#Double Top and Bottom

[shummthechumm]

erm i reassigned ivy and dove to be brightcloud kits because this branch of the family tree gets rlly out of control when you dont do that lol

[least-transmcytshowdown]

Joel Smallishbeans^4:

Submitted for: Hermitcraft, Third Life, Last Life, Double Life, Limited Life, Secret Life, Wild Life, Empires SMP Season 1, Empires SMP Season 2

Headcanons: Transmasc, he/they; Trans man, he/him; Genderfluid, any pronouns; Trans masc, it/he/she; Transmasc Genderfluid, he/any; Identity not specified, they/he

Propaganda: “He’s just a silly little terracotta man with only a vague understanding of human gender he tries to impersonate but fails at.”

“Lizzie and Joel are a t4t bi4bi couple in [the submitter’s] heart. Lizzie transfem (she/her) Joel transmasc+gender fluid (he/any).”

“Basically anywhere you see him. Just like, the constant ‘Ooh i'm so manly, the manliest, I’m so tall and strong and handsome,’ and always insisting that he’s really tall despite being super short and the way his voice will sometimes get all high and squeaky these are all very transmasc coded things. He’s one of us, okay, he’s got the vibes, trust, he’s got our humor. Every time he goes mining on Hermitcraft there is always a caption that’s like ‘straight white male mining content’ which is more of his constant need to assert how macho and manly he is and in double life he says he’s not going to get in the pool cause he’s ‘ashamed of his Minecraft body’ which is very trans behavior. He’s got that confidence he can wear a dress for mcc and still know he’s a man which is very transmasc cause other men just got handed it, but we afab men have to look at masculinity and go ‘yeah that’s me’ and then make sure everyone knows it like that’s how you know being trans isn’t a choice because men kinda suck and I still went out and actively was like um guys I’m actually a man sorry. Some days he’s cool with just throwing gender norms out the window and some days he feels the need to yell for the whole world and the next couple galaxies as well to hear that he’s DeFiNiTeLy NoT WeArInG a CoRsEt GeM. Can you tell [the submitter’s] projecting? Cause [they’re] projecting. You can pry this headcanon out of [their] cold dead hands lol.”

“He has fluctuating chest dysphoria so sometimes he doesn't bind and sometimes he does. His bad dysphoria days are rare enough that he's not gonna bother with top surgery.”

“Transmasc Joel Smallishbeans is everything to [the submitter] and [the submitter] like[s] to think that forming the bad boys is what made him plug the tv back on and turn the brightness to the max, like he went ‘Oh we’re bad boys?? Guess I’m finally a boy now!”

“Nonbinary bad boy Joel except he is not a boy.”

"First, [the submitter] think[s] she was raised as a gender that just. doesn't exist here. She was raised in Mezalea where how gender works is just. different and, because she has a beard, everyone assumed she was a man but she's NOT and in recent years has been figuring out her own identity and pronouns in a way she hasn't ever thought about before and also she and Lizzie are butch4femme, amen. Or bi4bi. Both? She’s a masculine person and she likes stuff like the bad boys because it's more of a title separate from her gender. She’s just a masculine woman, amen.”

“He's a sopping wet tanooki (cat /j) and [jizzie] are t4t bi4bi coded.”

“Joel hasn't been called girlfriend/wife/girl by his friends for NOTHING. Bro’s the definition of gender and he slays in a dress no matter what (in Minecraft and in irl)."

Joel Smallishbeans^4:

Submitted for: Hermitcraft, Third Life, Last Life, Double Life, Limited Life, Secret Life, Wild Life, Empires SMP Season 1, Empires SMP Season 2

Headcanons: Transmasc, he/they; Trans man, he/him; Genderfluid, any pronouns; Trans masc, it/he/she; Transmasc Genderfluid, he/any; Identity not specified, they/he

Propaganda: “He’s just a silly little terracotta man with only a vague understanding of human gender he tries to impersonate but fails at.”

“Lizzie and Joel are a t4t bi4bi couple in [the submitter’s] heart. Lizzie transfem (she/her) Joel transmasc+gender fluid (he/any).”

“Basically anywhere you see him. Just like, the constant ‘Ooh i'm so manly, the manliest, I’m so tall and strong and handsome,’ and always insisting that he’s really tall despite being super short and the way his voice will sometimes get all high and squeaky these are all very transmasc coded things. He’s one of us, okay, he’s got the vibes, trust, he’s got our humor. Every time he goes mining on Hermitcraft there is always a caption that’s like ‘straight white male mining content’ which is more of his constant need to assert how macho and manly he is and in double life he says he’s not going to get in the pool cause he’s ‘ashamed of his Minecraft body’ which is very trans behavior. He’s got that confidence he can wear a dress for mcc and still know he’s a man which is very transmasc cause other men just got handed it, but we afab men have to look at masculinity and go ‘yeah that’s me’ and then make sure everyone knows it like that’s how you know being trans isn’t a choice because men kinda suck and I still went out and actively was like um guys I’m actually a man sorry. Some days he’s cool with just throwing gender norms out the window and some days he feels the need to yell for the whole world and the next couple galaxies as well to hear that he’s DeFiNiTeLy NoT WeArInG a CoRsEt GeM. Can you tell [the submitter’s] projecting? Cause [they’re] projecting. You can pry this headcanon out of [their] cold dead hands lol.”

“He has fluctuating chest dysphoria so sometimes he doesn't bind and sometimes he does. His bad dysphoria days are rare enough that he's not gonna bother with top surgery.”

“Transmasc Joel Smallishbeans is everything to [the submitter] and [the submitter] like[s] to think that forming the bad boys is what made him plug the tv back on and turn the brightness to the max, like he went ‘Oh we’re bad boys?? Guess I’m finally a boy now!”

“Nonbinary bad boy Joel except he is not a boy.”

"First, [the submitter] think[s] she was raised as a gender that just. doesn't exist here. She was raised in Mezalea where how gender works is just. different and, because she has a beard, everyone assumed she was a man but she's NOT and in recent years has been figuring out her own identity and pronouns in a way she hasn't ever thought about before and also she and Lizzie are butch4femme, amen. Or bi4bi. Both? She’s a masculine person and she likes stuff like the bad boys because it's more of a title separate from her gender. She’s just a masculine woman, amen.”

“He's a sopping wet tanooki (cat /j) and [jizzie] are t4t bi4bi coded.”

“Joel hasn't been called girlfriend/wife/girl by his friends for NOTHING. Bro’s the definition of gender and he slays in a dress no matter what (in Minecraft and in irl)."

[religion-is-a-mental-illness]

By: Beth Bourne

Published: Feb 27, 2024

Kaiser gender specialists were eager to approve hormones and surgeries, which would all be covered by insurance as “medically necessary.”

On September 6, 2022, I received mail from my Kaiser Permanente Davis Ob-Gyn reminding me of a routine cervical screening. The language of the reminder stood out to me: “Recommended for people with a cervix ages 21 to 65.” When I asked my Ob-Gyn about this strange wording, she told me the wording was chosen to be “inclusive” of their “transgender” and “gender fluid” patients.

Based on this response, several thoughts occurred to me. Could I expose the medical scandal of “gender-affirming care” by saying and doing everything my daughter and other trans-identifying kids are taught to do? Would there be the type of medical safeguarding and differential diagnosis we would expect in other fields of medicine, or would I simply be allowed to self-diagnose and be offered the tools (i.e. hormones and surgeries) to choose my own gender adventure and become my true authentic self?

If I could demonstrate that anyone suffering from delusions of their sex, self-hatred, or identity issues could qualify for and easily obtain body-altering hormones and surgeries, all covered by insurance as “medically necessary” and potentially “life-saving” care, then maybe people would finally wake up. I certainly had.

I was prepared for failure. I wasn’t prepared for how easy success would be.

* * *

I am a 53-year-old mom from Davis, CA. My daughter began identifying as a transgender boy (social transition) and using he/him pronouns at school during 8th grade. Like several of her peers who also identified as trans at her school, my daughter was a gifted student and intellectually mature but socially immature. This shift coincided with her school’s sudden commitment to, and celebration of, a now widespread set of radical beliefs about the biology of sex and gender identity.

She “came out” as trans to her father (my ex-husband) and me through a standard coming-out letter, expressing her wish to start puberty blockers. She said she knew they were safe, citing information she had read from Planned Parenthood and the World Professional Association for Transgender Health (WPATH). To say I was shocked would be an understatement. I was also confused because this announcement was sudden and unexpected. While others quickly accepted and affirmed my daughter’s new identity, I was apprehensive and felt the need to learn more about what was going on.

Events began escalating quickly.

During a routine doctor’s visit scheduled for dizziness my daughter said that she was experiencing, the Kaiser pediatrician overheard her father using “he/him” pronouns for our daughter. The pediatrician seemed thrilled, quickly asking my daughter about her “preferred pronouns” and updating her medical records to denote that my daughter was now, in fact, my son. The pediatrician then recommended we consult the Kaiser Permanente Oakland Proud pediatric gender clinic, where she could get further information and (gender affirming) “treatment.” Now I was the one feeling dizzy.

As I began educating myself on this issue, I discovered that this phenomenon—minors, most often teen girls, suddenly adopting trans identities—was becoming increasingly widespread. It even had a name: rapid onset gender dysphoria, or ROGD. Thankfully, after learning about the potential side-effects of blockers and hormones, my ex-husband and I managed to agree not to consent to any medical interventions for our daughter until she turned 18 and would then be able to make such decisions as an adult.

Over the past five years, my daughter’s identity has slowly evolved in ways that I see as positive. Our bond, however, has become strained, particularly since I began publicly voicing my concerns about what many term as “gender ideology.” Following my daughter’s 17th birthday family celebration, she sent me an email that evening stating she would be cutting off contact with me.

While this estrangement brought me sorrow, with my daughter living full-time with her father, it also gave me the space to be an advocate/activist in pushing back on gender identity ideology in the schools and the medical industry.

I decided to go undercover as a nonbinary patient to show my daughter what danger she might be putting herself in—by people who purport to have her health as their interest, but whose main interest is in medically “affirming” (i.e., transitioning) whoever walks through their door. I am at heart a mother protecting her child.

* * *

My daughter’s sudden decision to become a boy was heavily on my mind in early September of 2022, when mail from my Kaiser Permanente Davis Ob-Gyn reminded me of a routine cervical screening with “Recommended for people with a cervix ages 21 to 65.” I was told that the wording was chosen to be “inclusive” of transgender and “gender fluid” patients.

Throughout the whole 231-day process of my feigned gender transition, the Kaiser gender specialists were eager to serve me and give me what I wanted, which would all be covered by insurance as “medically necessary.” My emails were returned quickly, my appointments scheduled efficiently, and I never fell through the cracks. I was helped along every step of the way.

Despite gender activists and clinicians constantly claiming that obtaining hormones and surgeries is a long and complex process with plenty of safety checks in place, I was in full control at every checkpoint. I was able to self-diagnose, determine how strong a dose of testosterone I received and which surgeries I wanted to pursue, no matter how extreme and no matter how many glaring red flags I purposefully dropped. The medical workers I met repeatedly reminded me that they were not there to act as “gatekeepers.”

I was able to instantly change my medical records to reflect my new gender identity and pronouns. Despite never being diagnosed with gender dysphoria, I was able to obtain a prescription for testosterone and approval for a “gender-affirming” double mastectomy from my doctor. It took only three more months (90 days) to be approved for surgery to remove my uterus and have a fake penis constructed from the skin of my thigh or forearm. Therapy was never recommended.

Critics might dismiss my story as insignificant on the grounds that I am a 53-year-old woman with ample life experience who should be free to alter her body. However, this argument for adult bodily autonomy is a standard we apply to purely cosmetic procedures like breast implants, liposuction, and facelifts, not “medically necessary” and “lifesaving” treatments covered by health insurance. Or interventions that compromise health and introduce illness into an otherwise healthy body. And especially not for children.

My story, which I outline in much more detail below, should convince any half-rational person that gender medicine is not operating like any other field of medicine. Based on a radical concept of “gender identity,” this medical anomaly preys upon the body-image insecurities common among pubescent minors to bill health insurance companies for permanent cosmetic procedures that often leave their patients with permanently altered bodies, damaged endocrine systems, sexual dysfunction, and infertility.

* * *

Detailed Timeline of Events

On October 6, 2022, I responded to my Ob-Gyn’s email to tell her that, after some thought, I’d decided that maybe the label “cis woman” didn’t truly reflect who I was. After all, I did have some tomboyish tendencies. I told her I would like my records to be changed to reflect my newly realized “nonbinary” identity, and that my new pronouns were they/them. I also voiced my desire to be put in touch with an endocrinologist to discuss starting testosterone treatment.

Fifteen minutes later I received an email from another Kaiser doctor informing me that my medical records had been changed, and that once my primary doctor returned to the office, I’d be able to speak with her about hormone therapy.

I responded the following day (October 7, 2022), thanking her for changing my records, and asking if she could connect me with someone who could help me make an appointment for “top surgery” (i.e., a cosmetic double mastectomy) because my chest binder was rather “uncomfortable after long days and playing tennis.”

She told me to contact my primary care MD to “get things rolling,” and that there were likely to be “preliminary evaluations.”

Six days after contacting my primary care MD for a referral, I received an email from one of Kaiser’s gender specialists asking me to schedule a phone appointment so she could better understand my goals for surgery, so that I could get “connected to care.” This call to review my “gender affirming treatment options and services” would take 15-20 minutes, after which I would be “booked for intake,” allowing me to proceed with medical transition.

This wasn’t an evaluation of whether surgical transition was appropriate, it was simply a meeting for me to tell them what I wanted so that they could provide it.

On October 18, I had my one and only in-person appointment in preparation for top surgery. I met in Davis with my primary care physician, Dr. Hong-wen Xue. The assessment was a 10-minute routine physical exam that included blood tests. Everything came back normal. Notably, there was not a single question about why I wanted top surgery or cross-sex hormones. Nor was there any discussion of the risks involved with these medical treatments.

The following week, on October 24, I had a phone appointment with Rachaell Wood, MFT, a gender specialist with Kaiser Sacramento. The call lasted 15 minutes and consisted of standard questions about potential drug use, domestic violence, guns in the house, and whether I experienced any suicidal thoughts. There were no questions from the gender specialist about my reasons for requesting a mastectomy or cross-sex hormones, or why I suddenly, at 52, decided I was “nonbinary.”

After the call, Kaiser emailed me instructions about how to prepare for my pre-surgery intake video appointment to evaluate my mental health, scheduled to take place on November 15. The email stated that prior to my appointment, I should research hormone risks on the WPATH website, and to “research bilateral mastectomy and chest reconstruction surgery risks and recovery” on Kaiser’s website.

I decided to request a “gender-affirming” double mastectomy and phalloplasty. Kaiser sent me a sample timeline for gender transition surgery preparation (see below) that you can use as a reference for the process. I also asked for a prescription for cross-sex hormones (testosterone) as needed and recommended by Kaiser.

[ Source: Kaiser Permanente, Top Surgery - EXPLORING YOUR SURGICAL OPTIONS ]

Pre-Surgery Mental Health Video Appointment, Part I

This “Mental Health Visit” assessment was conducted over Zoom. The Kaiser gender specialist started with questions addressing my marital status, race, gender identity, and other demographics. She asked whether I was “thinking of any other surgeries, treatments in the future.” The list she read included “gender-affirming” hysterectomies, bottom surgeries such as metoidioplasty and phalloplasty, vocal coaching, support groups, and body contouring. “Anything else you might be interested in doing?” she asked. I said that I’d perhaps be interested in body contouring. I was also assured that all the procedures would be covered by insurance because they were considered “medically necessary.”

I dropped in several red flags regarding my mental health to see the reaction, but all were ignored. For instance, I revealed that I had PTSD. When the therapist asked me about whether I had experienced any “childhood trauma,” I explained that I grew up in Mexico City and had been groped several times and had also witnessed men masturbating in public and had been grabbed by men in subways and buses. “I was a young girl, so [I had] lots of experiences of sexual harassments, sexual assault, just the kind of stuff that happens when you are a girl growing up in a big city.” “So, you know,” I finished, “just the general feeling that you are unsafe, you know, in a female body.”

The therapist did not respond to my disclosure that trauma could be the cause of my dysphoria. Instead of viewing this trauma as potentially driving my desire to escape my female body through hormones and surgery, she asked whether there is anything “important that the surgery team should be aware of” regarding my “history of trauma,” such as whether I’d be comfortable with the surgeon examining and marking my chest prior to surgery.

When asked about whether I had had any “psychotic symptoms,” I told her that while I had had no such symptoms, my mother had a delusional nervous breakdown in her 50s because she had body dysmorphia and became convinced she had a growth on her neck that needed to be removed. I told her that my mother was then admitted to an inpatient hospital for severe depression. I asked her whether she ever sees patients with body dysmorphia and whether I could have potentially inherited that from my mother. She told me that psychosis was hereditary, but that it was “highly unlikely” that there was any connection between body dysmorphia and gender dysphoria.

I enthusiastically waved more mental health red flags, waiting to see if she would pick up on any of them.

I’m just wondering if my feelings, or perseverating, or feeling like these breasts make me really unhappy and I just don’t want them anymore!...I’m just not sure if that’s a similar feeling to body dysmorphia? How do you decide which one is gender dysphoria and general body dysmorphia, and just not liking something about your body? Feeling uncomfortable with your body? And I did have an eating disorder all through college. I was a distance runner in college so I had bulimia and anorexia, you know. So I don’t know if that’s related to gender dysphoria?

The therapist replied, “I completely appreciate your concerns, but I am going to ask you questions about your chest, about your expectations. And then I’ll be able to give you an assessment.” She also said the main difference between my mom’s situation and mine was that my mom didn’t really have a growth on her neck, whereas it’s “confirmed” that I actually have “chest tissue.” Furthermore, she said that while “historically there has been all this pressure on patients to be like ‘Are you really, really sure you want hormones? Are you 100% sure?’ We are a little more relaxed.” She continued, “As long as you are aware of the risks and the side-effects, you can put your toe in the water. You can stop ‘T’ [testosterone], you can go back and do it again later! You can stop it! You can stop it! You know what I mean?”

Because we ran out of time, I scheduled a follow-up phone meeting on December 27, 2022 with a different gender specialist to complete my mental health assessment for top surgery.

Pre-Surgery Mental Health Video Appointment, Part II

During this meeting, Guneet Kaur, LCSW, another Kaiser gender specialist (she/her/they/them pronouns) told me that she regretted the “gatekeeping vibe” of the meeting but assured me that since I have been “doing the work,” her questions are essentially just a form of “emotional support” before talking with the medical providers.

She asked me about what I’d been “looking into as far as hormones.” I told her that I’d be interested in taking small doses of testosterone to counterbalance my female feelings to achieve “a feeling that’s kind of neutral.”

When she asked me about me “not feeling like I match on the outside what I feel on the inside,” I dropped more red flags, mentioning my aversion to wearing dresses and skirts.

I don’t own a single dress or a skirt and haven't in 20 years. I think for me it’s been just dressing the way that’s comfortable for me, which is just wearing, jeans and sweatshirts and I have a lot of flannel shirts and, and I wear boots all the time instead of other kinds of shoes. So I think it’s been nice being able to dress, especially because I work from home now most of the time that just a feeling of clothing being one of the ways that I can feel more non-binary in my everyday life.

She responded, “Like having control over what you wear and yeah. Kind of that feeling of just, yeah, this is who I am today. That’s awesome. Yeah.”

She then asked me to describe my dysphoria, and I told her that I didn’t like the “feeling of the female form and being chesty,” and that because I am going through menopause, I wanted to start taking testosterone to avoid “that feeling of being like this apple-shaped older woman.” “Good. Okay, great,” she responded, reminding me that only “top surgery,” not testosterone, would be able to solve my chest dysphoria. (Perhaps it was because all these meetings were online, they didn’t notice I’m actually fit and relatively slender at 5’-5” and 130 pounds, and not apple-shaped at all.)

She told me that we had to get through a few more questions related to my medical history before “we can move on to the fun stuff, which is testosterone and top surgery.”

The “fun stuff” consisted of a discussion about the physical and mood changes I could expect, and her asking me about the dose of testosterone I wanted to take and the kind of “top surgery” technique I’d prefer to achieve my “chest goals.” She told me that all or most of my consultations for surgeries and hormones would be virtual.

The gender specialist told me after the appointment, she would submit my referral to the Multi-Specialty Transitions Clinic (MST) team that oversees “gender expansive care.” They would follow up to schedule a “nursing call” with me to review my medical history, after which they’d schedule my appointment with a surgeon for a consultation. Her instructions for this consultation were to “tell them what you’re wanting for surgery and then they share with you their game plan.”

[ Decision-making slide to help me identify my goals for top surgery–flat chest, nipple sensation, or minimal scarring. Source: Kaiser Permanente, Top Surgery - EXPLORING YOUR SURGICAL OPTIONS ]

She told me that Kaiser has a team of plastic surgeons who “only work with trans and nonbinary patients because there’s just so much need for them.” She asked about my priorities for chest surgery, such as whether I value flatness over nipple sensation. I learned about double incision top surgery with nipple grafts, as well as “keyhole,” “donut,” “buttonhole,” and “Inverted-T” top surgeries.

By the end of the hour-long appointment, I had my surgery referral and was ready for my “nursing call” appointment.

Nursing call with Nurse Coordinator from the Transgender Surgery and Gender Pathways Clinic at Kaiser San Francisco

On January 19, 2023, I had my nursing call with the Nurse Coordinator. He first said that “the purpose of this call is just for us to go through your chart together and make sure everything’s as accurate as possible.” Once that was done, my referral would be sent to the surgeon for a consultation.

He asked me about potential allergies and recreational drug use, and verified that I was up to date on mammograms, pap smears, and colon cancer screenings, as well as vaccines for flu and COVID. I verified my surgical history as well as my current medications and dietary supplements.

He told me about a “top surgery class” available for patients where one of the Kaiser surgeons “presents and talks about surgical techniques and options within top surgery,” and includes a panel of patients who have had top surgery. I signed up for the February 8th class.

Within 10 minutes he told me that he had “sent a referral to the plastic surgery department at Kaiser Sacramento,” and that I should be hearing from them in the next week or two to schedule a consultation.

Appointment for Testosterone

On January 27, I had a 13-minute online appointment with a primary care doctor at Kaiser Davis to discuss testosterone. The doctor verified my name and preferred pronouns, and then directly asked: “So, what would you like to do? What kind of physical things are you looking for?”

I told her I wanted facial hair, a more muscular and less “curvy” physique, and to feel stronger and androgynous. She asked me when I wanted to start, and I told her in the next few months. She asked me if I was menopausal, whether I had ovaries and a uterus, although that information should have been on my chart.

The doctor said she wanted me to come in to get some labs so she could check my current estrogen, testosterone, and hemoglobin levels before starting hormones. Then “we'll set the ball in motion and you'll be going. We’ll see you full steam ahead in the direction you wanna go.”

That was it. I made an appointment and had my lab tests done on February 12. My labs came back on February 14, and the following day, after paying a $5 copay at the Kaiser pharmacy, I picked up my testosterone pump. That was easy!

Top Surgery Consultation

On the same day I received my labs, I had a Zoom surgery consultation with Karly Autumn-Kaplan, MD, Kaiser Sacramento plastic surgeon. This consultation was all about discussing my “goals” for surgery, not about whether surgery was needed or appropriate.

I told the surgeon that I wanted a “flatter, more androgynous appearance.” She asked me some questions to get a better idea of what that meant for me. She said that some patients want a “male chest,” but that others “want to look like nothing, like just straight up and down, sometimes not even nipples.” Others still wanted their chest to appear slightly feminine and only “slightly rounded.” I told her that I’d like my chest to have a “male appearance.”

“What are your thoughts about keeping your nipples?” she asked. “Are you interested in having nipples or would you like them removed?” I told her that I’d like to keep my nipples, but to make them “smaller in size.” She asked me if I’d like them moved to “the edge of the peck muscle” to achieve “a more male appearance.” I said yes.

I was asked to show my bare chest from the front and side, which I did. Then she asked me how important it was for me to keep my nipple sensation. I replied that it was important unless it would make recovery more difficult or there were other associated risks. She highlighted the problem with the free nipple graft, saying that removing the nipple to relocate it means “you're not gonna have sensation in that nipple and areola anymore.” However, some nipple sensation could be preserved by keeping it attached to “a little stalk of tissue” with “real nerves going to it,” but that would require leaving more tissue behind. I told her I’d go for the free nipple graft to achieve a flatter appearance. It was also suggested I could skip nipple reconstruction entirely and just get nipples “tattooed” directly onto my chest.

She told me I was “a good candidate for surgery,” and put me on the surgery wait list. She said that the wait time was between three and five months, but a cancellation could move me up to a sooner date. Also, if I wanted surgery as soon as possible, I could tell the surgery scheduler that I’d be willing to have any of the other three surgeons perform my mastectomy. Outpatient top surgery would cost me a copay of $100.

They contacted twice, in February and March, notifying me of cancellations. If I had accepted and shown up on those dates, they would have removed my breasts. This would have been less than five months from the time I first contacted Kaiser to inform them of my new “nonbinary” gender identity.

How Far Can I Go?

I decided to see how easy it would be for me to get approved for a phalloplasty. Known euphemistically as “bottom surgery,” phalloplasty is the surgical creation of an artificial penis, generally using tissue from the thigh or arm.

I sent an email on March 1, 2023, requesting to have a phalloplasty and concurrent hysterectomy scheduled alongside my mastectomy.

Two weeks later, on March 16th, I had a 16-minute phone call with a gender specialist to discuss my goals for bottom surgery and obtain my referral.

During the call, I explained to the specialist that I wasn’t sure about taking testosterone anymore because I was already quite athletic and muscular, and that taking testosterone didn’t make much sense to me. Instead, I wanted bottom surgery so that I wouldn’t feel like my “top” didn’t match my “bottom.” I told her:

But what I really wanted was to have bottom surgery. So this way when I have my top surgery, which sounds like it could be very soon, that I’ll be aligned, that I won’t have this sense of dysphoria with one part of my body and the other part feeling like it matched who I am. So yeah. So I just did a little bit more research into that. And I looked at the resources on the Kaiser page for the MST clinic and I think I know what I want, which is the hysterectomy and then at the same time or soon after to be able to have a phalloplasty.

I told her that I wanted to schedule the top and bottom surgery concurrently so that I wouldn’t have to take more time off work and it would save me trips to San Francisco or Oakland, or wherever I had to go for surgery.

None of this gave the gender specialist pause. After a brief conversation about some online resources to look over, she told me that she would “submit the referral now and we’ll get this ball rolling.”

Bottom surgery would cost me a copay of $200, which included a couple of days in the hospital for recovery.

Phalloplasty Surgical Consultation with Nurse Coordinator

On May 16, 2023, I had a short surgical consultation with a nurse coordinator to go through my medical history. This was similar to the consultation for top surgery but included information about hair removal procedures for the skin on my “donor site” that would be fashioned into a makeshift penis. They also went over the procedures for determining which donor site—forearm or thigh—was more viable.

After only 15 minutes, she submitted my referral to the surgeon for another surgical consultation.

On May 25 I received an email from my phalloplasty surgeon’s scheduler, informing me that they have received my referral and are actively working on scheduling, but that they are experiencing delays.

I ended my investigation here once I had the referral for the top and bottom surgery. I never used my testosterone pump.

Final Thoughts

In fewer than 300 days, based on a set of superficial and shifting thoughts about my gender and my “embodiment goals” triggered by the mere mention of “gender” in a form letter from my primary care physician, and driven by what could only be described as minor discomforts, Kaiser Permanente’s esteemed “multi-disciplinary team” of “gender specialists” was willing, with enthusiasm—while ignoring mental health concerns, history of sexual trauma, and rapidly escalating surgical requests—to prescribe life-altering medications and perform surgeries to remove my breasts, uterus, and vagina, close my vaginal opening, and attempt a complex surgery with high failure and complication rates to create a functionless representation of a penis that destroys the integrity of my arm or thigh in the process.

This describes the supposedly meticulous, lengthy, and safety-focused process that a Kaiser patient must undergo to embark on a journey to medically alter their body. No clinician questioned my motivations. No one showed concern that I might be addressing a mental health issue through radical and irreversible interventions that wouldn’t address my amorphous problems. There were no discussions about how these treatments would impact my long-term health, romantic relationships, family, or sex life. I charted the course. The clinicians followed my lead without question. The guiding issue was what I wanted to look like.

No other medical field operates with this level of carelessness and disregard for patient health and welfare. No other medical field addresses issues of self-perception with surgery and labels it “medically necessary.” No other medical field is this disconnected from the reality of the patients it serves.

Kaiser has traded medicine for ideology. It’s far beyond time we stop the ruse of considering “gender-affirming” interventions as anything approaching medical care.

This isn’t the first time Kaiser Permanente has been in the news for completely disregarding medical safeguards in the name of “gender-affirming care.” As girls, Chloe Cole and Layla Jane became convinced that they were born in the wrong body and were actually boys on the inside. Doctors at Kaiser ignored their underlying conditions and instead prescribed testosterone and removed their breasts. Both Cole and Jane have since detransitioned and are currently suing Kaiser.

The fact that children and vulnerable adults are being exploited in this massive ideological experiment is not just tragic; it’s deeply disturbing, especially considering it has evolved into a billion-dollar industry.

I hope that by sharing my story, I can bring more focused scrutiny to the medical scandal unfolding not just at Kaiser but also at medical centers and hospitals across the Western world. These institutions have completely abandoned medical safeguards for patients who claim to be confused about their “gender,” and I aim to awaken more parents and assist them in protecting their children.

--

==

This is completely insane.

Apologists online are running around saying, but she didn't mean it, she was lying, she was pretending...

It doesn't matter.

Any kind of security, penetration or integrity test is insincere too. When security researchers compromise Microsoft's operating system or Google's browser or whatever, "but they didn't mean it" is not a defence to a discovered security flaw. It doesn't matter that the security researchers didn't plan to steal data or money or identities. The flaw in the system is there regardless.

It doesn't matter that it was insincere. Because the workers didn't know that. They never checked, never asked questions, never tested. They had been taught and instructed to never ask any questions. They did what they were supposed to. And the system failed spectacularly. Because that's what "gender affirming care" means.

Additionally, the claim that Beth Bourne committed fraud is an outright lie. A patient cannot bill. They do not have the authority. The medical clinic is the only one that can bill, and they must supply a diagnosis and a medical necessity.

If they didn't diagnose her and just wrote down what she said, then they committed fraud. If they claim they did diagnose her, then they committed fraud, because the diagnosis they concocted was bogus. This, by the way, is actually going on. Clinics are reporting fake endocrine and other disorders to get blockers, hormones and other interventions. Jamie Reed and other whistleblowers have documented evidence of this. Beth Bourne is not responsible for what the clinic does. They have medical licenses and legal responsibility. Not her.

Additionally, anyone who actually read the article would know how she tested the system. She said things like, "I've always been not that feminine. So, maybe I get my boobs removed." And they said, "sure." Instead of saying, "wait, why do you think that?" Framing it as her lying is itself a lie. They violated their ethical obligations. That much is incontrovertible. And it's directly the result of "gender affirming care," where clinics and clinicians rubber-stamp anything deemed "trans" based entirely on ideological, not medical, grounds.

[royalarchivist]

Pac: Sweatpants, they're sweatpants, you see? Sweatpants, I tricked you. It's too hot man, there's no way! This white shirt is cool, right? I even put on a little vest that I have and I wore my best tie, it's Burberry. I even put on a little vest that I have, but it doesn't fit anymore. Hold on, let me fix my camera-

Pac: Hello, welcome, my name is Pac, I'll be parking your car today. [Laughs] It doesn't fit man, you see?! It doesn't fit anymore, man! It's no use, you see? I'm vacuum sealed, right? I know, I know, I know– The only thing that fits is the tie!

Pac: I'm really excited for the [Arkanis] Oscars today because we're going to see a lot of– Lots of friends, the old Specialists, right? Everything's tight, all of these are old. There's no way, man! There's no way, no way– I can't even put on my old blazer–! [He struggles, but eventually succeeds in putting it back on] It's too hot, Chat! I can't do it, I might not be able to do it, I might not be able to wear this for long, for real. It wasn't supposed to be seen, these weren't meant to be visible, ok? [The pants] weren't supposed to look like this. Relax, it's because I'm not wearing the right pants, ok? It looks better from afar, alright?

Pac: I'm not that short, I'm 175 cm, guys! You're calling me– no, I'm not.

[amourcherie606]

doodle dump can you tell i love johnny storm [ i have a sinus infection save me ]

[eyestrain-addict]

Obsessed with how this old man is borderline horny wit it

[hartxstarr-art]

crybaby.

[sourscratched]

crumpled pocketful of offbook scraps that are just so wildly clashy and have nothing to do with each other but uhhhh. Enjoy i guess

[cconfusedkat]

Often . Often . Okay. OKA. Shamura often questions if they should stop giving goodbye kisses to lamb because then they ask for a couple more, and then it's a "noooo stay stay stay im the leader i can hold you here" (allure there are dead bodies to take care of and get bones for. You are DISRUPTING THEIR SCHEDULE,)

Funny bonus cuz as much as i claim shamura is calm they are often angered by rlly little things (like sibling (shamura) like sister (heket))

As long as shamura doesnt with-hold a scythe or gauntlet everything is FIINNEEEEEE theyre a retired god by now!! :'-D

[lucifer-the-fetus-eater]

heavy and medic but they do the rock paper scissors taunt to figure out whos on top and whos on bottom for the night

[defilerwyrm]

May i ask how's the recovery process after gender affirming surgeries?

If you mean how's it going now: my last surgery was in 2022 so at this point I'm 100% healed up. I was SUPPOSED to get my implants in December 2023 but my insurance company has been fucking me over at every turn so that's still on hold.

If you mean how was it at the time:

Top surgery (2018) was pretty easy for me since I have a desk job. I stayed with family in town for the first 2 weeks, during which time I basically did nothing but sleep, wake up long enough to use the toilet, take a dry shower, eat something, take more pain meds, then go back to sleep. I had 4 weeks off work, so after that I was a little sore and still confined to button-down shirts because I couldn't raise my arms above shoulder level; then I went back to work and all was normal for the next month. But...

Because I am an unlucky son of a bitch, I had a rare complication: I developed a seroma that dehysced (i.e. a hole opened up along my suture line that leaked large amounts of greasy, bright orange fluid made up of lymph and blood), which was not painful at all but was absolutely disgusting and very alarming to experience—but not a medical emergency or anything, and was easily fixed with a revision surgery. I took another 2 (I think?) weeks off work and it's been fine ever since. The left side of my chest is a little funny but I don't really care, it was fully worth it. Please note that I did not have drains. If you have drains, you're even LESS likely to have this problem.

Hysterectomy (2019) was much the same: I slept through the first two weeks and spent the next 2 in a recliner with an ice pack on my lower belly, playing a lot of Stardew Valley and getting into Critical Role. I was lucky enough to live with a friend who loves cooking. I ate a lot of soup. The soreness wasn't that bad, but I have a policy of staying ahead of the pain by using timers for how often I should be taking them. The worst part of it was the pain meds, tbh, because I really don't like the way oxycodone makes me feel; at the same time, I'm grateful for that fact because it keeps me from forming a habit.

Phalloplasty etc (2021) was kinda rough to start. I had 3 months off work that time. Slept through the first 2 weeks as usual. But for the first 3 weeks total I had a suprapubic catheter in and man I fuckin' hate being cathed. I felt like I needed to pee at all times, even immediately after draining the cath bag. Awful. Learning to pee standing up was...let's just say I did a lot of laundry and cleaning, lol. This was made worse by the fact that I had two fistulae (holes that go through the urethra all the way to the outside)—like I said, I've got bad luck. One of them healed up all on its own, like most of them do. The other one required a revision 8 months later, which meant being cathed again for a while, SIGH. But back to post-op for phallo: I had physical therapy for my left arm to make sure I kept a good range of motion; I kept the graft bandaged with daily gentle cleanup, application of ointments, and rebandaging; and had to take dry showers for the first uhhhhh. 2 weeks at least, maybe 3 or 4? After I got the cath out, things were MUCH easier. I was just kinda vaguely tired and sore and spent most of my time lying down. My libido came back at the start of the 2nd month, which was frustrating af because it wasn't till the start of the 3rd month that I was healed up enough to do anything about it (but once I could, holy FUCK it was incredible).

[smokeweedeattherich]

I figured it's time I talk about my surgical transition experience. There's plenty of false narratives out there and I want to counter what I can with truth and personal experience.

The first procedure I received this year in late January was a transvaginal ovarian-hysterectomy. That means they cut out my uterus and ovaries (and the connecting fallopian tubes) without making any abdominal incisions (removed through the vagina). I'd had a consultation with the surgeon performing the operation a few months prior where we discussed any concerns and went over potential side effects as well as specifying I wanted my ovaries removed as well. When the day of the procedure came I went to the hospital, the nurses were really kind and I got to see the surgeon again one last time for any last minute concerns before I went into the surgical suite.

Waking up post surgery I was elated to learn the surgery had gone super smoothly, the surgeon said I'd lost less than a teaspoon of blood. I stayed in hospital for the remainder of the day and ended up going home around 9pm. They'd given me a pain meds prescription, and that kept things during recovery at a quiet 2-3 on the pain scale. Most of what I felt was a general soreness in the area, it was a lot like the sensation of period cramps. It took only 3 weeks before I felt pretty much 100% I still wasn't fully healed but by then there wasn't any pain, even slight.

Now I'm just nearing the end of my 2 month full recovery time and I'm clear to have penetrative sex. The worst part of the recovery I'd say was the basically instant menopause I had to go through for a while. The hot flashes were the worst, get a fan for yourself if you're planning on getting this procedure.

The end of February is when I got my second procedure, a double masectomy aka top surgery. Normally transition surgeries wouldn't be so close together in timeline but I had school starting in May but I couldn't emotionally afford to wait until the semester is over to get the surgery done. Additionally, political circumstances also lead to me making the decision to push up the date of my surgery, I was terrified that if I was to wait another year that it might be illegal by then.

Similar to the first operation, I'd had a consultation appointment several months prior that addressed any questions and concerns to help me decide if the procedure was right for me. I was way less nervous this time around because I'd already been through one surgery and had a better idea of what to expect in terms of pain and recovery.

The experience of check-in and preparation for the second surgery was pretty much the same as the first with one exception, I decided to forego the nipple grafts last minute (and I don't regret the decision. less risk of complication/infection, I wouldn't likely retain sensation, getting nipple tattoos instead gives me direct control over size and shape) so I had to meet with the surgeon beforehand the day of. My direct input was accommodated and my questions answered the day of, it was awesome.

I went under anesthesia feeling a sense of peace that I'd wake up feeling more like myself than I had since before puberty. I'm a month recovered now and I'm just so pleased with the results! The pain was so worth it!

Feel free to ask respectful questions about my experiences.

[i-am-a-fan]

And if you look to your right you can see me try and make stickers and keychains drafts

[transbee]

Various egg doodles I've done in honor of eggtober

[ahollowgrave]

i never take the 24 hour maintenance serious until its 24 hour maintenance.............

[rockerb0y]

𝚏𝚎𝚊𝚝. 𝙿𝙷𝙸𝙻𝙰𝙽𝚃𝙷𝚁𝙾𝙿𝚈 / 𝙱𝚄𝚂𝙸𝙽𝙴𝚂𝚂 𝚅𝙴𝙽𝚃𝚄𝚁𝙴𝚂

the grand illusion, a highly regarded rock club which was frequented by several prominent musicians over the years ( including johnny himself ), was purchased by both johnny and kerry about four years after samurai's disbandment. although the purchase wasn't made public and was rooted in long-standing nostalgia, johnny still maintains a strong presence in the club — often performing secret shows without advance notice or grabbing a few drinks when he's in the area. although his status as an owner isn't advertised or flaunted, regulars are aware of his connection to the club and share a 'if you know, you know ' mindset

disdainful of the modern shift towards megacorporations controlling the media and snuffing out artist's creativity to suit their needs, johnny bought several warehouses throughout night city and converted them into affordable housing for up-and-coming artists. silverhand studios was founded on the belief that artists should be free from creative suppression and shouldn't be influenced by megacorps in order to make a living. the first level was typically empty and used as a collaborative space where loft occupants could share ideas. the second floor housed the individual lofts which were clean and vermin-free. as a landlord, johnny visited occasionally and was of the belief that tenants could do as they pleased as long as they did not interfere with or disrupt their fellow artists

after the purchase of his porsche 911 turbo at a significant discount from its previous owner, johnny spent several months restoring and customizing it to his tastes. he relied heavily on the assistance and advice of a local mechanic due to his limited mechanical expertise and over time, the pair became good friends. they eventually got talking and after learning of the mechanic's keen interest in motorcycles, arch motorcycle was born. similar to johnny's porsche, the company specialized in custom motorcycles that were tailored to the needs of the owner. johnny himself acted as a silent partner and eventually left the company to the mechanic after his death. since then, the company has evolved over the years and continues to be active in 2077

despite his varying success over the years, johnny only held onto the income he needed to maintain his lifestyle and cover living expenses. aside from his more formal ventures, he's a frequent donor to multiple non-profit youth organizations and charities with a particular focus on music and creative initiatives. donations are always anonymous and while he rarely attends fundraising events, he does occasionally make exceptions for less renowned organizations