Research Roundup
From blood clot risks to agender robots, six studies across disciplines give insight into aspects of the transgender experience.
by Veronica Esposito
I’m Veronica, the author of Journal Club, a monthly column reporting in-depth on scientific studies of particular importance to the trans community. Of course, in my research I read many more studies than I can write about for the column. Here are a few of the most interesting ones I’ve read recently that didn’t quite make the cut for the column.
If you’ve taken feminizing hormone replacement therapy, chances are you’ve been warned about blood clots—doctors routinely inform transfeminine patients that they are a potential side effect of using exogenous estrogen, particularly when taken in pill form. However, there is mounting evidence that these warnings are outdated, as they are based on forms of estrogen no longer in use and are largely informed by studies in which comorbidities were not controlled. (In other words, even without estrogen therapy, you’d expect many more blood clots among a population more likely to smoke cigarettes, use alcohol, get less exercise, and have elevated rates of stress and depression.)
For this study, Daniel J. Slack and his colleagues looked at 2126 transgender individuals taking feminizing HRT and found the occurrence of blood clots was lower than prior studies had indicated. Additionally, when controlling for age, race, and number of comorbidities, blood clots were found to not be associated with any single factor, use of estrogen included. This is just one of a growing list of studies demonstrating that blood clots should no longer be a boogeyman for those using hormones to feminize their bodies.
Transgender participation in sports has been an issue of public concern for several years now, and the past two years have seen increasing efforts to prevent trans people from playing sports at various amateur and professional levels. Oftentimes, critics of trans participation say that they are doing so in favor of fairness, particularly for cisgender women—without much thought to the impact the demonization of trans women athletes has on trans people.
This study by Alex Siu Wing Chan and colleagues sifted through some 1,400 pieces of research in order to arrive at a dozen studies assessing the impacts of discrimination in sports to trans people. Looking at over 21,000 trans people in total, the study found that 1/3 had experienced some form of discrimination when attempting to play sports. It also found indications that trans individuals tended to initially participate in sports, but that over time discrimination reduced their involvement, resulting in negative impacts on physical and mental health. The study recommends that the health of the trans community can be improved by efforts toward trans inclusion, as well as through better training in trans competence for those attending to the physical needs of trans athletes.
It’s well known that cisgender women tend to have a more active immune system than cisgender men, leading to lower incidents of illness and elevated risks of autoimmune disorders. This has been explained by the belief that estrogen-dominant bodies bolster immune system function, as well as by particular genes on the X chromosome that support immune system activation.
So what happens when you give estrogen to individuals with XY chromosomes and give testosterone to individuals with XX chromosomes? Alice A. White and colleagues set out to discover the answer, finding there currently is very little research on the subject. The few studies that White and colleagues could locate gave some indications that trans women and men on HRT potentially experience immune activation similar to that of their cis counterparts, with trans women having a more robust immune response and potentially experiencing more autoimmune conditions. More research is needed in this area.
Microaggressions are defined as “subtle forms of discrimination regularly encountered in daily life,” and they have been shown to have negative impacts on the mental health of marginalized groups. One example of a microaggression would be when someone intentionally misgenders or deadnames a trans person.
Even though microaggressions have been studied in other contexts, there is currently little research on trans people and microaggressions, something that David Matthew Doyle and colleagues set out to address. They asked 39 trans-identified individuals to complete a 10-day diary tracking microaggressions, and chronicled the impacts on gender dysphoria, depressive and anxious symptoms, and self-esteem.
Doyle and his colleagues found that microaggressions occurred frequently, with 74% of study participants recording at least one of five pre-selected microaggressions over the study’s ten-day span, with overall microaggressions occuring at a rate of every-other-day. Misgendering was the most common form of microaggression, and the study found the largest impacts of misgendering on gender dysphoria. The authors call for more granular exploration of microaggressions (e.g., Does it make a difference if the microaggression comes from a stranger or from a close relationship?) as well as overall more data as to how these slights impact transgender mental health.
Evolving Media Coverage on Transgender Individuals: A Step towards Inclusivity
For decades, transgender representation in things like film, TV, and books was largely the province of outsiders to the community, and representations tended to be based on false stereotypes and caricatures of trans individuals. More recently, steps have been taken toward improving this picture, both by putting more trans people in the driver’s seat and by educating outsiders who depict trans people.
Bharat Dhiman found several categories in which he believed trans representation in media was improving, among them: a “shift towards more nuanced and empathetic portrayals”; mainstream media initiatives like GLAAD's “Studio Responsibility Index” and updates to the Associated Press’s Stylebook; the prominence of transgender role models; and recent documentaries, such as Disclosure, The Death and Life of Marsha P. Johnson, Born to Be, and The Trans List. He concluded by arguing that the field is still very much evolving and that more focus on improving trans representation is needed.
More Than Binary: Transgender and Non-binary Perspectives on Human Robot Interaction
Among those who study human-robot interaction, there is interest in developing agender robots in order to avoid having robots perpetuate things like sexism and gender stereotypes. In exploring agender robot design, researchers Michael Stolp-Smith and Tom Williams thought it would make good sense to bring in the perspective of the transgender community, as individuals who would be likely to have novel and valuable insights that could help expand knowledge in the field.
For their study, Stolp-Smith and Williams created an agender robot, and then produced videos of the robot interacting with two cisgender women, which they showed to ten participants, asking them questions about the human-robot interactions. Although study participants initially leaned toward gendering the robot as masculine, they quickly accepted the robot’s self-declared gender of agender, using they/them pronouns for the robot. Some participants approved of the agender robot as undermining the gender binary, whereas others argued for potential benefits to binary robot design. Participants generally expressed hope that agender robots could normalize non-cisgender identities, although participants also expressed fears of backlash, caricature, and dehumanization if such robots were to become widely adopted. Overall, Stolp-Smith and Williams concluded that “our participants presented fundamentally new possibilities and logics for approaching and making sense of the role of gender in robot design” and argued that trans and nonbinary perspectives could help bring important new perspectives to the field of robot design.
Veronica Esposito (she/her) is a writer and therapist based in the Bay Area. She writes regularly for The Guardian, Xtra Magazine, and KQED, the NPR member station for Northern California, on the arts, mental health, and LGBTQ+ issues.