"oh Sorry, I Guess I Was Infodumping Again" - Sad, Shy, Apologetic

saying "whoever did this should be stabbed" whenever i dislike anything ever just in case julius caesar happens to be behind it

Warning to all Tumblr users, do not attempt to post Rage Bait on the new app 'Blue Sky' because the users there are too intelligent to fall for it.

thinking about how when you experience a lot of shame in your formative years (indirectly, directly, as abuse or just as an extant part of your environment) it becomes really difficult to be perceived by other people in general. the mere concept of someone watching me do anything, whether it's a totally normal activity or something unfamiliar of embarrassing, whether I'm working in an excel spreadsheet or being horny on main, it just makes my skin crawl and my brain turn to static because I cannot convince myself that it's okay to be seen and experienced. because to exist is to be ashamed and embarrassed of myself, whether I'm failing at something or not, because my instinctive reaction to anyone commenting on ANYTHING I'm doing is to crawl into a hole and die. it's such a bizarre and dehumanizing feeling to just not be able to exist without constantly thinking about how you are being Perceived. ceaseless watcher give me a god damn break.

i was preparing a wet specimen one day and my dad was like this reminds me of my work buddy who ties dollar store balloons to roadkill and watches them fly away. and i had to drop everything for a second and say no. no i dont think this is like that

So today I want to talk about puberty blockers for transgender kids, because despite being cisgender, this is a subject I’m actually well-versed in. Specifically, I want to talk about how far backwards things have gone.

This story starts almost 20 years ago, and it’s kind of long, but I think it’s important to give you the full history. At the time, I was working as an administrative assistant for a pediatric endocrinologist in a red state. Not a deep deep red state like Alabama, we had a little bit of a purple trend, but still very much red. (I don’t want to say the state at the risk of doxxing myself.) And I took a phone call from a woman who said, “My son is transgender. Does your doctor do hormone therapy?”

I said, “Good question! Let me find out.”

I went into the back and found the doctor playing Solitaire on his computer and said, “Do you do hormone therapy for transgender kids?” It had literally never come up before. He had opened his practice there in the early 2000s. This was roughly 2006, and the first time someone asked. Without looking up from his game of Solitaire, the doctor said, “I’ve never done it before, but I know how it works, so sure.”

I got back on the phone and told the mom, who was overjoyed, and scheduled an appointment for her son. He was the first transgender child we treated with puberty blockers. But not, by far, the first child we treated with puberty blockers, period. Because puberty blockers are used very commonly for children with precocious puberty (early-onset puberty). I would say about twenty percent of the kids our doctor treated were for precocious puberty and were on puberty blockers. They have been well studied and are widely used, safe, and effective.

Well. It turned out, the doctor I worked for was the only doctor in the state who was willing to do this. And word spread pretty fast in the tight-knit community of ‘parents of transgender children in a red state’. We started seeing more kids. A better drug came out. We saw some kids who were at the age where they were past puberty, and prescribed them estrogen or testosterone. Our doctor became, I’m fairly sure, a small folk hero to this community. 

Insurance coverage was a struggle. I remember copying articles and pages out of the Endocrine Society Manual to submit with prior authorization requests for the medications. Insurance coverage was a struggle for a lot of what we did, though. Growth hormone for kids with severe idiopathic short stature. Insulin pumps, which weren’t as common at the time, and then continuous glucose monitoring, when that came out. Insurance struggles were just part and parcel of the job.

I remember vividly when CVS Caremark, a pharmaceutical management company, changed their criteria and included gender dysphoria as a covered diagnosis for puberty blockers. I thought they had put the option on the questionnaire to trigger an automatic denial. But no - it triggered an approval. Medicaid started to cover it. I got so good at getting approvals with my by then tidy packet of articles and documentation that I actually had people in other states calling me to see what I was submitting (the pharmaceutical rep gave them my number because they wanted more people on their drug, which, shady, but sure. He did ask me if it was okay first).

And here’s the key point of this story:

At no point, during any of this, did it ever even occur to any of us that we might have to worry about whether or not what we were doing was legal.

It just never even came up. It was the medically recommended treatment so we did it. And seeing what’s happening in the UK and certain states in America is both terrifying and genuinely shocking to me, as someone who did this for almost fifteen years, without ever even wondering about the legality of it.

The doctor retired some years ago, at which point there were two other doctors in the state who were willing to prescribe the medications for transgender kids. I truly think that he would still be working if nobody else had been willing to take those kids on as patients. He was, by the way, a white cisgender heterosexual Boomer. I remember when he was introduced to the concept of ‘genderfluid’ because one of our patients on HRT wanted to go off. He said ‘that’s so interesting!’ and immediately went to Google to learn more about it. 

I watched these kids transform. I saw them come into the office the first time, sometimes anxious and uncertain, sometimes sullen and angry. I saw them come in the subsequent times, once they were on hormone therapy, how they gradually became happy and confident in themselves. I saw the smiles on their faces when I gave them a gender marker letter for the DMV. I heard them cheer when I called to tell them I’d gotten HRT approved by insurance and we were calling in a prescription. It was honestly amazing and I will always consider the work I did in that red state with those kids to be something I am incredibly proud of. I was honored to be a part of it.

When I see all this transgender backlash, it’s horrifying, because it was well on the way to become standard and accepted treatment. Insurances started to cover it. Other doctors were learning to prescribe it. And now … it’s fucking illegal? Like what the actual fuck. We have gone so far backwards that it makes me want to cry. I don’t know how to stop this slide. But I wrote this so people would understand exactly how steep the slide is.

My fucking cat has figured out how to gently dig his claws into my eyelid and pull my eyes open while I'm sleeping. He does this. It does not hurt. He is remarkably precise and gentle. I however am asleep when it happens and do not appreciate being clockwork oranged by a needy clingy goddamn animal who thinks he needs attention.

I got a laptop with Windows 11 for an IT course so I can get certified, and doing the first time device set-up for it made me want to commit unspeakable violence

Windows 11 should not exist, no one should use it for any reason, it puts ads in the file explorer and has made it so file searches are also web searches and this cannot be turned off except through registry editing. Whoever is responsible for those decisions should be killed, full stop.

Switch to linux, it's free and it's good.

we went to bed at 6pm last night and whenever i woke up my brain would try to slowly reconstruct the phrasing and imagery of McDonald's Honey Bustard Pickled Sea fuck meal and as soon as id get it right i would fall back asleep happened about a dozen times

one time i fell asleep with a half eaten bag of chips on my chest and while i was napping one of my cats jumped up on me and chewed up the bag and sent the chips flying everywhere and a bit later i woke up completely covered in shredded bag and chip pieces and the last thing i remembered i had started eating some tasty chips so for a short while i was convinced i had blacked out and gone into some sort of uncontrollable chip frenzy

Finally some good fucking news