4 ms·

As an aside there is also the testis-blood-barrier, although this is not quite as tight as the blood brain barrier.

by Engineering-MD 7y ago

philwelch 7y ago
Also, personalities tend to change if the testes are removed.
- JimboOmega 7y ago
  There's a huge family of "Neurosteroids"[1], which impact various receptors in the brain in lots of super complicated ways that aren't entirely understood. They are synthesized in all kinds of ways naturally, and when it comes to "what they do" in terms of personality... "probably something" is the best we can do. There is massive complexity in all these things, all kinds of feedback mechanisms, genes and enzymes involved, etc. They do something but it's hard to say what exactly. I know about this personally; one of the amazing things about transgender medicine is that there is a huge range of responses to the hormones involved, and there's honestly no way to predict what will happen with a given person. There are tendencies in aggregate - like less testosterone = less libido - but how those come about biologically is unclear and the effect varies tremendously between different people. It's a joke to pretend like we fully understand or can predict how any of these things actually impact our lived experiences beyond very rough, bulk tendencies. [1]https://en.wikipedia.org/wiki/Neurosteroid https://en.wikipedia.org/wiki/Neurosteroid
  - allovernow 7y ago
    When we know so little, is it really ethical for a psychiatrist to prescribe these drugs to make people slightly more like the opposite gender, rather than teaching them to accept who they are and deal with the disorder like any other incurable condition?
    - dpark 7y ago
      What “other incurable conditions” do doctors not even attempt to treat and simply tell patients to “accept who they are and deal with it”?
      - dr_dshiv 7y ago
        Well, helping people cope and find acceptance could be a form of treatment. I am a little scared by the number of my friends who have gone on the medical transgender journey.
      - allovernow 7y ago
        You realize that the alternative is telling people to spend the rest of their lives in an irreversible, elaborate fantasy LARP? One which potentially comes with its own burdens and eventually leads to permanent sterilization? I'm not saying don't treat it. I'm saying hormones and plastic surgery do not make a woman, and more sane treatment would acknowledge this fact and teach coping skills much in the same way we are forced to treat conditions like autism, drug resistant depression, and any other chronic disorder with no cure. A treatment which is based entirely on indulging delusion is no treatment at all, and the bottom line is that you don't get to decide how your gender is perceived. The vast majority of men have no interest in dating or marrying transgender women and it's a disservice to those with gender dismorphia to pretend like they do. What happened to past messages of learning to accept who you are and be comfortable in your own skin? Why stop here? Why not prescribe plastic surgery to teenage girls who don't feel that they're pretty enough for their gender role?
        dpark 7y ago
        If you don’t support gender transitioning, fine, but don’t pretend that your concern is for the person transitioning as if they don’t understand the implications. Your agenda is painfully clear and has nothing to do with the ethics of prescribing hormones when we don’t fully understand them: “I'm saying hormones and plastic surgery do not make a woman”. The reality is that we don’t understand any medicine particularly well, but we do our best to treat an endless array of diseases and disorders anyway, because it’s more ethical to attempt to ease pain and discomfort than to ignore suffering. Also people do regularly get plastic surgery to address aesthetic concerns. Would you advocate that people with cleft lips should simply learn to accept who they are and we should consider it unethical to correct the deformity?
  - philwelch 7y ago
    Sure, but also if you neuter a cat, it'll be less prone to fight with other cats or to mark its "territory" with urine.

As an aside there is also the testis-blood-barrier, although this is not quite as tight as the blood brain barrier.

philwelch 7y ago

Also, personalities tend to change if the testes are removed.

JimboOmega 7y ago
There's a huge family of "Neurosteroids"[1], which impact various receptors in the brain in lots of super complicated ways that aren't entirely understood. They are synthesized in all kinds of ways naturally, and when it comes to "what they do" in terms of personality... "probably something" is the best we can do. There is massive complexity in all these things, all kinds of feedback mechanisms, genes and enzymes involved, etc. They do something but it's hard to say what exactly. I know about this personally; one of the amazing things about transgender medicine is that there is a huge range of responses to the hormones involved, and there's honestly no way to predict what will happen with a given person. There are tendencies in aggregate - like less testosterone = less libido - but how those come about biologically is unclear and the effect varies tremendously between different people. It's a joke to pretend like we fully understand or can predict how any of these things actually impact our lived experiences beyond very rough, bulk tendencies. [1]https://en.wikipedia.org/wiki/Neurosteroid https://en.wikipedia.org/wiki/Neurosteroid
- allovernow 7y ago
  When we know so little, is it really ethical for a psychiatrist to prescribe these drugs to make people slightly more like the opposite gender, rather than teaching them to accept who they are and deal with the disorder like any other incurable condition?
  - dpark 7y ago
    What “other incurable conditions” do doctors not even attempt to treat and simply tell patients to “accept who they are and deal with it”?
    - dr_dshiv 7y ago
      Well, helping people cope and find acceptance could be a form of treatment. I am a little scared by the number of my friends who have gone on the medical transgender journey.
    - allovernow 7y ago
      You realize that the alternative is telling people to spend the rest of their lives in an irreversible, elaborate fantasy LARP? One which potentially comes with its own burdens and eventually leads to permanent sterilization? I'm not saying don't treat it. I'm saying hormones and plastic surgery do not make a woman, and more sane treatment would acknowledge this fact and teach coping skills much in the same way we are forced to treat conditions like autism, drug resistant depression, and any other chronic disorder with no cure. A treatment which is based entirely on indulging delusion is no treatment at all, and the bottom line is that you don't get to decide how your gender is perceived. The vast majority of men have no interest in dating or marrying transgender women and it's a disservice to those with gender dismorphia to pretend like they do. What happened to past messages of learning to accept who you are and be comfortable in your own skin? Why stop here? Why not prescribe plastic surgery to teenage girls who don't feel that they're pretty enough for their gender role?
      - dpark 7y ago
        If you don’t support gender transitioning, fine, but don’t pretend that your concern is for the person transitioning as if they don’t understand the implications. Your agenda is painfully clear and has nothing to do with the ethics of prescribing hormones when we don’t fully understand them: “I'm saying hormones and plastic surgery do not make a woman”. The reality is that we don’t understand any medicine particularly well, but we do our best to treat an endless array of diseases and disorders anyway, because it’s more ethical to attempt to ease pain and discomfort than to ignore suffering. Also people do regularly get plastic surgery to address aesthetic concerns. Would you advocate that people with cleft lips should simply learn to accept who they are and we should consider it unethical to correct the deformity?
- philwelch 7y ago
  Sure, but also if you neuter a cat, it'll be less prone to fight with other cats or to mark its "territory" with urine.