#medical gatekeeping

[spacedocmom]

Doctor Beverly Crusher @SpaceDocMom I truly do not understand why so many doctors in your era seem to hate chronically ill patients so much, enough to body-shame them and/or refuse to diagnose them properly and/or treat them with any degree of consistent care. Why become a doctor only to not care? emojis: black heart, blue heart, masked 2:24 PM · Mar 15, 2024

#star trek #doctor crusher #star trek the next generation #star trek tng #star trek memes #support #kindness #care #compassion #health care #healthcare #medicine #bad doctors #medical fatphobia #medical gatekeeping #medical abuse #medical gaslighting #chronic pain #chronic illness #chronic fatigue #spoons #spoonies

[earhartsease]

once again counting the weird blessings of having already transitioned before we got diagnosed as autistic and with ADHD and DID (all in our late 50s) because if it had happened the other way round we'd probably never have "been allowed" to transition

and the irony is it was probably the self-determination involved in transitioning that enabled us to figure out who else we are and to pursue the other diagnoses later

#medical gatekeeping

[incognitoradicale]

personal opinion:

I think gatekeeping through thorough examination and therapy and evaluations to access transitioning measures is important/needed. Informed consent the way I see it in the US is failing, one meetup with a doctor is not enough. I do understand how debilitating dysphoria can be but it is important to not just take what's seemingly best and be as quick as possible, but to sit with those feelings for some time and maybe explore other root causes before going through medical treatment that will inevitably change you irreversibly. I think medical transition should be seen less as a fun side activity but for what it is: medical treatment. And it should be taken seriously as such.

An unnecessary way transition is gatekept through financial stuff,the cost of hormones and surgeries (even in countries with socialised medicine,hailing from Germany here),making it near impossible for poor people to access any care, but this is the only issue I have with "gatekeeping transition".

#trans #detrans #detrans questioning #rad leaning #ftmtf #detransition #transition #questioning transition #transsexual #medical gatekeeping #transmed

[vanilla-voyeur]

I'm not particularly wedded to the assertion that gender dysphoria is not a mental illness. However, there needs to be a distinction between being transgender and having gender dysphoria. They're heavily overlapping circles, but not concentric. Moreover, the most effective treatment we have for gender dysphoria is transition. Conversion therapy doesn't work. It might be worthwhile to concede the point that gender dysphoria is a mental illness and focus on how that still doesn't justify transphobia and medical gatekeeping.

#Transphobia #gender dysphoria #mental illness #Conversion therapy #Medical gatekeeping #Trans healthcare #gender affirming care

[chishiyashoodie]

Really considering changing my url to chishiyasscrubs lmfao

#nijiro murakami #chishiya #aib chishiya #shuntaro chishiya #alice in borderland #chishiya shuntaro #aib #literally just created a side blog with that name so nobody steals it lmfao #medical gatekeeping

[amagurith]

god sometimes (a lot of times) i get so angry about the medical gatekeeping/fatphobia combo the dutch trans healthcare system operates on

‘oh, you want potentially life-saving gender affirming surgery? sure! wait... you’re fat? nah, not for you’

i could’ve had top surgery years ago if not for this one little bmi rule. i wanna scream and cry about it

#trans #transgender #medical gatekeeping #fatphobia #'oh you've had horrible dysphoric feelings about your chest since they started growing?' #'well you're fat so good luck with that'

[vergess]

An adult human in my vicinity went for ADHD dx. She had a call that had a lot of standard ND screening questions and got a prescription for both Wellbutrin and Zoloft, and told that she needed acomputer test for a proper diagnosis and actual ADHD meds, plus blood work. Is that normal? Do you know anything about antidepressants and ADHD?

I mean, it's definitely normal, yes. Whether it's good is much more debateable.

But it's extremely normal, because we live in a fuckign hellscape and the government in this country likes to arbitrarily gatekeep life saving medications like pain relief and stimulants to prove they're "tough on drugs" even though it literally makes the problems of addiction, street drugs, and overdose related death much much much MUCH WORSE.

/ahem

Anyway, it's very normal for a medical practice to either say outright "we don't treat ADHD here at all sorry" or to put access to stimulants behind a bunch of weird obtrusive hoops. For example, I have to go to my doctor every three months for a physical, a mental health screening, and to sign a stupid fucking contract that says I'm Contributing To Society In The Legally Mandated Ways before I am allowed to get the medicine that literally allows me to feed myself or clean my own body.

The computer screening in particular sounds Very Legit to me, because a lot of the time they're going to end up using the same diagnostic exam you can fucking take online, but monitoring you while you do. Advise your friend to always describe their most extreme ADHD symptoms when taking the screener. If they've ever "forgotten an important work task" she needs to put that she constantly forgets them, like the maximum fucking amount. Stuff like that.

Okay the actual question now.

Wellbutrin+Zoloft is a common enough treatment for ADHD when your doctor is averse to stimulants for whatever reason. In a normal society, this would be "because you have a history of heart problems or have tried stimulants and found them unhelpful," but we don't live in that world. It's what's called a second-line treatment, which basically means it's supposed to be tried second, after first-line (stimulants) have failed.

ADHD is generally believed at this point to be a fault in the way neurotransmitters bind to neurons in the brain. They take 'too long' to bind, and end up getting cleaned up instead of transmitting their message. Since the cleanup system is being constantly triggered, you also make less of these neurotransmitters since there's an apparent oversupply. (This is a WILD oversimplification)

Stimulants cause you to make more neurotransmitters, bringing production up high enough that the transmitters have a chance to bind before the overzealous cleanup systems eat them.

Wellbutrin slows down the cleanup process of one neurotransmitter (noradrenaline, I believe). Zoloft slows down the cleanup of a different one (serotonin). So, they're often prescribed in concert.

But, they literally cannot help you produce more neurotransmitters so they fundamentally have limited overall utility in ADHD. Not no utility. Plenty of people who cannot take stimulants find this combination adequate to live with.

But in almost all cases stimulants will work fucking better.

The fact that our goddamn War On Drugs bullshit has made it this difficult to get them is disgusting and is also specifically the fault of Joseph Robinet Biden, who takes great personal PRIDE in having created this medically destructive hellscape during his pre-presidential career and now seems to take great joy in doing nothing to clean up his own goddamn mess.

Okay so!

Yes, SSRIs, NDRIs, and other reuptake inhibitors (cleanup slowdowners) are definitely An Option for ADHD, but they're SUPPOSED TO BE A SECONDARY OPTION FOR A FUCKING REASON AUGH

ETA: You can also be prescribed secondline treatments in addition to firstline ones, if you for example need stronger management of symptoms, etc etc there's a lot of nuance this is a rage fuelled over simplification.

#Medical ableism #medical gatekeeping #war on drugs #Fucking god fucking damn it #My doctor is relocating to a larger town btw #And the nurse replacing him is 'willing' to fill my prescriptions for the 3 months on my latest checkup #BUT THEN WHO KNOWS ITS A REAL MYSTERY #FUCK YOU JOE FUCK YOU ENTIRELY DROP DEAD YOU FUCKING FILTH MONGER

[sgt-papricka]

remeber reaching out to this girl who was diagnosed adhd as a kid and asking her how she got the diagnosis because i think i might have it and she was like "you can't have adhd because you like reading and i can't concentrate long enough to read a book therefore you don't have it"

#adhd #actually adhd #medical gatekeeping #dont gatekeep

[cobwebbed-crow]

Conversations With Doctors

"Why are you here? What services do you seek?"

"I outgrew my body. I seek medication to correct that."

"But you claim not to be a man or a woman? How is this possible?"

"..."

"Right, moving on then, from what age did you know?"

"From what age? I'm not sure."

"Were you abused as a child?"

"I don't see how that's relevant."

"Do you want to have a penis?"

"Not particularly."

"A real man should want a penis. Are you sure you aren't just faking it for attention?"

"I'm neither a faker nor a man."

"Would it be accurate to say that everyone sees you as a woman?"

"Yes."

"Interesting. I'm noticing that you don't seem all that distressed by this. I think you might just be confused. I'm going to send you to a therapist."

"But I have already seen a thera—"

"Right then. Go see a therapist. If these feelings persist after 26 weeks of therapy then you can get a referral back here from your doctor. Though, in my professional opinion, someone like you won't need to come back."

#queer #nonbinary #original post #ftnb #poetry #queer poetry #trans #medical gatekeeping #original poetry #poem #transgender #poetry on tumblr #trans poetry #poems on tumblr #enbyphobia

[aronarchy]

That person arguing about the transx thing is either coming from a privelleged mindset or doesn't know as much about things as they think they do.

I have had multiple professionals agree that I have things going on, but getting a single diagnosis would cost thousands of dollars and I am in poverty. Getting any of the diagnosis that I want would also put me at a structural disadvantage even if it did allow me to access disability support.

Therapists aren't always safe either, because they can be total inconsiderate assholes.

Ugh.

.

#ask #anon #self dx #self diagnosis #pro self diagnosis #self diagnosis discourse #self dx discourse #capitalism #medical gatekeeping #medical malpractice #psych critical #therapy critical

[spacedocmom]

Doctor Beverly Crusher @SpaceDocMom One of the worst things a health care worker can do is make a patient regret having asked for help in the first place. I have so much sympathy for the many patients in your era who are routinely made to feel this way. emojis: black heart, blue heart, masked 1:48 PM · Jan 12, 2024

#star trek #doctor crusher #star trek the next generation #star trek memes #star trek tng #kindness #support #care #compassion #health care #healthcare #medicine #medical gaslighting #medical gatekeeping #medical stress #chronic illness #chronic pain #chronic fatigue #disability #spoonies #spoons

[mermaidair]

The other all American sport all over those MDs sexism

#rebecca cooper #plagiarism #can y’all murder the evil MDs killing folks already? #medical gatekeeping #medical doctors in usa being killed by peterson #hopefully the DEA kills the bad doctors

[vanilla-voyeur]

The massive wave of anti-trans bills in the US this year are mostly terrifying. But there's also an element of frustration because all of these bills are NEW. THEY'RE NEW! THEY DIDN'T EXIST BEFORE!

We need to pass a bill to ban trans women from going into the women's bathroom or else they'll do something bad in the future. We need to pass a bill to ban trans women from playing women's sports or else they'll do something bad in the future. We need to pass a bill to ban trans minors from receiving gender affirming care or else something bad will happen.

No! No it won't! It demonstrably won't. If it could do that it already would've done that. These things have all been legal.

It's not opening up thorny new issues about who belongs in women's sports. This problem has already been solved. We need to go back to the real past. Not the imagined past that the reactionaries want to make real.

#Transphobia #Bathroom bills #womens sports #medical gatekeeping #Which is not to say that the past was idyllic for trans folks #But there wasnt all this new stuff that people keep adding on

[performing-personhood]

The line between "hypochondria" and "trying to figure out what the fuck is wrong with my electric meat sack without going bankrupt" is blurry and shifting in ideal conditions

If you have family in the healthcare industry, however, an accurate self diagnosis is actually impossible and you'll be condescended to the entire time.

Despite my frustration, having spent twenty years dealing with The Public���️ I completely understand why this is necessary. But boy does it fucking suck to feel like nobody believes me.

#how does anyone know whether their lived experience is normal or abnormal #its not like i can experience what is considered normal for someone else #please do not talk down to me #i do a lot of reading and i cannot tell if that is helping or hurting my cause here #but for a person with a severe inferiority complex it feels really bad when i am condescended to #i already know i am dumb #can you please pretend to take me seriously a little more convincingly please #the problem with the healthcare industry #medical gatekeeping #diagnostic gatekeeping

[bananacuts]

The Debbies, the morons gaslight the worst

Over being wrong

Stop trying to be the Md

Unless you have a uti… pyridium should be safe daily

Why not?

Well, according to what it does. But she’s still wrong either way. Ish.

#medical networking to save lives #aprn #nurse trashy trash #baby animals #danger: ego #pyridium #estrogen production #medical gatekeeping #jealousy #nerve damage #stop that drama lie racism white woman trash

[geneticautismloaf]

V and those followers of hers want Patel and those money

That lady wants to be me so badly

Racists and they are in hell.

Fatties in hell

You’ll stay there

But I won’t :)

Well I’m never going to TJ ever again the stupidity and blank stares

But they will remain in hell

#medical gatekeeping