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Androgen Insensitivity Syndrome
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An anti-androgen, or androgen antagonist, is a substance that tends to inhibit the production, activity or effects of a male sex hormone. It can be used to treat severe male sexual disorders including prostate cancer and aids in the process of hormone replacement treatment. Anti-androgens work as inhibitors of prostate cancer. They block the male hormone testosterone from binding to androgen receptors. This is useful because prostate cancer requires testosterone to grow. Anti-androgens also aid in hormone replacement treatment. Hormone replacement treatment is the replacement of natural hormones with hormones of the other sex. Transgender or transsexual men take anti-androgens to stifle their testosterone levels usually in order to prepare for sexual reassignment surgery (Prostate Cancer Research Institute, 2005).
USES FOR TRANSGENDER OR TRANSSEXUAL MALES
Transgender or transsexual males use anti-androgens to combat their testosterone levels as well as for hirsutism and virilization. Hirsutism is the development of facial and body hair. Anti-androgens are taken to reduce the facial and body hair to appear more feminine. Virilization is a form of hyperandrogenism which influences hair patterns, vocal changes and the overdevelopment of the skeletal muscles. Anti-androgens are used to correct these issues to make transgender and transsexual men appear more feminine. Anti-androgens are like a prerequisite for transgender men before they receive or undergo sexual reassignment surgery. They are usually taken for at least a year before receiving surgery to make sure the patients are confident that they are making the correct decision in undergoing the reassignment surgery (National Cancer Institute, 2011).
MOST POPULAR ANTI-ANDROGENS
The most popular anti-androgens used for prostate cancer are flutamine, bicalutamide, and nilutamide. Flutamide competes with testosterone and dihydrotestosterone for binding to androgen receptors in the prostate gland, preventing the growth of prostate cancer cells. Bicalutamide is used as monotheraphy for the treatment of earlier stages of the disease and as a combination treatment for advanced prostate cancer. Nilutamide blocks the androgen receptor, preventing its interaction with testosterone. It is usually used for advanced stages of prostate cancer (Wiki.Susans.org, 2005).
The most popular anti-androgens used for hormone replacement treatment are Spironolactone and Cyproterone acetate. Spironolactone causes the kidneys to eliminate unneeded water and sodium from the body into the urine, but reduces the loss of potassium from the body, and when used for hormone replacement treatment it suppresses testosterone levels. Cyproterone acetate blocks the actions of testosterone and prevents androgens from binding to them, suppressing luteinizing hormones therefore reducing testosterone levels (Wiki.Susans.org, 2005).
Overall, the primary use for anti-androgens is to reduce the testosterone levels in men rather it is for the treatment of prostate cancer or for hormone replacement treatment for transgender males.
Although these anti-androgens are useful for treating prostate cancer and aiding the hormone replacement treatment, they have many side effects. Side effects include mood and cognitive changes, loss in strength and muscle mass, loss of libido, increase in gynecomastia, nausea, diarrhea, the loss of appetite, dizziness, trouble sleeping and many more (Prostate Cancer Research Institute, 2005).
The most disturbing side effects of anti-androgens are the sexual side effect, the loss of libido. The chances that this side effect will occur are very high, with 90 percent of individuals using hormone blockage medication experiencing it. With this high percentage many individuals are concerned about and question using anti-androgens (Prostate Cancer Treatment Guide, 2010).
ANTI-ANDROGENS IN THE MEDIA
The representation of transgender or transsexual individuals in the media is extremely rare. With the launching of television networks such as Logo, they have had a small amount of exposure in the media. MTV’s True Life series has done an excellent job at giving the LGBT community representation in the media. On the episode “I’m Changing My Sex,” two, one male to female and one female to male, individuals in the process of changing their sex are featured. The pre-operation process, some of the surgery, the results, and their lives after the surgery were all shown. A part of the process was taking anti-androgens to allow the male to female develop feminine characteristics. The male to female individual mentions that she takes “anti-testosterone” (anti-androgen) pills, to reduce the testosterone in the body, along with wearing an estrogen patch, to increase the estrogen in the body. This episode does a good job at giving the world a glimpse of the effects of anti-androgens on the human body. They can lighten voices, decrease hair growth, and even reduce activity or function of male sex organs, but they cannot reverse what is already done (MTV, 2009).
Along with showing the process of using anti-androgens and changing one’s sex, True Life acknowledged the family communication involved in this process. Each subjects tells their story about “coming out.” Family and friends are interviewed and explain how they feel about it. Sometimes the family members and friends are shocked and unsupportive while most of the time they already knew and therefore supportive
of their relative or friend’s new lifestyle. In the episode a friend explained about the male to female individual, Elle, “When Elle said that she was getting married we were all just like ‘What?’ but when she said [she] was getting a sex change it was more like ‘Yeah, that’s fine. We completely saw that coming” (MTV, 2009). He was more surprised about the marriage than the sex change.
Elle (pictured above) was featured on MTV's True Life: I'm Changing My Sex, where her story of changing from a male to a female was shared.
Other shows have done an efficient job with exposing transgender or transsexual individuals in the media such as America’s Next Top Model. On Cycle 11, Tyra Banks selected the first transgender contestant, a male transitioning to a female, Isis King. Isis was pre-operation, but was in the process of preparing for sexual reassignment surgery. Part of the process includes using anti-androgens. Later, Tyra brought Isis on her talk show where she surprised her with the opportunity to receive the surgery by Dr. Marci Bowers, the leading genital reassignment surgeon in the United States. Bowers, a former transgender individual, now a woman also shared her story on The Tyra Banks Show. She explained how she was once married with children, took anti-androgens, and eventually got sex reassignment surgery (Tyra Banks Show, 2009).
Anti-androgens used by transgender individuals are more frequent in the media than anti-androgens used for prostate cancer.
1.Breaking Top Model News. (2009, 03 30).
Tyra Banks Show
National Cancer Institute
. (2010, 12 09). Retrieved 04 03, 2011, from Prostate Cancer Treatment:
Prostate Cancer Research Institute
. (2005, 08 31). Retrieved 04 03, 2011, from Anti-Androgen Withdrawal Response:
Prostate Cancer Treatment Guide
. (2010). Retrieved 04 03, 2011, from Prostate Cancer Hormone Therapy Side Effects:
5.True Life: I'm Changing My Sex. (2009, 09 19).
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