Hormones, Ideology, and the Cost of Dissent with Carole Hooven

30:20I just want to clear this up because there's a lot of confusion about this. So sex chromosomes do not define sex. I just told you what defined sex. It's gametes. But not all animals even have sex chromosomes. So there's temperature-dependent sex determination, say, in crocodilians. And that means that the undifferentiated gonad in very early development will become ovaries or testes based on the temperature in the environment. and that temperature will lead to the production of, say, a hormone enzyme called aromatase, which will lead to estrogen production, and in that case, ovaries, will develop rather than testes.

31:07So that's one way that sex is determined. So in crocodiles, you can't identify sex by sex chromosomes. So you can generally identify human sex by sex chromosomes because males have XY and females have XX, but not always. There are cases in which one male, a male might have XYY, sorry, a XXY or even XYY or a female might have XY. And there are interesting reasons for this. And this is because, I don't know if you want me to go into how a female could have XY, I'm happy to. But the point is that the only, if there's anything like an essence of sex, it's about the gametes. And those are necessary.

32:03All females will produce large immobile gametes or will have the theoretical capacity to produce those types of gametes. The reason this matters is because this difference is a very deep, ancient, evolutionary difference that influences the way that males and females develop physically and behaviorally. Because if you're a small gamete producer, you're going to have to go generally find and compete for the large gamete producers. and it helps to explain on average a lot of the behavioral and physical differences we see between the sexes the fact that males produce small mobile gametes and the females produce generally more expensive calorically expensive larger gametes okay so in humans it is the chromosomes that determine whether the gonads are going to differentiate into ovaries that are capable of producing the large gametes or testes capable of producing the small gametes.

33:19That is not the definition of sex, okay? Does that make sense?

33:23Coleman Hughes:Yes. So I'm getting to, sorry, this is a long way of saying that you are correct, that all the other traits that are associated with sex, that are associated with the ability to produce sperm or eggs, are on a spectrum. That includes something as basic as sex chromosomes, genitalia which are not always what you might predict for a male or female but generally you know almost always males will have x y sex chromosomes and a penis but they don't have to sometimes they don't sometimes a male can have what appears to be a vagina or a female could have what appears to be a penis so you can start with these very basic reproductive characteristics And those are not a clear, distinct binary.

34:15Of course, when you get into things like hormone levels, body types, breasts, breast size, gender identity, however you want to define that, gender presentation, desire for rough and tumble play, parental investment, all those things are, of course, on a spectrum. So I just think that's important to say and to clarify. And what is happening now is that there is a conflation between sex itself and the traits associated with sex. So a book just came out by Augustin Fuentes. He's a Princeton professor called Sex is a Spectrum. and in that book he you said that most people can agree i think you said that most people can agree that um the sex is men are taller than women yeah that men are taller than women example yeah and then other set you gave some other sensible examples sometimes people who defend the idea that sex is on a spectrum don't agree.

35:27Somehow they do these tricks where they don't agree with that, or they kind of play with what average means. So I just want to be clear that sex itself is binary and sex-associated traits are on a spectrum and differ on average. Okay. So then you asked, what does testosterone do? So when you think about the capacity to, when you think about sperm versus eggs, and the goal of natural selection is for organisms to get the highest proportion of their genes into the next generation as possible, generally. And it's just about copying. It's about copying DNA, one's DNA. And in the case of sexual reproduction, parents are combining their DNA to produce a new individual, and they're each providing half of their own DNA.

36:27Okay. So those organisms, to reproduce as a male and reproduce is a female, on average, different strategies are needed. So we can just talk about mammals because that makes it easier. And we can talk just about land mammals, say. Most mammals, in most mammals, males will have multiple female mates and compete for multiple female mates. In the book, I talk about red deer. So a dominant red deer, the goal of the red deer is to create a large harem. And in order to acquire a large group of females that you, as the dominant male, would be able to inseminate, the goal is to attain high status so that you are able to, I'm just going to use the word acquire, a large group of females that you will then be motivated to mate with, and you want to defeat other males in a status competition in order to do that.

37:33Those competitions are often physical and require weaponry and large body size and muscle mass and a psychological predisposition to fight during mating season with other males. That's called mating competition. And this is because males produce large gametes, and in order to reproduce, they use their reproductive energy budget. All adult humans have reproductive energy budgets. So we put some energy, a lot of energy, into growing and surviving. We put other energy into reproducing. So in order for males, and just with the example of the red deer, to reproduce, they're using a huge amount of energy to grow to a larger body size, to maintain a high amount of muscle mass, to grow antlers, to pursue females to mate with them, to prevent other males from stealing, stealing, in quotes, the females.

38:35So this takes a huge amount of energy. And people don't appreciate that, yes, female mammals gestate and lactate, and that requires an enormous amount of energy. But we do that with our bodies. It just, once we are pregnant, it sort of happens without us having to do anything. We have to nurture our child. We don't, we have to let our child suck on our boob. And it's pleasurable because of hormones like oxytocin. But males have to go out and invest energy in their body and their behavior in order to reproduce. Okay. And that is because of the difference in parental investment. So the sperm are less calorically expensive to produce.

39:19They can make millions, males can make millions and millions of them. Females make a limited number of more expensive eggs, which provide more of the nourishment for the developing embryo and fetus, obviously. Okay, so given those differences in strategies, I just gave you an example where there's an extreme difference, but in only 5 % of mammals do males actually invest much, if anything, in parenting the offspring. So what testosterone does is, first of all, male humans have from like 10 to 30 times as much testosterone as females. And I want to make sure I talk about the critical periods where that has an effect.

40:10But overall, testosterone is a reproductive hormone that helps to allocate energy. So you take energy in and convert it into offspring. That's the goal. You want to survive, but then evolution shapes us to be motivated to get energy and to use it, especially once we've completed growth, to then convert it into offspring. We have different strategies to do that because of the different ways we use our energy differently to do that. So females have to have their bodies be homes for the fetus that they are growing, and then their breasts are used with the energy that they're taking in to produce milk to grow the kid or kids once they're on the outside.

40:59so that energy for females has to be used to store energy so estrogen biases energy intake towards being used to produce body fat right testosterone biases energy intake to be used to produce muscle because these are the reproductive strategies that each sex needs and we need hormones that direct the development of the physical and behavioral traits, and this is starting in utero, that enable males to reproduce. And for instance, in utero, males will have, again, very high testosterone during a critical period in utero, which their testes are producing, and that testosterone directs the development not only of the internal and external genitalia, it also acts on the brain.

42:04And we know this from very clear studies in non-human mammals that testosterone is what is responsible, for instance, for higher rates of rough and tumble play in male animals. So that I should say there's also a period in humans directly after birth where testosterone rises again in males. That's called mini-puberty. It's about three months after birth. And that appears to be another time where testosterone is acting on the body, specifically, interestingly, and they're just sort of learning how this works, it has something to do with further penile development at that stage, but also potentially more actions on the brain to masculinize behavior.

42:48So we know from some evidence in humans, but mostly in other mammals, that you can regulate the expression of rough and tumble play like tackling each other. I have a 16-year-old boy. He's still doing this with his friends. And it makes me nervous because he's 6 '1 and his best friend is 6 '3 now. But this is what they did growing up. And they're not like these tough, you know, super athletic boys at all. But they, one of their favorite ways to play, and has been since they were little, is tackling each other and wrestling. Two girls playing as kids rarely play, you know, prefer to play that way.

43:31And this is not something that is unique to humans. We see this in male mammals, particularly when, as adults, physical competition is, necessary for reproductive success. And it's a skill that has to be learned, and aggression is reduced in adults when, as kids, boys learn how to play with each other aggressively and learn the signals, learn who's dominant, and learn sort of when to submit, when not to submit.

44:08Coleman Hughes:How do we know that aggression is reduced in adults? So we know this. So the best studies we have are from non-human animals, and there's a series of studies that if you prevent, you maintain a young male's social environment, but you prevent him from playing with other males, I think. and those males as adults have higher rates of aggression than the young males who just play typically rough with the their male friends or whatever you want to call them and other animals and the the reason they're less aggressive is because they learned how to regulate aggression so play is the main thing that kids do and the sex differences in play have something to do with reproductive behaviors.

45:03It's practice for survival and reproductive behaviors that each sex needs in adulthood. But what we do, I think, have good evidence for is that in non-human primates and in rodents, if you block male testosterone in utero or directly after birth, depending on when the critical period for masculinization is, you block rough and tumble play. So you can also add high male levels of testosterone to females in early development, and you increase rough and tumble play. And in humans, we know that in little girls who have excess testosterone in utero, they have higher rates of rough and tumble play. So the point is that it is this sex difference in testosterone that starts in utero that sets each sex down on somewhat of a different path because they are developing sexually specific mating strategies, essentially.

46:14and they're practicing them as kids. Again, this is on average. There's a lot of boys who don't like rough and tumble play. And notably, boys who grow up to be gay show lower rates of rough and tumble play, which is interesting. But those boys who grow up to be gay show typical male sexual behavior, which is interesting because both of those things are mediated by testosterone in non-human animals. So that's, but that's an aside. So your question about increasing, okay, so that's the first critical period. And the fact that when the kids are little, you know, say four, five, six, seven, boys and girls don't have differences in testosterone.

47:04That difference stopped a few months after birth. Like that was the end of the high testosterone. Girls never had much testosterone in utero. They have some, and they have a little estrogen peak after birth, but they don't require any specific sex hormones to show typical feminine behavior. It's that if you don't have that testosterone exposure, you are likely to show typical feminine behavior.

47:31Coleman Hughes:So just to get this clear, if we're looking at like a group of seven-year-olds and we're seeing that the boys are wrestling with each other and doing arm wrestling and the girls are by and large not doing that, that's not because their seven-year-old levels of testosterone, if we measure them today, are any different. That's just the long tail effect of being swamped in testosterone in the utero and in the early months of life. That's correct. Okay. So those are, again, so in humans we can't do the experiments to show exactly what is happening in the brain. but we do have a lot of evidence from non-human animals that testosterone is acting on specific parts of the brain but that have to do primarily with sex and aggression and there's some areas that have been identified but in it seems that testosterone is having more subtle effects on neuronal development, connectivity, death, that affect overall behavior.

48:42I don't think we still have great data on exactly what neural changes that testosterone leads to cause the different outcomes. But we do know that you can manipulate these sex-based behaviors that are more typical of one sex or the other by manipulating early exposure to testosterone. And so even if we didn't have puberty as the next critical period, or we didn't say we didn't have sex differences in hormones or any sex hormones in puberty, you would still have these long-term effects of the different behavioral patterns and social patterns that affect brain development that happened in childhood.

49:27You know, if you're doing a lot of rough play, that's going to shape the way your brain develops and the way you develop psychologically and socially. So just that large sex difference in behavior that is, I would say, caused by a difference in testosterone exposure has long-term effects on its own that don't go away. Okay, so how do we know that the behavioral differences like rough and tumble play, for instance, are the product of hormones that are downstream of sex differences as opposed

50:07Coleman Hughes:to how society tells boys they're supposed to behave, how society tells girls they're supposed to behave? What's the best evidence or the best natural experiment that you would show to a skeptic who believes it's all acculturation? So first I would ask the skeptic, why every culture all over the world, why do we have no cultures where girls are doing this behavior and boys are playing house? say. I mean, everyone uses their iPhones now, but when, you know, kids are playing outside and don't have a lot of technology, like the way I grew up, why do we not have any, why is culture everywhere across the world leading to the same outcome?

50:57Why is this the cultural norm?

51:00Coleman Hughes:Yeah. I mean, so I'm not a skeptic, but if I were to play devil's advocate, I would say, well, you know, there's a culture, a longstanding culture of the patriarchy almost everywhere in the world for thousands of years, where it just somehow it got locked in that men were to behave a certain way and women were to behave another way. And so, you know, it's basically, it's cultural on all four corners of the earth down, down through time. Yeah. I mean, I think that's a very hard argument to make, but where I go is to say, first of all, let's think about why this difference might exist. So I would point to evolution and reproductive strategies.

51:41So we have a theory that makes a whole lot of sense and clearly explains what we're seeing in non-human animals. We have, and we see the same thing in humans. So it's predicted just based on evolutionary theory and where we're coming from, our own evolutionary history where we no longer have to use physical aggression to attain status in order to attain mates. We've been acculturated out of that. Not everywhere, but in most Western societies. And so you would predict that, and then you do find that. We also have a mechanism, and that is testosterone and the that mechanism of this specific hormone regulates a suite of behaviors that promote male or have promoted male reproduction in human evolutionary history and currently in many non-human animals and we know this because when you manipulate testosterone in the different sexes or you manipulate the receptor or any number of other kinds of experiments you can reverse the feminization or masculinization in terms of brain and behavior.

52:55So then you could say, okay, well, where's the evidence in humans? Because we have this confound. We do have an extremely gendered society, and there's a lot of reinforcement of masculine norms, and that is a fact. So boys are, so here's some evidence. Boys' behavior is really very strict, often strictly policed to be, you know, especially by other boys who can be quite cruel if the behavior is not masculine enough. So there's an incentive for boys to engage in rough play because they may are often bullied and harassed if they're seen as sissies. but there are boys especially these boys who are gender non-conforming as kids they often will not engage in rough play because they don't like it no matter how much pressure they have from their dads or teachers and so I think there are some counter examples but then we have this evidence from girls who have congenital adrenal hyperplasia.

54:07And there's a lot of pushback on the evidence because the people who want to support the argument that you just made hate that there is any evidence that shows that testosterone in utero increases rough and tumble play in girls. At this point, there are probably over 100 studies, very well-designed, clear studies that show, I think it's over 100. But that show -

54:32Coleman Hughes:So there's a kind of, sorry, sorry to interrupt, but there's just a kind of, there's a kind of paradox, which is interesting to me where, because people on the sort of postmodern gender is a spectrum side of this argument will often cite these examples of girls that behave in male typical ways and boys that behave in girl typical ways. But then when you scratch beneath the surface, you find that those cases are cases of biology doing its work as well. And so beneath the surface, it actually ends up undermining their whole argument if all the girls that like rough and tumble play are girls with higher levels of testosterone, which then goes back and reinforces the idea that biology really is doing the lion's share of the work to begin with.

55:18Coleman Hughes:Is that right? I wouldn't. Yeah. I don't know. So for instance, I don't know that I had high prenatal testosterone. I had three older brothers, so maybe there was something about my, you know, my environment. But what we do know is that the girls who have congenital adrenal hyperplasia, who clearly have higher than average or sort of atypically high, not reaching the male range, that's very difficult for a female to do, but atypically high testosterone overwhelmingly are showing masculinized play. So that's just a fact. And there are many, many studies showing that. I don't know if you can make the claim from play to higher testosterone, but it's likely.

56:09And we don't have terrific measurements of testosterone levels in the womb that fetuses are exposed to in general, but we know when there are these disorders that there is elevated testosterone. And there's also a masculinization of the clitoris that, so there's some physical effects of these, of say congenital adrenal hyperplasia. So we have an index of how high the testosterone might have been based on clitoral size.

56:40Coleman Hughes:Right. So in everyday life, I'm talking about work, school, sports, etc. Where do these sex differences, these average sex differences matter the most? and where do they matter the least? Sex. Sex is the big one. So we have very clear evidence for testosterone. So here it gets interesting. So sex and aggression do seem to come apart a bit in terms of the effect. So what we should be thinking about when we think about the effects of testosterone and how to understand sex differences is really the fact that men have so much more than women. Not sort of the differences among men or changes in male testosterone, although male testosterone does change for some interesting social reasons, and I would like to come back to that.

57:49But the meaningful difference is that males have so much more, many, many times more the level, you know, just say 20 times as much as females. So there's some threshold. And above that threshold, you get male-typical behavior. So sexuality seems to be male-typical. It's not, you can have relatively low, but, you know, healthy range or relatively high. It predicts nothing about sexual behavior. And so far as we know, it predicts nothing about aggression. However, the fact that you have a male-typical level predicts that you are going to be, have a much higher sex drive than most women. You are going to have a much stronger preference for a variety of sexual partners than most women.

58:37That just seems a male, if you have been exposed to typical levels of testosterone, you're going to have a male typical sexuality. You may or may not have male typical aggression. You know, that's something we can't measure in the lab because most people are not physically aggressive. But of the people who are extremely physically aggressive, they're almost all male. You know, they're 80, depending on the violent crime, you know, 80 to 99 % male. So, and if you look at the patterns of violent crime, it pretty well parallels the peak and then sort of plateau in male testosterone levels, which from an evolutionary point of view would have mirrored the height of male-male competition for mates.

59:35There's a bit of a delay after the peak in puberty, and that is because, again, my son, sorry to use him, sorry, I won't say his name. Sorry, my son, but he's tall and thin right now. And he's 16, He's got a lot of testosterone going on. But the teenagers are just entering the adult kind of mating market. They're developing their musculature. They're developing their dominant skills. They're figuring out what they're good at, how they can achieve social dominance. It takes a few years for them to really enter that adult mating market. And that's when we see this peak in male violence. um so sorry that that was kind of getting off of your question but so we've got these two aspects of masculinity and i'm saying that the sexual the masculinization of sexuality seems to just require some threshold we have a huge amount of variation in aggression it's just that females on average are much much less physically aggressive than males so in terms of where this plays out competitiveness.

1:00:46A lot of women don't like that, but there's a different element. There's a females, of course, I'm not saying are not competitive. Many women are extremely competitive, but male-male competition takes on, in my view, a different nature here so that the evidence for the testosterone involvement is best for sex and aggression, and that's in humans and non-human animals in terms of the sex difference, particularly for sex. So what's interesting is that if you look at people who transition, making a gender transition, and use hormones to do that, if they go from female levels of testosterone, so a woman transitioning to live in the male sex role who takes male typical levels of testosterone, the most common and profound psychological effect that happens within a few months is they go through something like a male puberty and are generally shocked by the intensity of their sexual desire.

1:01:55There's variation here in the effects, but this is one thing where you're going from a female, typical, on average type of sexuality to a male type, which is more intense, more focused, more driven, and more objectifying of whatever the sex they're attracted to. So the same, there's a similar need for ultimately love, but the high testosterone seems to lead people, and here I'm using what I have heard, and there's hints of this in the literature about objectification. I've heard this from a few people who have transitioned that they began to objectify this body parts, think more and fantasize more and have more mental imagery about the body parts of the sex they're attracted to.

1:02:50While still having a longing for love and intimacy, there's this other heightened drive and obsession with sex.

1:03:00Coleman Hughes:The other data point there is firsthand accounts, which there's this guy, Plates More Dates on YouTube, who he analyzes, he's a former steroid user and bodybuilder that analyzes especially like famous celebrity body transformations. So you'll have like a celebrity like, you know, like Kumail, whatever his name is, Kumail Nanji. I might be getting that slightly wrong. But he's like, he's as like a totally normal guy's body. And then six months later, he's in a Marvel movie looking like a god. Which is, you know, as you know, not actually possible from, like you could lift weights two hours, three hours a day.

1:03:42Yeah, it's not going to happen.

1:03:43Coleman Hughes:And you can't go from a normal scrawny guy looking like, you know, Liam Hensworth in six months. It's just not possible. That takes many, many, many years unless you're taking a whole bunch of testosterone, in which case you can actually do that in three, four months. Yeah. So he analyzes these bodies, these bodily transformations from the point of view of someone who has taken steroids. And steroids is just like a suitcase term for different kinds of testosterone and other similar hormones. Often it's just straight up testosterone. But he analyzes these first-person accounts that people will, you know, former steroid users will, you know, I started taking testosterone and here's what happened to my life in the next two years.

1:04:29Coleman Hughes:and half of the stories are just people destroying their lives because they became so incredibly horny every single second of every day, destroying their marriages, their relationships, getting into physical fights. Sorry, this is the anecdotes from... These are anecdotes usually shared on Reddit or in essays, but this guy, More Plates, More Dates on YouTube, he'll read them because his whole channel is devoted to this genre of content. Okay. And so I have found those to be very entertaining and enlightening. So, you know, it's not only women that want to transition to present as a man. It's also men that double or triple their level, their natural level levels of testosterone in order to get jacked.

1:05:16okay this is interesting because there is some very solid uh data showing that even when you raise male testosterone levels to supra physiological levels but maybe not to the levels that you're talking about um sex drive tends not to change but these could also be guys who are in relationships or who are not so jacked that they're getting a lot of more attention from women. So here you have somewhat of a social, potentially confound, because once you change your body, it's going to be easier to get sex, generally, if you're a guy and you're getting completely ripped. So yeah, I haven't seen the data that shows that effect in males.

1:06:08So, but possibly, yeah, but I can imagine it would happen.

1:06:12Coleman Hughes:It's possible these are people taking like extreme amounts of like Tren, Trenbolone and things like this. Not like the amount that a 50-year-old guy would go to his doctor to get, you know, testosterone therapy. Like these people are taking much more than that. Yeah, so that's interesting. Did they say anything about aggression? Yeah, it's, you know, people for the first time in their lives getting in bar fights, this kind of thing. Ending up, in some cases, ending up in prison. and, you know, looking back on the whole thing is like, wow, like, why did I do all this to my life just to get jacked?

1:06:50Yeah, no, I'm so glad you're bringing this up because people do not appreciate that once you start getting the benefits of high exogenous testosterone that's not produced naturally by your own body, when you take that testosterone, your brain senses that you have enough testosterone in your system, and it stops sending signals to your testicles to produce testosterone. So your testes kind of shrivel up because they're not producing sperm or testosterone anymore.

1:07:26And it may take a long time for that function to come back online. And if you take enough of it for long enough, it's not clear that your fertility will ever return. So in some cases, from what I understand. It could cause permanent infertility. But suppose you're like, you have great erections, you're getting super muscular, you're getting a lot of attention, you feel great, and then you stop. Your testosterone won't come online for months necessarily. I mean, it could be quite some time. So during that time, you're not even going to be able to get an erection. You're going to start losing muscle mass.

1:08:03So this is why people become addicted, because coming off of it is so difficult. You know, you go from having tons of sex to essentially having none. So that's something to really consider before you start taking it. That'd be very difficult to come off of it.

1:08:26Coleman Hughes:Okay. So we never quite got to the second of my earlier question. Where are the sex differences in everyday life the least important? yeah well i guess i'm biased it's hard for me to think of any area where it's not important um because men and women are and boys and girls are are very different um even intellectually i think we're different cognitively we're different i wrote an article um for quillette on sex differences in chess and there are very large sex differences in chess with males consistently you know on average dominating females and it seems to be the case i i think the the reason is that males are more focused on have something called like higher rates of obsessive drive where they will focus intensely on one thing and becoming the best at that one thing and winning at that one thing and put they're more driven to put the time in i don't see a relation clear relationship to testosterone in the literature.

1:09:28So we're not important, super important in terms of the role of the sexes in raising the kids. Sometimes it's reversed, but in terms of large patterns in behavior...

1:09:40Coleman Hughes:It's important everywhere. I think it's important everywhere, but it must be not very important in some places. Maybe, can you think of it? Something? I've never been asked this. I love this. I mean, I agree it's important everywhere to a degree, but that itself is a spectrum. So you've got sports on one end where we just have to segregate men and women to play sports, essentially, unless you're one of the few people who thinks we can get rid of that. But we don't have to segregate a journalism school, right? Men and women can collaborate together on equal terms across various aspects of life and pretty much treat each other without regard to sex.

1:10:27Coleman Hughes:And things work out in certain spaces. And in other spaces, men and women actually just straight up need to segregate fully. You're talking about more about practical implications. Exactly. Yeah, yeah. Then it doesn't matter. Yeah, in the workplace, you know, it shouldn't matter. But of course it does. because there's sexual harassment, there's men doing each other favors, and, you know, women doing each other favors, or women gossiping about men, or, you know, so officially, I mean, so I guess I think it matters in every social environment, but like you're in a relationship, I think. What about your, do you think it matters in your, all aspects of your relationship, or would you say there's some...

1:11:05Coleman Hughes:With my fiancé? Yeah. Yeah, absolutely. Like, yeah, I would, it would not make sense for her to treat me as if I were a woman and for me to treat her as I would a man. Or just treating each other as human beings, right? So that's what I'm trying to think. Do we ever interact in a way that fails to account for or acknowledge or wear that one or sex, meaning the effects of testosterone, say, and or estrogen, different exposure over a lifetime is not part of that or an important part of that. Well, I think in like a healthy, normal workplace environment, most of your actions will be indifferent to sex.

1:11:46Coleman Hughes:That's not to say there'll be a sexual harassment situation or people will start dating, and then it becomes very important. But in the run-of-the-mill course of an average day, it really shouldn't matter that much. It shouldn't. And it doesn't. Yeah, I think it shouldn't, but I think it often does. Okay, so I didn't give a good answer there. No, that's okay. You gave an honest answer, and that's what matters. Okay, so what do we know about the long-run effects of suppressing testosterone in the case of, say, of puberty blockers in adolescents that have gender dysphoria or the long-run effects of taking testosterone in the case of a natal female trying to transition to present as a man?

1:12:39Okay. So this is a good way for me to piggyback on the last question because I can start out by talking about... So sex hormones are coordinated with the type of gametes we produce. So if you have... Like testosterone goes up in puberty because you're making sperm. You're becoming a sexually viable mammal and you need to then develop the secondary sex characteristics and behaviors that will allow you increase your chances of successful mating and etc right so just starting with that in adults especially in males we do not see this in females with testosterone or estrogen in any of the studies that i have seen and i have looked very hard we and so females have changes in estrogen, of course, across their cycle, those changes do appear to affect behavior in ways that are meaningful for reproduction.

1:13:39And men also have changes in testosterone that are relevant to their social situation, their status, their competitiveness, their risk-taking. Men get feedback based on their perception of what's going on socially that is translated often into alterations in testosterone level that are coupled with the environmental stimuli. So this is super important, and people don't really understand that this happens, and that when you take exogenous this testosterone, you are preventing these natural evolved, this whole system that has evolved to tune you into what's happening socially and how you, Coleman Hughes, can increase your status or, you know, how you can, should you compete or should you back off?

1:14:36Is this woman fertile or not? Do I have a chance competing? Not that you're competing now, but do I have a chance competing against this other guy for this woman's attention? Do I have a baby? Do I have a partner? So when you entered into your mateship, you probably, when you're committed to one female, you'd probably have a bit of a decline in testosterone. It's just like when monogamous birds are setting up their territory and fighting off other males, they have an increase in testosterone. But when they pair up with one female, their testosterone goes down. It has to go down or else they will, when she has kids, the father will abandon the children if the testosterone is raised.

1:15:25So suppressing testosterone in a relationship is adaptive. It's not always good to have high testosterone and be out aggressing and trying to find new females. Okay, so that's just a way of illustrating, and there's much more to those social changes than I just said, but the point is that there is a system in place where this is a dynamic hormone that influences and responds to social situations so that when you have people who, first of all go through it's not even a real it's not even it's a type of puberty will go through a like if a male goes through a estrogenic puberty he's that means he's taking exogenous hormones of course that whole system that happens in females with um monthly chain monthly cyclic changes in hormones is not going to happen in a male, first of all.

1:16:29And similarly, when a female takes testosterone, actually, yeah, she will not experience that same kind of social feedback. So that's one thing to think about. That's a very interesting point.

1:16:49Coleman Hughes:Can I linger on that before you go to the next point? So you're saying the way testosterone works in a natal male is that maybe I get it. I get a burst of testosterone in response to specific events that my brain is telling me are good times to get a burst of testosterone. I don't know what that would be. If you beat someone out in a competition. My team wins in a competition, right. Or if you win a chess game. Right. Right. So there's some kind of feedback between when I get testosterone and how much I get and what's actually happening in the real world. And that feedback allows me to navigate the world, encourages me to navigate the world towards higher status.

1:17:33Yes. Or it'll help you realize that, okay, you don't have high status. I'm not the alpha here. Yes. Maybe you need a different strategy, like pair up with one female and be an amazing dad. and you'll have just as many kids as if you're a higher status male with potentially higher testosterone out on the mating market all the time. You might come out even, but you're using two different strategies. Okay.

1:17:56Coleman Hughes:Right. And you're saying, you're making clear here that if you're a natal female taking testosterone, that link between testosterone and navigating the world isn't the same. You're just getting a constant dose. That's correct. Okay. So continue. Not only are you getting a constant dose. Okay. here's another really interesting what i think is a very interesting overlooked factor in transitions so i explained what happens in utero and there's very good evidence in non-human animals that testosterone is having you know high testosterone in males is having different effects on uh the brain development than having no testosterone in utero we know that there's that that really matters and influences some different outcomes.

1:18:46So the idea is that this is called the organizational activational hypothesis, and it's not this simple. It is more complicated. But the idea is that in puberty, when testosterone goes up in males, it is acting on the masculinized brain. It's acting on those masculinized neural structures to produce certain kinds of adult behavior. So if you are a female who is taking high levels of testosterone, you're not going to act exactly like a typical male because you have essentially something like, there's not also just a female brain and a male brain, but there are brains that are more feminized and more masculinized.

1:19:30If you're a female and you take testosterone, it has not been masculinized in utero. So it's not the same act, it's not going to be the same effect as pubertal testosterone in a typical male. So now you take trans women who do have a masculinized brain, say, who did go through male puberty, which is the second critical period, which also has permanent testosterone, that high testosterone also has permanent effects on the brain and body, obviously, in puberty. So if you take a trans woman who's a male who transitions after puberty, that male has already had a double dose of testosterone on the brain and is now blocking it and taking estrogen.

1:20:15You may have remnants of some very typically masculine behaviors, especially certain types of aggression seem to be still sexually differentiated more masculine style of aggression even in a male who is on estrogen and part of the reason might be that it's because of this early masculinization combined with the further effects of high levels of testosterone in puberty okay but what you asked about is what are the effects of taking cross-sex hormones in puberty right so one thing we know is so the the point of the high sex hormone or reproductive hormone levels in puberty is to masculine to sorry to um further develop, fully develop the reproductive system so that it's capable of producing sperm in males and eggs in females.

1:21:19And then combining that reproductive system development with changes in the brain, like more risk-taking, more sex drive, more nurturing, more socialization and status competition, pairing those traits with the availability of gametes. So if you do not go through a natural puberty and you do not develop the testes and ovaries and genitalia so that they're capable of producing gametes and then in the male case, delivering gametes into the external world, like a female's genital tract or however you want to release your semen. If you don't go through that development, so in the male, there's no capacity for erection anymore.

1:22:14The penis hasn't developed. The sperm will not be made. The semen will not be produced. So there will not be a typical male orgasmic capacity. I don't believe that there is evidence of orgasm. And here, there's definitely not going to be the capacity to produce sperm, so there'll be permanent sterility. And sexual function is definitely severely inhibited. And I don't believe there's evidence of orgasm in those males who go through an estrogenic puberty. There is some anecdotal evidence of non-ejaculatory orgasms in men, but I'm not sure that it happens in this particular population. And so for females, it's a little bit different because the clitoris grows under testosterone.

1:23:18And I believe that there's some orgasmic capacity for trans men. But there's, again, it depends on what tanner stage. I should qualify and say that if you let the ovaries and testes develop sufficiently, you might be able to harvest sperm or eggs or potentially resume capacity for their production. But generally, when puberty blockers are started, say 10 or stage 2, there's not sufficient development of the ovaries and testes to allow for gamete production, so there would be no future fertility. And of course, we need more time to study this stuff and do more research. So it does seem that infertility would be permanent in this population.

1:24:10And generally, sexual function will be severely inhibited, particularly in males.

1:24:16Coleman Hughes:So if you were to boil it down to the simplest possible terms to like a one-minute answer, What is it that the trans activist community in general has wrong about the implications of cross-sex hormones and so forth for adolescents or even young adults? yeah so i'm the my area is not really on um how effective transitioning would be for alleviating gender dysphoria i know about that literature but a lot of people know more than i do the idea is that the evidence base is just not there to support the claim that hormones and surgery particularly in young people, alleviate their psychological problems, especially gender dysphoria.

1:25:14So, you know, the recommendation is that young people under 18 not take puberty blockers because almost all of the people who start on puberty blockers progress to cross-sex hormones. So they would interfere with their natural puberty. And there are studies that strongly suggest that going through natural puberty is what allows people to come to terms with their sexuality and experience what it's like to be a sexual human and have sexual activity and maybe some orgasms, because if you interfere with natural puberty, you're not going to even experience any of that stuff before you decide to maybe never have it or never have kids.

1:26:03So the idea is just that the evidence base isn't there for the benefits.

1:26:11Coleman Hughes:Okay, two more questions. Yeah. I heard someone online recently argue that sports should be segregated by hormone levels instead of by sex. Neil deGrasse Tyson? It might have been, yeah. Good idea or bad idea? A terrible, terrible, terrible idea. Why? So it's just ridiculous on its face. Like, because what we have makes sense. So there's a reason we separate by sex. It's because all those things, hormone levels, strength, limb length, bone density, speed, all those things are generally captured by sex. It doesn't mean that it's fair. It's not fair. Whoever said sports was fair, it's not. Some people are just genetically blessed.

1:27:04Some people have more money and opportunity to practice. Some people put more energy into practicing. Some people don't have kids and can practice. I mean, there's a million reasons why some people are going to be better at sports than others, and it's not fair. But there's no bigger divide. There's no bigger single predictor of success than sex. if you're you know especially if you're at the elite level and everybody is similarly trained um there's just no evidence that females could do could match so ridiculous this claim and people are making it that um women could match men if they just had the same opportunities uh in terms of training and support there's no evidence for that there was a after title nine there was a large increase in female performance relative to males.

1:28:05But this plateaued, I think, in the, I can't remember, I don't want to say exactly one, but this plateaued many years ago, the sex difference. So it's, women are still, you know, doing a little bit, making small improvements relative to men, but there's no way that, there's no evidence that the gap is closing. It seems to have pretty much stabilized. And depending on the sport, you know, like a 2 % to 20 % difference. It depends on the sport, but it's such a monumental gap that there are thousands of high school kids. I think it's thousands. Sorry, I don't want to get the numbers wrong. There are a lot of high school boys who could beat the female Olympic champion in like most track and field sports, for instance.

1:28:56So it's just, okay, so you could take hormone levels. Okay, so suppose you take hormone levels. Suppose you take, yeah, how would this even work? So you could take somebody like Leah Thomas, who's a male, who's an adult male. Leah blocked, I'll say her, but people should keep in mind this is an adult male, blocked her testosterone. So if you used hormone levels, that it would be completely fair for Leah Thomas to compete against Riley Gaines. Okay. Both of them, you know, exceeding, have all of the opportunities for training and are both working hard, as hard as they can. And, but Leah Thomas has already gone through male puberty, already has increased bone density, already has height, already has masculinized heart and lungs.

1:29:46And all of these advantages that don't go away. So, and why should we just take hormone levels? Why should we mess with the categories that we have? It just doesn't seem fair because it only hurts women. It is males.

1:30:07Coleman Hughes:One of the strange things about this is like, I have never heard a professional female sports athlete ask for this? The people I've heard that want to sort of change sports are invariably not even athletes. They're not even people that play sports professionally for a living. They're like professors at a university of some issue. So if it were an organic demand coming from within the sports community, I mean, and of course, at some level, one has to discount the Leah Thomases of the world only because she, and to be polite, I'll use her pronouns as well, but she is precisely the small sliver that stands to benefit from this thing being changed.

1:30:57Coleman Hughes:She's one stakeholder in a world where 99 % of the stakeholders are not really going to benefit. Most men are never going to transition anyway, and no natal female stands to benefit from these categories being collapsed. So, and then you have examples where like the best women athletes in the world, like Serena Williams, um, you know, was very, was like, you know, you can go back and look at the actual interview, but she was like, why are people saying that the women could compete with the men? Like I, I, as the best woman tennis player in the world would not be able to compete with the men that I'm cures with.

1:31:35Coleman Hughes:Right, I quoted her in my book from that interview. And why do, I don't need this to be the case. Like, I'm perfectly happy being the best female tennis player in the world. Right, and she wants to compete against women. Yeah, which is awesome. And it's not fair to have to compete against men. And you're right, it's people who have no skin in the game or men who are advocating for this. And it is very annoying as a woman to have males who identify as females guilting women and gaslighting women and everyone else saying, you guys are bigots because males want to join your female category and you're not letting them, so you're a bigot or you're a transphobe and you're not even allowed to have the conversation.

1:32:24That is ridiculous in my view. It doesn't mean that there aren't people who are frustrated, like trans women in particular or trans girls frustrated about not being able to compete, but I don't think they should be barging into the female category. It's inconsiderate and wrong. And biologically, there's like just tons of evidence that it doesn't, if you block testosterone, yes, you're going to lose some of your capacity, but you don't get into the female category by picking out little pieces that matter and then saying, okay, maybe now you can have a chance as long as you're not, it just doesn't make sense and it would never work.

1:33:07And I, Neil deGrasse Tyson is completely wrong on this.

1:33:13Coleman Hughes:Okay. Last question. What is the most interesting unanswered question in the field of hormonal research? Oh, wow. So this is a really good question. And I think the area where we need more work is on what I was talking about before and how, first of all, testosterone motivates exactly how it motivates particular male behaviors and the dynamic nature of testosterone and how it interacts with the nervous system. So this is the neuroendocrine system. So for instance, there's some evidence that testosterone is having an effect on dopamine in reproductively relevant situations. And we have some clear evidence in non-human animals, and it would be great to understand more about how this works in humans.

1:34:14And also, we really don't have enough research on the role of estrogen in male and female behavior. And I think that would be super interesting because all estrogen comes from androgen precursors. So testosterone is converted in... People who lift a lot of weights and are trying to get really big know that the enzyme aromatase converts testosterone into estrogen because they try to block it. They take aromatase blockers. So what we don't know is if you, like I take some testosterone as part of my HRT. I take estrogen, progesterone, and testosterone. What we don't know is the extent to which in women, our testosterone is acting through estrogen and acting on estrogen receptors, or if it's acting as testosterone on androgen receptors.

1:35:07We don't know a lot of that in men either, whether male testosterone, you know, when is it acting as testosterone via androgen receptors or after it's been converted to estrogen in estrogen receptors. There's also some interesting research going on that is, look, it's more clinical about the relationship between testosterone and obesity and diabetes, and its potential for treatment in some metabolic disorders. Also, there's mood. What is the relationship between low testosterone and depression? Yeah. And then in women, just what exactly is testosterone doing in terms of behavior? I think we really, the research that we do have shows it's, as far as I can tell, it's not doing the same thing as it's doing in men.

1:35:59It doesn't react in similar ways to competition, et cetera. so we need more work in women.

1:36:07Coleman Hughes:All right, Carol Hooven, before I let you go, tell my audience where they can buy your book, what it's called, and how they can follow you online. Oh, here it is. All right, so my book, I just happen to have it right here, is called Tea, the Story of Testosterone, the Hormone That Dominates and Divides Us. And you can get it anywhere you get books, Amazon. and I am on Twitter at at Hoovlet, H-O-O-V-L-E-T. I'm trying to do Instagram. So maybe I think I'm carol.hooven on Instagram, but I still, yeah, have to figure it out. Awesome. Thank you. All right. Thank you so much, Carol. Thanks for coming on my show.

1:36:49Coleman Hughes:Okay, it's been a pleasure. Thank you. All right.