transdudebro

[transdudebro]

So today I want to talk about puberty blockers for transgender kids, because despite being cisgender, this is a subject I’m actually well-versed in. Specifically, I want to talk about how far backwards things have gone.

This story starts almost 20 years ago, and it’s kind of long, but I think it’s important to give you the full history. At the time, I was working as an administrative assistant for a pediatric endocrinologist in a red state. Not a deep deep red state like Alabama, we had a little bit of a purple trend, but still very much red. (I don’t want to say the state at the risk of doxxing myself.) And I took a phone call from a woman who said, “My son is transgender. Does your doctor do hormone therapy?”

I said, “Good question! Let me find out.”

I went into the back and found the doctor playing Solitaire on his computer and said, “Do you do hormone therapy for transgender kids?” It had literally never come up before. He had opened his practice there in the early 2000s. This was roughly 2006, and the first time someone asked. Without looking up from his game of Solitaire, the doctor said, “I’ve never done it before, but I know how it works, so sure.”

I got back on the phone and told the mom, who was overjoyed, and scheduled an appointment for her son. He was the first transgender child we treated with puberty blockers. But not, by far, the first child we treated with puberty blockers, period. Because puberty blockers are used very commonly for children with precocious puberty (early-onset puberty). I would say about twenty percent of the kids our doctor treated were for precocious puberty and were on puberty blockers. They have been well studied and are widely used, safe, and effective.

Well. It turned out, the doctor I worked for was the only doctor in the state who was willing to do this. And word spread pretty fast in the tight-knit community of ‘parents of transgender children in a red state’. We started seeing more kids. A better drug came out. We saw some kids who were at the age where they were past puberty, and prescribed them estrogen or testosterone. Our doctor became, I’m fairly sure, a small folk hero to this community. 

Insurance coverage was a struggle. I remember copying articles and pages out of the Endocrine Society Manual to submit with prior authorization requests for the medications. Insurance coverage was a struggle for a lot of what we did, though. Growth hormone for kids with severe idiopathic short stature. Insulin pumps, which weren’t as common at the time, and then continuous glucose monitoring, when that came out. Insurance struggles were just part and parcel of the job.

I remember vividly when CVS Caremark, a pharmaceutical management company, changed their criteria and included gender dysphoria as a covered diagnosis for puberty blockers. I thought they had put the option on the questionnaire to trigger an automatic denial. But no - it triggered an approval. Medicaid started to cover it. I got so good at getting approvals with my by then tidy packet of articles and documentation that I actually had people in other states calling me to see what I was submitting (the pharmaceutical rep gave them my number because they wanted more people on their drug, which, shady, but sure. He did ask me if it was okay first).

And here’s the key point of this story:

At no point, during any of this, did it ever even occur to any of us that we might have to worry about whether or not what we were doing was legal.

It just never even came up. It was the medically recommended treatment so we did it. And seeing what’s happening in the UK and certain states in America is both terrifying and genuinely shocking to me, as someone who did this for almost fifteen years, without ever even wondering about the legality of it.

The doctor retired some years ago, at which point there were two other doctors in the state who were willing to prescribe the medications for transgender kids. I truly think that he would still be working if nobody else had been willing to take those kids on as patients. He was, by the way, a white cisgender heterosexual Boomer. I remember when he was introduced to the concept of ‘genderfluid’ because one of our patients on HRT wanted to go off. He said ‘that’s so interesting!’ and immediately went to Google to learn more about it. 

I watched these kids transform. I saw them come into the office the first time, sometimes anxious and uncertain, sometimes sullen and angry. I saw them come in the subsequent times, once they were on hormone therapy, how they gradually became happy and confident in themselves. I saw the smiles on their faces when I gave them a gender marker letter for the DMV. I heard them cheer when I called to tell them I’d gotten HRT approved by insurance and we were calling in a prescription. It was honestly amazing and I will always consider the work I did in that red state with those kids to be something I am incredibly proud of. I was honored to be a part of it.

When I see all this transgender backlash, it’s horrifying, because it was well on the way to become standard and accepted treatment. Insurances started to cover it. Other doctors were learning to prescribe it. And now … it’s fucking illegal? Like what the actual fuck. We have gone so far backwards that it makes me want to cry. I don’t know how to stop this slide. But I wrote this so people would understand exactly how steep the slide is.

[transdudebro]

true gender liberation will never happen until the queer community can see masculinity as something which can be a real expression of self and which is worth protecting and loving

[transdudebro]

to every trans guy: when you tell other people you're trans you don' thave you say you're "unfortunately" a trans guy, or that you have bad news, or something else to that effect. you don't have to say that. you can be proud of being a trans man. you can even be neutral about it. you don't have to hate yourself for it. people want you to, but it doesn't help anyone. its not unfortunate, it's a blessing.

[transdudebro]

On this Trans Day of Remembrance, please spare a moment to mourn trans people who died in the closet.

People who were misgendered in their eulogies.

People whose lives were cut short before they could bloom.

People whose secret clothes will be thrown out.

People who couldn't survive the oppressive forces of transphobia.

People who took their own lives because the suffering of the closet was too much for them to bear.

People who were forced from their homes or their jobs because of their genders and died on the streets, or in poverty, socially murdered.

People who could've lived if they had a safe, welcoming community.

People whose identities were disrespected, mocked, and hated both in life and in death.

People who died on a waiting list.

People who died before they could get on a waiting list.

People who were denied the opportunity to express themselves, to live as themselves.

People whose graves are desecrated with a deadname.

If you're out and reading this: Help your sisters, brothers, and siblings in the closet. Listen to them when they ask for your aid. Reach out to them. Buy them clothes. Send them money. Tell them things about your own transition. More than anyone else, closeted trans people need community and support.

Mourn the dead, fight like hell for the living.

[transdudebro]

Senators are going to vote on whether or not we should continue to send aid to Israel on Wednesday, November 13th. Call them, bombard their phone lines with calls. Every fucking day. We have a chance of doing something about this.

[transdudebro]

i love you trans people in my phone i need you to stay alive trans people in my phone. i know it's a big ask, but there are so many people out there who do love you and will love you if you stick around. nothing is permanent. this feeling, this circumstance, will pass somehow, someday. i know it's scary. i know you're terrified. i'm terrified too. but please, as a trans man in your phone i am asking you (trans person in my phone) to also stay alive with me, okay? please, please choose to live trans people in my phone.

[transdudebro]

celebrating my 5 year top surgery anniversary today, so I wanted to draw something that reflects the bliss of feeling your chest for the first time. happy pride 🏳️‍⚧️⚧️💙🩷🤍

[transdudebro]

Trans allyship leaving y’all’s body the moment a trans man has a unique relationship with masculinity/manhood and doesn’t want to look like a cis man

[transdudebro]

i feel like people dont really acknowledge or appreciate how much patience transitioning takes

[transdudebro]

[transdudebro]

[transdudebro]

I don’t know what trans guy needs to hear this but please break up and cut off with that person trying to convince you not to transition. They don’t care about your happiness.

Go get that masculine hair cut. Change your wardrobe. Go on T. Get top and/or bottom surgery. Do what makes you happy, and don’t let anyone try to tell you their comfort matters more then your happiness.

[transdudebro]

I know I say this all the time, but I love you intersex people <3

I love intersex people who are traumatised and messy about it. I love intersex people who are still figuring out how to love their bodies. I love intersex people who are still unsure of how being intersex slots in with the rest of their identity. I love disabled intersex people who want to go remake the entire medical system. I love intersex people who are trying their best to fight for their intersex siblings

from one messy intersex person to another. wherever you might be around the world. I love you and I’m here for you

[transdudebro]

god forbid a trans man carry his baby and/or breastfeeds his baby

god forbid a trans man writes OCs or AUs including a trans man carrying his baby and/or breastfeeding his baby

seahorse dads (trans men who carry their babies) are absolutely wonderful and strong and deserve respect. non fetishy fictional depictions of this also deserves respect

so many queer people still treat this like its something weird, or it’s a fetish, and when u bring it up u get weird looks or “WHAAA MPREG!!??” type replies. shut the FUCK up!!!!

trans people like this exist in the world!!!! just because you think its weird (its not btw) and you think anything weird is automatically fetish material doesnt mean it actually is. LEAVE TRANS MEN THE FUCK ALONE!!!!!!!!!

[transdudebro]

Saw a post on Twitter that was like "I think it's entirely possible to be trans without dysphoria, but a lot of you are severely underestimating how much dysphoria you actually feel and how much you’ve let fade into background noise" and honestly? Yeah lol.