#page 3253

[pesterloglog]

Karkat Vantas, Jade Harley

Act 5, page 3250-3253

-- carcinoGeneticist [CG] began trolling gardenGnostic [GG] --

CG: ATTENTION HARLEY.

CG: PLEASE STOP WEEPING WITH AND OR BEATING THE SHIT OUT OF YOUR SELF PROTOTYPED LUSUSPRITE

CG: STOP DOING ONE OF THOSE THINGS AT LEAST

CG: LONG ENOUGH TO ANSWER ME.

CG: PLEASE.

CG: PRETTY POLITE EARTH PLEASE.

CG: WHO AM I KIDDING

CG: I'M WASTING MY TIME AGAIN

GG: karkat!!!!!

CG: WHOA FUCK

CG: YOU ANSWERED ME, I DONT BELIEVE IT

GG: yes

GG: im going crazy here

GG: i never thought id say this, but im actually almost relieved to talk to you

CG: WHAT

CG: YOU ARE

GG: or really ANYBODY besides that lunatic

GG: SHE IS DRIVING ME NUTS!!!!!!!

CG: OH YEAH?

CG: HOW SO, EVERYTHING HERE APPEARS TO BE PROCEEDING RATIONALLY.

CG: WHAT SEEMS TO BE THE PROBLEM

GG: are you joking??? look at this mess!

CG: MESS? JADE, NOW IT SOUNDS TO ME LIKE *YOU'RE* THE ONE WHO'S JOKING.

CG: YOUR HIVE BALL ROLLED DOWN A BEAUTIFUL WINTER HILL, AND YOU ARE SPENDING SOME QUALITY TIME WITH FAMILY.

CG: YOU ARE GOING TO HAVE TO FILL ME IN ON THE NATURE OF THE PROBLEM.

GG: okay...

GG: i made the mistake of prototyping my dream self who has been dead for years

GG: and shes completely crazy and theres no talking any sense into her

CG: HMM.

GG: hmm?

CG: YES. "HMM."

GG: hmm what

CG: HMM AS IN HMM INTERESTING.

CG: AS IN HMM HOW VERY, VERY FUCKING INTERESTING INDEED.

GG: :\

GG: what are you getting at???

CG: WHAT DO YOU MEAN WHAT AM I GETTING AT.

CG: I'M GETTING AT WHATEVER HMM INTERESTING GETS AT.

CG: PLEASE GO ON, I'M LISTENING TO YOUR PROBLEM.

GG: well...

GG: i mean, i understand why she is upset

GG: but she is completely inconsolable, and wont listen to reason about anything!

GG: and i guess i could deal with that but...

GG: the frustrating thing is that shes actually me :(

GG: i really dont think i would act like that

CG: HMMMMM.

GG: will you stop saying hmm!!!!!!

CG: OK, FINE.

CG: WHAT OTHER SEQUENCE OF LETTERS WOULD YOU HAVE ME USE TO REGISTER MY PROFOUND FASCINATION.

GG: fascination?

GG: what do you find so fascinating?

CG: I'M JUST TRYING TO UNDERSTAND.

CG: I AM BEING SENSITIVE ABOUT IT INSTEAD OF A RAGING FUCKASS, ISN'T THAT WHAT YOU WANT.

CG: YES, IT IS, IF YOU DON'T BELIEVE ME JUST ASK FUTURE YOU, ASSUMING THAT CONVERSATION DOESN'T MAKE YOU CRY AS WELL.

CG: NOW TELL ME MORE ABOUT YOUR FEELINGS.

GG: my feelings?

CG: YES, HOW DID THIS MAKE YOU FEEL.

GG: well...

GG: at first i was sad

GG: because she made me remember all the sad things that just happened

GG: but im trying to be strong about all that so we can keep moving forward

GG: and if i can then why cant she?

GG: but she just went on and on

GG: and i started getting angry...

GG: ugh i have never been so angry in my LIFE!!!

CG: HMMMMMMMMMMMMMMMMMMMMM.

GG: I SAID STOP SAYING FUCKING HMM

CG: o:B

GG: what does THAT mean?????

GG: is that supposed to be someone with a halo and goofy teeth?

GG: ARE YOU MAKING FUN OF ME?

CG: NO, NO

CG: YOU'RE LOOKING AT IT BACKWARDS

CG: THOSE ARE MY HORNS

GG: oh

GG: haha oops

CG: OK SO IF I'M UNDERSTANDING YOU

CG: YOU'RE ANGRY AT A VERSION OF YOURSELF FROM A DIFFERENT POINT IN TIME

CG: BECAUSE SHE'S BEING AN OVERLY EMOTIONAL SHITHEAD WHO IS BASICALLY THE MOST REVOLTING SELF LOATHING PIECE OF FILTH YOU HAVE EVER MET

CG: AM I FOLLOWING

GG: yeah, pretty much

CG: I'M NOT GOING TO SAY HMM AGAIN

CG: BUT COME ON

CG: DON'T YOU FIND THE SITUATION TO BE JUST THE SLIGHTEST BIT INTERESTING?

CG: I MEAN, CONSIDERING

GG: considering what??

CG: IF I RECALL, IT WASN'T THAT LONG AGO FROM EITHER OF OUR PERSPECTIVES THAT YOU WERE RIPPING ON ME AND MY SMUG WINDBAG FUTURE SELF FOR ARGUING WITH EACH OTHER

GG: oh come on...

GG: this is NOTHING like that!

CG: HOW IS THIS NOT LIKE THAT

GG: because she's...

GG: well

GG: she's ACTUALLY INSANE

CG: OH I SEE, AND ALL THOSE IDIOT PAST AND FUTURE KARKATS WEREN'T???

GG: but

GG: those are you

GG: im not her!

CG: OH AREN'T YOU

CG: YOU JUST SAID YOU WERE, I JUST HEARD YOU SAY THAT

CG: SO TELL ME

CG: HOW IS THIS EVEN THE SLIGHTEST FUCKING BIT DIFFERENT?

GG: i dont know

GG: it just...

CG: YES, GO ON

CG: I'M REALLY CURIOUS

CG: HOW

GG: ...

GG: oh my god

GG: youre right :(

GG: so then i guess

GG: im a hypocrite :(

CG: NOT REALLY

CG: IT JUST MEANS YOU'RE A SANE RATIONAL PERSON, AND THERE JUST MIGHT BE HOPE FOR YOU YET

GG: wait...

GG: so me arguing with my dead dream self

GG: and smacking her around while screaming at her

GG: makes me SANE???

CG: YES, ABSOLUTELY.

CG: IT MEANS ALL OF YOUR HIDEOUS FLAWS DISGUST YOU.

CG: YOU ARE RIGHT TO BE DISGUSTED, IT'S MORE THAN MOST PEOPLE CAN SAY FOR THEMSELVES.

CG: REALLY, CONGRATULATIONS ARE IN ORDER.

GG: hahaha, wow

GG: you are so weird

CG: CONGRATULATIONS, IN ADDITION TO, JUST MAYBE, AN APOLOGY.

CG: DON'T YOU THINK?

GG: you want me to apologize?!

GG: for what, calling you crazy for arguing with yourself???

CG: WOULD IT REALLY KILL YOU TO CONSIDER IT?

GG: after taking so much crap from you for all those years?

GG: no forget it, im not apologizing that is BULLSHIT

CG: DEAD DREAM DOG JADE, IS THAT YOU??? YOU'RE SOUNDING A BIT HYSTERICAL, MAYBE YOU SHOULD CALM DOWN.

GG: shut uuuup!!!

CG: WELL IF YOU CAN MANAGE TO GET YOUR ANEURYSM UNDER CONTROL

CG: MAYBE YOU WILL REALIZE I DIDN'T ACTUALLY SPECIFY TO WHOM AN APOLOGY WAS IN ORDER.

CG: IDIOT.

GG: what

GG: are you saying you want to apologize

CG: I GUESS

CG: THIS APOLOGY WAS GOING TO GO DOWN ONE WAY OR ANOTHER, SO THIS MIGHT AS WELL BE THE TIME.

CG: AND LET'S FACE IT, I WAS REALLY BEING THE WORST KIND OF PHLEGM BUBBLE BLOWN OUT A NOISY GLISTENING ASS.

CG: SO I'M SORRY.

CG: BUT TO BE FAIR, IT WAS MY PAST SELF WHO WAS GIVING YOU SUCH A HARD TIME, AND HE'S COMPLETELY DERANGED.

GG: ok, i appreciate the THOUGHT of an apology, but i dont know if it really counts if you are just going to pawn off responsibility on your "past self" again!

GG: maybe your "present self" should own up to it!

CG: YEAH THAT'S WHAT HE'S DOING.

CG: HE, BEING ME, RIGHT NOW, IS OWNING UP TO WHAT A FUCKING RETARD PAST ME WAS, AND CONTINUES TO BE.

GG: laaaaame

CG: YES, I KNOW IT'S LAME.

CG: OR I KNOW THAT YOU THINK IT'S LAME WHEN I SAY SHIT LIKE THAT.

CG: BECAUSE REMEMBER

CG: I HAVE BEEN TALKING TO YOU FROM THE FUTURE, AND I KNOW YOU DON'T COTTON TO MY PCG/FCG STUPIDITY.

CG: BUT SEE, YOU DON'T KNOW THAT YOU KNOW THAT YET.

CG: OR MORE SPECIFICALLY, YOU DON'T KNOW THAT I KNOW THAT YOU KNOW THAT YET.

CG: SO I'M KIND OF PULLING A FAST ONE HERE.

GG: hahahaha, that is so ridiculous

GG: why dont you stop it with all this nonsense and own up to being terrible unequivocally?

CG: YEAH I'M GOING TO.

CG: THE THING IS, I KIND OF MISREPRESENTED MYSELF.

CG: I'M NOT AS MUCH OF A SCUMBAG AS I WAS SO DETERMINED TO MAKE OUT WITH MYSELF TO BE.

CG: FUCK I MEAN

CG: MAKE MYSELF OUT TO BE

GG: :o

CG: I REALLY DON'T KNOW WHY I TROLLED YOU LIKE THAT SO PERSISTENTLY

CG: FOR SOME REASON DEEP DOWN I JUST KNEW THAT I HAD TO

CG: EVEN IF IT MEANT DIGGING MYSELF INTO A HUGE HOLE WITH YOU AND EVERYONE ELSE THAT WOULD BE HARD TO CLIMB OUT OF

CG: AND LIKE PRACTICALLY EVERYTHING I SAID WAS COMPLETELY BASELESS BECAUSE I DIDN'T ACTUALLY KNOW YOU

CG: JUST LIKE YOU DIDN'T AND STILL DON'T ACTUALLY KNOW ME

CG: SO I GUESS I AM APOLOGIZING FOR IT, LIKE REALLY SERIOUSLY NOW.

CG: I, PRESENT KARKAT, IN THE CURRENT MOMENT, APOLOGIZE ON BEHALF OF MY STUPID PAST SELF, *WHO IS ACTUALLY ME*.

CG: THE GUY TALKING RIGHT NOW.

CG: LIKE, THERE'S NO DIFFERENCE BETWEEN THOSE GUYS, OK?

GG: hmmmm...

CG: HMMMM???????

GG: yes, hm

CG: HM WHAT

GG: ok karkat, that sounds pretty sincere to me

GG: and youre right, i dont actually know you

GG: i just know the part of you who acted like a bully

GG: i understand there can be more to a person than just the stuff they say when theyre angry

GG: so i will accept your apology and give you another chance

CG: OK, GREAT.

GG: and i will apologize for calling you crazy

GG: obviously i am not in much position to judge :|

CG: NO BUT

CG: YOU WERE RIGHT, I AM CRAZY

CG: BUT THANKS ANYWAY

GG: so you say you have been talking to me from the future?

CG: YEAH

CG: MAKING PLANS AND WHATNOT

CG: TO PRY OURSELVES MUTUALLY OUT OF THIS MASSIVE MOBIUS DOUBLE CLUSTERFUCK.

GG: ok, so what is the plan?

GG: i mean, why did you want me to contact you at this moment so badly?

CG: OK WELL THE MOST IMMEDIATE POINT OF BUSINESS IS

CG: YOU SEE THAT GLOWING BLUE SCREEN BEHIND YOU?

GG: yes

CG: YOU NEED TO TURN THAT FUCKING PIECE OF SHIT OFF.

GG: ok, i can do that

GG: but why, what does it do?

GG: its been here my whole life and i could never figure it out

CG: I'M NOT GOING TO SAY MUCH ABOUT IT.

CG: BUT SUFFICE TO SAY THERE ARE JUST SOME THINGS YOU DON'T WANT TO SCREW WITH.

CG: THERE ARE OUTCOMES THAT ARE EVEN WORSE THAN THE COMPLETE ANNIHILATION OF EXISTENCE ITSELF

CG: FORCES MORE DAMAGING TO THE INTEGRITY OF REALITY THAN THOSE CAPABLE OF TURNING IMAGINATION INTO PURE VOID

CG: THEY ARE FORCES WHICH IF HANDLED RECKLESSLY WILL NULLIFY THE BASIC ABILITY OF INTELLIGENT BEINGS IN ALL REAL AND HYPOTHETICAL PLANES OF EXISTENCE TO GIVE A SHIT.

GG: i dont think im following...

CG: YOU DON'T HAVE TO FOLLOW

CG: ALL YOU NEED TO DO IS TURN THE THING OFF

CG: AND THEN DO THE NEXT THING I WAS TOLD TO TELL YOU TO DO.

GG: you were told?

GG: by who?

CG: BY YOU.

GG: oh...

GG: future me?

CG: YES.

CG: YOU COULD BE TELLING YOURSELF THIS RIGHT NOW, BUT WE'RE SORT OF WORKING ON A STRICT NO MEMO POLICY.

CG: WHICH IS YOUR IDEA OF COURSE.

CG: DID I MENTION HOW YOU DON'T LIKE IT WHEN WE ARGUE WITH OUR PAST/FUTURE SELVES? YES, PRETTY SURE I DID.

CG: SO I'M GOING ALONG WITH THE POLICY AS BEST I CAN.

CG: I AM BEING PLEASANT AND AGREEABLE, AND I WILL GENTLY LOWER A MAGNIFICENT, CORUSCATING COLUMN OF HOT FUCK YOU DOWN THE PROTEIN CHUTE OF ANYONE WHO SAYS OTHERWISE.

GG: uh... ok

GG: well it sounds like a pretty good policy to me!

CG: YOU DON'T SAY.

CG: SO ANYWAY, BECAUSE OF THAT, MY ROLE AT THE MOMENT IS TO ACT AS A SORT OF GO BETWEEN FOR YOU AND YOUR FUTURE SELF

CG: TO HELP ALONG THE PROCESS OF MAKING THESE PLANS

CG: WHILE YOUR FUTURE SELF IS DELIBERATELY VAGUE ABOUT SOME STUFF SO AS NOT TO "JINX" THE CONCEPTION OF THE IDEAS IN THE FIRST PLACE I GUESS?

CG: ALL WHILE YOUR CURRENT SELF IS NECESSARILY KIND OF DUMB ABOUT EVERYTHING.

GG: hey!!!

CG: SORRY, OK, JUST KIND OF IGNORANT

CG: BECAUSE STUFF HASN'T HAPPENED YET

CG: YOU KNOW WHAT I MEAN.

CG: IT'S NOT ALL THAT STRAIGHTFORWARD FOR ME EITHER, BUT I'M USED TO THIS SORT OF IDIOCY BY NOW.

CG: IT'S A LOT BETTER THAN THE MORONIC REVERSE CONVERSATION WITH EGBERT I TRAPPED MYSELF INTO.

CG: MEANWHILE TIME IS KIND OF RUNNING OUT HERE, WHERE I AM

CG: WE'RE COUNTING DOWN TO SOMETHING

CG: SOMETHING LOOMING ON THE TROLLIAN TIMELINE AND NO ONE KNOWS WHAT IT IS

CG: AND MY TEAM IS KIND OF FALLING APART

CG: I'M COMPLETELY LOSING TRACK OF EVERYONE AND WHAT THEY'RE DOING.

CG: SO AT THIS POINT I'M JUST GOING ALONG WITH WHATEVER THERE IS TO GO ALONG WITH.

CG: AND THAT IS YOU AND YOUR CRAZY FUTURE PLANS.

CG: AND THE SCRATCH.

GG: oh yeah! dave told me about that.

GG: what is it?

CG: I DON'T FUCKING KNOW!

CG: AT ONE POINT I THOUGHT I DID, I THOUGHT IT WAS JUST WHATEVER SENT JACK HERE.

CG: BUT CLEARLY IT'S NOT THAT SIMPLE.

CG: ARADIA KNEW BUT SHE DIDN'T SAY, AND THEN SHE WENT AND GODDAMN EXPLODED.

CG: YOU HAVEN'T TOLD ME EITHER, BECAUSE I'M NOT "SUPPOSED TO KNOW" YET.

CG: WHATEVER, I DON'T EVEN CARE, LET'S JUST DO IT.

GG: ok then...

GG: what was the thing i told you to tell me to do?

GG: right now, i mean

CG: OK, DON'T ASK ME WHY, BECAUSE I DON'T KNOW THAT EITHER.

CG: BUT THAT BLUE SCREEN THERE

CG: FIRST, LIKE I SAID, SHUT IT OFF

GG: ok

GG: then what

CG: THEN YOU NEED TO DRAW IT.

GG: draw it?

CG: YES

GG: and then?

CG: THEN NOTHING

CG: THAT'S IT.

[umbreonstuck]

Quick question, how many pages are there that feature kissing?

i excluded hs2 and also did not include a few panels from doc scratches segment where there were kiss panels that were both already scene and also very far in the background where it didnt really matter

apologies for any errors. i had to make this on desktop for image limits. problem? im a mobile baby

Aradiabot + Equius

pre and post retcon. page 2287

Tavros + Vriska

page 2380

Sollux + Feferi

page 2480

Jadesprite + Jade

pages 3252-3253

Karkat + Kanaya

page 3384

Terezi + Tavros

page 3384

Rufio + Hussie

pages 3391-3393

Snowman + Spades Slick

pages 3855-3857

June + Rose / Terezi + Tavros / Karkat + Kanaya / Jade + Dave

jade and dave dont touch lips here but she does still kiss him. page 3870

Gamzee + June

page 4944 ([S] DD: Ascend more casually.)

Dirk + Roxy

they do kiss but squarewave censors it. page 5238 ([S] Dirk: Synchronize.)

Jake + Dirk (Hal ig)

like do i legally consider this a kiss with hal or just dirk? funny how this is the only kiss in the unite and synchronize sequence that was not censored. pages 5249-5250

Dirk + Jane

again, they do kiss, but a fade to white censors the touching of lips. page 5252 ([S] Dirk: Unite.)

Jake + Dirk (Hal)

again. page 5252 ([S] Dirk: Unite.)

Kanaya + Rose

you were waiting for this. pages 5421-5422

Roxy + Dirk

page 5758

(Vriska) + Meenah

page 7351

Jade + Davepetasprite^2

page 8008. boob

apologies if i missed any. im 3 years old and have memory loss

[hauntedjpegcollection]

baldur's hero

wc: 3253 au: baldurs gate au ch: xavier, benji

Xavier rarely goes to the courtyard without purpose.

It’s too noisy with too many people and never enough room to breathe—the restoration to the gate had been beautiful to witness. To be a part of, even. But years since the destruction and the noise has returned, like birds returning to the skies or brooks bubbling once more. It was in full swing everywhere but especially in The Heroes Yard. Blooming gardens surround marble statues, lovingly tended by a circle of druids that helped Baldur’s Gate and then never left the city. Their constant humming—occassional singing, even chanting—was the undercurrent to people.

He dodges a throng of young mages in electric colored robes, as they’re lead through a trail by a wizened teacher. She knocks her cane against a statue here and there, imparting wisdom to the sleepy group who follow dutifully. Xavier deftly bends and snags a scroll thats slipped free of one pupil. When he winks to her, she blushes all the way to pointed blue ears and covers her smile with a clawed hand. There’s not a hint of recognition about her silver eyes, just amusement and maybe embarrassment as she tucks herself back in with her group.

It’s nice not to be known. There is no statue of Xavier in this yard. But—he does find the one he’s looking for.

It’s only just past a lovely fountain. A popular spot, where people gather to idle free time. It is rarely empty. Sometimes, Xavier wishes he could have been part of the decision making process that went into this particular statue’s placement. It feels only right, after all, that maybe he should have been able to direct the artist who’d captured his husbands likeness.

“Sorry, I’m late,” Xavier says to the life sized rendition, taller than him only because it sits atop a pedestal. Benji’s pose is hilariously stiff, not just because he’s made of marble. Whoever had been commissioned to fill The Heroes Yard must have spent at least some time with Benji. They’d gotten the heavy set to his brow, the uncomfortable placement of crossed arms, his grimacing (but gorgeous) mouth. A stranger might look at him and find his stance confident, boastful. Strong in the face of adversary. Chin tilted back to survey the very city he’d saved.

Only, there has been an addition to the statue. A fuzzy black mustache made of felt has been taped to it, covering the natural stones rendition of Benji’s actual facial hair. It’s a bit lopsided, admittedly silly looking. Makes Xavier grin staring up at it. But it’s hard not to grin at Benji, even if this isn’t actually Benji.

He sits down at the edge of the pedestal, rustling through his coat pocket for the mutton sandwich he’d brought himself. It’s been hastily wrapped in yesterdays news paper, oil making it translucent here and there in little dots. They have too many copies, because Benji cannot stop himself from purchasing a page from every young busker on the street. So they mill about their home, hoping not just for a glimpse of the hero, but some of his coin.

“I always add too much oil to these,” Xavier complains quietly to himself and to Benji’s hero statue. “What I wouldn’t give for a curry.”

It’s been some time since Benji’s left, so he fends for himself in the kitchen. It’s a lonely part of their home now. But that’s Harper business. Xavier doesn’t ask. Not because he doesn’t want to know but—

They’ve had more than one fight about Harper business. The old argument that maybe Benji should retire, should simply stay home and find something worthwhile, something heroic here has been shelved for some time now. They don’t argue that one anymore, because Xavier understands that one better. The need to be doing something. The need to be helping. But the renewed and much debated (hotly, with both of them saying things sharper than they mean) is about Xavier’s safety.

Because is is safer for Xavier to not know the details. However, a part of him itches for someone to think of him as Benji’s weak spot and come looking for an easy belly to cut open. Xavier is no longer a paladin (if one ever stops truly being a paladin), but that doesn’t mean his hands don’t sometimes ache for the hilt of a sword.

The sandwich is still good, even if it has far too much oil on it. He leans back against one of Benji’s marbled legs, one of his own tucked up. He stares out across a pretty horizon overlooking the ocean that runs up against Baldur’s Gate. Xavier misses his tiny fishing village sometimes, especially when there’s all this noise (lovers laughing as they sit by the fountain and hold hands, a baby crying loud in it’s mothers arm as she shows the faces of countless, timeless heroes, the wizard and her students). He closes his eyes and enjoys the sun.

“Oi!”

Xavier blinks and looks to the side. Then adjusts his gaze much lower so he can look at this intruding stranger properly.

“You do that?” the tiefling looks furious, pointing at the statue he leans against. Xavier follows the child’s finger up to Benji’s face and the terrible mustache.

“What?”

“Y’think that’s funny then, do ya? Defacin’ a hero like that?” if Xavier were standing, the tiefling would come up to his waist. If that. He’s small, with just the barest hint of horns. A dark umber color, with dots all over his face and bare arms. His eyes are shockingly yellow, the kind that glow a bit when the sun hits them properly. Xavier tilts his head and then looks up to the statue, and then back down to the tiefling.

“This guy?” He jerks his thumb back at Benji with a smile. The tiefling’s face floods darkly, clawed hands balling into little fists at his sides.

“That guy! You new to the gate, half elf? That tief’s a hero, I said.” The child enunciates the word hero so hard it feels like he’s trying to cast a spell with it. He’s slight, but not not waifish, nor is he unkempt. Xavier remembers the refugees. No one could forget the refugees—no one with a heart, anyway. The outpouring of orphaned children, many of them just like this one. But Benji’s fan wears clean clothes and good shoes. His curly black hair is combed back, even if it also fans out around him messily.

“You don’t say,” Xavier ponders, glancing over his shoulder. He’s trying hard not to smile, brushing his hands together to clear his palms of crumbs. “He your idol or something?”

“That’s none of your business.” The little boy adopts Benji’s posture, arms crossed over his chest. He has a dangling earring that is silver, in an interesting snowflake design. Xavier slowly slides his way off the pedestal and stands. As he does, the tiefling child stutters back a bit. He blinks up and up until his head is nearly tilted all the way back—despite that, he still glowers, even if it’s less pointed now.

“What did he do that was so important?”

Xavier watches the tiefling climb his way onto the pedestal. He clings arms around Benji’s statue to keep himself upright. Xavier’s hands begin to raise on reflex, but he quickly lowers them when the child looks his way. However, when he turns back and starts awkwardly trying to snatch at the mustache, Xavier’s hands return to a safe distance. If the boy fell and broke his elbow all because of a mustache that Benji himself had slapped onto the statue, his husband would be distraught about it for weeks.

“They not teach history lessons where you’re from?” the boy asks, grunting with effort and an outstretched hand. The way Benji’s arms are crossed make it difficult for his short arms to reach. “Alright, how about this? A trade?”

“Oh?”

“I’ll tell you the story if you get this blasted mustache off him—s’not right! No one messes with the statue of Gale Dekarios.” He says the mans name with a haughty, sniffling air. Xavier has to bite his lip not to laugh.

“Not a fan of the famed Wizard of Waterdeep?”

“You wouldn’t get it. People are always tellin’ the stories of human men. All the time. Had to hear about them my whole life growin’ up. Even elves, yeah? Even half elves. No ‘fense to you.”

“None taken.”

Xavier understands what the boy means.

Gale was a handsome human man who did not want to save Baldur’s Gate—or maybe he did. Maybe his ideas would have saved the gate and the people within the city. But what would have become of the human man, with all that power? And when did Gale’s desire to save the city become more about wanting the power? No one else knew that story, because Benji was good. Benji was a hero, who didn’t go telling people the truth. That Gale Dekarios, whose statue was never defaced, wanted to take that stupid fucking crown for himself.

He breathes deeply to avoid letting himself get lost back in that day. It’s not what he’d come to the yard for. He’d come, because he’d missed his partner and wanted to see his face, even if it was a marbled version.

“Alright, son,” Xavier says, stepping forward. He takes the tiefling by the hips and gently picks him up. The boy weighs practically nothing and he’s easily set back down on the ground. He doesn’t protest. For a moment, Xavier can imagine a father doing exactly this. Taking a rowdy child and hoisting them around. There’s a twinge inside his chest. Children with parents. How special that it’s not a novel idea anymore.

“Tell me the story then. Benji, right? One of Baldur’s heroes?” He hefts himself up onto the pedestal and throws a lazy arm around the statue’s waist. He can briefly imagine himself doing the same to the real Benji. How warm he’d feel, snug against him. How good he would smell—like healing herbs and something spiced, like a hint of rain or the promise of rain. Xavier stares down into the statue’s eyes.

I miss you, he thinks fondly, smiling. It feels good to miss you, it reminds me of before. A letter sits inside his coat as well. Just like before. He’d meant to drop it at the post before coming to the yard, but he’d been hungry.

The tiefling boy begins telling Xavier the tale. Some parts are wildly exaggerated—Benji rode a dragon, he dual wielded maces blessed by Tyr himself (Lathander, forgive him, Xavier laughs internally). Some are painfully true, like his one mystical hazel eye, the long draw of a scar down the middle of it.

“Mm, he didn’t get the scar from the eye,” Xavier comments softly, finally plucking the mustache free. He cannot stop himself from pressing a swift, chaste kiss to the statues cheek and then hopping down to the ground. The heavy sound of his body makes the tiefling jump back, though Xavier lands perfectly with knees bent. He rises slowly, holding up the mustache with a toothy grin. The boy is blushing even harder than he was in anger.

“He’s married, y’know,” Benji’s fan snorts, pointing to the statue. “Heard his husband’s ferocious—seven a half feet tall with a sword that calls lightning. They say he killed Ketheric Thorm—but I don’t believe that.”

Not just me. It is rarely just one person who kills a God.

“That’s good. Shouldn’t believe everything you hear. It was Dame Aylin that killed Ketheric.” Let her have the glory; she deserved it. Xavier toys with the plain silver wedding band on his finger. He feels a roll of nausea from the memory of Ketheric Thorm, but it is an ancient hurt, a cold and dead fear that he’s mostly grown free of.

“No. It was Karlach Cliffgate—you’ve pro’lly never heard of her, ‘cause she’s another tiefling.” The boy turns his nose up, snorting contemptuously. Xavier does not tell the young boy that Karlach had not been there for that particular fight, but instead a powerful and terrifying Githyanki woman, who stories do not tell of frequently enough for his liking. But that was history.

Favoring the Gale’s of the story—even glorifying Xavier to a seven foot lightning wielding paladin, though nameless as he was.

“You know,” Xavier says contemplatively. “I bet, whoever keeps putting these up there does it early in the morning. Probably right before dawn, so no one can see.”

His thoughts ease into the memory of Benji, the sunlight not even peeking over the horizon yet. The window to their bedroom open, because they’d secured a spot by the water and the smell of it comforted Xavier. Their hands on each other, touching faces or sides or arms. Small kisses while Xavier is half dozing still, almost asleep—Benji’s leaving, is telling him he’ll be back soon. Telling him to write, telling him he loves him.

The boy looks struck by the idea, his grin going sneaky. Then he schools it neutral and huffs.

“Not thankin’ you. Was an even trade. Information for help. That’s fair by Baldur’s ways.” Xavier bows deeply, making the boy look instantly sheepish. He turns to run, down a winding and flowered path. At the end of it sit two tieflings, a fat and happy baby in their lap. Xavier watches the boy crawl up onto a stone bench, whispering conspiratorially into a mans ears. The tiefling is the same shade, with the same spots.

Xavier lets himself have one last look at Benji’s statue before he leaves the garden.

—

Finally in his hands once more, Xavier does not let Benji go again.

Not for the entire night. There is no moment where he is not touching him; from the exact second Benji crosses the threshold to their modest home, Xavier’s palms slide across his forearms, to his shoulders. Their mouths crash together in a desperate, laughing kiss. Benji is lifted off his feet, crushed to Xavier’s chest. His armor clinks. The smell of leather oil and dirt, but also Benji.

His hands stay when they take a well earned bath together in a washing tub that they’d specifically bought for this depth, this width. To fit the two of them. Hands touching while they’re in bed, and not necessarily just for the sex that they have. That ranges from rough and needy and desperate and wild to slow and languid and sore and tired. But his hands stay even after that, just simply cupping ribs. Running over a broad torso, a hairy chest. His fingers roam until they find—

“This scar was not here before you left,” Xavier snips, pushing Benji to his side to stare down at the small healed wound on his side. It’s a tan scar on dark skin, no longer than his finger. It’s minuscule in comparison to the one on his back, or another on his hip, or the burn on his calf. Xavier peers down at it with narrowed eyes. The black kohl he paints around his eyes has run horribly and Benji’s cupped hand on his cheek brushes a thumb through it.

“That’s always been there,” he argues innocently, with wide eyes. One black and beautiful and the other hazel and ethereal.

“Fuck you,” Xavier seethes with a laugh. “I know every single scar on you. I’ve tasted them with my tongue.” He punctuates that sentence with a flat lick to this new, offending scar. It makes Benji shiver, his hand clutching harder around Xavier’s cheek. His other finds a home in his hair, carding through the long red strands.

“Arrow grazed me, s’all.”

“Archer dead?”

“If I said he weren’t?”

“Suppose I’d take my Oath up again and find him and shove an arrow through his fucking—”

“Archer’s dead,” Benji laughs, pulling Xavier closer for another kiss. It doesn’t stay gentle, though it starts with just the press of lips and a sigh of air. It deepens with both their mouths opening wider, their tongues rolling and sliding against one another. Xavier moans into the kiss, sliding himself until he’s entirely over Benji—and his hand stays around this new scar he has to memorize. They kiss until it’s messy and when they part, a string of spit momentarily connects their mouths. Xavier licks it hungrily, greedily, eyes hooded and it snaps.

“Death of me,” Benji mutters dramatically.

“Swear that,” Xavier laughs, ducking underneath Benji’s chin to kiss his fuzzy jawline. He moves until he finds his pulse. He sucks it hungrily, thinks to leave a long lasting bruise so that anyone who sees the Hero of Baldurs will know that hero does have a terrifying, greedy husband.

“What am I swearin’ to?”

“Your death is to me only.” Xavier pulls back. Their breathing has both gone harder. There is a flicker of Benji’s youth around his eyes; but they are both so undeniably older now. Gray to their hair, wrinkles at the corners of their eyes, scars everywhere. “An archer can give you a scar. Maybe some Zhentarim fuck surprises you with a dagger—maybe you come home with a scar here instead.” Xavier cups underneath Benji’s knee, touching the soft skin that is never touched by anyone but him.

“But you swear that, Benji. No Harper business takes you from me, I’m there the day you die, or you don’t fucking die, got it?”

Because it all felt unfair sometimes, for Xavier. The city got it’s statue. Boys got their heroes. Harpers got their cleric. He leans forward until their noses are nearly touching. Benji’s eyes have gone dark. Possessive. His hands touch Xavier’s lower back and shove firmly until they are touching every place they can touch.

“Swear,” Benji says in a husky voice.

—

“Tyr’s fucking greatsword,” Xavier moans through a mouthful of food. Breakfast sits, hot and loving prepared on their kitchen table. It’s wooden and long enough to fit company, when they eventually have company. That morning, it is only the two of them, Benji sitting on one side with a mug of steaming tea and a satisfied and sleepy expression.

“I missed your cooking.”

“Could learn to do it yourself.”

“I made sandwiches.”

Benji’s head rolls back with a loud crack of a laugh. Xavier has never heard him laugh like that around anyone, save maybe Maran. Lark’s never gotten that laugh—Benny’s never gotten it either. Matilda gets his soft, snorting laugh when she’s making too mean of a joke. Nettie gets his chest deep chuckles, whenever they visit the grove. Children, that swarm him in droves on the street when they recognize who is he, get humored, if not sometimes awkward laughs.

Xavier scoops more food into his mouth, goes for quick sips of the slowly cooling tea. If he were in the right frame of mind (certainly not the messy, debauched, fucked senseless and tired version of himself that finds getting out of bed harder and harder with every year that passes) he might have ruminated more on that laugh. On how much of Benji stays his, despite how much of Benji is also for others.

Instead, he clears his plate and flips the sign on his blacksmith shop to close—and they spend the evening together, the windows shut to the noise of the city.

[uglythug22]

Okay try this one on for size loamhead

Hex:

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Wall 4

Shelf 2

Volume 6

Page 216

library of babel website allows hexes up to 3200 characters long, this one is 3253

[zinniajones]

Undisclosed conflicts of interest in Florida Board of Medicine’s trans youth treatment ban

Here’s how to submit your comments on proposed Rule 64B8-9.019 (Florida Board of Medicine) and proposed Rule 64B15-14.014 (Florida Board of Osteopathic Medicine).

Previously:

Tracking organized anti-trans submissions to the Florida Board of Medicine October 28 meeting, which passed a ban on medical transition for trans youth

Florida Department of Health Guidance Against Transgender Youth Healthcare Contains False Statements and Misrepresentations and Should Not Be Used by Anyone

On November 14, the Florida Board of Medicine (BOM) and Florida Board of Osteopathic Medicine (BoOM, collectively the Boards) published their proposed rules to ban medical transition treatment for transgender minors, opening a 21-day comment period before these rules take effect on December 5. The BOM’s Rule 64B8-9.019 (“Standards of Practice for the Treatment of Gender Dysphoria in Minors”) is a blanket ban on puberty blockers, HRT or gender-affirming surgery for trans youth under 18, with exceptions for those currently receiving medical treatment:

(1) The following therapies and procedures performed for the treatment of gender dysphoria in minors are prohibited.   (a) Sex reassignment surgeries, or any other surgical procedures, that alter primary or secondary sexual characteristics.   (b) Puberty blocking, hormone, and hormone antagonist therapies.   (2) Minors being treated with puberty blocking, hormone, or hormone antagonist therapies prior to the effective date of this rule may continue with such therapies.

The Notice of Proposed Rule (26536889) states that a hearing can be requested by contacting BOM executive director Paul Vazquez:

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.   THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Paul Vazquez, J.D., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253, Paul.Vazquez@flhealth.gov

Comments can also be submitted through a form on the Notice page. 

The Board of Osteopathic Medicine’s Rule 64B15-14.014 (“Standards of Practice for the Treatment of Gender Dysphoria in Minors”) is substantially the same ban, with a limited exception for use of puberty blockers and HRT in certain clinical trial settings, applying only to the small proportion of doctors who hold a D.O. degree:

(1) The following therapies and procedures performed for the treatment of gender dysphoria in minors are prohibited.   (a) Sex reassignment surgeries, or any other surgical procedures, that alter primary or secondary sexual characteristics.   (b) Puberty blocking, hormone, and hormone antagonist therapies.   (2) Nonsurgical treatments for the treatment of gender dysphoria in minors may continue to be performed under the auspices of Institutional Review Board (IRB) approved, investigator-initiated clinical trials conducted at any of the Florida medical schools set forth in Section 458.3145(1)(i), Florida Statutes. Such clinical trials must include long term longitudinal assessments of the patients’ physiologic and psychologic outcomes.   (3) Minors being treated with puberty blocking, hormone, or hormone antagonist therapies prior to the effective date of this rule may continue with such therapies.

Similarly, this Notice of Proposed Rule (26536986) states that a hearing can be requested by contacting BOM executive director Danielle Terrell:

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.   THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Danielle Terrell, Executive Director, Board of Osteopathic Medicine/MQA, 4052 Bald Cypress Way, Bin #C06, Tallahassee, Florida 32399-3256, or by email at Danielle.Terrell@flhealth.com.

The November 4 meeting notice (p. 2) specifies the materials required for any appeals of the Boards’ decisions:

If any person decides to appeal any decision made by the Board with respect to any matter considered at this meeting or hearing, he/she will need to ensure that a verbatim record of the proceeding is made, including the testimony and evidence from which the appeal is to be issued.

In our capacity as the organization Gender Analysis of Seminole County, Florida, we call for a hearing on undisclosed conflicts of interest, patterns of bias and additional improper actions by the Board of Medicine and Board of Osteopathic Medicine during the rulemaking processes of proposed Rules 64B8-9.019 and 64B15-14.014 F.A.C., including but not limited to:  

Disregard for evidence of any quality and the findings of clinicians and researchers with relevant expertise in care for trans youth.

Heavy reliance on marginal opinions offered by small anti-trans advocacy groups, which do not constitute evidence, in formulating the proposed Rules, contrary to the Boards’ intended purpose as apolitical bodies.

Egregious misuse and misinterpretation of published studies on trans health outcomes and gender affirmation, frequently misrepresenting these findings as showing something that they do not.

Undisclosed prior commitments by a BOM member and state experts to reject any practice standards incorporating gender-affirming care, as part of their membership in the religious anti-trans advocacy organizations Catholic Medical Association (CMA).

Undisclosed cooperation between the Department of Health (FLDOH) and the Boards to provide a lineup of anti-trans speakers who are concurrently serving as witnesses for the Florida Agency for Health Care Administration (AHCA) in the ongoing Medicaid exclusion case Dekker et al. v. Marstiller et al.

The BOM’s deliberate misrepresentation of anti-trans detransitioners as far more numerous than they are, using this lineup of a small number of heavily reused individuals who have repeated their claims in several other states.

Undisclosed coordination between a BOM member and the anti-trans groups Society for Evidence-Based Gender Medicine (SEGM) and Genspect, to promote poorly-defined and unsupported anti-trans models of “care” for trans youth.

Permitting intrusive personal attacks against the bodies of transgender Floridians while cutting off a pro-trans speaker’s criticism of Governor DeSantis’ administration, on the grounds of civility and decorum.

Due to the pervasive nature of these biases and conflicts of interest and the Boards’ continued failure to address these urgent issues of public concern, we additionally call for an independent investigation into the origins and course of the anti-trans rulemaking efforts of the Boards, FLDOH, AHCA and any other relevant state agencies, including the Executive Office of the Governor. Our detailed outline of the Boards’ improper actions is provided below, with requested actions on these matters where appropriate.

Scope of issues: Involved parties, materials, and events

Florida Board of Medicine and Florida Board of Osteopathic Medicine

The August 5 BOM meeting and submitted materials (public book PDF, 1873 pages, last modified Aug. 2).

The October 28 joint Boards meeting (video) and submitted materials (public book PDFs version A [3336 pages, last modified Oct. 20], B [3336 pages, last modified Oct. 21, 3:52 PM], C [3331 pages, last modified Oct. 21, 6:39 PM], and D [3887 pages, last modified Oct. 26]).

The November 4 joint Boards meeting (video and audio) and submitted materials (public book PDFs version X [3887 pages, last modified Oct. 27] and version Y [4944 pages, created Nov. 2 and last modified Nov. 3]).

Statements and actions during these meetings and in relation to these meetings by the BOM and the Boards collectively as well as individual members Dr. David Diamond (BOM chair), Dr. Patrick K. Hunter, Dr. Hector Vila and Dr. Zachariah P. Zachariah.

Statements during these meetings by the state’s anti-trans experts Michael Biggs and Dr. Michael K. Laidlaw.

Public comment during these meetings by selected anti-trans speakers including but not limited to Zoe Hawes, Chloe Cole, Camille Kiefel, Yaacov Sheinfeld, Dr. Robert Roper, Bob Framingham, Erin Brewer, Julie Framingham, and Amy Atterberry, as well as undisclosed coordination involving this speaker lineup by the Florida Department of Health and Florida Agency for Health Care Administration.

Florida Department of Health and state surgeon general Joseph A. Ladapo

FLDOH April 20, 2022 document “Treatment of Gender Dysphoria for Children and Adolescents” and April 20 document “Treatment of Gender Dysphoria for Children and Adolescents: Fact check” and cited literature, enclosed with state surgeon general Joseph A. Ladapo’s June 2 letter to the BOM (Aug. 5 public book pp. 1-5, Oct. 28 public book version D pp. 2258-2262, Nov. 4 public book version Y pp. 3315-3319).

FLDOH July 28 “Petition to Initiate Rulemaking Setting the Standard of Care for Treatment of Gender Dysphoria” (Aug. 5 public book pp. 870-877).

FLDOH July 28 “proposed forms” (Exhibits C and D), requiring all adults seeking hormonal or surgical transition care in Florida to wait 24 hours sign state-mandated “informed consent” forms referring to the AHCA GAPMS findings and commissioned expert reports at ahca.myflorida.com (Aug. 5 public book pp. 1112-1113).

FLDOH’s role in providing an imbalanced lineup of anti-trans speakers to Boards at the October 28 meeting, which led with nine anti-trans detransitioners, some of whom have provided affidavits for the state of Florida’s defense in the ongoing Medicaid transition care exclusion case Dekker et al. v. Marstiller et al.; they did not disclose this related work at the Boards’ hearings.

Joseph Ladapo’s role in reviewing the medical records of an uninvolved transgender adult at the behest of their anti-trans parent Amy Atterberry, without any clear basis for this complaint other than an objection to trans people receiving transition care altogether (Amy Atterberry letter, Oct. 28 public book version D pp. 1251-1252).

Florida Agency for Health Care Administration and associated experts

The June 2 report “Florida Medicaid Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria” (included in Aug. 5 public book pp. 606-651, Oct. 28 public book version D pp. 2863-2908, Nov. 4 public book version Y pp. 3920-3965), attributed to Romina Brignardello-Petersen and Wojtek Wiercioch by BOM member Dr. Patrick K. Hunter at the October 28 meeting (see Appendix A, time index 2:03:15).

May 16 report Attachment C by Brignardello-Petersen & Wiercioch (included in Aug. 5 public book pp. 656-727, Oct. 28 public book version D pp. 2913-2984, Nov. 4 public book version Y pp. 3970-4041)

May 17 report Attachment D by James M. Cantor (included in Aug. 5 public book pp. 728-790, Oct. 28 public book version D pp. 2985-3047, Nov. 4 public book version Y pp. 4042-4104).

May 17 report Attachment E by Dr. Quentin L. Van Meter (included in Aug. 5 public book pp. 799-812, Oct. 28 public book version D pp. 3056-3069, Nov. 4 public book version Y pp. 4113-4126).

May 17 report Attachment F by Dr. Patrick W. Lappert (included in Aug. 5 public book pp. 813-828, Oct. 28 public book version D pp. 3070-3085, Nov. 4 public book version Y pp. 4127-4142).

May 16 report Attachment G by G. Kevin Donovan (included in Aug. 5 public book pp. 829-838, Oct. 28 public book version D pp. 3086-3095, Nov. 4 public book version Y pp. 4143-4152).

AHCA and secretary Simone Marstiller, in their capacity as defendants in the transition care exclusion case Dekker et al. v. Marstiller et al., which features affidavits for the state of Florida by several anti-trans speakers, or parties related to the anti-trans speakers, at the October 28 and November 4 meetings (Redacted defendants’ response in opposition, October 3, 2022).

Grounds for hearing and inquiry on the Florida Board of Medicine and Florida Board of Osteopathic Medicine 2022 anti-trans rulemaking efforts

1. Three of the five expert reports reviewed in AHCA’s June 2 GAPMS determination, the basis for FLDOH’s rulemaking petition to BOM, were by members of the Catholic Medical Association who hold a prior absolute commitment as of 2021 to oppose any standard of care permitting transition  

AHCA expert report writers Quentin L. Van Meter, Patrick W. Lappert, and G. Kevin Donovan (Attachments E, F, and G, respectively) are members of the Catholic Medical Association, a small right-wing group of 2,500 members who do not represent mainstream views in medicine or medical ethics. Declaration of Quentin Van Meter in American College of Pediatricians et al. v. Becerra et al., November 9, 2021:

13. I am a member of the Catholic Medical Association.

Patrick Lappert, “Catholic Medical Association - Medical Student and Resident Boot Camp”, February 25, 2017:

A graduate of Uniformed Services University, Patrick Lappert, MD, has served as the president and surgeon of Madison, Alabama’s Lappert Plastic Surgery since 2003. An experienced plastic surgeon and physician, Patrick Lappert, MD, is a member of several industry organizations, including the Catholic Medical Association (CMA).

“CMA Members Federally Appointed to The Human Fetal Tissue Research Ethics Advisory Board of National Institutes of Health”, Catholic Medical Association, August 10, 2020:

Doctors Greg Burke (Co-Chair of CMA’s Ethics Committee), Ashely Fernandes, Kevin Donovan and Father Tadeusz Pacholczyk, Ph.D. will work with other appointed members to advise the administration on the ethics of federally funded research which includes tissues from the bodies of babies who were aborted.

CMA has argued in legal actions that its members have “medical and ethical” conscience objections against agreeing to any transition treatment as part of a standard of care, based on their faith beliefs as adherents to this interpretation of Catholicism. Declaration of Mario Dickerson, executive director of CMA, in American College of Pediatricians v. Becerra, November 4, 2021 (see Appendix C for additional excerpts):

2. I serve as the Executive Director of the Catholic Medical Association (“CMA”). Given my involvement in CMA, I am familiar with the organization’s history, the issues confronting it, and the views of the organization and its members concerning various emerging issues, including the gender identify mandate at issue in this litigation.   3. CMA is the largest association of Catholic individuals in healthcare. CMA is a national, physician-led community that includes about 2500 physicians and health providers nationwide. […]   9. CMA’s mission is to inform, organize, and inspire its members, in steadfast fidelity to the teachings of the Catholic Church, to uphold the principles of the Catholic faith in the science and practice of medicine. […]   50. In accord with these scientific and religious understandings, CMA and its members believe that healthcare that provides gender-transition procedures and interventions is neither healthful nor caring; it is experimental and dangerous. […]   53. CMA thus opposes pubertal suppression of minors, as well as hormone administration or other surgical interventions for purposes of “choosing” a gender or sex, and it objects to engaging in speech affirming these gender interventions.   54. CMA has adopted an official resolution stating, “the Catholic Medical Association does not support the use of any hormones, hormone blocking agents or surgery in all human persons for the treatment of Gender Dysphoria.”   55. CMA has adopted an official resolution stating, “Catholic Medical Association and its members reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex” as well as “the use of puberty blocking hormones and cross-sex hormones.” […]

Dickerson specifically notes CMA members’ beliefs and conscience prevent them from approving of gender-affirming medical treatment within a standards of care process:

69. The gender identity mandate requires CMA members to engage in various practices to which our members objection on medical and ethical grounds, including the following: […]   m. Saying in their professional opinions that these gender intervention procedures are the standard of care, are safe, are beneficial, are not experimental, or should otherwise be recommended; […]   For ease of reference, the items in this list will be referred to as the “objectionable practices.”   70. The objectionable practices violate the teachings of the Church, and our organization’s members cannot carry them out in good conscience. […]   130. Our members’ sincerely held religious beliefs prohibit them providing, offering, facilitating, or referring for gender transition interventions and also from engaging in or facilitating the objectionable practices.

The conflict arising in the context of the Boards’ rulemaking process is clear: Of AHCA’s five expert reports included in the June 2 report and used as the basis for FLDOH’s rulemaking petition to BOM, three of these – a majority – were authored by individuals who would not be able to issue any finding in favor of gender-affirming care under any condition. If, hypothetically, it were shown that the broad field of gender-affirming treatment has only highly positive outcomes and beneficial effects with no drawbacks whatsoever, these three authors would not be able to recognize this in the course of writing their reports on the evidence in this field. The reason they would not be able to recognize this is because of their preexisting commitment with an external private organization that they will never say “in their professional opinions that these gender intervention procedures are the standard of care, are safe, are beneficial, are not experimental, or should otherwise be recommended”.  

This is a conflict of interest and would disqualify them from participating in any objective evaluation of evidence according to its intended purpose. Van Meter, Lappert, and Donovan did not disclose this conflict of interest in their reports to AHCA, nor did they decline to participate in this process on the basis of that conflict of interest. Romina Brignardello-Petersen and Wojtek Wiercioch, in their June 2 GAPMS determination report incorporating the five commissioned expert reports, did not note that this conflict of interest was present in a majority of the commissioned expert reports comprising their review. Brignardello-Petersen and Wiercioch note, twice, their heavy reliance on the five AHCA reports:

The determination process requires that “the Deputy Secretary for Medicaid will make the final determination as to whether the health service is consistent with GAPMS and not experimental or investigational” (Rule 59G-1.035, F.A.C.). In making that determination, Rule 59G-1.035, F.A.C., identifies several factors for consideration. Among other things, the rule contemplates the consideration of “recommendations or assessments by clinical or technical experts on the subject or field” (Rule 59G1.035(4)(f), F.A.C.). Accordingly, this report attaches five assessments from subject-matter experts:   Attachment C: Romina Brignardello-Petersen, DDS, MSc, PhD and Wojtek Wiercioch, MSc, PhD: Effects of Gender Affirming Therapies in People with Gender Dysphoria: Evaluation of the Best Available Evidence. 16 May 2022.   Attachment D: James Cantor, PhD: Science of Gender Dysphoria and Transsexualism. 17 May 2022.   Attachment E: Quentin Van Meter, MD: Concerns about Affirmation of an Incongruent Gender in a Child or Adolescent. 17 May 2022.   Attachment F: Patrick Lappert, MD: Surgical Procedures and Gender Dysphoria. 17 May 2022.   Attachment G: G. Kevin Donovan, MD: Medical Experimentation without Informed Consent: An Ethicist’s View of Transgender Treatment for Children. 16 May 2022. […]   Five clinical and technical expert assessments attached to this report recommend against the use of such interventions to treat what is categorized as a mental health disorder (See attachments):   Health Care Research: Brignardello-Petersen and Wiercioch performed a systematic review that graded a multitude of studies. They conclude 3 that evidence supporting sex reassignment treatments is low or very low quality.   Clinical Psychology: Cantor provided a review of literature on all aspects of the subject, covering therapies, lack of research on suicidality, practice guidelines, and Western European coverage requirements.   Plastic Surgery: Lappert provided an evaluation explaining how surgical interventions are cosmetic with little to no supporting evidence to improve mental health, particularly those altering the chest.   Pediatric Endocrinology: Van Meter explains how children and adolescent brains are in continuous phases of development and how puberty suppression and cross-sex hormones can potentially affect appropriate neural maturation.   Bioethics: Donovan provides additional insight on the bioethics of administering these treatments, asserting that children and adolescents cannot provide truly informed consent.

In the June 2 GAPMS determination report, Brignardello-Petersen and Wiercioch also did not describe how their review would account for biases such as the majority of reviewed reports originating from authors who were certain to provide the same negative finding in all possible circumstances. FLDOH additionally failed to recognize or disclose legal risks to the state of Florida inherent in requiring transgender adults to sign forms affirming the accuracy of these religiously-motivated anti-trans AHCA reports (Exhibits C and D), a requirement that could have opened the state to costly legal action on the grounds of possible violations of the Free Exercise Clause and the Establishment Clause of the First Amendment. CMA’s suit American College of Pediatricians et al. v. Becerra et al. also relies heavily on arguments involving the protection of their members’ consciences in the context of legal requirements that may conflict with this, indicating that CMA members are aware of the potentially serious burdens of such requirements; see Appendix C paras. 23, 69-70, 130, 138.  

The BOM should not have accepted the GAPMS report’s findings, and should not have accepted FLDOH’s petition for rulemaking on the basis of this report. Additionally, an inquiry is necessary into how AHCA or other state agencies located and selected these three CMA members to work in this area, given that this information about their preexisting commitment specific to this field was publicly available prior to 2022.  Further issues with the five AHCA reports collectively and individually are detailed by the Yale School of Medicine (“Public comments on Florida proposed rule denying Medicaid coverage for gender-affirming medical care”, July 8, 2022), including:

Van Meter’s disqualification as an expert in youth gender dysphoria in a divorce case in Texas in 2020, and his undisclosed substantial reuse of a prior declaration in Adams v. School Board of St. Johns County (2017) as Attachment E for the AHCA.

Lappert’s disqualification as an expert on gender dysphoria treatment in Kadel v. Folwell (2022), and his undisclosed previous work with the anti-trans Alliance Defending Freedom, which has worked to cultivate a stable of anti-trans expert witnesses (Deposition of Paul W. Hruz in Kadel v. Folwell, September 29, 2021; deposition of Patrick W. Lappert in Kadel v. Folwell, September 30, 2021).

Cantor’s undisclosed reuse of his work with the ADF in B.P.J. v. West Virginia State Board of Education (2022) as Attachment D, and the finding in Eknes-Tucker v. Marshall (2022) that Cantor does not have experience in treating gender-dysphoric youth.

2. BOM member Dr. Patrick K. Hunter is a member of CMA, holds the same prior commitment against any standard of care permitting transition, and did not disclose this or recuse himself  

Dr. Patrick K. Hunter was appointed by Governor Ron DeSantis to the Florida Board of Medicine on June 17, 2022 (“Governor Ron DeSantis Appoints Four to the Board of Medicine”, June 17, 2022). Hunter was also confirmed to be a member of the Catholic Medical Association in July 2019. Diocese of Orlando, “CMA students make a difference in NFP education and more”, July 25, 2019:

The Catholic Medical Association’s student chapter at UCF began with three medical students just three years ago. Kaitlyn Hite, Jais Emmanuel and Michael Mankbadi would gather to support each other in the faith. After participating in Mass at Nemours Children Hospital, a mutual friend connected them to the Catholic Medical Association Orlando Guild. Enter Dr. Peter Morrow, who was president that year. The introduction was a God moment. Morrow and friend, Dr. Patrick Hunter, had both been praying for the opportunity to establish a student guild at the university. In fact, the entire CMA Orlando guild was praying.

UCF College of Medicine, “Student Organizations & Student Events”:

Catholic Medical Association (CMA)

Faculty Advisor: Drs. Colleen Moran-Bano & Patrick Hunter

As with AHCA reports contributed by Van Meter, Lappert, and Donovan, Hunter’s CMA membership presents a conflict of interest in the context of his actions and statements as a Board member on standards of care for gender dysphoria. The Catholic Medical Association has specified precisely which treatments their members cannot support as part of a standard of care for transition treatment, including puberty blockers as well as HRT and gender-affirming surgery at any age. Again, if all available evidence were in favor of gender-affirming care, Hunter would not be able to recognize this because of his preexisting commitment to CMA not to accept these treatments as part of a standard of care.

This conflict of interest renders Hunter unable to evaluate the evidence and policymaking considerations at hand in a fair and objective manner, and should disqualify him from participating in any BOM proceedings on this subject. Instead, Hunter failed to disclose this conflict of interest, and failed to recuse himself from these proceedings. His actions as a BOM member have been in accordance with what is required him as a CMA member: Voting to advance bans on this care for trans youth at the August 5, October 28, and November 4 meetings, and specifically arguing at the November 4 meeting for a total ban without even an exemption for clinical trials, including entering a 10-minute statement into the record against gender-affirming care (see Appendix B, 23:56-33:52).

Hunter, as well as other BOM and BoOM members, AHCA and FLDOH staff, and their associated commissioned experts, should be required to disclose any membership in organizations such as CMA (and other groups in its umbrella organization Alliance for Hippocratic Medicine/AHM) which maintain a commitment against any positive evaluation of gender-affirming care. Members of these organizations should be required to recuse themselves from any proceedings on this issue.  

3. BOM member Dr. Patrick K. Hunter failed to disclose his association and history of working with the anti-trans group SEGM and related group Genspect  

Before being appointed to the BOM, Dr. Patrick Hunter cosigned Resolution #27 against gender-affirming care to the American Academy of Pediatrics on March 31, 2022 with director Julia W. Mason of SEGM and three others. Their resolution asserts that there has been a “near unified movement away from hormonal and surgical interventions as first line treatment in multiple countries”. A copy of this resolution with these names concealed was posted by Genspect (“An Open Letter to the American Academy of Pediatrics”, July 18, 2022), an organization documented by the Trans Safety Network and Health Liberation Now! as sharing a number of key leaders and advisors with SEGM (“SEGM uncovered: large anonymous payments funding dodgy science”, August 16, 2021; “A New Era: Key Actors Behind Anti-Trans Conversion Therapy”, June 1, 2022). The names of these signatories, including Hunter, were revealed on July 21, 2022 by Gender Analysis.

Hunter also retweeted Genspect’s open letter on his Twitter account without disclosing that he had signed the AAP resolution, while SEGM director Mason later argued on Twitter that the concealed signatories should not have been named (Tweet by @JuliaMasonMD1, July 21, 2022).

Hunter was present at an April 25, 2022 meeting requested by SEGM with the US Department of Health and Human Services Office of Civil Rights on “Nondiscrimination in Health Programs and Activities”, with fellow Resolution #27 signatories Julia W. Mason, Paula Brinkley, and Sarah B. Palmer. Notably, while the affiliations of Brinkley and Palmer were listed as “SELF”, Hunter’s affiliation was listed as “Society for Evidence-based Gender Medicine”. Hunter did not disclose his prior or current relevant work with SEGM or Genspect at any point during the Boards’ proceedings. However, he did rely heavily on their materials submitted to the Boards when calling for SEGM’s own proposed “community standard of care” for trans youth.  

4. BOM member Dr. Patrick K. Hunter called for an undefined anti-trans “community standard of care” excluding affirmation and transition, a novel term first used in this context by the anti-trans group SEGM and not appearing elsewhere  

At the November 4 meeting (see Appendix B, 24:09), BOM member Dr. Patrick Hunter seconded a motion to strike the clinical trial exemption from proposed Rule 64B8-9.019, and entered a statement into the record drawing heavily from SEGM’s October 27 submission to the Boards (public book version Y, pp. 33-45). Passages from SEGM’s Oct. 27 letter and Hunter’s highly similar remarks are compared below:

SEGM, ¶ 14. The “gender-affirming” model of care is relatively new and was scaled into practice without rigorous clinical research. Selected outcomes associated with using the so-called “Dutch protocol” to medically transition minors were published in 2014 in a case series of 55 patients. Many of the authors associated with the development of the Dutch protocol for medical transition of minors also authored The Endocrine Society guidelines for hormone administration to minors in 2009; these guidelines were updated in 2017, lowering the age of eligibly for medical interventions.

[24:09] DR. PATRICK HUNTER: “I want to read this into the record. Dutch researchers pioneered youth transition for gender dysphoria. They published several papers culminating in a 2014 paper that described the outcome for 55 youths they transitioned. The Dutch protocol is now what we call affirmative care: puberty blockers, cross-sex hormones, and breast and genital surgeries. The Dutch protocol was deemed a success because the youth continued to function well after surgery. This affirmative model of care has spread wildly in the last eight years.”

¶ 18. The practice of gender transition of minors rests largely on the results of one key study, which gave rise to the practice of pediatric gender transition worldwide. In 2014, Dutch clinicians reported on a carefully selected group of 55 youth who underwent gender transition. At follow-up 1.5 years post-surgery, the young adults (average age of 21) retained good psychological function. However, a comparison of pre- and post- transition improvements in psychological function found improvement was modest at best.

[24:56] HUNTER: “The Dutch protocol is the foundation youth transition was built on. It is flawed, it is based on weak evidence. These are some of the problems with the Dutch study. Many concerns have been raised about its methodology. It was a case series, a small cohort of 55 teenagers. There was no control group.”

¶ 19. The long-term outcomes of the cohort of the 55 young patients, beyond 1.5 years post-transition, have not been published.   ¶ 20. The 2014 “Dutch study” revealed a significant risk of harm of the gender-affirming hormones and surgery pathway. One patient died due to surgical complications. Three of the original 70 cases experienced new onset diabetes or clinically severe obesity. Several others refused to participate or did not return their questionnaires, adding to the uncertainty about their outcomes.

[25:24] HUNTER: “The follow-up period was only 18 months. This short period should be of concern. And most importantly, there has been no long-term data reported on these 55. The Dutch have been asked for their long-term data. In a June New York Times article, Dr. de Vries, the lead author, said the Dutch has [sic] lost contact with 50% of their early cohort. Dr. de Vries was interviewed on an American podcast in January. She made it clear that their patients’ lives are much more complicated than the original study’s outcome suggests.”

¶ 21. The Dutch researchers were acutely aware of the risk of psychological harm from wrongly transitioning a young person whose identity is still undergoing development. Consequently, they developed strict inclusion criteria for youth gender transition.

[26:15] HUNTER: “The Dutch, to their credit, were concerned about false transitions - transitions that would later be regretted. False transitions would be the worst possible outcome. Today we call that regret and detransition. The Dutch had inclusion and exclusion criteria hoping to limit false transitions.”

¶ 24. 3. Severe gender dysphoria from early childhood that worsens in adolescence. Only children with severe early-onset gender dysphoria were considered for medical gender transition. Those whose gender dysphoria first appeared around the time of puberty or later were disqualified from transition as minors. The requirement that gender dysphoria worsen during puberty was a critical diagnostic criterion.   ¶ 25. 4. No significant mental health problems. Youth with ongoing mental health issues, aside from mild depressive feelings, were excluded from transition as adolescents.

[26:43] HUNTER: “I want to emphasize two of these criteria. Early onset gender dysphoria was a requirement for transition. Early onset was described by the Dutch in one paper as gender dysphoria, quote, from toddlerhood, and there had to be no active mental health issues. Mental health problems excluded a teenager from transition.”

¶ 32. It should also be noted that the Dutch studies have poor applicability to currently presenting cases of youth gender dysphoria. To be eligible for medical transition, patients had to have persistent gender dysphoria “from toddlerhood onwards” with clear cross-sex identification. Currently, most gender dysphoric youth are gender-normative until their teen years and present with a high burden of comorbid mental health conditions present before the onset gender dysphoria. These two factors would have rendered most of the youth seeking to transition today ineligible for transition using the Dutch protocol criteria. Therefore, it can be argued that the Dutch research should never have been used as justification for scaling the practice of pediatric gender transition widely.

[27:11] HUNTER: “The very patients the Dutch excluded, late-onset post-pubertal gender-dysphoric youth with comorbid mental health issues, are now the majority of youth being transitioned. We are transitioning the very population the Dutch excluded, excluded because they feared harm. Affirmative care with transition is now touted as the cure for mental health problems. Just eight years ago, mental health problems excluded someone from transition. Our profession has abandoned the Dutch criteria, and these criteria were never based on hard evidence, only good intentions.”

¶ 12. The community standard approach to care for distressed youth enables clinicians to use evidence-based approaches aimed at reducing severe distress and improving general functioning, while allowing for the possibility of medical transition in the future, once mental health symptoms are well managed, and the individual becomes a mature adult capable of consent. The ability to consent is particularly important as many “gender-affirming” interventions are associated with significant risks to health including risks that are harder to comprehend and appreciate until one becomes a mature adult— such as the loss or impairment of fertility and/or sexual function. […]   ¶ 30. 9. Assessment of the ability to consent and understand risks. The Dutch researchers emphasized the need for young people to be able to provide meaningful consent, since the intervention is associated with known adverse effects such sterility, infertility, and a range of anticipated health risks from lifelong administration of cross-sex hormones.

[31:19] HUNTER: “For those that conduct future research in this area of medicine, the following questions must be answered: Can minors consent to transition? Can minors with active mental health problems consent? Can this research with hormones and surgery be done safely and ethically, when we know these treatments have negative effects on normal physiology, when these treatments probably have negative effects on an adolescent's psychosocial development and their neurodevelopment, to include their executive decision-making? Can research with hormones and surgery be done safely and ethically when we know these treatments will lead to loss of sexual function, when we know these treatments will lead to infertility?”  

Notably, Hunter uses the term “the community standard of care” to refer to an undefined practice standard in opposition to gender-affirming care:

[33:11] HUNTER: We need to return to the community standard of care for treating distress, and that is psychotherapy: ethical, compassionate psychotherapy that respects the child's experience. Let me say that again, ethical compassionate psychotherapy that respects the child's experience. This is what Europe is doing, our colleagues in Great Britain, Sweden, Finland and elsewhere agree change is needed. Less harm needs to be done, safety and ethics need to prevail.

This phrase (also as “the community standard” and “the community standard approach to care”) appears in paragraphs 2, 12, and 48 of SEGM’s letter:

¶ 2. There are currently two competing models of care for gender dysphoria. The “gender-affirming” model, which conceptualizes young people presenting with gender dysphoria as “transgender youth” and focuses on the provision of hormones and surgery for those seeking gender transition (not all transgender-identifying youth seek to medically transition, but many do). Over the last several years, this model of care gradually supplanted the previous community standard of care, which is based on a holistic view of identity formation, recognizing that identity undergoes changes during the adolescent and young adult years. This developmentally informed view recognizes that gender dysphoria can have many causes and many paths to resolution and does not support the notion that current gender identity should be medicalized into permanence using hormones and surgery in young people. Instead, psychotherapy is considered the first line of treatment, and gender transition in youth is pursued only in rare instances, as a measure of last resort. […]   ¶ 48. Fifth, the Board should consider that the European countries that no longer medicalize youth gender dysphoria with hormones and surgery are treating it instead with psychological and psychiatric care. The Board should make a strong and unambiguous statement that psychotherapy for gender-related distress is the community standard and should not be stigmatized or conflated with conversion therapy.

Although Hunter and SEGM have called for a return to this alleged previous standard, the meaning of “the community standard of care”, in the context of opposition to gender-affirming care, is unusually elusive for a supposedly widespread and accepted practice predating affirmation. In the general context of transition treatments, “community standard of care” is typically used in discussions on ensuring access to transition care and other medically necessary care for trans people in carceral settings or other institutions; it does not appear to refer to any intended prohibition on trans youth or adults accessing any gender-affirming care (Kendig & Rosseau, 2022; Brief of amici curiae civil rights & non-profit organizations in Edmo v. IDOC, 2019; Washington State DCYF Policy 4.30 statement 11, 2018; Complaint and jury demand in Hill v. BOP, 2013).  

SEGM’s use of this phrase, in opposition to any access to gender-affirming medical treatment by a significant portion of the transgender population, namely trans youth, appears to be novel. “Community standard of care” first appeared on SEGM’s FAQ page under “Why is there a ‘GIDS’ graph” (“Frequently Asked Questions”, retrieved on December 1, 2022) some time after October 18, 2022 (compare “FAQ”, Internet archive capture, October 18):

NHS England determined that the first line of treatment for youth gender dysphoria should be psychotherapy. The NHS concluded it's not viable or safe to place the care for gender dysphoric youth in a "gender clinic" led by "gender experts." Going forward, gender-dysphoric youth will be taken care of in standard clinical settings, led by experts in mental health, autism, child and adolescent development, trauma, and other relevant areas of expertise. The NHS decision has put an end to the "gender-clinic" model of care that is built on the foundation of "gender affirmation" endorsed by WPATH, and returned to the previous community standard of care based on a holistic view of identity development in children and adolescents.

This passage was not present in the October 18 version of SEGM’s FAQ, which primarily referred to the “standard of care” in the context of grounds for malpractice lawsuits against providers of transition treatments:

What is the standard of care in pediatric gender medicine?   There is much confusion about the “standard of care” in gender medicine.  Standard of care is a medicolegal concept essential for determining whether clinicians are negligent and liable for their actions in the context of malpractice lawsuits. For example, if a certain treatment harmed the patient, but the doctor only did what any other competent and skilled doctor would do in a similar situation, the doctor’s attorney will assert that they practiced according to a standard of care and should not be liable, even if the patient was demonstrably harmed.   What is contributing to the confusion is that an organization that promotes the practice of "gender-affirmation" of youth with hormones and surgeries, The World Professional Association for Transgender Health (WPATH), named their treatment guidelines "Standards of Care" also known as "SOC."  In a recent court case, WPATH clarified that despite the misleading name, their practice guidelines are indeed treatment recommendations and not a "standard of care."   Ultimately only the courts can determine whether clinicians who provide “gender-affirming” interventions can successfully invoke the standard of care argument when sued by a patient alleging harm. Those who will argue for it will point out that currently a number of medical organizations have embraced the practice of “gender affirmation” following WPATH's treatment recommendations. However, such an argument may not withstand scrutiny due to two key facts: the evidence base for "gender-affirming" interventions, as well as the WPATH guidelines themselves are recognized to be of very low quality; and a growing number of healthcare systems in the Western world recently diverged from WPATH recommendations, sharply limiting pediatric gender transitions to a few exceptional cases.

This does not actually describe or propose the substantial components of any such standard of care or how this would differ from existing gender-affirming care. SEGM’s post-October 18 FAQ refers to SEGM’s own October 24, 2022 blog post “The NHS Ends the ‘Gender-Affirmative Care Model’ for Youth in England”, which states:

The key highlights of the NHS new guidance are provided below.*   1. Eliminates the “gender clinic” model of care and does away with “affirmation”   The NHS has eliminated the “gender clinic” model of care where children are seen solely by a specialist gender dysphoria practitioner, replacing it with standard care in children’s hospital settings.

This post links to NHS England’s October 20 “Interim service specification for specialist gender dysphoria services for children and young people – public consultation” , which includes the documents “Public consultation”, “Interim service specification”, and “Equality and Health Inequalities Impact Assessment (EHIA)”. However, none of these documents include references to any “community standard of care” as used by SEGM. In particular, the October 20 interim service specification features key differences from SEGM’s recommendations in their October 27 letter to the Boards. SEGM called to “discourage early social transition” with “no medical interventions before age 12” (paras. 22-23):

¶ 22. 1. Discourage early social transition. The Dutch clinicians recognized that early gender transition creates a stressful environment for children as they reach adolescence, should they wish to detransition. At the time it was widely acknowledged (and is still acknowledged by the current Endocrine Society guidelines) that most gender dysphoric children will not identify as transgender by the time they reached adulthood. It was also noted that even for those who would go on to transition, early social transition creates unrealistic expectations and subsequent disappointment with the natural limits of transition-related healthcare.   ¶ 23. 2. No medical interventions before age 12. For prepubertal and early-puberty children <12 years, the Dutch standard of care was watchful waiting, careful observation, and psychotherapy if needed.

However, the NHS interim service specification allows for youth to continue a current social transition to maintain their level of functioning, initiate a social transition to maintain or improve their level of functioning, and begin treatment with puberty blockers at Tanner stage 2 if eligible:

In cases where a pre-pubertal child has effected, or is effecting, a social transition (or expresses a wish to effect a social transition) the clinical approach has to be mindful of the risks of an inappropriate gender transition and the difficulties that the child may experience in returning to the original gender role upon entering puberty if the gender incongruence does not persist into adolescence.   However, some children state that they want to make a social transition to their preferred gender role long before puberty, which means that increasing numbers of children may have made a partial or full social transition prior to the first attendance with The Service.   In summary, for pre-pubertal children the clinical approach and advice applied by The Service will be supportive and non-judgemental, balancing on a case-by-case basis a watchful approach overall with a more individualised approach in cases where the child’s level of global functioning may be maintained or improved through a carefully observed process of exploration of social transition. Medical interventions will not be considered at least until puberty has been reached (Tanner Stage 2).

Hunter and SEGM have represented an anti-trans “community standard of care” as a previously established and widespread historical practice, when this appears to refer instead to a set of mere assertions by SEGM - which are not practice standards - first published in a letter on October 27, 2022. Additionally, even though SEGM’s letter is dated prior to the October 28 meeting, it was not uploaded to the public book PDF until the day before the November 4 hearing, leaving the public with almost no time to review SEGM’s submission prior to BOM member Hunter’s extensive unattributed use of this third-party work. It is still not established at all whether there is any such earlier anti-trans “community standard of care” to which providers can “return”: it is apparently conjured from a network of mutual citations, with no ultimate reference to the substance of this alleged standard. Notably, the term “community standard of care” later appeared in a November 8 letter by SEGM to Iceland’s Althing parliament on the proposed Conversion Practices Prohibition Bill:

The low certainty of benefit of hormone treatments of youth was also reached by a recent “overview of systematic reviews” commissioned by the U.S. State of Florida (Brignardello-Peterson & Wiercioch, 2022). In November 2022, Florida’s Medical Board determined that hormones and surgeries for gender dysphoric youth are experimental, and banned this practice in general medical settings (Ghorayshi, 2022). The Board encouraged clinicians to treat gender dysphoric youth under the well-established “community standard of care” for distress, which is psychotherapy. […]   In Iceland, no diagnosis appears to be required to initiate social transition of minors, and clinicians are advised to refer for puberty blocking medication. To the best of our knowledge, many health practitioner codes of practice already follow this rubric. According to the Bill, should clinicians in Iceland follow international developments and the conventional standard of pursuing noninvasive interventions before attempting medication and surgery, making a referral to psychotherapy would in effect be considered practicing “conversion.”

In this instance, SEGM is not quoting the BOM broadly but BOM member Hunter specifically, who himself appeared to be quoting SEGM’s previous October 27 letter. Within these two SEGM letters, this “community” or “conventional” standard of care is not detailed, consisting largely of negative statements and prohibitions on most gender-affirming approaches and treatments. However, SEGM twice acknowledges the possibility that these “community standard” practices could be found to fall under definitions of anti-gay and anti-trans conversion therapy. The group’s alleged “community standard of care” altogether does not appear to consist of anything more than possible conversion therapy (as “conversion therapy” is understood by those who are not members of SEGM). Conversion therapy practices are recognized by the United Nations as a cruel, inhumane, degrading, and profoundly traumatic human rights violation, and can be considered an act of torture against LGBT people (“One UN human rights expert’s fight to eliminate ‘conversion therapies’”, UN News, February 18, 2022).  

Hunter’s introduction of an alleged “community standard of care” was inappropriately vague, did not properly attribute SEGM’s October 27 letter, and did not disclose details relevant to the public health mission of the BOM; namely, the risk that this vague standard could overlap with conversion therapy practices considered to be highly dangerous and harmful to trans youth. Instead, Hunter has allowed Florida’s state health agencies to be used as a mouthpiece for the outside interest group SEGM, laundering their poorly-articulated and risky proposals via the Boards to be exported abroad with apparent authority.  

5. BOM member Patrick K. Hunter has a history of failing to disclose significant and relevant information about his qualifications in bioethics  

In his May 2022 expert declaration in Eknes-Tucker et al. v. Ivey et al., BOM member Dr. Patrick K. Hunter stated that he is a “pediatrician with an advanced degree in bioethics” awarded by the University of Mary in 2020. Declaration of Patrick Hunter, May 1, 2022:

1. I submit this expert declaration based upon my personal knowledge, my experience as a pediatrician with an advanced degree in bioethics, and my review of the literature discussed below. […]   3. I am a pediatrician with a master’s degree in bioethics. I received my medical degree from the University of Louisville School of Medicine in 1992 and completed a pediatric residency at Tripler Army Medical Center in 1995. I obtained board certification in general pediatrics in 1995 and have continuously maintained that certification. I obtained a Master of Science degree in bioethics from the University of Mary in 2020. I have served on the ethics committee at Nemours Children Hospital, Orlando. […]

The Master of Science degree in bioethics from the University of Mary is not merely an “advanced degree in bioethics”, but a degree focused entirely on a specific Catholic interpretation of bioethics (“Bioethics, M.S. – University of Mary”). The University of Mary describes the program’s Catholic focus:

Bioethics is broadly interdisciplinary and encourages collaboration of various stakeholders in the discourse that helps people make morally sound decisions made within our Christian, Catholic, and Benedictine tradition, about responsible use of biomedical advances. […] Informed by the Christian, Catholic and Benedictine tradition, the program in Bioethics prepares graduates to meet bioethical health care challenges with confidence, courage and clarity.

One pathway for this degree is offered in association with the National Catholic Bioethics Center, an “allied organization” of the Catholic Medical Association:

The interdisciplinary Master of Science in Bioethics Degree offered in partnership with the National Catholic Bioethics Center (NCBC) consists of 32 credits and can be completed in two years. In the first year, the student enrolls in the NCBC Certification Program in Health Care Ethics.

All pathways for the M.S. in Bioethics are based on the NCBC’s teachings: Year one of the University of Mary M.S. in bioethics requires either the “NCBC Certificate Courses”, or attending “HCB 550 – NCBC Two-Day Bioethics Seminar”. Like the Catholic Medical Association, NCBC holds specific absolute positions on the topic of ethical care for trans youth, and opposes any affirming care or transition treatment for trans youth as well as adults. The group broadly describes all aspects of transitioning as “always morally evil” on the grounds of “Catholic anthropology and Church teaching”. In the NCBC’s 2021 book “Transgender Issues in Catholic Health Care” (Furton, 2021), NCBC Staff Ethicist Josef P. Zalot contributed the chapter “Catholic Health Care and Gender Identity: A Resource for Policy Guidance”, writing:

The affirmative model of care fails the principle of double effect on at least two of the four criteria. The first is criterion 1. To determine the liceity of a particular action (or intervention), one needs to evaluate it in light of the moral object – that which gives the act its moral significance. When psychotherapy is used to affirm patients’ perceptions that they are in the wrong body, to encourage them to socially transition, and then to move them toward hormones and surgical procedures, the moral object is gender transition – understood as the deliberate alteration of a person’s thinking, behavior, or appearance to affirm that person’s erroneous perception of sexual identity. Similarly, when puberty-blocking hormones are prescribed (and provided) for the direct and intended purpose of offering a child more time to discern his or her so-called true sex, the moral object is gender transition. When cross-sex hormones are prescribed (and provided) for the direct and intended purpose of altering one’s secondary sex characteristics (breasts, facial hair, and so on) so that the body presents with the physical attributes of one’s preferred gender, the moral object is gender transition. As previously explained, transitioning one’s gender (or attempting to do so) is contrary to Catholic anthropology and Church teaching, not to mention logic, basic biology, and medical evidence. As such, interventions directed toward this end are never morally good or neutral; they are always morally evil.

Notably, Hunter explains in his May 2022 declaration that the focus of his bioethics degree was “ethical dilemmas” presented by gender-affirming care:

15. I have always had a keen interest in medical ethics and often considered formal education in the field. I originally wanted to explore the merging of medicine and business—hospital systems dominating the marketplace and physicians becoming employees—and how this evolution was impacting the ethics of medical care. What I was learning about gender dysphoria further propelled my interest in an ethics degree. I undertook a study of bioethics, completing my master’s degree in bioethics in 2020.   16. In my degree, much effort was focused on the growing popularity of the so-called “gender-affirmative care,” which delivers life-altering, permanent interventions to minors that involve sterilizing procedures. I have focused on ethical dilemmas, such as whether minors have the capacity to give a meaningful informed consent.

According to the NCBC, which plays a foundational role in this bioethics program, the “ethical dilemma” of gender affirmation is clear: it is “always morally evil”. This directly comes to bear on BOM member Hunter’s statement at the November 4 meeting calling for “ethical, compassionate psychotherapy”. The NCBC states outright that “[w]hen psychotherapy is used to affirm” trans people’s genders, or when “the moral object is gender transition”, it is “morally evil”. This judgment of gender-affirmative care as “evil” is attributed to teaching and “anthropology” that is particular to this group’s interpretation of one religious faith.  

BOM member Patrick K. Hunter has a documented history of adhering to a narrow religious view of bioethics as applied to care for trans youth. It is not clear why these sectarian interpretations of bioethics would be of any relevance to the citizens of Florida impacted by the proposed Rules; the vast majority of Floridians, 79%, are not Catholic (2014 Religious Landscape Survey, Pew Research Center). In any case, these positions based on one group’s religious doctrine have no place in any policymaking under the secular government of the United States.  

Hunter should have disclosed that his approach to medical ethics is heavily informed by non-mainstream sectarian religious views and policies promoted by outside influence groups, which are not shared by most Floridians. Members of the Boards should be required to disclose any such deviancy in their training and credentials in medical ethics from mainstream standards of ethics and core public health goals. The Boards must prioritize the overall public health mission of Florida’s state health agencies and promote the health and well-being of all Floridians regardless of their religious faith or life philosophy.  

6. State-selected anti-trans expert Michael Biggs misleadingly conflated two distinct groups when describing transition outcomes  

At the October 28 joint Boards meeting, anti-trans expert Michael Biggs made the misleading claim that a patient “died as an indirect consequence of puberty suppression” when this was a postoperative complication of vaginoplasty:

[32:49] MICHAEL BIGGS: De Vries et al. acknowledge that one patient was killed by necrotizing fasciitis during vaginoplasty, out of 70 patients that’s a death rate exceeding 1%, remarkably high for a group of healthy teenagers. De Vries et al. didn’t mention that the death was actually a consequence of puberty suppression, as I’ll explain in a moment.  [. . .]   [34:25] Well, it’s certainly true that early puberty suppression produces a closer resemblance to the opposite sex, patients are more likely to pass superficially. However, this benefit must be weighed against several serious costs. There are some known costs. So for males, early puberty suppression makes subsequent genital surgery more risky and less satisfactory. The penis is so undeveloped that a normal vaginoplasty is usually impossible, and so instead a portion of the patient’s intestine has to be used. Leakage from the intestines after surgery is what killed the early Dutch patient at the age of 18, so that patient died as an indirect consequence of puberty suppression. [35:08]

Biggs is a sociologist and does not specialize in the treatment of gender dysphoria in youth. Biggs also did not note the limitation that because this study’s sample size is less than 100, the occurrence of any one rare event would result in the “rate exceeding 1%” that he considers “remarkably high”. He additionally erred in conflating two groups that are not comparable: patients receiving puberty blockers for gender dysphoria, and patients receiving intestinal vaginoplasty.  

Both of these groups are heterogeneous. The group of those receiving puberty blockers for gender dysphoria includes those assigned female (a possible majority) who would not receive any vaginoplasty, those assigned male who later undergo intestinal vaginoplasty, those assigned male who later undergo non-intestinal vaginoplasty, and those assigned male who do not undergo any vaginoplasty. Contrary to Biggs’ assertion, van der Sluis et al. (2022) found that 28% of assigned-male trans youth using puberty blockers since Tanner stages 2-3 were able to receive non-intestinal penile inversion vaginoplasty.  

The group of patients undergoing intestinal vaginoplasty is also heterogeneous, including cisgender women with various conditions of the reproductive tract, trans women without a history of using puberty blockers, and trans women with a history of using puberty blockers. Bouman et al. (2014) found in a review of intestinal vaginoplasty outcomes that “procedure-related complication rates were low” and “only 0.6% of patients had severe procedure-related complications”. Because Biggs is discussing a complication with intestinal vaginoplasty, this concern would not be applicable to those using puberty blockers who do not undergo this procedure.  

Biggs erroneously presented those using puberty blockers and those receiving intestinal vaginoplasty - two very different groups - as effectively synonymous when they are not even directly comparable due to their distinct compositions with limited overlap. However, the Boards failed to challenge these inaccurate assertions at the time they were made. Biggs’ remarks on these outcomes should be excluded by the Boards from consideration as expert testimony.  

7. State-selected anti-trans expert Dr. Michael K. Laidlaw incorrectly described desistance of gender dysphoria as occurring at adulthood rather than adolescence  

At the October 28 meeting, anti-trans expert Dr. Michael K. Laidlaw presented a slide (Oct. 28 public book version D, p. 137) claiming that the “desistance of children by adulthood” is “50-98%” and attributing this to Ristori & Steensma (2016):

[1:36:27] DR. MICHAEL K. LAIDLAW: I think it’s important to note that studies have shown that desistance, or growing out of this condition of children by adulthood, is very high, some 50 to 98%, and these are primarily studies done on 12 years old and younger.   [Slide stating “Desistance of Children by adulthood: 50-98%*”, citing Ristori & Steensma (2016).]

However, Ristori & Steensma specify that ages 10-13 are a crucial developmental period for the divergent outcomes of desistance or persistence – not adulthood:

The primary aim of the Steensma et al. (2011) study was to get a better understanding of the processes that contribute to the persistence and desistence of childhood GD. By interviewing adolescents (14 persisters, 11 desisters) who all fulfilled the DSM-IV or DSM-IV-TR criteria of a gender identity diagnosis in childhood (APA, 1994, 2000), it became clear that the period between 10 and 13 years was considered crucial. Both persisters and desisters stated that the changes in their social environment, the anticipated and actual feminization or masculinization of their bodies, and the first experiences of falling in love and sexual attraction in this period, contributed to an increase (in the persisters) or decrease (in the desisters) of their gender related interests, behaviours, and feelings of gender discomfort.

Ristori & Steensma also note a previous finding that persistence rates increased over time as some trans patients, who had apparently “desisted” as youth, later returned to the clinic as adults:

To test this hypothesis, Steensma & Cohen-Kettenis (2015) recently published a report on the first 150 childhood cases from Amsterdam, the Netherlands, and checked whether a longer follow-up period would result in higher persistence rates. The children were at the time of first assessment – between 5 to 12 years old and between 19 to 38 years of age at the time of follow-up. Out of the 150 cases, 40 re-entered the clinic during adolescence (12–18 years of age) and turned out to be persisters (26.7%). However, after checking the files of the adult clinic (which sees nearly all adults with gender dysphoria in the Netherlands), it appeared that five individuals applied for treatment after the age of 18, raising the persistence rate to 30% and showing the importance of long-term follow-ups. Based on this information, it seems reasonable to conclude that the persistence of GD may well be higher than 15%.

Laidlaw’s argument gives the inaccurate impression that waiting beyond adolescence and into adulthood is necessary in order for “desistance” to occur, which is not supported by the cited paper. Laidlaw’s testimony also conspicuously failed to address the impact of the Boards’ proposed total ban on up to 50% of gender-dysphoric children, who will (as Laidlaw himself recognizes) continue to experience gender dysphoria throughout their adolescence and into adulthood.  

Because a copy of Ristori & Steensma (2016) including these passages was enclosed in the August 5 public materials (pp. 10-17), members of the Boards should have been aware of these key details. Instead, the Boards failed to challenge Laidlaw’s incorrect statements at the time they were made. Laidlaw’s remarks on desistance should be excluded by the Boards from consideration as expert testimony.  

8. BOM member Dr. Patrick K. Hunter incorrectly argued that social transition is causative of persistence of gender dysphoria  

At the October 28 meeting, BOM member Patrick Hunter argued that social transition “changes the desistance rates” and that youth who socially transition “would then need to understand the surgical risks” (see Appendix A, 4:46:28):

[4:47:14] DR. PATRICK K. HUNTER: But any informed consent needs to disclose the degree of evidence or lack thereof, whether that, who that's coming from. I agree it needs to be a multi-disciplinary process. That's what the Dutch said they would do, and that needs to be, it's the, informed consent is not a simple process in this setting. It has to include surgery. I think it needs to include surgery, because once you're on the path of social transition, there's good, there is good evidence that social transition maintains that identity and it changes the desistance rates.   [4:47:53] Once that’s started, then you're on puberty blockers. We've heard that puberty blockers lead 98% chance [sic], 95% chance of cross-sex hormones. Now we're in the irreversible territory. What percentage of those kids go on to surgery? So for a 12, 13, 14 year old to understand that, they would then need to understand the surgical risks, because they're starting on a pathway that may not go back, that may be irreversible. So the consent process would have to involve a surgeon, I believe, too, for the family to understand. The 12 year old, 13, 14 year old might not understand that. But the parents, I think, are due that knowledge of what the evidence reviews show, and the full gamut of what may proceed over the next four, five, six years. [4:48:38]

This assertion of a causative mechanism is based on a misreading of Steensma et al. (2013), which proposed the authors’ own logistic regression model of predictive factors rather than causative factors (“Dr. Stephen Levine and the Plot to Police America’s Gender”, Gender Analysis, June 1, 2022). Even within this model, social transition status was one of multiple factors, and explained 12% of the outcome of whether an assigned-male child would experience persistence of their gender dysphoria into adolescence. For those assigned female, who may now comprise a majority of trans youth, social transition status was not even predictive of an outcome of persistence or desistance at all.  

Because there is no indication that social transition causes persistence of gender dysphoria, this does not support the argument that social transition in trans children – a reversible non-medical step including a change of name, attire, pronouns or hairstyle – should require the same capacity for informed consent as an adult agreeing to gender-affirming surgery. BOM member Hunter should not have made these incorrect claims at the time of the October 28 meeting, and these statements should be excluded from consideration by the Boards.  

9. BOM member Dr. Patrick K. Hunter introduced irrelevant and misleading arguments to amplify the credentials of AHCA GAPMS report authors Brignardello-Petersen and Wiercioch  

At the October 28 meeting, BOM member Patrick Hunter offered this response to Yale School of Medicine’s Dr. Meredithe McNamara, following her criticism of the AHCA GAPMS report authors’ lack of relevant expertise in gender-affirming care:

[2:03:15] DR. PATRICK HUNTER: This is going to be more of a statement, but then I would like Dr. McNamara to comment. The concern seems to be with the June 2 report, and I just want to clarify that this is my reading of the June 2 report, my understanding of the June 2 report, this is not a Florida report. This is a report from McMaster University in Ottawa, Canada. And I agree those people who wrote the report are not physicians, they are not involved in gender medicine, but they are experts in evidence review, McMaster University being the home of the term “evidence-based medicine”. Gordon Guyatt coined that term, and these are all trainees of Dr. Guyatt.   [2:04:02] And I think there is some concern in the literature that if evidence is not reviewed in this systematic fashion, and if it is reviewed by people heavily involved in the field, that the conclusions may in fact be biased. So I don’t think there’s a bigger name in evidence-based medicine than McMaster University and the experts who reviewed the literature in this area. I just want that clear and for the record, and if Dr. McNamara would like to comment on that.   [2:04:37] DR. MEREDITHE MCNAMARA: I’m not sure if you’d like me to comment, but I really couldn’t hear much of what you said. I apologize if I’ve missed.   [2:04:47] HUNTER: I can try to say it again. I think to describe the evidence reviewers as inexpert and not qualified, when it’s coming from McMaster University, where the term “evidence-based medicine” [sic] and they have an entire program reviewing the quality of evidence. [2:05:10]

This diversion was irrelevant and a waste of the public’s time on these matters: Hunter’s argument fundamentally does not succeed in supporting the quality of the authors’ work. No particular institution holds a monopoly on evaluating medical evidence or basing decisions on scientific findings; this is antithetical to every value of the open processes of science. While Hunter’s statement reiterates Brignardello-Petersen & Wiercioch’s credentials, the issue at hand was the quality of the June 2 GAPMS report; extensive issues with their report are documented in the Yale School of Medicine’s submission to the BOM (“Public comments on Florida proposed rule denying Medicaid coverage for gender-affirming medical care”, July 8, 2022).  

Although Hunter represents the authors as experts in evidence review, Brignardello-Petersen & Wiercioch failed to note a critical limitation of their June 2 review: the unavoidable bias present in a majority of the AHCA’s expert reports, which were written by individuals with a prior commitment to find against gender-affirming treatment in all circumstances regardless of evidence. Their eminent credentials make this omission all the more inexplicable, and Hunter and other members of the Boards did not address whether it is routine practice at McMaster University to omit any accounting of these biases from evidence reviews.  

Notably, although Brignardello-Petersen and Wiercioch have coauthored a number of evidence reviews and practice guidelines in a variety of medical subspecialties, these publications typically had 10 or more coauthors, and always included a number of specialists in the relevant medical fields. These include reviews and guidelines on:

Sensitive teeth (Martins et al., 2020) (12 authors)

Cavity treatment (Urquhart et al., 2019) (19 authors)

Dental care in epidermolysis bullosa (Krämer et al., 2012) (10 authors)

Allergic rhinitis and asthma (Brozek et al., 2017) (60 authors)

Corticosteroids for sore throat (Sadeghirad et al., 2017) (9 authors)

Treatment of gout (FitzGerald et al., 2020) (34 authors)

Ulcer prevention in ICUs (Alhazzani et al., 2018) (21 authors)

Management of von Willebrand disease (Connell et al., 2021) (19 authors)

von Willebrand factor levels (Kalot et al., 2022) (23 authors)

Cervical cancer screening (Mustafa et al., 2016) (15 authors)

Treatment of premalignant cervical lesions (Santesso et al., 2016) (15 authors)

Treatment of acute myeloid leukemia in older adults (Sekeres et al., 2020) (23 authors)

Comparing treatments for acute myeloid leukemia (Chang et al., 2021) (19 authors)

Ventilation in COVID-19 (Schünemann et al., 2020) (50 authors)

Remdesivir in COVID-19 (Rochwerg et al., 2020) (27 authors)

Adverse effects of COVID-19 treatments (Izcovich et al., 2021) (15 authors)

Diagnosis of VTE (Lim et al., 2018) (17 authors)

Treatment of VTE and PE (Ortel et al., 2020) (22 authors)

Test accuracy in diagnosing VTE (Patel et al., 2020) (29 authors)

Comparison of anticoagulants (Neumann et al., 2020) (17 authors)

Anticoagulants in cancer patients (Lyman et al., 2021) (16 authors)

Anticoagulants in COVID-19 (Cuker et al., 2021) (45 authors)

Heparin-induced thrombocytopenia (Morgan et al., 2020) (13 authors)

Outside of the June 2 GAPMS report, they do not have a history of writing reviews or guidelines with only one or two authors. This report was clearly conducted outside of Brignardello-Petersen and Wiercioch’s normal procedures for evidence reviews. While SEGM in their October 27 letter encouraged BOM not to “do it alone” (para. 3), Brignardello-Petersen and Wiercioch appear to have done exactly that in a dramatic departure from the standards of their previous work. Members of the Boards should refrain from irrelevant commentary that inappropriately inflates the quality of inadequate state-commissioned expert reports by individuals working outside of their areas of practice.  

10. The Boards accepted an imbalanced lineup of anti-trans detransitioners and other anti-trans speakers from the FLDOH, including several undisclosed witnesses for AHCA in Dekker v. Marstiller  

At the November 4 meeting, BOM member Dr. Hector Vila moved to eliminate the clinical trial exemption for use of puberty blockers and HRT by trans youth, citing the testimony of nine anti-trans detransitioners at the previous October 28 meeting (see Appendix B, 20:35):

[22:04] DR. HECTOR VILA: And finally and most significantly, the in-person testimony of multiple patients who were irreversibly harmed by hormonal treatments. In my 25 years of hearing testimony before this Board, I don't think I've ever seen that many patients talk about that much harm being done to them. And so given these facts, I am not supportive of this, of item 2 in the proposed rule, that allows for these treatments to be administered under even IRB-approved protocol. I just don't think that they're safe, and that they cause irreversible harm to a significant number of patients.

Vila has mistaken repetition for abundance, misrepresenting these anti-trans detransitioners as prolific, when they are actually rare but frequently resampled. Notably, although the October 28 meeting featured testimony from nine of these detransitioners, the Florida Board of Medicine has previously suspended the license of a Boynton Beach doctor in 2017 who had prescribed opioids, benzodiazepines, and other medications linked to 4 patient deaths (“Boynton Beach doctor's license suspended over 4 patient deaths”, South Florida Sun-Sentinel), and the Florida Department of Health suspended a Lake City prescriber in 2011 linked to 34 deaths from overdose (“Florida Pain Doc Suspended; 34 Patients Dead”, ABC News). The harms alleged by these nine anti-trans detransitioners are not singularly severe over the past 25 years of state supervision of medical practice in Florida, and many of these detransitioners received transition treatment and gender-affirming care outside of Florida.  

The small group of detransitioners at the October 28 meeting have been reused for their anti-trans testimony by the AHCA in 2022 in Dekker et al. v. Marstiller et al. and in other anti-trans efforts outside of Florida over the past several years:

[3:17:28] Detransitioner Zoe Hawes, who also provided a declaration for the state of Florida’s defense of AHCA’s transition care exclusion in Dekker et al. v. Marstiller et al. (Declaration of Zoe Hawes, October 3, 2022)

[3:23:22] Detransitioner Chloe Cole, provided a declaration in Dekker v. Marstiller (Redacted defendants’ response in opposition, October 3, 2022) and offered anti-trans testimony to California and Louisiana state legislatures (“Chloe’s story: puberty blockers at 13, a double mastectomy at 15”, MercatorNet).

[3:26:08] Detransitioner Camille Kiefel, provided a declaration in Dekker v. Marstiller (Declaration of Camille Kiefel, October 3, 2022)

[3:32:03] Detransitioner Clifton Francis (Billy) Burleigh, also contributed to an amicus brief for the defense of Alabama’s trans youth care ban in Eknes-Tucker v. Ivey (Brief for amici curiae detransitioners, July 5, 2022), contributed testimony to the defense of Arkansas’ trans youth care ban in Brandt et al. v. Rutledge et al. (Brief of defendants-appellants, November 12, 2021), and testified in support of proposed trans youth care ban H.675 in Idaho (House State Affairs Committee minutes, March 4, 2022)

[3:38:24] Detransitioner Helena Kerschner, contributed to an amicus brief in Eknes-Tucker v. Ivey

[3:41:31] Detransitioner Ted Halley, contributed to an amicus brief for the defense of Alabama’s trans youth care ban in Eknes-Tucker v. Ivey

This was not the tip of an iceberg of such cases, but a small recurring cast of characters who are frequently resampled for lack of any broader testimony as to the prevalence of this allegedly widespread and concerning phenomenon. Three other speakers at the October 28 Boards meeting have been reused by the AHCA and in other anti-trans efforts:

[3:45:00] Parent Yaacov Sheinfeld, provided a declaration in Dekker v. Marstiller (Declaration of Yaacov Sheinfeld, October 3, 2022), also contributed a brief in Eknes-Tucker v. Ivey (Declaration of Yaacov Sheinfeld, April 29, 2022) and contributed a brief in Brandt v. Rutledge (Brief for Yaacov Sheinfeld et al as amici curiae in support of defendants-appellants, November 19, 2021)

[4:06:38] Dr. Robert Roper, physician of detransitioner witness C.G. who provided a declaration in Dekker v. Marstiller (Redacted defendants’ response in opposition, October 3, 2022)

[4:18:20] Parent Bob Framingham, husband of Julie Framingham who provided a declaration in Dekker v. Marstiller (Declaration of Julie Framingham, October 3, 2022)

The public comment period of the October 28 meeting altogether featured 15 anti-trans speakers and only 6 pro-trans speakers. During the October 28 meeting, the Boards demonstrated undue deference to these anti-trans speakers, inconsistent with their standards of civility and decorum applied at other meetings. Anti-trans speaker Kiefel (Appendix A, 3:26:08) was permitted to attack the bodies of an identifiable group, transitioned Floridians, as being “mutilated”, “carved-up” and unlovable specifically due to undergoing these treatments; at no point did the Boards interrupt this inappropriate and prejudiced commentary. The following week at the November 4 meeting, pro-trans speaker Kimberly Cox (Appendix B, 1:31:19) was cut off and removed by BOM chair Dr. David Diamond for referring to the DeSantis administration as a “Nazi regime”. The Boards’ approach to civility is being applied in a way that silences pro-trans voices while elevating anti-trans voices, giving the impression that criticism of an autocratic approach to policymaking is unacceptable, while intrusive attacks on the bodies of thousands of trans Floridians are welcome.  

On October 28 following the joint meeting, BOM member Dr. Zachariah P. Zachariah stated to Florida Politics that he “read the names in the order they were given to him by Department of Health staff” (“Medical board members have Gov. DeSantis’ back financially and on gender-affirming care”, Florida Politics, October 28, 2022). The Boards broadly, BOM chair Dr. David Diamond, and BOM member Dr. Zachariah P. Zachariah should have disclosed prior to the hearing that this lineup was provided by the Florida Department of Health. They should have rejected this imbalanced lineup of 15 anti-trans speakers and 6 pro-trans speakers. They should have additionally disclosed the affiliations of anti-trans speakers Zoe Hawes, Chloe Cole, Camille Kiefel, Yaacov Sheinfeld, Dr. Robert Roper, and Bob Framingham with the AHCA’s defense in Dekker et al. v. Marstiller et al. Members of the Boards should refrain from misrepresenting the population of anti-trans detransitioners as larger than it is.  

The lineup of speakers at the November 4 joint meeting, which was described by BOM chair Dr. David as being "randomized" (see Appendix B, 19:33), featured both Zoe Hawes and Helena Kerschner again, as well as other anti-trans speakers linked to AHCA, FLDOH and other proposed care bans:

[1:09:49] “Former trans kid” Erin Brewer, also testified in support of Idaho H.675 with Burleigh, and appeared at the October 28, 2021 “Virtual SAFE Act Summit” on Arkansas’ trans youth care ban with bill sponsor Rep. Robin Lundstrum (Response in opposition to motion to quash, Exhibit 15, in Brandt v. Rutledge, May 24, 2022)

[1:19:59] Julie Framingham, provided a declaration in Dekker v. Marstiller (wife of Bob Framingham) (Declaration of Julie Framingham, October 3, 2022)

[1:46:36] Parent Amy Atterberry, who stated in the November 4 public materials version Y (pp. 2308-2309) that she shared her now-adult trans child’s medical records with state surgeon general Joseph Ladapo, and appears to have been quoted by AHCA as “Katie Caterbury” in Dekker v. Marstiller (Redacted defendants’ response in opposition, October 3, 2022)

Arkansas Rep. Robin Lundstrum, who frequently emails with Erin Brewer (Response in opposition to motion to quash, Exhibit 14, in Brandt v. Rutledge), recognizes the likely outcome of trans youth care bans such as Arkansas’ “SAFE Act” and Florida’s Rules 64B8-9.019 and 64B15-14.014. At the July 22, 2021 Family Policy Alliance “Gender Issues Policy Panel” (Response in opposition to motion to quash, Exhibit 27), Lundstrum openly acknowledged that the passage of these bans would certainly be followed by the plausibly attributable deaths of trans children who were not able to access gender-affirming care:

3. The Tough Stuff   a. One of the questions that kept coming up over and over again, even reverberating nationally, was “what about the children who are already undergoing ‘treatment’ with puberty-blockers and/or cross-sex hormones”? How do you both respond to that?   i. Robin: We’re not looking in the medicine cabinet; these drugs are already dangerous; once off drugs, suicide risk goes down, so this is critical to get children off of these medications; need care of a physician to help them work off the drugs; be prepared to be blamed when a child identifying as transgender commits suicide—it WILL happen

Such proposals, known even by their proponents to be an antecedent to children’s deaths, have no place in the policies of any Florida state health agency. This stands in opposition to any meaningful understanding of public health and clearly jeopardizes the safety and well-being of the children of Florida. The Boards should not provide a platform to this or any such sentiment. Members of the Board of Medicine and Board of Osteopathic Medicine must ask themselves this, both in their professional role and in their personal role as members of their communities: What would you do if someone was coming to your state to promote a policy they knew would cause the deaths of children?  

Conclusion and recommended actions  

We call on the Florida Board of Medicine and Florida Board of Osteopathic Medicine to hold a hearing on critical irregularities in the rulemaking process leading to the proposed Standards of Practice for the Treatment of Gender Dysphoria in Minors. We call on the Boards to repeal proposed Rules 64B8-9.019 and 64B15-14.014 F.A.C., or indefinitely postpone these rules from taking effect until they can be appropriately revisited and repealed, on the grounds that these rules were not validly enacted due to these procedural irregularities.

Zinnia Jones, Gender Analysis

Heather McNamara, Gender Analysis

December 2, 2022

Appendix A: Transcripts of October 28 joint Boards hearing

Detransitioner and defense witness Camille Kiefel in Dekker et al. v. Marstiller et al. describes trans people’s post-transition bodies as mutilated and unlovable (3:26:08 in meeting video)

[3:26:08] CAMILLE KIEFEL: My name is Camille Kiefel. I stand here before you today, Florida Board of Medicine, in hopes that you’ll make the right decision regarding transitioning children, and take greater consideration for adults. Prior to my transition, I had spent 20 years in mental health therapy with conventional modalities. I didn’t respond well to medications, saw a gender therapist, and had two rounds of transcranial magnetic stimulation therapy. I was diligent in wanting to heal, but nothing my doctors offered had healed me, because they always saw my issue strictly as a mental one.   [3:26:49] I was 30 and at the end of my rope when I transitioned. At the time, I believed I was non-binary. I struggled with severe mental illness and suicidal ideation. I had a trauma history. When I was in 6th grade, my best friend had been raped by her brother. Being a girl meant I was vulnerable. I started to present more masculine. This should have been a red flag, yet within months of requesting top surgery, it was performed on me. I developed complications after my surgery. There were many times when I didn’t know if I would make it through the night.   [3:27:26] If I made this mistake as an adult, a young girl could too. Not only did this surgery exacerbate my mental health issues, I now struggle with physical complications as well. Presenting and taking on another gender was a way for me to escape womanhood. Escape is not a valid way of dealing with trauma. You will have to deal with it eventually. I was able to work through these difficult emotions and improve my mental health through a holistic approach. I had physical health issues that had been previously overlooked. Had that been managed, I would have never gotten the surgery. The surgery was an abhorrent misdiagnosis. The goal of healthcare should always be to get to the root cause of the problem.   [3:28:12] Today I am more grounded than I have been in my entire life, but I am mutilated. Between my carved-up body and the physical complications, I often question if there is anything on the other side. Where my breasts were are hollow. I can never get them back. I can never fit a dress the same way again. I can never breastfeed. Who will love me? You know what keeps me going? Stopping this from happening to someone else. Thank you for your time, you will have a lot to consider, and I know you will make the right decision. [3:28:50]

Anti-trans speakers, partial list

[3:17:28] Detransitioner Zoe Hawes

[3:20:27] Detransitioner Rachel Foster

[3:23:22] Detransitioner Chloe Cole

[3:26:08] Detransitioner Camille Kiefel

[3:29:03] Detransitioner ”Shape Shifter”

[3:32:03] Detransitioner Clifton Francis (Billy) Burleigh

[3:35:13] Detransitioner Cat Cattinson

[3:38:24] Detransitioner Helena Kerschner

[3:41:31] Detransitioner Ted Halley

[3:45:00] Parent Yaacov Sheinfeld

[4:06:38] Dr. Robert Roper

[4:18:20] Parent Bob Framingham

BOM member Dr. Patrick K. Hunter claims that social transition causes persistence of gender dysphoria and argues that social transition in childhood requires capacity to consent to surgery as an adult (4:46:43 in meeting video)

[4:46:28] DR. ZACHARIAH P. ZACHARIAH: I have a question for Dr. Hunter. Dr. Hunter, you deal with these things. Do you think they should have a psychiatric evaluation or some psychiatrist involved in this decision-making?   [4:46:40] DR. PATRICK K. HUNTER: The level of mental health care, whether it's psychology, psychiatry, I think that's up for debate. One thing that I think that any consent needs to recognize and needs to share with the patient and the family is the level of evidence, and what the systematic reviews have shown. The NICE reviews out of England on puberty blockers and cross-sex hormones are the best English-language reviews. The Swedish reviews are only summarized in English, they have not been translated from the Swedish language to the English language, the full reviews.   [4:47:14] But any informed consent needs to disclose the degree of evidence or lack thereof, whether that, who that's coming from. I agree it needs to be a multi-disciplinary process. That's what the Dutch said they would do, and that needs to be, it's the, informed consent is not a simple process in this setting. It has to include surgery. I think it needs to include surgery, because once you're on the path of social transition, there's good, there is good evidence that social transition maintains that identity and it changes the desistance rates.   [4:47:53] Once that’s started, then you're on puberty blockers. We've heard that puberty blockers lead 98% chance [sic], 95% chance of cross-sex hormones. Now we're in the irreversible territory. What percentage of those kids go on to surgery? So for a 12, 13, 14 year old to understand that, they would then need to understand the surgical risks, because they're starting on a pathway that may not go back, that may be irreversible. So the consent process would have to involve a surgeon, I believe, too, for the family to understand. The 12 year old, 13, 14 year old might not understand that. But the parents, I think, are due that knowledge of what the evidence reviews show, and the full gamut of what may proceed over the next four, five, six years. [4:48:38]

Appendix B: Transcripts of November 4 joint Boards hearing

BOM chair Dr. David Diamond states that speakers will be chosen randomly (19:33 in meeting video)

[19:33] DR. DAVID DIAMOND: And as far as public comment is concerned, it’ll be randomized, meaning selected out of the hat, A-B A-B, until the public comment is completed.

BOM member Dr. Hector Vila introduces motion to strike clinical trial exception (20:35 in meeting video)

[20:35] DR. HECTOR VILA: Thank you. I want to echo those comments, I appreciate what the Board has gone through hearing testimony, extensive testimony, and then all of the letters that have been submitted that we've looked through. I was not at the rules committee meeting, but I watched the entire video of it, and that even further added to the body of knowledge and discernment that I've gone through.   [21:05] And after hearing extensive testimony from physician experts on the irreversible harm due to puberty blocker medications as well as the hormone therapy, and after testimony that other countries have restricted access to medications, after written testimony from the author of a study that found a significant percentage of patients who transition later choose to detransition and thus have a significant percentage that have suffered irreversible harm, given the lack of testimony from expert proponents of hormone therapy that there are adequate selection criteria that have sufficient specificity to avoid harm, and after testimony from expert proponents of these treatments that in fact they are relatively rare in minors and thus our rules would not substantially deviate from the care that they are providing, and finally and most significantly the in-person testimony of multiple patients who were irreversibly harmed by hormonal treatments. In my 25 years of hearing testimony before this Board, I don't think I've ever seen that many patients talk about that much harm being done to them.   [22:23] And so given these facts, I am not supportive of this, of item 2 in the proposed rule, that allows for these treatments to be administered under even IRB-approved protocol. I just don't think that they're safe, and that they cause irreversible harm to a significant number of patients. Now if you want to do any research, I suggest that you move it to those minors that are already undergoing treatment if they, if we want to ask the legislature to provide the data, but I want you to know that I am not support [sic] and I would move to strike item 2 in the resolution. [23:16]

BOM member Dr. Patrick Hunter seconds Dr. Vila’s motion to strike item 2 and reads a statement into the record (23:46 in meeting audio)

[23:46] DR. DAVID DIAMOND: Dr. Vila, please?   [23:48] DR. HECTOR VILA: I move to strike item 2 in the proposed standard of practice for the treatment of gender dysphoria in minors.   [23:54] DIAMOND: Do I hear a second on the motion?   [23:56] DR. PATRICK HUNTER: Seconded.   [23:58] DIAMOND: There’s a second. It is now open for discussion on that motion.   [24:03] HUNTER: Dr. Diamond.   [24:05] DIAMOND: Yes, sir?   [24:09] HUNTER: I want to read this into the record. Dutch researchers pioneered youth transition for gender dysphoria. They published several papers culminating in a 2014 paper that described the outcome for 55 youths they transitioned. The Dutch protocol is now what we call affirmative care: puberty blockers, cross-sex hormones, and breast and genital surgeries. The Dutch protocol was deemed a success because the youth continued to function well after surgery. This affirmative model of care has spread wildly in the last eight years. The Dutch protocol is the foundation youth transition was built on. It is flawed, it is based on weak evidence. These are some of the problems with the Dutch study.   [25:16] Many concerns have been raised about its methodology. It was a case series, a small cohort of 55 teenagers. There was no control group. The follow-up period was only 18 months. This short period should be of concern. And most importantly, there has been no long-term data reported on these 55. The Dutch have been asked for their long-term data. In a June New York Times article, Dr. de Vries, the lead author, said the Dutch has [sic] lost contact with 50% of their early cohort. Dr. de Vries was interviewed on an American podcast in January. She made it clear that their patients’ lives are much more complicated than the original study’s outcome suggests.  

[26:15] The Dutch, to their credit, were concerned about false transitions - transitions that would later be regretted. False transitions would be the worst possible outcome. Today we call that regret and detransition. The Dutch had inclusion and exclusion criteria hoping to limit false transitions. I want to emphasize two of these criteria. Early onset gender dysphoria was a requirement for transition. Early onset was described by the Dutch in one paper as gender dysphoria, quote, from toddlerhood, and there had to be no active mental health issues. Mental health problems excluded a teenager from transition.  

[27:11] The very patients the Dutch excluded, late-onset post-pubertal gender-dysphoric youth with comorbid mental health issues, are now the majority of youth being transitioned. We are transitioning the very population the Dutch excluded, excluded because they feared harm. Affirmative care with transition is now touted as the cure for mental health problems. Just eight years ago, mental health problems excluded someone from transition. Our profession has abandoned the Dutch criteria, and these criteria were never based on hard evidence, only good intentions.   [27:59] Now we have objective unbiased systematic reviews, the most prominent being from Swedish and British experts. These systematic reviews tell us the evidence for youth transition is poor quality and with very low certainty for benefit. However, we are told that more and more evidence supports hormonal and surgical transition. The quality of this research is extremely questionable. I want to cite one recent example. In September just two months ago in JAMA Pediatrics, there was a study reported from Northwestern University in Chicago. 70 patients were compared, 36 had a double mastectomy and 34 did not. The patients ranged in age from 13 to 24 years. The authors concluded that mastectomy was beneficial and should not be delayed in youth. What led them to that conclusion? The finding that three months after surgery, a mere 90 days, the 36 patients, as young as 13, 14 and 15 years, were happy with their flat chests. And it was not just 36 that had surgery, it was 42. They lost nine percent of their surgical cases to follow up, nine percent in three months.  

[29:37] It is absurd, meaningless to draw any conclusions after three months. This paper is indicative of the quality of research we have in this field, published in our most prestigious journals. We have a serious problem. The testimony last week from those who have detransitioned is evidence of that. Finland, Sweden and England have changed course. They recognize harms are occurring, that the evidence is poor, that the Dutch protocol should not have been adopted and scaled to the extent that it has. In our last meeting I suggested we carve out an exception for research. After much thought I can no longer support that idea. I do not believe the Board is authorized to regulate medical research. That authority lies with other federal and state agencies. The Board's duty is to regulate the general practice of medicine, and we can do that, we should do that, and allow others to address research in this field.  

[30:55] But I want to say something about human medical research. Ethical principles of human medical research were first articulated in the Nuremberg Code, then in the World Health Organization’s Declaration of Helsinki, and further described in the United States Belmont Report which followed the terrible revelations discovered with the Tuskegee syphilis experiments. For those that conduct future research in this area of medicine, the following questions must be answered: Can minors consent to transition? Can minors with active mental health problems consent? Can this research with hormones and surgery be done safely and ethically, when we know these treatments have negative effects on normal physiology, when these treatments probably have negative effects on an adolescent's psychosocial development and their neurodevelopment, to include their executive decision-making? Can research with hormones and surgery be done safely and ethically when we know these treatments will lead to loss of sexual function, when we know these treatments will lead to infertility?   [32:19] These ethical questions are very important, but it is also critical that researchers ask why so many young people are suffering from gender dysphoria. Depending on the survey, between 2 and 10 percent of youth now describe themselves as gender diverse. Many are suffering and need help. Researchers need to ask why this is happening. Why has the incidence of gender dysphoria skyrocketed? We would ask this question for any other condition. These questions need to be answered not just by the medical profession, but by society at large. Children and youth with gender dysphoria are suffering, they need care, the best possible care, excellent care.   [33:11] We need to return to the community standard of care for treating distress, and that is psychotherapy: ethical, compassionate psychotherapy that respects the child's experience. Let me say that again, ethical compassionate psychotherapy that respects the child's experience. This is what Europe is doing, our colleagues in Great Britain, Sweden, Finland and elsewhere agree change is needed. Less harm needs to be done, safety and ethics need to prevail. I'm confident the Board of Medicine will do the right thing. [33:52]

Pro-trans speaker Kimberly Cox and exchange with BOM chair Dr. David Diamond (1:31:19 in meeting video)

[1:31:19] KIMBERLY COX: More importantly, to everybody out there that's watching and all of the people in this room, if you're a teen or an individual who is thinking about suicide because of this decision today, please know from this mother: You are loved, you are valued, and you are more than worthy. And the men and women that sit here and donate to people like Governor DeSantis and the Nazi regime that he has -   [1:31:47] [gavel bangs twice]   [1:31:48] DR. DAVID DIAMOND: No!   [1:31:50] COX: Absolutely! You let them talk about the Bible, you will let me talk about this.   [1:31:56] DIAMOND: She's gone. Next.   [1:32:02] COX: I have 24 seconds left, and I will say that you can call 988 and talk to somebody. If you feel that your life is in danger, please make sure you reach out. Shame on all of you! Shame on all of you! I know everything about you!   [1:32:36] DIAMOND: Next is Zoe Hawes. We're not going to have people calling one another Nazis in this room today.

Anti-trans speakers, partial list

[1:02:13] Diane Gowski, president of the Florida Catholic Medical Association

[1:09:49] “Former trans kid” Erin Brewer

[1:19:59] Julie Framingham (wife of Bob Framingham)

[1:26:52] Detransitioner Prisha Mosley

[1:33:04] Detransitioner Zoe Hawes (also appeared at Oct. 28 meeting)

[1:40:43] Detransitioner Helena Kerschner (also appeared at Oct. 28 meeting)

[1:46:36] Parent Amy Atterberry

Appendix C: Excerpts from declaration of Mario Dickerson, November 4, 2021

Declaration of Mario Dickerson, executive director of Catholic Medical Association, in American College of Pediatricians et al. v. Becerra et al., November 4, 2021:

2. I serve as the Executive Director of the Catholic Medical Association (“CMA”). Given my involvement in CMA, I am familiar with the organization’s history, the issues confronting it, and the views of the organization and its members concerning various emerging issues, including the gender identify mandate at issue in this litigation.   3. CMA is the largest association of Catholic individuals in healthcare. CMA is a national, physician-led community that includes about 2500 physicians and health providers nationwide. […]   9. CMA’s mission is to inform, organize, and inspire its members, in steadfast fidelity to the teachings of the Catholic Church, to uphold the principles of the Catholic faith in the science and practice of medicine. […]   23. The Catholic Church teaches that each person must be respected in their conscience. “Man has the right to act in conscience and in freedom so as personally to make moral decisions. ‘He must not be forced to act contrary to his conscience. Nor must he be prevented from acting according to his conscience, especially in religious matters.’” Catechism § 1782 (citation omitted). […]   27. CMA and its members sincerely believe that sex is a biological, immutable characteristic. […]   29. They respect the dignity of the human person as an embodied true male or female. […]   33. These beliefs reflect scientific reality, as well as thousands of years of Christian anthropology, with its roots in the narrative of human origins that appears in the Book of Genesis, when “God created man in his own image . . . male and female he created them.” Gen. 1:27.  34. The Catholic Church teaches that men and women are created in two sexes with corresponding identities. (2) [2: See, e.g., Catechism § 2333, 2393; Pope Francis, Encyclical letter Laudato Si’ ¶ 155 (2015), https://www.vatican.va/content/francesco/en/encyclicals/ documents/papa-francesco_20150524_encicli ca-laudato-si.html.]   35. The Catholic Church thus opposes invasive and drastic medical interventions promoted by modern gender ideology. “Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law.” Catechism § 2297.   36. The Catholic Church also teaches this lived biological reality of two sexes creates various obligations for public authorities. Catechism § 1907.  

37. The Catholic Church’s most extensive statement today exclusively on gender identity is Male and Female He Created Them: Towards a Path of Dialogue on the Question of Gender Theory in Education. (3) [3: Congregation for Catholic Education, Male and Female He Created Them: Towards a Path of Dialogue on the Question of Gender Theory in Education (2019), http://www.educatio.va/content/dam/cec/Documenti/19_0997_INGLESE.pdf.] The Church calls for love and respect for all people.   38. In this guide it outlines both theological and scientific truths about the human person, including that there are two sexes created by God and found in nature, that one cannot separate one’s sex from one’s gender, and that there are biological and unchangeable differences between men and women. Ignoring these truths does not address or help persons who are suffering. […] 

46. Science shows that arresting puberty as a gender identity intervention is scientifically dangerous to children. Arresting puberty past its natural onset is therefore ethically, scientifically, and religiously objectionable for CMA members to support. […]   48. These scientific facts are reflected in Christian anthropology, which is ground in biological and medical reality. As one bishop explained in a recent pastoral letter, “We know from biology that a person’s sex is genetically determined at conception and present in every cell of the body. Because the body tells us about ourselves, our biological sex does in fact indicate our inalienable identity as male or female. Thus, so-called transitioning’ might change a person’s appearance and physical traits (hormones, breasts, genitalia, etc.) but does not in fact change the truth of the person’s identity as male or female, a truth reflected in every cell of the body.” “Indeed, no amount of masculinizing’ or ‘feminizing’ hormones or surgery can make a man into a woman, or a woman into a man.” (6) [6: Most Rev. Michael F. Burbidge, Bishop of Arlington, A Catechesis on the Human Person and Gender Ideology, https://www.arlingtondiocese.org/bishop/public-messages/2021/a-catechesis-on-the-human-person-and-gender-ideology/. Of course, at the same time, every “disciple of Christ desires to love all people and to seek their good actively. Denigration or bullying of any person, including those struggling with gender dysphoria, is to be rejected as completely incompatible with the Gospel.” Id.] As a result, the “claim to ‘be transgender’ or the desire to seek ‘transition’ rests on a mistaken view of the human person, rejects the body as a gift from God, and leads to grave harm. To affirm someone in an identity at odds with biological sex or to affirm a person’s desired ‘transition’ is to mislead that person. It involves speaking and interacting with that person in an untruthful manner.” Id.   49. CMA thus urges healthcare professionals to adhere to genetic science and sexual complementarity over ideology in the treatment of gender dysphoria in children. This includes especially avoiding puberty suppression and the use of cross-sex hormones in children with gender dysphoria. One’s sex is not a social construct, but an unchangeable biological reality.   50. In accord with these scientific and religious understandings, CMA and its members believe that healthcare that provides gender-transition procedures and interventions is neither healthful nor caring; it is experimental and dangerous.   51. For CMA and its members, gender-transition procedures and interventions can be harmful, particularly to children, and medical science does not support the provision of such procedures or interventions.   52. CMA and its members thus believe providing or referring patients for the provision of gender identity interventions violates their core beliefs and their oath to “do no harm.”   53. CMA thus opposes pubertal suppression of minors, as well as hormone administration or other surgical interventions for purposes of “choosing” a gender or sex, and it objects to engaging in speech affirming these gender interventions.   54. CMA has adopted an official resolution stating, “the Catholic Medical Association does not support the use of any hormones, hormone blocking agents or surgery in all human persons for the treatment of Gender Dysphoria.”   55. CMA has adopted an official resolution stating, “Catholic Medical Association and its members reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex” as well as “the use of puberty blocking hormones and cross-sex hormones.”  

69. The gender identity mandate requires CMA members to engage in various practices to which our members objection on medical and ethical grounds, including the following: […]   m. Saying in their professional opinions that these gender intervention procedures are the standard of care, are safe, are beneficial, are not experimental, or should otherwise be recommended; […]   For ease of reference, the items in this list will be referred to as the “objectionable practices.”  70. The objectionable practices violate the teachings of the Church, and our organization’s members cannot carry them out in good conscience. […]   130. Our members’ sincerely held religious beliefs prohibit them providing, offering, facilitating, or referring for gender transition interventions and also from engaging in or facilitating the objectionable practices. […]   138. CMA’s members are healthcare providers who object on grounds of science and medical ethics, as well as on religious grounds, to providing, offering, participating in, referring for, or paying for the objectionable practices.

###

Attachment: Gender Analysis FLBOM complaint 1 (PDF, 776KB)

[deusexlachina]

Trans-friendly Mods for DAI (Guaranteed to piss off terfy templars!)

As a mod enthusiast, I’ve combed through most of the Dragon Age mods that are out there. When working on an explicitly transfeminine Lavellan (yes, you can simply headcanon your character as trans, but it’s not quite the same, is it?), I gathered all the mods that allow for better customization of gendered traits, along with a few decor mods to reassure everyone that your unchecked paramilitary spy network/cult supports trans people.

Enhanced Character Creation - Removes most unnecessary restrictions on character creation, and adds a little more customization for things like tattoos and hair colour (which can now be dyed a wide range of at least two flashy colours at once - this absolutely allows Trans Pride colours!).

Note: This includes unlocking all voices, but it conflicts with the main files for Any Voice. (It doesn’t conflict with the combat exertion noise fixes, which are in fact necessary if you choose a voice that’s normally locked).

https://www.nexusmods.com/dragonageinquisition/mods/2707

Any Voice - A set of mods that allow you to use any of the four VAs regardless of gender (and change the combat noises your Inquisitor makes, which will be a different VA if you change the voice but don’t use these!) Any gender-specific lines will simply be unvoiced. The main files conflict with Enhanced Character Creation; the exertion changes do not.

Flipped Pronouns (on the same page as Any Voice, but very distinct effects and worth listing separately) - This file, towards the bottom of the Any Voice page, flips the gender flag of your Inquisitor, allowing you to select, for instance, an “Elf Male” body type while being registered in all dialogue as female. (No other genders/neutral addresses are scripted, so you are still limited to a binary choice). This does affect romance options but does not affect Codex/War Table text.

https://www.nexusmods.com/dragonageinquisition/mods/3108?tab=description

LGBT Heraldry - Replaces Templar heraldry with your choice of pride flags around Skyhold, including in Cullen’s office. Let Popular Video Game Character Cullen Rutherford celebrate his VA’s trans friends that he’s always bringing up!

https://www.nexusmods.com/dragonageinquisition/mods/3253

Clown Cullen - Exactly what it says on the tin.

https://www.nexusmods.com/dragonageinquisition/mods/2929

The Peacock Throne - Replaces Circle throne with a glorious peacock throne (peacocks being the iconic trans bird).

https://www.nexusmods.com/dragonageinquisition/mods/1547?tab=description

[ortodelmondo]

Chili septembre 1973 Koen Wessing

http://www.jeudepaume.org/index.php?page=article&idArt=3253

[yurupedia]

本日は、眠眠打破キャラクター「打破山眠太郎」について。

眠打破ゼミナールの予備校講師。 教育熱心で親御さんの信頼も厚い人気講師。 特技はペン回し。

https://w.atwiki.jp/yurupedia/pages/3253.html

[spideyy-girl]

Mine ~ Gilbert Blythe AU

Request: Request for Gilbert? The reader is best friends with him and they’re in college. Gilbert gets jealous because she’s spending time with another guy helping her in a class, and angst and fluff and just the classic trope of their feelings being revealed eventually? 😊💓

Summary: Gilbert had known Y/N his whole life, and for just about that long he’s been in love with her. Now they’re in college together, and Gilbert’s feelings have only grown.

Fandom: Anne with an “E” (Anne of Green Gables)

Warnings: jealousy, unwanted glances, mentions of sexism, super cliche at the end lol sorry not sorry

Word Count: 3253 (9 pages) issa long

Date: November 11, 2018

A/N: hope this is ok, I worked really hard on it. Feel free to leave your feedback or other requests. Taglists and requests are still open, never be afraid to ask! Hope you all enjoy and happy reading!

Also, John is Y/N’s study partner.

~Ciara xo

Y/N L/N. The only word he could think of to describe her was perfect.

For as long as he could remember she was in his life, holding his hand lightly in her much smaller one, her head resting on his shoulder. The image of them in that position in so many of his memories as he flashes through them, giving him a feeling that he's become so familiar with. It sent goosebumps down his arm, makes his stomach do flips, his mouth to go dry. He's felt this way for so many years, but never realized what it was until that day a few years ago, the day his dad died. Once again, an image of their stance appeared as the flashback played in his head. He could almost feel the light misty breeze of the Prince Edward Island beach near their small town, Avonlea.

"Gil?" her voice was so soft he hadn't even heard her, his own thoughts clouding his senses, his eyes caught on something in the distance, but he didn't know what. The light squeeze of her hand in his brought him back to her. As he looked at her, resting her head on his shoulder, he saw her E/C eyes already watching his own hazel ones. Her other hand came up and lightly caressed his face, fingers so cold from the dead winter.

"I'm sorry," he said, trying to hold back tears, leaning lightly into her hand. She sighed sadly and shook her head, taking her head off his shoulder and her hand of his face, grabbing his other hand as she stood in front of him. She gave him a light smile, and he could tell she was holding in her own tears.

"No, no. Don't be sorry, Gilly. It's ok," she whispered. "I was just saying that if we stay out for any longer we might get frostbite. Besides, dinner should be ready soon, and we ought not to be late." She looked into his eyes, but it seemed as if he looked right through her. He looked back out to the ocean, seeing the sun hit the horizon.

"Can we stay, just a little bit longer? Watch the sunset?" He asked, looking back at her. He looked so desperate, she couldn't say no to him. She smiled and nodded, wiping a stray tear that fell down his cheek. He pulled her closer, into a tight hug as she lay her head on his chest and they watched the sky turn many pastel colours until it went almost black. They didn't know how long they stayed like that, watching the sky, listening to the crashing waves. Once the sun had disappeared from sight, the pair started to walk home in the darkness. They reached the part in our path where they parted. Gilbert begrudgingly took his hand from hers, saying goodbye and beginning to walk away. 

"Gilbert Blythe! Where do you think you're going?" She called after him, an honest confusion in her voice. Gilbert seemed just as confused as her.

"Um.. home?" he replied. Looking back at the path behind him that lead to his farm. To be honest, he didn't want to go back there, he didn't know if he could. After all, that's where Y/N found him. After the funeral, he hadn't come back to the house, which worried her, so she went looking after him.

"You know I will not let you stay by yourself, especially after.. everything that.. happened today. We'd be more than happy than to have you over for tonight Gilbert. For the next few nights even." She said walking over to him and grabbing his hand in hers again, dragging her down the opposite path that leads to her house. "Besides, I need my knight in shining armour to protect me from the horrifying darkness of night." She giggled and looked back at him, eyebrows raised. He smiled a genuine smile, the first one in weeks, giving into her and letting her drag him along. She took his hand and swiftly put it around her shoulder, so his arm wrapped around her.

The knight in shining armour was a reference to when they were children. She would play the beautiful damsel in distress, waiting for her handsome prince to come and save her. And, to no one's surprise, that was Gilbert. Sometimes, she would get bored of always being the one in trouble and make Gilbert the princess stuck in a tower, wearing one of her dresses as she stole one of his sweaters and galloped along on the broomstick-horse, coming to the rescue. The memories, still so fresh in his mind even if so long ago, made him chuckle.

"Oh my goodness, Y/N L/N! Where have you been, young lady?! I've been worried sick! You missed dinner, so it must all be cold. You've missed all of your chores, so you'll be doing extra tomorrow, the second the sun rises!" Y/N's mother ranted as she put her dish towel that was hung over her shoulder on the sink. She came over and slowed once she saw the young boy beside her, still holding her daughter's hand. "Oh, Gilbert. Hello sweetie, how are you doing? I wasn't expected company, sorry the house is an absolute mess. Come in, come in, before your ears fall off! I'll put on the kettle." She smiled and rushed back to the kitchen.

Y/N and Gilbert, shaking intensely as they sat by the fireplace for warmth, sipping the scorching hot and slightly burnt tea made by Mrs. L/N, a giant fluffy blanket coated the two. Mr. L/N, Y/N's father, gave him a pair of his pyjamas to sleep in for the night as Y/N's parents sent them up to bed, giving Gilbert the guest bedroom across the hall from Y/N's bedroom. As they crept up the stairs, careful not to wake up any of her other many siblings, she took his hand and dragged him into her bedroom.

"Y/N!" Gilbert whisper-shouted at her. "What are you doing? I'm not supposed to be in here! A man should never be in a young lady's bedroom, especially at night. What will you're parents think? I'm not-"

"Gilbert be quiet! Before they hear us!" Y/N giggled, covering his mouth to stop his ranting. "There's nothing wrong with you being in my room, you've been in here before." 

"Yeah, when we were younger, much younger. Now it would be frowned upon." He started up again. She rolled her eyes, setting a few blankets on the floor and one of the pillows from her bed, pointing Gilbert to it as she climbed into her own, obviously old and almost at breaking point bed.

"You're sleeping here. I'm not leaving you alone." She said, her voice going deep, serious. Something that wasn't usual for the smiley girl. "Gilbert Blythe, I sure hope you know that I swear upon my life that I will never leave you. And we will always be together, forever. I swear it until my dying day."

The feeling, that one mentioned from before, had become so intense at that moment he surely thought he must've become sick. She leaned down from her bed and placed a light kiss on his cheek, before placing her nicest duvet (which wasn't that nice, but he wouldn't complain) over his still shivering body, but this time he was shivering over something else other than the cold. 

When Gilbert was young and asked his father what it was his mom was like, he would tell the boy about how she made him feel, whenever he saw her, held her, the undeniable feeling of love. He never quite understood the concept of butterflies, for how could such creatures even make their way into your stomach and still flutter around? But at that moment, in her bedroom as the warmth of her lips still lingered on his pale pink cheek, he understood everything.

He was so deeply in love with her, it almost pained him. But it did especially at this moment, almost 4 years after that night, and he still hasn't said anything. Which he thought to lead him to this moment, he should have expected it.

He was now at the age of 19 years, studying at the lovely Queen's Academy to chase his dream of becoming a doctor. Y/N was just about 17 and had been, much to her and his delight, also been accepted into the academy to study to be a nurse. That, of course, wasn't the part that had hurt, but the sight right before his eyes, an unknown man with his arm around her shoulders, like he had when they walked down that path, looking at each other, giggling at something, he couldn't tell what. 

He felt honestly betrayed. She had never been exactly his, but he still felt as if she had left him, forgot about him and their promise. But mostly he felt angry. Not at her, he could never be angry at her even he tried (he knew from many personal experiences), but from that stranger that had taken his girl away from him. He took his book and checked it out, trying to avoid their eyes, but of course, to his luck, that was no use. He heard her call out his name before he slammed the door shut of the recently quiet building. 

"Can we pause our session just for one second? He's my best friend." She smiled sweetly, taking his arm off her shoulders and looking back at the door he had just left out of. He nodded, sharing his own smile. "Ok if I'm not back in ten minutes you can leave! Thank you again so much for the help!" She called behind her shoulder as she ran out the door, tripping slightly every once in a while on her heels. She saw Gilbert's unmistakable mop of curly black hair walking just ahead of her, so she jogged to catch up with him. She tapped his shoulder, smiling a great smile as she linked her arm with his.

"Hey, Gilly! I didn't think you heard me in the library just then." She said, trying to get his attention, which was still focused on the path in front of him. "Gilbert, what's wrong? You've been acting so... distant lately," she sighed, pulling him to the side, to get out of the stream of walking people. He turned and looked at her, instantly feeling bad by the look of desperation on her face. He smiled at her and placed a strand of hair behind her ear gently, making her blush a little bit. Thankfully the red of her cheeks could be blamed on the cold winter.

"There's nothing wrong, Y/N. I'm fine," he said softly, trying to continue walking, but she wasn't having it. She grabbed his arm and brought him to a nearby bench, forcing him to sit.

"Gilbert Blythe! I know that isn't true, you know I can see right through you," she said grabbing his hands. "Please tell me what's wrong, I'll do whatever I can to help, I swear it." That look alone that she gave him almost made him cave right then. Almost. He knew he couldn't risk all those years of friendship over some silly crush. A crush that just won't leave him alone. He took his hands away from hers and got up.

"Sorry Y/N, but this isn't a problem you can solve," Gilbert said, turning his back to her, knowing the look of hurt that would be on her face about now. "I just need some time alone, away from you. Goodbye." It took everything in him to walk away from her and not turn back.

The next few days, Gilbert did everything he could to ignore the girl he cared so much for. He knew that she'd do anything she could to find out what was burdening him, and he knew he couldn't say it was her. It had been a few weeks since he last saw her, and it was an understatement to say he missed her.

He had seen her more and more at the library with that man. He couldn't help but feel as if he was being replaced every time he heard her beautiful laugh pass her lips, because of him. He tried to avoid the general area, but it was like he was drawn back each time.

Little did he know that Y/N was in just as much pain as he was. 

The past couple of weeks without him had been much too bland. She would only leave her small shared apartment when she went to her study sessions with John, in the library. And even though he was nice enough and made her laugh, he wasn't Gilbert Blythe.

She had tried aimlessly walking around the Queens Academy campus, in hopes of finding him, maybe sitting on a bench, reading a book. But she had no such luck. After all, it was a very big school, with many people. Many more than in Avonlea.

But she was truly hurt that he had, as it seemed, completely blocked her out. She still had no idea what she had done to cause anything upon him. And the idea of causing such a pain unto someone she loved so much had burdened her very much.

She was out on one of her walks again, it was getting cold outside, small snowflakes fell quietly from the sky, landing in her hair and on her face. She felt as if she was going to catch her death at any moment. 

John had caught a cold and wasn't able to make their study session, so Y/N was off to the library by herself. She was a bit nervous, walking by herself in a campus ruled by men, some of which with bad intentions on a pretty girl like her. Her eyes constantly scanning her surroundings. 

Thankfully she had safely made it to the library, with no trouble, but some unwanted lingering stares, but she had expected it. 

"Why, good afternoon Y/N, " the old librarian, Mrs. Dell said kindly. Y/N smiled and nodded politely, giving her a nice hello as well, before heading off to the books. 

Gilbert froze up immediately when he heard the name pass the old lady's lips. He heard her dainty footsteps walking slowly towards him. He wanted to run but it was as if his feet were planted to the ground, since he knew that he did want an excuse of seeing her again, even for a second. His back was to her, and he had hoped that that would be enough for her to dismiss him.

Of course, he didn't have such luck.

"Gilbert?" Y/N's voice was quiet and unsure, but the raven black curls were hard to miss, especially to someone who has become so familiar with it. Gilbert didn't change his stance, so Y/N walked forward and grabbed his shoulder, making sure that this time he wouldn't escape. "Gilly, please, can we talk?"

He didn't look back at her, it took everything in him to keep his gaze ahead. He could hear her sigh and feel her hand travel from his shoulder down his arm to his hand as she pulled him out of the library. He was shocked but didn't bother fighting it. She nodded at the librarian as she headed out, Gilbert being dragged not too far behind, earning a strange look from the kind old lady.

Y/N pulled him closer to her side, constantly checking her path and using him as a human shield from the lingering stares. Gilbert realized the odd behaviour, and also looked around, wondering why she was being so cautious. Probably because she doesn't want her new boyfriend to see us together, he thought to himself but didn't dare speak it aloud.

"You know, even if you refuse to talk to me, I just wanna say that I am thankful I found you. I was starting to think you left. My, that would've been torturous. You're my only friend here," she says quietly, squeezing his hand. He looks down at her, seeing that she was already looking at him. Their footsteps slowed to a stop as they looked at each other, both trying to hold in tears. 

"Surely that's not true. I've seen you around with other... people," Gilbert states blandly, breaking eye contact and looking over her head instead. She laughed.

"Well, maybe the only other person would be John but-"

"Yes, John," Gilbert interrupted her, looking back at her. "I thought you two seemed quite close. That's splendid." The last part of his sentence wreaked of sarcasm, telling her that something was up, and she thought she knew what.

"John is my study partner, Gilbert. We were paired up together since my professor thinks I can't handle my own work due to my.. well, gender." She rolled her eyes and crossed her arms, thinking of her nuisance of a teacher, who was too much like her old one in Avonlea, Mr. Phillips. "Besides, why are you getting so worked up? I've seen you with many other people and I've said nothing." Gilbert exhaled and pushed a hand through his messy curls.

"Because it's different, okay? I don't like seeing other guys like that around you. I don't want them to take you from me." He stated, not being able to look at her, his cheeks starting to burn up from the confession.

"Take me from you?" Y/N asked, slightly offended. "Might I remind you, Gilbert, I am not an object that you own. I am-" Y/N started to rant but was once again cut short.

"No, Y/N. Not like that." Gilbert said, taking her cheek in his hand. "I don't want them taking you away from me when I haven't even gotten the chance to make you mine." He couldn't believe what he had just said, and as it seemed, neither could Y/N. Her mouth went open, trying to think of a response, but nothing that could truly express her emotions came to mind. So of course, she didn't have to say anything and just kissed him.

She kissed him hard, everything breaking loose from their chains. And sure enough, he kissed back. They didn't care that they were in the middle of the campus, probably many nearby people watching in on the affair. Nothing could break the moment they had waited so long, too long, for. The butterflies from Gilbert's father's stories seemed to have tripled on their effect, as well as so many other things, as their lips moved in sync, slightly chapped from the cold. They broke apart for air, not moving too far apart from each other, placing his forehead on hers as she giggled, sounding like a wind chime.

"You were always mine, Gilbert Blythe. And I will always be yours," she whispered to him, looking him straight in the eye as her contagious smile grew a little bit wider. He smiled back, so big until it started to hurt his cheeks, and grabbed both her hands, pulling her in again and placing another kiss on her lips, guiding her hands around his neck, then placing his gently on her waist. "Until my dying day, I swear we will always be together."

And suddenly, John didn't seem that important anymore.

[hjmarseille]

Opposite page: Above, members of No. 1 Squadron RNAS pose proudly with 3253 at St Pol aerodrome. (Albatros/PL Gray Archive)

Photo and caption featured in Windsock Datafile No. 016 - Morane Saulnier Type L by J. M. Bruce

[dramaqueeenamby]

Space Between (7)

*****Tag notifications aren’t working so for those who don’t know, I update this story on Wednesdays. Your best bet is to just check for the newest chapters on Wednesday evenings. :/ At least, until Tumblr gets their shit together. Smh.*****

❤️ #BunBunWednesday ❤️

Words: 3253

MASTERLIST

TAGLIST: @katshrev @elaindeereads @soulmates8 @naturallyqueenie @onyour-right @msincognito67 @janellemonaenae @afraiddreamingandloving @hutchj @90sinspiredgirl  @airis-paris14 @dolphinpink310@purplemuse @purplemuse @amberkay284 @leafdragon117 @meeky-imagines @aieyr @h-challa @quietemptydiariess @katasstrophey @wakanda-inspired @destinio1 @dessianna1 @blackpantherimagines @httpjex

Space Between (7)

Y/N was avoiding T’Challa.

She’d been doing so ever since she woke up and carefully lifted Bunme out of his bed to prepare her for another day at school. She’d had breakfast delivered to their room and stayed in their even after her daughter’s departure. She wasn’t sure how long she could avoid him but was pleasantly pleased with her success thus far.

However, she realized that she needed to seek out Nakia and ask the woman about possibly accompanying her to Jabariland to go visit Hawla later that day and could not figure out how to work her Kimoyo beads.

She was walking down the hall, about to send up a prayer of gratitude for the continued avoidance of a certain king when she felt herself being grabbed.

Damn

“We need to talk.” She tried to not focus on how good he looked, smelled, or how his touch reminded her of their events just the night before. So passionate, so fulfilling.

As much as she hated him at times, she could never deny that the man always satisfied her every desire under those sheets.

“About?”

“Y/N.”

She jerked her hand back out of his hold, prompting the king to sigh. “Personal space, T’Challa. Personal space.”

“You really want to talk about personal space?” He propped a brow which earned a small glare from the woman.

“What do you want?” She relented.

“Why have you been avoiding me?” His handsome face took on a small frown which elicited a look of shame from the princess.

“I haven’t-“

“Y/N.” His voice indicated that he was in no mood for her sideways excuses.

“It was a mistake.” She said rather loudly. “We shouldn’t, I shouldn’t have, I don’t know.” She stammered, placing her middle and index finger on her temple. “I never should have come to your room, and I want us to just, to just forget it, okay? Let’s just pretend that it never happened. Alright?” Y/N went to walk away, but T’Challa grabbed her, pushing her up against the wall. “What the hell-“

“How much longer do you think you can hide from me?” He questioned darkly, his voice a mixture of frustration and desire.

“Let go of me-“

“Answer me!”

“Need I remind you the last time you neglected to heed my warning!” She hissed quietly, struggling against his grip on her wrist.

“Run? Just as you always do.” He shot back smoothly, remaining stagnant in his spot.

She tried to lunge at him, but his grip was iron. “I’m right here, T’Challa.” She sighed, letting her eyes fall on their connected hands. “How the hell am I hiding?”

“You know what I am talking about.” His voice dropped as he lowered his mouth toward hers.

“What are you doing?” She whispered with pure unadulterated apprehension, inhaling sharply as he quickly diverted his lips to the middle of her chest.

“Why do you continue to deny yourself?” He questioned against the top of her breast, sucking the supple skin that was pushed up by the corset of her top. “Deny us both?”

She exhaled shakily, her head dropping back against the wall. Damn him. Damn him to hell.

“It was just sex.” She tried to convince him, herself, maybe the both of them. It was hard to say and focus with such a talented mouth going to work on her bosom.

“We both know it was much more than that.” He spoke with a hint of humor, running his tongue up the middle of her cleavage. Y/N whimpered, shaking her wrists in an attempt to free herself from him. Again, she was unsuccessful. “Y/N.”

“Why can you not just leave me be?” She questioned with helplessness. “Why can’t you cast aside your feelings for me?” Her eyes were starting to water as T’Challa lowered their hands, lessening the distance between them so that their chests were almost touching. “Surely there are plenty of other women in Wakanda. Why must you like-“

“This is not a case of me liking you, sthandwa sam.” He interrupted with swiftness, his voice dripping with sincerity.

Y/N’s stomach dropped as she suddenly wished she had never gone to his room.

Or Wakanda, for that matter.

“What?” She breathed, her heartbeat going at an astronomical rate. Damnit, this sanctuary really was turning into purgatory.

The princess waited for the king to say something but instead watched as his gaze hardened with irritation.

“Stand down, boy.”

She frowned. “What are you-“

“Let her go.” Her eyes widened at the sound of Dumi’s voice. “Now.”

T’Challa growled and released her wrists, Y/N immediately deprived of his surprisingly warm touch.

“What did you just say?” It was almost rhetorical, but the menace and challenge in his voice were undeniable. “Have you forgotten who I am? Your place?”

“Dumi, stand down.” Y/N instructed as she moved between the two men, placing her hands on T’Challa’s chest.

“My place is to protect the queen.” Dumi retorted smoothly as he continued to hold his hand on his sheathed sword. “And I care not who I have to strike down to do so.” A beat. “Even if that includes the mighty Black Panther.”

At that, T’Challa ripped himself from the princess hold and grabbed Dumi, shoving him against the wall.

“T’Challa, let him go!” She pleaded, placing her hands on his bicep.

“You speak not to the Black Panther, but to the king.” T’Challa sneered. “And consider that a blessing from Bast for the politician is much more lenient than the warrior.”

“T’Challa!” Y/N yelled his name again, moving her hands to his waist, finally getting him to look at her. “Please.” She stared at him with pleading eyes, praying that she could get through to him, trying not to show her own fear.

She’d never seen this side of T’Challa.

However, she released a breath of relief when he finally let go as she moved her body in front of his.  “If you ever pull a stunt like that again, you will be removed from your duties-“

Dumi’s nose flared. “He was hurting you!”

“Raise your voice with her again, and it’ll be one of the last things that you ever do,” T’Challa threatened calmly.

She shut her eyes and avoided snapping at the king. “Do I look as though I am harmed? I am fine, Dumi. Now go.” She stressed. “That’s an order.”

Dumi looked from the princess to the king, a look of abhorrence and disappointment in his face. She was prepared to speak again when her guard turned on his heel and disappeared down the hall.

As soon as he was gone, T’Challa shared, “I don’t trust him.”

“Why? Because he does his job.”

“He is too invested and not into the right things.” He shared. “His loyalty is questionable.” Before she could further protest, T’Challa continued. “Why would he send Bunme, a five-year-old, alone, to navigate a palace in the middle of the night?”

Y/N frowned. “What are you talking about?”

“Last night.” He stepped closer to her, neither moving as he placed a hand on her hip. “She told me that he told her you were in my room and sent her, by herself, to go find you.”

“He told me that she snuck away.” Y/N explained, and she had no reason to doubt him as she knew better than anyone that her daughter was one clever child. That little girl could weasel her way out of the most secure situations. “That explains how she just so happened to end up by us.”

T’Challa recognized the look of realization. “What is it?”

“I never told him that I was going to see you. I said that I was going for a walk.”

He shook his head. “You didn’t have to. He’s a man. He knew exactly where you were going and who you were going to see.”

She blushed and dropped her gaze before clearing her throat. “I will talk to him.”

“Or I could.”

“I said talk, not maim.”

“You do not believe that I can control myself?”

“That-“ she gestured down the hall. “-was control?”

“He still lives, does he not?”

“Too much, T’Challa.”

His eyes squinted ever so softly as he leaned forward, grabbing her hips and pulling her against him. His mouth dipped against her ear. “And yet you take me so well.”

She turned her head and rolled her eyes, but he could still see the faint smile on her face as she shoved him off and walked away, purposely swaying her hips in the process.

♔ ♔ ♔ ♔ ♔

Y/N was reading a book, which book, she knew not or which page, just that it had occupied her thoughts and mind for the past thirty minutes as a way to keep her from thinking about everything else.

She wanted to talk to Dumi, needed to speak with him but was in no state of mind to do so.

How could she when the king of Wakanda had practically implied that he loved her? As if things weren’t bad enough already. She just really wished she’d stayed in her room last night, except she didn’t, and now she had to deal with the consequences.

Yet…..there was a small part of her that didn’t regret what happened. Waking up with T’Challa, her daughter snuggled between them, the three all so peaceful, there was a sense of normalcy that accompanied that image. Something about that which made her feel like she could get used to it. Like she could get used to him.

Damn.

“The History of Us,” She looked up from her book to see Erik leaning against the open door of the massive palace library with his signature smug smirk. “And here I was thinking that you were tired of hearing about Wakanda.”

“Erik.” She found herself smiling. “Please.” She patted the seat next to her, watching as he sauntered over before reaching over before to give him a hug. “Welcome back.”

“Thanks.” He chuckled, eyeing her up. “I miss anything?”

She paused. “Nothing noteworthy. I attended Public Training Day.”

“Heard you did more than just attend.”

She narrowed her eyes. “If you already knew, then why’d you ask?”

He shrugged. “And miss out on an opportunity to hear about someone kicking Challa’s ass? Shit, you must not know me very well.”

She giggled softly. “Where did you go?”

His gaze visibly softened before he cleared his throat. “To go see my mom.”

“She is American?” It made sense. The way Erik dressed, his lack of an accent, his Westernized way of dressing, and the whole nine yards.

He nodded. “She’s a professor down in California, over at Stanford.” He then went on to briefly explain how his parents never married, having conceived him when his father briefly visited America and how he spent his summers in Cali with her but the rest of his time in Wakanda with N’Jobu.

“Does she ever come to visit you?”

“Now that T’Challa has opened up Wakanda, that’s the plan.” He said, leaning back into the sofa and spreading his left arm over the top. “What?”

“What do you mean, now?”

“Come on, you know we never use to allow outsiders. It was the law. Ever since the beginning of our foundation.”

“Why?” She pressed, not even hiding her shock.

“Vibranium. It’s too powerful and valuable to fall into the wrong hands.”

“And you all are so perfect and faultless compared to the rest of the world?”

Erik grinned. “We’ve gone without incident thus far.” A beat. “But it makes no difference now, once T’Challa came back from Oxford and took the throne from my pops-“

“Your father used to be king?” Her eyed widened. This was all such surprising news to her and a much-needed distraction.

He nodded. “After T’Chaka was killed, T’Challa was too young and, obviously so was I, so the mantle fell to the next in line which was my father.”

She followed the chain of thought. “So technically, you could have been king too?”

“If I challenged him.”

“But you didn’t.”

“Politics isn’t really my thing.”

“Perhaps you just don’t think you could best your cousin in battle,” she teased with a small smile.

Erik chuckled. “You’d lose that bet, baby girl. On any given day.”

She remained quiet, allowing everything she’d just learned to settle in before speaking again. “So, once T’Challa became king, he reversed the law?”

He nodded. “One of his first acts.” His eyes fell on her. “Maybe now I know why.”

She picked up on his indication. “Oh, please.”

“What?” He shrugged. “If I was him, I’d make it so the woman that I love and my daughter could come to visit as they so pleased.”

Y/N’s heart stopped and her mouth dried as she snapped her head in his direction. “What did you just say?”

“Relax, your little secret is safe with me and pops-“

She tried not to show her panic at the mentioning of the fact that not only did he know the truth, but N’Jobu did too. “I don’t know what-“

“I’m sure you don’t,” he winked, standing up and stretching. “A little advice though? Tell him. He deserves to know the truth, Y/N.”

And with that, Erik left the stunned Princess of Niganda with many, many thoughts and situations to ponder.

♔ ♔ ♔ ♔ ♔

T’Challa walked into his room later that evening and stopped in the doorway.

“Hi, kitty!”

He couldn’t even stop his smile despite his confusion. “Hello, sam isipho.”

The energetic little princess was settled in the middle of his bed with a vibranium tablet, notebooks and other school supplies surrounding her. Of course, her doll was with her too.

He started to ask how she’d gained access to one of the arguably most secure rooms in the place but decided against it. It honestly didn’t matter. He doubted few could deny the child anything, period.

“Are you busy?” She tilted her head to the side and pouted slightly.

“For you? Never.”

That earned him a giggle. “Can you help me with my homework? I can’t find Shuri and bad kitty is being a meany head.”

“Bad kitty?”

She shook her head. “Erik.”

T’Challa mentally rolled his eyes and made a notation to ask Erik to politely return the Jaguar Habit back to the lab asap.

“Of course, I will help you.” He kindly agreed and motioned for her to follow him over to the sofa on the other side of his spacious bedroom. He watched with amusement as the child climbed off his bed with her dolly, tablet, and notebook, skedaddling over to join him on the expensive piece of furniture.

“It’s just the math that I don’t know.” She started to explain taking the king by surprise as she nonchalantly lifted one leg onto the sofa and then crawled over into his lap, making herself comfortable as she started to point out her area of difficulty. “Stay right there.” She wagged a finger to her doll that was sitting up beside them, earning a small chuckle from the Black Panther.

“Ah, I see what the problem is.” He started before going into a concise and lucid explanation for the child, watching in astonishment as she picked up on the concept in less than five minutes. “Brilliant.”

“That’s what my teacher said!” Bunme beamed while looking up and over at him. “She said I’m really...um.....umm...”

“Bright?” He suggested.

“Yeah!” She pointed with excitement before her smile dropped. “That’s good, right?”

“It is excellent.” He complimented. “You are a very special little girl, Bunme.” She retained her smile before it dropped again. “What’s wrong, sam isipho?”

“Can I ask you a question?”

“Of course. You can ask me anything.”

“Well.” He watched her twiddle her fingers. “You have a mommy and a sister and other family....where’s your daddy?”

He froze, not expecting the question but handled it as best he could. “Bunme, do you remember when you told me that bad people killed your father?” She shook her head. “Well, when I was a little boy, not much older than you, a bad man killed my father.”

Bunme gasped in shock and once again surprised the king as she leaned into him, placing her tiny arms around his body in an attempts to give him a hug. “Stupid, meany head, bad man.”

His lips lifted into a small and sad smile as his hand went to softly caress the back of her head. “Indeed.”

She lifted her head to look at him. “Do you remember him, kitty?”

He looked down at her. “A little. My memories are few.”

“I never met my father.” She frowned with sadness, looking down, around, and then up at him. “Do you think he would have liked me?”

He answered without hesitation. “He would have loved you, Bunme.”

She grinned with pure appreciation. “Kitty, when mommy and I go back....is it....is it okay if I come back and visit you?” Again, her smile faltered slightly. “I like it here, and...I don’t want you to forget me.”

T’Challa’s heart sank not only from the child’s statement but just from the mere thought of them leaving.

He didn’t want them to go.

Not now.

Not soon.

Not at all.

“Here.” He put his hands around his neck and pulled a necklace out of his collar. “I want you to have this.” She watched in awe as he removed the necklace with a black vibranium pendant on the end in the shape of a Panther on it and placed it around her neck.

“It’s a kitty!” She exclaimed with wide eyes of excitement while observing it.

“It is.” He confirmed, carefully watching her. “Passed down in my family for generations. My own father gave it to me, a gift from his father to him and so forth, and now….I am giving it to you.”

She looked slightly confused as she squinted one eye. “Isn’t it special to you?”

“It is, but so are you.” He answered, watching as her smile started to reappear. “And now you know that I shall never and could never forget you, Bunme.”

At that, the little girl lost it. She got on her knees while still in his lap and attacked him with a better version of her previous hug, wrapping her arms around him as she whispered in his ear. “I think your daddy would think you’re a really good kitty.”

T’Challa quieted for a moment as the little girl’s words deeply resonated with him even if she didn’t realize exactly what she was saying. Being a good ‘kitty’ aka king, Black Panther, making his father proud.....that was all he wanted for the late King T’Chaka’s legacy. Somehow, hearing it out of her mouth solidified his latent fears.

He closed his eyes and lightly kissed her temple. “Thank you, sam isipho.”

“I think he’d also want us to get ice cream.” She whispered while his lips were still pressed against her temple.

The king laughed loudly. “Is that so?” She nodded fervently. “Well then....” Bunme started laughing loudly as T’Challa stood up with her in his arms, switching her so that she was on his hip, placing a kiss to her cheek as she held onto his neck. “Ice cream we shall get.”

“Yay!” She cheered as the two left the room, Bunme not even remembering the infamous doll that still sat on the sofa.

Welp. So Erik knows? And N’Jobu?

And Dumi.

Imma just tell you right now.

T’Challa don’t like his ass. The feeling is mutual though so....

Wonder if anyone else does....hmmm.

I decided to pull from the comics in terms of backstory because I felt it goes better with this storyline.

Also, question.

I’ve been receiving comments and questions that my stories and characters are too loaded and intricate to be “Y/N” aka reader stories. Do you all agree? Should this be switched over to a T’Challa x Main Character story? Literally, nothing would change except “Y/N” would have a name, and I’d provide a picture of how I imagine her looking. lol 

Because we already have a picture of our child Bun Bun.

Or we can totally leave things as they are. I’m perfectly content with either option. Truly.

Let me know!

[oldschoolfic-ds9]

Rules of Infatuation

by longbeachtrekstar, 2005

The women of the house celebrate an old Ferengi tradition.

Words: 3253, Chapters: 1/1, Language: English

Rating: NC-17

Warnings: none listed

Characters: Ishka, Kira Nerys, Jadzia Dax, Leeta, Deanna Troi, Lwaxana Troi

Relationships: Kira/Jadzia Dax, Kira/Jadzia Dax/Leeta/Deanna Troi/Lwaxana/Ishka

Reader suggested tags (what are these?): crossover - Star Trek: The Next Generation, Femme Fuh-Q Fest (round 19)

links (link broken? report it and try the archive.org alternative):

trekiverse

archive.org - option 1 [Archivist’s note: NSFW image at top of page.] / option 2 / option 3 [Archivist’s note: NSFW image at top of page.]

[bandswithmice]

For anyone in New York State: senate bill 3253-A gives you the right to record police, peacekeepers, or security officers as they conduct law enforcement activity, as well as the right to retain that recording and the device it was recorded on. It prohibits police from attempting to stop you from recording them, or harassing you for doing so. If they do, you can bring them to court, and the court may cover your legal fees.

The bill is less than 3 pages. Read it if you can. Know your rights.

PSA to my white friends and followers: In the wake of a phenomenally important guilty verdict in the Derek Chauvin Trial, I’d like to remind you all that the fallout of this case will likely mean more police violence against our Black friends and neighbors, not less. Looking at the statistics in the weeks leading up to this verdict shows that this is already the case. Police in this country are angry that society is beginning to hold them accountable for their abusive actions, and they are looking for revenge. So if you see a cop interacting with a BIPOC, DO NOT walk away. Video record if you can (and as long as it doesn’t further jeopardize the safety of the BIPOC involved), but absolutely do not walk away. It is critical that we do our part and look out for people, and make cops think twice about abusing their powers of authority and near-immunity to murder citizens.

[efsgroupefsgroup]

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[prashanttyagime]

HealthWatch Review

I was scouring the net for a quality fitness tracker watch when I came across an advert of this watch. I must say that I was a little skeptical about its functionality, but when I received it and started using it, I could see why many health and fitness swear by it. I found the heart rate monitor, the calorie calculator, and the blood pressure monitor most helpful.

The real-time information the watch could give me during my workout sessions turned out to be very helpful in the long run as I used to make gradual developments towards better health. In summary, the watch works just like the manufacturer promises. It the functions listed by the manufacturer perform just right. If you like working out or doing sport, you will definitely like this product.

Benefits of Using HeathWatch

The smartwatch comes with a raft of benefits which include:

It gives you analyzed data on how various body systems are functioning in real-time

You can use the information it gives you to track your fitness activities and improve your health

It is compatible with Android and iOS devices so you can receive incoming calls and messages notifications

You can take photos with it

It can monitor your sleep so you know if you are sleeping well

It keeps track of your activity during the day

With its multi-sport mode, you can monitor a variety of sports activities such as swimming, football, basketball, cycling, et cetera

It is easy to use

HealthWatch Key Features

Heart Rate Monitor; Measures your heart rate and gives you data in real-time

Blood Oxygen Level and Blood Pressure Monitor

Calorie Calculator; Tells you how many calories you have burned in kilo-calories

Multi-Sport Mode; Monitors various sports activities like cycling, soccer, and swimming

Sleep Monitor

Social Network Notifications

Compatible with Android and iOS, which allows call and message notifications

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[mocfactorystore]

New Post has been published on https://factory.sweb-demo.info/product/moc-12653-battlestar-galactica-ucs-cylon-raider-ucs

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

After my UCS Colonial Viper MkII, right here is the UCS Cylon Raider, impressed from the reboot sequence! Built on the similar scale because the Viper, will probably be the proper match. Ligthing results will be simply added, and can give your mannequin a remaining agressive contact.For this mannequin once more, you should purchase the constructing directions as a top quality 326 pages pdf, which incorporates the ready-to-print UCS sticker, in addition to separated half lists for the show stand and for the Raider itself. The half lists are additionally supplied as an XML information. Just head over to BrickVault web site! So Say We All!

Comments 5

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MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by acroporabonsai  PRO

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by texgordon  PRO

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by texgordon  PRO

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope

MOC-12653 Battlestar Galactica UCS Cylon Raider UCS

by jackalope