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my-darling-boy · 3 years

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i am non binary and eventually want top surgery. i can't get it yet bc i'm a minor and i can't come out to my parents, but i'm gonna be 18 soon and have a question. if i want to get top surgery, do i need to tell the truth about it? like, do i have to come out and say the true reason behind it, or can i say it's for another reason? and what would be easier in the end? i'm really scared of having to be out like that to get surgery

Sorry for the length of this!

Some trans people give false reasons to their family for wanting top surgery, and this can be the case if you’re using parents’ insurance and don’t want them to know what you’re using it for. The problem with this is that if you don’t cover your tracks with the lie, your family can still find out, especially if you still live with them. While being over 18 (at least in California where I live) prohibits your family from accessing your health info because you are now legally an adult entitled to confidentially, it doesn’t stop them from opening up mail from health insurance or surgeon offices that arrive at the house. While the mail I was sent states my approved procedures were “Bilateral Masectomy” and nipple grafts, it CLEARLY states under the diagnosis section on the front page “female to male” and “Transsexualism”, regarding the diagnosis of gender dysphoria I needed for the surgery. If a parent doesn’t know you’re non-binary and they go digging through your mail, there is always he possibility they may see words related to the surgery being gender related.

For the medical setting, it’s much trickier to do completely in the closet. For top surgery, most places around the world—with some exceptions—require one or more of the following for insurance/medical reasons: a recent written and signed diagnosis of gender dysphoria from a licensed therapist, signed and written proof of hormone replacement therapy for X amount of time from either a physician or endocrinologist, having lived at least 1+ years socially using the name/pronouns you intend to use, or statements from close family members and/or friends that you exhibit dysphoria or that you have been living socially with the name/pronouns you intend to use. Those are the typical ones I’ve seen, but because surgeons/laws/and insurances or medical groups have varying definitions of what grants one permission for the surgery, it can vary wildly from person to person, and what can complicate this further is that insurance and surgeons will have different criteria you need to abide by. Some surgeons are very relaxed and will simply give you the surgery provided they deem you medically fit while your insurance company says you need dysphoria and Hrt for them to cover it. Which brings me to my next point.

A bilateral/double mastectomy is deemed a “cosmetic or non-essential surgery” by most insurances (unless you are a cancer patient, at least in the US) which means insurances don’t like to cover all of the cost. I’ve seen this procedure range from $3,500 all the way to $18,000. The average price is $5,000-$10,000. I don’t remember the cost of my overall surgery, but I know my office consult alone was $1,200. Using my parents’ insurance, I only paid $15 copays. The only way to get my insurance company to cover what could have been a $10,000 surgery was to make them see it was “necessary” and this is why they require the dysphoria diangosis. While I don’t believe you need dysphoria to be trans or have top surgery, unfortunately insurance usually asks for it (“dysphoria” for an insurance company basically tells them you have a mental health issue that is negatively impacting your life and the surgery is needed to correct the dysphoria). With this in mind, it might be near impossible to get coverage for a bilateral masectomy coupled with chest contouring while in the closet to everyone, unless you’ve had a serious medical condition such as cancer since “restoring a breast isn’t considered a cosmetic procedure. It’s reconstructive surgery. Since it’s considered part of the treatment of a disease, the law says insurance providers must provide coverage.” (x) Alternatives would be chest liposuction, however liposuction is still cosmetic and therefore probably not eligible for full, if any, insurance coverage and there are zero ways for chest contouring or nipple resizing.

And which route is easier? In my own opinion, if you’re not comfortable going behind your family’s back or you need their insurance, you might need to tell them the truth, provided you feel in a position to talk about it with your family, and I only say this cos there can be instances where not telling them the whole truth can have consequences for you in the end. Some trans people report issues where coverage was denied after they got the surgery and have to give a $6,000 bill they can’t pay to their parents, letters show up to the house referencing being trans and parents can open these and read them, and an insurance company or surgeon may need written proof from family members that you have been living under x name/gender for x amount of time to provide coverage or surgery. If you’re fine hiding the process from your parents and using your own insurance or paying out of pocket, then that’s an option. But the situation can get sticky if you pursue surgery and are still living at home or have lgbtq-phobic parents and need to hide any evidence of what the surgery is for. I understand coming out is a Huge Thing, but the unfortunate part about this sort of surgery is it can be impossible to go about it trying to conceal all your intentions. And from what I’ve been able to gather during my own process, it doesn’t appear to be possible to go through with this procedure and have it all covered by insurance without mentioning gender.

Again, I’m only speaking from the perspective of someone who lives in California and had my own set of experiences dealing with the hurdles of insurance and the process in general, so if anyone knows it’s different somewhere else or how you could do this in the closet to either family or to doctors, you’re welcome to add! I’m afraid I’ve never run into anyone who went through with surgery completely in the closet with everyone involved. The systems in place for this are based off an outdated binary “male or female” scales, which can make things uniquely difficult for non-binary people to obtain care.

You may find this article particularly helpful about receiving surgery specifically as a non-binary person.

TLDR; successfully acquiring top surgery while completely in the closet to your family or medical staff/insurance groups would be very difficult in most circumstances unless you go completely behind your family’s back and/or bring attention to your gender identity in a medical/legal setting.

#long post #trans health #non bianry #ftm #ftnb #top surgery #surgery mention

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comrade-meow · 3 years

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Bad data generates bad research; bad research generates bad treatments; bad treatments generate bad outcomes. The physiological differences between males and females are vast, and stamp their mark on every organ of the human body, not just the genitals and gonads. Ignoring these differences will muddle our data, blur our understanding of physiology, and hinder the discovery of new treatments for diseases. Females are much more likely than males to have autoimmune disorders. Males are more likely than females to develop Parkinson’s disease. Males and females may present with different symptoms preceding a heart attack. Males and females metabolize drugs differently. Blatantly ignoring sex as a variable hobbles the process of scientific inquiry and limits the types of questions that researchers will ask, thereby limiting the answers they get.

About this story: last November I came across some anonymous tweets from a person claiming to be a medical student at an American university where professors were teaching that sex is a social construct. I decided to try to find out if these claims were real, and I contacted the Twitter user, striking up a conversation with “C”. We agreed to meet on a Zoom call, and that C would show me C’s student ID, with their name and the name of the school covered, and that we would then do a written interview. C’s desire for strict anonymity is well founded in my eyes, due to the damage that could be inflicted on C’s career prospects if they were caught speaking to a publication about the ideological lies being peddled and the culture of fear at their institution.

On our thirty minute Zoom call, I met a highly intelligent, critical-minded, and determined young person who was expressing deep concern over the ways that gender identity ideology is distorting the teaching of medicine and the repercussions this may lead to in our next generation of doctors.

C held up their ID so I could see their picture on what was clearly a medical school ID. C told me their school can be categorized as “top tier.”

The irony of using “they/them” pronouns for a single person is not lost on me. I find it interesting that due to the tyranny of gender ideology, I must adhere to one of their tenets and accept the use of the plural pronoun for a single person whose sex I know. But the fact that I have to do this is because any information about C could potentially be enough to raise suspicion (just read their words to understand the climate of intimidation they witness in class everyday), and the knowledge of an individual’s sex is still a crucial identifying feature, no matter what the gender ideologues want us to believe.

C and I agreed that I would offer people on Twitter an opportunity to pose their questions directly and that C would respond in written form. Out of the many responses, the medical student chose what they considered some of the most representative and important of the questions. These are their answers below, beginning with a short message they wanted me to share.

-Sasha White

Thank you, Sasha, for having offered me this valuable opportunity to answer these questions. Before we start, I would like to clarify my stance on basic issues regarding sex and gender identity, so that people can keep these in mind while reading.

Biological sex is not a social construct – male and female are distinct material realities which have significant implications for medical and surgical treatment of many different conditions. These physiological differences are relevant on the levels of clinical practice, research, and policy, and absolutely must be acknowledged in order for physicians to best treat their patients. All patients should be treated with compassion, respect, and high-quality medical care, regardless of their professed gender identity. I remain agnostic as to what it truly means to have a “gender identity”, but will respect the wishes of my future patients in regards to their social presentation and pronouns. I believe that dysphoric adults should be able to pursue transition. Physicians should be aware of relevant aspects of trans healthcare, including hormone therapy and surgery, so that they can better advise trans patients on how medical treatments may impact their gender-related care, or vice versa. It is possible and desirable for us to have a healthcare system which is inclusive and respectful of transgender patients, in a way which does not pretend that biology is arbitrary or merely a social construct. Despite my liberal beliefs, the loudest voices at my institution would falsely accuse me of blowing transphobic dog-whistles, hence my anonymity. This hostile climate is corrosive to an inquiry mindset and critical thinking, and will ultimately be a disservice to the scientific community and to future patients, trans and otherwise.

IDD64 @IDD64 asks: “What happened to “nobody’s saying sex isn’t real”?”

This is actually what compelled me to speak out about this practice in the first place. Well-intentioned non-medical people often assume that medical schools are teaching something like, “Gender identity can be fluid and varied, but biological sex is real, binary, and relevant in medical contexts.” This idea is around five years out of date in the most progressive of institutions. I have been told multiple times in several classes that biological sex is a social construct – not just gender. Granted, I can speak only for my institution, but this change has been frustrating and disturbing to witness.

Robert Woolley @RandomlyBob asks: “Do any of the required textbooks also avoid using those words? If not, might you ask those professors if they think the books are either inaccurate or offensive?”

Our curriculum is constantly subject to revision. Around two-thirds of our written materials have been updated with this new language. For the one-third that has remained out-of-date, our class has received multiple apologetic, itemized emails from course instructors in which they provide corrections, beg for forgiveness and patience, and avow to “do better”. In class, we have been given multiple histories in which the patient’s sex has been deleted, even for cases involving disorders which can manifest differently between the sexes. The words “female” and “male” are being erased and replaced.

Born a space baby @ggynoid asks: “What’s the dynamic like for class participation? Do people start with pronouns? Do people tend to agree, disagree? What’s the female-male ratio in the class typically on these sort[s] of classes?”

When school first began, we were heavily encouraged to include pronouns in our Zoom names and email signatures; around 70-80% of the class did so. Most students and professors would start off verbal introductions with their name and pronouns, though that has subsided since we all have grown to know each other.

A vocal minority of students are loudly in favor of the most extreme aspects of gender ideology, while the majority seem to be vaguely supportive in a nonspecific way. I think that this comes from a mixture of naive goodwill and fear – they are trying to be good allies, and this is the only way they know how. Additionally, it is heavily implied that to ask critical questions, even in a way which is ultimately patient-centered and supportive, is perpetuating bigotry, so they just nod along. A silent minority seems to be secretly skeptical. I have met four or five students who have disclosed to me in private conversation that they disagree with one or more aspects of this dogma but they are hesitant to come forward in group settings. I am sure that more exist, but they are hard to find. None of these people have been transphobic.

The female-male ratio is approximately equal, with slightly more females than males in my class.

David Poole @MrDPoole asks: “Do you think the people telling you these things actually believe it or are they being forced to do it?”

I think that a very small minority of our professors actually believe that male and female bodies are interchangeable with the exception of genitalia and gonads. There are definitely more woke students than woke professors, and the most radical of students are far more radical than the wokest professor. Most of these professors are very fearful of saying the wrong thing, so they delicately couch their language by referring to “XX and XY people” or other such euphemisms, even though that can lead to inaccuracies.

The social consequences for misspeaking are highly magnified, especially when most classes are delivered online (due to the pandemic). Our class has been quietly accused of having a mean streak in regards to social justice. We have had petitions circulated (drafted by few, signed by many) to name, shame, and “hold accountable” various lecturers who used the “wrong” language, to the point of humiliation. One professor broke down crying after a genetics lecture which relied heavily on the use of “male” and “female” by necessity. (Though the lecture also made ample space to talk about transgender and non-binary individuals, this was not enough to appease the critics.) Another professor referred to “pregnant women” rather than “pregnant people” and spent a very uncomfortable few minutes after class abjectly apologizing for having caused offense “by implying that only women can get pregnant”. It was incredibly disturbing to see, for multiple reasons. One, this is based on bad science and zealotry that has the potential to harm patients. Two, the magnitude of the “crime” pales in comparison to the magnitude of the outcry. Three, it is a total inversion of the expected social order to see these physicians —some of whom are literally leading scholars in their field— be reduced to fearful puddles if a student so much as looks at them askance. Keep in mind that these professors are extremely liberal, compassionate, and well-meaning, yet they are turned upon with such venom and verve by the people who they are trying to please.

Chopper @RodeoChopper asks: How are cases presented? Normally the first line is “This is a such and such year old (male/female) with a past medical history significant for…”

Here are some examples of formats I have seen in our coursework:

“This is a 43-year-old woman with ovaries, presenting with …”

“A 3-year-old child, assigned male at birth, not assigned gender as of yet by parents, presenting with …”

“This patient is a 7-year-old child, gendered as a boy by his parents, who …”

“57-year-old woman with testes, here with …”

“A 16-year-old patient (gender non-binary, pronouns they/them) …”

“A 32-year-old woman (she/her/hers) …”

“A 16-year-old patient presents with complaints of …”

Of the myriad problems with this structure, the most concerning is that most of these cases do not accurately identify the sex of the patient, which is crucial in being able to weigh the likelihood of potential diagnoses and treatments. A person’s pronouns are not relevant when deciding to prescribe a particular antibiotic, and at which dose. Additionally, I find it somewhat irritating to be expected to state the obvious for things that are the default of the human experience. We do not say, “This is a 42-year-old woman with both her arms and legs”, although there are certainly women in this world who are missing one or more of their limbs.

MaryWrath @WrathMary asks: “So how are reproductively different bodies described then? How are cardiac arrest and stroke symptoms described, explained and taught as we know now they present differently across the two sexes? There are clearly two bodies in our species so how are the professors acknowledging?”

Organs are referred to by their actual names – penis, testes, vagina, ovaries, breasts. However, referring to patients as male or female is strictly taboo. If there are relevant but subtle sex-specific differences, then they will often be downplayed or ignored altogether. As an example, we were told that the higher risk of heart attacks in men was due only to the presence of testosterone, and not for any other reason, which is patently false. When the differences are utterly impossible to ignore, “male” and “female” will simply be rebranded as “people with testes/ovaries”, “AMAB/AFAB”, or “people with/without Y chromosomes”. My personal favorite is “persons with [testosterone/estrogen] as their primary sex hormone.” Oddly, “man” and “woman” are still used, often with redundant qualifiers (“56-year-old man with testes”).

thames pilgrim @thames_pilgrim asks: “What are the most dangerous medical implications for turning a blind eye to someone’s sex due to a belief that talking about “male” and “female” might offend?”

This is a very important question which should be addressed at the following interrelated levels: clinical practice, research, and public policy.

Clinical practice: Transgender patients who do not disclose their birth sex might be at risk for improper medical treatment. (I have seen a natal female person who identified as a nonbinary man, be suspected of having testicular torsion; this person did not disclose their sex to the physician, which resulted in a delay in their care). Out of fear of being branded transphobic, physicians may not accurately and completely inform trans patients about their sex-specific risk for certain medical conditions. And for all patients, if a poorly-educated doctor is unaware as to how disorders manifest differently between the sexes, then patients can be harmed through the failure to rapidly and accurately diagnose and treat their medical conditions.

Research: Bad data generates bad research; bad research generates bad treatments; bad treatments generate bad outcomes. The physiological differences between males and females are vast, and stamp their mark on every organ of the human body, not just the genitals and gonads. Ignoring these differences will muddle our data, blur our understanding of physiology, and hinder the discovery of new treatments for diseases. Females are much more likely than males to have autoimmune disorders. Males are more likely than females to develop Parkinson’s disease. Males and females may present with different symptoms preceding a heart attack. Males and females metabolize drugs differently. Blatantly ignoring sex as a variable hobbles the process of scientific inquiry and limits the types of questions that researchers will ask, thereby limiting the answers they get.

Policy: Patients who are not transgender may be misled by “inclusive” educational materials and miss out on crucial preventative care. This is especially impactful in women’s health; whether due to language barrier, subpar sex education, or cultural taboo, not every woman will even know that she has a cervix, but she will know that she is female. Additionally, recommendations made by professional medical associations are widely used in clinical practice; if these guidelines are generated based on faulty data, this could negatively impact patients on a wider scale.

However, the most pernicious of possible harms is not the denial of sex; rather, the denial of sex is just one manifestation of a greater problem, which is the corrosion of critical thinking itself. Whatever you call it – this postmodern poison, the triumph of dogma over data – it is fundamentally incompatible with critical thinking, the most powerful all-purpose tool a physician has at his or her disposal. Starting with a conclusion and working backwards, all while twisting the data to fit a narrative, strikes me as more religious than scientific.

Marjorie Hutchins @leakylike asks: “Part of being a doctor is taking on ethical & safeguarding responsibilities[.] Why aren’t medical students challenging something which [could] have health implications for patients?”

Our positions as students are precarious, especially if one is labeled as being on the wrong side of history. Consequences for speaking out can include shunning, being anonymously reported to the school for “remediation”, being informally blacklisted from research and leadership opportunities, and potentially expulsion. Until I have earned my degree and have completed residency, I need to remain anonymous. To do otherwise would be to kill my career before it has even begun, which would also limit my ability to help many more patients in the future.

Although I am very biased, I think it should be on the onus of administration and our tenured professors to stand up against this madness, rather than on lone students to publicly put themselves at risk of debt and ruin. For now, I resist in the small ways that I can; I wish to do so more publicly when I am more secure.

#Anglo.txt

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star-anise · 4 years

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An ask I got recently:

hi so i’m a transmed and i’m not sure if you’ll answer this because of that but i saw your post about transmedicalism and was wondering if you could expand on that? you seem like a genuinely kind and judgement-free person, thank you darling x

My response:

Heh, you call me “judgement-free” and ask for my opinion on a topic I’ve formed a lot of judgments about… I get it though, I’m not into attacking people for what they believe so much as providing FACTS. As a cis queer, my insight into transmedicalism isn’t really about the innate experience of trans-ness so much as using my education and professional experience to talk about social science research, diagnostic systems, and public health policy.

This ended up really long, so the tl;dr is, I think transmedicalism as I understand it:

Misunderstands why and how the DSM’s Gender Dysphoria diagnosis was written,

Treats the medical establishment with a level of trust and credibility it doesn’t deserve, at a time when LGBT+ people, especially trans people, need to be informed and vigilant critics of it, and

Approaches the problem of limited resources in an ass-backwards way that I think will end up hurting the trans community in the long run.

TW: Transphobia; homophobia; suicide; institutionalization; torture; electroshock therapy; child abuse; incidental mentions of pedophilia.

So first off I’m guessing you mean this post, about not trusting the medical establishment to tell you who you are? That’s what I’m trying to elaborate on here.

I have to admit, when you say “I’m a transmedicalist” that tells me very little about you, because on Tumblr the term seems to encompass a dizzying array of perspectives. Some transmedicalists believe in what seems to me the oldschool version of “The only TRUE trans people suffer agonizing dysphoria that can only be fixed with surgery and hormones, everyone else is an evil pretender stealing resources and can FUCK RIGHT OFF” and others are like, um… “I have total love and respect for nonbinary and nondysphoric trans people! I qualify for a DSM diagnosis of dysphoria but that doesn’t make me inherently better or more trans than anyone else.”

Which is very confusing to me because according to everything I’ve learned, the latter opinion is not transmedicalism. It’s just… a view of transness that acknowledges current diagnostic labels and scientific research. It’s what most people who support trans rights and do not identify as transmedicalists believe. But I kind of get the impression that Tumblr transmedicalism has expanded well past its original mandate, to the point that if a lot of “transmedicalists” saw the movement’s original positions they’d go “Whoa that’s way too strict and doesn’t help our community, I want nothing to do with it.”.

Okay so. Elaborating on the stuff I can comment on.

1. DSM what?

The American Psychiatric Association publishes a big thick book called The Diagnostic and Statistical Manual of Mental Disorders, called the DSM for short. This is the “Bible of psychiatry”, North America’s definitive listing of mental disorders and conditions. It receives significant revision and updates roughly every 10-15 years; it was last updated in 2013, meaning it will likely get updated sometime between 2023 and 2028.

The DSM lists hundreds of “codes”, each of which indicates a specific kind of mental disorder. For example, 296.23 is “Major depressive disorder, Single episode, Severe,” and 300.02 is “Generalized anxiety disorder.” These codes have information on how common the condition is, how it’s diagnosed, and what kind of treatment is appropriate for it.

Diagnostic codes are the key to health professionals getting paid. If there isn’t a code for it, we can’t get paid for it, and therefore we have very few resources to treat it with. The people who actually pay for healthcare–usually insurance companies or government agencies–decide how much they will pay for each code item to be treated. They’ll pay for, say, three sessions of group therapy for mild depression (296.21), or they’ll pay for more expensive private therapy if it’s moderate (296.22); they’ll pay for the cheap kind of drug if you have severe depression (296.23), but to get the more expensive drug, you need to have depression with psychotic features (296.24).

Healthcare companies, especially in the USA where the system is very very broken and the DSM is written, are cheap bastards. If they can find an excuse not to fund some treatment, they’ll use it. “We think this person who lost their job and can’t get off the couch should pay this $1000 bill for therapy,” they’ll say. “After all, they were diagnosed as code 296.21, and then saw a private therapist for five sessions, when we only allow three sessions of group therapy, and you’re saying they haven’t had enough treatment yet?”

A lot of the advocacy work mental health professionals do is trying to get the big funding bodies to pay us adequately for the work we do. (This is a much easier process in countries with single-payer healthcare, where this negotiation only needs to be done with a single entity. In the USA, it needs to be done with every single health insurance company in existence, as well as the government, sometimes differently in every single state, and then again on a case-by-case basis as well.) Healthcare providers have to argue that three sessions of group therapy isn’t enough, that Medicaid needs to pay therapists more per hour than it costs those therapists to rent a room to practice in, or else therapists would lose money by seeing Medicaid clients. DSM codes exist a tiny bit to let us communicate with each other about the people we treat, and a huge amount to let us get paid. The fact that their existence lets people make sense of their own experiences and find a community with people who share common experiences and interests with them is a very minor side benefit the DSM’s authors really don’t keep in mind when they update and revise different diagnoses.

So when it comes to convincing insurance companies to pay for treatment, humanitarian reasons like “they’ll be very unhappy without it” tend not to work. The best argument we have for them paying for psychological treatment is that it’s economical: that if they don’t pay for it now, they’ll have to pay even more later. If they refuse to pay, let’s say, $2000 to treat mild depression when someone loses their job, and either refuse treatment or stick the person with the bill, then that person’s life might spiral out of control–they might, let’s say, run low on money, get evicted from their apartment, develop severe depression, attempt suicide, and end up in hospital needing to be medically resuscitated and then put in an inpatient psych ward for a month. The insurance company then faces the prospect of having to pay, let’s say, $100,000 for all that treatment. At which point somebody clever goes, “Huh, so it would have been cheaper to just… pay the original $2000 instead so they could bounce back, get a new job, and not need any of this treatment later.”

Trans healthcare can be kind of expensive, since it often involves counselling, years of hormone therapy, medical garments, and multiple surgeries. Health insurance companies hate paying for anything, and have traditionally wanted not to cover any of this. “This is ridiculous!” they said. “These are elective cosmetic treatments, it’s not like they’re dying of cancer, these people can pay the same rate for breast enhancements or testosterone injections as anyone else.”

So when the APA Task Force on Gender Identity Disorder (a task force comprised, as far as I can tell, entirely of cis people) sat down to plan for the 2013 update of the DSM, one of their biggest goals was: Treatment recommendations. Create a diagnosis which they could effectively use to advocate that insurance companies fund gender transition. Like when you go back and read the documents from their meetings in 2008 and 2011, their big thing is “create a diagnosis that can be used to form treatment recommendations.” So that’s what they did; in 2013 they made the GD diagnosis, and in 2014 the Affordable Care Act required insurers to provide treatment for it.

A lot of trans people weren’t happy with the DSM task force’s decisions, such as the choice to keep “Transvestic Fetishism,” which is basically the autogynephilia theory, and just rename it “Transvestic Disorder”. The creation of the Gender Dysphoria diagnosis, basically, was designed to force the preventive care argument. They didn’t think they could win on trans healthcare being a necessity because healthcare is a human right, so they went with: Trans people have a very high suicide rate, and one way to bring it down is to help them transition. One of the major predictors of suicidality is dysphoria. The more dysphoric someone is, the more likely they are to attempt suicide (source). Therefore, health insurers should fund treatment for gender dysphoria because it was cheaper than paying for emergency room admissions and inpatient psychiatric hospitalizations.

I have spoken to trans scientists about what research exists, and my understanding is: The dysphoria/no dysphoria split is not actually validated in the science. That is, when you research trans people, there is not some huge gaping difference between the experiences, or brains, of people With Dysphoria, and people Without Dysphoria. Mostly, scientists haven’t even thought it was an important distinction to study. The diagnosis wasn’t reflecting a strong theme in the research about trans experiences; that research showed that trans people with all levels of dysphoria were helped with medical transition. The biggest difference is just that dysphoria is a stronger risk factor for suicide. Experiencing transphobia is another strong risk factor, but that’s harder to measure in a doctor’s office, so dysphoria it was.

(I’ve seen some transmedicalists claim that dysphoria’s major feature is incongruence, not distress. And I’ll just say, uh… in psychology, “dysphoria” is the opposite of of “euphoria”, literally means “excessive pain”, and is used in many disorders to describe a deep-seated sense of distress and wrongness. As a mental health professional, I just can’t imagine most of my colleagues agreeing that something can be called “dysphoria” if the person doesn’t feel real distress about it. If you want a diagnosis that doesn’t demand dysphoria, you’d need Gender Incongruence in the upcoming version of the ICD-11, which is the primary diagnostic system used in Europe, published by the World Health Organization.)

2. Doctors are not magic

Medicine is a science, and science is a system of knowledge based on having an idea, testing it against reality, and revising that knowledge in light of what you learned. We’re learning and growing all the time.

I don’t know if this sounds painfully obvious or totally groundbreaking, but: Basically all medical research is done by people who don’t have the condition they’re writing about. Psychology has a strong historical bias against believing the personal testimonies of people with conditions that have been deemed mental disorders, so researchers who have experienced the disorder they’re writing about have often had to hide that fact, like Kay Redfield Jamison hiding that she had bipolar disorder until she became a world-renowned expert on it, or Marsha Linehan hiding that she had borderline personality disorder until she pioneered the treatment that could effectively cure it. Often, having a condition was seen as proof you couldn’t actually have a truthful and objective experience of it.

So what I’m trying to say is: The “gender dysphoria” diagnosis was written and debated, so far as I can tell, by entirely cis committee members. The vast majority of psychological and psychiatric research about LGBT+ people is written by cisgender heterosexual scientists. Most clinical and scientific writing has been outsider scientists looking at people they have enormous power over and making decisions about their basic existence with very little accountability.

And to show you how far we’ve come, I want to show you part of the DSM as it was from 1952 to 1973. It shows you just why so many older LGBT+ people find it deeply ironic that now the DSM is being held up as definitive of trans experience:

302 Sexual Deviation This category is for individuals whose sexual interests are directed primarily toward objects other than people of the opposite sex, toward sexual acts not usually associated with coitus, or towards coitus performed under bizarre circumstances as in necrophilia, pedophilia, sexual sadism, and fetishism. Even though many find their practices distasteful, they remain unable to substitute normal sexual behavior for them. This diagnosis is not appropriate for individuals who perform deviant sexual acts because normal sexual objects are not available to them.

302.0 Homosexuality 302.1 Fetishism 302.2 Pedophilia 302.2 Transvestitism […]

Yes, really. That is how psychiatry viewed us. At a time when research from other fields, like psychology and sociology, were showing that this view was completely unsupported by evidence, psychiatry thought LGBT+ people were fundamentally disordered, criminal, and incapable of prosocial behaviour.

My favourite retelling of the decades of activism it took LGBT+ people and allies to get the DSM to change is from a friend who did her master’s thesis on the topic, because she leaves in the clown suits and gay bars, which really shows how scientific and dignified the process was. The long story short is: It took over 20 years of lobbying by LGBT+ people who were sick and tired of being locked up in mental institutions and subjected to treatments like electroshock training, as well as by LGBT+ social scientists, clinicians, and psychiatrists, to get homosexuality declassified as a mental illness. And that was homosexuality; the push to change how trans people were listed in the DSM is very recent, as seen in the latest version listing “Transvestic Disorder”, a description very few trans people ever use for themselves.

Here are a few more examples of how people with a condition have had to take an active part in the science about them:

When HIV/AIDS appeared in the USA, the government didn’t care why drug addicts and gay people were dying mysteriously. Hospitals refused to treat people with this mysterious new disease. AIDS patients had to fight to get any funding put into what AIDS is, how it spreads, or how it could be treated; they also had to campaign to change the massive public prejudice against them, so they could be treated, housed, and allowed to live. Here’s an article on the activist tactics they used. If you want an intro to the fight (or at least, white peoples’ experience of it), you could look into the movies How to Survive a Plague, And the Band Played On, and The Normal Heart.

Chronic Fatigue Syndrome (CFS) is a little-understood disease that causes debilitating exhaustion. It’s found twice as often in women as men. Doctors understand very little about what it is or why it happens, and patients with CFS are often written off a lazy hypochondriacs who just don’t want to try hard. There are basically no known treatments. In 2011, a British study said that an effective treatment for CFS was “graded exercise”, a program where people did slowly increasing levels of physical activity. This flew in the face of what people with CFS knew to be true: That their disease caused them to get much worse after they exercised. That for them, being forced to do ever-increasing exercise was basically tantamount to torture, so it was very concerning that health authorities and insurance companies began requiring that they undergo graded exercise treatment (and parents with children with CFS had to put their children through this treatment, or lose custody for “medical neglect”). So they investigated the study, found that it was seriously flawed, got many health authorities to reverse their position on graded exercise, and have made strides into pointing researchers to looking into biological causes of their illness.

Amyotrophic lateral sclerosis (ALS) is a rare but debilitating disease that isn’t researched much, because it affects such a small portion of the population. The ALS community realized that if they wanted better treatment, they would need to raise the money for research themselves. In 2014 they organized a viral “ice bucket challenge” to get people to donate to their cause, and raised $115 million, enough to make significant advances in understanding ALS and getting closer to a cure.

A common treatment for Autism is Applied Behaviour Analysis (ABA), which is designed to encourage “desired” behaviours and discourage “undesired” ones. The problem is, the treatment targets behaviour an Autistic person’s parents and teachers consider desirable or undesirable, without consideration that some “undesired” behaviours (like stimming) are fundamental and necessary to the wellbeing of Autistic people. Furthermore, the treatment involves punishing Autistic children for failure to behave as expected–in traditional ABA, by witholding rewards or praise until they stop, or in more extreme cases, by subjecting them to literal electric shocks to punish them. (In that last case, they’ve been ordered to stop using the shock devices by August 31, 2020. That only took YEARS.) Autistic people have had to campaign loud and long to say that different treatment strategies should be researched and used, especially on Autistic children.

So I mean… I get that the medical model can provide an element of validation and social acceptance. It can feel really good to have people in white coats back you up and say you’re the real deal. But if you get in touch with most LGBT+ and transgender groups, they’d say that there’s still a lot of work to be done when it comes to researching trans issues and getting scientific and governmental authorities to recognize your rights to social acceptance and medical treatment.

Within a few years, the definition you’re resting on will turn to sand beneath your feet. The Great DSM Machine will begin whirring into life pretty soon and considering what revisions it has to make. You’ll have an opportunity to make your voice heard and to push for real change. So… do you want to be part of that process of pushing trans rights forward, or do you just want to feel loss because they’re changing your strict definition of who’s valid and who’s not?

3. Scarcity is not a law of physics

One of the major arguments I see transmedicalists push is that there’s only a limited number of surgeries or hormone prescriptions available, so it’s not okay for a non-dysphoric person to “steal” the resources that another trans person might need more. This makes sense in a limited kind of way; it’s a good way to operate if, say, you’re sharing a pizza for lunch and deciding whether to give the last slice to someone who’s hungry and hasn’t eaten, or someone who’s already full.

When you start to back up and look at really big and complex systems–basically anything as big, or bigger, than a school board or a hospital or a municipal government–it’s not a helpful lens anymore. Because the most important thing about social institutions is that they can change. We can make them change. And the most important factor in how much the world changes is how many people demand that it change.

I’ve talked about this before when it comes to homeless shelters, and how the absolute worst thing they can have are empty beds. I used to work in women’s shelters, which came about when second-wave feminists started seriously looking at the problem of domestic violence in the 1960s and 70s, It was an issue male-dominated governments and healthcare systems hadn’t taken seriously before, but feminists started heck and did research and staged demonstrations and basically demanded that organizations that worked for the “public benefit” reduce the number of women being killed by their husbands. Their research showed that the leading cause of death in those cases were when women tried to leave and their partners tried to kill them, so the most obvious solution was to give them someplace safe to go where their partners couldn’t find them. Therefore the solution became: Women’s shelters. When feminists committed to founding and running these shelters, local governments could be talked into giving them money to keep them running.

(Men’s rights activists, the misogynist kind, like to whine about “why aren’t there men’s shelters?” and the very simple answer is: Because you didn’t fight for them, you teatowels. Whether a movement gets resources and funding is hugely a reflection of how many people have said, “This needs resources and funding! Look, I’m writing a cheque! Everyone, throw money at this!” In other news, The BC Society for Male Survivors of Sexual Abuse does great work. People should throw money at them.)

When the system in power knows there are resources it wants and doesn’t have, it finds a way to make them appear. For example, in Canada, the government knows that it doesn’t have enough trained professionals living in its far North, where the population is scarce and not very many people want to live. Doctors and teachers would prefer to live in the southern cities. But because it’s committed to Northern schools and hospitals, they create incentives. For example, the government offers to pay off the student loans of teachers or health professionals who agree to work for a few years in Northern communities.

Part of why trans healthcare resources are so scarce is that for a long time, trans people were considered too small a part of the population to care about. Like, “Trans people exist, but we won’t have to deal with them.” Older estimates said 0.4% of the population was trans, which meant a city of 100,000 people would have 400 trans people. A single family doctor can have 2000 or 3000 clients, so the city could have maybe 1 or 2 doctors who really “got” trans issues, and all the trans people would tell each other to only go see those doctors because all the rest were assholes. And the cracks in the system didn’t really seem serious. A couple hundred dissatisfied people not getting the healthcare they needed? Meh! Hospital administrators had more to worry about!

But the trans population is growing. A recent poll of Generation Z said 2.6% of middle schoolers in Minnesota were some kind of trans. which is 2,600 per 100,000. That’s enough to make hospitals think that maybe the next endocrinologist or OB/GYN they hire should have some training in treating trans people. That’s enough to make a health authority think that maybe the state should open up a new gender confirmation surgery clinic, since demand is rising so much.

Or well, I mean. Hospitals have a lot on their minds. This might not occur to them as their top priority. They’d probably think of it a lot sooner if a bunch of those trans people sent them letters or took out a billboard or showed up by the dozens at a public meeting to say, “Hello, there are a fuckload of us. Budget accordingly. We want to see your projected numbers for the next five years.”

When you’re doing that kind of work, suddenly it hurts your cause to limit your number of concerned parties. Sure, limited focus groups or steering committees can have limited membership, but when you put their ideas into action, to protest something or lobby for political change, you need numbers. If you want to show that you’re a big and important group that systems should definitely pay attention to, you don’t just need every trans or GNC or NB person who’s got free time to devote to your campaign, you also need every cis ally who can pad out numbers or lick envelopes or hand out water bottles or slip you insider information about the agenda at the next board meeting. You need bodies, time, and money, and you get them best by being inclusive about who’s in your party. Heck, if it would benefit your cause to team up with the local breast cancer group because trans women and cis women who have had mastectomies both have an interest in asking a hospital to have a doctor on staff who knows how to put a set of tits together, then there are strong reasons to do it.

Basically: All the time any marginalized group spends fighting over scraps is generally time we could spend demanding that the people handing out the food give us another plate. If you don’t think you’re getting enough, the best answer isn’t to knock it out of somebody’s hands, but to get together to say, “HEY! WE’RE NOT GETTING ENOUGH!”

That kind of work is complicated and difficult! It’s definitely much harder than yelling at someone on Tumblr for not being trans enough. But if you do any level of getting involved with activist groups that fight for real systemic change, whether that’s following your local Pride Centre on Twitter or throwing $5 at a trans advocacy group or writing your elected representative about the need for more trans health resources, you’re pushing forward lasting change that will help everyone.

#staranise original #transmedicalism tw #transphobia tw #homophobia tw #my problems with sj let me show you them

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snarkesthour · 3 years

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Happy St George's Day!

· In the midst of a pandemic when schools are all closed, the government votes to not allow free school meals to schoolchildren during school holidays, despite this being the only meal many of them have each day

· Marcus Rashford, a footballer, led the drive to feed the nation’s children, 49% of which live in poverty, and forced the government to provide food for them during the school holidays

· Instead of previous years when vouchers were given to parents that can only be spent on nutritious food, members of government give contracts to friends to provide a week’s work of food costing £5 to schoolchildren for a price of £30. Food is unhealthy and would not last a week

· Parcels also expect parents to cook two tablespoons of rice at a time in the oven and bake their own bread every day, ignoring poverty-stricken families possible lack of access to such equipment

· Wife of conservative MP attacks poor families for eating unhealthy food when healthy food is cheaper, ignoring the fact that not all families have access to equipment needed to store and cook it

· Nigel Farage, head of the Brexit party came out strongly against the government for their stance on starving schoolchildren. Not a good look.

· Another MP came out and said that poor families should not receive government assistance because the money would be going direct to brothels and crackhouses and the parents would spend it on drink and drugs instead of feeding their kids, a dangerous and persistent stereotype of working class people

· For the first time in its history, UNICEF is feeding kids in the UK – the 5th richest country in the world – and the head of the House of Commons accused them of “playing politics” and said they should “be ashamed of themselves”

· J.K. Rowling came out hard as a TERF (Trans Exclusionary Radical Feminist), writing a book about a serial killer that dresses up as a Muslim woman, which isn’t subtle when you look at her history of transphobia and other “-isms”

She also publicly supported an author who wrote a book about the destruction of Europe by waves of Muslim immigration

· Speaking of J.K. Rowling, the government’s response to the Gender Recognition Act.

· It is now impossible for under 16s to receive reversible puberty blockers

· Wait times at NHS Gender Clinics, of which there are only 7 in the country, have doubled, with wait times now up to 60+ months (5+ years)

· Keir Starmer, head of the Labour (left wing) party says he doesn’t want to get involved in trans issues

· With the loss of Labour, no major party supports trans rights

· Self ID is no longer allowed, meaning every step of transition is medicalised and involves the trans person having to prove that they are “trans enough” at every stage to panels of cis people

· Government wants to invalidate non-enrolled deed polls, essentially making available a public list of every trans person in the UK

· Hate crimes have quadrupled

· Anti-trans campaigners are now setting their sights on trans adults’ access to hormones

· A petition was formed to counter this and was reviewed by the government, who determined that nothing was wrong with the GRA except that it might have been a bit lax.

· The Guardian newspaper ran child labour and child starvation supporting stories

· Internal border now along the border of Kent and lorry drivers must produce travel papers (Brexit Passport) to cross it, placing the county of Kent in a state of “no man’s land”

· Government fails to lockdown on time, every time

· Government refuses to ban conversion therapy in the UK

· Scotland adopts Human Rights of Children, which requires the government to better support children and families, especially those who are poor, disabled, minorities or young carers. England does not

· The government declared that sleeping rough is now grounds for deportation

· Schools reopened several times despite being warned not safe to do so

· The government banned NHS workers from speaking out about COVID

· Do Not Resuscitate orders proposed for those in care homes, with learning disabilities and who are autistic

· The government cut pensions as the COVID death toll rose

· The government learnt about new South-East COVID strain in September and didn’t come forwards until December

· New COVID strain targets kids, teens, and young adults, and yet none of those groups are allowed vaccination unless a serious pre-existing condition is had, even if they are key workers

· Downing Street says UK should be model of racial equality because government report says no institutional racism in the UK

· Report also says young people are young and foolish for thinking it exists and that minorities are superstitious and irrational and are sabotaging themselves out of success

· It came out that the government was given the independent report and rewrote it to the version that was released to the public – the version that says racism doesn’t exist in the UK

· The rewritten report also refers to the slave trade as the “Caribbean experience”, like those enslaved were on holiday

· Woman in London abducted, murdered and dismembered by off-duty cop and when socially distanced vigil goes ahead, police wait until dark before trapping women, arresting them, using excessive force on them, and also destroying memorial

· Bill passed in government that allows undercover officers to commit serious crimes such as murder, torture and rape

· Plainclothes police to now patrol nightclubs and bars due to aforementioned murder by police officer

· Bill passed that bans any protest at all, no matter how quiet, unobstructive or small it is, including single-person protests. Bill also includes a 10 year sentence for damaging a statue, which is a longer sentence than for rape

· TV programmes critical of the government have been cancelled

· Universities have been told what to platform and schools have been told what to teach, including banning material speaking about BLM and calling for “overthrow” of capitalism

· Voting has been supressed, mainly those who are working class or POC

· During protests in Bristol, press was assaulted and pepper sprayed by police and two legal observers were arrested

· Being Roma/Traveller and living the traditional Roma/Traveller lifestyle is now illegal under that same bill that bans protests. They also have to register as such and receive a licence or risk losing their vehicles

· Hours before Eid, lockdown across the UK with no warning whatsoever, meaning people woke up the next morning after visiting relatives to find themselves “criminals”. The country was opened up specifically for Christmas though

· Conservative (right wing) party blamed BAME (Black And Minority Ethnic) communities for dying of COVID more than white people

· Landlords have been protected extensively and renters blamed for living in close quarters or having to take public transport to work

· Conservatives have launched investigation into possible corruption in Liverpool Council. Liverpool is a Labour stronghold and if corruption is found then the Conservatives can seize control of the council. No evidence of corruption is present as of yet

· Military threatened to stage a coup if Corbyn (then head of the labour party) became Prime Minister

· Government orders all government buildings in England, Wales and Scotland to fly the Union Flag every day to boost patriotism

· MPs call for the curriculum to require teaching the history of the Union Flag rather than Britain’s many atrocities

· The first fortnight of April saw a mini heatwave with temperatures up to 20°C immediately followed by snow, and this is ignored in favour of debating “vaccine passports” in order to visit the pub

· UK allows for international summer holidays despite being warned it will cause a third wave, such as the situation in Germany

· Government placed asylum seekers arriving in the UK in army barracks where they were to sleep 24 to a room with no open windows or air circulation, and when COVID inevitably ran rampant, the Home Secretary accused the asylum seekers of not following COVID protocol, such as social distancing

· Several accounts of self-harm and suicide attempts were reported from the asylum barracks and were dismissed

· UK to deport unaccompanied minor asylum seekers

· UK refuses entry into the UK for radicalised teen failed by system who joined ISIS. Case is difficult and controversial because teen wishes to return to the UK temporarily to fight for her citizenship after the UK broke international law by stripping it from her, despite her not having dual citizenship. Argument given was that her parents were from Bangladesh and so she could apply for citizenship there. Bangladesh refused. Teen is now stateless and living in a refugee camp after losing several children, unable to fight for her citizenship to be reinstated.

· Rioting in Northern Ireland, which included the first use of water cannons in 6 years, a bus being hijacked and burnt, a press photographer attacked, and people throwing bricks, fireworks and petrol bombs at police, not to mention some of the clashes happening over a peace wall in west Belfast, completely ignored in British media and then later drowned out by non-stop news of Prince Phillip’s death, obscuring any important news from being heard. Riots were over Northern Ireland’s being a part of the UK

· MPs take vote on whether China’s treatment of Uighurs constitutes genocide. They decide it does, but that it isn’t their job to do anything further

· Home Office released their spending for the 2020 fiscal year. It’s a mess, including over £77,000 at an eyebrow salon in March alone, and £6,000+ in Pollyanna Restaurant which doesn't appear to exist.

· When people started questioning the spending, the Home Office sent a tweet fact checking themselves

· Country reopened over the summer for Eat Out To Help Out, a scheme to boost the economy. COVID cases rose sharply and the government then blamed people, but mostly working class people, for not following restrictions such as only leaving the house when absolutely necessary, after telling them it was safe

· Foreign NHS workers denied COVID vaccinations

· GCSEs and A-Levels were cancelled due to COVID-19 and expected exam grades were to be used instead. Private school students received grades much higher than they were expecting, and state school students received grades much lower, some grades falling as far as an A to an E. This was because the government couldn’t imagine state school students being smart enough to receive the high grades they were predicted to get; after much uproar the grades were scrapped, and a new method was introduced

· BBC offered staff grief counselling following Prince Philip’s death, but not after having to report on the ever-rising COVID death toll

· The COVID-19 Infection Survey closed in mourning for Prince Philip, with workers to contact participants to reschedule visits for “as soon as possible” when they return to work

· Census workers told to pack up and go home and were placed on immediate unpaid leave due to the death of Prince Philip, but told they must make up the hours later

· Conservative MPs lobbied for a new royal yacht after voting to keep schoolchildren hungry (see first points)

· The BBC’s complaint page crashed over the amount of complaints they got of their coverage of Prince Philip’s death. It was covered non-stop for over 24 hours and the page came in at over 100,000 complaints before going down

· BBC also fast becoming politically biased despite their requirement to be apolitical, after cutting out the audience laughing at Boris Johnson on Question Time, displaying Corbyn as a communist figure in front of a prominent piece of Russian architecture, and providing a platform for a Conservative MP to tell a stage 4 bowl cancer patient that her life wasn’t valuable on live television

· On the COVID-19 pandemic, the BMJ, (British Medical Journal) said about the government that “science was being suppressed for political and financial gain” by “some of history’s worst autocrats and dictators”

· Not only did Boris Johnson launch Eat Out To Help Out when he was warned it was dangerous, lifted lockdowns too early when he was warned it was too dangerous, reopened schools when he was warned it was too dangerous, but when scientists said the second COVID jab should be delivered within 3 weeks he decided that was too tall an order and it should be within 12 weeks – after a period of radio silence, suddenly the science fit his plan. No scientists came forwards to defend it

· The Home Secretary, Priti Patel, blamed protestors for protests that became violent from police attacking protestors, bullied staff members under her, bought members of staff in her department, said it was “disgraceful” to topple the statue of Edward Colson, a slave trader, in Brighton because it undermined anti-racism protests, held treasonous meetings with Israel with the plan to divert aid money, and threatened to starve Ireland in order to get them to agree to Brexit

· She also wants to set up Australian-style asylum processing centres on British islands, but the islands she wants are in the Atlantic ocean and over 4000 miles away from the UK. This is because she wants to help asylum seekers enter the UK legally, completed ignoring or oblivious to all the reasons that asylum seekers might not be able to do that, and for the fact that to seek asylum you must essentially walk up the border and ask for it

· The bungling of the Track and Trace system – the government spent £10bn on a system to track and trace the spread of COVID-19. All data was stored on an Excel spreadsheet which developed a technical glitch and many results were lost before the system was scrapped

· As Autism Acceptance month began, the BBC ran a story saying the autism causes fascism, and that an autistic person who had chosen to embrace the ideology was incapable of seeing that a neo-Nazi group he joined was morally bad because he was autistic

#st george's day #uk politics

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naked-ambitions · 2 years

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My Controversial Opinions

Political Leaning(s)

While I do consider myself “politically homeless” (i.e. I don’t associate with any political party), I have taken that political compass test thing. I scored as a right-leaning libertarian.

LGBT Opinions

The acronym for is LGBT, that’s it. I don’t believe in any of those extra sexualitites or the 500 genders that tumblr is so well known for having made up. I guess you could just say I’m an exclusionist, to put it simply.

I generally view the word “queer” as a slur, so the phrase “the queer community” just is not where it’s at for me. I also consider the “queer” community to be separate from the LGBT community, in a way (more ideology wise). Note, I’m not here to police how people identify, if somebody wants to identify as “queer” that’s their deal, I’m just saying I’d prefer to not have that word used to describe me.

Non-binary skeptic. I’m not outright denying the existence of non-binary people because that would be dumb. There are obviously people who identify as non-binary, I just haven’t seen any definitive, scientific proof of non-binary.

Transmen are transmen and transwomen and transwomen. Yes, you heard me. I don’t believe the whole “transmen are men” and “transwomen are women” narrative, nor do I believe the whole “transmen are women” and “transwomen are men” argument. Trans people have taken the respective steps to transition as close as they can, or want to, to the opposite sex. So, to me, they get their own category. Not exactly “true men” for transmen and not exactly “true women” for transwomen. They are their own, unique category and that’s okay!

You need gender dysphoria to be transgender. To me, there is really no reason that anybody would transition if they don’t have gender dysphoria. Taking gender dysphoria out of the DSM was a mistake. Getting a diagnosis of gender dysphoria helped to treat people properly for what they were struggling with.

Informed consent is more trouble than it’s worth. While informed consent may give some who “need” it quick access to hormones to start their transition, it leads others down an irreversible path that they shouldn’t have taken. Detransitioners' voices are just as important as transitioners' voices.

More research needs to be done on gender dysphoria and possible treatments for it. Some have reported feelings of gender dysphoria that weren’t resolved by transitioning. To me, it would be worthwhile to look into getting multiple options for those who suffer from gender dysphoria.

The model of therapy for treating those with gender dysphoria is deeply flawed. The model of affirmation only has many holes and has created many issues for those who have sought treatment, believing they were transgender or had gender dysphoria when other underlying problems were occuring/also going on. Affirmation only and a fast track to transition without looking into any other issues the patient might be going through is bound to lead to trouble for many. I’ve heard of a model of therapy for transition where talk therapy was intensive and many issues were discussed during the span of a year. During this year the patient also tried his/her best to pass without hormones. After the resolution of any other issues the idea of transitioning could be revisited and see if it’s what the patient still needs.

To add to this, I am of the personal opinion that minors (those under the age of 18), should not be allowed to transition with hormones or surgery. They should, of course, be given therapy and allowed social transition.

Just because you aren’t a perfectly feminine female or a perfectly masculine male doesn’t mean you’re some magical “third gender”. You’re just gender non-conforming (GNC) and a lot of people are that way! Some GNC people aren’t even a part of the LGBT community. Once again, I cannot force someone not to identify in such a way, this is just my opinion.

Neopronouns… Honestly, just no. Once again, I can’t force anybody not to use neopronouns but I think they’re pretty much pointless and just an extra hassle. I realize that a lot of kids use neopronouns, so obviously we shouldn’t harass these people, but that sort of behavior also shouldn’t be encouraged to me. Same thing with people who use it/its. Don’t bully, just let them know gently or let them come to that conclusion on their own, I guess.

Social Issues

Just because you have a mental disability/disorder does not mean you get to make excuses for everything. At least put in the effort and try, but it annoys me so much when people are making excuses left and right for just being shitty people and lazy, then blaming it on mental illness and all that jazz.

Also, if you are mentally ill and can afford treatment but choose not to seek treatment/therapy, that’s nobody’s fault but your own. You’ve identified the problem, you have social/financial support (or means) to get help, but you choose to throw a pity party instead? No thanks.

Two-parent households where the parents are married (“nuclear family”, but I also think that gay couples are acceptable in this, as long as they’re married) should be encouraged, instead of single motherhood. How is single motherhood encouraged? Government hand-outs and the father having to “pay out” for the child he had out of wedlock. What if instead of giving those incentives we, say, gave a tax break to married couples with children? Children deserve a secure, loving home where both parents are present and actively caring for the child.

Political Opinions

Fundamentalist for the First and Second Amendment, the right to free speech and the right to bear arms is our means to protect ourselves against a tyrannical government. If we do not have that, we are doomed. Anti-compelled speech.

Hate speech doesn’t exist. Just because someone’s speech offends you does not mean you’ve been hurt. People have the right to their opinions and you have the right to confront them or walk away. This does not mean that I believe that threats of harm or threats on someone's life should be legal.

I am pro-life, for the most part. Controversial, I know. But I am pro-life because if you don’t want to get pregnant, you can easily use a condom, be on the pill, or get the morning after pill. I also belief that first term abortions should be available to women, because obviously some women might need time and might want to talk things out with their partners. There are some instances where I would obviously say abortion should be an option for the mother, such as rape, incest, or if the birth is going to be dangerous or kill the mother or child.

So these are all the opinions I could think of. This isn’t an all-expansive list of my opinions, of course, but it should give you a general feel of what I believe in. Also, I doubt you’ll agree with everything I believe, but that’s fine! If you like what I’m dishing up here, follow me for my hot takes! Also note that asks will be closed because I’m a college student (full-time) and for me school prioritizes all else. However, over the holidays and the summer, I will open up my asks!

#lgbt #non-binary #nb #trans #pronouns #politics #libertarian #rightleaning #ambi

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piss-bong · 6 years

Note

how do you get a doctor to prescribe testosterone? or is it possible to get it without a prescription?

so it depends on your state/country. I live in Pennsylvania in the US so I can really only speak for where PA but it seems to be pretty similar throughout most of the US/Europe.

note: this is gonna be a long post. Sorry.

First let’s discuss starting HRT under the supervision of a medical professional because that’s the best, safest way to go about the process:

Talk to a doctor/therapist.

They may be able to provide you with a prescription for HRT medication, but it’s rather uncommon

However, they will definitely be able to refer you to an endocrinologist.

Some doctors are easier to work with and more trans-friendly than others. Do your research, try to find reviews (especially from other trans people). If you’re able to travel to find a better doctor, do it. You deserve the best treatment possible and unfortunately that may be difficult to find, but trust me, finding good treatment is worth it and makes the entire process way easier.

provide informed consent

this is just a fancy legal way of saying “I know what I’m getting myself in to”

you just need to talk to your doctor/therapist before beginning treatment and verify that you understand and are comfortable with the affects of HRT as well as the assumed risk

This can get a little more tricky if you’re a minor because you may not be able to provide informed consent depending on your age and place of residence.

Where I live anyone over 16 and provide consent, but in other states/countries you need to be 18, and in some states/countries it’s as low as 13 or 14. Check up on the laws where you live. If you are not over the age of consent you will need to also have your parents sign some stuff.

I don’t know much about this because I’m nearly 18 but you can find more information about it online.

prove that you are capable and willing to medically transition

Depending on the doctor they may require you to present as your preferred gender for a given amount of time before actually prescribing hormones. This may be anywhere from 6 weeks to 12 months depending on where you live and what doctor you’re seeing.

This step can sometimes be bypassed if you have a therapist who is willing to write a reference letter you may be able to bypass this step.

It’s also worth mentioning that there are many doctors who don’t do this anymore because it’s a pretty shit practice. Do your best to find a doctor who doesn’t do this shit.

discuss some other medical stuff with your doctor

your doctor will want to discuss your other medical needs with you. This will include whether or not you take any other medications, have any preexisting conditions that may interfere with HRT, if you smoke, or anything else that may cause problems. It’s more of a discussion than anything and as long as nothing major comes up you should be fine

You will also need to take some blood tests so your doctor can measure your hormone levels to know what dosages to give you.

Get Your Fuckin Pills (or whatever method you choose to administer your hormones)!!!

once everything else is done you should be able to obtain a prescription for your hormones from your doctor.

They will also talk to your about what type of hormones/method of administration is best for you. Common methods include pills, patches and injections.

Go back for regular checkups

once you’re on hormones you will need to regularly go back to your doctor for blood tests just to make sure that your hormone levels are where they should be. Your doctor may adjust your dosages depending on the results, but this is pretty much all just to keep you safe.

These appointments usually happen every month to every other month and will probably become less frequent as you get further in to your transition.

There ya go! Now you got the right chemicals in your body!

While going through a doctor is definitely the better, more responsible way to go about things, that’s just not an option for some people. It is possible to get hormones without a prescription, however I don’t suggest it.

I am writing the following purely for harm-reduction purposes. I don’t recommend, nor do I condone the use of any medication without the strict supervision of a medical professional. It is dangerous and can have some really bad consequences. However I know that for some people it’s their only option so I’m going to write this guide to explain the safest way to DIY your hormone treatment. This isn’t me telling you “take hormones without a doctor”, this is me saying “if you’re going to take hormones without a doctor, this is the safest way to do it”. Please understand that I’m not advocating for this, I just want you to be as safe as possible.

okay so all of that said:

Understand that this will be more expensive.

your insurance can’t cover it so you will need to pay 100% our of pocket.

there’s also other expenses involved (which I’ll cover later) that you wouldn’t need to worry about if you were getting your hormones through a doctor.

When purchasing hormones online:

only buy from a trusted source. There are many reputable sites so make sure you’re buying from the right place.

Do your research! I can’t stress this enough, make sure you know what you’re doing, what dosage is right for you, and every other factor involved. This could really mess you up if you do something wrong.

also remember that you will have to pay shipping so factor that in to your budget

Test your hormone levels!!!

you can also go to a doctor to have them test it if it’s available to you. Your primary care physician would probably be easiest, but places like Alder Health provide testing too. This is probably the easiest and best way of doing it but I know not everyone has that luxury.

you can find places online where you send them a blood sample and they test your hormone levels.

I can’t stress how important this is. If your hormones are too high you can overdose, and if they’re too low it may make it difficult to achieve the results you want.

Get a PO box

it’s super easy, and provides an extra layer of security because you don’t have to get your stuff shipped to your house.

this does add an extra expense, but it’s not very much and it’s usually worth it.

tell your doctor

You have doctor/patient confidentiality. They can’t tell anyone, they can only warn you against the dangers and help you stay safe.

often times they will help you get anything you need (hormone testing, therapy, etc.) that you couldn’t get yourself.

best case scenario they may even set you up to get hormones through a regular prescription, but that’s unlikely.

Just make sure you’re safe. DIYing is very dangerous and it’s very difficult to do right.

I hope I got anything but if there’s something I missed someone please let me know and I’ll make sure to edit the post.

#asked and answered #trans resources #Anonymous

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divdevdump · 5 years

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"It's the most dangerous movie about a trans character in years," argues critic Oliver Whitney.

To the uninformed moviegoer, Netflix’s Girl may look like a timely and worthy Oscar contender. Belgian’s best foreign-language submission about a transgender girl debuted to a standing ovation at Cannes, where it scooped up multiple awards. It also has a 95 percent rating on Rotten Tomatoes. Yet the near-unanimous praise for the film has been exclusively generated by critics who are not transgender. Some have pointed out the backlash against the pic’s casting, which finds a cisgender (non-transgender) actor in trans role. As problematic as that is, it’s the least of Girl’s issues. The film isn’t just another case of irresponsible casting or harmful stereotypes, like much of Hollywood's long, ugly treatment of the trans community; it’s the most dangerous movie about a trans character in years. If Girl takes home an Oscar, it would be a drastic step backwards for trans representation in Hollywood. Directed by Lukas Dhont and co-written by him and Angelo Tigssens — both cisgender men — Girl stars Victor Polster as Lara, a 15-year-old trans girl with dreams of becoming a ballerina. The film has a disturbing fascination with trans bodies, from the leering opening shots of Lara stretching to a horrific, bloody finale. Cinematographer Frank van den Eeden uncomfortably lingers over Lara’s lower body with a persistent focus on her crotch. Even when Lara’s gaze is actively turned away from her body while showering and changing, the camera invasively presses in on her groin. Dhont’s voyeuristic eye can’t wait to learn what’s between Lara’s legs, and he wastes no time revealing it. Lara’s genitals, shown in multiple full-frontal nude shots of Polster’s penis, have a bigger presence throughout Girl and are central to more plot points than the character herself. Lara painfully studies her naked body in the mirror in five scenes — was one not enough? — and in four unnecessarily gory moments, she rips tape from her genitals after tucking her genitals during ballet. While showing tucking onscreen, a reality for many trans women, can be important to represent, Dhont turns it into a bloody horror show. What could have been a thoughtful exploration of a difficult part of a trans girl’s daily life instead uses her body as a site of trauma, inviting the audience to react with disgust. Much like the cisgender characters who continually silence Lara and tell her how to feel, the director shows no interest in understanding her internal struggles. Lara is merely a physical specimen to gawk at, and the more her body is pitted against her — both with gender and ballet — the more the film relishes in capturing her torment. Girl succeeds at one thing: showcasing the cruel ways trans people are continually reduced to and defined by their bodies, though without a stitch of self-awareness. While it’s unfortunate a cisgender male actor was cast to play a girl — which makes little sense given that a teenage trans girl on puberty blockers (as Lara is supposed to be) would look nothing like Polster — in a film this callous, it’s a blessing a trans actress didn’t have to undergo such gross treatment. The biggest issue with Girl is the harmful message it sends about HRT (Hormone Replacement Therapy) and self-harm. Lara is introduced as a happy young woman excitedly counting the days until she begins HRT and has gender-affirming surgery. Yet soon after her first dose of estrogen, her life starts to crumble. Her pointe work, though previously improving, begins to falter for no reason; the other ballerinas who never questioned her in the locker room suddenly harass her at a traumatizing sleepover; and as Lara’s health deteriorates (with little explanation), her surgeon refuses to perform the procedure. Lara is even blamed for it, chastised for taping her genitals and “undermining her body.” As Lara’s physical and mental health decline, Girl sends the inaccurate message that HRT will cause a trans person more agony. Dhont doesn’t understand how puberty blockers and HRT bring tremendous psychological relief to a trans person struggling with dysphoria. Instead, he eschews nuance to savagely exploit medically transitioning for heightened melodrama. Poor writing, yes, but also outrageously irresponsible filmmaking. With her surgery indefinitely on hold, the film ends with Lara — spoiler alert and content warning for self-harm — cutting off her genitals with a pair of scissors. That twist makes no logical sense — it’s hard to imagine a trans person who wants surgery cutting off a body part that’s literally necessary for the procedure — and once again turns a trans body into a subject of grisly violence. Most shockingly, Dhont doesn’t frame the act as a criticism of the healthcare system or even a regrettable tragedy, but depicts Lara castrating herself as an inevitable means of survival. The film randomly jumps to the future to show a smiling Lara happily walking down a sun-dappled street: Ah, now she’s a woman! Girl isn’t a “deeply humane” or “arrestingly empathetic” drama about the trans experience as the non-trans critics have described it. It’s sadistic exploitation made for uneducated cisgender audiences to feel like they get it. Dhont has done something far worse than make another clichéd and superficial portrait — he’s disguised trans trauma porn as a triumphant survival story. It’s unfortunate and dangerous that Girl will exist on Netflix where young trans people can easily stream it, but should it get the Academy’s seal of approval, such awards attention would only further spread the film’s misinformation about, and damaging treatment of, the trans community. Dhont’s movie is a primary example of what happens when non-minority critics are the only ones discussing a film portraying an underrepresented community, and the consequences of allowing non-trans creators to tell trans stories. That Girl has been celebrated without commentary from trans critics until now should be a wake-up call to allies in the industry. If trans people and informed allies had been working on festival staffs and at distribution companies and writing for major publications, Girl wouldn’t have made it this far into the awards conversation. If you care about boosting authentic visibility and helping reduce discrimination and violence against transgender people, then change starts by refusing to blindly award damaging art. Then, in seeking out and hiring trans voices in media and the industry.

#Lukas Dhont #Religion #hollywoodreporter #transmisogyny

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mredwinsmith · 6 years

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My Experience as a Transgender Woman in the Ultimate Community

My name is Ashleigh Buch, and I am a transgender woman who plays ultimate for the up and coming women’s club team, Kansas City Wicked. I am writing this piece with the hope of adding my voice to a very small minority of ultimate athletes who are trans or non-binary, and to increase awareness of our experiences as players. My journey as a trans female ultimate player is one that has been fraught with difficulty and heartbreak and, at one time, took me away from the sport, but it is also one that has seen me grow into a strong and confident woman who is unashamed to be her true self.

While ultimate is a large part of my life, I am also a Mandarin-Chinese linguist in the Air Force. I have served in the Air Force for eight and a half years. I am extremely passionate about fighting for trans rights and trans representation across all fields, but my focus has primarily been on the military. It was that fight for my right to exist in the military that ultimately gave me the courage to return to the sport as myself.

Beginnings

Like many, I began playing ultimate in college, and I joined Iowa State Ultimate Club (ISUC) during my junior year of school. I had played the sport a little bit after a few summer cross country practices, and I quickly fell in love with it, but I had absolutely no technical skills, and I could barely throw a disc. The two things I did have going for me were that I could run fast and run almost nonstop.

I was nervous about joining the team for many reasons, but at its heart, it was because I knew I wasn’t going to be able to be my true self. I also knew from my previous experiences with team sports that I was going to end up on the periphery. In the past, I was closed off from everyone because if someone were to discover the real me, I was afraid that I would face negative treatment from those in my life. Not opening up and forming real relationships with my teammates was the only way I knew how to protect myself.

While I learned a lot about ultimate and improved my game immensely during my time playing for ISUC, so many of my fears came to the forefront of my experience. It was an incredibly dysphoric experience trying to keep up this image of somebody I wasn’t. I tried desperately to put forth a masculine presentation, but I failed miserably. I was pretty sure most everyone on the men’s and women’s team at ISU either thought I was gay or just super metrosexual.

Having to hide behind a mask not only hurt my heart, but looking back on it, it stunted my growth as a player. Because I was so distant and often struggled with being around my teammates, it became difficult for me to ask for help regarding different parts of my game or understanding more advanced aspects of the sport. Unless we were at practice or a tournament, I rarely, if ever, spent time with my teammates. It was a suffocating and lonely experience.

Paralleling many of my experiences as a child and teenage athlete, I found myself desperately wanting to be a part of the women’s team at ISU, Woman Scorned. I fit in with many of the women so much more naturally than I did with any of the men. While there wasn’t a shortage of great players on ISUC, I found myself admiring and respecting the games of many of the women much more. When you are surrounded by incredible players like Rachel Derscheid, Melissa Gibbs, Taiwo Misra, Magon Liu, Sarah Hoistad, Jasmine Draper, and so many more, it is easy to be star struck.

They played each game with so much passion, and they fostered an incredibly empowering and supportive environment where they could be themselves unabashedly, something I deeply desired. I loved how they talked to each other on the field from the sideline and encouraged each other on the field. The cold reality was that I would never be a part of that team, and I struggled with that almost daily. It hurt my heart and further increased my dysphoria.

I know it sounds like I am coming down hard on the men’s team, but it is more that I didn’t fit in with those guys and the culture of the team. I am still friends with most of them, but if you were to ask them how I fit in with the team, they would almost certainly tell you that I was this incredibly quiet and shy individual who was almost always closed off from them. Looking back, I think that if I had come out about being trans while playing for the team, I have no doubt they would have supported me. At the time though, the thought of that terrified me. Because of the negative way in which society views and treats trans people, closing myself off was the safe thing to do.

Joining a Women’s Team

A few years later, I quit ultimate because I was in the midst of my transition, and I faced some bullying at the local summer league. This spring, I made the decision to return to the sport. Only this time, I was going to return to the sport as my genuine self, as the woman that I am. I didn’t want the fact that I am trans to be a hindrance to living my life any longer. Because of my proximity of Kansas City and what seemed like a team with great chemistry, I decided to reach out to Wicked to gauge their interest in letting me participate in their upcoming open tryouts.

I ended up sending a super awkward message to their Facebook page basically regaling them with my life story. Thankfully, the person in charge of their page is Steph Rupp, one of the most amazing people I have ever met and who is now one of my dearest friends. She was totally cool about it all, and after talking it over with the captains, she let me know that I would be welcomed with open arms.

Over the following weeks, I fought an internal battle of deciding whether I should try out. Indecision and fear almost overcame me the day of the first try out when I was about 40 miles away from Omaha on the road to Kansas City. I was at the point of turning around, but I made the decision to press on. The thought of returning to the sport as myself and being surrounded by so many incredible female ultimate players was something I deeply desired. Despite my fear, the decision to try out was the right decision. After a good showing at the invite-only tryouts, I was notified that I made the team, and I was overcome with emotion. It was something that I thought would never be possible, yet there was the confirmation right there. I was officially part of Wicked.

I struggled a lot throughout this past season. It was filled with many ups and downs, and there were a lot of tears. I am pretty sure I cried at every other practice, every power weekend, and most tournaments. Estrogen-based puberty is no joke. I struggled mightily with my confidence to the point where I was afraid to throw anything other than a quick dump or a quick give and go.

I was so afraid of letting my team down, and I was afraid that if I happened to do anything well, it would be because I was trans and not because I was a good player. It wasn’t until toward the end of the season did I break free of my funk. After a few in-depth conversations with my frisbee role models, Clare Frantz, Steph Rupp, and Amanda “Coffee” Borders, they helped me get out of my head, and I finally began to blossom as a player. The culture of our team is one of empowerment and support of each other through all the ups and downs.

Common Misconceptions

Many of the misconceptions and questions of fairness surrounding trans female athletes scared me about opening up about my experience as a trans woman playing for Wicked. So often as a trans woman, my identity is boiled down to one part of my identity, the fact that I was designated male at birth. Because of that designation, there are a lot of assumptions made about me such as having an innate biological advantage over my cisgender female counterparts. Not only is that an unfair assumption about me, but it is also insulting to all of the incredible cisgender female athletes out there who will accomplish more than I can ever dream of. I was afraid that anything that I was to achieve in ultimate would be credited to me being trans rather than to the all of the hard work and effort I put into growing as a player. More importantly, I am afraid that people will downplay Wicked’s accomplishment because of my trans status. We are some of the hardest working individuals you will ever meet, and if anybody took anything away from what we have accomplished because I am trans, it would tear my heart out.

One of the common misconceptions about transgender female athletes when it comes to women’s sports is that we are doing it so that we can dominate the sport in a way that we couldn’t in the men’s division. It pains my heart to hear that so often repeated. Aside from the extensive changes your body undergoes with hormone replacement therapy (HRT), the overwhelming majority of trans female athletes simply want to compete in an environment where they fit, somewhere where they don’t have to be somebody other than themselves. Team sports are a communal environment, and if you don’t fit for whatever reason, they can become a lonely place.

Another aspect to the question of fairness for trans athletes is how HRT affects the body. My athletic capabilities underwent a dramatic change. I dropped to nonexistent levels of testosterone while my estrogen was cycled in a way that matched those of an average cisgender woman. I went from having what now seems like endless energy that I used to balance a busy schedule with a heavy workout load to being constantly tired.

Despite the same level of exertion, after HRT, my strength decreased sharply and my running pace slowed. It became difficult to not only put on muscle mass, but to maintain any previous muscle mass. While at the same time, that lovely hormone, estrogen, made it easy to put on fat and in turn gain weight. That is exactly what happened. My body began changing rapidly and it never looked back. I basically went from being perceived as a high-level male athlete to being a high-level female athlete.

Finding a Home

Transitioning and playing for Wicked are the two best experiences of my life. Everything that I had desired in my life and in sports fell into place. I had reached the point where my mental, emotional, and physical health were finally at peace with one another, and for the first time in my life, I began to live. My participation on Wicked opened a new aspect to my being. I had finally found a place where I could be myself and play a sport I loved. I was surrounded by and lifted up by some of the most incredible people I have ever met, a group of women who supported one another. While these women are not Scorned, they are Wicked, and they make my heart sing. My journey is most certainly not over, but for now, I am home. #wickedlove

Ashleigh Buch can be reached at [email protected], on Instagram at ashleigh.kathryn, or on Twitter @AshKatRyn. Interested to learn more about her fight for trans acceptance in the military? Check out articles about her in the Omaha World Herald and on the Offutt Air Force Base news page.

The post My Experience as a Transgender Woman in the Ultimate Community appeared first on Skyd Magazine.

from Skyd Magazine http://ift.tt/2rPbMEF

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