Masculinizing hormone therapy

====Question of relationship with PCOS====

[[Polycystic ovary syndrome]] (PCOS), also called polycystic ovarian syndrome, is a set of symptoms with no known cause,<ref name=Fauser2011>Page 836 (Section:''Polycystic ovary syndrome'') in: {{cite journal | vauthors = Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, Howles CM | title = Contemporary genetic technologies and female reproduction | journal = Hum. Reprod. Update | volume = 17 | issue = 6 | pages = 829–47 | year = 2011 | pmid = 21896560 | doi = 10.1093/humupd/dmr033 | pmc=3191938}}</ref><ref name=FertSter_molecular>{{cite journal | vauthors = Legro RS, Strauss JF | title = Molecular progress in infertility: polycystic ovary syndrome | journal = Fertil. Steril. | volume = 78 | issue = 3 | pages = 569–76 | year = 2002 | pmid = 12215335 | doi = 10.1016/S0015-0282(02)03275-2 }}</ref> and no known cure as of 2020.<ref name=NIH2013Cure>{{cite web|title=Is there a cure for PCOS?|url=http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/cure.aspx|website=US Department of Health and Human Services, National Institutes of Health|accessdate=13 March 2015|date=2013-05-23|url-status=live|archiveurl=https://web.archive.org/web/20150405021527/http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/cure.aspx|archivedate=5 April 2015|archive-url=https://web.archive.org/web/20220605095616/http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/cure.aspx|archive-date=17 July 2023}}</ref> It correlates with high testosterone levels in people who were assigned female at birth. <ref name=NIH2017Def>{{cite web|title=Polycystic Ovary Syndrome (PCOS): Condition Information |url=https://www.nichd.nih.gov/health/topics/pcos/conditioninfo|publisher=National Institute of Child Health and Human Development |accessdate=19 November 2018|date=January 31, 2017|archive-url=https://web.archive.org/web/20230307033416/https://www.nichd.nih.gov/health/topics/pcos/conditioninfo|archive-date=17 July 2023}}</ref><ref>{{cite web|title=Polycystic ovary syndrome (PCOS) fact sheet|url=http://womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html|website=Women's Health|accessdate=11 August 2016|date=December 23, 2014 |url-status=live|archiveurl=https://web.archive.org/web/20160812093306/http://womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html|archivedate=12 August 2016|archive-url=https://web.archive.org/web/20230529134920/https://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html|archive-date=17 July 2023}}</ref> Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts. Its symptoms are associated with high testosterone, such as growing extra body hair, menstrual problems, and fertility problems.<ref name="NIH2013Sym">{{cite web|url=http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/symptoms.aspx|title=What are the symptoms of PCOS?|website=National Institute of Child Health and Human Development (NICHD)|format=05/23/2013|url-status=live|archiveurl=https://web.archive.org/web/20150303190314/http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/symptoms.aspx|archivedate=3 March 2015|accessdate=13 March 2015|archive-url=https://web.archive.org/web/20220605095615/http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/symptoms.aspx|archive-date=17 July 2023}}</ref> Some people informally consider PCOS a [[intersex]] condition, even though PCOS usually develops later in life, rather than at birth, as most intersex conditions do. PCOS itself is not harmful, unless if the androgenic symptoms are found distressing by the person who has them, but it does cause a higher risk of obesity, and therefore of Type II diabetes.<ref name=NIH2017Def/> Treatment for PCOS involves lifestyle changes and medications to reduce those risks. For cisgender women, some treatments for PCOS aim to undo masculinization, but that is not desirable to undo for trans-masculine people.

The WPATH says that an increased prevalence of PCOS has been noted among trans-masculine people, ''even in those who have never taken masculinizing hormone therapy'',<ref name="soc 45" /> according to studies from 1993,<ref name="Balen 1993">Balen, A. H., Schachter, M. E., Montgomery, D., Reid, R. W., & Jacobs, H. S. (1993). "Polycystic ovaries are a common finding in untreated female to male transsexuals." ''Clinical Endocrinology'', 38(3), 325-329. doi:10.1111/j.1365-2265.1993.tb01013.x</ref>

1997,<ref name="Bosinski 1997">Bosinski, H. A. G., Peter, M., Bonatz, G., Arndt, R., Heidenreich, M., Sippell, W. G., & Wille, R. (1997). "A higher rate of hyperandrogenic disorders in female-to-male transsexuals." ''Psychoneuroendocrinology'', 22(5), 361-380. doi:10.1016/S0306-4530(97)00033-4.</ref>

and 2007.<ref name="Baba 2007">Baba, T., Endo, T., Honnma, H., Kitajima, Y., Hayashi, T., Ikeda, H., ... Saito, T. (2007). "Association between polycystic ovary syndrome and female-to-male transsexuality." ''Human Reproduction'', 22(4), 1011-1016. doi:10.1093/humrep/del474</ref> This correlation has raised questions of cause and effect: whether going on masculinizing HRT causes PCOS, and whether having PCOS could cause someone to question their gender identity. However, the WPATH says, "there is no evidence that PCOS is related to the development of a transsexual transgender, or gender-nonconforming identity".<ref name="soc 45" />