Why Do Transgender People Report Hypermobile Joints?

https://astralcodexten.substack.com/p/why-do-transgender-people-report

[Related: Why Are Transgender People Immune To Optical Illusions?]

I.

Ehlers-Danlos syndrome is a category of connective tissue disorder; it usually involves stretchy skin and loose, hypermobile joints.

For a few years now, doctors who work with transgender people have commented on an apparently high rate of EDS in this population. For example, Dr. Will Powers, who specializes in hormone therapy, wrote about how he “can’t ignore anymore” that “some sort of hypermobility issue or flat out EDS shows up WAY WAY more than it statistically should” in his transgender patients.

Najafian et al finally counted the incidence in 1363 patients at their gender affirmation surgery (ie sex change) clinic, and found that “the prevalence of EDS diagnosis in our patient population is 132 times the highest reported prevalence in the general population”.

Coming from the other direction, Jones et al, a group of doctors who treat joint disorders in adolescents, found that “17% of the EDS population in our multidisciplinary clinic self-report as [transgender and gender-diverse], which is dramatically higher than the national average of 1.3%”

Why should this be? I know of four and a half theories: