admiralpaco

[admiralpaco]

[admiralpaco]

happy hanukkah!!!!

[admiralpaco]

HAPPY HANUKKAH! 🕎

[admiralpaco]

tis the season

[admiralpaco]

Happy Hanukkah Mark!

Happy Hanukkah to all my Jewish Question Marks!

[admiralpaco]

its christmas eve and look whos on tumblr

all of us

[admiralpaco]

Hanukkah is here soon!💙✡️

[admiralpaco]

[admiralpaco]

[admiralpaco]

northern hemisphere babes we made it to the longest night of the year. we made it. for the next 6 months, every day will give us a little more daylight than the last. let's go. take my hand. climb out of the darkness with me

[admiralpaco]

How to negotiate like Donald Trump

It's always the same thing. In both politics and business. And the media always falls for it.

Declaim that there is an easy solution to any problem, it's just that the people in charge are too stupid and/or too corrupt to make the simple deal that will fix the issue.

Make a fairly banal deal that actually changes almost nothing but that he can claim is a miracle cure.

Break the deal at the last second, usually making outrageous and unacceptable demands that both won't work but that create chaos he thinks he can exploit for benefit.

Renegotiate the deal, usually making minor changes he can claim as big wins. *Perhaps* blow it up again; *perhaps* agree for realsies.

Repeat on loop, thereby ensuring that all the focus is on him and his personality and not the emptiness of his deal-making or the failures of his actual policies and programs.

Watch for the next 4 years. It's going to be just this way. Same as it ever was.

[admiralpaco]

[admiralpaco]

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.

[admiralpaco]

[admiralpaco]

My apologies, I didn't mean it as a dig against you (in the opening to this conversation you even distinguish antisemitic lefties and breadtube). I was adding additional context as of the names listed they were all British so if someone was unfamiliar with the term they might walk away with the idea Breadtube was some British left thing.

I have to admit, as much as I hate the situation we're going to all find ourselves in with the Trump regime coming to power in the US, there's a schadenfreude-filled silver lining for me as a Jew.

Specifically, seeing all of the Breadtubers and other antisemitic Lefties who spent the last year campaigning against Biden and promoting blood libel having a collective freakout.

Like Leeja Miller here:

Basically going that due to the "genocide" going on in Gaza, she couldn't support Biden.

And now...

But Leeja! I thought you didn't want Biden to win! And you're a lawyer, so you know exactly what your accusations were and what the alternative was! Why are you so upset? I thought you wanted this!

Yeah, it's really not nice to have that reaction, and I own up to it and recognize it, but...

BUT...

After a year of antisemitic libels, historical revisionism, and what I can only call active Nazi-derived propaganda, there is a part of me that is taking far too much satisfaction in watching people like Shaun_vids, Leeja, Some More News, and other BreadTubers realize that by campaigning so hard against the lesser evil and endlessly indulging in antisemitism as they went, they now have the greater evil.

And I wish them the joy of it.