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this post was submitted on 28 Aug 2023
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No Stupid Questions
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hi! just so we're clear, there's no "the" surgery, there's a number of surgeries that trans people get: phalloplasty, vaginoplasty, mastectomy, breast implants, FFS, the lot of them. generally, most of these surgical interventions don't do too much to whole body musculature and are more localized, although having/not having a pair of boobies that you weren't/were used to can do a lot to your balance, but that's not the main thing that changes posture, center of gravity, etc.
possibly more relevant to the question, one of the most common medical interventions is hormone therapy, and this will absolutely change your musculature, flexibility, strength, and more. Transfems on E will see dramatic changes in their strength, muscle mass, and flexibility to be much more in line with cisfems, and transmascs will see similar but opposite. it's a super common meme among transfems who are dating cis women that they have to hand over jars to their cis girlfriends to open after starting E. Transmascs often report gaining an inch or two of height on T, transfems often report losing an inch or two of height on E, with no other interventions. Some people see shoe size changes, postural changes, more. there's no universally agreed upon cause for this but the current leading theories are that it's a combination of fat redistribution, muscle mass changes, and changes in tension in various tendons and ligaments. Anterior Pelvic Tilt is probably the largest cause of changes in postural change in trans people (and it's caused exclusively by GAHT), so if you're looking to learn more, that's probably the first thing you may want to read up on!
so to more explicitly answer the question, starting E will add a lot of fat to your lower body and remove a lot of muscle from your upper body, cause your pelvis to tilt, and more, and starting T will add a lot of muscle to your upper body and remove a lot of fat from your lower body, cause your pelvis to tilt, and more.
i'm super comfy with good faith questions btw so if you have more, feel free to ask me!
FFS means "Facial feminization surgery" in this context, correct? I automatically read it as "For f#$%'s sake" and paused, thinking "No, that can't be right."
lol yes, you're spot on. Facial Masculinization Surgery exists as well for transmascs, but it's a lot less common because, well, I'm not fully sure? but getting a beard for the first time in your life does wonders for transmasc gender euphoria and is often plenty enough for most transmascs.
That's so interesting, thanks for the learning!
This is exactly like the time I found out vaginal lubrication from arousal was a hormonally dictated thing. Even though I have an endocrine disorder and very personally understand how much hormones do around the body (or should be doing, but sometimes don't...), it blew my tiny little mind. I just sort of assumed the surgery wouldn't be able to address that functionality.
Hormones are hugely underestimated, they wield a lot of power over us. The fact we can reliably tinker with some of them with science is a little awe-inspiring and slightly terrifying.
The anterior pelvic tilt thing is wild, I never would have expected that change. Is it a documented change for transmascs too?
"documented" is tricky because very little of this is super well documented, seeing as trans people are a super small and, even proportionately to their small numbers, understudied minority in medical science. this is largely a community communication effort and a lot of the knowledge is not done through academic study. that being said, it does seem like it's talked about a lot less in the transmasc community, so possibly? on paper, the mechanism of action (tendon/ligament/muscle changes) goes both ways, but I haven't really seen many transmascs talk about it, so I don't know for sure!
Yeah that totally makes sense. I'd be keen to find out if how much is biomechanical and how much gender role social expectations influence it, but like most things I'm interested in I will have to wait another 30 years for a peer reviewed study.
Oh well, still cool and interesting to think about! I appreciate trans people's insights in comparative biology, even if I wish they didn't have to experience dysphoria to educate the rest of us.
I imagine FFS is very common among trans people. I know I say it a lot whenever I hear certain people talk about the trans community.
I'm not sure of the rates although I know a huge number, probably a very large majority, of transfems only take E and sometimes a T blocker. I can also tell you that after a while on E, facial fat and muscle will redistribute to create a more feminine face. Many people are happy at that but some more want additional feminization and that's where FFS comes in!
(statistics are very poor because us trans folks are an extremely under-studied minority as well as a moving target because of changing culture and treatment modalities, so I wouldn't trust most studies purporting to know statistics on things like how many transfems get FFS besides being a ballpark range)
I'll add on as someone that works with trans folks preparing for hormones/surgery, FFS is usually less common compared to other procedures, and is itself a cluster of surgeries that people may choose to do any combination of. Some of those surgeries are less drastic some are pretty intense (graphic warning: basically peeling back a portion of your face from your skull, changing bone and slapping that face back on). The more intense options are understandably not for everyone. FFS (and most other surgeries) usually comes into play after people give hormones a few years to do their thing and see where things end up. Let the canvas stabilize before working on it.
Sorry, your post is very informative and I was just making a dumb joke. I find that very interesting and I would imagine, especially based on the other person's response, that FFS is significantly less common.
OHH lmao that's what I get for trying to focus on three things at once, no that's actually hilarious now that I actually read it correctly without my brain doing word swaps
The point on pelvic tilt is especially fascinating to me!
I am a cis male who's been getting a lot more into latin styles of partner dancing these past years, a focus of the level I've been getting into lately is body-movement generally but including hip position / pelvic tilt. As I've gained more awareness of my own body in everyday life I've come to assume that fem people must have a "more tilted" pelvis when in a neutral position because of non-specific societal pressures.
If I'm understanding your statement correctly though, the neutral angle of one's pelvis has a strong correlation with the hormone balance or, perhaps more directly, the muscle/fat distribution around their body. Is that right?
I'd even go further and confidently call it causal. This is very much a thing that happens soon after ( < 1 year but mileage varies) you start gender affirming hormone therapy, at any age. nobody's fully sure on the exact causes, but the one most certain thing is that it's a multitude of factors - potentially, but also not limited to, the blend of tightness/looseness of ligaments and tendons that hold your pelvis neutral, the muscle mass and strength of muscles involved in posture, the amount of fat/weight your pelvis has to carry, and for trans people lucky enough to start gender affirming hormone therapy during puberty, the actual bone shape of your pelvis (although this last one shouldn't be too overstated - again, transfems transitioning well into their 50s and 60s notice changes in gait, balance, and posture).
Fuck this is so cool, fascinating!