#(this does not affect me - my insurance covers it

[snarp]

Who the hell is Walgreens ordering from that this $0.60/pill-on-GoodRX-medication allegedly cost them $6/pill.

#did they just fuck up my printouts #is someone using decimal places to embezzle #medical cw #money cw #depressing cw #(this does not affect me - my insurance covers it #it's just fucked-up)

[cardentist]

"yes trans mascs experience transphobia, but there's no such thing as trans mascs experiencing bigotry Specifically Related to them being men/from being related to men"

my mom, after some time sorting her feelings and sifting through trans resources, was accepting of my being a trans person. it took work, but it happened. she sought out trans media from trans people, she took initiative to inform other family members and put herself between me and them.

and she completely refused to even start the process of Maybe getting me on testosterone for 10 years, until I aged out of being covered by her health insurance and couldn't afford to do it myself.

Specifically And Entirely because she was terrified that testosterone was going to make me an angry, violent person. that it was going to, in her own word, "give me roid rage."

for years she made vague pantomimes about eventually seeing about transitioning, but That reasoning would still come up no matter how I tried to explain it to her otherwise.

I am not a particularly violent person, if maybe stubborn. but that didn't matter. what Mattered is that my mother had a preconceived notion of what testosterone does, what Masculinity Does, and that notion was an inherently negative, scary one.

and Because Of That I was denied access to resources That I Need for Years. something that has carried over into the rest of my adult life.

and I see sentiments like hers online, even and sometimes Especially in trans spaces, all the time.

this vision of men as inherently violent, of masculinity as inherently dangerous, and the onus placed in the laps of Trans Men (and often, on Trans Boys) to diminish and shrink themselves to Prove that they're non-threatening enough to be tolerated.

and it bares pointing out that this Isn't just something that affects trans men. trans Women are just as affected by this association with maleness as an inherently corrupting factor. and so to are butch women and nonbinary people presented as violent and scary.

likewise, I see Similar sentiments pushed at butches and trans mascs that it's their job to Protect other people within the queer community, that image of violence and anger filtered through a softer light designating their Use. you're Allowed to be a Scary Masculine Creature as long as you dedicate yourself to protecting the weaker frailer other (which is, you know. Sexist And Weird).

but it's like. people don't Want to think about different kinds of trans and gnc people having overlapping experiences, so instead people like to decide which Kind of people are allowed to have this experience and cut other sorts of people out of those conversations.

it's not about what a particular person's gender or presentation Is, it's how that person Is Perceived and the way that they're treated Because Of that perception. sometimes this transphobia that fears masculinity looks like a perception of scary men trying to pretend to be women, sometimes it looks like a perception of women Becoming scary men, and everything that lies in between (with combinations therein).

finding a term that is used to describe this is Useful not just for giving trans mascs a way to talk about their experiences without encroaching on other conversations about transness. but Also in giving us words to describe a specific phenomenon that Can affect All trans people (and gnc people, and genderqueer people, etc), but that is difficult for us to recognize as a shared experience because people seem to think that sharing experiences is either impossible or a bad thing.

#discourse #trans unity #queer unity #transphobia #transandrophobia #or #antimasculism #if you prefer

[some-triangles]

I am now at a level of obsession with Disco Elysium where I am watching at least a little bit of every playthrough I come across. Last time this happened was with Undertale almost a decade ago. With UT this helped me get a very thorough handle on the way the game was designed and with the subtler bits of player manipulation. DE is not subtle about anything and so instead I'm getting insights into the people playing it, particularly as it spreads beyond the youtube leftist bubble.

The one I'm having the most fun with right now is by this guy named Brady, who is a therapist specializing in addiction. The fun part is not so much his insight into Harry as an addict - again, the game is not subtle - but his absolute discomfort with politics. He refuses to engage with any of the ideological choices, and that makes the game a bit of a bumpy ride for him. It's particularly striking because he's willing to read into everything else that goes on in Harry's brain - he breaks out his Johari windows and his CBT flowcharts and pins the butterfly right to the corkboard - but he shuts down when the game asks him to pick a side.

To extrapolate wildly from one dude's hangups, I think this is just part of the deal with therapy. The aim of a therapist is to make the subject more functional (particularly these days, when if you're lucky insurance will pay for ten sessions, and you better document exactly what worksheets you made your patients fill out) - and being functional means being able to be happy and productive in the society you're currently living in. If I go to a therapist and say I'm bummed out about all the murdering my government is doing they will suggest I stop watching the news, or, if I'm lucky, they'll try to help me figure out why I feel guilt about things I can't control. Delving into the whys and hows of said murdering is actively counterproductive.

This is not to say that therapy is inherently bad, or, like, counterrevolutionary, because making you a more functional person does help with a lot of things, including your ability to help others. It's just a useful thing to keep in mind when therapy and politics bump into each other. I read this paper when I was googling ABA for podcast reasons and it stuck with me. The thesis boils down to: because the world is imperfect and people need skills to live in it we should continue to torture children, and we don't have enough research to conclude that torture could be traumatic. This is on one level reasonable and on one level insane. It depends where you stand, and whether you think "ability to express affection towards parents" is worth that kind of intervention. But the authors wouldn't construe this as a political argument.

Anyway: with all this in mind, I very much recommend reading "The Saint of Bright Doors", which we will be covering on wizards vs lesbians soon.

#disco elysium #the saint of bright doors #in the ways therapy can be helpful category Brady also points out how Harry sees everything in terms of power dynamics #which I never noticed because I also do that. I wonder why??

[so-i-did-this-thing]

Hey! A trans minor here. I want to ask how should I proceed as a trans minor in Florida? I can’t move and my mother doesn’t take me being trans seriously. She says she supportive but I don’t think she is. I’m worried about all these bills coming into place and how they will affect me. I’m a FTgender fluid. Do you have any advice? Also, I play the flute :) it’s nice to see trans instrument players

Ayyy, trans orchestra forming!

So, I won't insult your intelligence by pretending things aren't about to get bad. But maybe I can help you understand the risks and how to keep yourself safe and sane.

An assumption: I don't know if you want to pursue physical transition and that is a convo 100% between you, your mom, and your healthcare providers, so I'm providing it as a neutral option for information purposes.

Also: The bills I mentioned have not passed yet, but they are sitting on the governor's desk. He will most likely sign them, meaning they'll take effect July 1, 2023.

Staying with your family

SB254 is the bill that affects you the most. It's the "kidnapping" bill. Yeah. :/

I don't know what your family situation is like, but if you have family members who oppose your mother's even lukewarm support, that could be enough for the state to remove you from her custody and turn you over to them. It would be up to you and your mom to figure out how to avoid/appease these family members so they don't think you are "at risk" of physical transition.

Gender-affirming care

SB254 also completely locks you out of puberty blockers, HRT, and surgery (the latter 2 in the past are sometimes pursued by older youth with parental consent) in this state. If you want to pursue any of this care, talk with your mother about getting it in another state. You will have to physically travel, because telemed for gender affirming care is also being banned due to new consent form requirements.

Once you are 18, you can pursue physical transition, if that's something you're interested in, but be aware that there are soon going to be so many obstacles to adult care, that it might as well be a transition ban for everyone. But if you're close to 18 and think HRT is for you, review the map for informed consent care. But be prepared for a long search and your insurance not covering things.

That said, if you need a therapist now, I think you may still be good here. Be very careful that you don't end up with someone who wants to use conversion therapy tactics -- these are typically going to be religious-based providers. Talking with other trans kids in your town might help you find a good provider.

Remember, if you don't like a therapist, you can stop going to them; shop around for one that makes you feel safe and makes you feel like they help you with the stress in your life.

Bathroom ban

HB 1521 does a few things:

Bans multi-stall gender neutral bathrooms (single stall is fine)

Requires schools to have bathroom policies

Empowers cis people to confront trans folks in a govt owned/leased bathroom/changing room and force them to leave, otherwise they are subject to a fine and/or jail

This is effectively a bounty bill. Examples of bathrooms where this bill will apply include schools, airports, stadiums, courthouses, etc. It isn't every public bathroom, but it is a lot.

People who are gender nonconforming or are being stalked/harassed by cis folks who know their trans status are most at risk here.

It is up to you how much you want to weigh your self-expression against your physical safety.

As a minor, you don't have a lot of rights, so I advise you choose your battles carefully and always have trusted adults to have your back. Being FTGenderfluid, a lot of how you dress might fly under the radar, but I'd avoid being too heavily masc for now.

Keeping safe & sane

Unfortunately, a lot of support you'd normally find at school is going to be unavailable from now on. But some ways to lessen your stress:

Get a job (if you are old enough). I know, I know, but money makes a lot of life easier, from buying little treats now to stockpiling for things you may want once you turn 18.

Be honest with the reality that you might have to be in the closet a lot, and brainstorm safe outlets for your gender expression. I know at your age, I dressed how I wanted at home and used roleplaying games to explore and express my gender.

Hang out with queer youth, especially in person. You might have a local organization that has events and support groups. It helps a lot to share your feelings with other kids going through the same.

Start following trans political commentators. Erin is a good follow on Substack - she makes it easy to understand all the legal stuff going on.

Consume happy queer stories, by queer authors. It will help counter all the doom scolling. I've been watching Dead End: Paranormal Park (it is a comic and a show), which features a trans masc protagonist.

Cultivate your relationship with your mom. Gently, but firmly set boundaries with her if she gives you guff for, I dunno, wearing boys jeans or whatever. But also be aware she probably has a lot of misinformation about trans people, so you will need to gently pick that apart and see how you can educate her. Trusted adults she also trusts can also help you here.

Build your network. The friends your age you make today could be roommates or coworkers tomorrow. Be social, it will also be good for your mental health.

Be kind to yourself. Things look bleak, but there are states in the US that are actually strengthening trans rights. There continue to be options, you just might need to spend time and resources achieving them.

I hope that helps, and a big hug from a trans adult who grew up in the closet. <3

#trans stuff #anon #transgender

[bioethicists]

Please note I have only taken a few psych classes cause I was required to in college, but I have always seen disorders in the DSM like adjustment disorder or prolonged grief disorder as something to get insurance to pay for therapy because at least my insurance in the US will only cover my therapy if I have a diagnosis... is that wrong though? Are they actually trying to make greif a pathology?

it's the other way around- the dsm (or diagnostics in general) does not exist/modify itself because of insurance, insurance bills based on the widespread belief in psychiatric research + practice that there is a meaningful split between "normal" and "pathological" behavior which can be categorized into illnesses which are meaningfully distinct both from one another + from "normality" (exemplified by the dsm).

even if some therapists no longer abide by this belief, it is still the dominant narrative in psychiatric research. insurance requiring you to medicalize your own pain in order to be given access to healing is a problem that should be addressed directly, not by inventing more and broader ways to be 'sick'. if we're literally inventing disorders now just to get people access to therapy- that's a huge problem + not something we should settle back into + accept. to its credit, even the icd (medical dx book for insurance) has codes that essentially mean "no illness or disease here, just a need to speak with a physician".

to be clear (which i think ppl were not getting from the post i made)- there is no grand conspiracy to like... cover up grief or delegitimize pp due to covid. i do think that researchers for prolonged grief disorder do genuinely believe that they are helping increase access to healing (which may be true but at the cost of medicalizing grief) + that identifying a 'disordered' form of grief is somehow empowering or healing for ppl. what it does is further construct a cold (western-based) narrative that there are 'normal' + 'abnormal' ways to experience grief, that there are forms or intensities of grief which are a sickness (that is, a problem within to be solved or cured), that there are right and wrong ways to grieve. it stems from such a myopic, medicalized, neoliberal view of the world that someone whose life is permanently altered by a devastating loss is seen as a disordered object to shift onto the 'proper' track of grieving.

at the risk of getting too personal, because i've been thinking abt this a lot since losing my brother- criterion for this disorder include identity disruption, intense emotional pain, loneliness, and difficulty reintegrating into life. one of the worst parts of grieving in the US is the culture's rabid obsession with you getting over it as soon as possible w/o letting it affect you in any meaningful way. you have to get out of the house, get back to normal, don't let it drag you down! my dad said to me the day after my brother died "we can't let this change the course of our lives". the absolute arrogance + cruelty of implying that it hasn't already changed. that my identity isn't forever changed because i was a sibling + now i am not. now i am something different. of course i am lonely. of course i am having difficulty reintegrating into life. of course i am in intense emotional pain. i wrote that post before losing my brother + now it just feels like another manifestation of the unspoken cultural mandate that grief be contained, efficient, unimpactful.

tl;dr the insurance benefits may or may not be there, but this misses the larger issue of how insurance functions this way due to psychiatry's obsession with diagnostics + will ultimately serve to draw even stricter boundaries around acceptable/unacceptable grief, isolating grievers + severing their pain from a communal context

#anti psychiatry

[thejakeformerlyknownasprince]

Genuine question, what’s wrong with the DSM?

[OP refers to the Diagnostic and Statistical Manual of Mental Disorders, which I mentioned being unpopular among mental health professionals.] Disclaimer: I'm not a psychiatrist, I'm not a therapist, and I'm not trained in counseling. I'm a social psychology researcher. If a therapist contradicts me, listen to the therapist.

The problem with the DSM as I understand it: a lot of counselors/ psychiatrists/ etc. want to move away from a category- and source-based diagnostic system, toward a symptom-based treatment system. For example, think about Pepto Bismol: you feel nauseous, you chew pink tablets, it ends your nausea. It doesn't matter if your nausea is indigestion or seasickness or lactose intolerance. You match a treatment (pink bismuth) to a symptom (nausea) and don't waste time or money on diagnosis unless that treatment proves ineffective.

A large percent of counselors etc. would like to take the same approach to mental health. So we'd be researching treatments for nightmares (neurofeedback? MDMA?) in the long-term, and giving clients treatments for nightmares (meditation! Ambien!) in the short-term. All without worrying too much about whether the nightmares are caused by General Anxiety Disorder or a phobia or Seasonal Affective Disorder. There are many strengths to that approach.

Only, see, there's this big purple dinosaur holding us back.

[Image ID: Hardcover copy of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5, American Psychiatric Association; the title is white text on a purple background.]

So if everyone who uses the DSM also hates the DSM, why does it still exist and why do we keep buying it every time a $100 text revision gets published? Two reasons, in order of importance:

Insurance

Communication

Insurance is, I kid you not, the DSM's #1 reason for existence. American insurance companies won't cover treatment unless it's for a diagnosed illness, and so therapists put diagnosed illnesses on what they'd often be more comfortable describing as "bro, this dude is hella distressed and I'm trying to help undistress him." Note the word American on the cover; other countries have other manuals, and no other country's counselors are as chained to theirs as we are to ours. This means that the DSM helps — yay, affordable therapy! It means the DSM hurts — sets of symptoms get grouped artificially, spectra get split into categories, and diagnosis happens way too early in the therapeutic process.

Another comparison to unmental health: I don't have carpal tunnel syndrome, but my insurance provider thinks I do. I only announce that I don't because I haven't told you who I am or where I live. (If the insurance companies find us... Well, we just won't let them find us. The thing you should know is everyone is getting screwed by health insurance. Yeah, even you.) I have wrist pain and tingling. It has the wrong antecedents for carpal tunnel, and it has weird manifestations — pressure on the base of my thumb causes pain in my pinky — but my OT wrote down "Carpal Tunnel" on the forms because the alternative was a $500+ round of diagnostic scans. No one cares whether my median nerve is inflamed or not; occupational therapy still looks like "try this stretch, that stretch, this brace, that brace, and these activity changes; keep whichever combination makes the pain and tingling go away."

This kind of thing also happens in mental health all the time. Many therapists don't care — and neither should you — if your serotonin levels are low; if you're miserable and an SSRI prevents the misery, take the dang SSRI. If your mother was harshly critical and now you feel panic at any hint of criticism, it doesn't matter whether that better fits C-PTSD or NPD; it matters whether you cope with soothing self-talk or if you cope with alcohol. Put something from the DSM on the forms, and focus on finding which stretches (breathing exercises) make the tingling (panic) go away.

Communication is the biggest strength of the DSM. It means that clients can benefit from labels ("I'm not lazy, I'm ADHD") and consistent standards of treatment can be applied across different clients in different states. The DSM has huge lists of things like "if your client shows memory problems, be sure to check for alcohol abuse" or "if they have self-harm, make sure it's non-suicidal before you do anything else" that are tremendously helpful. It can help therapists who encounter a set of behaviors they've never seen before to go "client is rigid, rule-bound, and lacks insight... huh, looks like I'd better refer them to an OCPD specialist." (It's also the source of a lot of toxic misinformation on social media when symptom lists get taken out of context without that all-important differential diagnosis information, but I digress.)

However, diagnosis should never be the beginning point for therapy — it's impossible to know your client's mind without first building trust and transference — but reliance on the DSM for insurance often forces it to be. Diagnosis should never be the end point for therapy — knowing your perceptions don't match others' because of Bipolar I won't stop you hearing the dang hallucinations — but home use of the DSM often acts that way. Categorical diagnosis is limiting if your therapist is primarily interested in how depressed you are but the Beck Depression Inventory uses an absolute cutoff point for "depressed" or "non-depressed." Categorical diagnosis is useless if over 50% of people diagnosed with a depression are later diagnosed with an anxiety disorder, and vice versa. So it's an imperfect book that does a lot of things well and a few things badly, and many of its heaviest users would argue that it shouldn't exist at all.

For further reading, I recommend The Body Keeps the Score by Bessel van der Kolk. I don't agree with all the axes he grinds or all the ways he grinds them, but he's got decades of psychiatry experience and is (I hope) predicting the next paradigm shift in mental health.

For instance, van der Kolk argues that it doesn't matter if at intake your client has long blond hair and is named Linda, only to show up the next time with no hair and the name Gerald, only to come next time with short red hair and the name Taylor. The therapist should only be asking "how does the client feel about these changes?" and "what are these changes doing for the client?" If Linda can't remember what Gerald did, then focus on the terrible memory gaps that alter identities create. If Taylor became Gerald to try and please you, then focus on teaching mindfulness and self-compassion. If this is a happily genderqueer person, then figure out why they're seeking help and don't worry about the appearance changes. If this is someone who thinks in absolutes and regards their personality as constantly changing, then work on teaching them to see the world and themself with moral complexity. It doesn't matter whether Dissociative Identity Disorder exists or not; just ask your client what they need and how you can help, then go from there.

Anyway, the DSM is an imperfect solution to a complex problem, and a lot of mental health practitioners view it as a relic of a more paternalizing era. No one has come up with a really good solution for how to remove and replace it, so for now it's the least-bad option.

#dsm #dsm 5 #psychology #psychological research #therapy #counseling #mental health #diagnostic and statistical manual of mental disorders #psychiatry #diagnosis #long post #(almost) nothing to do with animorphs #depression mention #ptsd mention #suicide mention #american politics #to be 100% clear: I *do not know enough* to have an opinion about whether or not Dissociative Identity Disorder exists #i only know that some very expert people have argued for it *and* that some very expert people have argued against it #and that all these very expert people absolutely agree on listening to the client howsoever the client chooses to identify #more research is needed #I reiterate: I AM NOT A THERAPIST AND NONE OF THIS IS MEANT AS MENTAL HEALTH ADVICE

[fatliberation]

I just want to say I'm so glad i found your tumblr. I used to follow a couple fat acceptance tumblrs that just don't really post anymore, and was missing that in my life. I've been liking your posts all day. I know some ppl don't like that, but i hope you don't mind. I want to share it all with folks.

A question came to me while browsing. I'm going to need knee replacement surgery, but the ortho said they won't do surgery of you're over a certain bmi (in America, on medicaid). I don't know if that's just this particular surgeon, or if medicaid won't approve it because of my weight. Maybe a follower of yours might have some experience with navigating weight discriminating with medicaid?

Hey there! I don't mind at all, I'm so glad this blog fills that need!

It's likely the surgeon. Medicare and Medicaid do cover knee replacements, and so far I haven't been able to find anything that says the insurance has a BMI cutoff. Most surgeons won't operate on patients with a BMI over 35-40 because of "surgical complications, risk of infection and poor outcomes." (And, of course, a new University of Alberta study shows that losing weight before knee replacement surgery doesn’t lead to better outcomes for patients.) But I would still have a conversation with your doctor/surgeon to make sure that Medicaid does cover it. If anyone reading this has any relevant information to share, or resources on finding arthroplasty surgeons without BMI limits, please let me know!

I'm so sorry you're dealing with such a detrimental facet of weight discrimination, @enbycarp. It breaks my heart. You deserve treatment in the body that you're in TODAY. I sincerely hope you're able to get this surgery soon, but in the meantime, here's 6 Alternatives to Knee Replacement Surgery (really it's 5, cuz #2 is weight loss, so... ignore that one).

Related articles:

BMI Does Not Affect Outcomes in Knee-Replacement Surgery

BMI Cutoffs are Bad Medicine – High BMI Individuals Deserve Access to Total Knee Replacement Surgery

#tw medical #medical discrimination #weight discrimination #resources #inbox #fat liberation #fat acceptance #anti weight loss

[dee-the-red-witch]

The Monthly Roundup

Okay, normally, this is just a free monthly post over on my Patreon, but I figured I should push this out into the wild as well, because this kind of stuff's always needed. Want this, and a bunch of weekly readings from a cursed tarot deck, media reviews, and other content including fiction and the occasional build post? Maybe consider adding me over there as well. Anyways, like I said, it's a monthly roundup- in this case a bigass collection of links and resources for folks interested in pursuing gender transition one way or another. And while a bunch of it is transfem specific and sometimes medical transition specific, because it's stuff I dug up while hunting down things for myself, there's also things in there good for anyone of any gender, and resources for legal/social transition as well. And this is long enough to deserve a cut for once, so...

Hey! What If *I'M* trans?

The Gender Dysphoria Bible- https://genderdysphoria.fyi/en Wondering if you're experiencing Gender Dysphoria? This may be a good place to start. Realize the GDB is slanted largely towards transfem folks, so it doesn't necessarily apply evenly to everyone, but it does cover a lot of ground that folks may identify with.

Trans Medical Resources

DIY HRT- https://diyhrt.cafe/index.php/Main_Page (for legal reasons, I'm going to tell you to at least try to see a licensed physician or endocrinologist before starting to DIY your own hormones, but keep in mind, I'm not your responsible adult, and if you don't choose to listen, that's on you) This is the main, best hub for sourcing and getting info on doing your own hormone therapy. Keep in mind, it's once again slanted towards feminizing methods, because testosterone is still a controlled substance in most of the world (which is bloody fucking stupid, but that's a rant for another time).

GALAP- The Gender Affirming Letter Access Project- https://thegalap.org/ While we may have new WPATH guidelines with the Soc 8 updates that dropped a little bit ago, most providers and insurers are still on outdated requirements that insist on letters from mental health providers for transgender-related care. Which can affect access to surgeries, HRT, and more. GALAP exists to connect folks with providers who'll give those letters,m in some cases free of charge even.

Gynecologist List- https://docs.google.com/spreadsheets/d/1Djia_WkrVO3S4jKn6odNwQk7pOcpcL4x00FMNekrb7Q/htmlview This one's more for uterus-owners in general and less trans-specific, but giventhe number of folks with uteri who'd can end up with a hard time finding a willing doctor for some procedures, it's important for everyone. This is a Google database of hundreds of gynecologists, listed by location, willing to perform sterilization procedures with informed consent, without secondary authorization from anyone else. The list is patient-vetted, so your mileage may vary, but for those seeking sterilization and/or hysterectomies as part of their transition it may prove to be invaluable as a resource, because doctors willing to do this work can be few and rare in some areas.

Transfeminine Science- https://transfemscience.org/ Articles, journals and all sorts of researching into, well, just what the name says, transfeminizing science. A lot of medical professionals simply don't have knowledge in the field and are acting on what they learned in med school, which may be way out of date. If they're willing to listen, there's stuff in there to help bring them up to speed. Better yet, it;'s also a great resource to educate yourself so you can advocate for your own care a bit better.

Other Transition resources (legal, social, etc)

NCTE's ID GUIDE- https://transequality.org/documents The National Transgender Center for Equality's guide to changing your legal identity, in a handy format that lets you break it down by state or territory, or even federal documents (United States only, sorry.) and links to the right paperwork to use. Rainbow Passage- https://rainbowpassage.org/ It sucks that we need organizations like this in these times, but I'm glad to see there's people already stepping up to the task. Rainbow Passage is an organization dedicated to helping trans youth get out of trans-hostile states and relocate to safer areas. And if you can, volunteering for them is a great way to help improve safety for trans folk in general.

Seattle Voice Lab- https://www.seattlevoicelab.com/ if you've seen me on social media much lately, then you've seen me talking about this place. This is who I'm (through February and March at least) taking voice lessons through to feminize my own voice more. They also have a bunch of online resources, a discord server, and other help if you need to figure your own vocal chords out a bit better.

Strands For Trans- https://strandsfortrans.org/ Need a haircut, or color or other beauty services you're using for the first time ever as an out trans person and you're not sure where's going to be safe to go? Strands For Trans is the first comprehensive database of Aesthetics businesses for hair and everything, AND THEY VET THE BUSINESSES, to ensure your safety and comfort.

TLC's Life-Planning Guide- http://transgenderlawcenter.org/wp-content/uploads/2020/04/TLC_Life-Planning-Documents-Transgender.pdf The Transgender Law Center put this guide together specifically for planning end-of-life details. Yes, it's a depressing and tragic thing, but protecting and making sure our identities are still properly preserved after we die is still just as an important part of what we're fighting as anything else is. This guide will help you with establishing a Living Will, controlling hospital visits, and setting up proper Powers of Attorney, so that nothing potentially falls back into the hands of people who might refuse to recognize who you truly are. (In many states, you can designate someone other than your next of kin to take charge of your body when you die (next of kin is defined by law, not by preference). If you need to do that, go to nolo.com and look up article on "[your state] funeral law" to get a rundown on if and how to do this.

Trans Media

The Digital Transgender Archive- https://www.digitaltransgenderarchive.net "The purpose of the Digital Transgender Archive (DTA) is to increase the accessibility of transgender history by providing an online hub for digitized historical materials, born-digital materials, and information on archival holdings throughout the world." (In short, this is one of several free libraries of trans history.)

Totally Trans- https://www.patreon.com/totallytrans/posts Hey, look at that, it's another Patreon! Except, no, wait, it's a podcast! Totally Trans looks at media both historical and modern with a transgendered lens. Sometimes it's silly fun, other times, it's great insights into queer and trans history, and all around it's a great show to add on whatever service you're already getting podcasts through- or you can hit the link above to help support them at the same time for early access.

Trans News, Blogs, and Notes

Erin In The Morning: https://www.erininthemorning.com/ Erin's newsletter runs almost daily these days, mostly with updates regarding trans legislation all around the US. It's a good way to stay up to date, but it can also be a drag these days, largely because it's practically just a constantly expanding list of bad news thanks to the GOP right now.

Stained Glass Woman: https://stainedglasswoman.substack.com/ aka Doc Impossible/Zoe. I first discovered her work and writing when WPATH released their new SOC 8 guidelines, because she was one of the few people that could make the thing actually make sense in non-legalese. But I subscribed andkeep following here for regular updates both because she presents a trans coming out narrative that was just a joy to read, and also covers interesting  news in the field of trans medicine from time to time. Definitely worth adding to your feed.

A Self Defense Study Guide for Trans Women and Gender Non-Conforming / Nonbinary AMAB Folks: https://www.silversprocket.net/2021/09/13/a-self-defense-study-guide-for-trans-women-and-gender-non-conforming-nonbinary-amab-folks/

This is, quite honestly, one of the best self-defense guides I've seen for gender-nonconforming folks (and one of the few, to be honest), short of private defense instruction. AND it's available to read in full for free at that link, or in print for just a 5$ donation. Go check it out.

Other general roundups

Grassroots GAC Resources- https://docs.google.com/spreadsheets/d/19kSzBLo_hjpiBjHN8tvK73sVHU25NKWjMau2vNl8uuM/edit#gid=778305468 Google spreadsheet of links in general, from therapy help and hrt assistance, to all sorts of other info, some of which are repeats from here, but there's also a bunch of others I haven't had time or opportunity to vet yet.

#trans #transgender resources #link roundup #readmore #transgender

[financialzero5]

Why CometCare is the best ending (AKA why the public knowing about SparkleCare isn’t possible)

Let’s say, by some insane leak from a government official mad about their paycheck, the events of SparkleCare got leaked to the public, with enough evidence to back all of it up. Hooray right? Everyone knows what the patients and staff went through. Now this is the best ending! Here’s several reasons why this happening would be AWFUL for the Comet family (and nearfamily)

-Staff would be arrested | Imagine that you hear that the hospital you thought was safe and caring for their patients was actually torturing and killing them instead, while siphoning money out of their insurance. What would be your first reaction? The likely answer is get everyone involved imprisoned! And the government, now having to clean up their mess, would likely follow through with this in an attempt to show that they’re not incompetent. Now who do we know that was involved? This does include immoral characters like Sunny and Cuddles, but this also includes ALL the staff, like Boxa, Lovella, and most importantly for the Comets, DOOM, Mood, and Rem. I don’t think I need to explain why DOOM being arrested would be devastating for the Comets.

-EVERYONE finds out | The only person we see in CometCare that knows anything about SparkleCare outside of those involved with it, is Faerie. Faerie has a strained relationship with their parents, ESPECIALLY Boxa, due to him knowing what she did to people. Now imagine how characters like Marco or Cream would react to finding out one of their parents tortured and killed people. It’s stated in DOOM’s Toyhouse page that Marco’s respect means the world to him, and he does everything he can to make sure he doesn’t lose that respect. And Cream is noted for latching onto a bad thing about someone and never being able to move on from it. Needless to say, if DOOM somehow got out of being arrested, this would devastate him just as much. And this also affects the other parents, Uni, Polly, and Barry. A lot of their kids definitely wouldn’t understand why they were lying to them about all of this, and this would harm their relationship with their kids greatly. While this does mainly affect DOOM, I’m pretty sure finding out that their parents kept something like that hidden from them would sour their relationship quite a bit.

-Internet being the internet | Now this is mostly unsupported information, but considering that NO ONE believed the patients that broke into the music festival, covered in their own blood and wounds, it wouldn’t shock me if there were still some Bwitter users that think all of it is a government coverup for something else. Personally I would prefer everyone having mostly forgotten about SparkleCare’s existence, over having a bunch of True Crime podcasts talking about my trauma for money, and seeing a bunch of morons try to prove how all of it was a coverup to raise gas prices by 2%. This would be horrible for all the patients and staff, as well as their kids having to see that. Uni is also somewhat of an influencer online, so I’m sure that info coming out would be very traumatizing to both her and her fans on KneeTube.

While it sucks that all the atrocities that Cuddles committed are locked down in a government database somewhere, forever hidden from the public eye, this is just how it has to be. CometCare is the “best case scenario” for a reason. It’s simply impossible for that info to be public, AND have the victims live normal lives.

#sparklecare #cometcare #I went a bit crazy with the formatting on this one

[hyperlexichypatia]

Y'know, one thing I honestly struggle a lot with as a disabled person is like... with certain things I experience, where do I draw the line between "there is a very literal physical set of phenomena occurring in my neurological and related bodily systems that is responsible for my experience of these physical and emotional/mental events" and "these events are being influenced or caused by external stimuli, often related to class dynamics and oppression" and even "said class dynamics and oppression are responsible for much of said physical phenonena within my bodily systems, as they are simply an interaction/reaction to said external stimuli".

To me, it's like the nuance between how "choice feminism" is used to shut down very genuine real critiques of misogyny and patriarchal beauty standards (which are so deeply rooted in racism and white supremacism), but have also been misused to ironically deny women any autonomy whatsoever, rather than striking a balance with "these systems are fucked, much of this stems from a place of coercion and misogyny, and not acknowledging that can feed into it, but as a marginalized class within that system women (and gender minorities in general) do still have the right to decide how they want to respond to that and informed consent still does matter" if that makes sense?

I feel like I'm not able to exactly address the root of the issue for myself with disability but I think it has some to do with the social model of disability, some to do with the way cartesian dualism has been used to divide the disabled community, and some to do with how I am both anti-psych and anti-phys (the institutions including the biased science as it currently exists, not say, medication or treatment).

It's like... okay I tend to look at my own disability through a mixed medical-social lens. In a "perfect" world, neither medical knowledge nor treatment would be gatekept. I'd be able to get medication for things like what are now labeled ADHD, POTS, and MCAS, including getting compounded medication without having to have an official diagnosis of MCAS (seriously, who does it hurt other than insurance company bottom lines to just make a med without corn or milk sugars/proteins or dyes as filler ingredients -_-).

I would still, however, be disabled. I do understand that that is covered under the social model's definition of "impairment", but I also take issue with the relabeling of disability. It seems oddly euphemistic in the same way that "differently abled" does - defining disability itself as only the social access barriers that cause people to be unable to live a satisfying, fulfilling life including with "impairments", to me ignores the reality of those of us with more severe symptoms and higher support needs.

As I saw someone say so well, "chronic pain is still gonna hurt." But it's also that the pain itself is still going to significantly impact my quality of life, even with full access to treatment and meds. My symptoms are still a physical reality within my body, causing distress and dysfunction, and disabling my ability to engage in certain activities - not just "impairing" said ability. It still would have a significant negative affect in my quality of life, outside of my control. And here I am referring to activities in again, a "perfect" world, where the only reason to do them is out of pure, uncoerced and uninfluenced desire.

There's also the way that rather than actually depathologizing what we label as mental illness, its ability to be profoundly disabling and its very nature as occurring physically for whatever reason has been ignored in order to be neuroableist and sanist against neurodisabled people.

I am firmly for self-labeling, and firmly against the forced labeling of any trait as "abnormal" and "unhealthy". I do think even for self-labeling, it's important to question the premise behind many labels and explore more deeply what you are actually using said labels to mean.

I have talked at length about what "demedicalizing DID", as an example, actually entails, and how it actually increases access to resources and treatment for those that want to pursue those things.

The labels themselves are social, even if they are categorizations for material experiences in many cases. The line gets blurrier with psychiatric labels, as the experience is essentially an internal abstraction of physical phenomena, and the categories themselves are significantly more arbitrary without that solidly material basis.

"Trauma" is used as a label to essentially put the onus of class oppression on marginalized people. Things like "dopamine" and "seratonin" at this point are little more than neurochemically-named horoscopes, in a discipline I already refer to as "the astrology to neurology's astronomy" - and noting here, that neurology and medicine in general are still themselves more partially social than the significantly more mathematical discipline of physics I compare them to.

I also have a reactivity to things that I perceive (or misperceive) as divorcing "mental illness" or "neurodivergence" from any kind of physical basis. It's why I think I was initially confused about your use of "pathologization" - my own bias causing me to struggle to see the difference between what ultimately are very clearly different understandings.

It was, "We should question the categorization of certain experiences as innately pathological, meaning abnormal, unhealthy, and to be suppressed," versus "Mental illnesses are diseases of an abstracted mindsoul, with no physical basis, and can therefore be 'overcome' with a minimum of effort and can never be profoundly or physically disabling".

Which, to be clear, I didn't at all think you were saying the latter. More that I struggled to recognize the former because I had not yet divorced "physical experience" from "specific pathologizing label" in my head, and ironically seeing it laid out so clearly threw such a wrench in that existing perception that I had to go in and decouple/detangle the two to get things going again.

Really, though, it seems it's once again about informed consent in a society where "choice" is so deeply and insidiously influenced by prevailing hegemonic attitudes. It's "if you're going to label yourself disordered, it is still good to question the very premise of that label".

In a world with no access barriers and oppression, I would still have some of the same physical experiences I have now. With unrestricted access to medical treatments that directly interface and alter my biochemical processes, I would still likely not be without what we now label as "symptoms". Certainly, assuming I grew up in that world, "trauma" might very well be an unrecognizable concept as to what it is considered in our reality - assuming it even existed in any meaningful way at all.

I guess it's just - where is that balance between acknowledging the extreme influence of current societal norms and ideas about disability, the way the very language we use to talk about them is steeped in those biases, misconceptions, and assumptions, and the way that a physical result is treated as the cause itself; with the existence of varied experiences of abstracted neurological phenomena, having/creating language some need to help define and understand ourselves, and those societal causes still engendering a physical result?

Is it in the connotation? Is destigmatizing the concept of disability and "disorder" (as meaning "causing distress and/or dysfunction as defined by the person experiencing it") and stopping their misapplication enough? I admit, when my disabled identity has been repeatedly denied by ableists, my instinct is to cling to the labels that say "yes, this is an experience that makes me not able to achieve my own personal desires and goals and causes me distress".

While the concept of "ab/normalcy" is deeply unhelpful and often harmful, there are times when I at least want to say "my material experience is not the same as yours despite your insistence that it is" to people who identify as abled, who have described their perception of my experience as something oppositional to my actual experience. Not abnormal, but not identical, either.

Maybe that's getting off in the weeds. I guess just... at what point does acknowledging my own experiences as a significantly overlapped venn diagram of innate physical and purely societal causes meeting at mixed causes and societal causes of physical results, cross the line into mislabeling societal forces as innate physical events.

Is it just divorcing them from the greater context of society? It is the reversal of causality? Is it the lack of acknowledgement that the way we label these experiences is inherently tied up in the social environment surrounding them? If I view some of my experiences as entirely unrelated to and uninfluenced by that social environment (at least to the extent that is possible), while still being a natural variation in neurology (or physiology) that is itself neutral overall regardless of how I experience it, is that enough?

Is viewing the things labeled as ongoing "trauma" and "mental illness" as a natural and rational response to class oppression a factor in depathologization, as long as we also acknowledge that the labels of "trauma" and "mental health" themselves carry meaning and bias and connotations that don't uphold or even contradict that belief?

I dunno. Maybe I'm just stuck in stubbornly not wanting to give up labels I've been forced to fight for because I'm scared to admit that I could have been fighting for not having them at all while still having my needs met in the first place. Maybe I am just struggling as someone who can't actually process or understand their own experiences without language to integrate a new understanding of that language into my paradigm. Maybe some parts of us are still reactively misinterpreting "question and examine how the language we use is a social construct and how that has been wielded against marginalized identities, including your own" as some sort of threat to our autonomy and in particular self-determination.

I may very well be afraid of and biased by those things, but the one thing I'm not scared of is examining that and admitting it's a possibility.

I guess I'm sending you this ask in particular precisely because you've articulated precise analyses of these subjects so clearly. I'd love to hear your thoughts, if you're willing.

Oh, this is the ask I thought I'd lost!

So, before I start, my own bodymindbrain is VERY compromised by COVID right now. I am living that physical illness affecting cognition life.

This is a great question and I'm really struggling to come up with a thoughtful response, because so much of it, I just don't know. I have no idea "how disabling" any of my disabilities would be if I lived in a society that accepted and accommodated differences, because I've never lived in a society like that and I can only vaguely imagine it. I know that part of that goal is making it so that the supports we receive (medical, social, or otherwise) aren't contingent on any particular label or any particular concept of "disorder." And also that they're never an excuse to infringe on someone's autonomy.

On the language of it all, I'm always struggling to refine my own use of language, but it's especially frustrating because any potentially radical/liberatory use of language gets co-opted and appropriated by pathologization (like "neurodiversity," "Mad," or "anti-psychiatry"). I've left so many groups that I thought were about rejecting pathologization that turned out to be about "recovery" or "healing" (which is fine for people who are interested in those things! I'm just not one of them!).

I also struggle with my own... parts of my mind/emotions that are distressing to me... and I struggle to find words for that that aren't part of the pathology paradigm like "mental health," and also aren't spiritual because that's not what I believe. I just don't know the words. I know that I have anxiety attacks and it sucks and I hate it, but I don't know good overarching terms for "The experience of having profoundly unpleasant unwanted emotional states" or "The attempt by various means to mitigate or remediate profoundly unpleasant unwanted emotional states."

Your question is better than my answer, and I'm sorry for that, but I'm glad you asked!

#asks #cognitive liberty #mad pride #neurodiversity #liberation #disability rights

[mandana-the-service-pup]

My 2023 Review of PetsBest Pet Insurance + a few tips (LongPost)

Pet insurance will only reimburse payments that you have already made and this can take months. You will need to have a good savings account and/or credit limit to cover the costs up front. It’s rare to find a vet who will do a payment plan and it can be really stressful to have your ability to cover a large transaction during nonbusiness hours be the only thing stopping you from saving your pets life. So #1 apply for CareCredit ahead of time and if possible have a savings account and good credit limit for emergencies. Usually if the transaction is larger than $200 you can get a 6 months no-interest period with CareCredit. The limit is often determined by your credit score & income but the more you use it and pay it off the higher they will raise your CareCredit limit over time. As far as the amount is concerned I’ve seen people with CareCredit as low as $500 and as high as $10,000. Our starting offer was $2500 and was bumped up to $6000 after using it for over a year.

There are two main ways deductibles can work in pet insurance. Some companies have one deductible per annual period that you need to pay before receiving benefits. Others will have a deductible per incident and then anything related to that illness/injury in the future your deductible will have been paid already no matter the time period (which might not be good for accident prone dogs but is great for chronic illnesses) PetsBest does an annual limit that is customizable so it’s hard to give exact estimates but here is what it looks like for us: We pay $32/mo for Mandanas insurance for a 90% reimbursement level and supposedly unlimited annual limit. That $32 also includes the supplementary package for chiropractic/acupuncture/rehab (more on that later). We chose a $250 annual deductible that we have to meet by filing approved claims. So for every claim they first subtract what isn’t covered > then subtract the 10% “copay” >> then take that amount and subtract it from the $250 deductible >>> if the annual deductible is met then what’s left (90% of the approved expenses) is payed out in a check or via direct deposit. (It took us a little over a week to get our check).

Preexisting conditions is another thing that can vary in pet insurance. There’s no right or wrong when it comes to this. PetsBest doesn’t cover preexisting conditions but if your pet develops chronic issues they will continue to cover those expenses longterm as long as you don’t cancel your plan and start it over (as mentioned above you will still have to meet the deductible every year even if it’s the same issue). We recently got a large check for Mandanas elbow mass removal and the emergency visit that was related to that surgery. I asked how this would affect our future rates and PetsBest assured me they don’t change rates based on claims and payouts. (They have a super secret formula for how they change their annual rates which I think involves the pets age and other mystery variables. I guess we’ll see later this year if they raise our rates drastically after paying out)

They are in the business of making money and will use the fine print against you whenever possible. This goes for every claim you make but here is our specific example. As mentioned before, we chose to add on the chiro/acupuncture/rehab package and that has been our biggest disappointment (and as far as I know you can’t remove it from your plan without canceling and reapplying which is a big No No because every claim would now be considered preexisting!) For starters they will only cover these things if prescribed and performed by a licensed vet, so you are limited in that capacity even if the chiropractor works with your vet and comes highly recommended. The second issue is that they will only cover their definition of these therapies and that might not be what is used by your vet. My vet doesn’t do acupuncture in the strictest sense bc trying to convince a dog to stand still for 20 minutes with needles in their back is often more trouble than it’s worth. Like many vets nowadays, she uses aquapuncture which is saline/b vitamin injections into acupuncture points. It take about a minute to do all the injections and it has been one of the most effective treatments for Mandanas back issue. PetsBest doesn’t care what is best for the pet. They say they will only cover acupuncture or electro acupuncture (not acupoint, acupressure or aquapuncture). So if you are interested in various types of therapies be sure to read the fine print and not just what they will cover but specifically what they won’t cover because those are located in two different places in your policy. (Another note on this point that I’ve seen others experience is that they will try to claim everything they can is a side effect of the preexisting conditions. So if your dog has allergies as preexisting then they may try to say any skin issues, ear infections, diarrhea, UTIs ect from here on out are caused by the allergies and it doesn’t matter if that’s true or not. I haven’t personally experienced this yet but it does happen with every pet insurance company I’ve heard of so just be aware of that.)

Filing a claim is both easy & troublesome. All I have to do to file a claim is take a picture of the vet receipt and proof of payment (which would be the CareCredit receipt if that’s what was used). That picture is taken through the PetsBest app. I put the date the problem first started and a little description and then hit submit. In 35 days you should receive an email with a breakdown or what was covered and what wasn’t with a description next to each of why that decision was made. Recently they said it’s taking 42 days for claims to be processed, so that’s a decent chunk of time you have to manage a big transaction until you get reimbursed. If you file one claim and have other vet expenses come up before that claim has been processed go ahead and file those too. They will go over all of them in one session at the end of your waiting period and that will save you time in the long run.

The reason I say it’s also troublesome is because they have automated messages that talk about how your claim is delayed because of incomplete medical history due to lack of communication from your vet. I have a close relationship with my vet and that is absolutely false. When those emails are sent out I have been at my vets office and they haven’t even received the requests from PetsBest yet. Upon my request the staff will send the information via email to PetsBest and PetsBest will continue to say they haven’t received anything and that it can’t be processed. I have time-stamped emails from my vets office that proves otherwise and I’ve talked to PetsBest customer service who say they have the documents they need and to just ignore the email. As someone who struggles with healthcare related PTSD, this is really unacceptable. Vets and their staff are already taxed beyond belief due to the massive ratio of vets/pets in this country. To send out automated messages that discredit vet staff and encourage pet owners to put pressure on them is crazy. It quickly ruins the pet owner-vet relationship and for what? To make things slightly more convenient for the paid employees of PetsBest? So just know going into these claims, that they may actually need that paperwork but it’s better for you and your vet to call PetsBest as often as needed to confirm what they have on your account before turning that energy towards your vets office. (Also, when you call PetsBest you need to have your claim number available to type in even if you aren’t calling about a specific claim or it will be difficult to talk to a real person and you may get stuck in the automated call process or have your call dropped)

I know this is a long post, so I think I’ll wrap it up here. If you’ve made it this far then I hope you’ve found some of this information helpful. I don’t claim to be an expert on pet insurance. This is just my experience from having & using it over the course of the last year with a sick dog. I’m sure I will post more about it in the future when I’m able to offer more insights as to whether or not it’s worth it and if this is a good company to use✌️

#PetsBest #pet insurance #sick dog #injured dog #vetblr #dogblr #service dogblr #service dog community #service dog resources #dog recommendations

[switchcase]

hiya, i just came across naltrexone via a friend who was prescribed it for dissociative symptoms. i’ve also heard of it being used for cfs in low doses. since i have both a dissociative disorder and cfs i’m thinking about asking my gp or psychiatrist about it. have you heard of naltrexone being prescribed for dissociation or cfs or do you have any personal experience with it? do you know if there is research that backs this up or if it’s just anecdotal/ doctors and patients experimenting to see what helps?

There is no medication used to treat dissociation straight up. Any/all medication that is prescribed to reduce someone's dissociation is being prescribed for something else like PTSD and anxiety.

Naltrexone is an opiate antagonist (blocks a specific opioid receptor from receiving signals) used for treating opioid and alcohol addiction.

Low dose naltrexone has been studied* for off-label use in various chronic pain conditions, ME/CFS, and PTSD. The "low dose" "off-label" part is important because you'll have to get it from a pharmacy that does compounding or a special pharmacy, because pharmacies do not carry it in the right dosages (not pill cutter friendly because the dose is 50mg vs low dose of 1-6mg). A dr that tried to prescribe it to me for fibro a few years back wanted me to go to a special pharmacy an hour away by car that is not covered by insurance.

*The studies for chronic pain treatment are a few very small teeny tiny studies. The studies for PTSD treatment are even smaller and fewer. "Even smaller" as in one of these studies had a total of 15 patients, no control group (7 reported improved symptoms). So nothing expansive and no solid foundation, kind of like the adult version of a science fair project. For physical conditions, the idea is that at a low dose, naltrexone affects your immune response including reducing inflammation. For PTSD the idea is that the opioidergic system for Some Reason has Something to do with flashbacks.

So...it is both in the sense that yes there is Some research evidence that it does help, but yes it is drs and patients shrugging and throwing shit at the wall to see what sticks. It is by no means well studied or a tried and true treatment.

#ask #anonymous #not to be rude to the scientists involved but these operations were so small I could hear them crawling on their hands and knees #for more funding in the abstract #Pharmaceutical studies with low funding must be so harsh 😔 good luck out there

[alj4890]

Hi there! I'm here with a Valentine's Day prompt. PLEASE don't feel obligated to do it at all, but if you can, I'd love to see it. Since I'm a total hohoho for Tobias...

Tell us a little about Tobias x Chris's first Valentine's Together after they go public (after the attack).

Thank you! :) But again - DON'T feel pressured to do this! 💘

As if I can resist such a request 😉 Let's see what I can do for Tobias and Chris. Happy Belated Valentine's Day @jerzwriter 😘 And I don't know what happened, but this grew and grew into what it is now, LOL! I've been thinking of a series with these two and I think that mindset spilled over into this and made it so looonnng 🤣 I ended up doing the reveal and everything, so, yeah, LOL. Sorry about that and for taking so long to finally get posted 😬

Rating: Teen for some language

Not sure who to tag so I'm racking my brain for some OH tags I remember and a few on my perma list, LOL! @hopelessromantic1352 @jerzwriter @openheartfanfics @krsnlove @choicesficwriterscreations @twinkleallnight @tessa-liam

Masterlist

Interrupted Plans

A few weeks before Valentine's Day...

"You're here again?" Ethan grumbled in lieu of a greeting.

"You do know how insurance works for people." Tobias replied. "Some only cover certain hospitals for care."

Ethan made a humph sound with narrowed eyes.

Tobias merely smirked while flipping through his patient's chart.

"It seems odd that ever since you came to help during the attack," Ethan remarked, "that you have been here on a nearly daily basis."

"Perhaps you just didn't notice how often I was coming before." Tobias quipped back. "Maybe your keen sense of observation is slipping in your old age."

"We are the same age." Ethan reminded him.

"Technically, I'm younger by three months." Tobias closed the chart and began to walk away.

Ethan kept pace with him, determined to find out the reason he was really here.

"Where are you going?" He asked.

"To the diagnostic office."

"Why? Does your patient need a consultation?"

"Nope."

"Then why are you going to my office." Ethan demanded.

"For Chris." Tobias replied, knowing the time was finally at hand.

Ethan's eyebrows drew together. "Chris? Are you worried she hasn't recovered from that cure you created."

"Not exactly."

Tobias paused outside the glass doors. His gaze landed on her. A smile formed on his face over how serious she looked while reading over some lab reports

Ethan followed his gaze.

"No."

"No, what?"

"No to whatever thoughts you have about Chris." Ethan told him. "She isn't someone you can have a one night stand with."

"I agree." Tobias smirked at him.

He reached for the door handle.

Ethan slammed his hand on the glass to keep him from opening it.

Chris jumped in response to the unusual sound. Her wide eyes went first to Ethan's angry face then to Tobias smiling at her.

She quickly got out of her seat to stop whatever was about to happen.

"What's going on?" She asked.

"It's time." Tobias explained.

"Oh." She moved closer to him, slipping her arm around his waist.

He pulled her closer to him, then pressed a kiss to the side of her head.

Ethan's jaw dropped as the realization struck.

"How long?" He hissed. "How long has this been going on?"

Tobias looked up at the ceiling while doing a few calculations. "Let's see..."

"Eight months." Chris promptly answered.

"Eight!" Ethan choked out. "How--"

"I saw her at the South Street Diner." Tobias shrugged. "Naturally I asked her for her number and the rest is history."

Chris looked up at him with a smile. "Really good history."

"Why didn't you tell me?" Ethan demanded.

The couple merely stared at him.

"This type of reaction was a big reason." Tobias explained. "That and I didn't want our relationship to affect how you treat Chris now that she's a part of the diagnostic team."

Ethan glared at him.

Chris cleared her throat.

"Ethan has too much respect for me to ever hold my personal relationships with others against me." She quirked an eyebrow at him. "Right?"

An awkward silence fell between them.

Ethan's shoulders slumped in defeat.

"Right." He nodded to them. "Have a good night."

He slipped into the office, leaving the couple alone.

"That went better than I expected." Tobias teased her.

Chris laughed, shaking her head. She couldn't help but be relieved that this was no longer a secret.

"Come on." He tugged her away. "Let's get out of here."

****************

Saturday...

It was both an odd feeling and one that left Chris happy to finally have her relationship out in the open. Her friends were still in disbelief that they had not found out about her and Tobias. Ethan kept his opinions to himself and even managed to appear less irritated that he was seeing his former friend around the hospital more so than usual.

Valentine's Day was approaching. Hearts and cupids adorned the hallways and nurses' desks. Both patients and staff were soon receiving the typical gifts of bouquets, balloons, and other heart shaped treats.

Being in a relationship for a day filled with reminders of love was a nice change.

Much better than her previous Valentine's Day at Edenbrook, pining over a certain doctor and a particular surgeon .

A warmth filled her chest the moment she saw the one who would make the holiday all the sweeter.

"Dr. Valentine?" Tobias winked at her. "I could use your assistance."

"With wh--"

He yanked her into a nearby supply closet.

"Hi there." He murmured against her lips.

She melted against him when his hands moved over her curves.

"Hello." She pressed a kiss to his lips.

"So?" He grinned at her. "Are you free this Thursday?"

"This Thursday?" She pretended to ponder. "Hmm. I suppose I could squeeze you in."

"You better." His smile grew when she laughed.

"Thursday is a pretty romantic night. Are you sure you're up for it?" She teased.

"With you?" He kissed her. "Always."

"What are we doing?" Chris asked.

"We're going all out for our first Valentine's Day." Tobias cuddled her close. "A romantic dinner cruise. Dancing. Flowers. Everything you deserve."

"Tobias!" She couldn't stop smiling.

He pressed another lingering kiss to her neck. "That's how I expect you to say my name after we have our Valentine's date."

Chris jumped when the door swung open.

A muscle in Ethan's jaw spasmed at the sight of them entwined in the closet.

"If you don't mind," he grumbled, reaching past them for some latex gloves.

"Sorry. We were just--" Chris began.

Ethan shut the door.

Tobias chuckled once they were alone again. "He's taking us being together really well."

***************

Sunday, hospital cafeteria...

"Do you have a dress picked out for your date?" Sienna asked.

"I do." Chris replied between bites.

Jackie snorted. "Forget the dress. We all know the only thing Carrick will be interested in is what's underneath."

"I took care of that too." Chris colored some.

"So you finally took my advice on what to get him?" Jackie cackled. "About time you listened to me."

"What did you get him?" Sienna asked.

"She got him what most men want." Jackie answered for a very flustered Chris. "Lingerie the color of Chris's face."

The two laughed over how red their friend was turning. They continued to tease her over how the night would go, making Chris dissolve into tears of laughter. Their giggles stopped the moment they heard a chair scrape and a familiar grunt. Sitting on the other side of them, hidden by a large fern was Dr. Ramsey.

Without a word or glance, he tossed his half eaten lunch away and walked out the door.

Chris dropped her head on the table with an audible thud.

"Do you think he heard us?" Sienna whispered.

"Why are you whispering now?" Jackie snorted. "He's gone."

"He heard." Chris mumbled. "And I have to go back to the office later to discuss lab results."

"So?" Jackie shrugged. "It's his problem if he has issues with you being with someone else."

"Jackie." Sienna softly chided. "It isn't easy to see someone you have feelings for be with someone else."

"He had a chance." Chris sat up and rested her chin on her hand. "Numerous chances to be with me." Her eyes narrowed somewhat as she thought of her past. "But I finally found someone who not only made it clear how he feels about me but also made the effort to be with me."

She took a deep breath and released it. "I don't care how bent out of shape Ethan gets. He isn't going to ruin anything I have with Tobias."

***************

Monday...

"These came for you earlier." Baz motioned towards a vase filled with red roses and white lilies.

Chris plucked the card out with a shy smile. Her smile grew bigger as she read what Tobias had written.

I know there are more poetic ways of saying this, but these are the only words my heart comes up with: I love you Chris. You are everything to me. -T

Chris softly sighed as she leaned forward to smell her bouquet. With eyes closed, she began to imagine how romantic their date night would be. She couldn't wait to see his face when she revealed her special gift for him.

She then noticed Ethan and Baz staring at her.

Color flared in her cheeks as she slipped the card in her pocket.

"Can we discuss Mr. Flemming's recent fall?" Ethan asked a bit sardonically. "Or do you need another moment with your flowers?"

Chris quietly studied Ethan for a few heartbeats. "I think we should do a test to check for small blood vessel disease. After talking to his wife, she's seen the last few weeks that his way of walking has changed along with him getting confused over simple tasks."

"We should also do a psych evaluation to check for dementia." Baz added. "Since that is one of the other symptoms."

Ethan nodded. "Let's get to it then."

Baz left before Chris finished gathering her things.

She glanced at Ethan. He already had his attention on one of the books upon his desk.

She hesitated, wondering if she should discuss her relationship with Tobias with him. A part of her didn't understand why she felt almost like she'd deceived him by getting into a serious relationship with another man. It was ridiculous to feel like she owed him an apology for finally being in a normal, healthy relationship.

"Did you need something?" Ethan asked without looking up at her.

"No." She picked up her flowers. "I've got everything I need."

Deciding to leave well enough alone, she slipped out of the office without a backwards glance.

Ethan watched her leave with a heavy heart.

*****************

Tuesday evening, Tobias's townhouse...

"Hey Chris?" Tobias called out. "We might need to change our plans."

Chris came out of the kitchen to see what he was talking about.

He had the local news on. A nor'easter was brewing.

"We might not be able to do that dinner cruise." He told her. "We probably won't be able to go out at all once the storm hits."

"Oh." She sank down on the couch next to him. "I was really looking forward to that."

"Me too." He draped his arm around her. "We'll go another time."

She nodded before resting her head upon his shoulder.

He squeezed her close. "As long as we're together, it'll still be a special night."

"I know it will." She pressed a kiss to his cheek.

"Why don't we go back to your place and pack you a bag and then you stay here for the rest of the week?" He pulled her into his lap. "I don't want us being stuck in two different places when the storm hits."

"I guess I could be persuaded to stay with you." Chris teased. "I'll need a little more than the weather to make me agree."

"You do, huh?" In a quick move, Tobias had her under him on the couch. "How much more?"

His hands slid under her sweater while his lips traced a path down her neck.

She moaned over the way he knew just where and how to touch her.

"I'll let you know when it's enough." She managed to say right before his lips met hers.

****************

Thursday...

The morning was cold and dreary. The ominous storm clouds were beginning to grow as the day wore on. Chris and Tobias were comfortably nestled in his townhouse with a fire going to help ward off the damp chill that hung heavy in the air.

Snow accumulations were rising with each hourly news update. The wind was beginning to pick up speed, with eerie sounds rattling the upper windows.

"I'm glad I talked you into staying here." Tobias brought Chris a cup of coffee.

She chuckled. "As much as I hate to admit it, you've never had trouble talking me into anything."

"It's my charm." He dropped a kiss on her smiling lips. "Ladies simply can't resist me."

"This better be the part where you say that I'm the only lady you use that charm on." Chris playfully grumbled.

"You know I can't always control my charm." He teased.

She poked his side, laughing when he held his hands up in surrender.

"I guess I could try for your sake." He pulled her close for a kiss.

"Hmm. That's what I thought." Chris sighed contentedly as he kissed down her neck.

Her attention drifted over towards his mantle clock.

"I better get ready."

"For what?"

"For dinner." She wiggled out of his arms. "Just because we can't go out doesn't mean I won't dress up for our date tonight."

"I don't know." Tobias plucked at her University of Edinburgh sweatshirt and flannel pajama pants. "I'm kinda into your relaxed yet warm look."

She rolled her eyes, making him chuckle. Chris stood up and cajoled him into dressing up for their night.

"All right, Valentine." He got to his feet. "If that's what you want, then I'll wear a suit for you."

She pressed a tender kiss to his lips before hurrying off to one of his guest rooms to get dressed.

Smiling to himself over her enthusiasm, he went to his bedroom.

****************

An hour later...

Tobias let out a low whistle when Chris came downstairs.

"Now that's a dress." He met her at the foot of his stairs. "You look beautiful, Chris."

She stepped past him and did a little twirl. "You think so?"

"I know so." He replied.

His eyes drifted from her red hair pulled into a formal updo, past her one bare shoulder, to how her black velvet gown molded over her curves. It lingered on the high slit, revealing a peek at her leg.

"You look handsome yourself." She reached out to smooth the lapels of his jacket.

His arms settled around her waist when she moved closer to him. His teasing smile slowly disappeared as he held her close. He couldn't help but recall how close he'd come to losing her.

And how grateful he was to be holding her now in his arms.

Noticing the mood changing, Chris cocked her head to the side.

"What's wrong?" She asked.

"Nothing at all." Tobias answered. "I'm realizing that Valentine's Day might be more like Thanksgiving."

He pressed a lingering kiss to her forehead, eyes closed as he breathed in the gentle scent of her perfume.

"I have so much to be grateful for." He muttered as he sought her lips.

Chris wrapped her arms around his waist, hugging him close as he continued to speak of his love for her.

"I love you, Tobias," she began, "so--.

They both looked over to where their phones for work were charging.

Grumbling about bad timing, Tobias picked his up.

"Yes?" He looked over at Chris. "No, I understand." He walked over to look out at the storm. "I think I can make it."

"What's wrong?" Chris sat down on the arm of the couch.

"One of my patients at Edenbrook has taken a turn for the worse." He loosened his tie. "The family is demanding I come up there as soon as possible to discuss the possibility of life support."

Chris nodded, knowing there was little point in reminding him that it might be impossible to get there in time with the storm.

"I'll hurry back." He promised, kissing her on his way upstairs.

"You want me to come along?" She called out.

"No. I want you here where it's warm." He replied.

He sighed as he changed into warmer clothing. All his plans were for nothing. The romantic evening he'd wanted for Chris was getting worse by the second. And yet, she took it all without complaint.

As he layered up, he decided to take some snow skis along. If he couldn't drive back, perhaps he could travel the sidewalks with those. He was determined to get back to her as soon as he could. No storm nor patients were going to stop him.

"Go ahead and eat..." He trailed off the moment he came downstairs.

The sight of Chris stretched out in front of the fireplace in nothing but red lingerie struck him speechless.

She smirked at him, as she turned onto her side.

"I thought I better give you your gift before the night is over." She stood up and walked towards him. "Plus give you one more reason to hurry home."

He groaned as she kissed him.

"You are an evil woman." He growled, holding her close.

A smile formed on his lips when she hummed her agreement.

"And I love you for it." He kissed her once more.

"I love you, too." She could feel his arousal forming. "Shouldn't you do something about that?"

He shook his head as he admired her one last time. "It's four degrees out there. By the time I get to the hospital, it'll be questionable if I even have any genitalia."

Chris burst out laughing. Hugging him once more, she wished him a Happy Valentine's Day.

"It's not over until I enjoy my gift." He winked at her. "Stay warm until I return."

"I will." Chris watched him leave with a smile still on her face.

As she curled up under a blanket upon his couch, she couldn't help but think that this was still the best Valentine's Day she'd ever had.

****************

Edenbrook...

"Sorry you had to get out in this storm." Ethan grumbled. "But they refused to make any decisions without you."

"I understand." Tobias rubbed his hands together as he followed Ethan to the ICU floor.

He noticed that Ethan had not shaved and his clothes looked unusually rumpled.

"How long have you been here?" Tobias asked.

"Since last night. Once I heard the weather report, I thought I should be on hand if there were any issues." Ethan snorted. "With all the rookies here and the storm outside, something is bound to blow up."

Tobias snickered. "Remember our first year here? The night Hurricane Candace blew through?"

Ethan couldn't help but chuckle over that memory. "That's a night I doubt I'll ever forget."

"Naveen couldn't decide if he wanted to laugh or kill us for those stunts with the gurneys."

"Mine still went further." Ethan pointed out.

"Only because you rigged some type of sail with the sheets and an IV stand." Tobias argued. "Totally ruined the experiment."

"You shouldn't have eaten all the candy from that busted vending machine." Ethan teased, lost in the memories of when they had been friends. "All that sugar weighed you down to the point that hurricane force winds couldn't get you across the parking lot easily."

They both shared one last laugh before going into the patient's room. They went back into doctor mode, discussing ways to possibly help the elderly man before preparing to talk to his loved ones out in the waiting room.

Once all was decided, the two returned to the diagnostic office.

"I suppose you are going to do something stupid like try to drive in this storm back to Chr--your date." Ethan muttered.

Tobias nodded then paused. Pushing Ethan into the office, he shut the door and sat down at a table. He motioned for Ethan to take a seat across from him.

"We need to talk about Chris." Tobias began.

"No. We don't." Ethan had a hint of steel to his icy tone. "There's no way in hell, I'm going to discuss--"

"I'm in love with her." Tobias interrupted. "In fact, I've never loved anyone like I do Chris." He rubbed a hand down his face as he admitted to something he knew Ethan would finally understand. "I think I'm going to marry her."

Ethan sat down across from him. He blew a frustrated breath out before finally focusing on his former friend.

"I see."

Tobias waited on him to say something else.

Ethan's shoulders dropped as he pinched the bridge of his nose before speaking.

"She's..., Chris is a woman that I think many would have difficulty resisting." Ethan cleared his throat. "If anybody deserves to be happy, I think it's her."

Tobias quietly nodded.

Ethan narrowed his eyes once more.

"Before you propose to her, you better be sure your love of short term relationships are over and done with."

Tobias snorted. A hint of a smile graced his lips.

"Those have been done ever since I met Chris."

Ethan humphed. "Don't think I was unaware of your affair with June."

"Hirata? Tobias laughed, shaking his head. "That wasn't an affair. It was barely anything other than sex."

He met Ethan's narrowed gaze.

"It ended the moment I asked Chris for her number. Once I had it, I called June and ended things."

"Good."

The two sat there in awkward silence.

"Look," Tobias leaned forward. "I know about Miami and after Chris's hearing."

Ethan's eyes widened.

"I also know she held out hope that one day you would put her feelings before her career." He continued.

Ethan squirmed somewhat over the memories.

"But you didn't." Tobias added. "So that made it possible for someone like me to come into the picture and give her what she wanted."

Ethan swallowed, eyes lowered to the table.

"I'm only saying this so that you understand how serious I am about her." Tobias got to his feet and pulled his coat on. "I know if I screw up, you'll swoop in and take her away from me."

Ethan stood up and met his eyes.

"You're damned right I will." He vowed. "I now know what it feels like to see her with someone else. I won't make that same mistake again if given a chance."

Tobias held his hand out to him.

It seemed that at long last they understood each other.

Without hesitation, Ethan took it and shook his hand.

"Knowing there's someone like you waiting and able to win her heart," Tobias told him, "makes me all the more determined to never take a second with her for granted."

"You better not." Ethan replied.

"I won't." Tobias promised while pulling his hat and gloves on. "I'll see you in a couple of days."

He made his way to the door.

"Be careful out there." Ethan called out. "I don't want to have to send an ambulance out in this to save your sorry ass."

Tobias burst out laughing, hearing the familiar teasing tone that had once been between them.

"Who says I need an ambulance when you can rig one of your sailing gurneys to come get me?"

He waved goodbye. Tobias glanced back and saw that after all this time, Ethan was actually smiling at him.

#choices open heart #tobias carrick x f!mc #tobias carrick #oh ethan ramsey #choices oh #choices fan fic #choices fic writers creations #valentine's day #prompt asks #open heart fanfiction

[schizopositivity]

how do you deal with knowing you need medication but not trusting the pharmaceutical industry?

i.e. “they just want to make us sick so we keep buying medicine, it’ll just harm & give me brain damage”

i have a few different ways i can answer this, so ill just say them all so you can have options on what feels nice for you to think about (also i wanna say this is a totally valid fear and you should never be ashamed to express this idea to the people in your life).

•the pharmaceutical industry is highly regulated, everything must be approved before going out to the public through clinical trials that prove the med is more affective than placebo.

•most meds are adminsitered by drs and pharmacists, who are real people that usually care about helping other people and theres so many of them, you would think if any had a reason to doubt meds as a whole they would say something or quit.

•there are countless real testimonies of real people saying how meds have worked for them and improved their lives.

•for me personally meds were life changing, specifically antipsychotics, i couldnt function or surivive well without them, since being on them for years i have such a greater quality if life and thats why i stand by meds.

•not all meds are needed for your whole life. ive known plently of people who have been on antidepressants or different meds that over time didnt need them anymore or even drs suggesting they stop them because they can be fine without them. if they wanted to keep you on meds to keep you sick they wouldnt do that.

•some meds youll just have to be on for the rest of your life, not because they dont work, just that the symptoms it helps with will always be there and will always need managing. some people need to be on medication to even just survive, if it werent for the meds theyde be far worse off. and for me ill always be schizophrenic, ill probably always need to be on antipsychotics because they improve my life a lot and without them i wouldnt be able to function.

•not all meds cost money. it really depends on your income level and where you live but for me, im on my states low income free insurance that covers the cost of all my meds. i have not paid any of my own money for medication. i wish meds could be free for everyone obviously but sadly the reality is its not. but not all people on medication (especially in other parts of the world) pay for their meds with their own money.

•this can be a dangerous mindet to have and hold true, because where does it stop? this mindet could lead to you not taking antibiotics for an infection and it getting much worse, or not taking life saving meds, or not taking meds that prevent things form getting worse, or keep you from getting vaccines for preventable diseases. i say all this not as an abstract i know people personally who think this way and reality hit them hard during the pandemic (like someone i know irl didnt get the vaccine and then got sick and had to be hospitalized for weeks to stay alive, if the industry wanted them sicker they wouldnt create or give out vaccines for free).

i know it can be hard to believe in something like this, but your health is the most important thing, and if meds can help you than thats what matters. not all meds work the same for everyone so if you do start meds make sure to meet with your perscriber regularly so they can change doses or change meds to find the right fit for you.

#answered #tw meds #medication #pharma #big pharma #big pharma consipracy #tw big pharma consipiracy

[luxlightly]

Well, the 3 months worth of pills they found at my pharmacy that were the right brand are now all gone. So the only stuff I can get is the brand that does not work for me. My insurance refuses to cover name brand and the pharmacy is no longer stocking the off brand that worked.

So now I do not have medication that affects me. I might as well take sugar pills for all these do for me. I can try to pay out of pocket for name brand but I doubt I can afford that. I don't know if rite aid can give discounts on name brand.

Uggghhh. What a nightmare. I honestly don't really know what to do about it. Insurance has made it very clear they will not cover any other brand and I don't really want to change medications entirely. I'm already running out of depression medications I haven't developed a resistance to.

[wanderingguest]

i need to be real for a bit and i want to warn y'all upfront that I'm going to talk about my mental health struggles.

so, please take care of yourselves first. if you find those topics triggering, please don't read this post. i don't want anyone to read this who might feel like they aren't in the place to do so. take care of yourselves, babies.

my mental health has genuinely been suffering over the past few months. not just depression, but a major depressive episode. one that's only been made worse by not being able to provide any sort of christmas for my kiddo this year. most days, i am hanging on by a thread. some days, it feels like i'm drowning and i can't even save myself.

now, i would never harm myself. i've got a child and, even if i'm not the best mom, i would never leave him with that. it does not mean that i haven't thought about it. i have. i've been in such a dark place that i've thought he would be better off without me. in some ways, he probably would, but he's my kid and i love him. i'm not putting him in that position.

that dark place has affected every part of my life. yes, i know therapy could help, but i can't afford it and my insurance only covers a tiny part of it. as it stands, i have medical bills that are piling up and i have things like meds and oxygen that i have to be on just to survive. taking on another bill for therapy isn't possible right now.

i'm doing everything i can to drag myself out of that dark pit, but i can't pretend that i'm there. being in a place like this makes it hard for me to interact even with the best of friends. i don't want to drag anyone down with me and it's very hard to pretend that everything is good and i'm happy, when the opposite true. most of the time, i have to put that energy into making sure my son isn't miserable and the two jobs i'm now having to hold down. i'm sorry if anyone has felt like i've abandoned them or haven't been a good friend. i will try to do better, but it's going to take time and work.

please understand that this is not me asking for anyone to come to my rescue and it's not me asking for pity. everything got turned upside down a few years back and, since then, it's been a constant struggle. a struggle that i never really openly talk about. i just need to tonight, even if only for a few minutes, say this stuff out loud. talk about how fucking hard everything is and how it feels like i'm never going to feel okay again.

#( .mun ) #depression cw #suicidal ideation tw #personal cw #mental health issues cw