absent at a family funeral. 

 

I’ve been surprised to hear a large number of people, including women, argue along the lines of: 

"I had to tailor my career to the demands of childcare, so can they"; or, 

"I managed so why can’t they"; or,

"Other employers don't pay for childcare so why should my rates be spent on this."

 

This ignores the facts that only 6% of local government councillors are under 40, and one in three are women which is a situation we should be aiming to change. It also fails to account for the fact that family structures have changed and old community links have been shattered; most families can’t survive on a single wage, and many people have to work longer hours with greater inroads on personal and family time.

 

We will only get the best quality representation if we remove barriers to participation; otherwise we are governed mainly by those for whom there are no barriers. 

 

The argument that employers don’t subsidise childcare ignores the questions of whether employers should do so, and whether the state should stop committing so much money on  layers of highly paid managers and consultants, and subsidise childcare or – perish the thought – look at radical solutions like socialising it. 

 

The argument put forward in my district was that councillors are no different in essence from other 'volunteers' who don't get childcare allowances. 

 

All those who voted seemed oblivious, or chose to ignore the question that, if people get a car and phone allowance to enable them to serve as councillors, what’s the difference between that and reimbursement for what a parent might have to spend on child care to enable them to serve as councillors? 

 

If refusing remuneration for personal expenditure is a measure of commitment to service and acknowledges the unpaid work of volunteers, why did they not reject ALL allowances? Why pick on childcare?

 

That aside, councillors are not volunteers; they are elected officials who are remunerated for their service, at levels set by a central government body, and related to the population of the city, town or district. 

 

The same body also sets the pay range for CEOs, which establishes the baseline for the pay scales of the various levels of staff who are employed and managed by the CEO.

 

The CEO in my district – population 12,000 – gets a salary of $250,000 plus a car and other expenses. Fifteen senior managers earn between $100,000 and $200,000. 

 

The Mayor receives $90,000 pa (recently increased from $70k) and Councillors get $20,000, although that is increased if they chair committees.

 

Councillors in large metropolitan centres get significantly greater remuneration because it is decreed that demands on their time and the consequences of decisions they take may be proportionately greater.

 

The disaster of the Fox River landfill illustrates how problematic all these arrangements can become. A geographically huge district, with a low rating base, aside from its statutory regulatory and delegated obligations has to cater for a massive influx of tourists.  It put off dealing with a potential problem because it simply did not have the money to do anything about it. After a huge flood breached the old landfill and resulted in a mass pollution of a pristine river and shoreline, the council was also unable to pay for the clean up, which has to be taken over by central government.

 

How much more sensible would it be to have arrangements that would ensure local management and governance of a standard that could anticipate such disasters and have the funding to take steps to prevent them, or at least to have sufficient expertise and locally controlled funding to enable them to put right historical bad decisions before they become disastrous?

 

As a trade unionist, I look at it this way – councillors are paid elected officials who do an important job. They:

work irregular hours because meetings may have a scheduled start time but they can, and often do, run over; 

are expected to work unsocial hours, i.e. to attend night-time meetings and often do the equivalent of split shifts; 

are often required to respond to issues and to constituents' concerns outside normal working hours;

are on the equivalent of a fixed term contract with no guarantee of renewal; and,

may have interrupted their career progression in another field.

 

If people want to get their knickers in a twist about how their rates are spent, how about breaking with the good old Kiwi tradition of punching down and start looking up and thinking about how we can make local government more responsive to local needs including encouraging younger people and women to participate in governance.

 

A good start point would be to demand central government stops the iniquitous tax on a tax i.e. clawing back 15% from ratepayers in the form of GST on rates. 

 

Leaving that 15% in the council coffers could make a real difference to councils' ability to respond to at least some of the demands posed by climate change, for example.

 

Once Upon A Spectrum

Having an XX or XY sex chromosome is the biological norm and a foundational reality that is the basis of species reproduction. 

 

For those who inhabit the bubbles of technology, affluence and apparent choice, reproduction may not loom large in a world teeming with 7+ billion people, but for those outside the bubbles, it remains a more central and pressing reality. 

 

Numeric variations of the foundational chromosomal binary do occur; all are rare, some are extremely rare; some do not affect either reproductive fitness or wider health and well-being but most do affect reproductive fitness, and some have wider adverse outcomes for overall health and well-being, even causing death without the appropriate treatment.

 

The existence of a range of chromosomal and phenotypical variants on the XX: XY binary is used ideologically to claim that biological sex exists on a spectrum – taken by some to mean there are a number of different sexes. It is also used to justify the existence of a number of gender identities, some congruent with biological sex, some not. 

 

Although it is sometimes implied or overtly claimed they do, these numeric variants of the XX: XY norm do not constitute a range of sexes. 

 

The poor understanding of DSDs and the links between sex and gender can be illustrated by the claim made by the World Health Organisation, that it is possible for there to be people who have sex monosomy – i.e. only 1 X or one Y chromosome.

 

The truth is that, while a single X chromosome is compatible with life, (although known to be the cause of a large proportion of spontaneous abortions) – a single Y chromosome is incompatible with life. It would not make it past zygote stage, let alone to being a viable foetus.

 

Yet this claim has been repeated as fact in two major pieces here and here  on the transgender issue published by Stuff in the past year.

It may seem a bit nitpicky and a bit academic but it illustrates the way in which an ideology can harness science – in this case the existence of a growing list of numeric chromosomal disorders or variants – in order to influence a range of social policy decisions. 

 

In all of the above instances, the existence of DSDs is being used to strengthen the case for what is now seen as a "naturally occurring variation of human experience" – transgender identity. 

 

Gender identity is rather loosely defined as an individual's perceptions or subjective experience of being of a gender that may be 'cis' – congruent with their biological sex, or 'trans' – non-congruent, or neither. Given gender and sex are now used interchangeably, getting a grip on these increasingly slippery descriptors can be difficult.

 

There is an overlap between transgender and DSDs in that some people with a DSD may also be transgender but they are distinct phenomenon and it does no favours to either grouping for them to be lazily or opportunistically conflated in the way that the concepts of sex and gender have been to the point where they are so fused as to be politically and critically indistinguishable - which serves to undermine a key component of second wave feminist theory.

 

The change in the words that make up the acronym DSD illustrates this popularising and politicising of a scientific term. It used to be disorders of sexual differentiation and is now differences of sexual development. 

 

The descriptive umbrella term Intersex was coined to depathologise individuals born with a DSD, which is a valid strategy, but it may also serve to support a normalisation of a phenomenon for reasons that may not be benign or progressive.

 

For example, in a world saturated in endocrine disrupting (EDC) and DNA damaging chemicals, (DDC) if there is an increase in these conditions and others that are even subtler, it would not be surprising.

 

An increase in human genito-urinary disorders and a decrease in male sperm quality has been charted globally over the past 50 years, and we know there are profound effects of these chemicals on marine mammals.

 

We ought to be alert to the potential for snowballing effects on humans, given environmentally induced endocrine disruption is now widely accepted and evidence now shows that metabolic syndrome in horses is connected to the presence of EDCs in their food – most likely herbicide and pesticide residues.

 

The effects of any one of these chemicals on any given species or individual within that species, at any given point in the life cycle, are complex enough; the effects of thousands of chemicals in various amounts and combinations is a nightmarish unknown.

 

Mass chemical pollution is one of the three inter-related global catastrophes facing us. It would hardly be surprising if there were a variety of powerful entities with a vested interest in normalising chromosomal or autosomal disorders and other more subtle conditions, which may always have existed but the prevalence and severity of which are increasing. After all if these are all just naturally occurring variations in human genetics and physiology, then no-one needs to be held to account if they are increasing in incidence and severity.

 

Under significant pressure from the transgender lobby, which has a power and reach at complete variance with the claim of being the most marginalised and discriminated against of all minorities, the WHO has recently removed gender identity disorder  (GID) from its diagnostic manual, the International Classification of Diseases (ICD) – following the American Psychiatric Association’s influential Diagnostic and Statistical Manual’s  (DSM) 2012 replacement of GID with gender dysphoria (GD) – defined as the "emotional distress that results from a marked incongruence between one’s experienced or expressed gender and the assigned gender."

 

This move from a disorder – an illness,  to dysphoria – a non-specific state of anxiety or dissatisfaction, to a natural variation of human experience, combined with the almost complete fusion of the concepts of sex and gender, has huge implications, which I will explore further in another post.

Uterus Transplantation

I’ve been having a think about uterus transplantation. The view currently is that uterus transplantation is about to move from the margins to the mainstream – ie from experiment to viable therapeutic option. Forty-two uterus transplantations have been performed globally, resulting in twelve live births.

The women’s rights advocate in me can't help but wonder how many women and neonates have died easily preventable deaths during the period of this grand experiment? How much suffering could have been prevented or eased if the funds committed to this had been used differently? If a live donor liver transplantation costs around NZ$450k all up, it seems likely that a uterus transplantation will cost a similar amount.

In a world in which 100,000 + women die every year from birth related complications – most of them preventable – and over 1 million neonates die every year, also mostly preventable deaths, how ethically defensible is uterus transplantation for adult human females who have functioning ovaries but no uterus, let alone the additional implications of uterus transplantation into someone who was born reproductively male?

Given solid organ transplantation is usually carried out to save life, and this is not a life saving procedure in the sense that liver, heart and lung, kidney transplantations are, there are complex triaging and funding implications for publicly funded health services – whoever the recipient is.

In the UK it is considered that the reproductive aspirations and desires of male to female (MtoF) transgender women have equal weight to those of natal women so if uterus transplantation is available to the latter, it must also be available to the former given transgender people who have undergone gender reassignment are protected under the Equality Act (2010). To deny transgender women equal right to a uterus transplantation could be unlawful discrimination.

It seems only a matter of time before we have the first uterus transplantation into a transgender person since Hirschfeld’s medically ill-judged and ethically dubious 1930s experiment. Further, given the recipients are reproductively male, there is no reason why, prior to gender reassignment treatment, they could not freeze their own sperm, use it to fertilise a donor egg in vitro, and gestate their own biological offspring.

Uterus transplantation surgery is risky and complex; it involves extensive and very expensive pre- and post-operative care, and there are the potential adverse effects of immuno-suppressants on the foetus and the person who is gestating it.

These issues apply to uterus transplantation into genetic females who were born without, or who have lost their womb to disease/injury, but in people who are genetically male, there are the added challenges of the different shape of the male pelvis; (1) the positioning and vascularisation of a uterus in a body not designed to hold it; getting the balance of the gestational hormones right, and there are dangers of infection that are a common reason for pregnancy failures in women with neovaginas. 

Immuno-suppression treatment obviously results in a greater susceptibility to recurrent infections. A natural vagina contains epithelium capable of producing a number of protective mechanisms and microflora that help prevent infections which might compromise pregnancy. These do not exist in the penile or intestinal lined neovaginas (2) surgically created for transwomen, XY women, and genetic women born with vaginal agenesis.

To deal with this, researchers propose that a utero-vaginal transplant should be performed, using as much donor vagina and other structures as possible – using a technique similar to a radical hysterectomy with preservation of the vaginal branches of the uterine vessels, as well as a radical retrieval of ligamentous material to compensate for the fact that genetic males don’t have uterosacral ligaments.

This would seem to preclude the use of live donors in light of the fact that, while women might be prepared to donate a uterus they no longer need, (3) they would be highly unlikely to want to undergo such extreme surgery and lose most of their vagina, so a dead donor would be the most likely source.

However, there is a far greater likelihood of graft success from a living donor.  And here’s where it gets really thought-provoking. As interested parties have noted, there is a growing pool of live donors who might be happy to oblige, or be persuaded to oblige: FtoM transgender people – transmen.

The best uterus for transplantation is from a healthy young woman who has vaginally delivered a child, and that demand may be met by the growing phenomenon of transmen deciding to have children before undergoing "bottom surgery".

It is claimed that the development of a modified dissection technique has reduced surgical risk, and a reduction in surgery time from 12+ hours to between 4 & 5 hours reduces the risk of venous thromboembolism. The promoters of this technique claim that it "favours minimally invasive retrieval techniques which should enhance recovery and reduce potential morbidity further.” (4) (My emphasis)

As a bonus, given transmen won’t need their ovaries, they can be removed at the same time and the ovarian vascular pedicles can be repurposed to further facilitate the implantation.

This utero-vaginal transplant reduces infection risk, allows for easy checking of the health of the graft and, once the graft is fully operational, the implantation of an embryo etc.

Once the transplant is no longer needed – i.e., after a foetus has been gestated to the point of viability and is removed via caesarian section – the graft has to be removed which means further surgery to reconstruct the neovagina could be needed.

So, between five and twelve hours of reasonably high risk surgery for the donor; several days in hospital and several weeks before they would be fully healed; use of painkillers and possibly antibiotics; long term implications for general and musculo-skeletal health given scale of disruption to blood vessels, nerves, loss of ligamentous structures etc.

For the recipient, major surgery, lengthy recovery, big doses of anti-rejection and other drugs, complex doses of HRT to kickstart the uterus, plus constant testing for organ rejection, metabolic organ and cardio-vascular health over a minimum of 6 to 12 months, and the implantation of single embryos at a time, from a donor eggs, fertilised in vitro – itself a lengthy and expensive process.

This is the riskiest and most expensive of high-risk, expensive obstetrics. It’s stating the obvious that all surgery involves risk. No one should undergo major surgery unnecessarily – I include in that, appearance enhancement.

Nor should doctors encourage it – or see themselves as purveyors of commercial services – al la the US cosmedico who offered transmen a rebate on a mastectomy during Pride month. (I didn’t see any similar offer for a cut-price penectomy and orchiectomy.)

That aside, what are the ethical and legal implications of seeing transmen as a source of spare parts for womb-less women with neovaginas? Like the use of puberty blockers and cross sex hormones in neurologically immature young people, there are numerous ethical and political quagmires to be negotiated.

Let's stop and think about the reproductive aspirations of the new cohort of young transgender people who have not gone through their genetically determined puberty and who have had a counter-puberty forced by means of cross sex hormones in order to develop the secondary sexual characteristics of the other sex.

FtoM transgender kids who have been given puberty blockers and cross sex hormones are out of the personal reproduction picture; they’ve given up their genetically determined female sex function, and the male sex function - the production and delivery of sperm – can't be simulated by surgery or drug regimes.

They won’t be a source of donor eggs or utero-vaginal transplants as their eggs won’t have matured and their uterus and vagina will be that of a pre-pubescent child. Even if FtoM trans kids go far enough into puberty to produce mature eggs, both the collection of eggs and the long-term storage of them are expensive and have high failure rates.

Similarly, the sperm of MtoF trans kids will never mature and their male genitalia will remain child size and in fact, both cohorts will need to have their developmentally stalled sex organs removed early on as they are at increased risk of cancer if they retain them. Both will undergo complex genital and possibly other surgeries with all the physical trauma and exposure to drugs that involves, and they will be reliant on exogenous hormones all their lives.

MtoF trans kids who have never gone through male puberty, may look more conventionally feminine but to simulate part of the female sex function, the gestation of a foetus, they would have to go through highly invasive and risky surgery; be on immuno-suppressant drugs for at least a year to ensure the graft has taken, then go through a very high risk pregnancy for at least seven months while remaining on anti-rejection drugs, plus increased doses of female hormones, before undergoing yet more invasive surgery to deliver the baby and remove the uterus and all other transplanted tissue and make good any damage to the neo-vagina.

It would be disturbing even if the world weren’t teetering on the edge of ecological and social disequilibrium – the most likely outcome of which is extreme authoritarianism accompanied by a wave of social conservatism. 

1. The female pelvis differs significantly from their male counterpart, to the extent that they can be used to determine sex at autopsy.
2. Formed from the inverted skin of the penis or from tissue harvested from the bowel or inside of the mouth.
3. There is evidence that removal of a uterus, especially via a radical hysterectomy, can have profound impacts on women’s health.
4. Uterine Transplantion into Transgender Women

The Money Go Round

I've been reading some interesting stuff about the history of banking and how it was that fractional reserve banking and paper money came to be a big thing in the Anglo world and enabled capitalism.

 

Okay, since you asked. 

 

Fractional reserve banking (FRB) is where a bank holds in reserve just a fraction of what it lends out by means of bits of paper – bank notes –  that have no intrinsic value other than a promise to pay the bearer, in coin, the amount specified on the note.

 

Coin used to be made of your actual precious metals or alloys containing precious metals.

The idea of a gold reserve acted as a sort of monetary sea anchor but it became stretched when the paper money supply outstripped gold reserves, and was abolished in the digital-era to enable the money supply to expand massively to create global corporate capitalism's vast cyber-fortunes.

 

But, back in the day, a lender was supposed to hold enough actual cash in reserve to pay the holder of a note the amount specified, in the coin of the realm.

 

King Charles II, when denied a huge loan, appropriated all the treasures the rich had stored for safekeeping in the Royal Mint, and demanded a ransom – in the form of a £40k loan – for its return. 

 

The rich folk of London obliged him but thought "sod that for a game of thrones" and were a bit loath to expose themselves to that risk again.   

 

English goldsmiths – operating mostly in London – spotted a market opportunity and provided safe storage for the treasures of the rich – for a fee. 

 

(Poor people, who had sod all money and lived hand to mouth had no need of banks – what changes?)

 

Now, if you take a fee for a safekeeping service, the money you are safeguarding belongs to the depositor. You don’t have the right to on-sell, invest, lend out that money – that would be theft.

 

A couple of things happened here. As we know, the money you deposit in a bank is not the actual money you get back – it’s just the same value – you hope.

 

The precious metal in coins back in the day was not always very accurately measured and some had a bit more gold or silver than others. The London goldsmiths exploited these discrepancies and made a lot of bullion.

 

They began to lend out their fortunes and charged interest on the loans – but they lent it out by means of  promissory notes made out to bearer and thus paper money was born.

 

But there were constraints on this – while they needed to lend to the value of their cash (coin) reserve, they were limited in how many notes they could issue. 

 

They could look to increase their reserves by acquiring more coin, but the more coin they held, the more safe storage they needed, and the more vulnerable they were to theft. Coin is cumbersome in more ways than one.

 

Or they could operate on a fractional reserve, that  is lend out more by promissory notes than they held in reserve – which increased their risk because, if all the people they owed coin to demanded it all at the same time, the bank would go bust. The lower the reserve, the greater the return, but also the greater the risk.

 

At this point the goldsmiths were creditors in that they were owed loads of dosh in the form of the principal of the loans they made and the interest owed on them.

 

Then something really sneaky happened – the really big shift in banking was in the goldsmiths'  ability to utilise depositors’ cash as if it belonged to them.  And they achieved this by paying interest on deposits, and thus became both creditors and debtors.

 

At the time in England, interest was paid by the Crown on government bonds – latterly known as gilts. You loaned the Crown your fortune by means of buying bonds and they paid you a guaranteed bi-annual interest at 3 – 5 % per annum. 

 

The lower interest rate fund was known as the Consul – a long-term consolidated fund; the higher rated, shorter term funds were known as the four- or five–percents and they provided the very rich with a low-risk, guaranteed annual income, plus protection of the principal and they gave the Crown the money it needed to maintain the state's infrastructure, wage wars, expand empires, spend up large on estates, palaces and such like.

 

Someone who bought 5% government bonds with a value of £200k would get an annual income of £10k – a Mr Darcy sized fortune and worth millions in today’s money.

 

The Crown – as a seller of the bonds, effectively borrowing from investors – used the money as it saw fit as long as it paid out the interest and could repay the principal when required, both of which were necessary to ensure investor confidence and avoid being overthrown or beheaded.

 

When the London goldsmiths began to offer interest on deposits, they became borrowers and, as borrowers, rather than providers of a safe keeping service, they could claim a right to use the money deposited with them in any way they saw fit – such as lending it to third parties at a higher rate of interest.

 

They could not exceed the interest rate on a loan of 5% or so set by the anti-usury laws  (except to the Crown which might pay up to 10%) so they offered deposit interest of 2- 3% and a loan interest of 5% – making a profit from the difference and enabling them to put even more notes into circulation. 

 

They also got together and decided that, if they all accepted each others’ promissory notes at face value – they could reduce the risk they all faced of a run on their bank,  and they could safely keep many more notes in circulation.

 

These innovations of the City of London's goldsmith-bankers greatly increased the liquidity that enabled the growth of capitalism, created a mutuality of interests between the British Crown and other governments, and laid the foundations of the emergence in the early 19th century of powerful banking complexes that had and still have massive global reach and influence.

 

Ching ching.