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Ask Pandora #1

Getting Rid of Silicone

Nora writes:

I need information regarding silicone injected implants. There seems to be a widespread problem in our community with women who injected silicone years ago, and are having trouble now. My question is: is there a solution for this problem? Does anyone know of a treatment to get rid of the silicone?

Hi Nora,

Thanks for writing! Unfortunately, as far as I know, the only treatment that will remove silicone is surgery, and even then the doctors cannot guarantee that they can remove 100% of the liquid silicone.

I strongly recommend avoiding silicone injections if you can. I considered them myself but decided against them because the risks were too great.


Dana writes:

I’d like to know more about the biology/endocrinology affecting libido. With non-trans men and women, what hormones contribute to sexual feelings, and what happens chemically within bodies during orgasms of different kinds? Is there any biological basis for the stereotype of non-trans men being “finished” after one orgasm, unlike non-trans women?

There are several endocrinological and neurochemical factors correlated with orgasm in humans, including histamine, prolactin, norepinephrine, epinephrine, dopamine, oxytocin, GABA, acetylcholine and serotonin. Libido seems to be affected by testosterone, dihydrotestosterone, estrogens, progesterone, serotonin, dopamine, acetylcholine, and others. Hormones and neurotransmitters significantly related to orgasm are essentially the same between women and men, whether trans or non-trans.

One significant myth is that estrogens and progestins depress sexual desire, while testosterone increases it. It does seem to be the case that taking extra testosterone can make you extra horny, but the opposite does not seem to hold true; that is, an absence of or decrease in testosterone levels does not absolutely correlate with sexual disinterest.

I am a firm believer that libido is 90% in your head and 10% in the rest of your body. My sexual desire increased, not decreased, after my surgery, and continues to be high. On the other hand, some trans women report a complete loss of sexual interest. I don’t know if I can tell you why this is, but I would suspect that in most people it has less to do with hormones and more to do with mental states.

The issue of multiple orgasm is a bit more complex. I don’t think we really know how and why it happens; Masters and Johnson stated that non-trans men are monorgasmic, while non-trans women are multiorgasmic. There do seem to be biological differences between chromosomally XX and XY persons such that it is safe to say that trans women are unlikely to be multiorgasmic in the same way that non-trans women are. However, I know more than a few trans women who report that they are able to have multiple orgasms, so keep that in mind.

If trans men are multiorgasmic, they might not lose the ability after using androgens or undergoing surgeries. The interest in being multiorgasmic is something else entirely, and probably has very little to do with biological details.

In many ways, orgasm and libido are still mysteries to us that we are just beginning to understand. I can’t give you definite answers; all I can tell you is that, from my own experience and from the reports of others, a lack of testosterone and an increase in estrogen is not strongly correlated with either orgasm or libido.

Mistress Krista adds:

I agree with Pandora about libido being 90% mental and 10% physiological. In fact, many physiological functions are like this. Appetite is another good one. Yes, it is controlled by hormones, but to reduce its action entirely to the levels of hormone A and hormone B is only a partial explanation.

I have seen studies that show that MTF folks who wanted genital surgery and had it report a significant degree of satisfaction with their sex lives even if their surgeries rendered them less sexually functional, i.e. less sensation, sometimes nonorgasmic! I find this quite interesting. I also noted a tidbit from some sex therapist who said that the primary reason for reduced desire towards partners in women is resentment or anger towards the partner, not physiological at all.

As Pandora says, we are still struggling to understand the full roles that all the hormones play. I have noted a tendency in the literature to read gender assumptions over top of the evidence, such that behaviour and effects are interpreted through a gendered lens. I wrote an article about it for Herizons magazine a while back, on the assumptions around testosterone. Nelly Oudshoorn, a feminist endocrinologist, has an interesting book (Beyond the Natural Body) on the history of testosterone as a compound in the lab, and how the scientists used their study of androgens to shore up their own narratives of masculinity (it was a serious shocker for them when they discovered test’s aromatization to estrogen, in stallion testes no less, figurative endocrinological emasculation, hoo hah).

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