Transgender men might have a natural hedge against COVID-19.
When the Novel Cormovirus was first reported in Wuhan it quickly became apparent that more men than women were being infected. The media quickly attributed that disparity noting that while nearly half of Chinese smoke, less than 2 percent of women smoke. Unhealthy lifestyle choices, most made by men, such as diet, drinking and lack of exercise were also attributed.
But soon it became apparent that there had to be other factors. So while we anxiously await the outcome of clinical trials for Remdesivir and become proactive by breaking our own bad habits we need to be educated about this deadly virus.
Informed decisions aren't always easy
Studies in 2013 and 2017 have shown that female mice have a naturally occurring resilience to SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) Cormovirusi resulting in a much lower mortality rate than male mice. The results of these studies, regarding infection and mortality rates, have shown to parallel that of humans during this viral pandemic happening now.
This disparity has been attributed to higher estrogen levels in the female mice.
How does this relate to the transgender community? The studies show that:
- Female mice with artificially induced estrogen suppression, oophorectomy, or hysterectomy, when infected with Cormovirus, have increased mortality rates equal to that of male mice.
- Testosterone suppresses menstrual cycles and decreases the production of estrogen from ovaries as evidenced in these studies, as these mice had a higher mortality rate. By extension, and not verified by these studies, trans men currently taking HRT might result in increased susceptibility to COVID-19.
- Treating gonadectomized mice with estrogen reduced levels of TNF and CCL2 and thus protected these mice from influenza virus infection.
What SARS, MERS, and COVID-19 Have in Common and how they are different
There haven’t been any studies that I can locate which would specifically indicate that estrogen improves transgender women’s resilience to Cormovirus infection or mortality. All of the studies were binary sex-based comparisons.
We need medical professionals to undertake studies regarding the novel Cormovirus, HRT and the transgender community.
This article first appeared on Planet Transgender “Trans People, Estrogen, and COVID-19” where corrections, feedback, and submissions will be immediately considered.
Disclaimer. I am not a healthcare professional nor have I received training in epidemiology or any medical field. I am however in isolation recovering from a mild case of COVID-19 and am deeply invested in helping transgender people avoid COVID-19.
This post is for information purposes only and not as advice. Please consult with your doctor and adhere to CDC procedures.
Source Forbes “Sex Does Matter” Published 2/02/2020
“Females fare better than males. Much better. According to a New York Times piece this week, despite the fact that men and women have been roughly equally infected (51.4% infected are males), the death rates differ substantially: 2.8% death rate in males, and 1.7% death rate in females.”
“This was found to be the case across all age groups. Looking back on data from SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), which were both also pathogenic coronaviruses, males had higher mortality rates than females. Mice experiments where mice were infected with SARS and MERS demonstrated that male mice were more susceptible to infection than female mice, and that removing ovaries or blocking estrogen in female mice made them more susceptible to infection and infection-related mortality. One concept which continues to be investigated in this current outbreak is the protective nature of estrogen in such infections.”
The lower infection and mortality rate in cisgender women might be due to chromosomal differences.
“In addition to estrogen, the presence of two X-chromosomes, which carry genes for immunity, may play a part in the biologic difference between females (who carry two X-chromosomes) and males (who carry one X-chromosome) when it comes to immunologic response to infections.”
Source Covid-19 seems to hit men harder than women. Why? Published 2/20/2020
Experiments in which mice were exposed to the Sars coronavirus found that the males were more susceptible to infection than the females, a disparity that increased with age.
The male mice developed Sars at lower viral exposures, had a lower immune response and were slower to clear the virus from their bodies. They suffered more lung damage, and died at higher rates, said Dr. Stanley Perlman, a professor of microbiology at the University of Iowa who was the senior author of the study.
When researchers blocked estrogen in the infected females or removed their ovaries, they were more likely to die, but blocking testosterone in male mice made no difference, indicating that estrogen may play a protective role.
“It’s an exaggerated model of what happens in humans,” Dr. Perlman said. “The differences between men and women are subtle — in mice, it’s not so subtle.”
The Philadelphia Inquirer Why is the coronavirus so much more deadly for men than for women? Published 3/21/2020
In China, where cigarette smoking rates are among the highest in the world, 54% of men were current smokers in 2010, and 8.4% were ex-smokers. Yet only 3.4% of Chinese women had ever smoked, according to the same 2016 study.
In South Korea, the disparity was almost as pronounced: half of adult men and 4% of women smoke. In Italy, 28% of adult males and 20% of females smoke.
But that’s not the whole story, said Stanley Perlman, MD, Ph.D., a pediatric infectious disease specialist at the University of Iowa who has studied coronavirus infection in mice.
In a series of experiments in 2016 and 2017, a team led by Perlman infected male and female mice with the coronaviruses that caused severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). At every age, male mice were more susceptible to infection than females.
At the same time, the death rates of infected female mice shot up when their ovaries were removed, or when they got drugs that suppressed the activity of the hormone estrogen.
To Perlman, those dual findings strongly suggest that there’s something about estrogen that protects against the ravages of deadly coronaviruses — and he suspects it’s true for the new SARS-CoV-19 virus as well.
“Why does estrogen protect the woman, and how?” Perlman said. “We’d like to know.” Estrogen has so many important roles in the female body, “it’s hard to prove anything” about its specific protective powers, he said.
PubMed Sex-Based Differences in Susceptibility to Severe Acute Respiratory Syndrome Coronavirus Infection. published 05/17/2017
Ovariectomy or treating female mice with an estrogen receptor antagonist increased mortality, indicating a protective effect for estrogen receptor signaling in mice infected with SARS-CoV. Together, these data suggest that sex differences in the susceptibility to SARS-CoV in mice parallel those observed in patients and also identify estrogen receptor signaling as critical for protection in females.