#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

[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

[thedisablednaturalist]

Of course the kaiser Permanente office has a "why not take the stairs" sign right by the elevators. MOST PEOPLE COMING HERE CAN'T USE STAIRS YOU FUCKS

[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.

[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.

[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???

[aintgonnatakethis]

whenever i see the view of 'always be 100% honest with the medical professionals providing you with healthcare' i just... how much privilege do you have to have to not see the pitfalls with that statement?

i understand 'always tell first responders what drugs you've taken'. but when it comes down to trans healthcare or people who're disabled or have "scary" mental health conditions. do you really think being honest the entire time is safe?

[octobercowboy]

flexing on everyone with my Mayo Clinic referral (not really)(there is no healthcare where i live so time to travel like 13hrs)(like why can’t this cardiologist just provide me with fluids)(i got two saline flushes during an exam and even that made me feel better as i drink a giant water bottle every day)

[crippleprophet]

the thing is, misdiagnosis is a personal conviction & a retroactive pronouncement & a permanent horrifying specter, none of which are ever gonna make weight against the holy text of the medical record. like, i meet the diagnostic criteria for lupus, i have positive bloodwork for lupus, i experience certain symptoms that my extensive research has only shown attributed to lupus, i am on a drug used for lupus which manages my symptoms better than anything else has. i don’t “have” lupus because a doctor decided i don’t. & even if they had, that could be revoked – rendered false, irrelevant, untreatable – at any moment, by me moving or a physician retiring or a bad day or anything at all.

& even if it weren’t so tenuous, to structure “physical” diagnoses as even a unilateral advantage is completely baffling to me – diagnosis does not mitigate the ableist violence we experience, it just specializes it. & of course the most egregious forms of these are post-hysteria diagnoses like conversion disorders & functional disorders & fibromyalgia & what have you, but any label can be a bad one when applied under a violent system, even one that’s accurate.

idk i just wish there was a broader movement for deconstruction of all diagnostic labels bc i feel like even most people who recognize psychiatric diagnoses as socially constructed still talk like there is a knowable physical reality of chronic illness that can & should be sorted into distinct boxes & that just. isn’t true & is also so dangerous + damaging. diagnosis does not guarantee beneficial treatment & treatment should not be predicated on diagnosis.

[slowandsweet]

Until you heal the wounds of your past, you are going to bleed. You can bandage the bleeding with food, with alcohol, with drugs, with work, with cigarettes, with sex; But eventually, it will all ooze through and stain your life. You must find the strength to open the wounds, Stick your hands inside, pull out the core of the pain that is holding you in your past, the memories and make peace with them.

― Iyanla Vanzant