#big medicine

[healingdemeter]

The Lie About Pediatric Transition

I am currently reading Time to Think which details the trans medical scandal at the Tavistock. I have been following this for awhile and am still shocked at the details that are emerging.

One lie I am tired of hearing is that the Dutch Protocol and Pediatric transition were immaculately researched and have a strong evidence base. This book shows how poor the evidence base was, how the research was funded by pharmaceutical companies, how the pressure to transition children was driven by activist groups such as Mermaids, and how poor funding for children’s mental health services all contributed to this perfect storm of putting children on a medicalized pathway that leaves them at risk of being anorgasmic, infertile, and whose consequences to brain development we do not yet understand. 

Children who are gender diverse deserve better than this! Gender diverse children deserve to learn to love their bodies and to have bodies that are fully functioning!

[culturevulturette]

[culturevulturette]

And right after that they'll declare whatever series of riots is taking place virus-free zones.

[inkskinned]

"don't make it political!" .... what proportion of death and suffering must occur before politics are involved. if this isn't political, what is even the point of any politics, ever. of democracy. the words are "by the people for the people." if i am going to be left alone by my elected representatives to "figure it out" - to undergo damage, hardship, fear. what the fuck did i elect them for. what was their job. the entire point is that they handle this shit. this is why we were supposed to be electing leaders.

poverty is political. misogyny is political. gun control is political. climate change is political. how much aid a community gets is political. what the fuck are you talking about. it's been political this whole fucking time.

[cakesandfail]

apparently the goons over on twitter are now doing "antidepressants turn your kids ace" which sounds a little too much like "vaccines cause autism" and "puberty blockers are permanent" for my liking

[puppetmaster13u]

Prompt 94

Danny has no clue what he’s just agreed to but Ellie seems happy about it, so it can’t be too bad. Ellie is honestly surprised but more than a little touched her template-dad gave her permission to let her new clone-union-totally-not-a-revolution use his lair as a home base. Now she just needs to help Klarion figure out how to make those portal-bracelets for each of them…

[sallytwo]

AND I WANT TO BUILD A TOWER TO ALL THE NICER THINGS YOU COULD’VE BEEN.

[small-spark-of-light]

FINALLY FINISHED THIS PIECE LETS GOO :DDD another artwork for one of my fics!!! this time its my recent sickfic

here are some bonus doodles!!!

[caycanteven]

Don Balsam ref I? I think?

Cant believe the mafia version got a “ref” before his actual one LOL.

Balsam has a powerful hand in the medical field in his part of the city and some parts outside it depending on alliances. If an unfamiliar subordinate ends up in one of "his" facilities, it's not uncommon to hear from a another boss or even a Don looking for "cures" for their family who got in a pretty bad tussle. Don Bal doesn't really show himself in public unless it's to visit his favorite diner—or his favorite waitress, and meet for business. People who know his practices well nicknamed him "The Doctor.”

[koyangii]

Love in the big city and HIV

So, I have recently watched one of the best dramas of the year, “Love in the big city”, in which HIV is a major theme. 

The show portrays really well the stigmatized scenario around HIV: as a person living with the virus,  Go Young feels exactly as if he's carrying some kind of curse. He can't accept it, but who can blame him for that, if "Kylie", as he calls the virus, is always around like an inconvenient person? In his sex life, while applying to a job, and even while hanging out with friends. 

Society doesn't make it easy for a person living with HIV to accept the condition and that's essential when it comes to healthcare, which is what I want to address today. 

First, let me introduce myself: my name is Nico and I'm a Medicine student in Brazil. Here, we have probably one of the biggest public health system in the world, the Unified Health System (a.k.a. SUS). In this essay, I intend to share some general information about HIV, its treatment and prevention, by using some parts of “Love in the big city” to discuss this theme, because although the show did an amazing job when it comes to talking about it, there are some points I found needed some better explanation. 

HIV is a sexually transmitted infection (STI) that can also be transmitted by the contact with infected blood (e.g: incompatible blood transfusion; use of shared needles) or from the mother to a child inside the womb or during labor. The virus uses a specific type of immune cell to multiply. Explaining it in a very simple way, he gets inside the cell, uses its components to produce new viral copies and then ruptures the cell membrane to release these new copies in the blood, killing the cell by doing so. For this reason, untreated HIV is very dangerous, since it can cause immunodeficiency (failure of the immune system), making the person susceptible to acquire opportunistic infections, which are diseases that usually don’t occur in people with regular immune systems. When someone has immunodeficiency caused by HIV, this person is diagnosed with Acquired ImmunoDeficiency Syndrome (AIDS). That being said, AIDS and HIV are not the same. There are many people living with HIV that don’t have AIDS, thanks to appropriate treatment. 

There are multiple ways a person can discover about having HIV: you can be notified because the person you have had relations with discovered the infection, or by taking blood tests for blood donation, or in the worst case scenario, when you are already suffering from an opportunistic infection. Go Young, for example, discovered it because of the blood tests results while he was in the army. One thing I found very outrageous was that the physician instantly inferred that Go Young was gay because of that, but this is impossible, since anyone can get the virus, regardless of their sexual orientation. This appointment was like a death sentence: the unempathetic doctor as a ruthless judge, blaming the patient and not offering a single word of comfort. (Quite the opposite: he even asked that very intimate question about sex positions. Seriously, I wanted to punch this doctor so hard.)

Nonetheless, even if it was made in a very inappropriate way, diagnosis is still very important, because that is the only way one can have access to treatment. Each patient must be evaluated separately, since treatment may vary due to the different genetic subtypes of the virus and the person’s own body response. Medication can also be adjusted until satisfactory results are accomplished. Overall, all patients are submitted to a lifetime antiretroviral therapy in order to stop the virus from multiplying and to keep immune cells at a higher level. In the series, we can see Go Young asking for any antiretroviral in a pharmacy, but in real life, he would be very specific about the drugs.

If done properly, treatment can provide quality of life and long life expectancy (very similar to people who don’t have HIV), prevent opportunistic infections and, most importantly, transmission! Yes, that is exactly what you read: treatment can result in really low levels of HIV in the blood, which is called “undetectable viral load” if it happens for at least six months. There is even a saying which goes “Undetectable = untransmittable”. In this scenario the patient can even have sex without a condom with their partner, which is what happened with Go Young and Gyu Ho in the series. However, it is important to mention that this only applies to HIV: one can still get other STIs while having unprotected sex. 

In addition to condoms and proper treatment, there are other ways of preventing HIV infection. Susceptible people can use the pre-exposure prophylaxis (PREp) medication, which highly reduces the risk of getting HIV from intercourse (and also from blood contact in a less effective way). There is also the post-exposure prophylaxis (PEP), which can prevent infection if taken within 72 hours after possible exposure. Treating other STIs, not sharing needles, using lubricant (less chance of injury during intercourse) and avoiding sex while in use of alcohol or drugs are some other habits we can do ourselves to minimize the risk of acquiring HIV. 

Nevertheless, individual actions can help only until a certain point, given that the best prevention is the “combination prevention”, which includes not only behavioral and biomedical approaches, but also structural interventions. Every country should have their own public policies to assist people living with HIV and to prevent transmission. I’m proud to say that, in Brazil, thanks to our public health system, everyone has access to condoms, lubricants, tests, treatment, PREp and PEP - all free of charge. The system also has policies of damage control, providing all of these strategies to the population of risk, such as sex workers and people with a substance use disorder, including kits with individual needles to prevent sharing and, consequently, blood transmission. No wonder we are an international reference for HIV/AIDS treatment and prevention. 

To conclude, I also need to remind you that you can actively help in this cause by simply showing support. As we all watched in “Love in the big city”, a person living with HIV faces all kinds of prejudice in society. Go Young carried a heavy burden for years, not being able to share it with anyone until Gyu Ho embraced him. Sometimes, patients have these prejudices themselves and it can deeply hinder treatment. I have seen this myself: a patient that denied the diagnosis and returned to the hospital sometime later with a severe health condition.

You can be the person that will accept and embrace this other person, who is only living with a chronic condition, such as many people who live with hypertension or diabetes, for example. You can be the person that will call out on others for their preconceived opinions. You can be the person who will share high-quality information to your friends, family, fellow workers or students (There are links in the last paragraph with reliable information for those who want to do some further research). 

Finally, I can’t stress enough how much I loved “Love in the big city” for addressing so many types of love and so many sensitive topics, including this one, in such a beautiful way. It has been a long time since I had felt so connected to a story, to a character so human like Go Young. 

I hope this essay provided a little bit of information to you. I mostly used the knowledge I have learned in college and sites of well-recognized organizations, such as the UNAIDS, the World Health Organization (WHO) and, for the Portuguese speakers, the Brazilian Ministry of Health (Ministério da Saúde). Thank you for reading, and please, feel free to send me any questions you might have, I’ll do my best to answer them. Also, if you notice any English mistakes, please let me know so I can correct them. 

[healingdemeter]

Challenge Binary Thinking

One way that the Big Pharma and Big Medicine perpetuate the harm done to children who are gender diverse is by telling the lie that people are either 100% on board with pediatric transition or they are religious fundamentalists who are 100% against it. 

The reality is that there are people who care about trans rights and have legitimate questions about the evidence base regarding pediatric transition. There are people who believe that children deserve better than puberty blockers and irreversible surgeries and do not agree with banning such treatment or calling CPS on parents who pursue it for their children. 

But so long as the narrative is that you are either A or Z, trans and LGB kids will be hurt.

[lacaffeina]

i'm alive, i've just been dealing with histology.

[stuckinapril]

Woke up having a crisis about if I want an MD or an MD PhD………. It’s so over

[dosesofcommonsense]

[bootleg-nessie]

Illiterate pharmacist who can only tell medications apart by crushing them up and tasting the molecules

[spookiboogi]

Inspiration can be beautiful