[transatlantic38]

I'm not that poster but I can elaborate. Basically your physician couldn't easily use "biological sex" as a blanket term to accurately asses the risk factors and health needs of a medically transitioned person. Our sex is "otherwise complicated."

The reason for this is that medical transition, primarily through the mechanism of hormone replacement therapy, actually changes some aspects of biological sex and the associated risk factors at a "nuts and bolts" level even though its not touching every single aspect of biological sex. It's not purely cosmetic, though that's a common misconception. Hormones ultimately control a lot about how human bodies express sex and the associated medical factors. In reality "biological sex" is composed of multiple sexually differentiated systems within the human biology that can theoretically operate somewhat independent of each other, and changing the dominate hormone in your body will flip or at least shove a lot of those systems towards the other end of the distribution. I guess a way to phrase this in developer terminology would be that "biological sex" is sometimes a leaky abstraction.

As a personal example: despite my birth sex, it would be a mistake for my doctor to ask that I routinely get regular breast cancer screenings in the same way it would be a mistake to ask a cis man to regularly screen himself for breast cancer. My risk of breast cancer is much lower than a cis woman's and comparable to a cis man's. But at the same time I have absolutely zero risk of prostate cancer, and it would also be a mistake to try and test for that based on any possible symptoms I'm having. An ideally perfect doctor would be able take my history and be cognizant of what risk factors of biological sex, exactly, which conditions were associated with, and then be able to map that onto my body to figure out what I'm at risk for. As you can probably imagine, this is very difficult to do. A lot of times what makes a condition linked to sex isn't actually understood in the first place.

[37r7rudjduj]

I wanted to say thanks for giving such a detailed reply. I still have some things that I'm unsure about as far as the framing of everything but having concrete examples like your point about your lowered risk of breast cancer is immensely helpful in understanding where I'm making social judgements vs. just being ignorant about the topic as a whole. It's often hard to get clear answers like yours because just phrasing these kinds of questions often feels like a minefield. So your patience in answering what I'm sure is an at least somewhat demeaning line of questioning is very appreciated and helps a lot in wrapping my head around this.

[transatlantic38]

I appreciate this, thanks. Answering these kinds of questions can feel like unwrapping bandages in front of strangers. So it's good to hear that it helped somebody out. Thank you for your empathy.