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Hiiii

while you're here, check out the GFM I made for my partner, link here.

Short story: trans queer multiply disabled chronically ill college student needs an e-bike for accessibility

Long story: Hi hi hi that's Esker (aka Lou) and I love hir so so so much and I want hir to be able to move around on campus once ze stops testing positive for covid. Any amount of money goes a long way, as does reblogging ok thanks mwah

#coming back from the dead to tell you all to throw money at my beloved

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hey i’ve been seeing this implied a lot in trans support posts so i wanna make it clear: binding and tucking are not equivalent

i know that to an outsider eye they may seem similar—they’re both trans things where you wear a special garment that squishes you into a shape you want to be.

but binding consists of compressing the breast tissue against the chest to flatten ones silhouette. it is not without its risks, ofc, but when done properly is not innately permanently damaging. tucking, by comparison, usually consists of pushing the testicles up into the body via inguinal canals and then holding them in place. it can be incredibly painful, and even if done correctly can cause an inguinal hernia (an injury in which the intestines actually protrude down into the scrotum, which, left untreated, can be fatal) and other injuries.

conflating the two hurts transmascs and transfems alike, especially younger trans people. it hurts transfems by normalising tucking and minimising it’s dangers. i’ve seen “tucking resources” and how-tos on lists of tips for transfem children. arguably nobody should be encouraged to tuck, but to encourage children to do something so painful and potentially life threatening so that they “pass” better is just unacceptable. and it hurts transmascs by making binding sound scarier! binding is not particularly dangerous or painful if done right, and the idea that it carries similar risks to tucking is an old terf myth to scare transmascs out of transtitioning

the fact that transfems are EVER expected to go through such pain and even risk our lives just to hide the natural shape of our bodies is despicable, but if you absolutely must encourage tucking in your resource posts please PLEASE make it clear that it carries serious risks and trade-offs that binding simply does not

#tucking #transfeminine

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theyre trans and theyre dating

#catboys #catgirls #t4t

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-support trans women who have pattern baldness and can’t wear their hair in “feminine” styles.

-support trans women who have sensitive skin and can’t shave every day.

-support trans women who have pigment allergies and can’t wear tons of makeup.

-support trans women who have blood disorders and other health problems that make surgery a preventively high risk.

-also, support trans women who do not have these problems but still do not feel obligated to live up to your cissexist standards of femininity.

#trans women #transfeminine #trans

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No: “Dysphoria isn’t what makes you trans, gender EUPHORIA is what makes you trans!”

Yes: “The only requirement to be trans is that you do not 100% identify with the gender you were assigned at birth. Arbitrary standards of transness only serve to hurt trans people and give cis people more ammunition against us. Stop hyping up these arbitrary standards and milestones.”

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I was wondering if you guys knew of anyone who had tried Plume to get their hrt prescriptions. I'm considering the service but I'm a little wary because it seems too good to be true.

Lee says:

Their website’s FAQ says:

Plume is currently only available for people 18 and over, so you can’t be a minor.

You cannot use insurance, Medicaid, or Medicare to pay for Plume. 

The out-of-pocket total cost for Plume is $1,188 (one thousand, one hundred, and eighty eight dollars) per year, plus the cost of the copay for buying the HRT from the pharmacy.

Breaking it down:

You pay $99 per month which covers the cost of your virtual appointments and blood work

If you live in NY or NJ, the cost is $90, discounted to offset the out-of-pocket cost of labs. 

They recommend getting bloodwork done every 3 months

The cost of blood work is included in the $1,188/year cost so you don’t have to pay extra to get labs done

They order labs through Quest Diagnostics, so you’ll need to have a Quest lab site nearby to get your blood drawn

The $1,188/year cost does not cover the cost of getting the HRT from the pharmacy, so you still have to pay for your testosterone or estrogen and anti-androgens in addition to Plume’s $1,188 per year fees.

Out-of-pocket cost of medication varies from $5 to $300+ and depends on if you want your HRT to be via injection, patch, gel, or other methods.

Your insurance may cover some of the cost of your HRT prescription and you’ll only have to pay a copay at the pharmacy, but it depends on if your have insurance and if they cover HRT.

You cannot use insurance, Medicaid, or Medicare to pay for Plume. 

I think it really depends on your situation. When I started testosterone, I lived in CT, which isn’t a state that they offer services in.

You have live in one of the following states:

Alabama

Arizona

Arkansas* (estrogen-only, no testosterone option)

California

Colorado* (only if you are not currently on Medicare or Medicaid)

Florida

Georgia

Kentucky* (only if you are not currently on Medicare or Medicaid)

Maine

Michigan

Massachusetts

Minnesota* (estrogen-only, no testosterone option)

Missouri

Nebraska

New Jersey

New York

North Carolina

Illinois

Ohio* (estrogen-only, no testosterone option)

Oklahoma

Oregon

Pennsylvania

Texas

Virginia

Washington

NOTE: Plume is not available for recipients of Medicare in any state

Whether or not Plume is a good option for you depends on a few factors. Do you live in one of the states they cover? Is paying $1,188.00 per year going to be less expensive than the cost of seeing a doctor and getting lab work using your insurance? 

Here’s an example: I had an appointment when I started T, then another at 3 months, at 6 months, and at 1 year on T. Each appointment was covered by my insurance because I saw an in-network provider, and it had a $40 specialist fee copay. So that’s a total of $160 out of pocket for appointments in one year. 

But of course, that’s only the appointments! I also had blood work done each time, which my insurance mostly covered, and I’ll put that at $100 per lab. So that’s a total of $400 out of pocket for labs. 

So in one year, I paid $560 in total, which means Plume would have been more expensive for me.

Let’s note here that I was not even including the price of testosterone, which for both options you’d be either paying out of pocket, paying with a GoodRx coupon, or trying to get insurance to cover it and paying a copay. So let’s say I was on testosterone gel and had a $30/month copay because it was covered by my insurance but more expensive than injections. So let’s put that at $360.

In one year, I’d pay:

$1,548 for Plume

$920 using in-network IRL doctors

So you’d save $628 if you didn’t use Plume- and saving half a thou is a big deal for a lot of folks.

Now I had pretty bad insurance. If you have better insurance which charged you only a $20 copay for your appointments, or you only had to pay $50 per lab, or you were on testosterone enanthate injections and only paid $10 for a three month’s supply of testosterone, you’d be saving even more money.

Of course, the reverse is also true- if you have worse insurance than I did, your costs could be higher than the ones you’d be paying with Plume, especially if you were paying for all your lab work out of pocket. That’s where the costs really add up.

The Plume website offered these suggestions for defraying the cost:

https://pointofpride.org/HRT-Access-Fund/

https://www.youareessential.org/plume

https://transformativefreedomfund.org

The easier access with Plume also factors in to people’s calculations as well. 

But of course, minors can’t use Plume right now, even if they have parental consent.

Note that you can start HRT as a minor elsewhere, you just have to have permission from your legal guardian to start HRT if you’re under 18 unless you’re an emancipated minor. This post should help with getting the conversation started with your parents about starting HRT.

Some endocrinologists don’t allow someone to start HRT until they’re 16, but this is up to the prescriber’s discretion because there are no laws saying what age is too young to start hormones- some people even start HRT at 13. You do have to have started puberty to get HRT. If you haven’t started puberty yet, you should look into puberty blockers.

If you’re a minor and can’t use Plume, or you’re 18+ and want to explore your other options, here are the two most common methods for accessing HRT:

Option 1: Informed consent

Informed consent. This means that you discuss the effects of transition with a doctor, typically an endocrinologist or urologist (which more common for AMAB people), and confirm that you understand what you’re getting into.

Legally any medical provider who can prescribe medication can prescribe testosterone, but few of them are willing to do so because they don’t have experience with prescribing testosterone and ordering and interpreting the blood work and ensuring you’re healthy, so they aren’t comfortable doing it.

You’ll have to read and sign a document that lists all the changes to expect and potential health risks. (Examples of that document are here). You’ll get some tests done and then you’ll be good to go!

Important to note: You must be 18 years of age or older to consent for yourself. I haven’t heard of any minors getting informed consent with their parents’/guardian’s help, although it may be possible. Also, not all insurances will cover informed consent services because they may require WPATH letters sent to them to approve gender dysphoria treatment/coverage. If you want insurance to cover your HRT, speak to your insurance provider (call the number on the back of your insurance card).

Resources: ICATH has some good US-specific resources for informed consent. @plannedparenthood also provides informed consent services for HRT in some locations.. This Google Maps list here has a lot of informed consent clinics listed as well to check out, although it’s not a full list of all of them.

Option 2: Therapist’s letter

Therapist’s letter. This is the “traditional” method, based on the WPATH Standards of Care. Basically, you talk to a therapist, sometimes for several months. Usually, the therapist is one who knows about gender identity issues, or even specializes in them, but it doesn’t have to be - the main idea is that you’re looking for someone who can keep up with you and isn’t going to tell you that you’re mentally ill because you’re trans, so finding an LGBTQ-friendly therapist is a must. They write a letter that follows the guidelines in the example below, hand it off to insurance and your doctor, and you’re on your way. An example of that letter is here.

How long you have to see your therapist before their letter will work for you depends on a) the therapist, b) the doctor you want to see, and c) your insurance (if you plan on seeking coverage). You’ll have to communicate with all of these people in order to work out their requirements. The timeframe is typically around 3 months, but it can be longer or shorter depending on those factors. Information on getting a trans-friendly therapist is here.

Important to note: Not all insurances will cover HRT with a therapist’s letter, either, although many states are making it illegal to deny transition-related services. Be sure to check with your insurance provider first! Check out our Getting insurance to cover your transition post.

After that:

Finding a doctor can also be hit-or-miss. You can speak to your GP (general practitioner; i.e. the doctor you go to for regular checkups) - sometimes they know what they’re doing, and I’ve definitely heard of GPs prescribing HRT or hormone blockers to their patients.

You can start with contacting your primary care doctor and asking if they can prescribe your T, or if they have any referrals to places that do prescribe HRT. Some people can get their HRT prescribed by pediatrician/general practitioner!

However, most of them will refer you to an endocrinologist (and many insurance plans require referrals before you can skip off to a specialist, too) for the actual hormones. Then you can also check with local Planned Parenthoods to see if they prescribe HRT or if they can refer you to someone who does.

You can also check with your insurance to see if they cover any endocrinologists in the area, then contact those endocrinologists who see If they can prescribe your T, or if they have any referrals to places that do prescribe HRT.

You should also reach out to the trans community IRL- they have to be getting their hormones from someone! If there are any trans support groups in your area, or LGBT organizations, ask them if they have any providers they can point you to.

And finally, it can also be helpful to simply do some googling! I (mod Lee) found my endo by google. It can take some legwork to find a trans-competent doctor who will prescribe HRT, but you just gotta keep trying!

I started HRT at Planned Parenthood with a nurse, then I switched to an endocrinologist associated with a local hospital, then I moved states and got my T from a nurse at Callen-Lorde. While endocrinologists often specialize in HRT because hormones are part of the endocrine system, you can get HRT prescribed by many nurses, and by pretty much all doctors including psychiatrists and urologists.

Some doctors won’t let you do HRT. It’s okay if you shop around. Look around online; call their office first to make sure they work with trans patients. Remember, if a doctor refuses you healthcare, you have a right to refuse them your business!

Once you get to a doctor, you’ll get a preliminary blood test and a general health screening to check for contraindications (any medical conditions that might make it difficult or impossible for you to be on HRT). Nearly every contraindication is possible to work around, though, so don’t worry too much! They’ll likely be looking at your cholesterol levels and heart and liver functions in particular, although this may vary from doctor to doctor and treatment to treatment.

Finally - as long as all medical conditions are sorted out - you’ll be prescribed your hormones. You can choose which delivery method you receive.

For testosterone, the most common forms include injections (which involve needles, but typically only need to be administered once a week or every 10 days), patches (daily, can badly irritate sensitive skin), and creams / gels (daily, have to be careful so that you don’t get it on another person). More info on testosterone is in the Testosterone FAQ.

AMAB folks will need to take both estrogen and an anti-androgen. Typically, estrogen is oral, but can also come in the forms of injections; anti-androgens are nearly always oral. More info on estrogen is in the Estrogen & anti-androgens/testosterone blockers FAQ.

Stick to the instructions they give you in terms of dosage and administration - they give these instructions for good reason! Your doctor should monitor your hormone levels and health status / conditions, and will likely adjust your dosage as time goes by to ensure it is still accurate, so make sure you continue to go in for checkups.

This post lists the locations of some of the Planned Parenthood clinics that provide HRT in the USA

This post has mod Lee’s experience with starting HRT at Planned Parenthood.

Starting HRT at Planned Parenthood during Covid-19

Estrogen & anti-androgens/testosterone blockers FAQ

Testosterone FAQ

So that was how you’d be looking into starting HRT if you weren’t using Plume.

But if you live in a rural area, and there’s no Planned Parenthood that’ll prescribe testosterone near you, there’s no LGBTQ+ clinic anywhere, your primary care provider refuses to prescribe your testosterone, you’ve called around to other general practitioners in the area and nobody else is willing to do it either, and after a bunch of back and forth phone tag with their office the only endocrinologist in a 500 mile radius eventually says they won’t treat trans people, you can’t find urologist or psychiatrist who feels comfortable doing it, etc, and you find yourself having to first jump though the WPATH hoop and find a therapist willing to write you a letter and then find a way to travel 4 or 5 hours for your HRT appointment and then you have to fight with your insurance to get blood work covered... Plume is going to start looking more appealing even if you do end up having to pay more.

Personally, as someone who is on HRT, and has recently moved to a Plume-covered state, am not tempted to switch to Plume at all. I’m lucky enough to have moved to NY and while it does take me around an hour and a half to two hours on public transport to get to my doctor, I was just approved for NY Medicaid and now I basically pay $0 in total for my appointments, blood work, and my prescription costs are capped at $3 per prescription. So at max I’m paying $36 per year now.

Another alternative to Plume is QMed.

They write “QMed accepts patients of all ages and provides puberty blockers for those yet to enter puberty,” so you can get HRT or puberty blockers from them as a minor, but you do need to have permission from your parent/legal guardian to do so.

They do say that “All states require that patients receiving testosterone need to have at least one in-person appointment prior to starting hormone therapy. When we receive your first appointment request, we will help you determine if and when you will need that required visit,” so it may be an easier for people starting estrogen than people starting testosterone. But I think that’s different now- their most recent update says: “Prior to the spread of COVID-19, an in office visit was required for the initial consultation for testosterone. However, the government has waived this requirement until further notice, so we are only offering video visits until the pandemic is under control to protect our patients, families, and staff.”

They say they accept Aetna, SOME Blue Cross PPO plans, Cigna, Humana, PHCS. But they do not take Medicare, Medicaid, Peachstate, Ambetter, United, or Kaiser. If your insurance is accepted, the cost will be the same as it would be to go to an IRL prescriber.

If they don’t accept your insurance and you self-pay for some of their appointments the first visit will cost $299, and visits after that will cost $149. But you’ll only have to pay when you have an appointment, so there’s no monthly fee. Blood tests will be $99 each time they check hormone levels, which may be needed up to 4 times in the first year, and 1-2 times per year after that.

QMed uses the informed consent model for patients 18 or over, so a therapist visit is not required. But a letter from a mental health professional following WPATH standards is necessary to start hormones if you’re a minor.

Plume is currently only available for people 18 and over, so you can’t be a minor, but QMed does accept minors who have parental permission.

Anyway, back to the Plume thing! I haven’t heard anything bad about them in the posts I’ve read online though. Most people seem pleased but frustrated with the cost. One person wrote “The sign up process was on multiple apps and intake forms were disjointed. While this may be useful for new people who wanted to start HRT, for folks wanting to continue care I found the question about how long have you felt this way, how long have you been living in your gender offensive.”

I don’t personally know anyone who has done it because most of the folks I know don’t constantly have $99 each month to pay out of pocket so they tend to go the traditional route even if it’s harder logistics-wise, but I don’t live in a rural area so going the traditional route is a possibility for us, and it might not be so easy for others.

The one thing I’d remind everyone of is the cost. Losing access to testosterone can be a physical health issue if you’ve had a hysterectomy and oophorectomy and are worried about osteoporosis without having a dominant hormone, and the same if you’re on estrogen and had an orchiectomy, so remember that the $1,188/year cost for Plume doesn’t include your hormones themself! So consider how much the individual testosterone vial/estrogen patch/antiandrogen pills/etc will cost when you go to the pharmacy to pick it up!

Followers, has anyone over 18 used Plume to get their HRT prescription and would you recommend it? Or have you heard anything cautioning against it?

#long post #transitioning medically #hrt

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Nonbinary people, nondysphoric trans people, people with “weird” pronouns and genders, “transtrenders” and “tucutes”, you’re allowed to participate in Trans Day of Remembrance. You’re allowed to mourn and be angry and upset and scared. You’re allowed to celebrate resilience despite the circumstances. This day is for you.

#tdor #trans day of remembrance

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like many, I have few words this tdor this year. on a day of grief in a year of loneliness and pain, it’s hard to come up with something to say. for all those silent today, either because they are no longer with us or because they do not have the energy to speak, know that you are loved at every volume, and that every single trans heartbeat creates the drumming rhythm that allows the legacies of those we’ve lost to be sung. exist however you need to today.

in lieu of a new work of art as is my tradition, I’d like to share Gender, Explored, a student documentary I made in 2019 with my dear friend Flynn (flynn_arts on instagram) composed of interviews with some of the lovely trans, non-binary, and gnc people I’ve had the pleasure of meeting in my life. it is dedicated to another dear friend of mine, Peter Conrad, who the world lost in 2016. it’s by no means a professional film but has a lot of heart put into it by everyone involved and is my way of honoring not only Peter but every trans life that has brought light and love to mine. It deals with many aspects of living as trans folk, but overall is celebratory and positive. You can watch it for free on youtube by clicking here. (content warning: brief discussion of transphobia and homophobia)

boosts are appreciated but not necessary. I hope all my trans siblings can find some comfort and safety in their current situations.

#documentaries #tdor #trans day of remembrance

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i'm not an artist by any means and tumblr is gonna crunch the image quality of this but i just thought it was important to put out into the world today. wishing everyone a solemn and safe day.

#tdor #trans day of remembrance

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TDOR 2020. Each candle represents one of the 350 transgender individuals killed this year globally. The United States, where I live, had 37 cases of fatal violence against trans people. 

On this day, we remember those we have lost. 

Statistics reported by Forbes and the Human Rights Campaign.

#trans day of remembrance #tdor

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This is just a reminder to Cis people not to wish your trans and non-binary friends a happy Trans Day of Remembrance. It's a day for mourning who and what we've lost over the past year(s). Some may choose it as a day for celebration of life and survival, but that's a personal choice.

(Feel free to reblog, but no shenanigans on this post please. TDoR is on November 20.)

#tdor #trans day of remembrance

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I get kind of annoyed everytime I slap down the “dysphoria is mandatory” narrative and tons of people reply “yeah! gender euphoria exists!” And like yeah it does but you’re really making it a this or that thing, why does our existence as trans have to have a reason? Why can’t people just be trans? Why do you need a to explain everything?

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being a trans woman makes you powerful

#trans woman #trans humor #trans positivity #positivity

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The AMAB Wardrobe

Here is a post that AMAB trans folks might find useful. It is about how to do your makeup, feminize your voice, where to buy wigs etc. 

Note 1: I have not used the shops listed myself, so I cannot give a review on them. Use the websites at your own risk and I cannot be held responsible for anything.  

Note 2: Some of these resources are aimed at crossdressers, or crossdressers along with trans people. I am not lumping AMAB trans folks with cross dressers but I do feel that the resources could be helpful, thus they are included.

Note 3: This post contains information on how to “pass.”  (I’m not a fan of the concept of passing) This post is not trying to make you into the cis world’s idea of a “perfect woman” but instead to give those who want resources for things that will make them feel more comfortable what they want. Remember, if you do all of these, some of these, or none of these it does not make you any more or less of your gender.

Wigs and hair

http://www.wig-supplier.com/ 

http://www.thebreastformstore.co.uk/ 

http://www.annabelleswigs.co.uk/ 

http://www.josephs-wigs.com/ 

http://www.hothair.co.uk/ 

http://www.ewigs.co.uk/ 

http://www.jonrenau.com/ 

How to make short hair look feminine

Hairstyle mistakes to avoid 

Hairstyles that take less than 10 minutes

How to do a french side plait

Makeup 

http://www.eyeslipsface.com/ 

http://www.superdrug.com/ 

http://www.illamasqua.com/

Make up tips for AMAB folks

Make up mistakes to avoid 

Make up tips

How to choose the right foundation

How to feminize your face

Covering facial hair

1950’s makeup tutorial

Voice

Voice feminization video

Voice feminization mistakes to avoid

Feminization voice lesson  1 (Her other lessons can be found on her channel) 

Feminization voice tips

Girl talk. The transgender guide for voice and feminization (also talks about behaviors)

Chest 

Breast Forms

Tape for creating cleavage 

Breast forms

Breast enhancers

Breast forms

Breast forms

Making your silicone bead forms

Finding your bra size

Bras for under $10

Rice bra (A clever and cheap idea!)

Accessories

Jewellery for £5 and under

Hair clips, accessories and brushes for £5 and under

Not badly priced bags

Alternative accessories

Affordable accessories

More affordable accessories

Clothing

http://www.longtallsally.com/

http://www.tallgirls.co.uk/ (does footwear in bigger sizes too)

Dressing Emo/Scene for Trans girls

Trans clothing swap

Doreen (They are an actual physical shop that you can visit too!)

What to wear if you’re broad shouldered

Plus size clothing

http://www.katesclothing.co.uk/ (gothic)

http://www.tkmaxx.com/page/home

Underwear/tucking

Gaffs in sizes up to XXXL

Padded panties

Padded panties

Padded panties

Padded panties

Gaff

Gaff

Tucking

3 different ways to tuck

Movment

Walking like a woman

Walking like a woman in flats and heels

Feminine body language part 1

Feminine body language part 2

Feminine movement mistakes to avoid

Shoes

Best shoes for AMAB folks

Heels in bigger sizes

Isy B- Search tool for feminine shoes in bigger sizes

Payless-Does women’s shoes up to size 13 at affordable prices

Feminine shoes in sizes up to a US 14

#transfem #transitioning #amab

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#Monica Helms #trans history #trans #transgender #pride flag #trans flag

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“Two-Spirit” is an umbrella term for Indigenous individuals who do not fit the Western gender binary. The term was created by Native people, but many people who fall under that umbrella also identify with a culturally-specific term, and may or may not identify with the language of “trans,” “non-binary,” or “non-conforming.”

Gender is a personal experience. No one needs to identify with terms that do not fit just because they are “more common,” and no one needs to abandon a culture-specific identity because they live in a colonized society.

Read about the history of gender diversity in Native American cultures, including the Two-Spirit identity, in this presentation from the National Congress of American Indian: http://www.ncai.org/policy-research-center/initiatives/Pruden-Edmo_TwoSpiritPeople.pdf

#two spirit

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Resources for Depicting Trans Women!

This is one of my most frequent asks (followed by how to depict trans men, but that merits its own post.) As such, I wanted to hand pass the mic to trans women with a masterpost! 

A disclaimer: many of the resources included below apply to trans people of all genders, but all are from trans women, and apply primarily to trans women. 

Happy writing, everybody! 

Videos:

HOW DO YOU WRITE TRANS CHARACTERS?

How to write trans characters

How hormones (HRT) change a trans woman’s body

Do trans people need to “pass?”

Transploitation: The Reality of Being a Black Trans Woman

My Trans Body And Dysphoria

Voice Training 101

What It’s Like To Be a TRANS Woman (this one’s funny)

Trans Lady Youtubers:

Kat Blaque

Becky Boulton

Riley J. Dennis

Stef Sanjati

Chauncey Jadore

Articles:

Older Transgender Women Tell Their Coming Out Stories

Living as a Transgender Woman: Surgeries, Stigma, and Struggle

Gender Affirmation: Do I Need Surgery?

What Trans Women Aren’t Told About Bottom Surgery

Books:

Whipping Girl: A Transexual Woman on Sexism and the Scapegoating of Femininity

Transgender History

Gender Outlaw: On Men, Women, and the Rest of Us

She’s Not There: A Life in Two Genders

The Collection: Short Fiction from the Transgender Vanguard

#trans fem #trans women #transfeminine