November 11, 2013

Hi, I have a wonderful friend whom I love dearly and has made the decision to transition from biological female to biological male. He intends to proceed with the appropriate medical procedures in due time and my main concern is he is severely overweight. My main question is this, is transitioning more dangerous for people who may be considered obese? I have heard and read mixed views and was wondering if there were a consensus.

The closest thing to consensus for transition is the WPATH Standards of Care, and they warn of two potential problems with being overweight and undergoing masculinizing therapy: a potential increased risk for high blood pressure and development of type 2 diabetes, both of which are complications already associated with being chronically overweight. There’s also a fair chance that your friend will gain some weight when he begins T.

Having said that, HRT is generally stressful for a body, and losing weight in general is a good idea for overall health while transitioning. Most therapists will encourage this, both for the health benefits and for the increased self-image and self-esteem that weight loss brings to the transitioning man or woman. 

Where your friend may find issues is if/when her goes in for some sort of surgery. Doctors in general advise patients who are scheduled for surgery to lose weight first, and especially when the surgeries are non-life-threatening or cosmetic. I have known more than one transitioning person who was told they could not schedule “bottom” surgery until they lost weight. 

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