"CAIS" (Complete Androgen Insensitivity Syndrome) proves that Transgenderism is Real"

submitted by Kai_Decadence from self.GenderCritical

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[–]MarkTwainiac 19 insightful - 1 fun19 insightful - 0 fun20 insightful - 1 fun -  (7 children)

Kai, when TRAs bring up DSDs/VSCs, I think it's best just to say that people with these very rare, distinct medical conditions have repeatedly asked that their often traumatic medical histories not be brought into the convo about transgenderism, coz DSDs have nothing to do with transgenderism.

DSDs are real, tangible physical conditions that can be medically and scientifically verified and are based on specific, identifiable processes and mechanisms going awry in the human body.

Trans is a psychological state that cannot be verified medically or scientifically and which is based entirely on sexist stereotypes, fantasies, desires, wishful thinking, covetousness, magical thinking, narcissism, emotional immaturity, irrationality, gaslighting, authoritarianism, disassociation and so on - and it's also based on a total denial of the material reality of the human body and reproductive biology.

But if you're going to discuss DSDs, please don't use the term "hermaphrodite," which long has been considered a slur. And best to avoid "intersex" as well.

As to your questions about whether transgenderism "exists" and is "real," I'm not sure what you mean. It's as real as Scientology, Mormonism, Islam, Judaism, Roman Catholicism, Shintoism and all other religious belief systems based on faith and fantastic stories.

[–]Kai_Decadence[S] 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (6 children)

Yeah and that's what I did initially when he brought up intersex people to which I said that they don't disprove biological sex class and then he hits me with CAIS and honestly I genuinely never heard of that one so it did cause me to hiccup when thrown it, especially when I read the deifnition of it. But ultimately you are right that aside from it being an extremely rare genetic condition, these people don't want to be used as pawns for the transgender argument.

But if you're going to discuss DSDs, please don't use the term "hermaphrodite," which long has been considered a slur. And best to avoid "intersex" as well.

Oh my bad on this. Is there a better word to describe these kinds of people then? I remember when I was a kid people used to conflate "Hermaphrodite" and "Intersex" as one in the same and I believed that for awhile until I read up on Intersex and learned that conflation was false but I hadn't come across a term that I'm aware of that is more socially acceptable to call these people.

As to your questions about whether transgenderism "exists" and is "real," I'm not sure what you mean. It's a real as Scientology and all other religious belief system based on faith and fantastic stories.

Oh all I meant was whether this genetic condition did have some validity to the whole trans argument because yesterday was the first time I had ever heard of "CAIS" and I couldn't find much people talking about it in gender critical (I wanted to avoid Reddit because of the bias I know it would have since it's overrun with TRAs).

[–]MarkTwainiac 11 insightful - 1 fun11 insightful - 0 fun12 insightful - 1 fun -  (5 children)

Is there a better word to describe these kinds of people then? I remember when I was a kid people used to conflate "Hermaphrodite" and "Intersex" as one in the same and I believed that for awhile until I read up on Intersex and learned that conflation was false but I hadn't come across a term that I'm aware of that is more socially acceptable to call these people.

The word hermaphrodite comes from Greek mythology, not science or medicine. And like most of the stories from Greek mythology, the tale of Hermaphroditus is pretty twisted.

In 2005, medical professionals decided to retire the term "pseudohermaphrodite" and "pseudohermaphroditism." Those terms - not just plain hermaphrodite & hermaphroditism - were the ones previously used by some in medical and scientific fields. The "pseudo" prefix shows that in medicine it's long been known that there is no such thing as actual hermaphroditism in humans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082839/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682611/

In answer to your questions about whether there's "a better word (or term) to call these people," I suggest calling them people. People with medical conditions known as disorders or differences of sex development (DSDs) that cause them to have variations in sex characteristics (VSCs) that are anomalous.

The known DSDs are 41 (or so) very distinct medical conditions that vary so markedly from one another that they shouldn't all be lumped together in the same category and regarded as if they and those with these conditions are one and the same - or that they even have that much in common with one another. Even amongst persons with the same exact DSD, there's often a huge range in how the condition presents and manifests from one individual to the next.

Individuals with CAIS - complete androgen sensitivity - have XY sex chromosomes and testes (usually internal) that produce normal amounts of testosterone - and they also are capable of converting T to its more potent form DHT. But as they don't have any functioning androgen receptors, their bodies do not and cannot react to the testosterone they produce as XY people typically do. As a result, they end up developing observable characteristics - external genitalia - that appear female, aka a "female phenotype," as well as the lower portion of a vagina, but not a full vagina or the other internal organs typical of the female reproductive tract.

Due to an enzyme known as aromatase, some androgens are converted into estrogen in everyone; in persons with CAIS, this happens with all androgens. As a result, in puberty, individuals with CAIS will have female levels of estrogen, which cause them to develop breasts and other visible aspects of a female adolescent body such as general body shape. However, since they have testes and lack ovaries, a uterus and Fallopian tubes, they will not reach menarche or become fertile. It's because they never get their periods in/after puberty that most individuals with CAIS are finally medically evaluated in/after adolescence and their particular DSD gets diagnosed.

https://youtu.be/wik6uRl6Wjo

https://en.wikipedia.org/wiki/Complete_androgen_insensitivity_syndrome

https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/labmed/androgen-insensitivity-syndrome-ais/

all I meant was whether this genetic condition did have some validity to the whole trans argument because yesterday was the first time I had ever heard of "CAIS" and I couldn't find much people talking about it in gender critical

I honestly have no idea what you mean by "the whole trans argument." But generally speaking, the best way to get answers is to pose questions using precise language rather than resorting to shorthand and vague generalities.

One of the reasons people in gender critical don't talk much about CAIS is coz it's a medical condition that is immaterial to the issues at hand. And coz most of us are aware that individuals with CAIS have a hard enough time as it is. However, I've spoken in some detail on this sub about specific DSDs that persons with XY sex chromosomes have - such as 5-ARD, Klinefelter's, CAIS and PAIS - and some people think I'm a hateful and cruel asshole as a result.

So instead of discussing CAIS any further, let's draw an analogy by using another extremely rare inborn condition that affects me personally. I happen to have a form of primary immune deficiency that causes me to be unable to make antibodies to most pathogens. As as result, vaccines don't work on me. And once I have a virus, bacterial, fungal or prion infection, I don't build cellular memory of it or immunity to it.

But the fact that I and some other people on earth have very rare defects of immune function does not mean that we can't make general statements about the human immune system and how it works in 99.99% of the population. People with inborn immune defects aren't proof that the human immune system doesn't exist or is too complex to be understood. And my particular immune defect doesn't mean vaccines are useless; it just means they don't work for me and a few other people. The various inborn defects of human immune function that a small number of people have only go to show that sometimes nature makes mistakes, and some people have rare medical conditions that make us outliers and set us apart from the norm. Which is also the case for the teensy tiny fraction of the population with CAIS and other DSDs.

BTW, there's some info on CAIS - and some links to papers I posted about it - on this thread on this sub from 7 days ago you might find helpful:

https://saidit.net/s/GenderCritical/comments/731o/the_boy_who_always_knew_he_was_a_girl_and_is_now/

Some more information on individual cases, some of which deal with "gender identity": https://pubmed.ncbi.nlm.nih.gov/20358272/

[–]Kai_Decadence[S] 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (3 children)

Right, I'm a little more informed on CAIS after someone linked me a video to an explanation of what it is as well as some of the other DSD genetic conditions that I did know a little about but still learned some new things I didn't know. And you're right that even with these conditions in mind, it's very rare and that is something I did try to explain to the TRA and how I think that most Trans-identified people do not have conditions like CAIS.

On the individual case of Gender Identity, I mean sure technically these people could be the gray area but it seems like most people with CAIS are women and girls because they are socialized as such and more or less have the same biological outer appearance of a female and the internal testes are practically useless anyway. And I'll just take the advice and call these people "People with very rare sex conditions" . I'm not trying to offend people at the end of the day and I know that DSDs are very sensitive subjects but it's also telling how even most of them are tired of TRAs using them to justify their ideology of Transgenderism.

[–]MarkTwainiac 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (2 children)

it seems like most people with CAIS are women and girls because they are socialized as such and more or less have the same biological outer appearance of a female and the internal testes are practically useless anyway.

Kai, I know you don't mean to cause offense, but it's hurtful to say that the internal testes of persons with CAIS "are practically useless anyway." This is not so, and it reflects an attitude that is one of the reasons so many people with CAIS have had their internal testes removed, often to find it has deleterious effects on their physical and mental wellbeing.

The testes of persons with CAIS produce normal amounts of testosterone that via the enzyme aromatase get converted to estrogen. Testosterone and estrogen play important, indeed essential, roles in human health, affecting everything from secondary sex characteristics to bone density to libido to mood to cognitive function/dementia risk to energy levels to cardiovascular status to ability to build and maintain muscle to body weight and BMI - and much more. Without their internal testes, persons with CAIS would never have developed a female appearing phenotype in the first place.

I think if someone told you your gonads were "essentially useless" you might take offense - and with good reason, too.

[–]Kai_Decadence[S] 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (1 child)

Oh wait, I thought the reason why they removed the internal testes was because they would develop health complications as they got older? Either way I take back that comment then Again I know this is a very sensitive subject and it further just aggravates me when Trans-identified people use people with DSDs as a "Gotcha" for the legitimacy that Transgenderism is a real thing.

[–]MarkTwainiac 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

The one main reason that is usually cited for recommending that the internal testes be removed is that there's a risk of the testes becoming cancerous starting in early adulthood. However, it appears that this risk may have been overstated: https://pubmed.ncbi.nlm.nih.gov/28351649/

Also, whereas in the past just the word "cancer" was enough to scared the hell out of people coz it raised the specter of certain death, nowadays there is a more sophisticated understanding both amongst medical practitioners and the public that not all cancers are the same. Re testicular cancer in CAIS specifically:

The diagnosis (of CAIS) is based on the presence of female external genitalia in a 46, XY human individual, with normally developed but undescended testes and complete unresponsiveness of target tissues to androgens... this condition is associated with an increased risk of testicular germ cell tumour (TGCT), although TGCT results less frequently than in other disorders of sex development (DSD). Furthermore, the majority of detected tumoral lesions are non-invasive and with a low probability of progression into aggressive forms.

The exact incidence of cancer in patients with CAIS is very difficult to estimate because of the frequent change in management of this disorder over the years, particularly regarding the correct time of gonadectomy. Data from the literature review report a general risk of approximately 5% in AIS disorder overall and a prevalence of <1% in CAIS. In addition, the risk of malignant progression is elevated only with increased age; indeed, it rarely occurs in prepubertal age (less than 1%), in contrast with other DSD, including PAIS. In the general population, GCNIS advances into invasive cancer in approximately 50% of cases over five years, while the majority of malignant lesions described in patients with CAIS after puberty were pre-GCNIS or GCNIS, with a low likelihood of becoming invasive. These data suggest that malignant progression from pre-GCNIS to invasive TCGT is very infrequent and probably takes place only in late adulthood. These findings validate the possibility of postponing a gonadectomy until after puberty. Even the occurrence of a bilateral inguinal hernia during childhood no longer represents an absolute indication for early gonadectomy.

Several studies have tried to identify [specific additional] factors associated with cancer development and progression

in persons with CAIS beyond just the the presence of CAIS itself. Also

There may be several reasons for a low trend of malignancy in retained gonads in patients with CAIS. First, in contrast with other disorders of sexual development with gonadal dysgenesis, testicular tissue is normally developed in CAIS. Second, the lack of signal coming from androgens may play a key role in modulating cellular development and differentiation. Finally, the high rate of germ cell apoptosis in CAIS reduces the possibility of malignant evolution. However, the residual paracrine actions of androgen in testicular tissue, also described in CAIS, could be a risk factor for cancer development, especially during and after puberty. Indeed, it could promote neoplastic progression of germ cells and explain the increased risk of developing malignancy in adulthood. On the other hand, some authors suggested the possible protective role of the residual androgen activity in cancer development, precisely because it allows the survival of the normal germ cell population overall.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480640/

https://pubmed.ncbi.nlm.nih.gov/30970592/

Clearly, the situation re gonadal function and the routine removal of the entirely normal and normally-functioning gonads that persons with CAIS have for "prophylatic" reasons is much more complicated that it has been portrayed traditionally.

But another reason for recommending that the testes be removed appears to be prejudice within the medical community owing to such beliefs and unexamined assumptions as: the internal testes of persons with CAIS do more physical harm than good; having gonads of "the wrong" sex is likely to cause psychological problems for all patients; and taking exogenous hormones manufactured by Big Pharma is just as good - or better - than having hormones that naturally come from one's own gonads and are converted via aromatase.

Yet another reason might be the medical establishment's longterm affinity for aggressive surgical solutions to vexing medical problems; if certain organs are likely to cause problems down the line, the reasoning has been, why not just yank the pesky buggers out once and for all? Giving extra "credence" to this approach have been aforementioned assumptions that certain organs are "useless," do more harm than good or have outlived their purpose.

The sex and sexism of many the physicians who treat people with CAIS probably have come into play as well: after all, most of these doctors are men, and knowing how hung up on dicks and balls men are, it's conceivable that some/many men who practice medicine might have a real problem with the idea that patients they perceive as girls and women have internal testes.

Whilst removing the internal testes does indeed totally remove the risk of the specific kind of cancer they might develop - TGCT aka gonadal germ cell cancer - the experience of persons with CAIS who've had their testes removed also show that there also are, or can be, health and psychological downsides to removal that previously had not been acknowledged.

An international survey of 22 medical centers from 16 countries published in 2018 showed that gonadectomy by or in early adulthood was routinely recommended by 67% of the centers, but that 11.4% of patients with CAIS refused gonadectomy. Some patients and medical specialists suggest that a better, more evidence-based approach would be to wait and see whilst conducting rigorous regular cancer screening of the gonads rather than just removing them outright. With todays' diagnostic techniques and ability to detect genetic and other factors that might help trigger development - and/or those that might protect against development - of specific cancers within specific populations and individuals, routine gonadectomies might not be the only or best way to protect the longterm health of persons with CAIS.

https://www.karger.com/Article/Abstract/493645

[–][deleted] 3 insightful - 2 fun3 insightful - 1 fun4 insightful - 2 fun -  (0 children)

This is (as usual from you) very well written and thorough. I really like your analogy to the immune system. And also I'm sorry you're saddled with a malfunctioning one.