I've had some medical professionals see that I'm nonbinary, look at me, and assume that I'm afab. Which perhaps they also see the estrogen prescription on my chart and take the wrong conclusion, but either way it's definitely a bit awkward getting asked when my last period was and having to explain.
So many people seem to have this set idea in their heads on what to expect when they hear trans or nonbinary, and get awkward about it when it suddenly doesn't match. Surprise, we're people and not some monolithic group!
As a trans guy, we take localized estrogen for atrophy (to avoid infections, bleeding, and pain from vaginal atrophy). Any trans person can reasonably need estrogen.
Yeah very fair point, but in my case I went from oral pills to injections so in either case I'd think that should indicate it's not a local application haha. I also figured my sex assigned at birth would be noted somewhere in my chart but honestly who knows, maybe it isn't clearly stated.
I'll take that further: any human being can reasonably need estrogen. Even cisgender men's bodies tend to make themselves a little estrogen. It's an important hormone for humans, no matter which sex a human's body might be categorized as in any part of that human's life...
Lots of trans masculine people don’t even know that we need localized estrogen supplements! I’m fortunate my T prescriber explained the signs of atrophy to me.
Other not fun fact, you can risk pyometra, which is an infection of the uterus. Atrophy causes perfect conditions for bacteria to grow in the scar tissue. Pyometra is usually lethal.
It's not a need for every trans masc person. I'm trans masc and don't experience any atrophy or vaginal dryness so I don't need localized estrogen. I can agree that doctors should inform trans mascs taking testosterone that atrophy is a possibility and localized estrogen can help. But it is not inherently needed for every trans masc.
You can have moisture but still have atrophy, actually. It tends to cause dryness (wetness from sexual arousal can still happen, but there’s a lack of moisture otherwise) but the tissue atrophying is the biggest concern since that can lead to incontinence & infection risks.
Atrophy is going to happen if you have male T ranges just because of how hormones work, T dominance causes a lack of estrogen in the vagina. You likely just haven’t had it happen yet or you are asymptomatic for now. This happens to post menopausal cis women, it happens to us trans mascs, to literally anyone who has vaginal tissue but not enough estrogen to support it.
I've been on t for 6 years. When does it usually start happening?
Edit: doing some research it looks like 70% of trans masc who take testosterone long term develope atrophy. So there's roughly 30% that don't due to many factors such as cell resilience or producing estrogen from the adrenal gland.
So it's not guaranteed to happen but everyone should be aware it could happen and has a treatment. But every body behaves differently. Some people's sex drives dissappear on antidepressants, others don't notice any change. Some people gain weight easily, some it's a struggle
as an AFAB nb, i feel similarly. but also i have seen AMAB NBs be treated even worse than AFAB NBs in queer spaces, which is trash. i thought "theyfab" was bad but no some queer spaces legit come up with borderline conspiracy thinking to justify their hatred of AMABs and say they're fakers who just want to feel included or infiltrate queer spaces.
I've definitely had some instances where my nonbinary identity felt mostly discarded by some people, until I mentioned that I was on hrt. Then suddenly using they/them for me got easier? It can be very frustrating feeling like you have to be "trans enough" to be seen as valid, and I can only imagine how frequently more masc presenting nbs get that treatment. It really comes down to people trying to shove nonbinary folks into one of two gendered boxes at the end of the day.
Not long ago I came to the conclusion I am non-binary, and informed my partner. She's fully on-board with it but struggles to keep it in mind - so she ends up referring to me in the masculine and as a man. It is fine for me, as I was brought up as masculine, but it kinda stings.
I have not come out to anyone else in my life, and I feel it will be difficult for them to get to terms with it.
Learning it is this hard in the queer community for AMAB NBs kinda hurts. I'm sorry you have gone through this hardship. I see you. Be yourself and stay strong.
I will say, while there are definitely struggles with getting people to acknowledge you for who you are, there are also people out there who will accept you and see you for you. Even with the difficulties I've faced I'm still happier than I've ever been by just being myself, it's still very much worth it.
The early days are rough, but I hope your partner is able to adjust and see you for you, and that you can have more acceptance within your circles soon. Even having just one person being accepting can be a huge help. I see you as well, and I hope you'll continue to be yourself and stay strong as well <3
Im only out to my friend group and a single family member and you are so right.
Im still closeted in most situations due to safety with family, and just people's gendered assumptions in public
But the fact that i have a space where my pronouns and gender are wholeheartedly accepted and I am seen as myself truly does soothe the burn from my burning closet.
Thank you for your kind words to the other commentor ❤️
Hi, your comment and the one you replied to made me sad, so I apologize if you feel this perspective is unwarranted, but I offer it in hopes that it might make you feel a little more seen.
I am a male who has been in a relationship with an AFAB NB for the past 7 years. “They/ them” is now fully integrated into my subconscious, I don’t even have to think about it, but it wasn’t that way when we started dating.
They had to give me a lot of grace because I messed it up often. I always felt terrible after doing so. They were the first NB person I had regularly interacted with. It took some getting used to.
I never once felt like they were asking too much, and made sure to reinforce the pronouns around my friends/ family I introduced them to so they didn’t have to feel like they constantly had to explain themselves or be validated. It took effort, but it was worth it because now I feel like I see them and other trans people how they actually want to be seen.
My partner also struggled to feel validated by other queer communities. I wish they had more trans/ queer friends because even though I love them and see them, I can never truly understand what that dysphoria feels like. But they are loved and seen by me, my friends and family.
I guess what I’m getting at is that I can’t imagine how much anxiety you must feel about coming out beyond your GF, but if she loves you and you love her, I hope you trust that her mistakes are not to invalidate you, she will get better at it and can help be a bridge to introducing the real you to everyone else.
Yeah, even in a lot of queer spaces nonbinary people are treated as basically "woman-lite." So it's all "you don't owe anyone androgyny" when you're AFAB NB, but if you're AMAB, you're expected to perform.
As an AFAB enby who doesn't even present that masc, I'm correctly gendered pretty consistently in queer circles, but I do notice my AMAB enby friends facing a lot more resistance. It's weird. The enbyphobia really is just coming from inside the house sometimes.
I think in a lot of cases it just makes it click for people that it's serious and not some fleeting thing, but it still has some weird transmed vibes to it yeah. I think it mostly comes from ignorance though.
In my experience the sort of person that will start referring to binary trans women with they/them pronouns will suddenly find it so difficult to do so for me who actually uses they/them... I tend to limit interactions with that sort of person.
This is why I don't feel comfortable in queer spaces as a cishet guy in general - I'm not a dick, I'm not trying to pretend i'm any more queer than "what's in your pants isn't a dealbreaker" or be part of "the group" or anything, but it really feels like just being there would somehow detract from the purpose of that space.
Like there are spaces that are queer-friendly and there are queer spaces, and in an ideal world that venn diagram would be a circle but right now those are two different things
and in an ideal world that venn diagram would be a circle
I don't think that's true at all. Maybe you mean concentric circles? Queer spaces are a sub-set of queer-friendly spaces, but all places should be queer-friendly spaces.
I think you're agreeing with me and making what is a valid technical clarification, but I'm also saying there shouldn't even been a need for that distinction because nobody should be put in a position to feel a need to have ANY kind of exclusionary space. Part of the problem is that all spaces are assumed to be "straight spaces" and there's a need to indicate being queer-friendly at all, because not being queer friendly is common enough that there is a need to mark a space as friendly.
Again, that's wholly idealistic and not something that's realistic given gestures broadly, and this is getting more philosophical than the original intent of "some people suck and ruin things for others, and I wish it weren't that way"
nobody should be put in a position to feel a need to have ANY kind of exclusionary space.
I feel like that is both unrealistic, and untrue. There is some value in having a shared space where everyone is on the same page and has shared experiences. It's just that the size of those circles contained in the bigger one should be tiny. The majority of the world should be welcome to everyone, but having a juggler's club or something isn't inherently bad.
Yeah but having a hobbyist club is about enthusiasm for a subject and not because talking about juggling in public is something that's potentially unsafe.
Nothing about being "queer" should be a reason for being ostracized, judged, or excluded in any way, and I don't think that's equivalent to finding people who share an interest.
Again, "realistic" in current society is not the same as ideal, and I recognize that. There shouldn't be a need for queer spaces because queer people shouldn't feel that they can only be themselves in specific places/situations
same shit happens to bisexual men in queer communities, they get ostracised because reasons? there just seems to be a really nasty undercurrent of misandry in non binary and other queer spaces for AMAB people who arent "queer enough"
I’ve seen AMAB enbies get kicked from queer venues for hitting on women, the LGBT community genuinely seems to hate you guys. And allies are worse, one of my friends got kicked out of a club because large AMAB body + slacks and full beat of makeup did not read as trans woman or gay man enough, and the staff just assumed my friend was a creep or that they weren’t taking things seriously enough.
Its rough as a trans man too. Lots of queer friendly events in my area! Except when you read them it tends to say something along the lines of “lesbians, trans women, nonbinary”
I’ve met more trans men by being involved in the local parks system and going to reptile shows than by going to actual queer places/events. Y’all are completely talked over online AND there’s no place for you irl, it really sucks, I’m sorry
I’m an AFAB nonbinary person, and my AMAB nonbinary sibling is definitely a lot less vocal about their identity than I am. A part of it might just be our overall personalities; they’re far more introverted than I am. But yeah, I definitely buy that.
samesies. add onto that im aroace and even cis/allo spaces become burdensome. theres also enough aphobia/erasure in the queer community to compound the issue.
Yeah, I was military for a bit, long-time gamer so my language reflects all that. I come off as super CISHET despite being pan and NB. Outside of cases where someone is likely required to ask gender, everyone just assumes straight man.
It’s easier to just.. correct the opinions of people you care about. Sometimes an AFAB will tell me they’re NB, and I’ll say, “Same here.” And I’ll get this look from them. It’s either confused, or disbelieving. I’ve been accused of pretending to be NB or pan in order to attract “quirky” women, or to seem sensitive. I hate people sometimes.
It's so weird to me to think that queer spaces seem to be exclusionary to "the wrong kind of queer" people.
Like, I'm cishet and I manage to not care about what someone else identifies as just fine. I had a colleague who identified as a dragon (no joke, she was transspecies). I admit, it took me a second, but really I don't care.
I'm weird in my own ways, so why would I care what someone else wants to be "non-standard" about?
In the light of that it does confuse me a fair bit why there seem to be so many queer spaces that exclude "the wrong kind of queer" people, considering that inclusivity to queer people is the main point for queer spaces to exist.
I wonder if it has something to do with it being more socially acceptable for women to present masculine, such as wearing pants, versus it being less acceptable for men to present feminine, such as wearing dresses? AFAB people might be more likely to experiment with their gender presentation in comparison to AMAB people because there’s a higher social cost to it. So maybe the AMAB people who do experiment are more likely to be binary trans women, and therefore have a stronger desire to present femininely than someone who is just enby.
That being said, I also think that a lot of people that are assumed to be trans women in reality have a more complex relationship with gender. They might be enby but present feminine, or genderfluid, or any number of things.
I don’t know, maybe I’m phrasing some of this badly but it’s interesting to me how social perceptions affect the numbers on these things.
I definitely think it’s a big part of it sadly. That and afab people are seen as ’safer’ because ’omg weak woman can’t think and must simply be confused but at least she isn’t hurting anyone but herself’.
And masculinity is often praised, and while afab people who participate in it in ways that aren’t acceptable by most of society are definitely still facing a lot of hate and all of that for it, but many sexist and bigots can still sort of come to terms with the idea (not support it but somewhat claim to understand it) that a ’weak worthless woman’ would want to be a ’big strong man’ because femininity is deemed and seen as bad, even when it’s done in their correct idea, and for a perceived man to want to stop to women’s level is deemed as completely unacceptable and they are seen as both ’weak’ because ’femininity and women are weak’ and also a ’threat’ because they’re ’still a man’ etc.
Genuinely is so bigoted in so many aspects and it’s genuinely terrible.
Yeah. I honestly feel a lot of it comes down to a fear of masculinity and general misandry/perception of male = threat. Which, ironically, is the same reason transfem people get so much flak.
And why within the trans community, trans men/masc are weirdly hated by many trans fems. Sadly I'm not exaggerating that point, most of the generic trans spaces online seem to delete, ban or insult/abuse any trans masc willing to say that they are one, or talk about their/masc issues in a space that isn't specifically a trans masc space.
We all get flak, the people who are being nasty to us just happen to be different based on your sex and/or gender.
(There are lots of lovely people online in these communities, but sometimes it's hard to see that when you feel hated for daring to be a guy.)
there's a lot of that, from what I have heard second hand, about queer-but-not-just-gay men (bi men especially) and AMAB-but-not-transfem people in general, like any kind of "in between" is ok for some groups but not others
I mean so does afab queer folks too? What biases are you referring to? The fact that any form of feminity is deemed as weak because women = weak and weak = bad or?
I just use he/him around people whose thoughts and feelings I don't give a shit about because the conversations are worse than the discomfort of being called a man
They found, out of 123,441 records, 502 identified as Nonbinary. Of those, 392 (78%) were AFAB. There's a chart on page 5.
That's just one state and one data source of course, but generally you'll see in discussions that somewhere around 70-80% of nonbinary people are AFAB.
AMAB certainly exist, but as others have said, they get treated horribly. I've seen it many times. The fact is, most public NB groups are also AFAB only, unspoken but true, which is a shame.
As a transman, I can't tell you how many times I've had a conversation with "cis" men that goes like this:
"But how did you figure out you're trans?"
Me: "I feel like a man inside just like you do."
"But nobody feels like a man. You're just what ever you were born as."
"I do feel that and so have a lot of other cis men I've spoken to... Do you really not feel like a man inside?"
Then I get some random nonanswer and we sit in silence for a few minutes until they change the subject. I think AMAB people are more likely to be extremely resistant to exploring their gender.
A lot of people see nonbinary as girl+. The queer community unfortunately just isnt very friendly to amab nonbinary. You ever see events that are “girls and nonbinary people only”? They only want afab people there.
Egg culture is also a bitch in that a lot of people will see an amab person experiment with their gender in any way and say “oh! Closeted trans girl!” And when they’ll say they don’t think theyre a trans girl, people will say they’re in denial and just need to explore themself more.
It’s very counterproductive. I think a big part of it is that a lot of queer women hate men, and they see amab nonbinaries as “men intruding in women’s/queer spaces”. I don’t see much hatred from afab nonbinary folk, it’s mostly from cis queer women from what I’ve seen
In my perspective it's pretty much just because people assigned female at birth are punished less for exploring their own gender presentation (as long as it's not hormone related), so they build confidence then come out and get beaten down or told it's a phrase. While people assigned male at birth get punish for even considering femininity or anything none manly as a cis person. Then you have the separate group that's very common in non-binary people which is autistic people. Autistic people are more likely to be non-binary because gender is social and being autistic impacts on your ability to socialize. AFAB autistic people are taught to care more about socialization than their male peers so in theory they are more likely to notice their gender experience doesn't fit with the norm for girls and explore that.
Cis people tend to be under the impression that nonbinary people don't medically transition, so when they see a transfemme nonbinary person on estrogen they assume that they're afab.
They are either ignored/dismissed or perceived as binary trans women. Most cis and binary (non non-binary) people who have only seen non-binary rep on social media will only see afab non-binary because social media algorithms promote the idea that only pretty afabs are non-binary and that it's a woman 'lite' mode when that's not the case at all.
Honest question, how would you prefer medical professionals approach such a topic? I imagine it is important that they ask individuals who are capable of menstruating these sorts of questions. Shy of guessing or asking directly (which they seem to do), what other approach is there?
“It says here your gender is NB, is there anything I need to know to be sure we are doing all the necessary biological checks (menstruation, prostate check, etc)”
Assumptions and thinking of trans/queer people as lesser (ala acting like someone doesn’t know what a hysterectomy is because they must bee stupid) solves a lot of problems.
Also, all other commentary that involves making your trans patient educate you about things you should get your own education on is a no.
I had this happen at an obgyn who didn’t understand Asexuality and apparently wanted me to sit down and give a while class on ace peeps and sexual activity and how their relationships might work. While also making insulting and belittling comments based on their ignorance.
I might be misinterpting the situation, but I have to imagine that them asking when you last menstruated is giving you a chance to explain whether or not that is a relevant question. Medical workers tend to be direct in their questions for good reason and asking the patient if there is anything they ought to be aware of would lead to situations where a shy or uninformed patient causes information to be ignored.
"anything I need to know?" would be a terrible question, because the person receiving the service doesn't know what's relevant or necessarily what the doctor needs to hear.
However the details of nuanced communication are handled, the doctor does need to directly ask the exact questions that need to be answered rather than being anything vague.
Wouldn't it be more helpful to have people provide their sex on their intake forms? Not saying not to ask for gender also, but if sex is relevant then it should be listed. If we all agree that sex and gender are different things we should be comfortable listing both.
Sex is far more fluid than a neat couple of boxes which is why that approach also fails to fully capture the trans experience. It's easiest to just ask someone directly about whatever bits are relevant to what you're doing and leave it at that.
Sure, but you can say that about any biological condition. It's still relevant information, and someone can choose to give more information beyond then ix tick. Like, I can tick the box to say nobody in my family has dementia, but also state that I'm aware that I have a genetic predisposition to it. I don't see any reason to not ask for it, especially if you're also asking for their gender, which isn't medically relevant but certainly is relevant from a patient experience perspective.
If someone has been medically transitioning for a while, their sex doesn't neatly fit into a box like that though unless you're specifically asking for their sex at birth which in most cases is irrelevant unless the health professional is directly dealing with the organs in question.
I would have thought it would be. Especially if you’ve had things like a hysterectomy.
I think how good the chart info is would vary by clinic/hospital. And how it’s interpreted would depend on how well educated the drs are. For example in this comic the dr didn’t know trans men existed.
I’ve also met people who don’t know what trans man means.
Not unless that section on the form is a heck of a lot longer than a m/f tickbox because there’s a whole lot of combinations possible. Like yes or no ovaries/testes, yes or no vagina (and is it a surgically created one), yes or no cervix, yes or no penis (and is it surgically created) yes or no prostate. All of these things can exist or not independently of each other depending on what you’re born with and what surgical procedures you’ve had. And then a section detailing what if any hormone treatments you’re taking. Cuz the likelihood of various conditions can vary both based on what you’re born with, what genitals and internal organs you have, and what hormone configuration you have.
So like yes that info on forms could be useful! But it’s also a lot more complicated than most people think and also often not necessary info. Like if I’m going to urgent care because I have strep and need antibiotics it is truly not necessary for them to know what everyone’s internal organs and genitals are like. And frankly some people just don’t know what they actually have. Intersex people exist and a lot of times they don’t discover they’re intersex until much later in life. Like some people who were assigned female at birth and are women find out when they’re trying to have a kid that their body made testicles where their ovaries should be. So someone like that could spend the first 30 years of her life (or her whole life if she never decided to have kids) never knowing she didn’t have ovaries.
Actually, not having ovaries at all is something that she would probably find out around puberty. Or rather by not going through puberty. When the Ovaries should start producing estrogen that should make her go through female puberty, and they don't do that, so she doesn't go through female puberty, that should be a sign.
It's nice when they preface it somewhat. I think I was asked something along the lines of "This may or may not be relevant to you, but is there a possibility of pregnancy?".
Or if it's something they ask everyone, you can just say that and then go through the questions. Like I think with some vaccines or tests there were check lists which everyone had to go through without assumptions on which would be relevant to each person.
It is tricky though, because in some ways a lot of these questions should just be asked to everyone, because there will be some people who don't get asked relevant questions if you go based on assumptions. But a lot of people would get very offended if doctors did that, particularly cis people I imagine.
I ask "may I ask permission to ask some potentially dysphoria inducing questions? Yes? What were you assigned at birth? How do you identify now/what's your pronouns? What surgeries have you had and what meds are you on (If afab- do you menstruate?)"
That usually covers it and typically doesn't seem to torpedo the working relationship from my side as an ED nurse.
Why don't you tell your medical professionals information that is pertinent to your possible diagnosis and treatment rather than trying to make them guess?
Seems very weird, you're basically saying "oh my god every time I go to the doctors I deliberately hide information about my biology and make them guess instead and then they guess wrong! What bastards!!"
I do tell them? All I said is that it's awkward, I'm not hiding anything and in theory that info should be on my chart regardless. But also a lot of people can get stuck on their assumptions regardless and then you have to explain again and again like the above comic and dealing with that can be very frustrating.
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u/TheElectronicsFella Jul 31 '26
I've had some medical professionals see that I'm nonbinary, look at me, and assume that I'm afab. Which perhaps they also see the estrogen prescription on my chart and take the wrong conclusion, but either way it's definitely a bit awkward getting asked when my last period was and having to explain.
So many people seem to have this set idea in their heads on what to expect when they hear trans or nonbinary, and get awkward about it when it suddenly doesn't match. Surprise, we're people and not some monolithic group!