#leore

[yvesverte]

@worlddominvtion

[rokkzalm]

Pixy Lord Leore

FFED64 / D0230E / 57AE01 / 059280 / 65D4D1

[thecatcherintherye-16]

Primo libro del 2023 📖 #leore #cunningham #instabooks #reading #booklover #readersofinstagram #readingchallenge #bookaholic https://www.instagram.com/p/CnB6DP5AIXI/?igshid=NGJjMDIxMWI=

[bread-wizards]

Keyleth's relationship with Orym reminds me a bit of Vax's relationship with Kynan towards the end of the campaign. "This is my little guy. He's great, very anxious, a little messed up but I want to see him succeed in life."

[religion-is-a-mental-illness]

[fabuloustrash05]

“I don’t ship Karai x Shinigami because they’re basically like sisters, which is wrong!”

Me: Who do you ship Karai with then?

“Leo!”

Me:

[justinspoliticalcorner]

Alyssa Tirrell at MMFA:

Dr. Eithan Haim, a former medical resident at Texas Children's Hospital, was indicted in May for allegedly illegally accessing trans patients’ records, which he subsequently shared with Manhattan Institute senior fellow Chris Rufo.  Right-wing media figures have since defended Haim and brought him in for interviews, often equating the care allegedly provided at Texas Children's Hospital — such as the prescription of "puberty blockers" — with harm or mutilation and alleging that Haim is the target of political persecution.  The campaign has successfully raised both Haim's profile and at least $888,865, which he claims will be used for both his legal defense and “offensive legal action against those who have abused their professional responsibility in service of radical transgender ideology.” 

Haim allegedly illegally accessed trans patients’ records

On February 18, 2022, Texas Attorney General Ken Paxton issued an opinion that qualified youth gender-affirming care as "child abuse", prompting Texas Children's Hospital to announce that it would stop proving such care. Although the opinion was not legally binding, the hospital released a statement announcing that it would stop prescribing gender-affirming hormone therapies. The statement, which also alluded to recent measures that Gov. Greg Abbott had taken against families of children receiving gender-affirming care, added that “this step was taken to safeguard our healthcare professionals and impacted families from potential legal ramifications.” [Office of the Attorney General of Texas, 2/18/22; American Civil Liberties Union, 2/23/22; The Washington Post, 3/8/22]

In late spring 2023, Dr. Eithan Haim allegedly accessed the records of trans patients at Texas Children's Hospital and shared them with Manhattan Institute senior fellow Chris Rufo. Haim, a resident at Baylor College of Medicine who had previously conducted rotations at Texas Children's Hospital, shared redacted files with Rufo that allegedly demonstrated that the hospital was continuing to provide gender-affirming services to minors. [Houston Public Media, 6/10/24; U.S. Attorney's Office, Southern District of Texas, 6/17/24; United States District Court of the Southern District of Texas, 5/29/24]

On June 2, 2023, a Texas bill restricting gender-affirming care for children was signed into law. S.B. 14 prohibited “the provision to certain children of procedures and treatments for gender transitioning, gender reassignment, or gender dysphoria” as well as “the use of public money or public assistance to provide those procedures and treatments.” The law went into effect on September 1 of that year. [Texas legislature, 6/2/23]

[...]

Right-wing media figures platformed Haim in solo interviews, where he defended himself 

Since January 2024, with the revelation of his identity, Eithan Haim has appeared as a guest alongside many prominent right-wing media figures. In these interviews Haim neither claimed to have worked directly with trans patients nor disputed sharing the documents with Chris Rufo. Instead, Haim often alleged that he was being unfairly targeted and defended his case on the grounds that the care allegedly provided at Texas Children's Hospital was harmful to pediatric patients. 

Right-wing media defend Dr. Eithan Haim’s HIPAA-violating ways of illegally accessing trans patients’ records while at Texas Children’s Hospital in which he shared those records with far-right anti-LGBTQ+ agitator Christopher Rufo.

[manueltorresart]

It contains Spoiler traces if you've seen only The Legend of Vox Machina. Not a character you might know from @criticalrole, he isn't that relevant but Kynan's character growth it's cool to see.

Again, NPC voiced by Matthew Mercer.

[who-do-i-know-this-man]

⚠️Vote for whomever YOU DO NOT KNOW⚠️‼️

[critter-genfic-events]

This time, we have seven fics that talk about mentorship! Sometimes for the better, sometimes for worse - and a lot of thoughts about legacy. Check them out behind the cut, and as always - comment and kudos if you like them!

The Slow March of Time by Swan_Song (13737,General) Warnings: Major Character Death/Lifespan angst Pairings: Yussa Errenis & Essek Thelyss & Caleb Widogast, background Shadowgast, QPR Essek and Yussa

Yussa and Essek talk about Caleb, about grief, and about memory.

Reccer says: gorgeous and sad

we all need someone to stay by whyyesitscar (2776,Teen) Warnings: None Pairings: Dairon & Beauregard Lionett, Dairon & Yudala Fon

a short character study on dairon's thoughts and feelings about our favorite punk monk

Reccer says: I liked it

Tiny Monks and Little Mages by devil_seabird_king (ShaaKi) (2011,Teen) Warnings: None Pairings: Beauregard Lionett & Caleb Widogast

When Caleb needs assistance with a lesson, Beau takes the opportunity presented and runs with it. The outcome may just have a lasting impact.

Reccer says: Great Beau voice, and cute!

Unnamed Baby Boy by tfm (1270,Teen) Warnings: Pairings: Dairon & Beauregard Lionett, background Beauyasha

Beau takes her newly adopted son to Zadash. Dairon is unimpressed (or are they??)

Reccer says: Fun and hilarious and adorable

prospective pupils by quinn_of_aebradore (1128,General) Warnings: None Pairings: Essek Thelyss/Caleb Widogast

After a two year break, Caleb begins tutoring another class of Soltryce rejects.

Reccer says: I love the characterization and thought put into the students, and the emotions described for Caleb

Let Others Light their Candles by ChronicBookworm (2801,General) Warnings: None Pairings: Patia Por'co & The Raven Queen, Cerrit Agrupnin & Patia Por'co, Imyr Por'co & Patia Por'co, Maya Agrupnin & Patia Por'co

Patia, her mentors, and the one she never got the chance to mentor.

Reccer says: God, thinking about Patia just kills me and this fic does her justice and gives me so many feelings

kill your heroes by CorvidFeathers (16440,Teen) Warnings: None Pairings: Kynan Leore & Anna Ripley

The ballad of Kynan Leore and Anna Ripley

Reccer says: Amazing fic about a character that doesn't get too much attention - and super clever to boot

This is one of our weekly communally-generated gen rec lists. Every week we announce a new theme and allow anyone to submit a fic recommendation. Please note that the summary and content notes are provided by the reccer, and may be different than what the author has provided. Please assume good intentions all around. <3

And hey, anyone includes you!

We'll be back on the first with Scanlan Recs - then on the fifteenth with fics featuring dreams.

Any fics coming to mind? Well, then use this form to submit! If you're looking for some more, check out some fics written in the critter genfic bingo tag, or the older rec lists! Or you can request your own card and join in on the fun!

[kill-a-man-for-kynan]

Keyleth: Imagine if someone handed you a box full of all the items you have lost throughout your life Cassandra: Self-esteem, haven't seen you in years! Percy: Oh wow, my childhood innocence! Thank you for finding this! Kynan: I knew I lost that potential somewhere! Vax: My moral code, is that you? Keyleth: Keyleth: I was just gonna show you this cool trunk my mother left me but do you guys need a hug?

[hinumay]

I wish more people would appreciate or remember Vax and Kynan's sibling, mentor relationship even though it wasn't really highlighted or explored sighh

ive been really sad lately, due to fears and stuff, so i wanted to latch on to these guys, because they're sad too, i want to be sad with them both they're smiling here tho

[luegootravez]

Leore Hayon by © Emman Montalvan

[blorbologist]

This little space between us

Cassandra de Rolo/Kynan Leore, T, 16K, Hurt/Comfort

Giftfic for @burr-ell! <33

"... So, if you don’t mind - I guess that makes me your guard, now?” Cassandra does mind. Very much so. So at her first opportunity, when the stumbling and sighing and shifting becomes too much, she slips away. -- Cassandra de Rolo survived by hiding and still finds comfort in small spaces. Regrettably, Kynan Leore is pretty damn good at finding her.

Cassandra is used to jumping at her own shadow. It slinks too close to her heels, looms too tall overhead by candlelight. She will spy it out the corner of her eye and think it part of the castle’s literal skeleton crew. Worse - Sylas or Delilah. Unfortunately, her wallbound twin resembles the latter more than anything. She takes to wearing her hair down, or braided, or pulled back, just anything but the tight bun - 

She hates her shadow. Wishes she could carve it from her heels with a stolen kitchen knife.

So to find she has two, after Percival revealed a dragon hiding in their castle, she - she would scream, she should, but that habit has been cut from her successfully. 

He’s not Assum. Though that hardly matters, with a shapeshifter (can she trust the next Percival she sees to be her brother at all)?

Older demons, at least, she can identify. His flesh is not sloughing. His bones are all well-hidden. He is not Sylas. He is not Delilah. (She is not Delilah.)

And so Cassandra swallows enough bile to squeak “Who?” at this stranger. 

Her new shadow startles, backing some paces. “I - oh, I’m sorry, my Lady! I just - sorry, did no one tell you?”

It feels like a trap. Smells like one, too, but that might be the familiar cold sweat she breaks into at mind games. She swallows and feels the snare against her throat. The dagger in her corset. “Tell me what? Why are you here - and speak clearly, or I will - I’ll -”

What? Cry for help? Gut him like a fish? Die prettily? She isn’t sure. So she pretends it’s a hanging threat.

To his credit, however he takes it, he takes her seriously. 

[Keep reading on AO3!]

[criticalrolenpctournament]

ROUND 1, POLL 54

Which NPC is the best overall character?

[religion-is-a-mental-illness]

By: SEGM

Published: Aug 13, 2023

Near-zero regret” findings among adults suffer from a critical risk of bias and have low applicability to youth

Recent research published in JAMA Surgery evaluated satisfaction and regret among individuals who had undergone chest masculinizing mastectomy at the University of Michigan hospital. The average patient age at the time of mastectomy was 27 years; no patients who were under age 18 were allowed to participate in the study.

The participants reported high levels of satisfaction and low levels of regret at an average of 3.6 years following mastectomy. The study authors lauded the “overwhelmingly low levels of regret following gender-affirming surgery,” and framed their findings as in conflict with the “increasing legislative interest in regulating gender-affirming surgery,” referring to current legislative attempts to restrict or ban “gender-affirming” procedures for minors. Another group of authors provided an invited commentary on the paper, reinforcing the view held by the study authors, and asserting the presence of a “double standard:” “gender-affirming” mastectomies have come under undue scrutiny by states’ legislators, while other surgical procedures with higher regret rates do not appear to concern legislative bodies.

The study suffers from serious methodological limitations, which render the findings of high levels of long-term satisfaction with mastectomy among adults at a "critical risk of bias"—the lowest rating according to the Risk of Bias (ROBINS-I) analysis. ROBINS-I is used to assess non-randomized studies for methodological bias. The "critical risk of bias" rating signals that the results reported by the study may substantially deviate from the truth. The results also suffer from low applicability to the central issue the study and the invited commentary sought to address, which was whether legislative attempts to regulate “gender-affirming” surgeries are warranted in minors. Unfortunately, these highly questionable findings are misrepresented as certain and highly positive by both the study authors and the invited commentators, several of whom have significant conflicts of interest.

Below, we provide a detailed explanation of the key methodological issues in the study which render its claims untrustworthy and not applicable to the patient population at the center of the debate: youth undergoing gender reassignment. We also comment on the alarming trend: several prestigious scientific journals appear to have deviated from their previously high standards for scholarly work and instead have become vehicles for promoting poor-quality research, seemingly to influence judicial policy decisions rather than advance scientific understanding. We conclude with recommendations about how journal editors can restore the integrity of scientific debate and raise the bar on the quality of published studies in the field of gender medicine.

[ For in-depth analysis, see: https://segm.org/long-term-regret-satisfaction-mastectomy-critical-appraisal ]

SEGM Take-Aways

Although this study reports extremely high rates of satisfaction and low regret, the timeframe in which these outcomes were assessed is insufficient—just 3.6 years post-mastectomy on average. The sample is also highly skewed: 50% of the participants had mastectomies in the last 3.6 of the 30 years. This skewing of the length of time since surgery is expected, given the sharp rise in the number of people (especially adolescents and young adults) identifying as transgender and undergoing chest masculinization mastectomy. It is also a short time in which to assess regret, particularly since one quarter of study participants were younger than age 23 at time of surgery and the median age of first birth in the US is 30 years.

The conclusion of high satisfaction/low regret suffers from a critical risk of bias due to the high non-participation rate, important differences between participants and non-participants, and lack of control group. Problematically, the authors misuse the (critically-biased) results from adults to argue against regulations for irreversible body alternations for minors and do so with a decidedly politicized spin.

The only intellectually honest commentary is that we do not have good knowledge of the likely rates of detransition and regret following chest masculinization mastectomy, nor do we know how many people experience regret but remain transitioned. There is an urgent need for quality research in this area. Previously, detransition and regret rates were considered to be low: they may have indeed been low due to the much more rigorous screenings, or the results may have been biased by the notoriously high dropout rates that plague “regret” research. Regardless, there is now growing evidence of much higher rates of medical detransition.

A recent study from a comprehensive U.S. dataset with no loss to follow-up revealed a 36% medical detransition rate among females within just 4 years of starting hormonal transition. At least two recent studies suggest that average time to regret among recently-transitioned females is about 3-5 years, but there is a wide range. Much less is known about detransition among those who undergo surgery. A growing number of detransitioners now express regret associated with the loss of breastfeeding ability, with one case study detailing breastfeeding grief experienced some 15 years post-mastectomy.

The study and invited commentary exemplify three problematic trends that plague studies emerging from the gender clinics: problematic conflicts of interest of the authors; leveraging scientific journals to disguise politically-motivated pieces as quality research; and a conflicted stance by the gender medicine establishment on surgery for minors. We expand on each briefly below.

Conflicts of interest of study authors and commentators 

The significant conflicts of interest of the gender clinicians who study and report on the outcomes of “gender-affirming” interventions cannot be overlooked. These clinicians are conflicted financially, since their practices specialize in “gender-affirming” interventions, as well as intellectually. While conflicts of interest among experts are common, such experts should still attempt to be balanced in their discussions and should acknowledge and reflect on their conflicts of interest.

The interpretations of the data in the study is neither rigorous nor balanced, and both the study and the invited commentary have a decidedly political spin. Further, the invited politicized commentary does not disclose that at least one of the authors is a key expert witness opposing states’ efforts to regulate “gender-affirming” surgeries for minors. This role alone precludes the ability to provide a balanced commentary.

There is a fundamental problem with research emerging from gender clinic settings. The same clinicians provide gender-transitioning treatments to individual patients in their practice; serve as primary investigators and custodians of data used in research informing population health policies; and increasingly, provide paid expert witness testimony in courts defending the unrestricted availability of hormonal and surgical interventions for minors.

As a result, such clinicians cannot express nuanced perspectives. Since any balanced statements may be used against them in a court of law when they serve as expert witnesses, they must resort to the lowest common denominator of the "winner-takes-all" adversarial approach. Such an approach does not tolerate nuance. Unfortunately, this approach contributes to the erosion of the quality of the published work in the arena of gender medicine and accelerates loss of trust about the integrity of the scientific process.

Misuse of scientific publications to promote politically-motivated articles disguised as scientific research

That prestigious medical journals now serve as platforms for promoting misleading, politically motivated research that aims to apply a veneer of misplaced confidence in  highly invasive, irreversible treatment should worry everyone committed to evidence-based medicine and the integrity of science. Moreover, it impairs our ability to accurately assess and improve the long-term health outcomes of the rapidly growing numbers of gender-diverse and gender-distressed youths.

This is not the first time that a JAMA has been used as a platform for positioning advocacy for “gender-affirming” care as scientific research. In 2022, JAMA Pediatrics published a study that assessed bodily happiness in a group of subjects aged 14-24 three months after chest masculinization mastectomy. Despite the very short follow up and dropout rate of 13%, the authors argued that their findings supported the premise that there was no evidence to suggest that young age should delay surgery. They also asserted that their research would help dispel the misconception that such surgeries are experimental. The editorial commissioned to bolster the authors claims was descriptively titled, “Top surgery in adolescents and young adults-effective and medically necessary.”

Another troubling trend is the misuse of statistical tools to reframe research findings that contradict the author's own position. For example, a well-known study that claimed that access to puberty blockers reduce the risk of suicide disregarded the fact that individuals reporting use of puberty blockers use had twice as many recent serious suicide attempts as their peers who did not use puberty blockers. Like the finding cited above, the doubling of suicide attempts was not statistically significant due to a small underpowered sample—but the magnitude of the effect was striking and should have tempered the authors’ enthusiastic conclusion that puberty blockers prevent suicides. Another recent gender clinic study, widely and positively covered by major media outlets, claimed that puberty blockers and cross-sex hormones led to plummeting rate of depression—even though the rate of depression among youth taking those medications remained demonstrably unchanged. More information about problems with research originating from gender clinics is detailed in this recent analysis.

Gender medicine’s stance on pediatric surgery

More generally, the gender medicine establishment is in a curious state of internal conflict about its stance on “gender-affirming” surgeries for minors.  On the one hand, it has become common for advocates of “gender-affirmation” of minors to insist that surgeries for minors are not performed and anyone who suggests otherwise is spreading “scientific misinformation” and “science denialism.”  On the other hand, gender clinicians publish mastectomy outcomes for minors in major medical journals, and laud surgeries for minors as “effective and medically necessary.” It is not uncommon for these opposing claims to be made by the same group of researchers and clinicians, as they test various arguments, searching for the "angle" that is most likely to convince judges and juries--and public at large--that scrutiny of the practice of pediatric transitions, which is increasingly occurring in European countries, is not warranted in the United States.

Notably, none of the European countries that are enacting severe restrictions on the use of puberty blockers or cross-sex hormones for minors have ever allowed surgeries for youth under 18. That the U.S. gender affirmation professionals continue to fight regulation of these problematic procedures speaks volumes about how far the U.S. healthcare has drifted when it comes to "gender affirmation" of minors.

Final thoughts

While it is challenging to determine how best to reduce the temperature of the highly politicized nature of the debate in gender medicine, the editors of scientific journals can begin to restore balance by recognizing how far the field has drifted from the standards of quality scientific research, and begin to expand their circle of peer-reviewers to those with diverse views. Inviting those concerned with the state of gender medicine (and not just the practices’ advocates) into the peer-review and commentary process is the first essential step to improve the quality of research published in the field of gender medicine.

--

--

==

The activists are predictably - and consistent with the superficiality of their own ideology - upset that anyone should look below the surface. It seems to be more troubling that anyone would notice the shoddiness of the research, than that the research is shoddy.

If this is supposed to be "healthcare," you would think that they would want the best healthcare, and be more alarmed at the misrepresentations of the study, than by people finding those misrepresentations.

Could it be that this is ideological rather than medical? 🤔

The conflicts of interest and funding sources alone are remarkable.