Last Night I Had A Dream Where Instead Of The Usual Unrelated Next Game Paper Mario And The Thousand

Finally finished this painting, after working on it on and off for like a month. Pretty happy with it. 

So the other day (read: like 5 months ago) I bought some art at a local shop and talked to the cashier a bit about the artist while checking out, at which point the cashier dropped this wonderful nugget:

"Oh I love that artist, she's local and suuuuper young, she's like, 30."

Y'all

Y'ALL

YOU ARE NEVER TO OLD TO DO THE THING. 30 IS SUPER YOUNG. 50 IS YOUNG. YOU'RE BARELY AN ADULT AT 70.

Learn new things, try new things, continue improving on the thing you're just kinda okay at. It's never "too late" to do things.

Can you guess the current hyper fixation?

no love is too deep

hey cis people! now more than ever gender-nonconforming behavior is an act of resistance! and it's one anyone can engage in!

Whenever I take a long car ride I end up exhausted afterwards, and I'm always like "why am I so tired? I was just sitting around doing nothing all day."

But the answer, it turns out, is I was doing something. Riding in a car jars your body in many directions and requires constant microadjustments of your muscles just to stay in place and hold your normal posture. Because you're inside the car, inside the situation, it's easy not to notice all the extra work you're doing just to maintain the status quo.

There's all sorts of work that we think of as "free" that require spending energy: concentrating, making decisions, managing anxiety, maintaining hypervigilance in an unfriendly environment, dealing with stereotype threat, processing a lot of sensory input, repairing skin cells damaged by sun exposure, trying to stay warm in a cold room.

The next time you think you're tired from "nothing", consider instead that you're probably in situation where you're doing a lot of unnoticed extra work just to stay in place.

Bianca wants to help parent the baby. Unfortunately she can’t resist the urge to kick

@banditsandbookworms

Not to go "if you have ADHD just go for a run" or anything, but I am so serious if you have ADHD you should regularly go outside, no headphones no phone no nothing and just stand and observe for a while until you've had enough. Not until you get bored, until you've had enough. Drink your coffee without watching tiktok. Have a bath without music. Turn down the volume in your headphones. I cannot overstate how much learning to be bored is cruicial with ADHD. Life is not just about pleasure, no matter what your dysregulated dopamine system thinks, and when you teach your brain to be okay with being bored, then boring tasks stop feeling like torture. By letting yourself be bored you are yoinking your system out of the high/low binary and allow for the highs to feel like actual highs and not just anything that isn't low. I am so serious go literally touch grass. Listen to the sounds in your flat. Stimulate your body the way it was designed. It lowers anxiety and makes you feel like you're real and best of all it's completely free

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.