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Originally Posted by Psycho Dad
I have another question that I found myself wondering about today... What becomes of generally male or female health problems later in life? Things such as prostate problems or osteoporosis. Do these types of diseases or problems still occur and how is the treatment different if they do?
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An MTF, particularly after the age of 40, faces two big potential problems, and you've identified one of them, osteoperosis. The other is breast cancer. Prostate cancer is also a risk, but not to the same degree.
Osteoperosis becomes a risk a lot earlier, particularly for those who transition young, like Sissy. The high dose cross-sex hormone treatment can lead to loss of bone density as early as the 20's, but becomes a bigger risk after the age of 40. Treatment is generally the same as for a post-hysterectomy or post-menopause woman, depending upon age.
MTF's have a greater incidence of breast cancer and benign cysts in the the breasts, and it's just as important for them to do regular breast exams and get mamograms once a year after the age of 40 as with biological women. Treatment is generally the same as with a biological woman.
The prostate gland is the only primary male sexual organ an MTF retains post-op. It shrinks in response to anti-androgens and estrogen, and the incidence of infections and cancer are a lot lower, and some of the medications used for their anti-androgenic properties are also used to treat the prostate. but a regular exam, especially after the age of 40, is still required.
Pre-ops have a greatly increased incidence of testicular cancer so long as they retain their testicles, and regular exams are necessary. Treatment for cancer is removal of the testicles, and if it's spread, treatment is as with anyone else. MTF's who don't have their testicles removed lose them anyway, as they stop producing the testosterone that helps maintain them, and the estrogen acts as an antagonist, eventually dissolving them over a period of 10-20 years. During the first few years, it's necessary to check regularly, though.
MTF's also tend to have some of the same gynecological problems as natal women, namely urinary tract infections, intravaginal infections, and cancer of the tissues or the neo-vagina.
The new gyno I just found for me and Sissy jokingly referred to having more than one patient getting a yearly M,P & P--mammogram, pelvic, and prostate exam.
One that you missed was loss of upper body muscular strength. MTF's lose so much upper body muscle mass that they become much, much weaker than they were as a male, in many cases debilitatingly weak even in comparison to a natal woman of the same height and weight. Sissy is only slightly taller than I am (she had her growth stunted in late puberty by the administration of anti-androgens, the poor thing
) and weights some 10-15 pounds more, so she's roughly comperable in size, but she's already lost so much muscle in the upper body that I'm stronger up top than she is, and you can see from my picture that I'm not exactly the most muscular person. This loss of strength plateaus, but it does leave a lot of older MTF's very fragile in terms of ability to perform normal every day lifting tasks, especially when combined with loss of bone density.
In general the MTF has most of the same medical concerns as a post-hysterectomy natal woman, with a slightly greater chance of breast problems, and has a slight chance of prostate problems. The problems are treated for the most part as with anyone who has that same problem.
Diabetes is one of the more troublesome things that can happen to a transwoman, as type 2 diabetes has cross-sex hormones counter-indicated as a treatment, and prevents most surgical treatments. I have a friend in this situation; she can't take hormones or androgen blockers, and can't have any of the common surgeries. It's a real shame, because there's a significant positive correlation between type 2 diabetes and transsexualism in physical males--a physical male with type 2 diabetes is about 10 times as likely to be transsexual as a physical male without it (say a 1/1000 chance instead of a 1/10,000 chance).
Not that you asked, but there also seems to be a positive correlation between IQ and transsexualism in physical males; males with genius IQ's have a much higher incidence of transsexualism than those with normal IQ's by about a factor of 10. You'll also find that financial and professional success is positively correlated to transsexualism in males--there are a lot more engineers, doctors, lawyers, psychologists, and college professors out there who are MTF than construction workers or plumbers.
Sissy, by the way, has an IQ of a little over 170, or so it was when she was tested at about the age of 10. Nobody was surprised at this.
Gilda