Testosterone is classified as a “teratogen” due to the fact that it can cause significant developmental issues in a fetus, particularly when administered in high doses or when exposure occurs during critical periods of fetal development. Studies, including animal models, have shown that excessive levels of testosterone can lead to genital abnormalities and other developmental issues.
Unlike some other drugs (e.g., paracetamol), testosterone's effects do not simply wear off; instead, it induces permanent changes at the cellular level. These changes, such as alterations in the size of the clitoris or the pattern of hair growth, do not revert even after stopping testosterone. These permanent cellular changes may affect the ovaries and the eggs they contain. If the structure of the eggs is altered by testosterone, this could have implications not just for the pregnancy and the developing fetus, but also for future generations. Specifically, if a woman who has taken testosterone has a baby girl, that girl could be born with eggs potentially carrying these altered cells into the next generation.
There are significant medical ethics issues warranting consideration, as the long-term effects on the infant and future generations are not fully understood. This is why it is crucial to prioritize extra monitoring and comprehensive care for these pregnancies so that any potential health issues from these hormonal changes can be addressed and studied.
“Why are we not providing comprehensive obstetric services for this population that isn't just talking about cheerleading for your pronouns and the importance of getting all your literature correct. Actually, there are conditions that we need to be screening for and managing.”
In this bonus episode for premium subscribers, Elaine Miller considers the complex and nuanced implications of exogenous testosterone use in females, particularly focusing on those who become pregnant while on the hormone. She also underscores the importance of mother-infant bonding and the potential impacts of cross-sex hormones on that critical relationship, alongside the societal implications of surrogacy and the unique needs of those families.
Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language. Gribble KD, Bewley S, Bartick MC, Mathisen R, Walker S, Gamble J, Bergman NJ, Gupta A, Hocking JJ and Dahlen HG (2022) Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language. Front. Glob. Womens Health 3:818856. doi: 10.3389/fgwh.2022.818856
The Importance of Sexed-Based Language in Women's Healthcare, presented by Dr. Karleen Gribble
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