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How are there 0 studies (maybe 1) on sex-concordant hormone therapy?

LessWrong · Jun 20, 2026, 10:36 PM

As your friendly neighborhood transhumanist liberal, I think "trust the science" is mostly a great heuristic.So here's my attempt to trust the science/evidence trans issues. Obviously coming out and transitioning is very scary and very strongly suggests trans people experience something very real, intense and specific and I trust the reviews that gender-affirming care can help.However, it seems some (!) people can experience gender dysphoria without being best described as simply trans or non-binary (GPT). This includes episodes of dysphoria related to hormone changes during pregnancy and menstruation. Similarly, dysphoria correlates with higher frequency of schizophrenia (Rajkumar, cited in ACX) and in some cases, it can be reduced by treating schizophrenia. Lastly, birth-sex-supporting hormones seem to help cis-people who experience body-dysmorphic disorder - an obsessive rumination about (sometimes invisible/imagined) flaws of your body. A thread on SSC Reddit contains two comments that claim sex-aligned behavior helped them reduce dysphoria. Kelsey P. suggested experimenting with hormones based on her experience with medication-induced dysphoria.I think this is particularly important for the hormonal treatment of dysphoria in adolescents, where the evidence for gender-affirming care seems mixed. I agree with Scott Alexander that there's no point in obsessing over the meaning of "true men/women" and that both trans- and cis-gender are partially culture-bound constructs - the only relevant question is what actually helps people feel better. But I also have to partially agree with J. K. Rowling that children are not "born trans" - although I would add they are also not born cis or heterosexual - children are simply not born with all sexual instincts fully formed and active, just like all (?) other animals. See also the fascinating Bem's theory of attraction development and Scott's fun post on paraphilias and AI alignment.Given all this, I was shocked that when I ra

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