#Seeking Recommendations and Referrals

[soldier-of-self]

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[transmonstera]

PLEASE READ BELOW

Hi! I am a UK based trans artist and writer looking to pursue a private hysterectomy. I run an Etsy store (you may even have one of my stickers or badges!) and work part time but am still struggling to save much of anything towards surgery due to debt, living costs, etc so I’m looking for a little bit of help!

The reason I am pursuing a hysterectomy now is due to having cervical ectropion. This condition is where the cervix is essentially inside out and causes bleeding and excruciating pain. Frustratingly enough the treatment for this condition worked for all of two weeks before returning straight back to how it used to be. Cervical ectropion is aggravated by fluctuating hormone levels, particularly estrogen, so if I was to ever experience atrophy and seek treatment for that it would only make my ectropion far worse. The NHS does not offer hysterectomies for this condition due to them deeming it “a harmless condition”. Funnily enough the only procedure they approve of to “treat” this is a tubal ligation which has nothing to do with the cervix (make it make sense). 

I could attempt to get a hysterectomy through my GIC (Nottingham), however their communication is abysmal, I get one appointment a year with them and I cannot sit by and wait for the topic to come up on their terms, they never even spoke to me about top surgery (after telling me they would) leaving me to get that privately too, and I think even if they do approve a referral it’d take far too long and I would have little control in the situation. I simply cannot be in this pain for however long they wish to take to help me. Especially with how things are going for trans healthcare.

So I’m looking to get it privately. I have been recommended Mr Saurabh Phadnis with Nuffield Health in London due to him approving hysterectomies for many reasons and getting rid of everything you wish to remove and not just the bare minimum. I would like to go with him as I wish to remove everything including the cervix. My GP is happy to do a referral for him, so it is literally just a case of getting the funds. I was quoted an estimate of roughly £9000. I’m not going to ask for people to send me that amount as I know it is a huge sum to ask for. I’m hoping to raise as much as I can by about January/February time (through donations, etsy sales, and anything I can spare from my part time job) and look at taking out a loan for whatever is left over and if I can save even a third of the full amount that would help immensely.

A hysterectomy would truly change everything. I don’t want to take depo injections for the rest of my life, I don’t want to be in pain anymore and I don’t want to bleed randomly throughout the day because I dared to go for a walk. This is not just for transition purposes, this is so I can live without fear of further pain, more bleeding, being unable to treat potential atrophy because of an existing condition, HPV, cervical cancer, pregnancy scares etc.

If you'd like to donate:

ko-fi.com/transmonstera

cashapp: £transmonstera

Even if you can’t donate, please take a moment to share. It’d mean the world to me.

[she-is-ovarit]

This is for all the younger gen Z women, particularly those of you within the ages of 17 to roughly 23. This is written from an American perspective, things might be a little different depending on where you're from.

I graduated high school with the unconscious assumption that certain systems will take care of me. The medical system would educate me on proper nutrition and health issues was probably my largest underlying assumption, but really I just had trust in institutions generally.

This isn't true. You are responsible for learning. As an example, I have been vegetarian since age 14. Nobody talked to me about proper nutrition, they just told me I needed to eat more protein.

I lived a decade of my life having shortness of breath, sleeping issues, clumsiness, cold hands and feet, having brain fog, extreme fatigue, heightened anxiety, etc. My period was extremely light and brown, it'd last for about 2 or so days. I'd go and talk about these problems, and telling doctors that I was vegetarian was one of the first things that came out of my mouth just with any visit because I knew at least that piece was important to communicate.

There was really no action taken over the span of about 10 years. I was told the period thing was normal, that changes for women. A sleep specialist let me know that feeling exhausted was also normal. The brain fog was probably due to anxiety. Here, try allergy medication (tbh that did help for other reasons). Then one day I just asked them to check my vitamin and mineral levels. Prior to this I didn't think you can make requests to doctors, I thought you showed up and they performed tests on what they recommended. With some reluctance from my primary care physician and some compromise because she said my insurance wouldn't cover testing things like B12 levels (I later found out from a nurse that, they would, she would have just needed to fill out extra paperwork), she did some tests.

I found out both my iron and D3 levels were low. What else could be?

I later learned pretty much all the vitamins common to be low for vegetarians were low. D3, magnesium, vitamin Bs, iron, and healthy fats. Bought some liquid vitamins (because the body only absorbs 10% of the pill supplements), began eating an avocado a day, my period became normal for the first time in nine years, and I am able to function.

Another example of how human systems won't educate you: I don't have feeling in some of my toes due to wearing incorrect sized footwear for years resulting in permanent nerve damage. I'm size 11.5 in women's, and I was relying on someone to tell me how proper footwear worked, because surely the guy in the minimum wage position working the footwear section would know.

Don't trust human systems to guide you through how certain things work. Seek specific specialists and experts when you can, and inform yourself on your own. Don't blindly trust search engines like Google, it's not like how it used to be when I was growing up and many millennial adults will tell you to "just google things" because we're used to finding actual substantive answers when we do. However, now, usually whoever pays is who makes the first page or two of search engines, it has nothing to do with what information is "most correct". Don't be afraid to request certain tests be done by doctors or certain referrals made to different specialists.

Edit: And also, I've found general practitioners are terrible when you walk in and tell them about several different symptoms at one time. They're more used to treating one symptom at a time, and they treat the symptom not the root cause. If you go in with a runny nose, general practitioners are going to throw medications at you to try and treat the runny nose, not look deeper into what's causing the runny nose. It's equivalent to if you're in a boat and it's sinking, they're bailing out water without actually fixing the hole or trying to figure out where it is, with the exception of emergency situations and even then it depends.

[kj-bishop]

Kim Gibson et al's paper:

I've come down with some hearing loss in one ear post-covid, a couple of weeks after symptoms started and around the time they were finally going away. I only noticed it because cicadas (my great thanks to them) woke me up in the small hours of yesterday morning and I found that when I lay on the other side I couldn't hear them. Thankfully my right ear seems to be compensating so that when I hear with both ears I can't notice a change. An audiology test showed that my left ear is indeed somewhat fucked. The audiologist suspects SSHL (sudden sensorineural hearing loss). I've started the recommended meds, hopefully in time, as the window for action is tight. I'm seeing an ENT Wednesday. I also have to get other tests to make sure there isn't some other cause.

Meanwhile, it seems worth sharing this now. Be aware that covid could harm your hearing, and if it seems damaged seek medical care immediately. (ETA: or if you have other audio-vestibular symptoms. In any case, consider checking your hearing, as loss isn't always noticed.)

ETA2: From Gibson et al: "There is heterogeneity in COVID-19 severity and the timing of audio-vestibular symptoms reported in published case studies. COVID-19 severity has ranged from asymptomatic or mild, moderate, requiring hospitalisation, to severe, where intubation and intensive care were needed. Timing of audio-vestibular symptoms ranged from being the first indication of COVID-19 to 3–12 days and between 4 and 12 weeks after reporting COVID-19 symptoms. [...] delayed diagnosis is a common challenge with cases of SSNHL with many patients and clinicians attributing sensations of ‘ear fullness’ to impacted cerumen or congestion due to respiratory infection or allergies. Early administration of high-dose corticosteroids is a significant predictor of auditory outcome and is the recommend first-line treatment. It is therefore important for clinicians to carefully consider the potential for SSNHL and ensure prompt referral to specialists when symptoms first develop."

[itsaspectrumcomic]

If you’re comfortable, what made you decide to seek diagnosis and how did you go about it? It has been suggested to me (friends, therapist), and I have suspected that I might be autistic but I’m kind of scared to find out for sure because of stigma.

I wondered silently for a really long time before I did anything about it - like, for years. I worried about the stigma too, or that I was wrong and I wasn't autistic and I was just weird, or maybe everyone found things this hard and I was just being dramatic and overreacting. I also self-identified as autistic for a while before I decided a diagnosis would be helpful for me, mainly for getting accommodations.

What started it off was my mum sending me an article about Melanie Sykes revealing her own diagnosis and noting the similarities, and I thought if she could see it too then maybe it wasn't just in my head. And then I spent a really long time researching.

I joined some communities of autistic people (eg discord and reddit) and followed neurodivergent people on social media to see if I could relate to their experiences (which was way more helpful than reading a traits list off WebMD).

I also did some self-assessments online like the Autism Spectrum Quotient (there's the AQ10 and AQ50) and the RAADS-R. I've linked to where you can take those on Embrace Autism since I found that website particularly helpful :)

AND THEN I took all my results and notes to my GP to try to get a referral which was another whole thing since the NHS waiting lists are literally years long.

Even though it took a long time and was pretty difficult, I'm really glad I went for a diagnosis! It made me feel much more comfortable in myself, and I've found others take me more seriously when I say I'm struggling with something. Most people I've told have responded pretty well, but I am careful about who I tell in real life because there are so many stereotypes so it wouldn't necessarily be helpful for them to know. You don't have to tell anyone if you don't want to.

If you're wondering about yourself, I recommend taking those quizzes I linked as well as seeing if you relate to other autistic peoples' experiences. Also, know you don't have to actually go for a diagnosis if you don't want one. Self-identifying and figuring out what your needs are and accommodating them where you can is also good :)

Anyway, this has been an essay but basically I'm happy I was able to get my diagnosis :) It's not something everyone can access for a variety of reasons so I'm very grateful.

[mcginnlawfirm]

What Should You Look for When Choosing a Personal Injury Lawyer?

Choosing the right personal injury lawyer can make all the difference in getting the compensation you deserve after an accident. When you're already dealing with recovery, navigating legal options shouldn’t add to your worries. Whether it’s a car accident, slip and fall, or another injury, you need a lawyer who’s experienced and understands your unique situation.

1. Experience with Personal Injury Cases

Start by looking for a lawyer with extensive experience in handling personal injury cases. You’ll want someone who has dealt with situations similar to yours and knows the best strategies to pursue a successful outcome.

2. Proven Track Record

A lawyer’s track record speaks volumes about their ability to achieve favorable results. Look for evidence of successful settlements or court verdicts that demonstrate their capability to handle personal injury claims effectively.

3. Clear and Open Communication

Good communication is key when working with a lawyer. You should feel comfortable asking questions and receiving clear, straightforward answers. A lawyer who keeps you informed throughout the process can help alleviate stress and provide confidence in your case.

4. Transparent Fees

Legal fees should be clear from the start. Many personal injury lawyers work on a contingency basis, meaning you won’t have to pay upfront fees. Make sure you understand how the fee structure works before moving forward.

5. Personalized Attention

Your case deserves personal attention, not a one-size-fits-all approach. Choose a lawyer who takes the time to understand your specific needs and works closely with you to build a strong case.

6. Reputation and Client Reviews

Check online reviews and testimonials to see what past clients have to say about their experience. A good reputation for professionalism, dedication, and effectiveness can give you confidence in your choice.

7. Trial Experience

While many cases settle out of court, it’s important to choose a lawyer who is prepared to go to trial if necessary. A strong trial record ensures they have the skills to advocate for you in the courtroom if the situation demands it.

8. Professional Reputation

A lawyer’s standing within the legal community can provide insight into their credibility and capabilities. Seeking recommendations or referrals from other professionals can help you make an informed decision.

9. Be Cautious of Solicitation

If you receive unsolicited calls or letters from lawyers after an accident, be cautious. It's usually better to seek legal representation based on research and recommendations rather than responding to aggressive marketing tactics.

10. Free Consultations and Contingency Fees

Many personal injury lawyers offer free initial consultations to discuss your case with no obligation. Look for a lawyer who works on a contingency basis so you don’t have to worry about upfront costs while focusing on your recovery.

11. Access to Resources

A strong personal injury case often requires access to medical experts, investigators, and other professionals. Make sure your lawyer has the necessary resources to build a solid case on your behalf.

Conclusion

Choosing the right personal injury lawyer is an important step in ensuring you get the compensation you deserve. Focus on experience, a strong track record, clear communication, and personalized attention to find the best fit for your needs. Contact our lawyer today for a free consultation and take the first step toward securing the support you need.

[justinspoliticalcorner]

Sophie Perry at PinkNews:

The documents leaked by the Good Law Project and reported by QueerAF state that young people and their families who use “unregulated” and “overseas providers” for gender-affirming care should cease doing so, or they may face safeguarding referrals. Speaking with QueerAF, Jo Maugham KC – executive director of the Good Law Project – said: “It’s reasonable to describe this as an attempt to force people to detransition.” The document, which the Good Law Project states does not bear the name of any NHS professional, asks providers of mental health support to children and young people (CYP) to invite those on the national waiting list for gender services for a face-to-face appointment.

[...] Furthermore, at the assessment stage, the providers have been asked to follow recommendations of the Cass Review and advise children not to take puberty blockers or gender-affirming hormones obtained via routes without “appropriate care”. Whilst it is not stated what “appropriate care” refers to, the “overseas” routes being advised against. If a trans young person disregards such advice and a provider considers that this “puts the child/young person at increased risk, then a safeguarding referral may also be appropriate in line with standard safeguarding approaches”.

In essence, if a trans young person seeks private gender-affirming care and their parents support them, they could be referred to local authorities. [...\ In a statement provided to QueerAF following the publication of its report, a spokesperson for the NHS said that this process is about putting in place an “enhanced mental health support offer for all children and young people under 18 on the waiting list for specialist gender services, or who are awaiting their first appointment with the new services.”

England continues its not-so-sterling reputation as “TERF Island”, as trans kids in England could be forced to detransition following the Cass Review, per a leaked proposal from NHS England.

[intersex-support]

hello! i display a lot of the symptoms of having trisomy x and would like to find out for sure if i'm intersex or not, but afaik the only way to know for sure is to get a karyotype and i'm terrified of the medical discrimination i might face as a result of doctors knowing i'm intersex. is there any other way for me to find out but still have my doctor not know? or am i just overreacting (especially since most other intersex people don't get the choice of finding out or not)?

Hi anon!

I think it's totally understandable that you have a lot of fear about trying to navigate the medical system as a potentially intersex person. It can be really difficult to have to deal with the amount of discrimination we face when we're seeking a diagnosis and existing as an intersex person in the medical system. It's fucked up that we have to think through all these things when we're seeking care, instead of just being able to trust that we would receive compassionate and respectful care that honored our autonomy.

Unfortunately, I don't think there is any way for you to confirm a Trisomy X diagnosis without getting a karyotype/chromosomal microarray, just because there really is no other way to confirm what chromosomes you have. However, I think there are some ways that you could navigate it that might make it a little easier to avoid some kinds of discrimination.

This information is all based on the US healthcare and insurance system because that's what I have direct experience with, but feel free to send another ask if you live somewhere else and we can brainstorm some ideas for your health system.

My first thought is that if you want a diagnosis but don't want to impact the rest of the medical care you receive, you might be able to see a separate genetic counselor that's not linked to the rest of your medical record and medical care. There are a lot of services that do telehealth genetic counseling such as Genome Medical, and if they take your insurance, you might be able to get testing set up through them but not have it show up on the rest of your medical record. The nice thing about this is that you only have to deal with the telehealth clinician a few times and then get to choose whether or not you want to disclose this information to any future providers you see, and you don't need to have this information in your medical record if you don't want to.

If that's not an option but you have a PPO or POS health insurance plan where you can see any preferred network providers without referrals, you might be able to go to a separate genetic counselor that is part of a different hospital or clinic than where you normally receive care.

If your health insurance is an HMO plan where you have to get PCP referrals and can only see in network providers, that might make it difficult to seek care that isn't linked to your medical record. If this is the case but you're still interested in seeking a diagnosis, it might be worth brainstorming some things that would make you feel safer through the process. This could look like bringing another supportive person with you who could help advocate for you, preparing scripts for how you want to advocate for yourself, seeking out information about your rights as a patient, asking other intersex people for doctor recommendations, bringing in the "What we wish our doctors knew" brochure from InterACT. I won't lie, having an intersex variation on your medical record can make seeking medical care more complicated, but I think it can be slightly easier to navigate when you're a teen or adult who has more autonomy over their care, can consent to things, switch providers more easily, and has more of a say in their care.

If any followers have any other innovative ideas about how to seek diagnosis, feel free to add on.

Ultimately, the choice about whether to seek a diagnosis or not is always up to you. You're the expert on your own experience and know what would feel right for you at this point in your life. I don't think you're overreacting or being silly, and I wish things were different and it was easier for you to seek a diagnosis.

Truly wishing you the best of luck, anon.

[anamericangirl]

Hello, just discovered your blog and have gone through it I hope to not be an illiterate anon, apologies if i am, I'm very tired all the time. Your post appeared on my recommended and I'd like to respond.

If a doctor put a perfectly healthy person on chemotherapy because they walked into their office and said “I think I have cancer” that would be malpractice and the doctor would lose their license.

Let's check this. Quote from transcare https://transcare.ucsf.edu/transition-roadmap: "Requirements for a behavioral health evaluation and preparation in advance of chest and genital surgery, and the use of hormone therapy and presenting full time in one's chosen gender identity for 1 year before genital procedures, unless there is a medical or other reason that prevents meeting these requirements." What that means is kids do not just walk in at the first sight of dysphoria and ask. They've got to be committed to it for a year. What about dysphoria? How does one get diagnosed with it? Quote from mayo clinic https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/symptoms-causes/syc-20475255#(sry if the link doesn't work) :

"Gender dysphoria might cause adolescents and adults to experience a marked difference between inner gender identity and assigned gender that lasts for at least six months."(bold mine) Six months. That's not just walking in and asking, that's again, a long time.

What if they regret it? There's an incredibly high regret rate. They're only kids, we know better than them. Well, those figures might have been exaggerated a little. Quote from transeqality "This study ( https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00254-1/fulltext ) found that 98% of youths prescribed puberty blockers went on to be prescribed hormone replacement therapy after turning 18." That means that 98 percent of kids knew they were trans and correct about it.

Quote from the same site "One Dutch study ( https://genderanalysis.net/2018/11/large-study-of-trans-people-in-the-netherlands-shows-growing-numbers-seeking-treatment-low-regret-rates/ ) of nearly 7,000 transgender people found that the rate of regret was less than 1% among those who received treatment as adults – and there were no cases of regret among those who received care before the age of 18."

To put that in perspective, 30 percent of people regret getting knee surgery https://www.aarp.org/health/conditions-treatments/info-2018/knee-replacement-surgery-regret.html

You claim to care about children? Check this out. https://www.thetrevorproject.org/survey-2022/ 45 percent of trans youth seriously considered suicide, and that number more than halved when they got support. Half.

Referral letters are required for a surgery. If a surgeon had a person who looked perfectly healthy come into their office and say "I have cancer, here's my proof of living in pain for 6 months, here's my proof of taking medicine, telling people I have cancer, my proof of going to support groups for my cancer, my cancer screenings, a signed letter from a specialist saying I have cancer, and one more for good measure." then the surgeon would get them surgery immediately because they do not specialise in cancer diagnosis. Yet this same thing happens for trans people all over the world where they're denied surgery by transphobic doctors.

Hi thanks for your thoughtful response. I have to disagree, though.

I have a couple of issues with your first point about surgeries and hormone therapy. First, one year is not that long to wait, especially if the person is a minor (and frankly this not should not even be an option for minors at all). If a perfectly healthy person walks into a doctor's office and says they have cancer and the doctor, instead of testing them for cancer, says "come back in a year and if you still feel that way we'll start chemotherapy" that's still malpractice.

Also, I would encourage you to listen to the testimonies of detransitioners because these "requirements" aren't always adhered to. One woman I was listening to who underwent transition as a minor said the first medical intervention she ever received was a double mastectomy.

And I wasn't just referring to surgeries and hormone replacement therapy with that post; I was also talking about puberty blockers. And if you consider Mayo Clinic a reliable source, this is what they list as the requirements for getting on puberty blockers.

In most cases, to begin using puberty blockers, an individual needs to:

Show a lasting pattern of gender nonconformity or gender dysphoria.

Have gender dysphoria that began or worsened at the start of puberty.

Address any psychological, medical or social problems that could interfere with the treatment.

Be able to understand the treatment and agree to have it. This is called informed consent.

This could all be accomplished in a single visit and just requires the doctor to ask a few questions.

"Gender dysphoria might cause adolescents and adults to experience a marked difference between inner gender identity and assigned gender that lasts for at least six months."(bold mine) Six months. That's not just walking in and asking, that's again, a long time.

No, six months is not a long time before diagnosing a severe mental illness where the next steps are essentially permanently altering your body.

And, mind you, this does not mean they have to be observed by a doctor for at least six months. It means it has to have been established that they have felt that way for at least six months. Meaning, a little boy can walk in and essentially the following exchange can take place:

Boy: I'm a girl

Doctor: How long have you felt that way?

Boy: About six months.

Doctor: Ok. I am diagnosing you with gender dysphoria.

Again, it can be diagnosed in a single visit. And btw, people can go through phases that last much longer than six months. That is nowhere near enough time to diagnose someone, especially a child, who is living in an environment where there gender confusion is being affirmed by the people around them, with gender dysphoria.

"What if they regret it? There's an incredibly high regret rate. They're only kids, we know better than them. Well, those figures might have been exaggerated a little. from transeqality "This study ( https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00254-1/fulltext ) found that 98% of youths prescribed puberty blockers went on to be prescribed hormone replacement therapy after turning 18." That means that 98 percent of kids knew they were trans and correct about it."

Ok so there's some important information being left out here and it's information that shows this study can't be really be a credible source of information for the rate of regret and it doesn't show that 98% of kids "knew they were trans and were correct about it."

First of all, the sample size of this study was only 720. Not that big. Most importantly, at the start of the treatment they were following the median age for boys was 14 and the median age for girls was 16. When they concluded the study the median age of boys was 20 and the median age of girls was 19 so this was only measured for about four or five years and can't be taken seriously as evidence of anything. Certainly not evidence that "98% of kids don't regret transitioning and know they are trans and are correct about it." That study is hardly long enough to show that children still consider themselves trans once they are adults.

This study, published in 2022, looked at a sample of about 1,000 individuals and found that the 4 year continuation rate of gender affirming hormone treatment is around 70%, which means the detransition rate is 30%. Not 1-2% like you suggest.

This study, while not a study on how many people detransition, looks at a number of people who have detransitioned (237, so not a lot) and reasons why they detransitioned. Here is a chart from the study showing that the main reason for detransitioning (70%) was realizing their gender dysphoria was related to other issues.

It's also worth noting that 45% of the people didn't feel "properly informed about the health implications of the accessed treatments and interventions before undergoing them."

This study also indicates that, at least for the detransitioners sampled, their detransitions happened approximately five years after they started their transition, which, interestingly, is right about the point of time the study you linked stops.

"Quote from the same site "One Dutch study ( https://genderanalysis.net/2018/11/large-study-of-trans-people-in-the-netherlands-shows-growing-numbers-seeking-treatment-low-regret-rates/ ) of nearly 7,000 transgender people found that the rate of regret was less than 1% among those who received treatment as adults – and there were no cases of regret among those who received care before the age of 18.""

This study was mostly following people who started transitioning when they were already adults and remember we're talking about kids here. And I don't know where you got the idea that "there were no cases of regret among those who received care before the age of 18" because I don't see that mentioned anywhere in the link you provided or the study itself. What I did see them mention was about 40% of the adolescents they evaluated started puberty blockers and then several stopped taking them without getting any further treatment.

"You claim to care about children? Check this out. https://www.thetrevorproject.org/survey-2022/ 45 percent of trans youth seriously considered suicide, and that number more than halved when they got support. Half."

I do care about children, but I don't trust the Trevor project. They are an activist organization and are only going to publish things that affirm their narrative, whether it's true or false. I suggest you look at data from both sides before taking the Trevor project at their word.

For example, I came across a paper that found an interesting phenomenon in the youth suicide rate.

In the past several years, the suicide rate among those ages 12 to 23 has become significantly higher in states that have a provision that allows minors to receive routine health care without parental consent than in states without such a provision. Before 2010, these two groups of states did not differ in their youth suicide rates. Starting in 2010, when puberty blockers and cross-sex hormones became widely available, elevated suicide rates in states where minors can more easily access those medical interventions became observable.

Rather than being protective against suicide, this pattern indicates that easier access by minors to cross-sex medical interventions without parental consent is associated with higher risk of suicide. 

This suggests that the Trevor project is not entirely accurate and the suicide rate among youth tragically rose after having access to "gender affirming care."

"Referral letters are required for a surgery. If a surgeon had a person who looked perfectly healthy come into their office and say "I have cancer, here's my proof of living in pain for 6 months, here's my proof of taking medicine, telling people I have cancer, my proof of going to support groups for my cancer, my cancer screenings, a signed letter from a specialist saying I have cancer, and one more for good measure." then the surgeon would get them surgery immediately because they do not specialise in cancer diagnosis. Yet this same thing happens for trans people all over the world where they're denied surgery by transphobic doctors."

So you mean the doctor has to have substantial evidence that someone has cancer before treating them? Like a screening? As opposed to simply confirming that they've felt that way for a long time?

And I'm sorry but using the phrase "transphobic doctors" takes credibility away from your entire message. This is why transphobic doesn't mean anything anymore. You just use it to refer to anyone who thinks gender dysphoria needs to be determined by more than someone simply saying they feel like the opposite sex and have for a long time. It's not "transphobic" for a doctor to determine a person doesn't need a sex change surgery. Doctors are there to observe and treat people's physical and mental health, not affirm their feelings. And it's incredibly petty and disingenuous to refer to a doctor who denies someone a surgery after they have supposedly gone through all the requirements you said had to be met that they are transphobic.

So let me ask you, if all those requirements for surgery aren't met and the person is denied the surgery how is the doctor transphobic? You assure me that all these strict requirements must be met before people surgically transition so it's not just happening to anyone who walks in but at the same time if anyone who wants the surgery doesn't qualify then the doctor is transphobic. You're not being consistent.

There are two sides to every story. Make sure you're not just looking at one.

[fortunatelyfantastickitty]

Finding Reliable Truck Accident Lawyers Near Me: Tips for Selection

Introduction

In the bustling streets of Los Angeles, truck accidents are unfortunately a common occurrence. Victims of such incidents often face not only physical injuries but also emotional and financial challenges. When it comes to seeking justice and compensation, finding a reliable Los Angeles truck accident lawyer becomes essential. This article provides valuable insights on how to locate and select the right truck accident attorney to help you navigate through the complexities of your case.

Understanding Truck Accidents in Los Angeles

Truck accidents can result in serious injuries or even fatalities. The vastness of Los Angeles means that there are thousands of trucks on the road every day, which increases the potential for accidents. Statistically, truck accidents are more likely to involve severe consequences due to the size and weight of commercial vehicles compared to standard passenger cars. Therefore, it is crucial to engage truck accident lawyers in Los Angeles who specialize in these cases.

Common Causes of Truck Accidents Driver Fatigue: Long hours on the road can lead to drowsy driving. Speeding: Many truck drivers feel pressured to meet tight delivery schedules. Improper Vehicle Maintenance: Trucks require regular maintenance to ensure safety. Overloading: Carrying more weight than permitted can affect control and braking. Reckless Driving: Aggressive maneuvers and disregard for traffic laws increase accident risks.

Why You Need a Specialized Truck Accident Lawyer

Choosing a lawyer who specializes in truck accidents is crucial due to the unique nature of these cases. Los Angeles big rig accident lawyers have an in-depth understanding of trucking regulations, liability issues, and the tactics often used by insurance companies to minimize payouts. A specialized attorney can help in several key areas:

1. Knowledge of Trucking Regulations

Truck drivers and companies are subject to strict federal and state regulations. Knowledge of these laws is essential when building your case. A seasoned big rig accident lawyer in Los Angeles will know how to identify violations that may have contributed to your accident.

2. Expertise in Collecting Evidence

Truck accidents often require extensive evidence collection, including:

Accident reports Witness statements Truck maintenance records Black box data from the truck

An experienced big rig accident lawyer will understand which pieces of evidence are crucial and how to obtain them.

3. Negotiating with Insurance Companies

Insurance companies often offer settlements that are not adequate to cover medical bills and related expenses. A truck accident attorney can negotiate on your behalf to ensure you get a fair settlement.

Tips for Selecting the Right Truck Accident Lawyer

Finding a competent truck accident attorney can seem daunting. However, following these tips can simplify the https://biancafianca754.gumroad.com/p/top-strategies-for-finding-the-best-los-angeles-truck-accident-lawyer-near-you process:

1. Research and Referrals

Start your search by asking friends, family, or colleagues for recommendations. Also, look online for lists of truck accident law firms in Los Angeles. Check for

[thebesthealthcareprovider]

Finding the Best Neurologist in Dubai: A Comprehensive Guide

Navigating Complex Neurological Conditions

When faced with neurological conditions, seeking expert care is paramount. In Dubai, a city renowned for its world-class healthcare, finding the best neurologist can significantly impact your health and well-being. This comprehensive guide will help you navigate the process of finding the right neurologist in Dubai.

Understanding Neurological Conditions

Neurological conditions affect the brain, spinal cord, and nerves, leading to a wide range of symptoms. Some common neurological conditions include:

Stroke

Multiple Sclerosis (MS)

Parkinson's Disease

Alzheimer's Disease

Epilepsy

Headaches and Migraines

Neuropathies

Spinal Cord Injuries

Why Choose a Neurologist in Dubai?

Dubai has emerged as a global healthcare hub, attracting renowned medical professionals from around the world. When you choose a neurologist in Dubai, you can expect:

World-Class Expertise: Access to highly skilled neurologists with extensive experience in diagnosing and treating complex neurological conditions.

Advanced Technology: State-of-the-art diagnostic tools and treatment options, including advanced imaging techniques and minimally invasive procedures.

Comprehensive Care: A multidisciplinary approach involving neurologists, neurosurgeons, physical therapists, and other specialists to provide holistic care.

International Standards: Adherence to international standards of medical practice and patient care.

Multicultural Environment: A diverse healthcare environment that caters to patients from various cultural backgrounds.

Tips for Finding the Best Neurologist in Dubai

Seek Recommendations: Ask your primary care physician, friends, or family members for recommendations. Word-of-mouth referrals can be invaluable.

Check Credentials: Ensure the neurologist is board-certified and has relevant qualifications and experience.

Research Online: Utilize online resources to research neurologists, read patient reviews, and check their credentials.

Consider the Clinic or Hospital: The reputation of the clinic or hospital where the neurologist practices can also influence the quality of care.

First Consultation: Schedule a consultation to discuss your medical history, symptoms, and concerns. A good neurologist will listen attentively and answer your questions.

Communication Skills: Effective communication is crucial. Choose a neurologist who can explain complex medical information in a clear and understandable way.

Comfort Level: A good doctor-patient relationship is essential. Choose a neurologist with whom you feel comfortable discussing your health concerns.

Conclusion

Finding the best neurologist in Dubai is a crucial step in managing neurological conditions. By following these tips and seeking expert advice, you can make informed decisions and receive the highest quality care. Remember, early diagnosis and prompt treatment can significantly improve outcomes.

[pestcontrolblue]

5 Suggestions On Opting For The Right Kissimmee Pest Control Provider

Opting for the appropriate parasite control company in Kissimmee is vital for guaranteeing your home or business is actually free of cost coming from undesirable parasites. Along with many companies giving companies, it may be mind-boggling to decide which one will certainly finest fulfill your necessities. Listed here are 5 important suggestions to assist you by means of the method:

1. Study as well as Verify Qualifications

When picking a kissimmee pest control, regularly ensure they possess the correct credentials. Validate that the business keeps the required licenses, accreditations, and also insurance to function lawfully in Fla. Licensed bug control companies are actually needed to follow state regulations as well as use accepted techniques for parasite monitoring.

Look for accreditations from trustworthy associations, like the National Pest Control Organization (NPMA) or even the Fla Insect Administration Association (FPMA), which show the company sticks to market finest techniques. Also, ensure the company is actually insured to protect you in the event that of any kind of damages to your building or accident throughout the parasite control process.

2. Look at the Forms Of Infestation They Focus on

Various Pest Control Kissimmee suppliers provide services for different types of bugs. Some might concentrate on common house bugs like ants, cockroaches, as well as termites, while others might concentrate in more particular concerns, like bedbugs, rodents, or wild animals control.

Before deciding, assess the kinds of pests you are actually taking care of. If you're experiencing a termite infestation, for example, you'll require a provider that focuses in pest treatment and also prevention. Similarly, if you have concerns with mice or even creatures, try to find a supplier along with expertise in holding and also humane removal.

Make certain to inquire the firm concerning their expertise with your certain insect issue. A focused company will definitely have the tools, methods, as well as know-how to handle your insect concern extra properly than one that handles an extensive stable of parasites.

3. Read Through Testimonials as well as Seek References

Some of the greatest techniques to review a Kissimmee Pest Control provider is through going through consumer testimonials as well as requesting references. Appear for on the web assessments on platforms like Google.com, Yelp, and also Angie's List to find what other customers have experienced. Good feedback as well as testimonials are actually a great clue of reliable solution and also efficient parasite control techniques.

Furthermore, talk to pals, household, or next-door neighbors that stay in the Kissimmee location for referrals. Personal recommendations can easily give you insights in to the premium of service, consumer satisfaction, and the lasting efficiency of the treatments supplied.

Distrust firms with consistently adverse customer reviews or grievances regarding amateur actions, hidden charges, or even ineffective bug control treatments. A trustworthy firm is going to have a strong report of customer contentment and be available to addressing any sort of concerns.

4. Analyze Their Insect Control Methods

Various insect control providers use varying techniques, ranging from standard chemical treatments to a lot more ecological choices. If you possess concerns concerning chemicals or even yearn for an extra green approach, inquire the company about the methods they make use of.

Some providers may use integrated parasite management (IPM), which pays attention to lasting deterrence via a mix of all-natural, technical, and chemical strategies. IPM is actually a comprehensive technique that minimizes the dependence on chemicals and concentrates on getting rid of the underlying reasons for parasite concerns.

Be actually sure to inquire the company concerning the security of the products they make use of, particularly if you possess family pets, children, or allergies. A credible company will definitely be actually clear concerning the materials they utilize as well as explain the prospective threats, if any type of, involved.

5. Review Pricing as well as Company Deals

While price must not be the exclusive consider your decision, it is crucial to contrast pricing among various providers. Acquire quotes from various business and also examine what is consisted of in their service deals. Some providers deliver one-time treatments, while others may use ongoing bug control strategies, which could be actually even more cost-efficient in the end.

See to it to make clear whether the quote consists of an assessment, follow-up check outs, and any type of warranties on their job. A reputable pest control company will certainly supply translucent rates without any hidden expenses and also a crystal clear illustration of what companies you will receive.

Also, inquire regarding solution warranties. Numerous reputable parasite control carriers supply guarantees to guarantee the effectiveness of their treatments. If pests yield after treatment, the firm will re-treat the area at no extra cost.

Conclusion

Picking the right pest control carrier in Kissimmee involves cautious point to consider of many variables, featuring references, expertise, evaluations, methods, and also pricing. By observing these 5 suggestions, you can easily make certain that you select a reputable, effective insect control company that are going to deliver enduring remedies to your bug troubles. Making the effort to research study and contrast choices are going to cause satisfaction as well as a pest-free home or even organization.

All American Pest Control

1101 Miranda Lane, Suite 131

Kissimmee, FL 34741

(321) 337-0919

Kissimmee Pest Control

[artemisbarnowl]

So just wondering basically whatever you can think would be good advice or insight or tips for someone wanting to move to Melbourne from the UK

Doesn't have to be limited to the likes below;

healthcare, prescriptions (I have a few chronic illnesses; nothing too serious, but I do need different medications etc), Visas, nominations, what sort of yearly wage/income would I need to be comfortable, taxes/insurance, bills, education (I don't have a family; but say I wanted to do a uni course, could ?); rent or buy, is a car needed, should I look into city living or suburb living, is it safe for a single female to move there & live on her own... and yeah just anything else you or anyone else can think of, l've never moved abroad before

Oh sis I'm sorry but as a native a lot of stuff like visas or healthcare for an expat I won't know about. I feel like the procedure is fairly similar to the UK in that you go to a gp first for scripts or any tests and referrals. We've got Medicare which is similar to NHS but I don't know when or how you can get a medicare card once you move here.

It depends where you are but I reckon you'd be fine to move and live alone (like misogyny is everywhere but it's not like women don't go anywhere alone), however living alone is EXPENSIVE, almost prohibitively so. The minimum wage for full time work is around 50k a year, or 900 a week before tax, rent for an apartment is at least 350 but that's for a studio that's small and likely old, or in the middle of nowhere where you need a car. The average "entry level" apartment in a major city is going to be around 600k and generally requires a 20% deposit. Repayments will vary with interest rates and size of mortgage. It's very common for people to live in share houses and it's not difficult to find women only ones but I haven't lived in a share house in over a decade so wont know much about good platforms or how the search goes.

Taxes are mostly automatic, your pay is taxes before you get it, sales tax is included in all prices where it's applicable, it's unlikely you'll have to pay additional at eofy unless you're earning a lot more (over 90k) and don't have private health insurance. You can study, but courses will be expensive as you likely won't be eligible for a commonwealth supported place which has reduced fees.

If you need a car depends on where you live. I recommend looking at job listings for things you'd likely be doing to get an idea of wages, and looking for housing/rent prices in different areas. Once you've picked a city, you've still gotta get a feel for where things are in relation to each other, what part of the city etc etc real estate dot com, seek, and the public transport website for each state can help with figuring distances and if you want a car. I don't THINK it's difficult for poms to move here as there are plenty and they do it all the time, there might be websites or forums to discuss common hurdles that can help.

Other important info: footy means one of 3 games (rugby league, rugby union, or AFL), the big beer is nearly always called a pint but the small ones change by state, it's a parma, "how are you?" is a hello type greeting that should be answered with a basic 'good thanks' and not the truth unless the asker is quite a good friend.

[femmefatalevibe]

I am currently taking a course to start copywriting/editing as a side gig to my main career. I have the basic writing and grammar skills required, so I am taking the course to familiarize myself with the job itself. That being said, do you have suggestions for how I might market those skills after completing this course to obtain some jobs? I have helped friends and family edit documents forever but I have no paid experience. My coworker suggested Upwork, which I might try, but I am still seeking outside suggestions.

Hi love! I would say to create a portfolio of your work/clips from any projects relevant to your industry from school, helping family/friends, or self-created mockups that are similar to the types of work/projects you want to do for clients. I think it's best to take a global/local approach here.

Online, I would market your services on Upwork/optimize your LinkedIn profile to potential copywriting clients in your niche/industry. Creating a website (even a blog if you have the time/energy) also legitimizes your presence. On a local level, I would pitch your local businesses (like coffee shops, hair salons, restaurants, etc. – depending on your niche, definitely do some research to see if they're hiring) to do some initial projects like social media copywriting or website copywriting for them to get your foot in the door (lower rates tend to be part of the game in the initial stages).

Also, I recommend pitching yourself to publications to do some freelance commerce writing in your niche to gain some free (and also paid even if the rates are low) press coverage for yourself. Friends and family/professional network referrals also are a goldmine if you have any available to work with.

Hope this helps xx

[itsaspectrumcomic]

hi im really sorry to bother you, and obvs you dont need to answer this at all im just some internet guy lol but do you think i could get some advice?

so ive been diagnosed with autism for like, 5 years (was diagnosed p late, in comparison to others) and im beginning to have some real goddamn big suspicions that i Also have adhd (because. yaknow. the gift that keeps on giving yk? lol). i have a lot of really major issues with executive dysfunction that is directly impacting schoolwork and also a lot of stuff in my life, generally. ive also got a lot of memory issues nd junk

and the thing is; ive got a therapist, but due to a whole slew of things im really scared to like, bring this up with her yk? and, like, im a minor so i cant exactly just seek it out myself yk? and i cant really talk to my parents about it because my mom is a very specific kind of vaguely ableist and my dad generally just isnt involved with that whole section of my being, yk? like, he doesnt manage any of my therapy, aside from bringing me to appointments when my mother isnt available.

and like, ive brought certain things UP to my therapist before and it went mostly ok, aside from one pretty distressing misunderstanding but it feels different for this one because i really do need medication for this, i feel. and thats a whole thing with my mother specifically, since at the start of the whole diagnosis process she outright refused the idea of medication and like. idk man, im so super sorry to write a whole bullshit essay when you're literally just vibing but yk. idk who else to ask lol, and you seem like you know what youre doing i guess?

real sorry. thanks in advance. insert other applicable signoff message here

I'm sorry you're struggling with this. Your therapist should be someone you can talk to about things like this but I understand being anxious about it. Are you afraid to bring it up because she's said ableist/anti-adhd stuff in the past or you have reason to suspect she won't help? If that's the case I really recommend trying to get a different therapist if you can. You deserve a therapist you feel safe sharing things like this with.

If it's impacting schoolwork it might be worth talking to your teachers to see if there's any additional support you can get from them. You don't have to tell them you suspect ADHD if you don't want to, you can just tell them you've been struggling with certain aspects of school and hopefully they can help. School is hard for lots of people so know you're not alone.

It might be different where you live, but in the UK you're able to make your own doctors appointments if you're over 16 so asking a doctor about getting a referral for a diagnosis/medication could be an option as well. Although waiting lists for that are incredibly long at the moment - I've personally been waiting nearly a year just to get an appointment 🙃

In the meantime, have you heard of How to ADHD on YouTube? Her channel has lots of videos with advice and various discussions about living with ADHD which you might find helpful.

Sorry I don't know if that helped much but I hope you're able to get support soon!

[mcginnlawfirm]

What is the role of the prosecutor in a criminal case?

Facing criminal charges is a daunting experience that can significantly impact one's life. Securing competent legal representation is crucial to navigating the complexities of the criminal justice system and safeguarding one's rights. This article delves into the prosecutor's role in a criminal case, emphasizing the importance of hiring an experienced criminal defense attorney in Council Bluffs. It also provides guidance on finding reliable legal representation and outlines the benefits of engaging local legal professionals.

Understanding the Role of the Prosecutor in a Criminal Case

A prosecutor is a state or government legal representative responsible for presenting the case against an individual accused of breaking the law. Their primary objective is to ensure justice by proving the defendant's guilt beyond a reasonable doubt. The prosecutor's responsibilities encompass several stages:

Investigation and Charging: Prosecutors collaborate with law enforcement agencies during the investigation phase to assess evidence and determine whether sufficient grounds exist to file charges. They decide which charges to bring based on the evidence and applicable laws.

Pre-Trial Proceedings: During this phase, prosecutors negotiate pleas, file motions, and prepare for trial. They are also responsible for disclosing evidence to the defense and ensuring that the defendant's right to a fair trial is upheld.

Trial: At trial, prosecutors present evidence, examine witnesses, and make arguments to establish the defendant's guilt. They must adhere to legal and ethical standards, ensuring justice is pursued fairly and impartially.

Sentencing and Appeals: If a conviction is secured, prosecutors may recommend sentencing. They also handle appeals, defending the conviction against any legal challenges the defense raises.

Understanding the prosecutor's role highlights the adversarial nature of criminal proceedings and underscores the necessity of having a skilled defense attorney advocate for the accused.

Qualities of a Reliable Criminal Defense Attorney

When seeking legal representation, especially in serious matters like felony charges, it's essential to find an attorney with the following qualities:

Experience and Expertise: An attorney with extensive experience in criminal law, particularly in handling cases similar to yours, can provide invaluable insights and strategies.

Strong Communication Skills: Effective communication is crucial for negotiating with prosecutors, presenting arguments in court, and informing clients about their case progress.

Analytical and Research Abilities: A competent attorney can analyze complex legal issues and research precedents and apply them effectively to your case.

Integrity and Professionalism: Trustworthiness and adherence to ethical standards ensure that your attorney will act in your best interest.

Local Knowledge: An attorney familiar with the local legal landscape, including the courts and prosecutors in Council Bluffs, can more effectively navigate the system.

Steps to Find the Best Criminal Defense Attorney in Council Bluffs

Finding the right attorney requires careful consideration. Here are practical steps to guide you:

Research and Referrals: Start by researching criminal law firms near you. Seek recommendations from friends, family, or other legal professionals who may know experienced criminal lawyers in Council Bluffs.

Review Credentials and Experience: Examine potential attorneys' qualifications, experience, and areas of specialization. Look for those who have successfully handled cases similar to yours.

Schedule Consultations: Many attorneys offer initial consultations. Use this opportunity to discuss your case, assess their communication style, and determine whether they fit well.

Assess Reputation: Read client reviews and testimonials. A strong reputation can indicate reliability and competence.

Discuss Fees and Payment Plans: Ensure you understand the attorney's fee structure and whether they offer payment plans that suit your financial situation.

Benefits of Hiring Local Legal Professionals

Engaging a local criminal defense attorney in Council Bluffs offers distinct advantages:

Familiarity with Local Courts: Local attorneys understand the procedures and preferences of local judges and prosecutors, which can be beneficial in strategizing your defense.

Accessibility: Proximity allows for more convenient meetings and better communication.

Community Connections: Local attorneys often have established relationships within the legal community, which can aid in negotiations and obtaining favorable outcomes.

Common Legal Services Offered by Criminal Defense Attorneys

Criminal defense attorneys provide a range of services, including:

DUI Defense: Representing clients accused of driving under the influence, aiming to reduce penalties or dismiss charges.

Felony Defense: Handling serious charges such as assault, robbery, or drug offenses, working to protect clients' rights and achieve the best possible outcomes.

Misdemeanor Defense: Addressing lesser charges like petty theft or minor drug offenses, striving for minimal penalties.

Court Representation: Advocating for clients during trials, hearings, and appeals to ensure fair treatment.

Practical Tips for Choosing a Criminal Defense Attorney

Verify Credentials: Ensure the attorney is licensed to practice in your jurisdiction and has a clean disciplinary record.

Evaluate Communication: Choose an attorney who communicates clearly and promptly.

Consider Specialization: An attorney specializing in criminal defense is more likely to be up-to-date with relevant laws and defenses.

Assess Comfort Level: It's important to feel comfortable discussing personal details with your attorney, as trust is crucial in this relationship.

If you or a loved one is facing criminal charges in Council Bluffs, seeking legal representation is imperative. Contact a trusted and experienced criminal defense attorney today to protect your rights and secure the best possible outcome for your case.