Doctors cannot be trusted


No you cannot assume your doctor knows best or even tries to do what's best for you. These people are busy working and thus may not have much time to look up scientific studies, they just follow their education.

They also make a lot of errors which can be partly mitigated by making sure to always get a second opinion.

If the probability for your doctor giving one particular incorrect advice/diagnosis is X than the probability for two independent doctors making said error is X², this will mostly protect you iff most doctors actually give you a correct diagnosis or are inconsistently wrong (both diagnosis you incorrectly but differently).

A far better way to protect yourself is to actually look into the science for your particular condition yourself. Does what your doctor recommend fall in line with the science? if not then it's likely you are dealing with a quack or someone who hasn't bothered to update his knowledge since he/she recieved his education which can be decades ago.


Vitamin D effective in the case of covid-19
For some reason they seem very unwilling to use it even though it's safe and very likely to be effective



Chiropractors are quack
People have died due to not sticking to evidence based medicine, it's not just about the money and time wasted.



Genital mutilation
For some reason doctors seem to have a thing for mutilating genitals, possibly due to christian insanity (they view sexual pleasure as sinful).



Questionable transgender surgeries
I have noticed a general phenomenon in the trans community where people tell each other that bad surgery results isn't bad. Low regret rate does not mean the surgery was beneficial since people may tell themselves it was the right thing since it's irreversible. Even if the surgery was an improvement it's still likely they could have gotten a better result by going to a better clinic/surgeon.

This is a rather sensitive topic but ignoring the harm done by these surgeries wouldn't be ethical at all, trying to sweep these things under the rug isn't helpful.

There is also the general issue of the neo-vagina being created between the anus and the prostate which is very likely to make anal sex significantly less pleasurable, i have not heard anyone even talk about this, it's just an obvious issue i realized on my own.

To a very large degree the issue is simply bad clinics/surgeons butchering people. Most SRS results you can find when looking them up online are very bad but there are a few exception

Another option to consider is penis preserving SRS.

I dont see any real benefit with this when you injections or ethinyl estradiol alone supresses testosterone enough to the level of castrated men

This will also make you permanently infertile and thus the only way for you to have children willbe via sperm you have backed up.

Breast enlargement
If you look at natural vs enhances breasts you will see a very clear difference, you can tell it's fake when it's fake (few exceptions) and it doesn't look right

Compensating for bad HRT
Whats common with these questionable surgeries is that they are done because the HRT regime was bad or the individual simply started too late, no amount of surgeries will compensate for the fact that you didn't transition in time, this is why it's important to start early.


Is only 18% evidence based?
Even mainstream medicine is lacking when it comes to being based on good science. A lot of it is just an educated guess your doctor gave and often there are not even any good studies you can look at.

But in that study they classified psychiatric interventions as the highest grade, i have not found any good evidence in favor of any medical mental health intervention. Therefore we can conclude that the real number is a lot lower than 18%, even when recommendations are based on scientific studies these studies are often highly flawed.

A cochrane review rated 13.5% of the evidence as high quality


Who actually benefit from medical transition?
There is decent evidence in favor of MtF hormone replacement therapy.

MtF prior to transitioning
Body Image scale, 43.25
Quality of Life scale, 62.50
Quality of Sexual Life scale, 56.25
Interpersonal Relation-ship scale, 50.25

MtF after transition
Body Image subscale average score was 68.75 (p<0.05)
Quality of Life score was 72.2 (p<0.05)
Quality of Sexual Life scale score was 62.05(p<0.05)
The Interpersonal Relationship scale reported an average score of 75 (p<0.05)

FtM comparason
Despite being significantly more dysphoric prior to transitioning they did not improve as much in terms of quality of life. It seems like AFAB individuals where more reluctant to transition (less of them in the study, more dysphoric) but the ones that actually transitioned were very happy with the physical results regarding their bodies.
MtF Body image: +25.5
FtM body image: +41.4
MtF quality of life: +9.7
FtM quality of life: +5.5

FtM prior to transitioning
Body Image scale, 21.85;
Qual-ity of Life scale, 63.25
Quality of Sexual Lifescale, 50.25
Interpersonal Relationship scale, 50.02.

FtM after transition
Body Image subscalescore was 63.25 (p<0.05)
the average Quality of Life score was 68.75 (p=ns)
the average Quality of Sexual Life scale scorewas 56.25 (p=ns)
the Interpersonal Relationship scale average score was 81.25(p<0.05).

Most MtF individuals in the study probably didn't pass
This explains why their social relationships did not improve as much as FtM individuals, it was difficult for them to pass as the opposite sex.
Age: 32.7±8.8 yr
Height: 172±7.38 cm


Long term outcomes
The study above only laster a year, we do however have the following in the case of people who had transgender surgery


Of course not everyone have surgery and individuals who do not have surgery actually receive less treatments, these groups however are not equal.

People are required to be screened for mental health problems before gender-affirming surgery and might therefore have particularly high odds of mental health treatment in the perioperative year because of their perhaps involuntary receipt of mental health services. These individuals might be less likely to voluntarily seek treatment for mental health problems with greater time since surgery.


Why do some people regret transitioning?
The main reason causing regret is lack of social support.

The study above is however outdated (done 1998) and it did not study transexuals who did not opt for SRS, there is a very large (probably majority) who do not want SRS in the first place.

We found transsexuals to be more at risk for dropping out of treatment when they were MFs, showed more psychopathology, more GID symptoms in childhood, yet less gender dysphoria at application
So if you were more dysphoric as a child but it's getting better now you might not be the best candidate for medical transition. It so worth nothing that childhood gender identity disorder is largely defined as being gender-nonconformative 0 1 it's not surprising that many of these will later realize medical transition isn't for them.

Only non-homosexuals reported some regrets during treatment, and two during and after SR, which they all related to a lack of acceptance and support from others.
This is a general pattern we are seeing in these studies, social factors are the biggest factor when it comes to regrets and worse outcomes.

Overall, adolescents with poorer peer relations, poorer general family functioning, advanced age, and a female sex assigned at birth showed more behavioral and emotional problems, or lower psychosocial functioning. Thus, the present study confirms the important role the social environment - both peers and family support - play with regard to the mental health outcomes in this group. Consequently, incorporating the family and social environment into Transgender Healthcare seems crucial in order to adequately tend to the needs of adolescents with GD.

As we see the regret rate is dropping despite more people transitioning.

The FMs who applied for reversal were younger at application than those who did not(median 22 years compared to 27 years for the whole FM group). Conversely, the MFs who later applied for reversal were older when they applied for sex reassignment than those who did not (median 35 years vs. 32 years for the whole MF group). Since the group is small, these data must, however, be interpreted cautiously.
What many people ignore is that surgeries is more or less a requirement for AFAB individuals, you will not be taken seriously as a male if you do not have a penis or if your penis is very small. There is less need for surgery if you are AMAB and can pass facially without FFS.
It is worth nothing that surgeries (especially mastectomy) can leave visible scars which can out people as transgender.
Eleven FMs (28.9%) weresatisfied with their breast removal, 5 (13.2%)were dissatisfied due to the visibility of the scars,and 22 (57.9%) were not completely satisfied.Four FMs were satisfied with their metaidoio-plasty or phalloplasty. One FM was dissatisfied because of urinary problems, while four were not completely satisfied.
The dating market is changing
Old studies are misleading since what was true 10 years ago no longer holds
  1. now it's significantly harder to date as heterosexual male
  2. the transbian dating pools is a lot bigger making it easier to date as gynephilic trans female.
  3. dating as androphilic female is now a lot easier.
Because of that we can expect trans-females to have better outcomes when they transition while gynephilic trans-males will have significantly worse outcomes.


Puberty blockers
Puberty blockers are sometimes used to medically 'treat' precocious puberty in cis people, this is however very questionable

There is no good medical reason for delaying puberty (cis or trans), its done for social reasons. It's against christian moral dogma for young teens to be sexually active and people having early puberty may also be teased by peers.

It was only when puberty blockers started to be used to delay puberty in trans people (for no good reason) that they finally came under scrutiny and results are bad.

If children could get on HRT earlier there wouldn't be any need to use puberty blockers at all. Instead we would have the following 3 option

A: start full HRT before puberty. This has the advantage of allowing the individual to pass better as a female but the price is very high, the child will become sterilized for life and SRS will be significantly more difficult since there isn't enough tissue to work with.

B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.

C: have the child undergo puberty and delay HRT.

The following study does seem to show puberty blockers to be better than C but even then it can be strongly argued A or B would have been a far better option.

The methodology used was very poor so its not in any way a convincing result.

It is worth noting that its very rare for children that started on puberty blockers to desist, almost without exception they will proceed with cross-sex hormones meaning they will be infertile for life unless some medical advancement is made allowing them to somehow have biological children.

Spack has, he says, put “about 200 children” on to hormone blockers at the onset of puberty. Of these, 100% have gone on to take cross-sex hormones.

No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment.” These were out of 70 children put on hormone blockers.

What was the point in delaying puberty if they all ended up on cross-sex hormones anyway?

DreamGirlReb wrote:

B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.
This is what I would go for.

The puberty blocking route sometimes lead to awkward situations. Like having to use a breast prosthesis to keep up with the other girls in the class. And also change it regularly for correct size for the age. Kinda weird and fake and feel horrible to wear. But you have to do it as Its just to important to not miss out on teen years.


They can claim you have a cavity when there is nothing wrong with your teeth.

Do not let your children be alone with your dentist

Making sure to get a second opinion will mostly eliminate the risk of a dentist drilling in your teeth when there is nothing wrong with it, even if the second dentist also is a quack he will be unlikely to pick the same teeth to drill in, especially if they find multiple 'cavities'.


Dr will powers is a charlatan
He specializes in transgender healthcare and like to be a bit experimental when it comes to treatments, there isn't any good evidence in favour of his protocol so it's probably not ideal.

He have stated that he offers informed consent but that is only if you pass his psuedoscientific psych-evaluation.


He is good at sounding convincing at presentations

For example he sounded really authoritive when he claimed that "only 1 of 1500 had autogynephilia" when in reality "autogynephilia" is a normal aspect of female sexuality and very common both in cis and trans females, this really illustrates how poorly he has researched these topics.

It took me 60 seconds to find the study falsifying his claim regarding male genital mutilation.

Regarding the power method
Dr will power anecdotally observed that people had better results starting on oral estradiol, thinks this is becuase of estrone itself when it's far more likely it's simply becuase oral estradiol is less potent and thus you get closer to cis female puberty.

The only real advantage with starting with oral administration is that it's easy, injections are harder to do on your own (DIY) and not needed if you do not want to get a big dosage (even then transdermal might be superior).

Vandenberg (2006) found a non-monotonic response of size of breasts developed as a function of the dose of exogenous estrogen administered to ovariectomized female mice. Size of breasts was smaller in mice administered the highest dose of estradiol than mice administered an intermediate dose. The optimum dose for breast growth in humans can not be extrapolated from this study because metabolization of pharmaceuticals does not scale linearily with body mass and the growth of the human body is slower than that of mice. This result suggests the hypothesis that to maximize breast growth in transsex people it can be appropriate to use a lower dose of the estrogen or increase the dose slowly. However many HRT regimes rely on the estrogen to suppress endogenous androgens; therefore, starting with low dose of an estrogen potentially risks some degree of continued masculinization and sub-optimal feminization.

I would not recommend blindly following his protocal, you can do better than that

Constantly getting the science wrong
He claimed in one video that trans females have a the brain of the sex they identify as prior to transitioning, this largely false

There is zero evidence that "non-sexual dysphoria" would be needed to benefit from transitioning, in reality the amount of dysphoria and "belonging to a core group of transexuals" is a poor predictor of whether or not an individual would benefit from transitioning. See posts above.
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