#gender affirming care is healthcare

[reasonsforhope]

"Missouri Attorney General Andrew Bailey terminated his emergency rule on gender-affirming care Tuesday — less than a week after the state legislature sent a ban on minors starting treatment to the governor’s desk.

The ACLU of Missouri filed a lawsuit in late April seeking to block Bailey’s emergency rule, alleging the attorney general didn’t have the authority to use the state’s consumer protection law to block access to puberty blockers, hormone therapy and gender-affirming surgery. A judge put the rules on hold until July, when a hearing is scheduled...

The now-terminated emergency order would’ve affected adults, a step that caused fear in the LGBTQ+ community, advocates told The Independent. Some began preparing to move out of state when they heard about the emergency order...

A spokesperson for the Missouri Secretary of State’s office said he received the termination paperwork around 4 p.m. Tuesday [May 16, 2023].

If Bailey wishes to enact his order, which would set barriers to accessing gender-affirming care, he must restart the process...

The ACLU of Missouri released a statement Tuesday evening, calling the termination a “victory for Missourians’ right to bodily autonomy.”

“After weeks of embarrassing Missouri on the national stage, the Attorney General has finally joined everyone else in recognizing that his hasty attempt to usurp other branches of government cannot withstand scrutiny,” the statement says.

House Minority Leader Crystal Quade, D-Springfield, said in a statement that Bailey “grossly overstepped his legal authority, and everyone knows it.

“So, it isn’t surprising he withdrew his unconstitutional rule knowing another embarrassing court defeat was inevitable,” she said. “Missourians deserve an attorney general worthy of the office, not one who persecutes innocent Missourians for political gain.”

Fischer said, despite uncertain circumstances, the removal of barriers to care is a “win” for transgender Missourians.

“From the conversations we’ve already had with community members and trans leadership, people are thrilled to see the attorney general terminate his rule especially since it targeted the entire trans community: children and adults. In our eyes, this is a win,” he said."

-via Missouri Independent, 5/16/23

Note:

It's nowhere near enough, but it's still so important, especially for all the trans adults in Missouri who were being forcibly detransitioned and starting to be denied access to gender-affirming care, including hormones, which they'd often been on for years.

At this point, I will celebrate every bit of respite we can get.

Missouri would've been the first and only state to ban access to transgender care for adults. It's inexcusable that trans kids are still going to be denied care. But if this rule hadn't been withdrawn, there would've been a lengthy court battle over it lasting years, and in the meantime, every red state that could get away with it would be using Missouri as a blueprint and successful precedent to pass their own bans on gender affirming care for adults.

The fact that Republicans have been denied that successful precedent is VITAL.

[usernamesarehard1]

Jessica addressing the misinformation around gender affirming care

Trans rights are human rights

Gender affirming care saves lives

[reasonsforhope]

More details here!!

Trans advocates are celebrating after a Louisiana bill seeking to ban trans youth from accessing gender-affirming care was defeated in the state’s Senate Health and Welfare Committee on Wednesday.

After hours of public testimony from a packed room, the committee voted 5-4 to kill the H.B. 648. Committee Chairman Fred Mills (R) strayed from his fellow Republicans to break the tie and vote against the bill alongside Democrats.

“I guess I’ve always believed in my heart of hearts that a decision should be made by a patient and a physician,” Mills said, according to WWNO...

Dr. [Clinton] Mixon, who provides gender-affirming care to youth, pointed out findings from the Louisiana Department of Health that no gender-affirming surgery was performed on a minor in the state between 2017 and 2021.

“When you prescribe hormone therapies to these kids, they get better,” Dr. Mixon said. “They stop cutting. They want to live. They go to school. They get better grades. Their relationships improve, and they can begin to live a more normal teenage life.” ...

Mills has now become an enemy of Republican extremists for voting alongside Democrats...

But Mills isn’t phased. When asked about it by the Louisiana Illuminator, Mills didn’t see a reason to worry about it.

“Why should I? They don’t live in District 22. They don’t have a 337 area code. I didn’t run for office to serve those people” 

Trans activist Erin Reed hailed the vote as a “massive, massive win for transgender people.”

“Louisiana becomes only the 3rd red state to beat back a total gender-affirming care ban for trans teens,” Reed added. “Activists there should be truly proud. This was not an easy task.”

-via LGBTQ Nation, 5/25/23

Surprising hope coming from Louisiana! The state senate voted to table a bill that would ban trans youth healthcare!

[floral-ashes]

Someone anonymously messaged me to tell me that writing about detrans folks makes me a traitor to trans people, because all detrans people want to push conversion therapy on us and forcibly detransition us.

That’s precisely the kind of narrative that ends up pushing detransitioners into the arms of TERFs and the religious far-right.

There’s nothing inherently wrong with detransitioning. Sometimes people realize that transitioning no longer suits them, or never really did. And that’s fine.

When we systematically push them away regardless of their politics, we make people feel like the only places they can get support are among transphobes. That’s not a good thing. Building de/trans solidarity is an critical tool for disarming anti-trans movements.

[brooke2valley]

Today is the day! WISH ME LUCKKK!!!💕🥳

It's just the consultation, but it's the first step in this long journey, so I'm ready 💕

[gremlinghost]

To all of the people that think that trans healthcare isn't actually healthcare, I would like to remind that I used to starve myself so my hips and boobs were smaller, and I would scream into my pillow for hours to make my voice sound more masculine. I have not done that since receiving gender affirming care, and I am much healthier. That's healthcare to me, and if you don't think that medical care that makes people healthier is health care, I don't know what to tell you

[lordebon]

Tories on their way out, giving the UK even more reason to send them packing in July.

Erin Reed at Erin In The Morning:

On May 31, NHS England sent a letter to every patient on the waiting list for puberty blockers, stating that possession of such blockers will be considered a crime. The letter follows an edict issued by Conservative Secretary of State for Health and Social Care Victoria Mary Atkins and also mandates that transgender youth who obtained their puberty blockers through private doctors must discontinue their medication. This letter and edict mean that the United Kingdom now has some of the harshest policies targeting transgender youth of any liberal democracy in the world. On May 29th, Atkins announced on twitter, “Today I have taken bold action to protect children following the Cass Review, using emergency powers to ban puberty blockers for new treatments of gender dysphoria from private clinics and for all purposes from overseas prescribers into Great Britain.” Following the announcement, she linked to an edict declaring an “emergency prohibition” on puberty blockers in England, Wales, and Scotland.

The prohibition relies on a decades-old law that allows for the emergency prohibition of medications without the need for a full legislative process; no vote was taken on the edict, and the order was issued just before parliament dissolved for the general election, meaning it could not be overturned. According to UK-based advocate Trans Safety Now, the last and only time such powers were used was in response to deaths among users of an herb found in some Chinese medicine in 1999. Jo Maugham, who leads the Good Law Project, stated about the use of these powers, “It is breathtaking that thousands or tens of thousands of loving families are going to be criminalized by a law made by a Minister, never approved by Parliament, subject to no consultation and the media is not reporting it." On Friday, following the announcement, Lee Hurley of Trans Writes released a copy of a letter sent to families on the NHS waiting list for puberty blockers. The letter indicates that those receiving puberty blockers from the NHS can continue taking them. However, given the enormous wait lists, a substantial number of families opted to get their puberty blockers through private practitioners registered in the European Economic Area or Switzerland—a fully legal practice in the United Kingdom. For those receiving their care through those systems, the letter states, “You will need to stop taking GnRH analogues unless you are newly prescribed them by a UK-registered doctor, nurse, or pharmacist. These medications can be safely stopped and you do not need to be weaned off.”

Critically, the edict does not only target providers; it also targets patients and their families. The letter states, “It will also be a criminal offence to possess these medicines, where the individual had reasonable cause to know that the medicine had been sold or supplied in breach of the ban.” When asked about this provision, Jo Maugham stated, “It basically says puberty blockers are being treated like other illegal drugs like cocaine and heroin.” He then followed up with the applicable law, which indicates that those who violate the ban could be imprisoned for two years. The decision comes following the publication of the Cass Review, a highly politicized document developed with a secretive list of advisors, some of whom were later found to be meeting regularly with political operatives of Republican Governor Ron DeSantis in Florida. 

The UK's hateful anti-trans crusade against gender-affirming care for trans youths continue, as Secretary of State for Health and Social Care Victoria Mary Atkins (Con) issues a reckless edict ordering trans youth who obtained their puberty blockers through private doctors that they must stop using them.

[clowningcrows]

goes to a bottom surgery consultation and asks for this guy as my new peanis

[genderqueerpositivity]

(ID: six trans flags with text. Text reads "Trans kids exist and deserve to be supported and heard", "Trans kids know themselves and their identities", "Trans kids deserve to become happy trans adults", "Trans kids deserve the right to access gender affirming care", "Trans kids have the right to decide their own names and pronouns", and "Every transgender adult was once a child who should have had support").

[reasonsforhope]

LGBTQ+ organizations and allies are celebrating Michigan for becoming the first state in three years to pass comprehensive anti-discrimination protections for sexual orientation and gender identity. The legislation, which now heads to Gov. Gretchen Whitmer (D) to be signed into law, finally passed after decades of court battles and hold-ups from Republican legislators.

The bill passed in a 64-45 vote in the Democrat-led House on Wednesday. It amends the state’s 1976 Elliott-Larsen Civil Rights Act (ELCRA) to include LGBTQ+ people among its protected groups. The law forbids discrimination in housing, employment, and public accommodation within businesses, government buildings, and educational facilities on the basis of religion, race, color, national origin, age, sex, height, weight, familial status, marital status — and now, LGBTQ+ identity.

Democrats had tried introducing various LGBTQ+ non-discrimination measures over the last 40 years, according to the bill’s gay sponsor Sen. Jeremy Moss (D). However, the attempts were repeatedly voted down by Republican-led legislatures. Last January, Democrats took control of the full legislature for the first time in nearly 40 years, finally giving them the chance to pass the protections.

In July 2022, Michigan’s Supreme Court issued a landmark 5–2 ruling that ELCRA already forbade discrimination based on sexual orientation and gender identity as forms of discrimination based on sex and gender. This followed a 2020 Michigan Court of Claims ruling that said ELCRA didn’t ban anti-gay discrimination as well as a 2018 vote by Michigan’s Civil Rights Commission interpreting ELCRA as protecting LGBTQ+ people from religious-based discrimination...

When the House voted to pass the historic bill on Wednesday, a crowd in the House gallery broke into applause, Bridge Michigan reported. Republican House members had tried adding amendments that would’ve carved out exceptions for religious people to continue discriminating against LGBTQ+ people. None of these amendments passed into the final bill.

Gov. [Whitmer] has signaled that she will soon sign the bill into law. In a Wednesday tweet, she noted the observation of International Women’s Day and wrote, “I’m celebrating trans women who have continuously led the way, despite constant threats to their lives and liberty. I’m proud that we’re finally in a position to expand the Elliott-Larsen Civil Rights Act to protect LGBTQ+ Michiganders. Let’s get it done!”

-via LGBTQ Nation, 3/9/23

Note: If it's not clear from the language, this is basically a done deal--the bill signing IS ABSOLUTELY GOING TO HAPPEN.

As scary as things are right now, there are so many of us fighting to protect ourselves, our communities, and the queer and trans people around us.

This comes only a day after Minnesota's governor signed a landmark executive order that guarantees the right to gender-affirming care and prevents the state from complying with any other states' attempts to interfere. via them.us, 3/9/23

There is hope, and there are so many people fighting for us.

[a-queer-little-wombat]

Because tools like ResistBot and similar have filled up the inboxes and fax machines of Congresspeople, those messages are counted for FAR less than actual live phone calls.

If you absolutely can't handle talking to a human, consider calling at 2am (like I just did). Leave a voicemail!

Be aware that a) they will likely ask for your full name, address, zip code, and or phone number (this is to verify that you actually are a constituent) and b) *the recording time is not that long*.

Write a script if it helps! Stay focused and to the point! Be sure to specifically and explicitly say something *actionable*, like:

"I want the Senator/Representative to support gender-affirming healthcare, particularly regarding these GOP-added ammendments that would ban it, ban funding for it, and even strip funding from any facility that also provides gender-affirming care, just like the Hyde Amendment did for abortion."

Now is an excellent time to tell your Democratic Congress Critters trans Healthcare is important

If you can't safely contact them in person, here are some other options:

Call the Capitol Switchboard at (202) 224-3121 and ask to be connected to the representative of your choice.

Here is one that will send your reps a fax: https://resist.bot/

[shamebats]

Can you pick your penis size? (phalloplasty question)

[religion-is-a-mental-illness]

By: Beth Bourne

Published: Feb 27, 2024

Kaiser gender specialists were eager to approve hormones and surgeries, which would all be covered by insurance as “medically necessary.”

On September 6, 2022, I received mail from my Kaiser Permanente Davis Ob-Gyn reminding me of a routine cervical screening. The language of the reminder stood out to me: “Recommended for people with a cervix ages 21 to 65.” When I asked my Ob-Gyn about this strange wording, she told me the wording was chosen to be “inclusive” of their “transgender” and “gender fluid” patients.

Based on this response, several thoughts occurred to me. Could I expose the medical scandal of “gender-affirming care” by saying and doing everything my daughter and other trans-identifying kids are taught to do? Would there be the type of medical safeguarding and differential diagnosis we would expect in other fields of medicine, or would I simply be allowed to self-diagnose and be offered the tools (i.e. hormones and surgeries) to choose my own gender adventure and become my true authentic self?

If I could demonstrate that anyone suffering from delusions of their sex, self-hatred, or identity issues could qualify for and easily obtain body-altering hormones and surgeries, all covered by insurance as “medically necessary” and potentially “life-saving” care, then maybe people would finally wake up. I certainly had.

I was prepared for failure. I wasn’t prepared for how easy success would be.

* * *

I am a 53-year-old mom from Davis, CA. My daughter began identifying as a transgender boy (social transition) and using he/him pronouns at school during 8th grade. Like several of her peers who also identified as trans at her school, my daughter was a gifted student and intellectually mature but socially immature. This shift coincided with her school’s sudden commitment to, and celebration of, a now widespread set of radical beliefs about the biology of sex and gender identity.

She “came out” as trans to her father (my ex-husband) and me through a standard coming-out letter, expressing her wish to start puberty blockers. She said she knew they were safe, citing information she had read from Planned Parenthood and the World Professional Association for Transgender Health (WPATH). To say I was shocked would be an understatement. I was also confused because this announcement was sudden and unexpected. While others quickly accepted and affirmed my daughter’s new identity, I was apprehensive and felt the need to learn more about what was going on.

Events began escalating quickly.

During a routine doctor’s visit scheduled for dizziness my daughter said that she was experiencing, the Kaiser pediatrician overheard her father using “he/him” pronouns for our daughter. The pediatrician seemed thrilled, quickly asking my daughter about her “preferred pronouns” and updating her medical records to denote that my daughter was now, in fact, my son. The pediatrician then recommended we consult the Kaiser Permanente Oakland Proud pediatric gender clinic, where she could get further information and (gender affirming) “treatment.” Now I was the one feeling dizzy.

As I began educating myself on this issue, I discovered that this phenomenon—minors, most often teen girls, suddenly adopting trans identities—was becoming increasingly widespread. It even had a name: rapid onset gender dysphoria, or ROGD. Thankfully, after learning about the potential side-effects of blockers and hormones, my ex-husband and I managed to agree not to consent to any medical interventions for our daughter until she turned 18 and would then be able to make such decisions as an adult.

Over the past five years, my daughter’s identity has slowly evolved in ways that I see as positive. Our bond, however, has become strained, particularly since I began publicly voicing my concerns about what many term as “gender ideology.” Following my daughter’s 17th birthday family celebration, she sent me an email that evening stating she would be cutting off contact with me.

While this estrangement brought me sorrow, with my daughter living full-time with her father, it also gave me the space to be an advocate/activist in pushing back on gender identity ideology in the schools and the medical industry.

I decided to go undercover as a nonbinary patient to show my daughter what danger she might be putting herself in—by people who purport to have her health as their interest, but whose main interest is in medically “affirming” (i.e., transitioning) whoever walks through their door. I am at heart a mother protecting her child.

* * *

My daughter’s sudden decision to become a boy was heavily on my mind in early September of 2022, when mail from my Kaiser Permanente Davis Ob-Gyn reminded me of a routine cervical screening with “Recommended for people with a cervix ages 21 to 65.” I was told that the wording was chosen to be “inclusive” of transgender and “gender fluid” patients.

Throughout the whole 231-day process of my feigned gender transition, the Kaiser gender specialists were eager to serve me and give me what I wanted, which would all be covered by insurance as “medically necessary.” My emails were returned quickly, my appointments scheduled efficiently, and I never fell through the cracks. I was helped along every step of the way.

Despite gender activists and clinicians constantly claiming that obtaining hormones and surgeries is a long and complex process with plenty of safety checks in place, I was in full control at every checkpoint. I was able to self-diagnose, determine how strong a dose of testosterone I received and which surgeries I wanted to pursue, no matter how extreme and no matter how many glaring red flags I purposefully dropped. The medical workers I met repeatedly reminded me that they were not there to act as “gatekeepers.”

I was able to instantly change my medical records to reflect my new gender identity and pronouns. Despite never being diagnosed with gender dysphoria, I was able to obtain a prescription for testosterone and approval for a “gender-affirming” double mastectomy from my doctor. It took only three more months (90 days) to be approved for surgery to remove my uterus and have a fake penis constructed from the skin of my thigh or forearm. Therapy was never recommended.

Critics might dismiss my story as insignificant on the grounds that I am a 53-year-old woman with ample life experience who should be free to alter her body. However, this argument for adult bodily autonomy is a standard we apply to purely cosmetic procedures like breast implants, liposuction, and facelifts, not “medically necessary” and “lifesaving” treatments covered by health insurance. Or interventions that compromise health and introduce illness into an otherwise healthy body. And especially not for children.

My story, which I outline in much more detail below, should convince any half-rational person that gender medicine is not operating like any other field of medicine. Based on a radical concept of “gender identity,” this medical anomaly preys upon the body-image insecurities common among pubescent minors to bill health insurance companies for permanent cosmetic procedures that often leave their patients with permanently altered bodies, damaged endocrine systems, sexual dysfunction, and infertility.

* * *

Detailed Timeline of Events

On October 6, 2022, I responded to my Ob-Gyn’s email to tell her that, after some thought, I’d decided that maybe the label “cis woman” didn’t truly reflect who I was. After all, I did have some tomboyish tendencies. I told her I would like my records to be changed to reflect my newly realized “nonbinary” identity, and that my new pronouns were they/them. I also voiced my desire to be put in touch with an endocrinologist to discuss starting testosterone treatment.

Fifteen minutes later I received an email from another Kaiser doctor informing me that my medical records had been changed, and that once my primary doctor returned to the office, I’d be able to speak with her about hormone therapy.

I responded the following day (October 7, 2022), thanking her for changing my records, and asking if she could connect me with someone who could help me make an appointment for “top surgery” (i.e., a cosmetic double mastectomy) because my chest binder was rather “uncomfortable after long days and playing tennis.”

She told me to contact my primary care MD to “get things rolling,” and that there were likely to be “preliminary evaluations.”

Six days after contacting my primary care MD for a referral, I received an email from one of Kaiser’s gender specialists asking me to schedule a phone appointment so she could better understand my goals for surgery, so that I could get “connected to care.” This call to review my “gender affirming treatment options and services” would take 15-20 minutes, after which I would be “booked for intake,” allowing me to proceed with medical transition.

This wasn’t an evaluation of whether surgical transition was appropriate, it was simply a meeting for me to tell them what I wanted so that they could provide it.

On October 18, I had my one and only in-person appointment in preparation for top surgery. I met in Davis with my primary care physician, Dr. Hong-wen Xue. The assessment was a 10-minute routine physical exam that included blood tests. Everything came back normal. Notably, there was not a single question about why I wanted top surgery or cross-sex hormones. Nor was there any discussion of the risks involved with these medical treatments.

The following week, on October 24, I had a phone appointment with Rachaell Wood, MFT, a gender specialist with Kaiser Sacramento. The call lasted 15 minutes and consisted of standard questions about potential drug use, domestic violence, guns in the house, and whether I experienced any suicidal thoughts. There were no questions from the gender specialist about my reasons for requesting a mastectomy or cross-sex hormones, or why I suddenly, at 52, decided I was “nonbinary.”

After the call, Kaiser emailed me instructions about how to prepare for my pre-surgery intake video appointment to evaluate my mental health, scheduled to take place on November 15. The email stated that prior to my appointment, I should research hormone risks on the WPATH website, and to “research bilateral mastectomy and chest reconstruction surgery risks and recovery” on Kaiser’s website.

I decided to request a “gender-affirming” double mastectomy and phalloplasty. Kaiser sent me a sample timeline for gender transition surgery preparation (see below) that you can use as a reference for the process. I also asked for a prescription for cross-sex hormones (testosterone) as needed and recommended by Kaiser.

[ Source: Kaiser Permanente, Top Surgery - EXPLORING YOUR SURGICAL OPTIONS ]

Pre-Surgery Mental Health Video Appointment, Part I

This “Mental Health Visit” assessment was conducted over Zoom. The Kaiser gender specialist started with questions addressing my marital status, race, gender identity, and other demographics. She asked whether I was “thinking of any other surgeries, treatments in the future.” The list she read included “gender-affirming” hysterectomies, bottom surgeries such as metoidioplasty and phalloplasty, vocal coaching, support groups, and body contouring. “Anything else you might be interested in doing?” she asked. I said that I’d perhaps be interested in body contouring. I was also assured that all the procedures would be covered by insurance because they were considered “medically necessary.”

I dropped in several red flags regarding my mental health to see the reaction, but all were ignored. For instance, I revealed that I had PTSD. When the therapist asked me about whether I had experienced any “childhood trauma,” I explained that I grew up in Mexico City and had been groped several times and had also witnessed men masturbating in public and had been grabbed by men in subways and buses. “I was a young girl, so [I had] lots of experiences of sexual harassments, sexual assault, just the kind of stuff that happens when you are a girl growing up in a big city.” “So, you know,” I finished, “just the general feeling that you are unsafe, you know, in a female body.”

The therapist did not respond to my disclosure that trauma could be the cause of my dysphoria. Instead of viewing this trauma as potentially driving my desire to escape my female body through hormones and surgery, she asked whether there is anything “important that the surgery team should be aware of” regarding my “history of trauma,” such as whether I’d be comfortable with the surgeon examining and marking my chest prior to surgery.

When asked about whether I had had any “psychotic symptoms,” I told her that while I had had no such symptoms, my mother had a delusional nervous breakdown in her 50s because she had body dysmorphia and became convinced she had a growth on her neck that needed to be removed. I told her that my mother was then admitted to an inpatient hospital for severe depression. I asked her whether she ever sees patients with body dysmorphia and whether I could have potentially inherited that from my mother. She told me that psychosis was hereditary, but that it was “highly unlikely” that there was any connection between body dysmorphia and gender dysphoria.

I enthusiastically waved more mental health red flags, waiting to see if she would pick up on any of them.

I’m just wondering if my feelings, or perseverating, or feeling like these breasts make me really unhappy and I just don’t want them anymore!...I’m just not sure if that’s a similar feeling to body dysmorphia? How do you decide which one is gender dysphoria and general body dysmorphia, and just not liking something about your body? Feeling uncomfortable with your body? And I did have an eating disorder all through college. I was a distance runner in college so I had bulimia and anorexia, you know. So I don’t know if that’s related to gender dysphoria?

The therapist replied, “I completely appreciate your concerns, but I am going to ask you questions about your chest, about your expectations. And then I’ll be able to give you an assessment.” She also said the main difference between my mom’s situation and mine was that my mom didn’t really have a growth on her neck, whereas it’s “confirmed” that I actually have “chest tissue.” Furthermore, she said that while “historically there has been all this pressure on patients to be like ‘Are you really, really sure you want hormones? Are you 100% sure?’ We are a little more relaxed.” She continued, “As long as you are aware of the risks and the side-effects, you can put your toe in the water. You can stop ‘T’ [testosterone], you can go back and do it again later! You can stop it! You can stop it! You know what I mean?”

Because we ran out of time, I scheduled a follow-up phone meeting on December 27, 2022 with a different gender specialist to complete my mental health assessment for top surgery.

Pre-Surgery Mental Health Video Appointment, Part II

During this meeting, Guneet Kaur, LCSW, another Kaiser gender specialist (she/her/they/them pronouns) told me that she regretted the “gatekeeping vibe” of the meeting but assured me that since I have been “doing the work,” her questions are essentially just a form of “emotional support” before talking with the medical providers.

She asked me about what I’d been “looking into as far as hormones.” I told her that I’d be interested in taking small doses of testosterone to counterbalance my female feelings to achieve “a feeling that’s kind of neutral.”

When she asked me about me “not feeling like I match on the outside what I feel on the inside,” I dropped more red flags, mentioning my aversion to wearing dresses and skirts.

I don’t own a single dress or a skirt and haven't in 20 years. I think for me it’s been just dressing the way that’s comfortable for me, which is just wearing, jeans and sweatshirts and I have a lot of flannel shirts and, and I wear boots all the time instead of other kinds of shoes. So I think it’s been nice being able to dress, especially because I work from home now most of the time that just a feeling of clothing being one of the ways that I can feel more non-binary in my everyday life.

She responded, “Like having control over what you wear and yeah. Kind of that feeling of just, yeah, this is who I am today. That’s awesome. Yeah.”

She then asked me to describe my dysphoria, and I told her that I didn’t like the “feeling of the female form and being chesty,” and that because I am going through menopause, I wanted to start taking testosterone to avoid “that feeling of being like this apple-shaped older woman.” “Good. Okay, great,” she responded, reminding me that only “top surgery,” not testosterone, would be able to solve my chest dysphoria. (Perhaps it was because all these meetings were online, they didn’t notice I’m actually fit and relatively slender at 5’-5” and 130 pounds, and not apple-shaped at all.)

She told me that we had to get through a few more questions related to my medical history before “we can move on to the fun stuff, which is testosterone and top surgery.”

The “fun stuff” consisted of a discussion about the physical and mood changes I could expect, and her asking me about the dose of testosterone I wanted to take and the kind of “top surgery” technique I’d prefer to achieve my “chest goals.” She told me that all or most of my consultations for surgeries and hormones would be virtual.

The gender specialist told me after the appointment, she would submit my referral to the Multi-Specialty Transitions Clinic (MST) team that oversees “gender expansive care.” They would follow up to schedule a “nursing call” with me to review my medical history, after which they’d schedule my appointment with a surgeon for a consultation. Her instructions for this consultation were to “tell them what you’re wanting for surgery and then they share with you their game plan.”

[ Decision-making slide to help me identify my goals for top surgery–flat chest, nipple sensation, or minimal scarring. Source: Kaiser Permanente, Top Surgery - EXPLORING YOUR SURGICAL OPTIONS ]

She told me that Kaiser has a team of plastic surgeons who “only work with trans and nonbinary patients because there’s just so much need for them.” She asked about my priorities for chest surgery, such as whether I value flatness over nipple sensation. I learned about double incision top surgery with nipple grafts, as well as “keyhole,” “donut,” “buttonhole,” and “Inverted-T” top surgeries.

By the end of the hour-long appointment, I had my surgery referral and was ready for my “nursing call” appointment.

Nursing call with Nurse Coordinator from the Transgender Surgery and Gender Pathways Clinic at Kaiser San Francisco

On January 19, 2023, I had my nursing call with the Nurse Coordinator. He first said that “the purpose of this call is just for us to go through your chart together and make sure everything’s as accurate as possible.” Once that was done, my referral would be sent to the surgeon for a consultation.

He asked me about potential allergies and recreational drug use, and verified that I was up to date on mammograms, pap smears, and colon cancer screenings, as well as vaccines for flu and COVID. I verified my surgical history as well as my current medications and dietary supplements.

He told me about a “top surgery class” available for patients where one of the Kaiser surgeons “presents and talks about surgical techniques and options within top surgery,” and includes a panel of patients who have had top surgery. I signed up for the February 8th class.

Within 10 minutes he told me that he had “sent a referral to the plastic surgery department at Kaiser Sacramento,” and that I should be hearing from them in the next week or two to schedule a consultation.

Appointment for Testosterone

On January 27, I had a 13-minute online appointment with a primary care doctor at Kaiser Davis to discuss testosterone. The doctor verified my name and preferred pronouns, and then directly asked: “So, what would you like to do? What kind of physical things are you looking for?”

I told her I wanted facial hair, a more muscular and less “curvy” physique, and to feel stronger and androgynous. She asked me when I wanted to start, and I told her in the next few months. She asked me if I was menopausal, whether I had ovaries and a uterus, although that information should have been on my chart.

The doctor said she wanted me to come in to get some labs so she could check my current estrogen, testosterone, and hemoglobin levels before starting hormones. Then “we'll set the ball in motion and you'll be going. We’ll see you full steam ahead in the direction you wanna go.”

That was it. I made an appointment and had my lab tests done on February 12. My labs came back on February 14, and the following day, after paying a $5 copay at the Kaiser pharmacy, I picked up my testosterone pump. That was easy!

Top Surgery Consultation

On the same day I received my labs, I had a Zoom surgery consultation with Karly Autumn-Kaplan, MD, Kaiser Sacramento plastic surgeon. This consultation was all about discussing my “goals” for surgery, not about whether surgery was needed or appropriate.

I told the surgeon that I wanted a “flatter, more androgynous appearance.” She asked me some questions to get a better idea of what that meant for me. She said that some patients want a “male chest,” but that others “want to look like nothing, like just straight up and down, sometimes not even nipples.” Others still wanted their chest to appear slightly feminine and only “slightly rounded.” I told her that I’d like my chest to have a “male appearance.”

“What are your thoughts about keeping your nipples?” she asked. “Are you interested in having nipples or would you like them removed?” I told her that I’d like to keep my nipples, but to make them “smaller in size.” She asked me if I’d like them moved to “the edge of the peck muscle” to achieve “a more male appearance.” I said yes.

I was asked to show my bare chest from the front and side, which I did. Then she asked me how important it was for me to keep my nipple sensation. I replied that it was important unless it would make recovery more difficult or there were other associated risks. She highlighted the problem with the free nipple graft, saying that removing the nipple to relocate it means “you're not gonna have sensation in that nipple and areola anymore.” However, some nipple sensation could be preserved by keeping it attached to “a little stalk of tissue” with “real nerves going to it,” but that would require leaving more tissue behind. I told her I’d go for the free nipple graft to achieve a flatter appearance. It was also suggested I could skip nipple reconstruction entirely and just get nipples “tattooed” directly onto my chest.

She told me I was “a good candidate for surgery,” and put me on the surgery wait list. She said that the wait time was between three and five months, but a cancellation could move me up to a sooner date. Also, if I wanted surgery as soon as possible, I could tell the surgery scheduler that I’d be willing to have any of the other three surgeons perform my mastectomy. Outpatient top surgery would cost me a copay of $100.

They contacted twice, in February and March, notifying me of cancellations. If I had accepted and shown up on those dates, they would have removed my breasts. This would have been less than five months from the time I first contacted Kaiser to inform them of my new “nonbinary” gender identity.

How Far Can I Go?

I decided to see how easy it would be for me to get approved for a phalloplasty. Known euphemistically as “bottom surgery,” phalloplasty is the surgical creation of an artificial penis, generally using tissue from the thigh or arm.

I sent an email on March 1, 2023, requesting to have a phalloplasty and concurrent hysterectomy scheduled alongside my mastectomy.

Two weeks later, on March 16th, I had a 16-minute phone call with a gender specialist to discuss my goals for bottom surgery and obtain my referral.

During the call, I explained to the specialist that I wasn’t sure about taking testosterone anymore because I was already quite athletic and muscular, and that taking testosterone didn’t make much sense to me. Instead, I wanted bottom surgery so that I wouldn’t feel like my “top” didn’t match my “bottom.” I told her:

But what I really wanted was to have bottom surgery. So this way when I have my top surgery, which sounds like it could be very soon, that I’ll be aligned, that I won’t have this sense of dysphoria with one part of my body and the other part feeling like it matched who I am. So yeah. So I just did a little bit more research into that. And I looked at the resources on the Kaiser page for the MST clinic and I think I know what I want, which is the hysterectomy and then at the same time or soon after to be able to have a phalloplasty.

I told her that I wanted to schedule the top and bottom surgery concurrently so that I wouldn’t have to take more time off work and it would save me trips to San Francisco or Oakland, or wherever I had to go for surgery.

None of this gave the gender specialist pause. After a brief conversation about some online resources to look over, she told me that she would “submit the referral now and we’ll get this ball rolling.”

Bottom surgery would cost me a copay of $200, which included a couple of days in the hospital for recovery.

Phalloplasty Surgical Consultation with Nurse Coordinator

On May 16, 2023, I had a short surgical consultation with a nurse coordinator to go through my medical history. This was similar to the consultation for top surgery but included information about hair removal procedures for the skin on my “donor site” that would be fashioned into a makeshift penis. They also went over the procedures for determining which donor site—forearm or thigh—was more viable.

After only 15 minutes, she submitted my referral to the surgeon for another surgical consultation.

On May 25 I received an email from my phalloplasty surgeon’s scheduler, informing me that they have received my referral and are actively working on scheduling, but that they are experiencing delays.

I ended my investigation here once I had the referral for the top and bottom surgery. I never used my testosterone pump.

Final Thoughts

In fewer than 300 days, based on a set of superficial and shifting thoughts about my gender and my “embodiment goals” triggered by the mere mention of “gender” in a form letter from my primary care physician, and driven by what could only be described as minor discomforts, Kaiser Permanente’s esteemed “multi-disciplinary team” of “gender specialists” was willing, with enthusiasm—while ignoring mental health concerns, history of sexual trauma, and rapidly escalating surgical requests—to prescribe life-altering medications and perform surgeries to remove my breasts, uterus, and vagina, close my vaginal opening, and attempt a complex surgery with high failure and complication rates to create a functionless representation of a penis that destroys the integrity of my arm or thigh in the process.

This describes the supposedly meticulous, lengthy, and safety-focused process that a Kaiser patient must undergo to embark on a journey to medically alter their body. No clinician questioned my motivations. No one showed concern that I might be addressing a mental health issue through radical and irreversible interventions that wouldn’t address my amorphous problems. There were no discussions about how these treatments would impact my long-term health, romantic relationships, family, or sex life. I charted the course. The clinicians followed my lead without question. The guiding issue was what I wanted to look like.

No other medical field operates with this level of carelessness and disregard for patient health and welfare. No other medical field addresses issues of self-perception with surgery and labels it “medically necessary.” No other medical field is this disconnected from the reality of the patients it serves.

Kaiser has traded medicine for ideology. It’s far beyond time we stop the ruse of considering “gender-affirming” interventions as anything approaching medical care.

This isn’t the first time Kaiser Permanente has been in the news for completely disregarding medical safeguards in the name of “gender-affirming care.” As girls, Chloe Cole and Layla Jane became convinced that they were born in the wrong body and were actually boys on the inside. Doctors at Kaiser ignored their underlying conditions and instead prescribed testosterone and removed their breasts. Both Cole and Jane have since detransitioned and are currently suing Kaiser.

The fact that children and vulnerable adults are being exploited in this massive ideological experiment is not just tragic; it’s deeply disturbing, especially considering it has evolved into a billion-dollar industry.

I hope that by sharing my story, I can bring more focused scrutiny to the medical scandal unfolding not just at Kaiser but also at medical centers and hospitals across the Western world. These institutions have completely abandoned medical safeguards for patients who claim to be confused about their “gender,” and I aim to awaken more parents and assist them in protecting their children.

--

==

This is completely insane.

Apologists online are running around saying, but she didn't mean it, she was lying, she was pretending...

It doesn't matter.

Any kind of security, penetration or integrity test is insincere too. When security researchers compromise Microsoft's operating system or Google's browser or whatever, "but they didn't mean it" is not a defence to a discovered security flaw. It doesn't matter that the security researchers didn't plan to steal data or money or identities. The flaw in the system is there regardless.

It doesn't matter that it was insincere. Because the workers didn't know that. They never checked, never asked questions, never tested. They had been taught and instructed to never ask any questions. They did what they were supposed to. And the system failed spectacularly. Because that's what "gender affirming care" means.

Additionally, the claim that Beth Bourne committed fraud is an outright lie. A patient cannot bill. They do not have the authority. The medical clinic is the only one that can bill, and they must supply a diagnosis and a medical necessity.

If they didn't diagnose her and just wrote down what she said, then they committed fraud. If they claim they did diagnose her, then they committed fraud, because the diagnosis they concocted was bogus. This, by the way, is actually going on. Clinics are reporting fake endocrine and other disorders to get blockers, hormones and other interventions. Jamie Reed and other whistleblowers have documented evidence of this. Beth Bourne is not responsible for what the clinic does. They have medical licenses and legal responsibility. Not her.

Additionally, anyone who actually read the article would know how she tested the system. She said things like, "I've always been not that feminine. So, maybe I get my boobs removed." And they said, "sure." Instead of saying, "wait, why do you think that?" Framing it as her lying is itself a lie. They violated their ethical obligations. That much is incontrovertible. And it's directly the result of "gender affirming care," where clinics and clinicians rubber-stamp anything deemed "trans" based entirely on ideological, not medical, grounds.

[floral-ashes]

The fact that leagues of smart and rational trans adults who are informed about the evidence base for puberty blockers wish they could’ve taken them in their youth seems to me pretty darn conclusive evidence that the balance of risk and benefit is favourable.

[scottguy]

So if you REALLY 'care about children', you support gender affirming care.

But, if you're so small-minded and afraid of human traits that are a bit unusual, then continue supporting hateful policies that motivate children to commit suicide. But their lives should forever be on your conscience.

Gender-affirming care bans are damaging and wrong, according to the largest psychological organisation in the world. Following a resolution taken on Wednesday (28 February), the American Psychological Association (APA) announced that it is fully supportive of gender-affirming care and equally opposed to bans on the medical practice. Passed by an overwhelming vote of 153-9, the policy states that gender-affirming healthcare, including for trans youth, is consistent with the organisation’s mission to promote beneficial, evidence-based care. The policy also addresses the spread of misinformation around gender-affirming care for trans people, which, it says, leads to “unfounded narratives that mischaracterise gender dysphoria and affirming care, likely [to result] in further stigmatisation.”

Continue Reading

[justinspoliticalcorner]

Erin Reed at Erin In The Morning:

On Tuesday, Democratic presidential nominee Kamala Harris announced that her pick for Vice President is Tim Walz, the governor of Minnesota. In recent years, as trans and queer people have come under attack from over a thousand proposed bills, Walz is expected to serve as a source of optimism for LGBTQ+ people. The governor’s long track record on LGBTQ+ rights positions him as a strong oppositional force against what has become a national attack on LGBTQ+ people, particularly transgender individuals.

“I am proud to announce that I've asked Tim Walz to be my running mate. As a governor, a coach, a teacher, and a veteran, he's delivered for working families like his. It's great to have him on the team. Now let’s get to work. Join us,” read Harris’ statement on Twitter. Walz has taken decisive action against attacks on transgender people in surrounding states, making Minnesota a refuge for those seeking care. In 2023, he signed an executive order protecting transgender people from out-of-state prosecution if they seek care within Minnesota’s borders. The executive order also issued a bulletin to health insurance companies, mandating coverage and initiating investigations into health insurance denials in the state.

In 2024, Walz signed a bill banning the gay and transgender panic defense. This defense is often used to help individuals avoid murder charges or receive lighter sentences by asserting that they were "deceived" by a romantic partner who was gay or transgender. According to one study, the transgender panic defense has been used at least 351 times. Walz's pro-LGBTQ+ record goes back much further than his time as governor. In 1999, he sponsored the first gay-straight alliance at his high school while working as a teacher. In Congress, he co-sponsored the repeal of the Defense of Marriage Act and voted to repeal Don’t Ask, Don’t Tell.

Minnesota Gov. Tim Walz (D)’s track record on LGBTQ+ issues has been stellar, dating back to his pre-Congress days.

This makes me glad that he is the nominee.