Trans biology 101

So, you think that being trans-gendered is being just a "man in a dress" and a social construct ?

I am going to upfront make these basic two statements before you have to read all the boring medical facts that (1) trans-women are a biological reality proven by medical facts (2) as far as athletic prowess, trans-women specifically (not trans-men) SUCK at sports  - significant cardiovascular fatigue.  This supersedes any other supposed biomechanical advantage.  Item 2 means that a trans-woman mostly huffs and puffs up stairs due to blood oxygen STARVATION - YOU CANNOT DO SPORTS - except in rare cases like the 20 or so professional athletes around the world.  Also remember that ANY narratives pushed around the internet and social media states CIS-MEN vs CIS-WOMEN, which is entirely DIFFERENT than TRANS-WOMEN vs CIS-WOMEN.

Plus, maybe some of the other dozens of totally incorrect narratives being pushed around.

This blog isn't my opinion, it's simply my regurgitation of dozens and dozens of medical studies (actually over 50), and other assorted things I know from verified sources. Am I a medical student or doctor ? No, but I am not lacking in the intelligence category, I am a member of the Society for Evidence-Based Gender Medicine, part of my career I managed from a technology standpoint a sizable chunk of a multi-national company and at age 16 worked in the information technology group of Union Bank of Switzerland for 5 years. Basically, smart people have smart hobbies.

Why am I doing this particular blog, because I am tired of repeating myself like a mommy scolding a room full of toddlers.

I will explain the following things, that trans-gender people are born this way, what makes that happen, why a trans-woman is a woman and a trans-man is a man, what biologically will change in a trans-woman by taking estrogen (this relates to the mythical sports advantage). Again, this is from medically available studies or basic biology you can confirm with your endocrinologist.

Okay, so ending the preamble and into the stuff …

Mental Illness ? ...

Not everyone has heard of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), but it's a manual written by the American Psychiatric Association and tells us about all the mental diagnosis that people may have and why, i.e. it's the standard classification of mental disorders used by mental health professionals
Here is a brief snippet overview of what the DSM-5 tells us about trans-gender people and that it's NOT defined as a mental illness or really even a disorder ...

Despite increased attention to transgender people, the first two editions of DSM contained no mention of gender identity. It was not until 1980 with the publication of DSM–III that the diagnosis “transsexualism” first appeared. In 1990, the World Health Organization followed suit and included this diagnosis in ICD-10. With the release of DSM–IV in 1994, “transsexualism” was replaced with “gender identity disorder in adults and adolescence” in an effort to reduce stigma. However, controversy continued with advocates and some psychiatrists pointing to ways in which this diagnostic category pathologized identity rather than a true disorder.

With the publication of DSM–5 in 2013, “gender identity disorder” was eliminated and replaced with “gender dysphoria.” This change further focused the diagnosis on the gender identity-related distress that some transgender people experience (and for which they may seek psychiatric, medical, and surgical treatments) rather than on transgender individuals or identities themselves.

The presence of gender variance is not the pathology but dysphoria is from the distress caused by the body and mind not aligning and/or societal marginalization of gender-variant people. It needs to be ego-dystonic to qualify as a diagnosis and having a discussion with our patients about the diagnosis prior to charting it is necessary and good care.

The DSM–5 articulates explicitly that “gender non-conformity is not in itself a mental disorder.” The 5th edition also includes a separate “gender dysphoria in children” diagnosis and for the first time allows the diagnosis to be given to individuals with disorders of sex development (DSD). DSM–5 also includes the optional “post-transition” specifier to indicate when a particular individual’s gender transition is complete. In this “post-transition” case, the diagnosis of gender dysphoria would no longer apply but the individual may still need ongoing medical care (e.g., hormonal treatment).

 

CIS vs other ...

Yes CIS and TRANS are real prefixes and not made up by ideological morons.  Both terms are in fact Latin and mean precisely what they imply in the case of gender.  I am not going to give explanations, just google it.   But the gist of it is as follows ...  trans means "across-from" in Latin, i.e. the opposite of "cis".  It's called a "root" word.  An example would be, "transatlantic" - meaning across the Atlantic. Not on the same side-as, which would be "cisatlantic".

Gender and Sex ...

Yes both of those are in fact SPECTRUMS, I don't care what nonsense you think about sex being binary yada yada yada, medical science says it's not.  Gender is a spectrum of 72 current official pronouns, sex is governed by 25 karyotype sets of chromosomes.  XX and XY are just two of them and both are interchangeable between male and female.  Yes I know, but but but, only a boy and girl happens, but it's still overlapping characteristics and attributes of those chromosome pairings that give the outward appearance of binary.

What is a trans-gender person ?

Trans-gender people aren't just trans-women. Trans-gender people come in two flavors. Trans-women and trans-men. About 50/50.

A trans-man is a person who is born biologically female but has a male identity at birth.

A trans-woman is a person who is born biologically male but has a female identity at birth.

The important part of the above statement is 'at birth'. Yes, being trans-gendered is NOT a delusion or mental illness as neither of those can be valid if you are BORN a certain way, IE. it's biological fact, we also know it's not a mental illness because of the DSM-5 mental disorders manual clearly states that it is NOT. Does being trans-gender have mental health issues associated with it ? Yes, but it's a cause and effect, the effect is the initial unknown reason why you are feeling significantly 'off'. Transitioning to your correct gender is then the solution, not the reason why there are mental health issues, quite the opposite, it's a mental relief.

Basically trans-gender people are simply 'normal', no more or less prone to any other mental deficiency.

How does a trans-gender person become trans biologically / genetically ?

The results of the study is here, https://pubmed.ncbi.nlm.nih.gov/30247609/ but I'll summarize the genetic markers, these are as per the study, … ERα, SRD5A2, and STS alleles, as well as ERα and SULT2A1 genotypes. Several allele combinations were also over-represented in transgender women, most involving AR (namely, AR-ERβ, AR-PGR, AR-COMT, CYP17-SRD5A2).

Gender is not the same as sex. Sex is more of the biological side of things, but still is on a spectrum so far as the chromosomes are concerned, XX and XY represent the most common combinations, neither however mean specifically male or female. Female can be XX or XY, same as males, can be XX and XY. There are also 25 combinations of chromosomes, such as 47,XXY also some with SRY etc etc. However do these variations create 25 distinct sexes ? Not totally however some combinations do exhibit dual sex / genital expressions that are not fully male or female.

There are 23 sets of chromosomes, the last one, 23rd (karotype) is what typically dictates external representation of a human and that has the master switch of X or Y, however the other 22 pairs carry X and Y. Genetics and embryonic level biology is immensely complicated and there is information discovered every day related to how life comes in to existence.

Gender is more of an identity of who you are and while more of a social construct, it's tied to your inner identity, yes that lump between your ears. Officially as of 2026 there are 72 listed genders.

Since the 2000's, it has proven MULTIPLE times that trans-gender people have different brain structures using scans, the structures are other than what their biological birth sex denotes. This is due to genetics and neuroscience. The high level view is that due to a hormonal in-balance between testosterone / estrogen and those specific trans-gender related genetic markers I mentioned previously, cause the incongruence between the brain structure and genitals. These two parts of the body develop at different times, the result is why a baby pops out and is thus trans. Yes, a boy body and girl like brain, or, a baby girl with a boy like brain. While the brain scans mostly show exact gender matches, some studies show trans-gender people have brain structures in-between male and female. The vast majority however more closely match. This then is why a trans-woman for example is for all intents and purposes a woman.

What defines a person ?

Its predominantly your brain, not boobs or pointy thing between your legs, although for a woman, boobs are in a way part of her identity, but, no body part is really defining of a persons identity. So is a "trans-woman" a woman, yes, because her brain exists as female, otherwise she'd be a boy. Transitioning is just a mechanism for that woman to regain some of her missing femininity, her figure, facial features, breasts etc that nature didn't make in the first place, its not a man wanting to be a woman or take the place of, or be better than a woman, its because she is one already. These are crucial things to understand from the get go.

What happens biologically to a trans-woman on estrogen ?

• Breast Development: Growth typically begins 3–6 months after starting treatment, with full development within 2-3 years.

• Body Fat & Muscle: Fat redistributes to a more typically feminine pattern (hips, buttocks, thighs) and muscle mass/strength decreases.

• Skin & Hair: Skin becomes softer and less oily. Facial and body hair growth slows, becoming finer, and hair loss on the scalp can be reduced.

• Genital & Sexual Changes: Libido decreases, spontaneous erections become less frequent, testicles decrease in size (testicular atrophy), and fertility is reduced.

• Body Odor & Metabolism: Sweat changes in odor, and metabolism changes.

• Emotional Changes: Many report improved mood and reduced emotional distress.

• Hemoglobin: This after only 3 months changes to work exactly the same as a cisgender woman. This means that oxygen to muscles are greatly depleted, also the transfer of carbon dioxide back to the lungs. Also effected is cardiovascular fatigue, this is significantly more due to the higher blood volume that needs oxygenating. This is the total reverse in trans-males, which is why a trans-man often exceeds the capabilities of a cisgender male.

• Bone structure: while the overall structure doesn't change, the density does and becomes less strong.

• Cartilage: Cartilage and ligaments generally weaken and shrink.

Trans-women then go through this process knowing these outcomes because it's a need. So they do this to become super-human female athletes ? Given the above, obviously NOT. Are there some that do compete ? Yes but a handful, literally. Professional world wide, less than 20 compared to tens of thousands of cisgender female athletes. Trans-women just aren't in the same ball park as cisgender women. The amount of high school trans-athletes going to the NCAA competitions have been around 19 over the last 2 decades, hardly a concern.

What is this hemoglobin thing ?

So like I mentioned above about hemoglobin changes. After only 3 months, a trans-woman's hemoglobin changes to that of a cis-gender woman, around 13 g/dL vs 16-17 g/dL for a biological male. Each 1 g/dL change up or down is a 5% performance hit. So a trans-male transitioning from female to male will get a 3-4 g/dL increase in hemoglobin.

For a trans-woman, this is around 15% loss of ability. The other aspect is blood volume. A biological male has 12 pints of blood vs 9 for a cis-gender woman. So while a trans-woman has the same hemoglobin as a cis-woman, a trans-woman is diluted 25%. This gives rise to a significant cardiovascular fatigue. It's why very few trans-women are athletes, they just can't do that anymore.

A brief thing about sports ...

I am not going into much additional blurb, what I already stated is enough to prove the point, but if you want to know what the real impact of trans-women are in women's sports based on the real numbers I gathered from publicly available sources such as the NCAA and government resources on student enrollments, you can find it all here.  However, these numbers I in a way adjusted to be on the more conservative side, i.e. BIASED more [against] the trans-gender community as they ended up calculating lower than the published official numbers.  https://princesspnut22.blogspot.com/2026/02/protect-womens-sports-facts.html

 

To summarize then …

• Trans-gender people are biological not social.
• Trans-gender people outwardly express their identities as living as a female if born male etc.
• Being trans isn't a mental illness.
• Trans women are not super-human athletes.
• Trans-women are not functionally 'male'.
•  Intimacy from a Trans-women's standpoint is very limited.