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Chloe Cozee

Good Morning! Sipping coffee. It snowed here, looks like a blizzard outside. I am thinking of taking the day off. If I do, after I clear the driveway, I am going to dress up!


Have a great day everyone!

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Emily michelle
6 hours ago, Mmindy said:

Small World Emily, my baby brother is a dispatcher and batch operator for Arnold Readymix. I hope things are going well for you. GirlMechanicsRock and being in the quarry/mining industry you really Rock. 


Best wishes, stay positive, and safe



Wow it is a small world. We used to have a sand plant there too. We still load and unload barges in Herculaneum. I don’t make it down that way much there is an underground mine in st. Charles county I usually go to. Haha thanks girl mechanics do rock. Mining is interesting lol. It’s a lot of hours. You always have to watch your back in a mine it doesn’t take much for a situation to turn deadly.


Congratulations on the hrt 2bebreanna. Let the fun begin. I just celebrated 9 months the other day.

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Elizabeth Star

Good morning. I'm enjoying a cup of caramel flavored coffee. Looks like we finally got a little snow last night. I've got hour and a half before I get ready for work. Time to drink down my coffee and pray my snow blower behaves.

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Oh that sucks. At least you had white socks. I would have to use a towel, and it would take a while even to find that. Hope you have a better day.



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Sorry, I was replying to Willows post about getting her foot wet. 


You gals are early risers. A dammed mouse just woke me up. For some reason they've really gotten bad recently. I use a live trap. They seem to come out to eat about 8:30 pm and 4:30 am. I've caught about 10 of them in the last week. I live across from a cemetery so I let them loose over there. Didn't get much snow here. A little freezing rain though. I'll be putting on coffee in about 15 min.  


Enjoy the day .


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Elizabeth Star

That sucked. I got 2 passes done and my snow blower quit. I'm hoping it just needs a new plug. I believe the governor needs adjustment. It never ran right unless it was on choke. Shovel time! Thankfully the snow is light and fluffy. It doesn't look like the streets haven't been plowed yet so I might not get out of neighborhood. I've never lived anywhere so hilly that got snow.

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typically not a governor issue. Sounds like you need to unscrew the fuel mixture screw about 1/4 turn to give it new fuel. As far as why it quit, there could be several reasons for that. Good luck Liz. Be careful.



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CD Rachel

Good morning all,


Working from home and enjoying being able to work in girl mode. No snow here in NEPA but we are expecting sleet and freezing rain within the next couple of hours. Another reason to be happy about working from home.


Have a terrific Tuesday everyone!



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Up early and shoveled driveway.  Then decided to head towards work early.  We were supposed to 6-8 inches.. got 2.  Everyone is driving insanely slow for just a little snow. 


@Willowhope your foot heals just as good as if it had your normal cast. 


 you are so lucky to have such great coworkers.  It must feel amazing to be so accepted at work and getting all the stuff you do. 

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Good morning everyone, hope you all are feeling well this morning.


Sounds like the storm through the Midwest was (mostly) less severe than expected? We're supposed to get some kind of winter weather here today but it hasn't started yet, so I was able to get my usual exercise in. I tell you, I don't miss dealing with snow myself. Here in NYC, building supers and maintenance staff will be outside taking care of it moments after it stops so we're ridiculously spoiled. But then, they use those awful de-icing salts and chemicals that destroy anything they touch. I believe every New Yorker must sacrifice at least one pair of shoes to the winter deities.


Expecting a fairly quiet day otherwise. Lots of client appointments today and one program meeting in the late afternoon. I'm ready with a fresh pot of coffee from Plowshares, it's called "Kanzu" and it's from Rwanda. African coffees are always my favorites.


@ElizabethStar I think that if the world offers you with a dress, it's a sign you're meant to have it! I hope it looks wonderful on you, and that your wife won't argue semantics about the "no dresses" rule.


Enjoy your day everyone!




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It's finally getting cold here...must be down to 40 degrees.  Ok, I'm spoiled here in the west.  I'm not sure I've ever seen a snow blower.  We have had crazy wind though.


I have to bundle up and wait outside at my local DMV today to transfer a car title.  Then I'll spend the rest of the afternoon fussing about how I look for my first transgender group therapy on zoom.  I'm a little nervous about it, but looking forward to meeting some local trans people.


Have a safe and warm day.¬†¬†‚ĚĄ


(Cafe Pajaro from Trader Joe's this morning)

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Hi, now I’m having my coffee.  I did manage to get a little more sleep.  

Thanks @2beBreanna and @Jamie68   The air cast or boot I am wearing is exactly what I’ll be wearing for the next 4 weeks anyway, I just started a few days early on my own.  I couldn’t bear to toss my Harley socks. They are so soft and comfortable.  This is actually the first time I’ve worn them in 4 years but I still won’t toss them!

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Surprised that Illinois drivers are reacting to only 2‚ÄĚ of snow. ¬†Then again southern drivers start panicking at just the mention of the word. ¬†


Today is our one warm day, the weather people said dress for the seventies.  There are people walking around in paisley and big bell bottoms and doing the hustle.


okay I get one bad joke every so often.


Liz, did you leave gas in your snowthrower for a long time. That could cause varnish or gum things up.  Like Jamie68 said try opening the needle a little.  The other thing is depo you have non-ethanol gas or just what can out of the pump?  Next time add marine fuel saver it keeps the water out of ethanol gas. Water is a huge problem with ethanol gasoline and the longer it sits in a tank the worse it gets.  

Good luck with the snow.  I hope it’s a non-event.





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13 hours ago, ElizabethStar said:

Congrats @2beBreanna!   I couldn't stop myself and took mine as soon as I got in the car. Why did I park so far away? Stupid street parking.


One of my friends at work gave a bag of clothes today. She came into my office area with it and immediately started  rummaging through it. Pulling stuff out and showing it to me. I think you'll like this...This'll look good on you. I was only slightly mortified this was happening. My office mates are guys and knew me before, made it kinda awkward. I got some nice stuff though and a dress. A sleeveless dress none-the-less. Of course I had to try it on when I got home (I tried it all on). It fits....really good. I just started going out in skirts and now a dress appears in my life. Just need an occasion to wear it. And the wife thing. I think she said no dresses but I'm not sure if that was no buying, wearing or just not in front of her. Oh well, life's a gamble.



Another fashion show in "what are you wearing today"?

It's so nice when the work crew comes out in such support.  

When I needed a dress for a wedding one of the ladies brought in all her formals for me to try on and borrow!  It was so much fun and a couple of the other ladies got into the trying on process to see if they could borrow them too. lol

I'm so lucky to have an all female staff (or was it just smart hiring on my part lol)

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Good morning all. Coffee is strong with coldstone creamer. Standing in my mom's kitchen. It's a big adjustment for them, but she and her husband have been trying very hard to be supportive since I came out to them and started socially transitioning. I keep getting deadnamed, but hey, Rome wasn't built in a day. Found these adorable cheapo travel mugs at Walmart. Gotta order some car parts for the replacement vehicle at AutoZone today, and this girl only has femme clothes with her, so as long as nobody blurts out when we all walk in (, going with mom, her husband is a wrench monkey, reason I'm here), it will be an excellent field test of the voice. I wish everyone a good day!


-Smile, folks

Keira ‚̧ԳŹ



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Keira, boo hiss, auto zone. O'reilly is much better. JK.


@Willow , I know a good pair of socks is like an old friend.


Well, my Thursday. We got about 2" of white crap. My oldest in Lincoln, NE had 15" on the ground yesterday. And still coming down. The mule express must have gotten lost between here and Cheyenne. Still no E. anxious to get it.


Have a safe day everyone.



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@KymmieLPatience is a virtue.  Keep telling yourself that, patience is a virtue, like hell it is when your waiting on HRT meds.  Makes a girls lose it!

yes good socks that are thick and soft just can’t be parted with.  I have three pair.




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40 degrees? That's a heat wave for us Illinois gals.

Love the coffee cup.

We only got maybe a half inch of snow and a little freezing rain here in Pontiac. 


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I went to the gym with my 23 yr old  grandson this morning. First time since start of transition almost 5 months ago. They say you loose upper body strength. Oh yeah, they weren't wrong. He was doing 260 pounds and I was lucky to do 30 pounds. What a shock! I knew I was getting weaker, but didn't know it was that bad. Time to get serious about working out. Don't want to get ripped, just want to stay healthy.

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6 hours ago, Jamie68 said:

A dammed mouse just woke me up. For some reason they've really gotten bad recently. I use a live trap.

Those little creeps piss me off.  They got into some of my clothes and chewed a hole in one skirt.   They always seem to get my favorites.  I have a kitty, but she seems to prefer to do her hunting outside.  Useless thing.  Well, I still like her.


No snow here, had thunderstorms last night.  They claim it's supposed to be warm today - we'll see.


Spent the weekend at my daughter's house.  That was a nice break.  A friend up there has a teenaged daughter who is saying she is trans now.   Fortunately her mother is quite open to it.  I did tell them about this place if they want to check it out.


I watched Jack Rabbit's latest youtube.  It is pretty good for for an older girl to watch.

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I'm a little short on patience also. I want "B" cup breasts so bad, I get depressed they're not growing faster. Shame on me for complaining. At 5 months I'm probably ahead of schedule with my "A" cups. Mostly want them bigger so that I will HAVE to come out to my family. I want to wear girl stuff SO bad. I have been leaving little clues around the house, but no one has mentioned anything yet. Wearing pretty high cut boy shorts and painting my toenails helps with the dysphoria some. Dressing and living as a woman will be much better. Sorry about the whimpering.



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I think society in general is becoming more accepting with transgender people. I have 2 relatives who just came out recently. The most recent is a 13 yr old niece/nephew starting HRT for FTM transition. Seems awful young, but they've been dealing with dysphoria for years, with therapy. He's lucky to have parents who support him. I couldn't even begin to talk to MY parents about it. They probably would have put me in a mental institution.

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Jackie C.

Finally home for a minute. Decent workout at the gym to start my day. I forgot my towel though so I spent more time than I like wiping the machines down with paper. @Jamie68, I was more worried about losing bone density, but I've got a pretty intense workout going on (well, now). I can't say for sure how much upper body strength I lost because I didn't have much when I started, but, depending on what you're talking about, I can squat 180 pretty easily and leg press 900. My chest press is at about 180. I don't deadlift. Well, my straight-leg deadlift was 230 today, but I don't do a full deadlift. I know it's good for me, but I'm afraid I'm going to hurt myself with or without a spot. Probably silly, but there you are. Then again, I'm a giant dork and it's probably a miracle I haven't crippled myself yet.

So yeah, research says that after about 9 months on HRT (Well, MtF HRT obviously) you lost around 30% of your performance capability. At around two years you're where a cis-woman would be. Basically we're like big cars with small engines. I'm at about two-and-a-half years so there's nowhere to go but up. Assuming that I keep exercising and taking care of myself.


I got my wife's wedding ring back from the jeweler today. It was shedding diamonds again. Poor thing. The jeweler decided not to charge us anything because they go to where my spouse works for their vet care. I was wound so tight that about had me bawling right there in the store.


Next up is lunch. Lunch will be boring but if I'm going to lose the rest of this weight I need to stick to my diet. I miss food.


After lunch, I'm going to put on some pants (my leggings do nothing to stop the cold) and start shoveling. The snow is heavy and wet, so it should be an absolute joy.



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2 hours ago, Jamie68 said:

I'm a little short on patience also. I want "B" cup breasts so bad, I get depressed they're not growing faster.


I hear you.¬† Mine are only "A"s.¬† Almost.¬† "B"s would be so much better.¬† At least they would be bigger than my stomach. ūüôɬ† After four years, I guess they are all I am going to get.

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      This is what I found...... ¬† ¬† Gender Identity Disorder and Schizophrenia: Neurodevelopmental Disorders with Common Causal Mechanisms? Ravi Philip Rajkumar1 ¬† Show more Academic Editor:¬†Luis San Received19 Sep 2014 Accepted20 Nov 2014 Published04 Dec 2014 Abstract Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as¬†Toxoplasma¬†infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed. 1. Introduction Gender identity disorder (GID) is a rare condition characterized by an incongruity between gender identity and biological sex. Individuals with this condition experience distress related to their biological sex and frequently express a desire to change it by hormonal or surgical means; in simple terms, they identify themselves as belonging to the opposite gender, and behave accordingly. GID is distinct from disorders of sexual development, such as chromosomal abnormalities or congenital adrenal hyperplasia, in that there is no anatomical or physiological ambiguity regarding the individual‚Äôs sex; rather, there is a subjective dissatisfaction with it [1,¬†2]. The central role played by this dissatisfaction and distress has led to the condition being renamed ‚Äúgender dysphoria‚ÄĚ (GD) in the DSM-5, though the term ‚Äúgender incongruence‚ÄĚ (GI) has also been proposed by some authors [1]. Various theories have been proposed to account for GID/GD and related conditions, known as gender identity variants (GIVs) [3]. Abnormalities in genes related to gonadal hormone synthesis and action have been found in these individuals, suggesting that GID/GD is a disorder of sexual brain differentiation caused by exposure to altered hormone levels during a sensitive period [2,¬†3]; however, evidence for such a viewpoint has not been consistently found, and it fails to account for patients with late-onset GID who have few or no symptoms during childhood [4]. Alternately, GID has been conceptualized as a disorder of cortical representation of sex-specific bodily features, particularly the genitalia [5], but such a proposal does not account for the other behavioural changes seen in this condition. In this paper, I review theoretical and research evidence suggesting that GID is a neurodevelopmental disorder, involving the processes of brain lateralization and sexual differentiation, which is related to schizophrenia. First, the evidence of a symptomatic overlap between the two conditions is reviewed; next, evidence of common causal pathways and mechanisms is outlined and synthesized. 2. Clinical and Phenomenological Overlap between Schizophrenia and GID/GD 2.1. Comorbidity between the Two Disorders A relationship between two distinct disorders can be inferred if they cooccur at a higher level than would be expected by chance. According to recent estimates, the prevalence of schizophrenia is approximately 1 to 8 per 1,000 population [6], and that of GID is even lower, estimated at around 1 in 10,000 for male-to-female GID and less than 1 in 25,000 for female-to-male GID [7]. Their cooccurrence would therefore be expected to be rare: a crude estimate, obtained by multiplying prevalences, would be less than 1 in 1,000,000 individuals. Hospital and clinic-based studies of individuals with GID have found rates of schizophrenia far in excess of both this estimate and the general population prevalence; however, comorbid mental illness is likely to have been overrepresented in such samples. A Dutch survey of 186 psychiatrists evaluating patients with GID found that 31 (16.7%) reported seeing patients with comorbid GID and psychotic disorders, including schizophrenia [8]; however, it was not possible to calculate the percentage of patients with schizophrenia from the data provided by the authors, and the study has been criticized on the grounds of response bias, low external validity, and lack of a standardized means of confirming the diagnosis of psychosis [9]. A second Dutch study compared 20 patients who underwent gender-reassignment surgery and 27 in whom this treatment was deferred or delayed; no patient in the former group had schizophrenia, while 2 in the latter (7.4%) received this diagnosis, and a third was reported as having ‚Äúpsychotic episodes‚ÄĚ [10]. An earlier clinic-based study obtained similar results; in a sample of 51 individuals with GID referred for psychiatric evaluation, 8% were found to have schizophrenia [11]. An unusual clustering was reported in African-American women with GID at a clinic in the United States; two of these five subjects (40%) were diagnosed with schizophrenia and a third was noted to have a ‚Äúschizophrenic character‚ÄĚ [12]. More modest but still significant results have been obtained in population-based samples. A recent study from Ireland found that 8 of 159 patients with male-to-female gender dysphoria (5%) had comorbid schizophrenia, as opposed to none of 59 patients with female-to-male GD [7]. Psychiatric evaluation of 230 self-referred applicants for gender-reassignment surgery in Spain, after excluding patients with psychosis but no clear diagnosis of GD/GID, identified six cases (2.6%) of psychosis, with equal rates in male and female subjects [13]. Though these figures are lower than those of the referral-based studies, they are likely to be closer to the true prevalence in this population and are still far higher than would be expected by chance alone. A study of Taiwanese students which measured symptoms, rather than diagnoses, found a strong correlation between symptoms of GID and schizophrenia in male students [14], also suggesting an effect of gender on this association. Taken together, these studies provide indirect evidence for a link between schizophrenia and GID, on the grounds of their greater-than-chance cooccurrence. However, not all studies in adults or adolescents have been positive. A study of 579 subjects with GID from Japan found only one case of schizophrenia (0.17%) in a female-to-male patient, a rate which is comparable to the lower bound of general population values [15]; however, another publication involving the same sample makes it clear that five subjects with schizophrenia were excluded from the first paper, yielding a corrected prevalence of 1.02% [16]. A study of 435 patients attending a gender clinic in Texas found only four (0.92%) cases of schizophrenia [17]. In a sample of 83 Iranian patients with GID, no cases of schizophrenia were reported [18]. 2.2. Beliefs Related to Gender Change in Schizophrenia Beliefs or ideas related to gender change‚ÄĒhistorically termed¬†metamorphosis paranoica sexualis¬†by Richard von Krafft-Ebing‚ÄĒhave been documented in schizophrenia for over a century. One of the most influential cases in the early literature on this disorder‚ÄĒDaniel Paul Schreber, whom Freud used as the basis for his psychodynamic formulations of schizophrenia‚ÄĒexperienced bizarre delusions in which he believed that he would be transformed into a woman, and that this was part of his mission to redeem the world [19,¬†20]. Though no study has systematically examined the prevalence of such delusions in schizophrenia, there have been numerous case reports of patients with schizophrenia who had seemingly delusional beliefs related to gender identity [21‚Äď27]; in some of these cases, a weakening [21] or resolution [27] of gender dysphoria was reported after antipsychotic treatment, while in others, schizophrenic symptoms resolved and features of GID persisted, suggesting that they were distinct [26]. These reports suggest that there is a grey area between patients with schizophrenia, those with GID/GD, and those whose phenomenology does not clearly fit into either category. This situation is complicated by the fact that many researchers view the two diagnoses as mutually exclusive [15], which may lead to an underestimate of gender-related psychopathology in schizophrenia. 2.3. Gender Identity in Schizophrenia Leaving aside overt delusions of gender change, are there subtler indications of gender disturbance in schizophrenia? A number of older studies have attempted to address this issue, though they are largely based on projective techniques of psychological assessment [28]. Evidence of disturbed gender role and gender identity in these studies includes distortions or omissions of anatomical features on being asked to draw human figures [29,¬†30], reduced satisfaction with body parts in male patients with schizophrenia [31], and inappropriate responses on psychological tests of masculinity-femininity [32,¬†33]. A more recent study of 90 patients with schizophrenia using the Bem Sex Role Inventory found that both men and women had culturally appropriate scores on the feminine role scale and low scores on the masculine role scale [34]. These findings provide evidence for a disturbed or distorted perception of gender identity and role in patients with schizophrenia; however, given the significant impact of culture on gender roles, they need to be replicated in non-Western settings. 2.4. Schizophrenia-Like Traits in Patients with GID/GD In a similar way, some researchers have assessed schizophrenia-like traits or personality variables in individuals with gender identity disorder. Two studies have used the subscales of the Minnesota Multiphasic Personality Inventory (MMPI) to assess personality dimensions in subjects with GID. In the first, high scores on the femininity subscale were found in men applying for gender-reassignment surgery; however, an elevation in the schizophrenia subscale was found only in those men who were continuing to live as men [35]. In the second, female-to-male transsexuals receiving testosterone therapy as part of the management of GID showed a significant decrease in scores on the paranoia subscale of the MMPI-2 [36]. A study of Taiwanese university students found that gender dysphoria was strongly associated with schizoid personality in both men (OR 4.7; 95% CI 2.2‚Äď9.9) and women (OR 3.6; 95% CI 2.1‚Äď6.3) [37]. These findings suggest that schizophrenia-linked personality traits may be commoner in persons with GID, though gender and hormonal treatment may moderate this association. 3. Processes and Mechanisms Common to Schizophrenia and GID/GD 3.1. The Role of Prenatal Hormonal Factors in Schizophrenia and GID/GD An influential model of GID, briefly alluded to above, posits that this condition is due to a disorder of sexual development which specifically involves the brain, but spares the internal and external genitalia [3]. This theory has gained some support from brain imaging studies in which sexually dimorphic brain regions resemble those of the desired rather than the anatomical gender in subjects with GID [38‚Äď40]. There is evidence that some brain structures may show a similar variation in schizophrenia, with men showing a ‚Äúfeminized‚ÄĚ pattern and women showing a ‚Äúmasculinized‚ÄĚ pattern [41,¬†42], leading to the proposal that schizophrenia itself may be related to gender-atypical brain development, perhaps caused by prenatal hormonal imbalances [43,¬†44]. However, there are important differences in brain structure across the two disorders: most importantly, the thickness of the cerebral cortex is increased in male-to-female transsexuals [45], while schizophrenia has been consistently associated with decreased cortical thickness, irrespective of gender [46‚Äď48]. This suggests that even if both disorders are related to common neurodevelopmental pathways, the changes seen in GID are less severe and more region-specific than those seen in schizophrenia. Apart from the direct evidence of brain imaging studies, indirect evidence of prenatal hormonal influences can be obtained by studying the ratio of the length of the second and fourth digits (the 2D‚ÄČ:‚ÄČ4D ratio) in adults; higher ratios indicate a more ‚Äúfeminized‚ÄĚ pattern. In persons with GID, evidence of an altered 2D‚ÄČ:‚ÄČ4D ratio has been reported in several studies [49‚Äď51], though some researchers have found a specific association only in men [49] or women [50,¬†51]. These alterations are generally in the direction of individual‚Äôs self-identified sex, with female-to-male subjects showing a more ‚Äúmasculinized‚ÄĚ pattern than control women, and male-to-female subjects showing a more ‚Äúfeminized‚ÄĚ ratio. Very similar alterations in the 2D‚ÄČ:‚ÄČ4D ratio have been reported in schizophrenia, more specifically in male patients where a reversal of normal sexual dimorphism has been documented [52,¬†53]. Similar abnormalities are also found in schizotypal disorder, a condition which is genetically and clinically related to schizophrenia [54,¬†55]. This alteration, especially in male patients with schizophrenia, has also been tentatively linked to abnormalities in prenatal testosterone exposure, a mechanism relevant to GID. 3.2. Cerebral Laterality and Handedness Besides indicating sexual dimorphism, the finger length ratio is also an indicator of cerebral lateralization [56]. Alterations in cerebral lateralization may result in an excess of atypical hand dominance patterns, such as left-handedness or mixed laterality. A meta-analysis of 40 published studies found that schizophrenia was consistently associated with increased atypical hand dominance, particularly left-handedness [57]. Similarly, both male and female transsexuals have higher rates of non-right-handedness than healthy controls [58], and this has been documented even in young boys with childhood GID [59]. These findings suggest an altered pattern of lateralisation [58], presumably of developmental origin and at least partly linked to genes involved in neurodevelopment [60]. 3.3. Toxoplasma Infection, Gender Identity, and Schizophrenia Prenatal or childhood infection with the parasite¬†Toxoplasma gondii¬†has been identified as a risk factor for schizophrenia [61,¬†62]. Though evidence of this infection is not found in all patients with the disorder, it may be associated with a less favourable outcome [63] and with a higher risk of suicidal behaviour in younger patients with schizophrenia [64]. The exact mechanisms involved in this association are unknown but may include increased dopamine levels [61], alterations in brain development [65], or the activation of endogenous retroviruses [66]. Though there is no direct evidence linking¬†Toxoplasma¬†to GID, there is evidence suggesting that prenatal infection can result in ‚Äúmasculinization‚ÄĚ of the foetus and even a predominance of male births in infected mothers [67]. In a follow-up study of seven adult patients with congenital toxoplasmosis, one male patient had developed a male-to-female GID and undergone gender-reassignment surgery [68]. It is therefore possible that¬†Toxoplasma¬†infection may be a common risk factor for both disorders, though this proposal needs to be tested serologically in individuals with GID. The link between¬†Toxoplasma¬†infection and suicidality is also not without relevance, as suicidal and self-injurious behaviour is very common in individuals with GID [15,¬†17]. 3.4. The Role of Brain-Derived Neurotrophic Factor Brain-derived neurotrophic factor (BDNF) is a nerve growth factor that plays a key role in brain development, as well as in the maintenance of neural plasticity in adult brains. The activity of BDNF can be influenced by several factors, including sex hormones such as oestrogen and testosterone [69]. A meta-analysis of studies conducted in patients with schizophrenia has identified a consistent, moderate decrease in blood BDNF levels compared to healthy controls [70]. A recent study has found evidence of decreased serum BDNF levels in patients with GID [71]. The authors of this paper have suggested that these changes may be due to childhood adversity [71] or stress related to the patients‚Äô ‚Äúminority‚ÄĚ status [72]. Yet, it is equally probable that low BDNF levels may signal a defect or deviation in normal brain development in this patient group [73], in the light of what is already known about the role of this molecule in the sexual differentiation of the brain [74]. Moreover, as discussed below, these two explanations are not mutually exclusive. 3.5. The Role of Childhood Attachment and Childhood Adversity It is now well established that disturbances in parent-child attachment, including severe adverse experiences such as physical and sexual abuse, are associated with an elevated risk of schizophrenia [75]. A variety of biological and psychological mechanisms may underlie this association, including sensitization of dopamine pathways, impaired mentalizing abilities, and distortions of internal representations of the self and others; moreover, childhood adversity can itself alter brain development to some extent [76]. A relationship between disturbed childhood attachment and GID has been recognized for decades [77‚Äď81] and has unfortunately led to simplistic, reductionistic approaches to the management of this condition in some cases [82]. Nevertheless, more recent research has also found high rates (25%) of childhood maltreatment in male-to-female transsexuals; patients with a history of maltreatment had greater dissatisfaction with their body and worse mental health [83]. It is possible that, as in the case of schizophrenia, childhood maltreatment interacts with an underlying developmental vulnerability to lead to symptom formation in GID/GD; alternately, trauma-related release of stress hormones may lower BDNF levels [69], affecting childhood brain development. 3.6. Links between Autism, Schizophrenia, and GID/GD Autism and related conditions, collectively known as autism spectrum disorders (ASD), are neurodevelopmental disorders which are distinct from schizophrenia but also overlap with it substantially on anatomical and neurocognitive grounds [84,¬†85]. The two conditions are also genetically linked; a family history of schizophrenia is a risk factor for ASD [86], and common genetic vulnerability loci have been identified [87]. Like schizophrenia, autism is linked to abnormalities in prenatal testosterone exposure, which is relevant to the pathogenesis of GID/GD [88,¬†89]. A study of individuals with ASD identified deviations in gender typicality, particularly lower overall levels of masculinity in both genders and higher levels of ‚Äútomboyism‚ÄĚ in women with ASD [90]. Individuals of both biological sexes with ASD and comorbid GID/GD have also been reported in the literature [91,¬†92]. Conversely, studies of individuals with GID have identified high levels of autistic traits [93] and comorbid ASD [94,¬†95], though some of these results appear to be gender-specific. Deficits in empathising, a feature of ASD, are also associated with GD, especially in female-to-male subjects [96]. Though none of these studies have specifically examined links with schizophrenic symptoms or dimensions, they provide further indirect evidence for an etiological and phenomenological zone of contact between GID/GD and schizophrenia. 4. A Tentative Synthesis Beginning with the observation that the comorbidity of schizophrenia and GID/GD is greater than would be expected, it is seen that patients with either condition may exhibit symptoms or traits of the other. Several converging lines of evidence, involving cerebral sexual dimorphism, laterality, prenatal infection, and childhood adversity, suggest that both these disorders have their roots in abnormal brain development and that their overlap may be explained by shared risk factors (such as¬†Toxoplasma¬†infection) or mechanisms (such as abnormal lateralization and sexual brain differentiation) via common biochemical pathways, such as prenatal hormonal imbalances or reduced BDNF expression and release. Schizophrenia is also associated with disturbances in body image and concept [97‚Äď99], which may be mediated through a frontal-limbic-temporal-parietal neural network [100]. Such processes would be relevant to an alternate model of GID, in which disturbances in body image representation, involving suppression or distortion of body maps in the parietal cortex, are considered to be the central feature [5,¬†101]. In either case, the existence of a link between the two disorders is certainly more than possible. Yet another intriguing possibility is raised by studies showing an association between GID and social cognitive deficits. It has been found by some researchers that individuals with female-to-male GID have deficits in empathising. This leads to difficulties in interacting with people of their own sex, who use empathising as a preferential mode of interaction [93,¬†96], and may cause them to identify more readily with males, who use ‚Äúsystemizing‚ÄĚ more prominently than empathising [96]. Though this possibility was raised in the context of autistic traits, it may also be relevant to the schizoid or schizophrenia-like personality traits seen in individuals with GID/GD [14,¬†37] and provides a further pathway by which a neurodevelopmental vulnerability can lead to the development of this disorder. 5. Further Directions for Research The proposal outlined above can be tested in several ways. Structural brain imaging studies can assess similarities and differences in sexually dimorphic structures in both groups and identify areas of overlap. Functional brain imaging and neuropsychological assessment may shed the light on anomalies of cerebral lateralization in these disorders. Clinical studies could focus on identifying body and gender disturbances in patients with schizophrenia and their first-degree relatives and schizotypal-like traits in patients with GID. The contribution of individual risk factors, such as¬†Toxoplasma¬†infection, can be assessed serologically. Genetic studies could examine the links between gender dysphoria, schizophrenia spectrum disorders, and related conditions such as autistic spectrum disorders. The consistency of, and correlations between, information obtained through these various methods would either clarify the link between schizophrenia and GID or refute it. 6. Limitations of the above Proposal The model proposed above is not free of shortcomings. In the first place, it makes the assumption that schizophrenia and GID are both clear-cut syndromes, which is far from the case; schizophrenia is a heterogeneous disorder [102], and some of the clinical and developmental marker studies mentioned above have identified differences between male-to-female and female-to-male GID [7,¬†49‚Äď51]. Second, GID is comorbid with a variety of other psychiatric disorders, particularly mood and anxiety disorders, at rates higher than those reported for comorbid schizophrenia [7,¬†13,¬†16,¬†18]. It is not known if these disorders are the psychological consequence of living with GID, if they reflect shared vulnerabilities that need to be examined in their own right, or if patients with GID are at a nonspecifically elevated risk for a variety of disorders. Third, there are no systematic large-scale studies on gender disturbances in schizophrenia, or schizophrenia-like or schizotypal traits in GID, which would strengthen the case for the association proposed in this paper. Fourth, while the evidence presented earlier points towards a link between these two conditions, it does not explain the large differences between them. Fifth, owing to the relative rarity of comorbid GID and schizophrenia, no study has systematically examined the differences between patients with GID/GD alone, schizophrenia alone, and those with both conditions. Finally, there is evidence that risk factors for schizophrenia and GID/GD, apart from the ones discussed earlier, may be distinct. For example, factors such as migration, urbanicity, obstetric complications, cannabis use, and maternal viral infection are specifically linked to schizophrenia [6], but not to GID. Similarly, developmental antecedents of GID, such as early childhood cross-gender behaviour and same-sex sexual fantasies [103], are not specifically associated within schizophrenia. In the case of birth order, the relationship between GID and schizophrenia seems to be inverse; an earlier birth order is associated with schizophrenia in males [104], while a later birth order is associated with male-to-female GID [105,¬†106]. These divergences suggest that the two conditions may share certain causal pathways but do not overlap completely. A further note of caution must be introduced here. The fact that scientific evidence suggests a link between GID and schizophrenia must not be taken to imply that GID is a psychotic disorder, that a wish for gender change is a form of schizophrenic thought disorder [107], or that such individuals must be treated with antipsychotic medication. It is beyond the scope of this paper to address the social and political controversies surrounding the diagnosis of GID [3,¬†108]. Research in this area should be driven by methodologically sound science rather than personal or political beliefs. 7. Conclusion The available evidence, though limited, suggests that both gender identity disorder and schizophrenia are neurodevelopmental disorders and that they may share common causal mechanisms and risk factors. Further systematic investigation of these factors may provide a new perspective not only on these quite different conditions but also on the mechanisms and processes involved in normal brain development and sexual differentiation. Conflict of Interests The author declares that there is no conflict of interests regarding the publication of this paper. References A. A. 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    • Shay
      Have any of you, like me, found that hiding all your life and lying about things you are doing in the quiet is tremendously hard to overcome? I know they say that breaking a bad habit is one of the hardest things we as humans are faced with. If you were able to overcome - what did you do every time you slipped to help you get back up and soldier on in your goal of overcoming YOU?
    • Shay
      Having a goal. I recently failed to overcome hiding the truth and it hurt me deeply as it did my wife. After living 69 years in the dark - staying in the light is so hard but I am INSPIRED to overcome my weakness, if for no other reason, then to life free.
    • Jamie68
    • Bri2020
      I feel for both of you. I worked 7 years 7pm-7am in the PICU and it wore me down and I ended up with severe depression.  I wasn't seeing daylight most days  Shift work is for the birds. I'm happy for both of you on your post op recoveries and happiness!  @Aurora I didn't realize how similar our hair is! Mine was that bright at your age but has lightened up a bit since then.  My goal is this woman's hair!  She's got some great pointers for our hair texture BTW.   
    • Jandi
      I've got one here that comes by to help out with the cat food.  Sometimes shows up in the middle of the day.  It gets up in the attic also.  If I'm out on the porch at night it come anyway, and just looks at me from time to time while eating.   I just gave up and named him/her Rorrie.   I was exposed to depleted uranium, which may have helped.  But I'm right on the edge income wise.   I would hate to loose it.  They've been good to me.
    • Jandi
      Glad it's going well for you.
    • Davie
      Inspiration What inspires you today? I‚Äôm not sure myself what inspires me. OK, I‚Äôm trying to write stories about the only non-binary trans bi-gender person I know (don‚Äôt know). I‚Äôm trying to be inspired, but trying doesn‚Äôt seem to work. I don‚Äôt feel inspired yet. So I‚Äôm asking myself‚ÄĒand the only answer now is coming right here to TransPulse. Thank you, Davie ¬† ¬†
    • Jamie68
      I forgot, I can't upload a bmp file.
    • Jackie C.
      Definitely @Bri2020, you'll really be filling that out.   Hugs!
    • Jamie68
      Sorry about your chickens. I don't know what got to them, but I know from personal experience that a raccoon can climb and squeeze through a tiny opening. I've been trying to get a mother and babies out of my basement for weeks now without hurting them. Finally yesterday the mother abandoned them and I was able to get the little ones to a shelter. The lady from Raccoon Ridge was thrilled to get them. 5 wk old baby raccoons.bmp
    • Erica Gabriel
      I understand how you feel. We had good luck with our hens but our ducks and turkeys didn’t make it through the summer. This was when we live in the country a few years back. Those little dinosaurs were fun.
    • Bri2020
      You look comfy Shyla! I went thrifting last night with my wife, looking for "summer evening wear" to wear out to music in the park and happy hour kinda of things. I found three dresses. 1 is a maxi with spaghetti straps and slit side. It barely fits my chest so once I get my BA it will have to go but it looks great now. I also got a bodycon maxi in almost sheer black with a racer back strap set up.  Last but not least is the pre-sewn sarong pictured below.  I absolutely love it and it will accommodate my BA just fine ( I think I will look fab in it at that point although I'm feeling pretty fabulous in it right now!)  
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