> Yeah - it's a selective testosterone blocker, kind of, and tries to target the part that causes male pattern baldness without lowering overall T Levels.
> I assume it still blocks enough hormones to cause mood shifts or other effects?
Endocrinology is a lot more complicated than you're giving it credit for. DHT blockers don't necessarily lower testosterone levels; they can actually increase it (although even then, the mechanism isn't as direct as you might think).
It's neither established nor a given that any side effects of finasteride have anything to do with effects on testosterone or hormone levels at all. A lot of people make that assumption, and there's reason to suspect there's truth to that hypothesis, but it's completely possible it's an unknown side effect of the drug, and there hasn't been enough study into the mechanism to understand it (in part because the side effects are relatively rare and weakly established).
> Reports from trans people, way back in the 1940s, show clear links between sex hormones and depression: a priori, one would assume such a relationship.
We have a lot of data about trans women taking finasteride as part of HRT and depression, and the clear correlation runs in the exact opposite direction from what this article is talking about.
Fin blocks the conversion of T to DHT, that rarely causes lower blood serum testosterone levels and can possibly even increase them depending on what else you've got going on hormonally.
indeed, finasteride raised my T levels slightly, from 18 ng/dL to 30 ng/dL. the same enzyme that converts T to DHT (5α reductase) can also to convert progesterone to DHT via the backdoor pathway, but i reckon that would have a very small effect for most cis men (where normal progesterone levels range from 0.0-0.5 ng/mL, compared to 2.0-24.0 ng/mL in cis women during the luteal phase, and much higher during pregnancy).
a sudden hormonal change can absolutely cause changes to mood and libido, but with finasteride these seem to be rare and generally mild. i would expect them to lessen or even disappear after some time of continued treatment. i wonder how often finasteride is discontinued before the body even has a chance to adjust to the new hormone levels. the claims that the side effects persist after discontinuation are particularly dubious, and they remind me of castration anxiety.
Right, but it's not the serum levels that matter: it's the agonistic effect on various receptors. (Most) hormones don't have direct chemical effects on the body. According to Wikipedia:
> Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR).
> Right, but it's not the serum levels that matter: it's the agonistic effect on various receptors. (Most) hormones don't have direct chemical effects on the body. According to Wikipedia:
>> Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR).
Judging from this and your other comments in the thread, I'm assuming you're not an endocrinologist.
You're pulling quotes from tertiary sources that at first glance seem to support the argument you're making, but you're missing the broader context, which is that pharmacokinetics and our endocrine systems are way more complicated than you're giving them credit for. It's not as simple as "drug A makes X go down, and X does Y, so A decreases Y".
It would make a lot of people's jobs much easier if that were the case, but the clinical reality is actually much more complicated.
The endocrine system is indeed extremely complicated, but this is one of the simplest and best-understood parts of it. We know relatively little about the mechanism behind the psychological effects of sex hormones (for example, we have no idea why they seem to have different effects in different people, with some people being severely affected, and other people barely noticing), but we have a lot of data showing that there is an effect.
"Drug A makes X go down, and X does Y, so A decreases Y" is a good description of the operation of finasteride and dutasteride (if we disregard the unexplained differences between the effects of the two drugs (we'd naïvely expect one to be strictly "better" than the other, but this is not the case)) on everything except the brain. Everything else responds as you'd expect a priori from modelling hysteresis with pencil and paper. But there's a lot we don't understand about the brain.
> You might expect trans women to react differently to lower T levels than cis men for various reasons
Sure but that's besides the point. I was responding to - and refuting - the claom:
> Reports from trans people, way back in the 1940s, show clear links between sex hormones and depression: a priori, one would assume such a relationship would exist here.
There's no reason to believe that the effects of hormones on depression in trans people are predictive of hormones taken by cis people in completely different doses for different reasons, but it's especially fallacious to assume that it's not only predictive, but predictive of the the exact opposite effect.
It's possible there's a separate mechanism responsible for gender dysphoria in trans men, and the remarkably similar symptoms in hypoandrogenic cis men, but Occam's razor.
Many trans men who go on testosterone report reductions in suicidality. If the theory is that gender dysphoria related to hormonal incongruence causes depression, then the data from trans women taking the medication supports the theory that cis men might really struggle with it.
> Many trans men who go on testosterone report reductions in suicidality. If the theory is that gender dysphoria related to hormonal incongruence causes depression, then the data from trans women taking the medication supports the theory that cis men might really struggle with it.
This is a really weird argument because it gets so many basic facts wrong. The most fundamental of which is the idea that taking finasteride means lower testosterone levels - it doesn't!
And I'm not even going into the issues with all the other confounding variables at play here, such as the motivations and dosing schedules for HRT being substantially different from other uses of finasteride.
I really don't know why you're bringing up data about HRT for transgender people that's nearly a century old in an article that's not about HRT, when we have plenty of data that's not only far more recent but far more germane to the topic at hand.
Taking finasteride means higher œstrogen levels, and reduced androgenic activity. There are subtle differences between the effect of testosterone and DHT (it's not just that DHT is a more potent androgen), but I wouldn't expect the effects of higher testosterone to counteract the effect of significantly-reduced DHT. Of course, the effects aren't too significant for most adult cis men, other than reduced hair loss.
I'm bringing up trans HRT in the 1930s (got the decade wrong, sorry!) because the Nobel Prize for the synthesis of testosterone was awarded in 1939. That discovery was made at the start of our understanding of what happens when you muck around with sex steroids: "what effect does this have on mental health?" has always been a question that people have considered, and I was frankly shocked by the article's claim that it hadn't been properly considered in the US.
Of course, others have pointed out that this article is more of a hit piece than a scientific work, so it appears my surprise was justified.
> Nope. It's universal. The denser the city, the more child-hostile it is.
> Just imagine getting into Tokyo subway with a stroller for 2 kids. There's a reason why Tokyo fertility rate is below 1.
This is a glaring example of hunting for data that supports a preexisting belief, rather than basing beliefs on empirical data.
To point out how absurd this logic is, consider that it fails to consider the fertility rate of Japan as a whole outside urban areas, as well as failing to account for the many other extremely dense cities outside Japan that do have very high fertility rates.
Bigger the city, more expensive housing becomes. That is the real reason for low fertility rates in big cities. People who want children have to be either rich, or move further away.
Nope. I'm anti-urbanist, so I actually analyzed the data :)
The correlation is undeniable for any developed country, especially the US. Developing countries are a bit different they are only now starting the second demographic transition.
> To point out how absurd this logic is, consider that it fails to consider the fertility rate of Japan as a whole outside urban areas, as well as failing to account for the many other extremely dense cities outside Japan that do have very high fertility rates.
> There's a reason that "ban the cars" posters never mention a partner or children in their bios.
To the extent that "ban cars" even exists as a real political archetype rather than a meme, this is just patently not true. At least one of the two co-hosts of The War on Cars (again, a title which is intentionally tongue-in-cheek) has a preteen son.
But more importantly: car-dependent suburbs are an absolutely miserable place to grow up as a child if you're not wealthy enough to have one non-working parent and/or a nanny (or both). Being dependent on someone else to enable your entire social life until you turn 16 is a torturous enough experience that I'm not surprised that the first generation to have universal access to social media as teenagers has become the first generation to use social media to organize a teenage-driven movement for public transit.
> To the extent that "ban cars" even exists as a real political archetype rather than a meme, this is just patently not true. At least one of the two co-hosts of The War on Cars (again, a title which is intentionally tongue-in-cheek) has a preteen son.
Similar for the YouTube channel NotJustBikes, who has gone into great detail about the advantages of raising kids in a city planned around pedestrian and cyclist usage, and not in a suburban sprawl.
Well, duh. That's because I don't know any. And probably neither do you.
And sure, humans are extremely diverse and adaptable, so you'll be able to find examples of any physically and logistically possible behavior. Eventually.
But statistically? We both know that I'm right. The Netherlands (the bike heaven) has the total fertility rate of around 1.5 And even within the country itself, Amsterdam (North Holland province) is at the second-to-last place from the bottom: https://en.wikipedia.org/wiki/Demographics_of_the_Netherland... And the highest fertility rates are in Flevoland and Zeeland that are about 3-4 times less dense.
Then how do you explain that Amsterdam, which is in Noord-Holland, is by far the largest city in Noord-Holland, and is far more dense and car hostile than the rest of Noord-Holland, actually has a higher TFR (1.43) than the rest of Noord-Holland (1.29 total, so lower for Noord-Holland ex-Amsterdam)?
I barely know them. Not because they don't like bikes, but because in my country fewer than 1 in 10 households with children had 3 children or more.
But my friend that has four children brings her kids to the school that's in front of my apartment, that promotes bike riding to school, and they even have a morning bike route that kids alone or with parents can join.
> This is not child healthcare. That is already free in every US state. This is free babysitting.
It's not quite free in every state, although it's closer to that than many people here probably realize.
At least until 2025 (unsure how the July budget cuts will affect this longer-term), Medicaid provides free or low-cost insurance to eligible children/families, which in theory should apply to everyone who isn't eligible for health insurance through other means. Emphasis on in theory, though - in practice, there are plenty of people who aren't covered.
It's probably more accurate to say that almost all children are eligible for healthcare coverage, and that coverage is free or low-cost for millions of people who meet various income thresholds. (People who are covered on private insurance almost always have copays or deductibles, so it's not truly free for them because there is some out-of-pocket cost).
> It baffles me (as European) that any politician, or informed voter, would stand up for non free child healthcare. Let alone the moral aspect of denying a child healthcare because she happen to be born into a low income family, it can’t possibly be economically advantageous for any society to ignore child healthy issues and it’s future.
This post is about childcare - ie daycare/preschool/babysitting - not child health care.
As someone who is just starting their proper adult life, the feeling of seeing the past's most bleak, extreme, "irrational" depression fuel resurface as today's level-headed, sensible predictions for the future is difficult to describe.
> I do that and then sync that folder with another computer using SyncThing.
AFAIK SyncThing only monitors for changes between files with matching names, and Signal stores each backup with a separate (timestamped) filename. Are you storing every day's backup individually, or do you have some tool for deduplicating?
Encrypted backups can't be deduplicated unless the encryption is flawed. There shouldn't be a way to tell that one Signal backup is somewhat related to another, unless you have the passphrase.
That also means that Syncthing can't do better than sending the full backup. But if you're syncing via wifi (e.g. at home) it's not really a problem anyway.
> Encrypted backups can't be deduplicated unless the encryption is flawed.
Would you mind elaborating on why this would be an issue? 1) Tools like borgbackup provide the exact functionality you're describing and considered secure. 2) Encrypted file systems also don't re-encrypt your entire HDD whenever you change a single file.
> Encrypted backups can't be deduplicated unless the encryption is flawed
This isn't an encryption problem; each device can only have one instance of Signal installed, and the latest backup (assuming it has terminated successfully) is a superset of the previous ones (aside from any messages that have dropped from retention, which you presumably don't want to be preserving, by definition).
"Deduplicate" in this context means ensuring that you only have N backups in your remote storage, rather than cumulatively storing every day.
> I'm confused, I've restored Signal from encrypted backups before. I did it like 4 months ago. What's this feature?
Those backups are stored locally, are platform-specific (Android-only), and there is no feasible way to automate their transfer to any other device, which means that either you have to manually manage them regularly, or you risk losing your entire message history if your phone suddenly dies (or is stolen, or broken beyond repair, etc.).
This is a true automated, off-site backup feature.
> It would be really useful to have more client-side control over media storage. That way, I could better manage storage growth without wiping entire threads.
> For example, being able to see all media across chats, sort by file size, and optionally group by conversation would make it much easier to clean things up.
I have good news for you: this already exists.
On Android:
Settings >> Data and Storage >> Manage Storage >> Review Storage
This allows you to view all of your media, files, and audio across all chats, sorted by the amount of storage used. You can also delete those files individually without affecting the rest of the chat.
You can also do the same thing within a conversation.
The issue I have with this is that it deletes the whole message, not just the media. In WhatsApp, you can delete media from the images/video folders and the messages remain in the conversation, they even still have the blurry preview iirc. In Signal, you end up with gaps in your history instead.
I’m also hoping similar media management options are available on iOS and desktop, since I use Signal across devices.
By the way, does Signal treat synced devices (like desktop or a second phone) as “replicas” vs a “primary”? If so, does this affect how storage or message history is handled between them?
Would appreciate any insight from folks familiar with the technical side of this!
> I assume it still blocks enough hormones to cause mood shifts or other effects?
Endocrinology is a lot more complicated than you're giving it credit for. DHT blockers don't necessarily lower testosterone levels; they can actually increase it (although even then, the mechanism isn't as direct as you might think).
It's neither established nor a given that any side effects of finasteride have anything to do with effects on testosterone or hormone levels at all. A lot of people make that assumption, and there's reason to suspect there's truth to that hypothesis, but it's completely possible it's an unknown side effect of the drug, and there hasn't been enough study into the mechanism to understand it (in part because the side effects are relatively rare and weakly established).