I note that many MtF's identifying as female do not desire particularly any of these purported benefits (bugs vs. features) related to maintaining typical male interest in sex, particularly its compulsiveness nor are they interested in maintaining function or size of male genitalia whereas non-binary folks tend to split down the middle related to what is a bug and what is a feature. I would never, ever want to be hostage to T or DHT again.
Monotherapy with NSAAs including bicalutamide, flutamide, nilutamide, and enzalutamide shows a significantly lower risk of certain side effects, including hot flashes, depression, fatigue, loss of libido, and decreased sexual activity, relative to treatment with GnRH analogues, CAB (NSAA and GnRH analogue combination), CPA, or surgical castration in prostate cancer.
[51][49][123][124] For example, 60% of men reported complete loss of libido with bicalutamide relative to 85% for CAB and 69% reported complete loss of erectile function relative to 93% for CAB.
[51] Another large study reported a rate of impotence of only 9.3% with bicalutamide relative to 6.5% for standard care (the controls), a rate of decreased libido of only 3.6% with bicalutamide relative to 1.2% for standard care, and a rate of 9.2% with bicalutamide for hot flashes relative to 5.4% for standard care.
[125] One other study reported decreased libido, impotence, and hot flashes in only 3.8%, 16.9%, and 3.1% of bicalutamide-treated patients, respectively, relative to 1.3%, 7.1%, and 3.6% for placebo.
[126] It has been proposed that due to the lower relative effect of NSAAs on sexual interest and activity, with two-thirds of advanced mPC patients treated with them retaining sexual interest, these drugs may result in improved quality of life and thus be preferable for those who wish to retain sexual interest and function relative to other antiandrogen therapies in prostate cancer.
[49] Also, bicalutamide differs from GnRH analogues (which decrease BMD and significantly increase the risk of bone fractures)
[127] in that it has well-documented benefits on BMD, effects that are likely due to increased levels of estrogen.
[120][128]
As noted by Bridge who definitely was in this cadre of folks preferring the feminine aspect and mind-set, our solution to all of the "benefits/bugs" listed above is to increase estrogen levels, not decrease them and that depression often seems to accompany being "stuck in the middle" and is not associated with ~200 pg/ml and upwards, and interest in non-compusive sexual action and thought increases as E levels go up for many, not down. Again, individual divergences can be strong, hence our slogan, YMMV.