#term life insurance with living benefits

[naamahdarling]

Maybe it isn't that I actually hate medical professionals? They just suck and are weird sometimes, and a lot of them shouldn't be practicing, but I don't hate them as a group, like, personally.

What I hate is their ability to make my life harder in ways that are often completely opaque to me, and a lot of the crap things they do are not really possible to challenge. And I hate the fact that holding them responsible fort dogshit behavior in any way that will actually benefit me is almost always impossible.

And I also hate the fact that they have to do stupid things sometimes because that's how the system is set up, and those things sometimes mean patients actually get harmed. They aren't fond of that part either! They don't want the system to be the way it is! But they don't have a choice, so sometimes people like me get forced by bureaucracy into doing things that are re-traumatizing. And I can't imagine that feels good for them at all, knowing that their patients are sometimes only "consenting" because that bureaucracy will not let them be helped in any other way. Which isn't consent at all. I imagine that must be pretty traumatizing for them, too, sometimes.

If it were easier to actually access medical care without tremendous delays in this country right now I would have much less trouble finding providers who are good at what they do and are not horrible people, and who have clinic staff who can do their fucking job.

Oh and I also don't appreciate how evasive and unwilling to commit they are out of fear of being held to an answer that turns out to be inaccurate, but I can't make an informed decision about my own care unless they give me at least some information about probabilities and trajectories and typicalities. Genuinely, how the fuck am I supposed to navigate that shit. I get that some patients are really fucking difficult, but I should be able to get a special stamp on my file or something that says I understand that sometimes medicine isn't an exact science and the best answers that my doctors can give may not always prove to be accurate in the long term. I know they don't like being in that situation either.

A lot of medical professionals are fucking assholes, and unfortunately the ones who are not are still hamstrung by a system set up to actively prevent people from getting care.

I miss my old doctor. He gave no shits about anything that wasn't the patient. He prescribed scheduled meds based on what the patient needed and not based on fear of consequences potentially being imposed on him by the punitive patient-hostile drugs-are-bad moral panic machine developed to force suffering people into buying more dangerous drugs off the street in order to prevent far fewer people from maybe getting high off of drugs that at least weren't laced with lethal substances. (The purpose of a system is what it does.) Did he get sanctioned and become locally unhireable? Unfortunately yes he did. Does he now provide concierge care to rich people? Yes he does. He found a way to make it work, God bless him.

Everything about the medical system in this country is fucked. Hospitals, doctors, nurses, pharmacies, pharmacists, pharmacy techs, phlebotomists, clinic administrative staff, insurance companies, medical schools and schooling, licensing boards, drug advertising to both providers and patients, pharmaceutical reps, researchers, research, publishing, medical trials, pharmaceutical companies, manufacturers and distributors, medical equipment, charting software, billing and billing codes, diagnostic criteria, charity and low income services, accessible transportation, home care, the lack of independent individual patient advocates, dietitians and nutritionists, access to physical and occupational therapy and physical and occupational therapists, the massive bigotry of every kind rampant in every corner of the medical field, social work, senior care and assisted living, deprioritization of informed consent and harm reduction, disability applications, inaccessibility of medical records, especially psychiatric notes which are specifically allowed to be withheld from patients, lack of continuity of care for disadvantaged people, care that is equitably accessible to disabled people, telemedicine, patient portals, phone systems, clinic hours, every single aspect of inpatient and outpatient psychiatry, facility security, all sorts of things going on with therapists who are nevertheless probably the least malicious group of people in this entire charade, aaaaaand patients themselves.

Also hospital toilets that are too tall and make it literally physically impossible for me to poop while I'm there waiting for somebody to come out of surgery. I just needed to take a crap, guys. You didn't need to make the toilets so tall that my feet didn't even touch the floor. It is very clean but there is no shitting for short people at St Francis.

[covid-safer-hotties]

Also preserved in our archive

A disgustingly economic discussion that is far more clear about the realities of covid than what our governments are telling us

“There is a huge delusion at the moment that COVID is over and when we talk about it, we say ‘when the pandemic happened’ but actually it is still happening,” he said. “So, insurance companies need to be very conscious of that and to be thinking ahead. Swiss Re has a powerful role across the market to make sure that this is being thought about. “In our view, there are a range of scenarios, but most of them anticipate a return to normality in five to 10 years, depending on your level of optimism. And we think that because of the other more fundamental movements happening around cancer, lifestyle risk and eventually Alzheimer's, to name the three biggest ones, that mortality improvements will also return over the longer term.”

By Mia Wallace

“COVID-19 is far from over.”

A recent Swiss Re report suggested potential excess mortality in the general population of up to 3% in the US and 2.5% in the UK by 2033 in a pessimistic scenario, highlighting the lingering impact of COVID-19 – both as a direct cause of death and as a contributor to cardiovascular mortality.

Discussing the report with Re-Insurance Business, Paul Murray (pictured), CEO of L&H Reinsurance at Swiss Re, outlined some of the key ageing and mortality trends shaping the life and health reinsurance market today. “Of course, we saw excess mortality when we were locked down and experiencing the pandemic but now we’ve returned to normal life, we think it’s over and it’s not. People are still getting ill with the COVID infection and they’re still dying.”

The debate for the market now is how long that trend is likely to continue, and whether its impact will fade over time – with Swiss Re’s recent report offering multiple scenarios into the reinsurance giant’s viewpoint on that question. Top of mind is understanding the key factors driving future mortality trends and changing life expectancy statistics – and how these influencing factors may change going forward.

What are the top trends driving future mortality trends? Pinpointing some of the key considerations driving future mortality trends, Murray underscored the need to look at historical data. “The headline for me is always that there has been a phenomenal period of mortality improvements, of life expectancy extending. This is probably one of the biggest social transformations that the human race has been through.

“One of the main drivers of that has been cardiovascular improvements. Smoking cessation helped a lot towards that in the 20th century and is continuing now as well. There’s also new technology that enables low-intervention cardiovascular surgery, like stents. We’ve shifted from a lot of surgery having to be open-heart and high-risk in an operating theatre to in-and-out in a day with injected stents. It has been completely transformational.”

Where do medical advances go next? The ”plumbing” of the human body and the way it’s protected and healed by modern medicine has been largely optimised, he said, but now some of the benefits of that is starting to level off. Looking to the future, he sees that there is still the potential for some further improvements as a factor driving increased life expectancy, particularly amid improving access to information and education about healthy living choices – and improving intervention techniques.

“When we look forward, I anticipate the area where we have the best chance of improvements is on the cancer side,” he said. “Comparatively to cardiovascular risk, improvements to cancer treatments have been relatively low in the past. Of course, it’s very complex as 'cancer' is a bucket term which combines 200-plus types, but we are seeing some very promising technologies emerging here that will help address that.

“Take mRNA vaccines, for instance, which are not new but became very prominent in the pandemic, specifically as it helped us develop vaccines very quickly. mRNA capabilities, combined with immunotherapy, are currently in trials, and showing very significant improvements in outcomes for cancer patients in specific causes. And we've only really started scratching the surface of that. Looking 10-to-30 years out, which is the duration we have to think about as life insurers, we think that’s a prominent contributor to future improvement.”

Alzheimer's is another pressing area for consideration, he said, as, with people generally living longer, this is becoming a much more significant risk. Due to a myriad of reasons, more people than ever are living with Alzheimer’s today and society is being increasingly challenged to deal with it and to support those living with the disease. “Again, improvements in dealing with Alzheimer's historically have not been that great, and I think this is one area where there's the potential for a meaningful breakthrough, and we're starting to see some signs of that in scientific research.”

Understanding the impact of lifestyle factors on future mortality trends An interesting element shaping discourse in the life and health reinsurance market is the question of the impact of lifestyle factors on future mortality trends. Murray noted that if you characterize overall mortality rates into lifestyle or non-communicable diseases, between 30-40% of mortality is driven by lifestyle choices – including such factors as what you eat, whether you smoke, whether you exercise, how much sugar you eat, and how you manage your stress.

The insured population are typically quite happy to engage with that, he said, and Swiss Re is seeing improvement on those metrics, but there remain large swathes of the overall population who don’t engage in that conversation. As more data emerges over time, he believes the market will start to see stronger connections between activity and outcomes which, in turn, will help it to drive better results.

“An interesting area here is diabetes and Swiss Re is taking a leadership position on this globally,” he said. “We regularly engage with policymakers around the world – with doctors and thinkers on nutrition and food policy in particular – to [highlight] how your diet has a big impact on your health, but also to assess whether the current advice is appropriate for the future.

“Obesity and diabetes continue to increase. That debate has a long way to go, but if it continues to evolve positively, it will have a positive impact on mortality.”

Poor metabolic health drives obesity and diabetes, which are offsetting previous advances made by treating cardiovascular diseases and smoking cessation. The emergence of GLP-1/GIP weight loss injectables has shown early promise in reducing weight and improving baseline clinical risk factors, when combined with long-term lifestyle alterations. Although long-term data doesn’t yet exist on the impact of GLP-1 drugs, in the short term these medications are showing positive results in reducing all-causes, and specifically cardiovascular mortality. In addition, the drugs appear to positively affect a range of other conditions such as cancer, liver and kidney diseases, and even neurodegenerative diseases.

When will excess mortality return to pre-pandemic levels? Underpinning the broader conversation is the big question on the minds of many across the life and health reinsurance market – when, or if, excess mortality will return to pre-pandemic levels. Swiss Re’s recent paper posited both a pessimistic and an optimistic scenario because its role is not to say what will happen, but rather to encourage people to think about the tail risk of the COVID crisis and how it might play out.

“There is a huge delusion at the moment that COVID is over and when we talk about it, we say ‘when the pandemic happened’ but actually it is still happening,” he said. “So, insurance companies need to be very conscious of that and to be thinking ahead. Swiss Re has a powerful role across the market to make sure that this is being thought about.

“In our view, there are a range of scenarios, but most of them anticipate a return to normality in five to 10 years, depending on your level of optimism. And we think that because of the other more fundamental movements happening around cancer, lifestyle risk and eventually Alzheimer's, to name the three biggest ones, that mortality improvements will also return over the longer term.”

Study link: www.swissre.com/institute/research/topics-and-risk-dialogues/health-and-longevity/covid-19-pandemic-synonymous-excess-mortality.html

[greater-than-the-sword]

If you live in WA you BETTER vote to allow opt outs for that shitty "long term care" program. It's a massive payroll tax for insurance that most people dont actually want, and pays out meager amounts (not enough to actually cover anyone's long term care. That is, a nursing home).

I'm 29. My money for long term care is better off invested than in this ill conceived state program.

And guess what? If you move out of state at any point do they refund you this massive payroll tax you've been paying toward your entire life? Hell no. But do you get the benefits of the insurance you've been purchasing your whole life in case you need a nursing home when you're old? Hell no

[cranquis]

Your recent reblog made me sad, but also makes a lot of sense. I've been following you since I was in medical school, and I'm now in my fifth year of specialty training (I am not American). I did occasionally wonder why I've been seeing less of the kind of content you used to put out.

All I can say is - thank you for the work you do. I've seen enough online to get an idea of what you must face on a daily basis. I think I'm lucky that somehow, the doctor-patient relationship overall hasn't deteriorated to such an extent where I live (yet at least), but I definitely understand the frustration and despair of trying to communicate with people who aren't coming into the conversation in good faith.

You've always been a kind of role model for me in terms of your passion for your work and your open sharing about your faith. I guess I just wanted to say that I hope you find hope and joy in your work, even if those you serve aren't wise enough to appreciate what you do for them.

Hi, my colleague! Hey first of all, thank you for your kind words of encouragement and affirmation. Negative med-related interactions (online or in person) anymore just roll off me, but the positive ones still give my heart a thrill! :) And congrats on your continued journey down the medical pathway.

Second, I'm glad your message gives me the chance to clarify for all my long-time Cranquis Pants* that I still do enjoy my work. I have been doing the exact same Urgent Care job in the exact same location (with quite a few staff turnovers) ever since I finished residency 17 years ago! I still enjoy the bulk of my patient interactions, I continue to hone my diagnostic skills, I feel very confident in my procedural skills, I have a reputation in our local medical community as a reliable and thorough physician, and I have a loyal group of patients who routinely nag me to "quit urgent care and become a regular doctor so we can be your primary care patients". My staff likes and respects me (despite my best efforts to ruin that on the daily, with my puns etc); I like my staff and appreciate the hard work they do in the face of the same administrative and societal opposition that I encounter; I am not distressed when little kids freak out during physical exams (and my success rate of turning those frowns upside down with playful interactions and silly sound effects is pretty darn good).

I am blessed with amazing work-life balance, more than the majority of Family Medicine-trained physicians I suspect. I carry no pager, I take no call, I leave my work at home when I go home. I know my schedule months in advance, I have a shift template that gives me plenty of week-long stretches off, and I have my Sabbaths 100% free to attend church and spend time with my family. My pay is decent and my benefits are solid, my debts get paid and I have a roof over my head. My kids and wife are happy to see me come home. Personally, I really have nothing to complain about.

But the bloom is off the rose for my profession as a whole. The politics and trends of the US health care system continues to disenfranchise physicians, devaluing the years and $$ invested in becoming physicians, over-valuing patient satisfaction scores and inexpensive labor and glitzy administrative initiatives and staff rumor mills more than evidence-based, experience-driven clinical medicine. The power structure is upside down, as if doctors ought to be automatically doubted and disdained by pharmacists, insurance companies, administrators, patients, and APCs because of their systematic educational journeys and reliance upon scientific evidence.

And one of the saddest results is watching medical professionals turn on each other. The fragmentation and super-specialization of every aspect of medical care creates artificial "us v. them" scenarios; specialists and primary-care battling over who does the paperwork for pre-op visits and FMLA, ER and Urgent Care arguing about how much workup should be undertaken by the UC when the patient is obviously going to need ER management, primary-care so overwhelmed with insurance-required goals that their patients can never get same-day/soon-day appointments, pharmacies so understaffed that it's easier for them to tell the patients that "the doctor never sent the prescription" when in reality ...

I could go on.

I miss the old days (said the geezer on the internet), when I could enthusiastically support a pre-med student's dreams of getting into medical school and "helping people as a doctor someday." Now I wince at the idealism in a high-schooler's eyes, and try to find a nice way to say "there's more options for helping people than just becoming a doctor... be sure you have your motivations straight, because medicine is not what it was even 10 years ago..."

So hope and joy in my career? Hope for the profession of physicians, I have little. But I make the joy in my practice when I can make it, and I only expect to find joy in my non-medical time with family and hobbies and travel and friends and the lifestyle which my medical career still does make more feasible than otherwise.

*Probably not the term historically assigned to "fans of this blog", back when I posted frequently -- it's been a minute -- but if not, SHOOT that was a missed opportunity.

[chadfallout76podcast]

Major Update: Life...is a changing for me/us (and a sneak peek of Vault-Tec Rises!

Good afternoon!

I wanted to give you all an update on Vault-Tec Rises as well as an update on myself and some major life changes happening this year that may impact our season while the dust settles. Firstly, I'm more than halfway done with our next major feature length episode, "Vault-Tec Rises"...which is technically episode 16, set BEFORE Little Sanctuary of Horrors. It essentially is the story of how everyone came to be there in the first place, what Vault-Tec and the Enclave are really up to, and is the start of our last 4 episodes of the season as the Battle for Appalachia begins.

Secondly, I've shared quite a bit about the journey of these past 10 years with my husband Travis and his struggle with mental health. Many of you were kind of enough to support or share our GoFundMe to help take the pressure off the crushing debt we were under with mounting medical bills and his bills, none of which was covered by insurance fully. Trying to keep us afloat financially has been a long-term struggle of mine and here's in New Hampshire we just haven't been able to get ahead. After having to cancel some of his services last week as we couldn't afford them, we made some major decisions.

The next few months I'll be doing a lot of painting, landscaping, plastering and prepping to list our home on the market. Financially we can't afford to buy again for a while, so we're stuck renting. Based on what things are selling for in the area, I'm not too worried about getting out of it fairly quickly. We'll be moving to Texas, in between Dallas and Fort Worth in a really beautiful, new planned community where leasing and the overall lower cost of living will save us $20k a year which will allow us to not only fix our debt issue permanently, but also they have one of the leading centers in the country for C-PTSD. Once settled, I'd be able to get him more direct help he's needed that we just don't have access to out here.

Texas is going to be a big, big change for us...a huge move, but one I'm eager to make. Our backup editor is continuing to plug away at stories as well as I've had my hands full with work trying to keep the lights on (literally). I wanted to explain all of this with clear honesty so you know what I've been doing, what I'll be doing this year and why it often takes us so long to ship episodes to you. Your patient and support of me really, really means the world to me. The other benefit of this move is that once I'm not strangled hustling for work 7 days a week, I'll have more free time to actually create. Something I really want to do...as there are still two more seasons of Chad and some other projects I really want to share with you all.

I hope to have our 3-hour feature length Vault-Tec Rises completed in the next few weeks, so stay tuned. :) And if you can please excuse how hectic this year will be between selling and moving halfway across the country I'd appreciate it.

Much love to you all,

Ken

[justinspoliticalcorner]

Jonathan Cohn at HuffPost:

Democratic presidential nominee Kamala Harris on Tuesday proposed a major new initiative: expanding Medicare to cover the cost of long-term care at home. Such a plan could mean the option of staying at home, rather than in a nursing facility, for the millions of seniors and people with disabilities who need help with the daily tasks of life. It could also mean physical and financial relief ― and new opportunities for school or work outside the home ― for the millions of working-age Americans who today provide so much of that care on their own without much in the way of outside assistance. If the proposed legislation is enacted, such a program would represent a substantial boost in federal support for caregiving and, by any measure, one of the largest one-time increases in American history. Harris made her announcement during an appearance on “The View,” the nation’s top-rated daytime talk show, and presented the initiative as a way to help the “sandwich generation” ― that is, the working adults who have aging parents while still caring for children. Roughly a quarter of the American population falls into that category, according to Pew Research.

“There are so many people in our country who are right in the middle ― they’re taking care of their kids and they’re taking care of their aging parents ― and it’s just almost impossible to do it all,” Harris said. “Especially if they work, we’re finding that so many are then having to leave their job, which means losing a source of income, not to mention the emotional stress.” Harris pledged to finance the home care initiative fully, in part by tapping the savings from yet another reform she has proposed: expanding the federal government’s power to negotiate drug prices directly with manufacturers. The federal government acquired that power just two years ago, thanks to Democratic legislation that Harris supported.

[...]

The Home Care Struggle Today

Dollars alone don’t capture the scope of the proposal ― or the change it could mean for individual families. Nearly 20% of seniors require some kind of help with bathing, eating and other daily life functions, according to the available research. The percentage is even higher for older seniors, plus there are non-elderly people who need these services because of disabilities. But Medicare doesn’t cover this kind of long-term care, except in limited circumstances, nor does private insurance. And few families have the income or savings to pay out of pocket for these supports and services, which over the course of a year can easily generate bills into six figures. That leaves Medicaid, currently the nation’s single largest payer of long-term services and, for millions of Americans, a true lifesaver. But Medicaid is available only to people with low incomes, which means that families cannot qualify until they have “spent down” whatever savings they have or figured out ways of transferring those savings to relatives. (An entire legal specialty exists purely to guide people through this process.)

And that’s not the only issue with Medicaid. States manage the program, even though the federal government covers most of the cost, which means eligibility, benefits, management and reimbursement for long-term care vary enormously depending on where people live. That’s especially true when it comes to home care. Many states cap enrollment, creating long waiting lists for services and forcing people into nursing homes (which Medicaid covers more uniformly) even when they would prefer to remain at home. The alternative for many families is to provide care on their own, which is nice in some cases and terrible in others and somewhere in between for the rest.

[...]

But the version Harris is putting forward now is different from the old one. The previous proposal would have essentially taken the existing Medicaid program and made it bigger. Harris envisions Medicare taking on home care for its beneficiaries, which to many analysts and advocates for the elderly seems like an improvement, in part because Medicare is not limited to those in the most dire economic circumstances. “The care that people need ― the long term-care ― is part of their overall health care needs,” Georgetown public policy professor Judith Feder, a co-author on one of the recently published papers sketching out a proposal, told HuffPost. “Nobody should have to be impoverished because they need health care or long-term care. It needs to be a true guarantee of security, not simply a last resort.”

Whether a home care program was part of Medicaid or Medicare, moving from Harris’ campaign pledge to actual policy would require answering all sorts of complicated questions and confronting all sorts of difficult trade-offs, over not just money but also issues like how to balance support for professional care workers and those who prefer to provide care on their own. There would also be questions of whether and how to restructure Medicaid’s long-term care supports, how those would integrate with the new Medicare initiative and what that would all mean for the providers of care, who, undoubtedly, would have a thing or two to say about it. But the potential complications go hand in hand with potential benefits, which include everything from additional savings to Medicare (because some studies suggest home care reduces hospital expenses) to shifting more care out of nursing homes and back to the home setting.

Democratic Presidential candidate Kamala Harris is making a major proposal to help seniors and their caregivers by expanding Medicare to include home-based care.

See Also:

Vox: Biden’s push for child care failed. What lessons are there for Kamala Harris?

[religion-is-a-mental-illness]

By: Aaron Kimberly

Published: Dec 18, 2021

Between 1995-2006 I was a part of the butch lesbian community. During those years, despite my life-long and sometimes intense gender dysphoria, I hadn’t given any serious thought to medically transitioning. It wasn’t even on my radar as a possibility until after 2000. The idea of medically transitioning seemed fringe, far-fetched, and risky.

Most of the butches I knew also had gender dysphoria (GD) or rather, Gender Identity Disorder (GID), as it was called then. Many butches I knew in Winnipeg, Halifax, Toronto, and later Vancouver, were strong, stoic people. I admired many of them. I know that their lives weren’t always easy, but they carried themselves with dignity. They had butch “brotherhood” and femmes who adored them. Many were “stone” which meant that their GID made it difficult for them to relate to their female anatomy so didn’t allow themselves to be touched by anyone, or rarely. They were often harassed and abused for being masculine women, as I was. It was often stressful using female public washrooms, because our gender ambiguity made people so uncomfortable. There was a term “butch bladder” to reference the ways we’d avoid using bathrooms in public.

In the early-mid 2000s, more and more FTMs were appearing in the community, alongside the butches. Many lesbian spaces welcomed them, some didn’t. It seemed to me at the time that butches were presented with two options: we could choose to be butches, or we could choose to be FTM “trans guys”. Why people chose one or the other...that was very individual and personal. It really came down to which option solved a problem and made life easier. The problem could be homophobic parents, fatigue from being harassed, differing degrees of dysphoria and bodily discomfort, not understanding what GID is, poor social or occupational functioning, trauma, other mental health challenges like depression or the anxiety that seemed inevitable for us. Some transitioned but still identified as butch women. They chose medical interventions to look more masculine, not to identify as men. Some trans guys said they never had GID at all. I don’t know what their motivations for transitioning were. Some said “political reasons”. There were some who were big fans of Queer Theory icons like Judith Butler and Judith Halberstam. Those women adopted male personas - intentional “female masculinity” - as an expression of Queer Theory, not to be men/male. I chose to transition soon after a gay man was beaten to death in a nearby park.

If kids with gender dysphoria today are anything like who we were 20 years ago, I feel saddened by their trajectory. Others see benefits: Access to medical interventions has been made easier. They no longer have to do a “real-life test” (live their life as the opposite sex for 2 years without medical assistance). They don’t have to go through months or years of therapy and assessment. More is now known about the effects and risks of hormones. The surgeries have improved, are easier to access and now paid for by insurance. (I paid for my own mastectomy out of pocket, and was on the SRS surgery waitlist for 10 years.)

But, what have we done? Have we eliminated all of the conditions for why a butch girl would find their innate masculinity hard to live with? Have we made the lives of butch women better and safer? Have we eliminated homophobic families, communities, employers, clinicians and policies? Are we educating young people what gender dysphoria is, in evidence-based terms, supporting them to integrate that into a healthy identity and self-image? Do we tell masculine girls how attractive they are? Do they have an abundance of healthy role models? Are they fully embraced and integrated into their workforces, educational settings, faith communities… or, are butches still getting weird looks from strangers? Are they still getting yelled at in public bathrooms? Are young, obnoxious young men still yelling slurs out their car windows as they drive by a butch woman? Do gender non-conforming women still fear for their lives in some places? Can they get Brandon Teena out of their heads? Can they travel the world freely? Can they find clothing they like that fits their bodies well?

I’m not convinced we’ve made any real progress at all. I think we’ve just made it easier for people to jump ship, younger and faster, and gave it a different spin. We now call that “self-actualization”. We’ve facilitated a better illusion. We’ve convinced more and more people that the illusion is real. We continue to push for better surgeries. Penile and uterine transplants are on the horizon. Young people are flooding into clinics. They can’t keep up with the demand. Activists have pushed Queer Theory as an explanation for our difference, displacing evidence-based clinical definitions of GID/GD. It’s no longer talked about as a condition that requires treatment but a natural human variation that requires affirmation in whatever form we demand (often life-long medicalization). I’ve travelled that road to its end, and its hurt just as much as it’s helped.

The surgeries available to FTMs right now are awful. A double mastectomy and phalloplasty or metoidioplasty are gruesome procedures to go through. The US surgeon I went to for metoidioplasty boasts low complication rates, but the anecdotal evidence I’ve witnessed (myself and everyone I know who had the procedure there and elsewhere) is close to a 100% complication rate. One guy at the surgical recovery centre I stayed at started to hemorrhage and was laying on the floor unable to reach the call bell when another FTM patient found him and advocated for him to be rushed to hospital. Fistulas and strictures are the most common problem. I chose metoidioplasty because it’s thought to be the less risky of the two options. I immediately developed two large fistulas (meaning that my urethra burst open in two places) that needed additional surgery to repair. I couldn’t bathe or go swimming for a year until those openings were repaired. I have chronic perineum pain, altered bowel function due to changes in my pelvic muscles, and no sensation in most of my chest. When we have complications, local physicians and surgeons don’t know what to do. So we have to wait, and travel to whoever can help.

Listen, I don’t doubt that sometimes medical transition is helpful for people. It’s not my place to say they can’t or shouldn’t. But let’s not sell this like it’s a Disney park ride. The marketing of everything trans is ridiculously misleading. Don’t put sparkles and rainbows over real pain as though that helps at all. It’s insulting.

If we really want to help these kids, we need to make it easier for lesbian kids. Butch kids. All gender non-conforming kids. The quirky and awkward kids. Kids who feel they don’t fit it. Let’s get better at working with parents and preserving families. Be honest about what medical transition is really about. No one really changes biological sex and these procedures are really hard to go through. Why are we putting all of our resources into escaping brutality rather than eliminating brutality? We’re cutting up our bodies because our lived reality is worse. Why do we celebrate that?

Medical transition is but one option for those with GD. We need to reclaim our understanding of GD as a condition so that we can have reality based-conversations and solve real personal and social problems. “Trans” as a concept, masks many underlying issues. A queer theory-based understanding of myself worsened my GD. Medical transition became an addiction. The illusion only works if we’re lucky enough to pass and everyone else plays along perfectly. It’s an exhausting game of whack-a-mole to dodge the reminders of my female past and female biology. How is that kind of dissociation desirable? Some people may benefit from medically transitioning, but we still need a reality-based understanding of ourselves, to keep our feet on the ground.

Our children deserve better. If this sounds transphobic to you, you’re a part of the problem. Owning our reality for what it is isn’t self-hatred. It’s self-acceptance. Having different ideas and a different vision of how to move forward isn't hatred. Hatred was the skinheads who circled around us at the small 1992 Winnipeg gay and lesbian march, long before Pride was a parade. Hatred was the men who drove from the suburbs into Vancouver with the intent to "kill a fag" and murdered Aaron Webster in Stanley Park. I’m well acquainted with phobia. This isn't phobia. This is love.

[mariacallous]

Almost one in five Americans over age 65 are unable to manage basic activities of daily life—bathing, dressing, eating, toileting—without assistance. Among those over age 85, the proportion is closer to half. Friends and family members can and do help out, but even so, about half of people reaching the age of 65-years of age will use paid long-term services and supports (LTSS) at some point. Most Americans do not have enough income or savings to cover these costs. The private long-term care insurance industry has never worked well despite many creative efforts to fix it and to encourage enrollment. The Federal Medicare program covers only short spells of home care after a hospitalization and does not provide coverage for long-term support. That leaves Medicaid. Medicaid offers a critical long-term care safety net for people who get their healthcare primarily through Medicaid—but it isn’t a good solution for most Medicare beneficiaries as it doesn’t align with the system that manages their care and pays their providers. Moreover, eligibility for Medicaid is restricted to those with very low incomes and few assets, so few older adults qualify. It is well past time to add a universal home care program to Medicare itself.

Prior efforts to move in this direction have been stymied. Some proponents have called for a universal, open-ended benefit. Critics have argued that any universal home care benefit would be a budget buster. These tensions are ubiquitous in social program design. An additional tension in designing a program that serves people towards the end of their lives is that public funds should be focused on expanding access to necessary care rather than protecting the ability of people to leave large bequests to their children. Designing a fiscally responsible, universal benefit that does all that is a challenging task—but we believe it is not an impossible one. In this post, we describe some design options for a Medicare home care benefit that could be dialed up or down depending on the priority assigned to program generosity or fiscal feasibility. 

Several features make designing a universal home care benefit challenging.

The need for home care is based on measures of functioning, not lab tests. A program must have simple and reliable ways to measure who needs care and how much care they need.

Most people report a preference for care in their own homes over that in nursing homes or other institutional settings. This is because, unlike medical care, which is often unpleasant and painful, home care typically provides support, comfort, and a degree of safety for beneficiaries. One consequence of these preferences is that a home care benefit would be susceptible to overspending. The program will need to have measures in place to avoid overuse.

Income alone is a poor indicator of how much Medicare beneficiaries can afford to pay for home care. For example, beneficiaries who are renters may depend on their incomes to afford housing; other beneficiaries may have very large, non-liquid assets but limited incomes, leaving them ineligible for Medicaid programs while unable to pay for care. Program design will have to address the importance of assets in this population.

Much LTSS is provided through informal care. Beneficiaries often prefer care provided by family members, but paying for informal care raises the potential for overspending, fraud, and exploitation of older adults.

State Medicaid programs currently cover the cost of home care for 4.2 million people, according to KFF, though eligibility and costs vary considerably across the country. Medicaid would continue to provide home and community-based services for people who are not Medicare beneficiaries. Some of this spending could be redeployed by states to improve the quality of nursing home care and for home and community-based services for people who are not eligible for Medicaid. The federal share of Medicaid savings could be used to defray the costs of a new Medicare home care program.

None of these challenges can be ignored—but none of them are damning either. As with any program, policymakers will need to make tradeoffs across these challenges to design a program that provides the maximum benefits consistent with their budget appetite. The good news is that the current landscape of home care financial protections is so limited that even a modest program that made conservative choices across these parameters, with costs we estimate at around $40 billion annually, would make many people who currently lack services much better off. Turning the dials more generously would, of course, cost more—and it would extend more benefits to more frail and vulnerable Medicare beneficiaries. 

What might such a very-conservatively designed universal program look like? Eligibility for the program would be restricted to people who independent clinical reviewers determined were unable to perform two activities of daily living (e.g., bathing, toileting, or eating). That’s the standard that many State Medicaid programs already use, and it could be assessed annually during the initial implementation period to further develop and monitor the uniformity of functional assessments over time. Second, the program would include cost-sharing that varied according to people’s means. Medicare beneficiaries with high income and assets would receive modest assistance from the program to defray a portion of the costs of home care; those with fewer assets and less income would pay much less. Third, beneficiary contributions to the costs of their care would depend on both their current income and their accumulated assets, but through cost-sharing rather than a strict cutoff. For example, at the cost listed above, we could allow all qualifying Medicare beneficiaries to fully retain income up to 150% of the poverty line ($22,600 in 2024) and assets up to $30,000; beyond that limit, individuals would still qualify but would pay cost-sharing out of their resources to defray taxpayer costs. Fourth, only care provided by formal caregivers associated with home care agencies would be covered. Hours of support would be based on need, but provider agencies would be subject to a population-based hours of service budget. The combination of resource-based copayments with population-level budgeting will ensure that the costs of this program will not explode. Finally, Federal Medicaid savings from shifting home care benefits from Medicaid to Medicare would be used to defray the costs of the program.

The program we’ve outlined tightly focuses benefits on the most vulnerable people who currently have little eligibility for care, and few means to pay for services. But many others could also benefit from a new home care program. People who have impaired functioning that does not meet the two activities of daily living standard may also need assistance. Lower cost-sharing for middle-class people would leave them more resources to make the most of their lives. The tradeoff is simple: at a higher cost to the federal budget, more people would get more protection. We can’t define where the lines should be drawn—that’s Congress’s job—but our analysis suggests that there are programmatically tractable, fiscally feasible ways to add a home care benefit to the Medicare program.

[tf2heritageposts]

saw your post about chronic pain and thought i'd give some pointers (from someone who is developing chronic pain themself and is learning how to deal with it)

stretching is important. yes i know this is the most basic ass response someone can say but trust me here. i am an artist who has been in shrimp position for more than 50% of my life (thus far) and just doing simple shoulder, elbow, wrist and hand stretches before/after working helps a T O N in the long run. it will be painful at first! it always is! but stretching does help to prevent even more pain down the line. i am unsure what pain bothers you the most (mine is my feet, lower legs, lower back and arms), so i'd suggest starting with some simple stretches in the regions where you tend to have pain.

collagen. if you don't know what that is, i can give you a summary without the science-speak: its the stuff in your joints that keeps your cartilage from breaking down. best way(s) to get it? if you are simple, and can afford it, they sell the stuff as vitamin supplements. if you're looking for a way to just naturally get more into your diet, i would suggest bone broth. (yes you could buy bone broth, but if you go through meat on the regular, and are able to cut bones out of them, don't toss out the bones! make bone broth with em. i would give an entire guide of how to do it but i would be here for much longer)

waterrrrr. the drinkerrrrrrrrrrrrr. hydration is also really important for preventing joint pain (or really pain of any variety). making sure to get proper hydration is important. if you live in a city area where the tap water might not be good, please be sure to get mineral water and not pure distilled. while distilled does taste better, it lacks a lot of minerals that water can naturally have that would be of benefit to your health.

don't overexert yourself!!!!!!!! please please PLEASE be sure to sit down if you need to (and are able to). repeated overuse of your muscles/bones/tendons can have a negative impact in the worst ways possible. (also getting a walker or cane is ideal!!! most walgreens and/or cvs's have an asile dedicated to mobility aids!!! do not feel ashamed to use it if you need it!! please!!!)

in terms of short term solutions, ibuprofen will not kill you. just be sure to rotate tylenol and ibuprofen. doing this will prevent you from unintentional ODing. (you may have heard this one before. if so feel free to ignore it)

going to an arthritis clinic sooner rather than later is a good idea. i don't know what your physical/insurance situation is like, but as someone who just recently was told by a primary care that the symptoms i am having is similar to rheumatoid arthritis [which runs in the family] (and really needs to move into a different state or city or town and get a different insurance that can cover the cost of multiple arthritis doctor visits AND a doctor who will take them seriously), it is important that you go to an arthritis clinic as soon as possible. If you do not know where to go, and are able to ask your primary doctor for a referral, most primary care doctors will refer you to something that is on your healthcare plan

i do apologize if this was really really long and winding... i am not the best at keeping things short

well i just realized i am living badly because

- i never stretch

- i am comstanrlh underhydrated

- i am always up and out and about hyerexerting myself

- only use ibuprofen

thank you kindly man

[bellobambino]

bad user interface kills people

i have worked with insurance and the government and lawyers and estates and hospitals for my whole life and I have some stories about how fucking terrible these institutions are.

Here's one of them.

I used to have Medicaid under Aetna while I was considered in the same 'household' with my ex boyfriend at the time. I was the head of household just for administrative purposes.

Anyway. Things didn't work out with him. I moved across state lines, and I had to remove myself from all other accounts that were accessing my medicaid benefits.

I called up Aetna and explained the situation. I told them please remove me from the account, and transfer the head of household to my ex, who was still living in the state and reliant on the benefits.

He said there was no way for them to remove me from the account (he reeeeally tried) and the best bet to keep my ex's healthcare coverage was to simply change my mailing address on the account to match the address I had on file with Medicaid. He said once that's updated, I just need to notify Medicaid that the change was made and it should be all good to go!

He must have pulled that idea out of his ass, because I don't hear anything about it for a week or two, and I'm assuming it's fixed and I can move on with my life.

And then my ex calls me. He was beyond furious. Because he went to his audiologist appointment just for them to say ... yea your insurance isn't effective anymore. And he assumed i hated him so much that I went through the trouble to forcibly terminate his Medicaid coverage. (we did not end on good terms and that would be kinda par for the course for me but i digress)

anyway, I spent the next 3 days on hold with Aetna and Medicaid.

Turns out, if you change the Head of Household's (HoH) address, it automatically applies that address to everyone in the account. So my ex's address was changed to out of state, their system database immediately considered him ineligible because of it, and ceased all coverage.

I know this is getting long, and maybe boring, but bear with me, it gets worse.

When he called, they wouldn't let him change his address to regain coverage. Because he wasn't head of household.

I called and told them to transfer him to head of household. They said they can't transfer HoH within the account, they can only add and remove members from the account. I said dawg... I first thing I tried to do to solve this shit last time was to simply remove me from the account. Now its possible?

They pulled some convoluted policy out of their ass to blame the confusion on. They said they'd look into the issue and call me back.

Well a week later (without either of us having any coverage due to this madness), Aetna Man calls me and says okay so i figured it out. In the program we have, you have to actually assign another member the Head of Household role before you're able to remove the existing Head of Household. It's a system issue, it seems.

I almost walked into the river. I spent 2 entire weeks PLUS with a lapse in healthcare coverage for me AND an innocent party. Because Mark or whoever had Boomer's First Computer Interface disease.

Still took an entirely separate series of phone calls to get them to change his address back to the one he lived at after their mistake.

im very much filled with hate.

[stevenhodgellc]

[kiefbowl]

Would love to know how you feel about breast reductions. Like idrc what others do, and it's nice to not have back pain yea, but I also wonder if others with big breasts feel a bit trapped in presentation the way I do and thats why they do it. I keep seeing breast reduction videos and 70% of them are from masc women or nonbinaries and you can tell that people find masculine women with big chests to be a ridiculous contradiction so it does make me feel like I *have* to get one to be taken seriously in masculine outfits. And I also think people don't like fat women and breasts are fat and therefore unattractive unless they're being shown off sexually for men so the only thing that actually looks good on me and fits right are super revealing and feminine(maybe just me but i think i look best naked lol). So I wonder that if I get a breast reduction I will be "giving in" fatphobia and if I don't I'll continue to be forced into feminine skimpy outfits to feel comfortable

I think there are plenty of good reasons a woman would seek out a reduction that is going to be a very positive impact on her life, and is going to have more physical benefits than something "more" cosmetic like a breast implant. To some of your points, that doesn't mean that a breast reduction can't be a cosmetic decision, and ultimately surgery for purely cosmetic reasons is not going to provide the relief that person is seeking, as it's not addressing the root of the issue for them. I have large breasts, and I attempted many years ago to try to get them reduced, but my insurance wouldn't help me out so...went out the window.

I don't think that when you're seeking large and risky QoL changes, you should worry about if you're "giving in" to things like fatphobia, or other stigmas you're facing, you should only worry about if a) this change is actually going to change the quality of your life in both the short-term and long-term b) do you have the resources to actually commit to the change and trade in one problem for another problem, like debt c) have you fully considered all options and causes to the best of your ability. I don't think a 16-year-old can fully understand the ramifications of getting a rhinoplasty, but I think a 26-year-old has a better chance even if I don't think it's going to solve the body issues they're really facing - however I would ultimately want anyone to get a rhinoplasty than harm themselves.

Personally, I would suggest you stop watching videos of people who have gotten their breasts removed to be more masc, because obviously they are presenting a bias view that "people find masculine women with big chests to be a ridiculous contradiction." They believe that, and they assume others do, too - so that's how they're presenting their decision. But there's no reason to think "everyone" believes that. There are plenty of women on this app who will happily tell you they love butch women and they love breasts. Why not explore butch lesbian art and stories to see some ways women present more masculine in the world while having breasts? See if that doesn't give you enough perspective to question the need to get a reduction.

Additionally, I would challenge you to consider why you have to be masc? I mean, just dress how you want to dress, why does it need a label and why does it need to live up to an external validation? Wear suits, wear men's clothes, get a buzz cut, do whatever you want. You'll look like you no matter what. You can call it masc if you'd like, or you can just call it you :)

[argumate]

One of the central contradictions of capitalism is that in order for it to function the people in charge of huge multi-national corporations are expected to act in the corp's best interests, but are incentivized to instead prioritize any short term gains over long term ones.

Capitalism does not seek out good design, good products, happy customers, satisfied users, or sustainable environments. It seeks only short-term profits.

Everyone's lives and quality of life for some short-term unsustainable capitalism

As opposed to capitalism which is burning the planet to the ground with climate collapse for short term profits for billionaires

Healthcare Insurance (not healthcare delivery) Insurance is one sector of the economy where capitalism does not work very well because the short term incentive to cheat is too strong.

Reality - this is 20 years too late. Many of us knew this back in the 2000s. Wall St, traders, investors put short term profits above US jobs and technological lead.

Marx was right about capitalism inherently leading to crisis. Short term cost-cutting through wage reduction benefits companies, but over a long period it shrinks the economy by reducing the spending power of workers. The post-WW2 boom masked this for a while, but no more.

Capitalism prioritizes profit, which can result in the exploitation of workers through low wages, poor working conditions, and limited job security. Companies operating with a wellbeing economic lens prioritize long-term investments in their employees over short-term gains.

Western capitalism outsourced itself to death to chase short term profits (throwing our industrial working class under the bus). On the other hand China can plan for the long term and exploited this shortsightedness to build up its industrial capacity and know-how.

@raginrayguns looking for people talking about capitalism and short-term profits on twitter gets a lot of hits but it's noteworthy that many of these conceptions of "short-term" range from 5 to 10-20 or even 50 years, and just mean "not sustainable indefinitely" or "cause long-term damage", they are not literally talking about the figures for the next quarter.

[bumpkinspice0]

Parallels Chapter 7

Miguel O'Hara x Spider!FemReader

No use of y/n

Rating: Explicit (Minors DNI!!!)

Word Count: 3796

Summary: Miguel and your agreement is going well... really well. You feel like you have control of your life again, but Jess has a favor to ask you.

Warnings: SMUT (Oral- fem receiving, office sex) angst, pining, mentions of grief from a past death, reader is doing her best to be a mentor, I don't know how super villain insurance fraud works

Previous Next

Series Masterlist

AO3

_______________

Chapter 7

Friends and Benefits

It’s funny how you don’t realize how much a seemingly small thing affects you in your day-to-day life. A minor annoyance snowballs into the thing that keeps you awake at night, which snowballs into missing work which… well you get the idea. A domino effect. A constant never ending merry-go-round of frustration. That’s what your spider-sense was to you. Nothing but another distraction. Now you’d call it… manageable.

It was being managed.

It’d been over a month since you’d come to an agreement with Miguel. A mutually beneficial, totally platonic agreement. Call it whatever you wanted, it was incredible. The difference it made was practically night and day. It used to rule your headspace. Your anxieties and your doubts— it was exhausting. You see that now. 

Now that you had an answer and a temporary solution you were back on top of it all again. Missions, protecting your neighborhoods, hell you were even meeting your deadlines at work for the first time in months. All because you just needed to bone Miguel O’Hara on the regular. Not entirely a bad deal, all things considered.

He’d fucked you against every surface in his lab by now. You’d had the entire room mapped out and memorized. You used to be certain this lab was his living quarters, but you’d since completely abandoned that theory. You never once saw a bed, or a kitchen, or really anything homey. You wondered if you’d ever see his real home— if he’d let you into his life in that way. In a lot of ways he still treated you like a work colleague. Probably best if this wasn’t going to be a permanent thing.

There was a set of rules, of course. There always was with Miguel.

One, don’t talk about this with anyone. Like he even had to ask. You didn’t want to be viewed differently for fucking the boss, and he didn’t want to look like he was taking advantage of you. Lyla had your secret under lock and key. Admittedly you’d found some solace in talking to her about it once or twice. 

Second, call in advance. It was a looser rule but it helped. No more sneaking up to the other or a surprise in some crowded meeting. Just a good ol’ booty call when you wanted it. 

Third, this was exclusive. No other partners. Fine by you— Not that you had much luck in that field anyway. 

And fourth, no staying the night. It was more for interdimensional safety reasons than anything. That and you both didn’t want this to turn into more than it was— A deal. There wasn’t a repeat of the first night he came to your apartment. As time went on you realized how much of a mistake that might have been. You both lingered a little bit after sex, if only out of force of habit. Hands roaming, taking a moment to gather yourselves and appreciate the moment, you were still human after all. Other than that, it was all quick and dirty. 

You were fuck buddies now, for lack of a better term.

He’d only been to your place only once or twice. The tower just worked better, if only for convenience's sake. You were both always there. Being in the same building just made the sense stir up anyway.

Stacking up to hours of time alone pleasuring the other, you’d started to learn each other's bodies intimately— and their desires. It came so instinctually with him. You’d always thought yourself a decent sexual partner. Willing and always eager, but this— this was something else. It brought out things you never thought you had. Your harmonic connection led to the best orgasms of your life, and you barely had to say a word for him to get you there.

Your mouth had memorized the curves of his body, the slopes of his stern face. His tongue had traced over nearly every part of your being twice over. You think he liked leaving marks behind. Evidence that he was there. Your skin was a minefield of little red and purple marks.

He absolutely reveled in your pleasure, you noticed. Watching you fall to pieces so he could put them back together every time. He was not a selfish lover. He never just received without giving back— or just giving you all.

There was one time that stood out to you. The first time he came to your apartment after the agreement. It was maybe 2 weeks in? He didn’t call. You were fast asleep so you didn’t hear him come in. You woke up and he was just… there— The spider-sense screaming in your head. 

Any normal person would be terrified. A giant man with piercing red eyes looming next to your bed in the dead of night— the perfect opening to a cheesy thriller novel. He said nothing, his hands dragging the blanket off your naked body. He caressed the soft flesh of your thigh, silently asking permission. 

He went down on you as soon as you nodded, hiking your legs over his shoulders in a frenzy. He devoured you like a starved man, bringing you to climax in a meager handful of minutes— but he didn’t stop. He lavished and suckled at you so needily, your mind glossed over in a fog of overstimulated bliss. If someone had asked your name at that moment, you’re positive you couldn’t have answered. 

“Hold still for me, little spider.” He repeatedly told you. His hand pinned you down, steadying your writhing, burning-hot body under him.

Wave after wave of pleasure washes over you as he wantonly consumed you. You lose track of time. You lose track of your orgasms— His eager mouth permanently between your legs for what felt like days.

It’s not until you’re completely exhausted from the constant tension in your muscle that he stops. His face dripped in your multiple releases, his breaths were heaving and deep. His hands soothingly stroked your shaking, useless legs.

The spider-sense lulled in your head, pleased and urging you both the rest. You wished he’d stay the night. Just this once. The longing in his eyes told you some small part of him wanted to— maybe. Or you were just reading too far into something that wasn’t there. If he wouldn’t stay for you then he at least could for himself. He looked exhausted in the best way. 

“ Hasta pronto, añarita, ” He placed a final kiss on your knee before backing away into the portal home. You sat awake until you could no longer feel him lingering somewhere in space and time.

Yeah— Miguel liked to give.

Miguel also liked to have control— Like he did right now. He had you pinned against the wall in a private meeting room. Your legs wrapped around his waist as he held you there for him. You didn’t have to even fully undress anymore. The week before he’d gifted you a suit made of the same nanotech his was. It looked exactly the same as your regular one, it was incredible. Before you could say thank you, he’d ripped your old fabric suit off in a single stroke.

He cages himself around you, bouncing you up and down on his cock. He growls into your neck as he fucks up into you. You both come with a shaky gasp. He puts you down gently, backing away to lean on the nearby meeting table. His suit phases back over his bare skin. Yours does the same.

“Where have you been?” He asks, slicking back his messy hair. You hadn’t been to the tower in almost five days. Not that abnormal for most spiders but you’d been there nearly every other day for the past month. 

“The Fisk Family,” you answer. “Crime lords back home. They’re orchestrating a bank-robbing spree across the city on their own facilities tryna get a bailout on top of the billions they already have. Long nights investigating, pursuing, and coming up with nothing. Caught a break in the case last night.”

Everyone could see through their little masquerade, but they had half the city in their pocket. Pay the right people and you could get away with anything. You’d been trying to take them down for years, but they were careful. Their actions this past week were sloppy though. Desperate. You got a tip on which location they were going to hit tonight. This could be your big break.

“You’ll get ‘em, little spider. Don’t be too long next time, though,” He stands up to his full height, dwarfing you entirely. You're not sure you’ll ever get used to just how big he was. He gently lifts your chin between his thumb and index finger, “Five days was too long. Call me next time.”

You wholeheartedly agree but can’t seem to bring yourself to say it. You could have used a few hours with Miguel after the frustrating night you’d been having. He chuckles lightly at your flushness and turns for the door.

“Oh,” He pauses in the doorway, “Jess said she was looking for you.

“What does Jess want?”

He shrugs, “You’ll have to go ask her.”

__________

“Absolutely not.” You blurt. 

Jess is clearly taken aback by your immediate bluntness to the question, “Oh really?”

“Really,” you stand your ground, “I wouldn’t be much of a mentor.”

“I don’t think you’re giving yourself much credit.” She scoffs. “Ten years of experience under your belt and a city that adores you, that’s gotta count for something.”

You— a teacher? You were barely a functioning adult.

“I don’t know how to teach someone that.”

“You don’t have to teach anything. You just… lead by example. Be a role model.” She rubs the back of his head, gaze dropping to the floor, “Look, the kid doesn’t have many places to go. Her name’s Gwen. She can’t go home and she can’t stay in any dimension too long, as per the rules. She needs her community and I can’t be the only one holding her up. I want her to get involved. To feel comfortable here.”

Okay, well you can’t argue with that. You already feel sorry for the kid, honestly. If you couldn’t be a mentor then you could at least be a couch to crash on. Jess took her under her wing about a week ago. She was just trying to get her acclimated to this place’s dynamic.

“Plus,” Jess pats her rounded pregnant tummy, “I could use the help.”

“Oh, so now you’re using the pregnancy card?”

“If it gets results, yes.”

Jess had been adamant about not being treated differently once she announced her pregnancy a few months ago. She only started to show in the last month or two and it was so obvious how people's attitudes shifted around her. Treating her like she was made of glass or taking her off team missions. She absolutely hated it. Yes, she deeply wanted to be a mother, but that didn’t mean could just stop being Spider-Woman while the multiverse was in shambles.

She wasn’t remotely planning on taking a break through her pregnancy, it just simply wasn’t in her nature. She might take a more passive, behind-the-scenes role but she wouldn’t just flat-out quit. She worked constantly . She liked it that way. She was a superhero and soon-to-be kick-ass mom— And now a mentor. A mentor asking for a little help. Jess never asked for help.

“Okay, fine,” you sigh into your palm, “Send her over to my place in an hour. We’re stopping a bank heist… and hopefully an entire crime family.”

__________

Okay, you take back every sour thought you had about this whole mentor thing. Gwen was fucking awesome— You owe her every favor ever until the end of time. You should work on these kinds of cases with a partner more often. It made everything infinitely easier. 

Your tip was right, they targeted the bank on 9th and 42nd. Before you’d just sat in anticipation, waiting for an alarm to go off and pray that you made it there in time. There was no pattern to their robbery spree. They had dozens of locations around the city and any one of them could be next. This time, you finally had them.

You stationed Gwen as a lookout on the outside of the building while you lay in wait inside. The only problem was, no one ever came inside the bank that night. 

“Um, boss?” Gwen warned you through the comm link, “I think we’ve got some trouble out here.”

Of course this would happen when you’re stuck babysitting.

Turns out they planned to take the safe…quite literally.

The bank's safe was positioned in the very corner of the building, with only a single layer of brick separating it from the outside world. The fuckers hooked it up with tow cables to a military-grade truck, shot them through the wall, and just… started to drive off with it. They just took the whole fucking thing without breaking in. You’re not surprised Gwen didn’t act right away being she couldn’t even tell what they were doing. You told her not to intervene unless absolutely necessary. You could account for a lot of weird things happening in this job, tonight an entire goddamn safe being ripped out of the entire goddamn building and being driven down the street like a boating tube was not one of them.

Guess they wanted to add property damage to their growing list of insurance fraud.

Gwen pursued while you scrambled to get out of the building. They were moving fast despite dragging a multi-ton safe behind them. Still, Gwen managed to web up their wheels and bring them to a screeching halt. You got there just in time to disarm them and stop the driver from escaping. Richard Fisk, son of Wilson Fisk. Son of the Kingpin, getting his hand dirty personally. Oh, it was all over now. There was no hiding their two-faced plans with him at the scene.

And you couldn’t have done it without Gwen. 

You thanked her profusely, to the point she was clearly getting annoyed. How else can you tell someone how grateful you are they just helped topple a massive secret criminal syndicate you’d been going after for nearly a decade? You settle on taking her out for breakfast and lunch the next day. It was a start.

A strange apprehension about it all had been stirring in your stomach since that morning. The culmination of the excitement last night and having a younger spider around you think. You have no idea if you’re doing any of this right.

She reminded you so much of your sister Jacy. It was both amazing and a little painful— to feel like you had a sister again. You missed her so much. Just another reason why your emotions were running so high. More unresolved shit about your past. 

Even so, you were happy to have Gwen here. 

Gwen was a good kid. She was young and eager to learn. Excited to just be a part of something. It’s exactly how you felt when you joined a few months ago. She was bubbly and quick with a joke. It was a refreshing change of pace from the broody spider partner you were usually stuck around these days. 

Fun would probably be the right word to describe her. Yeah, she was fun. You could use some more fun in your life.

You’d planned on having her stay the full 48-hour limit, no reason not to. She’d been here roughly 24 so you still had a whole day to fill— Well, a whole night mostly. You both just finished the first evening’s patrol and decided to take a minute to watch the sunset from the top of the Brooklyn Bridge. Views like this were one of your favorite parts of this whole spider thing. 

“We should just go back out,” Gwen sighs, leaning back against the brick ledge. Well, guess she was already over the stunning view, “We’re bound to find something if we do.”

“We took care of everything on patrol so now we wait and listen for anything else.” You correct her, turning up the police scanner frequency in your ear, “Be patient. Take a breather, young grasshopper. It’s New York, more crime will take like, what… Five seconds to happen.”

“Or I could go scout ahead and you wait here!” She counters.

“And let people know there’s two Spider-Women in the city and risk the fabric of reality. No way.” You playfully pull her hood over her face, “You stay my shadow. My ghostwriter.”

“I think you mean Ghost-Spider ,” she pushes her hood off. Ghost-Spider. You liked the sound of that. “I just wanna get back out there.”

“You’ve been out there nearly the entire time you’ve been here.” It was true. Almost all her time in your dimension you’d been doing non-stop hero work. A few breaks to eat and sleep then, back at it. She was antsy. She was eager— and she was trying to distract herself. 

Jess let you know the details. She was only 16. She had to leave her home, leave her entire life behind because her father was too scared to face the reality that his daughter was his self-proclaimed mortal enemy. A rough start into spider society, to say the least.

She should be in school. She should be worried about college and what to wear to prom and planning a future. God, even you still got to be a teenager after you became the spider. 

Now being the spider was all she had left. So, she drowned herself in it. It wasn’t healthy— but you can’t say you haven’t done the same.

You tried to bury yourself in spider-work when this whole thing with Miguel started. You tried to bury yourself in spider-work when you lost your sister— your parents. Whenever your real life started to crumble around you, running away to your alter-ego was just so easy. To go somewhere where you just didn’t have to be you for a while. Yeah, it was addicting to hide away in the shadow of the spider. 

Gwen was hardworking, spunky, and too smart for her own good— But also so hungry for approval. So eager to show everyone what she could do, even if it was to her own detriment. Just even more ways she was like Jacey. You didn’t want her to fall down the same path your sister did. 

Gwen didn’t need more hero duties. You weren’t much of a mentor, but you could at least be a friend.

“Hey,” you nudge her elbow again, “Race you to the top of The Empire. Last one there has to get the other boba.”

“Oh, you’re on.”

__________

It turned out to be a quiet night. Your constant work since Gwen got here probably had something to do with that. Everything that came over the scanner was minor or something the police were more equipped to handle. No super villains and no interdimensional travelers. You do a final small patrol around midnight before deciding to head back home, picking up the greasiest pizza you could find along the way.

Despite Gwen’s protests, her constant action was catching up to her. She was practically falling asleep through every swing. Luckily you made it home unscathed. A few artery-clogging slices over some idle chatter and a shower, and she was down for the count. Good. She needed it.

You let her have the bed tonight, setting yourself up on the couch downstairs. She’d probably wake you up at the ass crack of dawn to do another goddamn patrol before work. Maybe you could convince her to just wear your suit and do the job. You could use a day off from being Spider-Woman. It was tempting. Were there any rules that said she couldn’t?

The adrenaline is still buzzing in your head when you lay down, you’re afraid you won’t be able to fall asleep. It was a long day. An emotional day— for you at least. Still, a very good day, regardless. 

Your thoughts wander to Miguel, as they often tend to at this time of night. Probably still working tirelessly in his lab or hunting down the latest massive anomaly by himself. You wondered if he considered you a friend. An actual friend. You’re not sure if you consider him one. Friends with benefits, sure of course— but someone you could just drop in on and chat with? 

You’d known Gwen barely a day and you feel like you could tell her your entire life story. You’d known Miguel in the most intimate of ways for months and you didn’t even know his favorite color. His middle name? Where he was from?

What do you actually know about Miguel O’Hara? You start to compile a list in your head. 

6’9. Stubborn. Devilishly handsome. Can’t take a joke. Constantly working— okay, but what do you know about him that isn’t obvious? The things only you get to see that no one else does. 

He cares deeply about everyone but hides it behind a snarl. You don’t think he likes having to be a leader. He’s lonely. It’s so obvious in the way he touches you. He hasn’t had contact like this in a long time. He hasn’t had anyone to cherish because he feels like he has to constantly push everyone away. He thinks he’s a bad man so he’s constantly trying to make up for it. He wanted a family so badly— He wanted someone to love him back so badly. Miguel… was heartbreaking. 

Even behind all of the brutish facade, you saw the man there. A man just as scared and confused as the rest of you. A man that could use a genuine friend.

Maybe you should ask his favorite color next time you see him.

You’re just on the cusp of sleep when a familiar yellow light pulls you from your drowsiness. Lyla hovers in your living room, projecting from your watch on the coffee table. 

“Lyla?” You ask, rubbing at your eyes.

“You need to come to the tower right away. It’s an emergency,” There’s none of the usual bubbliness in her voice. Her face was stone serious.

You sit up, suddenly feeling a pit drop in your stomach. “What’s going on?”

She looks away for a moment, worry painted over her pixelated features, “Miguel’s been missing for over 18 hours and I think you’re the only one that can find him.” ______________________

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[jackalgirl]

“Women are not some piece of collectively owned community property the disposition of which is decided by majority vote,” [Judge Robert McBurney, who just overturned Georgia's abortion ban] wrote. “Forcing a woman to carry an unwanted, not-yet-viable fetus to term violates her constitutional rights to liberty and privacy, even taking into consideration whatever bundle of rights the not-yet-viable fetus may have.” Judge McBurney wrote that “it is not for a legislator, a judge, or a Commander from The Handmaid’s Tale to tell these women what to do with their bodies during this period when the fetus cannot survive outside the womb any more so than society could — or should — force them to serve as a human tissue bank or to give up a kidney for the benefit of another”.

Just what I've been saying with respect to bodily autonomy. You should not be allowed force a person to unwillingly provide service to another (body, mind, or spirit). If the state can't call you up and force you to give up a kidney to save someone else's life (and I hope you have good insurance, because you'll be responsible for the cost), they shouldn't be able to force you to be unwillingly pregnant.

If this bothers you, unfollow me. When we live in a world where women (and other people who can be pregnant) can say "no" and that wish be respected and honored, then we can talk. But not before then.