#lgbtqia+

[owlsounds]

Death to all the right-wing scum who inserted themselves into the personal, private work of patients and doctors.

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.

[justdavina]

Gigi Gorgeous

[emmikay]

TRANS DRESS

"A breathtaking masterpiece of 1920’s couture by legendary designer Sadie Nemser. Composed of aquamarine silk velvet and metallic silver lace, adorned with hand made ribbon flowers, beads and pearls."

xtabayvintage via Instagram

[forsapphics]

ÌFÉ (2020)

directed by Uyaiedu Ikpe-Etim

[catgirlfingies]

Hi everyone

Reblog if you think im a cutie

[osokasstuff]

i don't want to sound like i'm forcefully shoving identities on people who don't want it (who am i to do it, the patriarchy?), but.

"lots of people with PCOS/gynecomastia don't identify as intersex/don't want to be called intersex!" may it have something to do with all this aggressive gatekeeping around intersex label? with medical workers and scientists purposefully narrowing the definition of being intersex to exclude as many people as they can? with medical workers NOT SAYING even the actual diagnosis and being like "oh your hormones are messy you need to take these pills/get surgery?" with all these terfs screaming about "just disordered women/men?" with blatant misinformation around the definition of intersexness? with these ideas that intersex = visible difference at genitalia (at best) / bigenitalia (at worst)? with all these ideas that intersex people are rare freaky freaks, and it's nearly impossible to even see one of us, not to say BE one of us? may it have something to do with this?

"but we can't just say that 10% of people are intersex!" WHY? what makes you so scared of this idea? what makes you think that being intersex has to be something extremely rare? what you're afraid of?

i don't want to push labels on someone and pressure someone to identify with community they don't want to. but i'm really sure that gatekeeping and stigma play a big role in choices of people who don't identify as intersex while have body traits that fit the definition (not the narrow gatekeepy one but the community one).

[our-arospec-experience]

I have no one to properly yell about this too, but the amount of joy I have right now is about to burst. So the guy that I wanted to be more than friends with and I finally had a conversation with, and I was literally shaking as I came out, but we’ve agreed to an ‘unlabelled, exclusive, more than friends’ thing! This is the first time I’ve ever not had a panic attack when things progressed past friendship (I only realised I was aro this February, so all previous relationships were “romantic”), and I’m actually okay with sharing about him to my friends even though they don’t know I’m aro, which I didn’t in all previous relationships. I don’t know whether this counts as aromantic joy, or something, but I literally feel so comfortable which I never had in this context and it’s like this massive breath of fresh air after drowning.

I’m so happy for you!!!!

[emmikay]

ACE DRESS

Embroidered chiffon evening dress for Queen Alexandra of Denmark

c.1910

Doeuillet, Paris, Fashion Museum of Bath

[bastienb33]

Sunset on the road 🌅🛣️

Beautiful sunset on the way home 🏡

[your-blorbos-are-queer]

Ok uhh could you do a PFP of Penny from Pokemon with a nonbinary flag? (And could I actually use it?) Would appreciate more than you could imagine. Thanks

sorry this took forever! and of course you can use it!

[forsapphics]

HAPPIEST SEASON (2020)

directed by Clea DuVall

[talisidekick]

A while back my pharmacist saw my deadname on my profile and accidentially called it out, he corrected and deleted my deadname from the system so only my preferred name shows up now. There was a crowd of people behind me, so as he hands over the pills he apologized, in equal tone and volume as when he called my deadname and lied saying it's been a long day and he didn't mean to call out -his own- name. I quietly told him it was fine and he didn't need to do that for my sake.

His response: "No, it's my name now."

I went to the pharmacist yesterday, his nametag is my deadname. He informed me he's immigrating and in the process he's changed his first name to my deadname to have an English sounding name. That's why he's now able to get a reprint of his nametag to be my deadname. And repeated, with the intense seriousness of someone who is going to die on this hill: "It's mine now. Not yours. I'm taking." His tone indicated that decision is final.

Bro literally deadnamed me once, and has committed to flat out stealing my deadname. It's his now. Legally. Officially. I over heard his co-workers call him by the name.

[destiel-news-channel]

[Image ID: The Destiel confession meme edited so that Dean answers 'There's a petition to ban conversion therapy in the EU' to Cas' 'I love you'. /End ID]

If you are a citizen in the EU please sign this petition:

[sad-klown-syndrome]

*grabs your hands and speaks to you in a tone that is so gentle* they/them pronouns stop being universal once you learn a person's pronouns. Sometimes that person's pronouns will include they/them and in that specific case you are allowed to keep using those pronouns for that person. In any case where you learn a persons pronouns and that person doesn't use they/them, you should no longer use those pronouns for that person. If you continue to use they/them pronouns knowing that person doesn't use them, you are now misgendering that person. Kindly stop doing that please. Thank you, I love you.