#pain clinics

[theabigailthorn]

What in the academic fuck is a GIC assesment

A GIC assessment (Gender Identity Clinic) assessment is the psychiatric interrogation you have to go through in Britain if you want permission to medically transition (and some aspects of legal transition too). Also called a Gender Dysphoria Assessment.

It involves answering a bunch of medically irrelevant, repetitive, deeply humiliating, repetitive questions like how you masturbate, what you wear when you masturbate, your sexual history, your childhood history, what toys you played with as a child, your employment, the clothes you like to wear, your relationship with your partners and family, etc. The classic is "Do you imagine yourself as a woman when you masturbate?" It also involves various psychiatric tests to check whether you're psychotic, which are deeply stigmatising. You will likely have to suffer this interrogation more than once if you want certain medical and legal doors to open. If you do not answer these questions "correctly" you may be refused transition.

If you want to get it for free, you'll need to wait several years, possibly decades depending on where you live, to be admitted to a Gender Identity Clinic.

If you want to go private, it will cost you about £500 a go, maybe more. (It's not technically a GIC Assessment unless it takes place at an NHS GIC; otherwise it's just sparkling humiliation.)

At the end of your interrogation you will - if you answered correctly - be diagnosed with "gender dysphoria." There is no way for them to check whether the answers you gave were truthful or whether you just told them what they want to hear. In Britain, about a third of trans people surveyed said they lied or withheld information during these assessments. There was no way for the 2015 American Psychiatric Association Working Group on gender dysphoria - the cis people who created the diagnosis* - to know that the interview data they based it on wasn't also full of people telling doctors what they wanted to hear! The unreliability of that data, some researchers have said, calls into serious question the use and sense of the diagnosis! * Fun fact: Ray Blanchard and Kenneth Zucker were both on that working group!

The NHS spends somewhere between 20 and 90 million pounds a year (depending on how you count it) on doing this.

Contrast that process to, say, the treatment pathway for menopause, where a cis woman who wants hormone replacement therapy can just get it from her family doctor 🙃

If you'd like to know more about this, I spoke about it here in more detail with citations

And wrote about it here

[sacredfixation]

Loki fixes his jacket, Mobius doesn't look, and I fall apart

I was in the midst of making a thirst edit for loki, I was just admiring loki being unfairly attractive when I ended with anything but a thirst edit and got emotionally devastated instead.

I refer to that little moment of Loki straightening himself out. First, when he's trying to find his footing at the TVA. When he first puts on his jacket, its this smooth, practiced motion, he sweeps that hair back, adjusts his lapels, chin up, like he's slipping into a role, trying to play along, trying to present himself as someone in control even though he is anything but.

And mobius, watching him, already amused, interested.. and Loki sees that, clocks it, gives that tiny little 'oh you like this?' smile.

Then cut to Dons timeline and tell me why Loki does the exact same motion, only this time, its hesitant. In the TVA it was almost performative, like he was trying to present himself well.

But Dons timeline? its more tentative, like he's nervous, like he wants to get it right.. Because now it isn't just some TVA game. This is Mobius, living a quiet human life that Loki isn't apart of. Its almost like Loki's bracing himself before stepping back into something he knows he can't stay in.

And Mobius-Don- god. Mobius doesn't clock it this time. Because this isn't that kind of story anymore. Theres no knowing little smirk, no teasing remark- just Don, squinting at Loki like a stranger.

Its the tragedy of the saddest little muscle memory. The way Loki's hands move before he could ever even realise why. Because once upon a time, in a place that doesn't exist anymore, he did this exact thing. He straightened his jacket, swept his hair back and looked up- and Mobius was there.

Watching him. noticing him. Seeing him.

Mobius doesn't see him this time. Not in the way he used to. And yet, Loki straightens his jacket. Because some part of Loki remembers what it was like to be looked at by him.

[sunshine-zenith]

Quick lil work doodle

🟦❌🟣

[taylortruther]

must be very strange to have to perform your heartbreak. as authentic as the emotions are, to market them at all (do a photoshoot, decide on "promo")... it must be strange to reconcile that with your private life, the intimate details, at times

[syn0vial]

living in a country with nationalized healthcare after being raised in the US is just

> experience uncomfortable medical issue > leave it untreated for months or years bc it's "not serious enough" to warrant professional medical attention > it gets worse > finally go to a clinic > they ask me how long i've had this problem and i tell them how long > they look at me like i'm a fucking nutter, treat it in 5 minutes, and charge me $6 USD > i walk out feeling like the world's luckiest idiot

[a-minke-whales-tale]

I Never was a Therian

I have for years felt unwelcome in the therian community because of being a clinical zoanthrope. Although some individuals would be kind to me and reassuring, still many places simply would not allow those like me, or if I was allowed I was always on the edge and would have to make it known to everyone that I knew my experience was delusion and was not real in the way the experience of -real- therians were. It took many years to feel that I was even allowed to use the term therian for myself, still I always would have that doubt if I was actually welcome.

Sometimes it feels that maybe the tide might be shifting a bit - we are not outright rejected as often as we used to be. Still though, even when we are accepted it is still always under the requirement that we make it known our experiences are delusion and not real. At still it is nearly every day I am reminded how many therians think we do not belong - how many therians think we should not even have our own communities or spaces. It is nearly every day I see somewhere people concern trolling us, how we need to be in therapy, on medicines, put into hospitals as though those are not things almost all of us actively deal with. I hear how people think we need to constantly be brought back to reality and not have out delusions validated (by which they mean simply being in spaces with other CLCZs, spaces we can talk and be ourselves and support each other).

I want to believe that the humans would someday accept us into their communities - that we could somehow reconcile with them. I know it is only a few humans who hurt us directly. But so so many support the things done to us, including so many therians. We do not belong, that has been made clear to me time and time again. I am too animal for the humans, and yet also too animal for the therians. I do not think I want to call myself therian anymore, or try still to cling to that label.

So many therians seem fundamentally interchangeable to humans to me, just wearing a (normally) fuzzy coat. Many therians would baulk at that comparison - indeed in discussions of misanthropy so often people bring up that you simply cannot tell. And therein lies the problem; when you look up and the person standing over you - another in the long line that have hurt you before - in the shadow of the sun's glare, I cannot see that bit of fur, and they look to me the same. -and in the end, the result is no different. The humans are in charge and I have to obey them, even if that human feels sometimes as animal. I am sure this will probably upset a number of therians, but then I never -was- a therian, the community has made that much clear.

[chicago-geniza]

Okay my friend's brother had a $120 bottle of Ardbeg so I had a single drink (it was very nice, peaty, heady, with a malted caramel finish) and two things happened, one predictable and one very surprising:

Alcohol relaxed my muscles and my fuckass leg unlocked after two days and I am in so much less pain

I DIDN'T WANT ANOTHER DRINK AND I DIDN'T HAVE ONE AND I HAVE NO DESIRE TO DRINK AGAIN. Other people were drunk and I didn't want to be at all and I was able to socialize without inebriation as "prosthesis". Like I got out of the habit of drinking for long enough that it's not appealing anymore when I'm confronted with it in practice. Moreover I'm not afraid of myself or some uncontrollable id-monster compelled by its base impulses who will pilot my chassis into dangerous situations to satiate its cravings or whatever. That's not real and that narrative of addiction isn't real!!! Free will and habit formation win the day babeyyy

[liminalweirdo]

Poll: Health and gender re medical malpractice

if you feel comfortable please share your choice as well as whether you have ever experienced medical malpractice

not to be that person but please consider reblogging this, my tumblr don't have a ton of traffic and i'm genuinely interested in the results.

[emgoesmed]

11/18/2024

Emergency medicine rotation ✔️

Next: 2 weeks of outpatient clinic and getting my sleep schedule back to normal.

[emilynyaesmp]

CRYING SCREAMING THROWING UP ABOUT THE END OF SIX HUNDRED STIRKES OHHHH MYY GOODDDDD WHY MUST JORGE DO THIS TO ME IM ACTUALLY GOING TO CRY

ODY SHOWING POSEIDON RUTHLESSNESS AS THE GOD WHO SHOWED IT TO HIM SCREAMS IN AGONY AND CALLS HIM A MONSTER, THE AMOUNT OF ANGUISH AND GRIEF AND JUST PAIN IN ODY’S VOICE AS HE REMINDS POSEIDON THIS WAS WHAT POSEIDON TURNED HIM INTO

HOW AM I SUPPOSED TO ACT NORMAL NOW?????

[prince-liest]

I didn't understand what people meant when they said that the patients where I've done medical school and am doing residency are "very sick," and I'm starting to realize that this is because I haven't actually had context for practicing medicine in a location where patients are less sick, and it is not in fact all that average to think, "It's a good day when I have a patient with a functioning liver and kidneys!" or be pleasantly surprised when I don't have to list "type 2 diabetes mellitis, hypertension, hyperlipidemia, chronic kidney disease stage X, heart failure (of some sort)" on the chart's problem list just, like, at default baseline, with a side of chronic opioid use and/or intravenous drug abuse.

On the other hand, those same people were correct: it's making me better at treating all of those things and handling comorbidities really quick!

One of the big things I keep running into is pain management, because three common things for me to see are liver disease and kidney failure. To simplify it a lot, liver disease precludes the use of acetamniphen/Tylenol, and kidney failure precludes the use of ibuprofen/NSAIDs. There are other pain treatment medications, but I have less experience with them, and they tend to either be for more specific/adjuvant uses (like lidocaine, the gabas, antidepressants, steroids) or opioids... and I've literally seen two patients in the past week who had to get Narcan for opioid overuse.

On the other hand, obviously people in the hospital often have very legitimate reasons to be in pain and we don't want to leave them that way. But it's a hard line to walk when the family is asking questions like "Why is dad not getting enough pain medication?" and "Why is dad talking to the walls about his days in the war?" or when you get people pulling shenanigans like, "I'm allergic to Tylenol, give me Norco instead!" (Hint: Look up what the main ingredient in Norco is.)

Thank you, on-call pharmacy. :'))))

Another thing I'm quickly becoming relieved about is patients who are...not jerks, I guess? It feels not great to put it that way because generally being in the hospital is an extremely poor time for anyone, but also, it sucks when a solid 1/3 of my patients are actively ornery to everyone who tries to work with them for whatever reason (altered mental status, depression, being in pain, general anger issues, drug withdrawal). Shoutout to the folks actively working together with me to help them get better.

Anyway, the hospital is very tiring. Surely the emergency department I'm going to next will - nah, I can't even pretend to finish that joke.

YOLO! I am really enjoying how much and how quickly I'm learning! Despite the crazy hours this is definitely a drastic improvement on medical school in terms of actually enjoying the work.

[inseparabiles]

google search history:

how do you tell if it's fibromyalgia again, can you die of muscle pain, ms, als, heart attack in women, trapezius pain, why can't I lift my arms, how long does a fibro flare last, how do I stop hurting everywhere, things that aren't drugs that clear your brain fog, what to do when your hands hurt, joint pain that isn't arthritis, ginger health benefits, ginger inflammation, what to do when painkillers don't work, how to sue god

[nexus-nebulae]

me as a kid: i have all these problems

every adult around me: you're not old enough to know what's wrong with you, you're fine

me as an adult: i still have all these problems

my doctors after i finally got the opportunity to choose them myself: oh my fucking god why have you never gotten help for all these problems. you should have seen me 10 years ago

[foolforshera]

Remember when I said I wasn't writing much because I had a shoulder problem? Yeah, turns out it's not a shoulder problem it's a pinched nerve in my neck, probably from a bulging disc, and it's taking forever to get it taken care of. So I haven't stopped writing, I'm just on hiatus until this crap finally gets taken care of.

[californiaquail]

missed the bus by one minute because of my piece of shit job fuck my stupid baka life etc

[holalinkkk]

Okay I’m seeing a lot of “Stolas shouldn’t have sprung everything onto Blitzø all at once and he should’ve given Blitzø time to process” but 1. This talk was soooo long overdue that it’s better that Stolas was as clear as possible and got everything off of his chest because their communication has been pretty awful thus far and 2. Blitzø was kinda the one who started heavily insulting Stolas while following him down the hallway? I don’t blame Stolas for teleporting Blitzø out, they both were very hurt in the conversation and anything further said probably wasn’t going to help the situation at all. I just hate how the fandom has to make one or the other into the bad person in the relationship like???