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| | Gynecomastia in M2F transgenderism, Journal of Gender Speculation |
 | | While transgenderism is often not associated with identified intersex states (11, 12), some authors state that gender change in intersexuals is higher than in the general population (13), and may not follow assigned gender in some cases (14), suggesting the possibility that past assessments of the transgendered may have overlooked subtle variants of intersex stigmata. |
 | | Since transgenderism is a complex phenomenon occurring in a stigmatized, relatively hidden minority, most efforts at identifying biological factors have involved small studies often limited by concurrent estrogen effects, complex and difficult follow-up (90, 166), differing methods or patient profiles, difficulty in monitoring patient status, labile gender identification, and lack of replication. |
 | | Identifying underlying metabolic disorders causing both gynecomastia and transgenderism requires excluding exogenous feminizing agents, excluding psychological reactions to the social experience of gynecomastia per se, and excluding causes of gynecomastia unrelated to transgenderism. |
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