somedrunkpirate

[somedrunkpirate]

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.

[somedrunkpirate]

I love this so much <33 Thank you, its perfect.

“On the matter of touch,” Crowley begins, waving his teaspoon in what he hopes passes for idle curiosity. “Thoughts?”

For two ineffable husbands, they don't really touch each other much. Here is a story on why that might be.

Words: 9,030

Status: Complete

Rating: Teen And Up

@somedrunkpirate

[somedrunkpirate]

why did you people come up with russian names for what is supposed to be a movie set in italy. what was the thought process here. why does she sound like she walked out of a tolstoy novel

[somedrunkpirate]

you! the person reading this! please tell me one good thing that happened to you today

[somedrunkpirate]

I need to run a survey really quick. This isn't serious, but I need people to cooperate and not cheat for the sake of it because it'll skew the results.

Imagine you wake up tomorrow and you realize you (and everyone else in the world) can turn into an animal (And back into a human) at will.

Please go to this link to see what animal it will be for you:

(this is random, and yes, you only get one, no redos)

With this in mind, please reply to the following questions as truthfully as possible based on your current situation. (Not an ideal fantasy one.)

[somedrunkpirate]

im gonna put my humantities degree to good use and do some Textual Analysis TM at some point when I have time/am awake but tldr this is great art and I love it

I've been working on some fanart for one of my favourite Witcher fics, A Lover's Lament by @somedrunkpirate. It's 25k words of scary, beautiful and enthralling Geraskier fic, with one of the most original monster ideas I've ever read! So do check it out if you fancy a spooky bedtime story with a nice happy ending:

[somedrunkpirate]

THIS IS SO AWESOME!! Thank you so much!!! I am bragging to all my writer friends about it omg. like @theheirofashandfire LOOK I GOT FAN ART

I've been working on some fanart for one of my favourite Witcher fics, A Lover's Lament by @somedrunkpirate. It's 25k words of scary, beautiful and enthralling Geraskier fic, with one of the most original monster ideas I've ever read! So do check it out if you fancy a spooky bedtime story with a nice happy ending:

[somedrunkpirate]

i think it is unjust to deny a child their right to dig a hole motivelessly

[somedrunkpirate]

Avavav always has the most interesting concepts

[somedrunkpirate]

[somedrunkpirate]

A lot of people around me are having kids and every day it becomes more apparent that hitting your children to punish them is insane because literally everything can be a horrible punishment in their eyes if you frame it as such.

Like, one family makes their toddler sit on the stairs for three minutes when he hits his brother or whatever. The stairs are well lit and he can see his family the whole time, he’s just not allowed to get up and leave the stairs or the timer starts over. He fucking hates it just because it’s framed as a punishment.

Another family use a baseball cap. It’s just a plain blue cap with nothing on it. When their toddler needs discipline he gets a timeout on a chair and has to put the cap on. When they’re out and about he just has to wear the cap but it gets the same reaction. Nobody around them can tell he’s being punished because it’s in no way an embarrassing cap, but HE knows and just the threat of having to wear it is enough.

And there isn’t the same contempt afterwards I’ve seen with kids whose parents hit them. One time the kid swung a stick at my dog, his mother immediately made him sit on the stairs, he screamed but stayed put, then he came over to my dog and gently said “Sorry Ellie” and went back to playing like nothing happened, but this time without swinging sticks at the nearby animals.

[somedrunkpirate]

Sketches by A.K. MacDonald, 1932

[somedrunkpirate]

israeli youth burn their enlistment orders (via oren_ziv on instagram)

[somedrunkpirate]

[somedrunkpirate]

nothing frustrates me more than when adults refuse to even slightly indulge the questions and thoughts of children. i remember one time when one of my younger cousins accidentally stumbled across the concept of purchasing power parity because she realised 10 rupees which bought her 10 candies in India only bought her ~3 candies when we went on holiday to Japan, and when she asked her mother about “why the same things cost different amounts in different places” my aunt had the audacity to call her spoiled for not understanding the “”worth” of money, that’s not what she was ASKING damn it!! your daughter just set up her own big mac index and realised a key metric of macroeconomics!!! how do you not find that utterly fascinating !! why don’t adults talk to children !!

[somedrunkpirate]

Shoutout to the dedicated cheerleaders of wips who comment on each chapter and motivate the poor fic writer to keep going you are crucial to the ecosystem

[somedrunkpirate]

Surely, you think, this is an old post.

It's new as of December 2023! Congrats on your (checks notes) 14th breach, War Thunder!

Fucking incredible.