Study ‘hides’ dangers of giving biological females high doses of testosterone: endocrinologist

Michael K. Laidlaw and colleagues wrote a July letter to the editor of the Journal of Clinical Endocrinology & Metabolism (JCEM) regarding a study conducted by Milou C. Madsen and colleagues, which was published in the journal in February.

Madsen's study attempted to measure the risk of erythrocytosis, which is an increase in the number of red blood cells in the body due to the administration of testosterone in transitioning females.

The increase can result in cardiovascular events. Laidlaw and his colleagues argue that the study "hides the true numbers of trans males at risk for high red blood cell counts and therefore cardiovascular harms" by significantly undercounting "patients who may ultimately be at risk for cardiovascular events."

In an explanation of the July letter published in early December on website Gender Sanity, the authors outline the normal levels for hematocrit in females and males. "For adult men the range is 38.3 to 48.6 percent. For adult women the range is 35.5 to 44.9 percent," they explained.

"High testosterone levels can directly cause high levels of hematocrit," they state. "Females who identify as trans males are given very high doses of testosterone to attempt to bring their testosterone levels into the male range."

"In the study we have critiqued, the authors use what is considered very high hemoglobin levels in males (greater than 50) for trans males (females). This is a difference of 5 whole units compared to the Framingham study (greater than 45)" they explained. "This difference leads to a dramatic undercount of the number of females who will likely be at increased risk of cardiovascular disease and death because of high red blood cell counts due to very high levels of testosterone."

The recent study departs from 1994 Framingham study, which showed "having high red blood cell counts (erythrocytosis) puts females at increased risk of cardiovascular disease, coronary heart disease and death due to both." This study considered hematocrit levels above 45 for biological females the point of concern.

"Women who identify as trans males are being given very high, very risky doses of testosterone," Laidlaw told Breitbart News. "These high doses lead to high red blood cell counts. High red blood cell counts can lead to heart attacks and death. We believe these risks are being hidden."

"Males and females have different normal ranges for red blood cell counts," he continued. "We believe that the authors' use of the male range for females hides a large number of females who will be at risk for heart disease and death."

They state that physicians advocating for such high levels of testosterone argue that a person's gender identity should determine those hormone levels.

"In other words they believe that a metaphysical construct (gender identity) can somehow change physical reality and cause a woman to acquire male reference ranges for testosterone and other sex specific laboratory tests like hemoglobin. This of course is impossible," they wrote.

"This is, of course, impossible," Laidlaw told Breitbart News. "Not only that, it's also dangerous because doctors will miss a large number of trans males who are risking heart attacks and death from testosterone."

Laidlaw and his colleagues are proposing "that the female reference range for hemoglobin and hematocrit be used for trans males so that both clinicians and patients can help more accurately assess risk factors for cardiovascular disease and death." The group also warned that "because of immature brain development, adolescents are prone to risk taking behavior."

This includes the use of anabolic steroids, such as testosterone, which are also drugs of abuse. "We believe that adolescents should not be given testosterone to treat gender incongruence under any circumstances because of these factors."