Bone Density: An important factor to consider
In general, the maintenance of healthy bone density in all people is partly dependent on both estrogen and testosterone levels. When an individual's body produces estrogen as its main sex hormone (as in the case of female-bodied people), that estrogen in healthy levels protects against bone loss. If a female-bodied person were to begin testosterone therapy, there would be a time of transition in the body while hormone levels adjust. While testosterone would soon become a more dominant presence in the body of a trans man, he would still retain some estrogen in his system, both through the presence of his ovaries (if he has not had an oophorectomy) and/or via the natural aromatization of testosterone into estrogen (which takes place whether or not the ovaries are still present and functional).
Hormone levels may be drawn and evaluated before therapy is started. This may include an FSH, estradiol, and testosterone (free and total) for women. Men need a PSA (prostate specific antigen), estradiol, testosterone, and blood count prior to starting therapy. Thyroid hormone levels (TSH) may also be evaluated. In men, follow up levels, including a PSA, blood count and estradiol, may be obtained prior to some of the subsequent testosterone implantation. Men are encouraged to notify their primary care physician and obtain a digital rectal exam each year. Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their gynecologist or primary care physician.
For Muscular Christians, moral strength and physical strength were not unrelated; disciplining one’s body through athletic training built one’s will, and strength of will was vital to turning down temptation. Teaching the body to obey the mind through exercise, could translate into teaching the body to obey the soul as well; in attuning oneself to natural laws, one could become more attuned to following divine ones. Physical training, after all, is premised on the postponement of present desire in order to fulfill future aims, which is also the basis of Christian discipleship.