Transgender hormone therapy (male-to-female) males is associated with higher serum estrogen. Both estrogen and testosterone help to stimulate bone formation, especially during puberty. Estrogen is the predominant sex hormone that slows bone loss, even in men. In spite of the induction of breast development, transgender women who undergo HRT do not have an increased risk of breast cancer. Only a handful of cases of breast cancer have ever been described in transgender women who have undergone male-to-female HRT. This is in accordance with research in cisgender men in which gynecomastia has been found not to be associated with an increased risk of breast cancer,
Sexual selection in mammals neck length is not correlated to increases in other parts of the body, which would be expected from foraging selection, so sexual selection may be a more satisfactory explanation. Studies have failed to resolve the causes involved: perhaps the neck was a result of both or other forces. Precopulatory mechanisms determine who father an offspring prior to sex. Male-male competition is the biggest precopulatory mechanism in mammals. Sexual dimorphism is a result of male-male competition that is easily seen in species. Male-male competition to copulate with the opposite sex is often seen in mammals. African elephants strongly promote male-male competition.