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Thank you so much Sue Donym. This is has been written with care and detail and a thoroughness that is astounding. This whole issue of the medical aspect alone could be a book. I've been haunted by it since I stumbled upon it in 2017; I was given AbbVie's Depakote as a teen and developed anorexia, among other things. I also joined a support group for Lupron victims on Facebook even though I'm not one myself, but feel such empathy with what they've been through. Please let this be **the thing** that breaks through to people the horror of this movement. I hope that your calling attention to this will help to get us there.

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Good grief. This is even worse than I previously thought - and I already thought it was a disaster.

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its a dangerous business (and apparently lucrative). i wonder which came first, naming children 'deviant' and in need of change if they play with the wrong kind of toys (new for dsmv 5) or the drugs (not properly tested on children). it reminds me of the growth hormone scandal - when children deemed 'too small' were medically treated so they might 'grow up' to be the 'right size'. of course that didnt work - but funding and research happened. am i being too cynical? can doctors/funders/the writers of the big bad manual dsmv 5 ever be held to account?

Also for anyone who doesn't know poly cystic ovaries might be the cause of facial hair on some women at/after puberty. there are other causes of post puberty/pre-menopause facial hair on women - and solutions such as the more painful than it looks -electrolysis are pushed by the medical professionals (a friend had a nasty experience) - even waxing is less painful/but messy- but shaving like the boys makes sense.

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I don’t have PCOS, but I’m guessing somewhat pre-PCOS, because I have other hormonal disorders and a few small cysts on my ovaries (similarly to type II diabetes, losing weight is one of the first treatments before Metformin to help your body reverse PCOS). I also have some mild hirsutism under my chin which is pretty common in the women in my family, and related to having hormonal and metabolic illness as a woman; there’s way too much stigma around facial hair in women. While I’ve seen women rocks theirs and applaud them- and mine is so light and sparse it’s not really that noticeable- still, I prefer to shave. It’s easy and painless, and extremely fast since my facial hair is so relatively sparse.

Being someone with several hormonal illnesses, I know that there are things you can do to control them naturally; for example, you can take inositol, as helpful as the drug with many side effects - Metformin- you usually take for PCOS, as good for lowering testosterone; and saw palmetto, which also reduces testosterone in women. I take these as a part of a larger hormone-balancing regimen I do to send my autoimmune disorders into remission, which so far is working (knock on wood).

One of the first things I can tell you is that hormonal illnesses have major mental health effects. High thyroid makes you paranoid and psychotic, low thyroid makes you tearful, depressed and distressed. High testosterone has enormous effects on women’s behavior and mental states as well. Add in both medical sexism and also people telling you if you’re being aggressive and you’re hair it must mean you’re a man, and no wonder so many of them are presenting with dysphoria, especially in a rigidly patriarchal country like Japan.

Why not treat these women first and see if they still feel like men once their hormone levels are normal?

There is absolutely no excuse for not treating these women’s PCOS first before ruining their health for life in order to make

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Got cut off!

...in order to make them no longer dysphoric. Why not try Metformin or inositol and saw palmetto (natural way to reverse PCOS) first, and approve electrolysis for hair removal, and encourage the patient to manage contributing factors such as weight, and then see how the patient is in a year and if they still want to transition?

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I dont pretend to know anything about medical matters but I did once read about the Castrato singer. Back in history, boys who were deemed to have the requisite perfect voice for a choir, were sometimes castrated in order to preserve that voice through into adulthood. The last country to outlaw this practice was in 1870. It is worth reading about this as it may be relevant to the situation today, where children are being sterilised, often with the same effects on their bodies as the Castrato or Evirato. I cannot see how the drugs of today would have any significant difference to the medical procedures of yesteryear

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My trans identifying daughter believes she has PCOS especially after she started noticing darkening facial hairs recently. It's plausible knowing what I do about her menstrual difficulties. I tried for years to get a diagnosis for her while she was at home. I heard about the Japanese study through one of the Gender a Wider Lens podcasts and dropped it in the conversation with her, hoping it would take root.

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