> He's taking a cocktail of drugs that gets prescribed via telemedicine and was telling us about the serious side effects he was suffering: one of these drugs, spironolactone, is primarily a drug that alters your mineral metabolism but has the effect of suppressing testosterone if you take 20x the normal dose. (My doc gives it to me for my blood pressure.) He has insatiable cravings for salt as a result.

It's worth noting that while Spironolactone can be used to suppress testosterone, that's not really what it's used for. Rather it weakly blocks androgen receptors so it makes the body act like the testosterone isn't there or is lower than it actually is. And this is effective at a far lower dose than the testosterone "suppression".

This is why it's sometimes prescribed to women for hair loss, improper hair growth, and/or acne.

It's for that purpose that it's normally prescribed in trans healthcare and it's generally only temporarily (~3-9 months) prescribed while an estradiol regimen suppresses testosterone production. After that it can be dropped with the estradiol doing the rest of the work.

And outside the US it's far less commonly prescribed for this purpose with other androgen antagonists generally being preferred but US doctors tend to be more weary of those other medications and therefore prefer spironolactone.

So while said kid may be a bit "weird" in your eyes, nothing about this really seems unusual. At worst they probably just need to ask their doctor to prescribe a different androgen antagonist instead of spironolactone.

Thank you for providing this exhaustive and necessary context.

I don't think it's the spironolactone part that was concerning, but that the idea of the new gender identity came from someone else and lots of convincing was required.

It reminds me of a friend I have who is quite severely depressed and has gone through a wide range of sexual identities. Straight, to asexual, then gay, then polyamorously bisexual, and now back to monogamously straight. Each change she excitedly explained to me that she had unlocked some deep secret to her identity and now her whole life made sense. This happened well into her adult years, not adolescence.

Some people seem to have a strong sense of a "missing piece" in their lives, and might be susceptible to latching on to almost any identity or community if it can explain that feeling.

EDIT: Because of the current barrage that trans people are under, I should clarify that I know trans people who have a deep and abiding certainty that their gender is different from what it says on their birth certificate; my above comment is not meant to include those people.

Another factor is the media outrage machine. Being a part of a conflict is appealing to some, for the same reasons that some people join the military. I could see this appetite for conflict leading some people to falsely claim to be trans. Whereas they wouldn't if people were more accepting of it, and the media didn't frame every story in a way that showcases outrage.

So far as the "media barrage" my experience is that I got a lot more negative about the trans movement when I joined Mastodon a few years ago and got exposed to their own words.

My trans friend in college suffered terribly because her mother disowned her. I can say as a parent though, if I saw my child was involved with people who were as hateful and negative as the trans people I see on Mastodon, I'd think "I'd do anything at all to spare my child from that suffering."

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I think "asexual", as a fashionable label, is particularly harmful. I've met a lot of people who are definitely sexual who went on a phase of glomming on to it and it certainly contributed to their misunderstanding of themselves.

The proliferation of labels about sexuality seems harmful to me (polyamorous is another, BDSM people introduce 10s of them, like you couldn't possible be articulate about your desires but you imagine there is some place where you can pick them off a menu)

My recent experience is that when something squicky goes down or a paraphilia rears its ugly head the people you can trust the least are the ones who talk about sex as if they were liberated or who claim to have some subaltern identity. I think people like this are dangerous not just as direct social connections but even if they are 2, 3 or 4 steps removed.

This classic of French theory

https://monoskop.org/images/9/96/Baudrillard_Jean_Seduction....

has a great part near the beginning about how glib talk about sexuality is a trap, not a way to liberation.

I don’t assume that I can know anything about another person’s experience of the world. But from the outside, I agree that some communities seem full of deeply aggrieved and unhappy people who seem intent on dragging others into their miserable worldview.

But lots of non-gender-related online communities also look like that to me: some political groups, antiwork, etc.

To be honest I don't think that's really concerning. It's not unusual for people even into their late 20s to experiment and figure themselves out. And sometimes that experimentation is influenced by the people we surround ourselves with.

People have done this all the way back time eternal, the only thing that's different today is that people are allowed to be more open about it and that there are many discrete labels that allow people to easily describe what they are specifically feeling.

This person's 'weirdness' is, I think, a neurodivergence which I won't offer a diagnosis of.

I don't think a gender transition will make this person whole, this person will just be a weird person who is also trans. The old problem will persist but now he (maybe she or something else later) will have additional side effects and other baggage not to mention lost opportunities such as not being able to be a father.

The goal is not to make yourself whole and even if it didn't work out, they could de-transition (and should be supported in doing so). Stopping HRT (as long as you at least temporarily take HRT in the opposite direction to kickstart things again) has little in the way of long term effects.

> not to mention lost opportunities such as not being able to be a father.

This isn't true. Even if you stay trans the entire rest of your life you can still often have kids. This goes for trans women, trans men, and nonbinary people. Generally at worst you'd just need to supplement with some hormones to support fertility but often even that isn't necessary.

But supposing someone de-transitioned, fertility generally returns completely or near completely within 6 months to a year.

The only case where you can't "undo" any degree of loss of fertility is with an orchiectomy (testicle removal) but even then the standard procedure is to preserve sufficient semen in cold storage for future use.

I'll say, being in some subreddits around these things, there really is a subculture which attributes nearly all abnormalities, disharmonies, regrets, or desires around gender to the person being trans. Like, they speak as if they already know what this person is going to do in the future, like they understand more from one message than this person knows about themselves from their entire life. It's mostly young kids doing this to other young kids, the same way social pressure has played out for millennia, i assume. But this is a new way it's being expressed, i think it's on the adults (as it always is) to explain to the kids that asserting facts about other people's genders or desires is exactly what we were trying to stop, and that it's very disrespectful, disenfranchising, dehumanizing to assert someone else's inner world is something you know better than them. I've said as much when I've come across it, no one's ever tried to fight me about it