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The Nonad of Trans? I continue to see more associated conditions with both MTF and FTM transgender people at rates far beyond what is plausible to be due to chance. Please help me out with this.
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Basically, here is the list. An overwhelming amount of my patients have these conditions, ranked in order of most common to least common, but nearly all patients have at least two.

  1. Gender Dysphoria (pretty obvious why my patients would have this a lot)
  2. A non-straight sexual orientation. Some flavor of the rainbow.
  3. Autism Spectrum Disorder - Anywhere on the spectrum, often "eccentric" or "Asperger's" or "gifted and different", described that they were a "sensitive" child. Often dyslexic
  4. ADHD or ADD - Associated with sleep disorders, particularly irregular sleep schedules and general problems with time regulation and insomnia.
  5. Hypermobility - Ranging from severe to mild, hypermobile joints, loose skin, translucent skin, easy bruising. (I often see telangiectasia or "spider veins" on the upper central back, or in dermatomal patterns along the anterior abdomen. These are often coupled with nevus anemicus. These patients also often have unexplained striae (stretch marks) even if they are skinny and have never been overweight. (in fact the amount of "lanky" transgender women I have is astounding).
  6. Postural orthopedic tachycardia syndrome / Dysautonomia- Low blood pressure, passes out when standing up rapidly, or any other lightheaded/syncopal event sort of stuff. Many have resting tachycardia / low BP all the time.
  7. Congenital Adrenal Hyperplasia - mild salt wasting variant. Related to POTS as well, low serum sodium or high urine sodium, as well as elevated androgens in AFABs with hirsutism and other masculinizing issues such as clitoromegaly, incorrectly diagnosed PCOS, and menstrual issues. Many suffer from acne. They have frontal bossing of the forehead or masculine jaw/chins on these AFABs as well. The transgender women tend to show this mostly as POTS.
  8. Hashimoto's thyroiditis / thyroid problems
  9. Gastrointestinal issues - ranging all the way from IBS to flat out Crohn's disease.

Edit: for future versions I am going to add here things that I see often but not as often as the above.

Secondary list (stuff I see more often than baseline but not as much as above): PTSD, Myopia (glasses prescription more than 3 diopters negative), Dissociative Disorders, significantly increased intelligence. Many of these people are geniuses. Telangiectasia at the base of the neck / upper back (spider veins)

Tertiary list (stuff I've seen just a little above baseline) : Highly Acidic urine (PH 5 or below) with increased night time urination / bladder sensitivity to caffeine/alcohol. Aka "Irritable bladder" Also I see in the hypermobile population a lot of heterozygous or homozygous bad MTHFR genes. I have no idea why. Its on a totally different chromosome.

Edit 2: I think that the 21 hydroxylase enzyme's function is directly related to how much stress a person can endure and that there are people with increased function and decreased function. Highly resilient and durable people with high 21a2 function and people who crumble and break whenever they need to produce some cortisol to cope with stress.

Edit 3: OCT 2022 UPDATE TO NEW THREAD: https://www.reddit.com/r/DrWillPowers/comments/y30ubw/ive_been_speaking_to_other_doctors_who_have/?utm_source=share&utm_medium=web2x&context=3

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