Steroid Dimensions

Adding Perspective to the Scope of Androgens and Estrogens

Aug 6, 2022

[Left: Christine Jorgensen. Right: Marsha P. Johnson and Sylvia Rivera.]

Christine Jorgensen. Do you recognize this name? Christine was born in 1926 and served in the U.S. military. She was the first widely known person to have sex-reassignment surgery. That surgery was in the 1950s. Christine was far from the first trans person to exist; she just happened to be a white American who transitioned male-to-female—something bound to make news headlines. Marsha P. Johnson. Do you recognize her name? Sylvia Rivera. Do you recognize her name? Both of these women were trans women of color who should have made headlines for the revolutionary work they did in fighting for equality. They were tireless advocates for homeless and trans youth, especially youth of color, and fought until their deaths for trans rights and the inclusion of trans people in legal protections. Marsha and Sylvia were born in 1945 and 1951 respectively. These three women are but a few among many transgender people born in the 20th century.

If you aren’t aware of LGBTQ+ history, you probably hear people say that being transgender is a new trend or that more young people are coming out as trans because its trendy. People who say and believe such things would be surprised to know that being transgender or gender non-conforming has existed for millennia. Not only have indigenous cultures recognized and honored more than two genders, there are many documented cases in Europe and the United States of transgender and gender non-conforming people. Since this piece is about hormones, I won’t go into detail here about the history and prevalence of transness and gender non-conformity, but I will add some links at the end if you’re interested in learning more.

Hormone History

Although gender variation has existed for millenia, it has been politically supercharged in more historically recent western cultures. Gender variation threatens patriarchal societies. Gender variation threatens power. Thus, there will always be strong efforts to uphold the binary gender construct. This effort influenced the discovery and study of a group of steroid hormones. We still call these hormones “sex hormones” or “sex steroids,” while other steroid hormones are called corticosteroids. The name corticosteroid not only distinguishes the steroid function, but also the place they’re made (cortex [cortico-] of the adrenal gland). Corticosteroids are then specified even further as glucocorticoids or mineralocorticoids—steroids synthesized in the adrenal cortex that influence glucose metabolism and mineral function (mineral and water balance) respectively. In these names we have three pieces of information: the location of synthesis (corti-), the location of action/target (gluco-/mineralo-), and the type of hormone (-roid). When steroid hormones are synthesized in the brain they are given the name neurosteroids. [1] But for androgens and estrogens, we are simply stuck with “sex hormones” or “sex steroids.” We are told very little with these names other than the biases of the scientists who pushed for their discovery and their use as a proof of a sex and gender binary.

Let’s go back to the 1920s-1940s, for a brief understanding of the discovery and naming of androgens and estrogens. In her book, Sexing the Body [2], Anne Fausto-Sterling dedicated chapters 6 and 7 to these hormones and related glands. She explains that “the idea that the public sphere was by definition masculine lay so deep in this period’s metaphysical fabric that it did not seem surprising to argue that women who aspired to the Rights of Man had also, by definition, to be masculine. . . . It was this context in which inherent sex difference—and female inferiority—was taken as a matter of unquestionable fact that shaped the scientific investigation of the internal secretions of ovaries and testes” (Fausto-Sterling, 154). From even before the concerted effort to identify, describe, and name these “internal secretions,” scientists had already decided, based upon their biases, that they were looking for something to support their beliefs, not to find and describe and name what these “internal secretions” truly are and do. Because these assumptions about hormones were so deeply ingrained, any discovery that didn’t fit within those assumptions was manipulated to fit or disregarded.

“As hormone researchers took each step toward isolation, measurement, and naming, they made scientific decisions that continue to affect our ideas about male and female bodies. Those judgements, understood as ‘the biological truth about chemical sex,’ were, however, based on preexisting cultural ideas about gender. But the process of arriving at these decisions was neither obvious nor free from conflict. Indeed, by looking at how scientists struggled to reconcile experimental data with what they felt certain to be true about gender difference, we can learn more about how hormones acquired sex” (Fausto-Sterling, 177).

Unsurprisingly, deeply held assumptions about gender influenced how we as the public and we as later generations have been given information about our own bodies. These deeply held assumptions served to uphold male superiority and female inferiority in the public realm. There was more than just belief behind them, there was motivation. To further exhibit these biases, the names chosen as standards for these hormones show what the majority of these scientists believed about men and women. The name chosen for the group of hormones testosterone belongs to is androgen. And the name chosen for the group of hormones estradiol belongs to is estrogen. The suffix of both words is -gen meaning to produce or to birth. Their belief was that these hormones are what produce a male or a female, which in their belief were man and woman respectively. Let’s start with androgen. The root andro means “man.” So their naming of that group of hormones seems pretty straight forward: “to produce man.” In contrast their naming of the group of hormones they associated with women was named estrogen. Before explaining the root word, let me add a quote on the way this name was chosen: “using the word estrus as the root on which biochemists built female hormone names happened over drinks ‘in a place of refreshment near University College’ when the endocrinologist A.S. Parkes and friends coined the term estrin. One of the participants in this brainstorming session found the choice ‘a happy thought which gave us a satisfactory general term and a philologically manageable stem upon which to base all new nouns and adjectives that physiologists and organic chemists soon needed’” (Fausto-Sterling, 188-189). So, for the hormones they associated with men they chose a root that means “man,” and for the hormones they associated with women they could have simply chosen a root that meant “woman,” yet they didn’t. Apparently, they felt the need to brainstorm over drinks to find a word that made them happy to call these hormones. So they chose the root estrus which means “frenzy,” “gadfly,” or “mad.” Androgen: to produce man. Estrogen: to produce frenzy, to produce gadfly (nagging type of bug), to produce madness (which at the time was associated with insanity).

Does this belief about women sound familiar? It should. Women being diagnosed with hysteria, women being accused of being witches and hunted down, women being ignored because irrational behavior was how they were believed to made. The men who decided upon these names, and designed the experiments, and chose what to publicize believed in the inferiority of women, and looked to science to support their beliefs instead of letting science inform their beliefs. Motivations behind this would include denying women the right to vote, not hiring women for work, justifying paying women lower wages, making decisions about women’s bodies for them, controlling women’s lives, etc. (Science has been used in this way to support racist and classist beliefs as well.) And an important thing to remember is that these beliefs were about cisgender straight white women. These beliefs were the ceiling for women, and beliefs about cisgender straight white women are still the ceiling. If you think beliefs about the intersections of race, ethnicity, class, sexuality, etc. aren’t worse, then you’re fooling yourself. We are still experiencing the effects of this dishonest, heavily biased scientific effort. As Fausto-Sterling puts it, “a scientific fact once established, may sometimes be disproved in one field, remain a ‘fact’ in others, and have a further life in the popular mind” (Fausto-Sterling, 169). No matter how much evidence there is that these hormones are necessary for every human body, for multi-system function, and for overall homeostasis, they will likely forever be limited by their names and designation. Androgen. Estrogen. Sex Hormone.

Hormone Structure and Multi-System Function

Knowing that we haven’t been given clear or complete information about androgens and estrogens, let’s do a quick break down. As mentioned above they are steroid hormones, which are derived from cholesterol. Below, I have edited a figure [3] I found helpful. I have purposefully labeled the androgens and estrogens in a way that removes our biases about them and that also shows their similar structures. I used “gonadoroid” to show that they are synthesized mostly in the gonads and that they are steroids.

[Synthesis of Steroids from Cholesterol]

Although some of these hormones have specific sites for the majority of their synthesis, all of these are synthesized to some degree in the brain and many other organs. Noting the similarity in chemical structure, let’s move on to see how these gonadoroids function on a multi-system level. Fausto-Sterling notes that “as it became clearer that hormones played multiple roles in all bodies, theories linking sex and hormones became confusing” (Fausto-Sterling, 177). Gonadoroids’ multi-system functions were discovered alongside with their functions on the reproductive system. So this isn’t new information, however it is information that has been purposefully downplayed to keep the emphasis on sex and gender in order to uphold the societal status quo. These hormones, though, function alongside and in concert with other hormones to keep the body’s homeostasis. Any hormone imbalance will affect all body systems to some degree. Testosterone, for example, affects the metabolism of carbs, fats, and proteins. [4]. If your body produces more testosterone than it does estradiol, then you will be accustomed to certain ways your body processes and distributes carbs, fats, and protein. If suddenly you either increase your testosterone or your body starts making less of it, you will see changes in how your body metabolizes foods. This pertains to your whole body, “highlight[ing] the importance of taking multiple tissues into account and thus focusing on a systems biology approach.” [4].

Gonadoroids affect cellular function as well. Each cell in our bodies has the potential to be anything. As embryos our cells are undifferentiated, meaning they have no specific function. But as development continues, our cells differentiate into specific cells. Undifferentiated cells are stem cells—they can become anything. After differentiation, some stem cells become heart cells, some become nerve cells, some become skins cells, and so on until we are fully developed. And no matter what these cells become, they are each and every one affected by these hormones because “testosterone improves the efficiency of the proton pump at the mitochondria in producing ATP [unit/molecule of energy], but increases oxidative damage. Estrogen [estradiol] on the other hand decreases oxygen damage but also decreases the efficiency of the proton pump. . . The increased oxidative damage may also explain why in males the testosterone that reaches the brain is turned into estrogen [estradiol]” [5]. What this means is that testosterone is effective in increasing energy but it also increases damage to cells, shortening the life of the cell. Estradiol on the other hand doesn’t increase energy, but it also gives cells a longer life by decreasing damage. Of course, any sort of imbalance will have other affects, but as a baseline understanding, this is one of the ways these hormones influence cellular function. On speaking of males turning testosterone into estradiol in the brain, I’d like to add that males require estradiol, as Fausto-Sterling notes, “for normal development of everything from bone growth to fertility” (Fausto-Sterling, 147).

Before moving on to how gonadoroids function in specific bodies, I want to use one more quote from Fausto-Sterling of her summing up her understanding of these hormones. She says, “A variety of organs can synthesize steroid hormones, and an even wider variety can respond to their presence. Under the right circumstances these hormones can dramatically affect sexual development at both the anatomical and behavioral level. They are present in different quantities and often affect the same tissues differently in conventional males and females. At the cellular level, however, they can best be conceptualized as hormones that govern the processes of cell growth, cell differentiation, cell physiology, and programmed cell death. They are, in short, powerful growth hormones affecting most, if not all, of the body’s organ systems” (Fausto-Sterling, 193). Calling theses hormones ‘sex hormones’ drastically misleads us into misunderstanding their necessity throughout the human body.

As I stated above, all bodies need these hormones. So, below I’ve included some lists from Cleveland Clinic [6] [7]:

Functions of androgens in all bodies: help with bone density, muscle development, puberty, red blood cell production, sexual desire and function

Functions of estrogens in all bodies: affects cholesterol levels, blood sugar levels, bone and muscle mass, circulation and blood flow, collagen production and moisture in skin, brain function, including your ability to focus

Specific functions of androgens in people assigned male at birth (AMAB): deep voice (vocal chord lengthening), hair growth on face, scalp, chest, underarms, and genitals, sperm development

Specific functions (reproductive) of estrogens in people AMAB: influences sex drive (too little = low sex drive), ability to get erections (too much = erectile dysfunction), production of sperm (too much = infertility)

Specific functions of androgens in people assigned female at birth (AFAB): Estrogen synthesis for: regulating menstruation, aids conception and pregnancy, minimizes osteoporosis, stimulates pubic and underarm hair growth

Specific functions of estrogens in people AFAB: puberty. menstrual cycle, pregnancy and fertility, menopause

As you can see, while different bodies have different hormonal influences on their reproductive systems, all bodies need these hormones for essential non-reproductive functions. If we limit these hormones to the reproductive system, then we ignore their significance in the skeletal system, the muscular system, the cardiovascular system, the endocrine system, the integumentary system (skin), and the nervous system, not to mention their significance on a cellular and molecular level.

Hormones and the Reproductive System

Now that we’ve established that these hormones affect more than just the reproductive system, let’s take a clearer look at their influence on the reproductive system. For this part I’m mostly going to reference Come As You Are by Dr. Emily Nagosk [8]. I highly recommend this book for everyone. In the first few chapters, Dr. Nagoski talks about the homologous parts of the reproductive system. Something she says often throughout the book is “all the same parts, organized in different ways” (Nagoski, 19). We all have the same parts that start out organized the same way, and then differentiate further based on hormonal influence. Notice that it isn’t just chromosomal influence, it’s also hormonal influence, significantly so. Below is a figure about the fetal development of genitalia, illustrating that we all have the same parts, organized differently.

[Fetal Genital Development][9]

If you think of male and female as poles, then intersex is all the space in between the poles. Each one of us has all the same parts organized uniquely. Dr. Nagoski gives us a succinct description and example of homologous parts: “Homologues are traits that have the same biological origins, though they may have different functions. Each part of the external genitalia has a homologue in the other sex. I’ve mentioned two of them already: Both male and female genitals have a round-ended, highly sensitive, multichambered organ to which blood flows during sexual arousal. On females it’s the clitoris; on males it’s the penis. And each has an organ that is soft, stretchy, and grows coarse hair after puberty. On females, it’s the outer lips (labia majora); on males, it’s the scrotum. These parts don’t just look superficially alike; they are developed from the equivalent fetal tissue. If you look closely at a scrotum, you’ll notice a seam running up the center—the scrotal raphe. That’s where his scrotum would have split into labia if he had developed female genitals instead” (Nagoski, 20). Homologous parts are all throughout the body, but the significance here is that what many people consider makes a man or a woman all comes from the same starting point. It’s not different, just organized differently. We are not different, just organized differently. The hormones I’ve been talking about are the influence that organizes these homologous parts. But it isn’t just estrogens vs. androgens. It’s the ratio of these hormones and the cellular reception of these hormones (among many other factors) that influence our reproductive organization. A greater synthesis and reception of testosterone will organize our reproductive systems to look like the male organization; while a greater synthesis and reception of estradiol will organize our reproductive systems to look like the female organization. However, from what I’ve learned, if testosterone is further synthesized, it will become estradiol; meaning that to synthesize estradiol, testosterone must be synthesized as well. So, these hormones themselves aren’t made separate from each other, but both come from cholesterol and are on the same linear path of synthesis. This is true of the other androgens and estrogens too.

Nagoski later highlights how there is as much variation within each of the sexes than between them. She uses height as an example, showing that among female people there is a greater degree of height difference than there is between female and male people, and the same is true among male people. She concludes with the description of a type of bell curve overlap. Following this illustration, she says, “The same goes for sex. Within each group we find a vast range of diversity—and I don’t mean just anatomically. I mean in sexual orientation, sexual preferences, gender identity, and expression, and—the subject of the rest of this book—sexual functioning: arousal, desire, and orgasm. . . . And variety may be the one and only truly universal characteristic of human sexuality. From our bodies to our desires to our behaviors, there are as many ‘sexualities’ as there are humans alive on Earth. No two alike” (Nagoski, 36). With there being so much variation among male and female sexes, it is not only logical for intersex people to exist, it is expected. The same parts organized in different ways applies to intersex bodies the same as it does male and female bodies. Dr. Nagoski explains, “Homology goes a long way in explaining how intersex genitals come to be. People whose genitals are ‘somewhere in between’ experienced some slight variation in the hugely complex cascade of biochemical events involved in the growth of a fetus, from egg fertilization through embryonic development and gestation. This small change results in slightly different genitals. . . As long as those genitals don’t cause pain and aren’t prone to infection or other medical issues, they’re healthy and don’t require any kind of medical intervention. We’re all made of the same parts, just organized in different ways” (32). Simply put, we’re all human no matter how our bodies are organized. We are all naturally equal no matter how our bodies are organized.

I’ve heard folks before question how common intersexuality is, writing it off as so infrequent as to not be pertinent to conversations of gender and sexuality. I want to first point out that even if it were infrequent, intersex people are still human beings deserving of love and respect. However, it is more frequent than you might think. Fausto-Sterling has a statistical comparison that I found useful. She says, “for most [intersex births], numbers exist. The figure we ended up with—1.7 percent of all births—should be taken as an order of magnitude estimate rather than a precise count. Even if we’ve overestimated by a factor of two, that still means a lot of intersexual children are born each year. At the rate of 1.7 percent, for example, a city of 300,000 would have 5,100 people with varying degrees of intersexual development. Compare this with albinism, another relatively uncommon human trait but one that most readers can probably recall having seen. Albino births occur much less frequently than intersexual births—in only about 1 in 20,000 babies” (Fausto-Sterling, 51-53). Granted, this does depend on how intersexuality is determined or what is considered to be intersex, however, earlier in her book, Fausto-Sterling speaks on how with the reclassification of certain intersex manifestations “medical science was working its magic: hermaphrodites were beginning to disappear” (Fausto-Sterling, 38). Another comparison I’ve seen before is to the frequency of people with red hair. No matter what, I argue that the frequency of intersex people is less important than the simple fact that they exist and deserve to be treated with dignity and respect.

Sex and Gender Metaphor

As a helpful metaphor, sex and gender are like the earth and its electromagnetic field (emf). The poles represent male and female (earth), and the general concentration/dispersion of gender (emf). Most AMAB people are men and most AFAB people are women. But those aren’t the only places that exist and take up space on earth, and they certainly aren’t the only places affected by electromagnetism. You not only have different latitudes and longitudes, you also have different altitudes. You also have different places in and around the electromagnetic field where people are each affected uniquely by the emf. Everywhere physically someone could be on earth represents the possibility of intersex and variation. And everywhere the earth’s electromagnetic field reaches represents all the ways people can experience their gender. The human experience when it comes to sex and gender is vast and various and powerful like the earth and its electromagnetic field.

[Illustration of Earth and its electromagnetic sphere]

My purpose in writing this is not to change minds or start arguments. I wanted to share several things I’ve learned over the past few years and somewhat recently. From all that I’ve learned, I’ve come to believe that people may express many manifestations of humanness on physical and spiritual levels, including some that I may not be familiar with. And there’s nothing wrong with that. My hope is that this will be helpful and useful information. I hope that for those of you looking for information or conflicted about what you believe, this either gives you some answers or gives you a starting point with resources to inform yourself. Just below here I have a post script that speaks on transness and the Christian faith. Then, I have my references in numerical order of when I first used them. Following that are some additional resources on LGBTQ history and information about the process of transitioning.

Post Script

If you subscribe to Christianity, specifically evangelical Christianity, you probably either believe that being trans is a sin, have been taught that being trans is a sin, or are conflicted about what you believe. I have a few points to consider that might challenge what you believe or give you clarity. Let’s examine the creation story in Genesis and cross-examine it with what we see existing today.

Maybe you weren’t taught this, but I was taught this and hear many people speak of it. The belief is that during creation only one kind of each animal was created (and later survived the Flood). Each kind carried within them the potential for all the variety we see today. Dogs are an easy example of this. Say that wolves were created. The teaching is that all potential for every various species of dog that exists today existed within wolves. The same for cats, birds, rodents, fish, etc. That’s a lot of potential. If we examine that scientifically, we’re dealing with a significant exponential potential. The classification system goes in this order: kingdom, phylum, class, order, family, genus, species. Genus would be the equivalent of a Biblical “kind.” This gives us an almost unlimited number of species and subspecies, depending on how much variation existed to begin with. And since we will never know how much potential existed at the beginning, we will never know what is and isn’t possible. I did some quick google searches to see how many different species of the genus Canis existed: 9 extant species and 8 extinct species (and an extinct sub genus with 3 species). Of the Canis familiaris (domestic dog) species there are 450 recognized breeds—that much variety within one species. As you can imagine, the first wolves or first of the Canis genus must have carried immense variety within them. With the example of dogs being an easy example, it goes without saying that the entirety of nature began with incomprehensible potential.

Now, if we take this understanding and apply it to humans, it brings up a few important considerations. First, the creation of humans started with one that became two. With the line of teaching above, then we should consider that the first human created, Adam, carried within him the potential for all humans who exist today. Humans being set apart from other animals and being given the image of God to bear, means that all variation that exists today among humans IS in the likeness of God. If all potential for variation existed within Adam and Eve, that means all potential for variation of sex and gender also existed within Adam and Eve. It is not only logical, but it is intellectually consistent to embrace intersex, trans, and gender non-conforming people as equal and fellow images bearers of God. We cannot gatekeep variation within nature. We cannot say what variation can and cannot happen; we do not have that power. If the belief is that all potential for variation existed at creation, that must include ALL variation (whether advantageous or disadvantageous mutation or hybridization). This means that variation in gender and gender expression is natural and amoral.

If you counter this with Gensis 1:27, saying that the Bible says “male and female created he them,” then you must be consistent and apply this to the entirety of the Genesis 1. If the only things to exist as true are the things that are explicitly described, then there should only be light and darkness, day and night. But we have sunrises and sunsets. We have artificial light also. There should only be land and seas. But we have wetlands, swamps, marshes and such. And man-made lakes. There should only be grass, herbs, and trees. But we have flowers, vines, moss, and other plants. There should only be birds, fish, whales (specifically) and cattle, creeping things, and beasts of the earth. But we have amphibians and other animals that inhabit land and water. So it follows that though male and female, man and woman are the only explicit descriptions of humans in Genesis 1, we should have intersex people and trans and gender non-conforming people. I will further point out that the trajectory of the Bible is one of inclusion. It is a theme woven throughout the Bible that people once seen as excluded are often included and honored. Then we have Peter being given the command to “not call unclean what I (God) have called clean,” a metaphor that erases the line between Jews and Gentiles. Then later we have Paul saying, “there is neither male nor female,” making the distinction of sex irrelevant to status as children of God. Austen Hartke wrote a book called Transforming about being trans and Christian. He and others have done more work to educate and at this point I defer to them if you have more questions or concerns.

Finally, Jesus as a metaphor of inclusion and expansiveness. (Whether you believe in Jesus as a literal historical person or not, Jesus carries in him metaphor and symbolism.) If chromosomally, you are to say that XY is male producing a man and XX is female producing a woman, then it is equally as probable that Jesus is a trans man as is probable that Jesus is a cis man, what you probably claim to be so. If Jesus was born of a virgin, then he has only X chromosomes. If he had a Y chromosome, it would carry some DNA from another human, making Jesus not divine, which wouldn’t be consistent with tenets of evangelical faith. So, Jesus with only X chromosomes develops as female (to whatever varying degree), yet presents and moves through the world as a man. In the person of Jesus, transness is expressed and included. Further, I recently learned of the Newman-Goldfarb protocol, where trans women (or anyone who desires) can lactate and breastfeed their children. Most all of us have nipples and have the capacity to feed offspring from our bodies. I’ve also learned of comfort nursing, where non-birthing partners will comfort nurse their kids. Knowing that the human body can be and do so many things, plus Jesus being expansive and inclusive, leads me to believe that we can bear the image of both God the Father and God the Mother. We can be both protector and nurturer, regardless of sex and gender. And I believe that intersex, trans, and gender non-conforming people bear the expansive and inclusive image of God more clearly than cisgender, male, or female people can in the world we have built.

To end this, I’d like to ask a few questions for thought. If you come to a point where you can’t support your belief about transness being a sin, yet you’re still hesitant to accept and love trans people, why? What are you afraid of? Are your more afraid of being wrong than you are of being unloving? Are you more afraid of being wrong than you are of being inclusive? If everyone is included, does that make you feel less special? Are you afraid that if you accept trans people, you will make God upset, so to appease God, you do what you think is right, no matter how harmful it may be? Do you know any trans people personally? Do you actually feel threated by trans people or are you just disgusted by them? Why? Because transness is different from you? These are just some questions I’ve thought of over the past year. Being honest with ourselves is harder than we think, but being honest with ourselves is good and is the first step to growth. If you’ve read this far, I hope this has been informative and helpful. As we all go on with our days, I’d like to share what Jesus said was most important. “You shall love the lord your God (Divine Goodness) with all your heart, with all your soul, and with all your mind. This is the first and great commandment. And the second is like it: You shall love your neighbor as yourself. On these two commandments hang all the law and the prophets.” Love is it, whether that means being accepting and comforting, or whether it means fighting for others and doing scary things, like questioning what you believe.

References:

[1] Neurosteroids

[2] Fausto-Sterling, Anne. Sexing the Body. 2000.

[3] Biosynthesis and metabolism of steroid hormones.

[4] Testosterone: a metabolic hormone in health and disease

[5] The information encoded by the sex steroid hormones testosterone and estrogen: A hypothesis

[6] Androgens

[7] Estrogens

[8]Nagoski, Emily, PhD. Come As You Are. 2015.

[9] Fetal Genital Development

Additional Resources:

1. Gender Variance Around the Wold Over Time 2. Christine Jorgensen’s Story