Brain and Behavioral Effects of Female-to-Male Gender Transition Treatments

Female-to-male (FtM) drug treatments raise testosterone dramatically and suppress estrogen and estrogen receptors. GnRHa “puberty-blocking” treatments also suppress estrogen in females. Testosterone and estrogen are sex hormones, which affect the entire brain.

Transition treatments alter patients’ brain activity, brain structures, and behavioral proneness. The treatments may be extremely dangerous, especially for patients who already have conditions such as autism, attention deficit disorder or other brain-related disorders. They may impair social and emotional functioning, increase aggression, impair verbal abilities, and have other effects. Excerpts from medical studies are here.

The treatments may worsen autism

Female-to-male (FtM) drugs might trigger autistic-like disorders in females. If a female already has autism, then the drugs might make her autism worse.

Testosterone has been linked to female autism and psychiatric disorders: Females with high testosterone conditions have elevated rates of autism, and females with autism have elevated rates of testosterone-related disorders. This was reported by researchers from the U.K. in 2018 and Sweden in 2016. Researchers said in 2010 that high testosterone conditions might be a “biomarker” for female autism. Researchers began to correlate testosterone with autism in females back in 2007.

Researchers also linked high testosterone conditions to female psychiatric disorders and behavioral problems, including schizophrenia and bipolar disorder, borderline personality disorder, suicidal behavior, criminality, psychopathic traits, cognitive problems, mood problems, body dissatisfaction, risky decisions, and aggression.

Testosterone drugs impair females’ social skills: Researchers have done experiments where they gave testosterone drugs to biological females. The experiments show that testosterone drugs alter females’ brain activity, which in turn may impair females’ thinking and outward behaviors. Testosterone drugs impair females’ social cognition and decision making. They alter females’ moral judgment and decrease interpersonal trust. They might lead to social aggression. Researchers said in 2016 that their findings revealed “a neural mechanism” by which testosterone might trigger difficulties that are linked to autism.

FtM treatments suppress social brain activity: Researchers reported in 2011 that FtM treatments suppressed activity in social brain areas. The treatments also weakened connectivity (brain activity) among frontal, temporal, and striatal brain areas, which are associated with self-control, but strengthened connectivity among limbic brain areas, which are associated with aggression. Excerpts from other relevant studies are here.

The treatments are not FDA-approved

Testosterone drugs and estrogen-blocking drugs are not FDA-approved for gender transition purposes in females. An FDA panel said in 2015 that doctors should “prescribe testosterone therapy only for men.” In 2019, hormone experts said: “There are no clearly established indications for testosterone therapy for women.”

In 2016, the FDA warned that testosterone drugs were being abused by adolescents and adults. The FDA said that “abuse of testosterone…is associated with serious safety risks affecting the heart, brain, liver, mental health, and endocrine system.  Reported serious adverse outcomes include…depression, hostility, [and] aggression.”

The National Institute on Drug Abuse warned that paranoia, extreme irritability and aggression, delusions, impaired judgment, and mania could result from drugs that are “variations of…testosterone.”

The FDA launched a safety review of testosterone drugs in 2014 after federal studies linked the drugs to serious health problems. Experts noted that long-term safety data are lacking for testosterone treatments for women.

What can you do about this?

If you or your child got inappropriate transition treatments, then you may wish to take action.

File a malpractice claim: Click here to learn more about how you might file a personal injury or fraud claim, or lodge a complaint with the medical licensing board in your jurisdiction. Note: This site provides general information but does not offer legal advice.

File an FDA report: If you think that drugs were prescribed inappropriately or if a patient has already suffered problems that might be the result of FtM drug use—such as increased aggression, depression, anxiety, worsened autism symptoms, neurological problems or physical health problems—then please consider filing a report with the U.S. Food & Drug Administration (FDA). Click here for instructions and links to the FDA site where patients can report problems.

You are not required to give your child’s full name to the FDA. You do not need to be a U.S. citizen to file a report. You can file a report even if your child is age 18 or older.

Work to change our laws: The Kelsey Coalition and other organizations have been advocating for changes in laws to better regulate transition treatments. Click here to visit the Kelsey Coalition.