#many of us do not have family doctors and have no way of seeking treatment or basic aid

[genericpuff]

hi this is your obligatory reminder from a Mi'kmaq-Saulteaux pal that:

1.) the ribbon skirt is a traditional ceremonial garment worn by many First Nations women to celebrate their connection to Mother Earth and reclaim their Indigenous identity from and in spite of colonization;

2.) the RCMP was literally founded as a colonial police force meant to drive Indigenous / First Nations peoples out of their territory to make way for settlers (see: the "starlight tours")

3.) racism towards indigenous people in Canada is still alive and well (the last residential school didn't close until 1996) and so the RCMP adopting ribbon skirts is not only incredibly tone deaf towards their own history and the role they played in wiping out Indigenous culture, but insulting to the practice of ribbon skirts and what they mean to many Indigenous people across the country

4.) when a government entity limits who can comment on their posts, that should tell you exactly where their priorities and intentions lie.

[genderqueerdykes]

Feminizing HRT Overview, Guide & Information for All People Seeking It

we also have a version of this post for testosterone/masculinizing HRT as well. we wanted to write a companion piece as many folks have asked about this. it has take a bit of time, but here we are!

The testosterone HRT post is here.

Getting Your Prescription

To start taking estrogen, you will need to find a general practitioner, family doctor, endocrinologist or informed consent clinic where you can discuss gender affirming care with knowledgeable staff. Planned Parenthood is a good option for many trans people in general. Your mental health may also be evaluated, and your heart health and screening for a few other health conditions, as well as having access to your family health history if possible will be required.

Check to see if you have medical insurance, either through your family, your job, or if you are low income, a program like medicaid. Search for low income insurance plans in your area if it is needed, many places offer insurance plans for those who can't afford care on their own.

Here is a map of informed consent HRT clinics in the US.

You will discuss any gender dysphoria, gender presentation needs, if you have a support network, how you are impacted by your gender in your every day life with your provider and so on before being given a prescription. You will only be given a prescription after you discuss the risks of HRT and are screened for possible health problems and diseases or ways your body could react negatively to HRT. If you have needle trauma or phobias and can't inject hormones, it's best to bring it up before you get your prescription to save time and confusion.

The Medications

Treatment typically starts with spironolactone (aldactone), an anti-androgen that blocks androgen receptors ("male" sex hormones) for a few weeks, and then add estrogen, but many folks start with spiro and estrogen at the same time. Spiro will lower the amount of testosterone your body makes. For some people, spiro isn't necessary at all!

Some forms of spironolactone are reported to make folks pee like crazy, others do not have as bad of a time with it. Your mileage will vary depending on manufacturer. Spironolactone is intended to be a blood pressure medication, meaning it is a diuretic and is intended to help your body flush out fluids + salt. You will need to keep yourself hydrated if you notice this effect, as well as increasing electrolyte intake where possible.

Estrogen also lowers how much testosterone your body makes, and triggers changes in the body that occur during puberty in afab & adjacent people. Estrogen can be taken several ways, and is usually taken daily, and several times a day. You can take it in a pill or shot, and several forms of estrogen that can be applied to the skin like creams, gels and patches.

Make sure you thoroughly sanitize the skin of any injection sites or areas you will be applying gel or patches. If you are given topical estrogen, make sure you wash your hands after application and do not have someone else apply it for you. Make sure you do not go swimming or shower within several hours of application to make sure your skin absorbs the hormone.

You may not need to take anti androgens if you are doing estrogen injections, depending on how effective the estrogen injections are for you. Some people may not end up needing anti-androgens at all, and may be able to skip that entirely as spiro has unwanted side effects. Your natural hormone levels will dictate whether or not it's necessary, but it is not necessary for everyone.

You may end up being recommended to switch from one form of estrogen to another as your transition progresses, depending on how your body responds.

It's recommended to not take estrogen as a pill if you have personal/family history of blood clots in a deep vein or in lungs (venous thrombosis).

Some people also end up taking progesterone as well alongside estrogen. Progesterone is typically taken to encourage breast tissue growth, as this is the most prominent effect of the hormone. If sufficient breast tissue growth isn't seen from estrogen alone, progesterone can be added to your regimen, though this is only done later on into treatment, around a year or so in.

If you choose injectable estrogen, make sure to listen to your provider and ask for instructions about how to use needles and syringes, as well as injection angles, how and where you'll be injecting. Do not inject in the exact same spot every time, this can prevent the issue from healing properly and create scar tissue or cause infections or skin tissue necrosis (death). You also need a sharps container to safely dispose of your needle tips. Never re-use a needle, even if it was used previously on yourself. Always ask the pharmacy if you need more needles. A lot of places let you get them in bulk.

If you are going the injection route, make sure you know whether or not you are instructed to do intramuscular or subcutaneous injections. Intramuscular injections usually taper out of the system more quickly and need to be done more frequently, where as many patients find subcutaneous injections less painful and easier as they can be done less frequently.

For more information on safe intramuscular or subcutaneous injection for estrogen, please read here.

Another option for feminizing HRT is to take gonadotropin-releasing hormone (Gn-RH) analogs. They lower the amount of testosterone your body makes and may allow you to take lower doses of estrogen without using Spiro. Gn-RH analogs are usually more expensive, but are an option if for whatever reason the conventional route can't work for you.

DON'T GIVE UP IF YOU DON'T SEE THE EFFECTS YOU WANT TO SEE RIGHT AWAY! Many of them can take a long time to develop, often times patience is the key. If you wait it out and still don't see the results you'd like, you can try another route. Don't give up, a lot of people get deterred in the early stage of transition, you'll get there with patience and communication.

Stay patient, stay positive!

What to Expect from Feminizing HRT

Less facial and body hair growth: typically happens 6 - 12 months after treatment starts. Full effects within ~3 years on average.

Slower scalp hair loss: begins 1 - 3 moths after treatment begins. Full effect between 1 - 2 years on average.

Softer, less oily skin, and changes in general skin texture: 3 - 6 months after treatment starts, full effects within 2 - 3 years on average

Rounder, softer features including face and body, and more body fat: 3 - 6 months after treatment starts, full effects in 2 - 5 years.

Breast development: begins 3 - 6 months after treatment starts, full effects within 2 - 5 years on average or more, according to medical studies, but it can vary wildly from person to person, give dosage and hormones taken. If desired effects are not seen, progesterone can be taken alongside estrogen to help after around one year on estrogen. When breast growth begins, it starts with hard lumps under the nipples along with some soreness and itchiness. Some have sore breasts for a long time, and some may get scared and think they have cancer during this stage. Breasts will be swollen and tender for good while, and nipples may be especially sensitive to even light touch.

Reduced muscle mass/density: 3 - 6 months after treatment starts, full effect in 1 - 2 years on average

Potential decrease in libido if on estrogen alone, though not guaranteed: If it happens, it's generally within 1 - 3 months in and can last a while, but may even out over time

Fewer erections, decreased ejaculate volume, and erections that can become painful or uncomfortable if frequent erections are not maintained. This begins 1 - 3 months after treatment starts, and the full effect is within 3 - 6 months. Regularly maintaining erections and frequent ejaculation can ease some of these uncomfortable feelings in some people.

Changes in how orgasms feel, changes in texture and degree of sensation of penis and scrotum skin as well as changes in body odor: typically begins within 3 - 6 months, though it varies from person to person. Often times the way one's body responds to orgasms completely changes, many people find themselves experiencing full-body orgasms and more intense erogenous zones elsewhere in the body other than the genitals.

Smaller testicles, or testicular atrophy happens within 3 - 6 months and the full effects are usually seen within 2 - 3 years.

Increase in size of bladder and decrease in size of prostate over time which can lead to making one's gspot harder to find, and make prostate examinations more difficult, though they are still vital, as prostate cancer is still a possible factor.

Potential mood fluctuations while adjusting to the hormones, many report increased crying and sadness during the first 3 - 6 months with this tapering off after a full year at most.

Increased fatigue while adjusting to the hormones, sleepiness and becoming easily exhausted are common reports. This can vary drastically from person to person, ymmv.

If you have testicles and choose to have them removed, you may need to take testosterone as well as estrogen in order to have a healthy endocrine system. You will need to discuss the effects of this with your specialists if you want to go this route. If your androgen levels get too low because your body cannot synthesize enough testosterone after bottom surgery, you may need additional medication.

Potential infertility, though this is not a guarantee, and safe sex should still be practiced at all times. No timeline projected though the longer one is on E the more likely it becomes.

Monthly cycles akin to menstrual cycles: these are not present in everyone, but many people report entering a cycle of extreme fatigue, body aches, abdominal cramping in the approximate area where a uterus would sit, headaches, and more for around the duration of a menstrual cycle (4 - 10 days on average).

Progesterone inversely to estrogen can cause an increase in libido in most who take it, and is the primary hormone used for breast growth. Lactation may also occur while taking prog, if this happens, talk to your doctor right away.

Keep track of your progress when and where you are able, and don't be afraid to bring up any concerns you may have with your professionals or trans friends, or any other trans resource. Your transition is in your hands and you're allowed to modify it as you see fit. If you do not see the effects you want from traditional HRT, you may be able to seek the Gn-RH route, and if you aren't seeing the results you want from just estrogen, progesterone might be of use to you.

You will need to keep an eye on your bone health as high levels of estrogens can increase your chance to develop osteoporosis, and potential new cancers like breast cancer may arise, as well as heart problems. Getting checkups as frequently as possible and communicating with your doctor/s will be of great use when and where possible

Either way, we hope this helps in some way! We will add to it as we find/think of more information. Good luck to everyone seeking feminizing HRT, you deserve to look and feel like yourselves!

[turtletaubwrites]

Bend Until You Break ~ Part 1

Thank you for this request from the lovely @anemptypuddingcup for a Yandere!Law that the Reader goes to for help with a serious health condition, only for Law to take a liking to her... I swear I will write sweet Law one of these days, but for now please enjoy Yandere!Law. This contains !!DARK CONTENT!! so please check the warnings, and skip this one if it may be triggering or uncomfortable for you. This one's for us hypermobile baddies out there. 🥄

Pairings: YANDERE!Trafalgar Law x Fem!Reader

Bend Until You Break ~ Masterlist

Word Count: 2679

Ao3 Link

Summary: You have struggled with mystery pains and injuries for most of your life, and had resigned yourself to suffer after every doctor told you there was nothing wrong. But when a world renowned doctor/pirate comes to town to offer aid in exchange for supplies, you decide to give hope one more chance. Maybe you'll finally find a doctor you can trust.

Rating/Warnings: Explicit Sexual Content, 18+ ONLY, MDNI, AFAB!Reader, She/Her Pronouns for Reader, Reader-Insert, DARK CONTENT, DUBCON, Dubious Consent, Swearing, Eventual Smut, Yandere, Manipulation, Power Imbalance, Hypermobility, Medical Examination, Medical Trauma, Medical Conditions, Chronic Pain, Injury, Physical Disability, Physical Therapy, Doctor/Patient, Abuse of Authority, Kidnapping, Possessive Behavior, Other Additional Tags to be Added, (Reader is described as having hair "above her shoulders" that she can brush)

A/N: This chapter is SFW, but I'm adding in many tags to start out with since this mini series will contain heavy/dark content. PLEASE heed the tags, and do not read this fic if you aren't comfortable with these topics. Some of these medical issues may or may not have come from personal experience 🙃

Extra A/N: I am not a doctor, and this is not meant to be educational, or to contain any health advice. Please seek a health professional. Hopefully you'll have better luck than Reader 🙄

| masterlist | about me | rules | ao3 |

I should just leave. He’ll just tell me the same things. It’s a waste of time. 

You were close to convincing yourself to walk away, especially as the discomfort and pain of standing in one place for so long started radiating up your body. 

The line got shorter, and you stretched and bounced, trying to hang onto a sliver of hope.

“Hello, how’s your day going?”

A talking polar bear in an orange jumpsuit waved at you from behind a small table, handing you a clipboard. 

“I-I’m well thanks. How…”

“Good! It’s always nice when the captain can help people. He’s the best! Just fill that out, and he’ll be with you soon.”

Looking at the form brought you out of the shock of speaking to a bear. Instead, it filled you with intense frustration, until you were practically boiling in your skin.

‘Rate your pain from 1-10.’

How the fuck am I supposed to rate all the different types of pain I’m in on any given day?

‘Circle the parts of the body where you are experiencing pain.’

I could put circles over so many things. Might as well circle the whole fucking chart, and have them call me a liar.

‘List your diagnoses, and family medical history.’

I don’t have one, doctors never find anything. Mom has some similar symptoms, but they're so mild that she's never tried to get a diagnosis. You’re the one who’s supposed to figure this out!

You resisted the urge to vent your anger onto the page, bullshitting your way through instead. You tried to write in the most convincing way to get this new doctor to take you seriously. 

This new doctor. “The Surgeon of Death.” A fucking pirate. 

But he was supposed to be the best, and he was here on your shitty little island for a couple of weeks, trading medical treatment for the town's supplies. You had already heard reports of “miracles,” that he could perform surgeries in an instant, that he could fix anyone. 

Please fix me.

This was it. You couldn’t take anymore trying after this. Just trying to get a doctor to listen to or believe you was almost worse than the daily pain. Almost.

“Miss Y/N? The captain is ready for you now. My name is Bepo, by the way,” the bear grinned as he took the clipboard from your clammy hands. At least you hoped it was a grin.

He handed the form back to you as he led you through the dimly lit hallways of this strange submarine. It felt like you’d entered some other realm, an underworld, on your way to strike a deal with a demon. 

As long as he can fix me…

“Here you are,” Bepo motioned as he opened a large metal door. “You’re in great hands.”

Hands. 

Hands were the first things you noticed as you entered the examination room. 

Those hands were tensed over the back of a rolling chair, gripping the thin padding as if waiting for you so he could sit down. 

Long fingers mesmerized you, tattoos etched along the back of each hand. And as you stepped into the well lit room, you saw the word “death,” spelled out across both sets of those fingers. 

The sound of his throat clearing snapped your eyes to his, your skin flushing as you realized he’d been speaking to you. 

As you realized how fucking gorgeous he was. His black hair looked a bit mussed, but it only added to the effect, along with his goatee, and his dark, pretty eyes.

Already more useful than my other doctors. Easy on the eyes. 

“May I look at your form, miss?”

‘Oh, of course,'' you stuttered, thrusting the paper toward him. “I’m Y/N.”

“Dr. Trafalgar. You can take a seat.”

Well, his bedside manner seems pretty standard, you thought with a small sigh, sitting down on the familiar crinkly paper covering the exam table. 

He circled behind you to close the door, and what sounded like a lock clicking into place had your heart rate spiking. 

“Stand up, please,” he said firmly, your form still unseen in his hand. 

“Oh, sorry. I thought you said–”

“Walk to the corner, and sit back down, please.”

His voice was unreal. You would have jumped through hoops for him anyway, praying that any doctor would listen. 

But his command seemed to curl into your brain, and you followed it immediately. 

“Why are you favoring that hip?”

“Oh, it…” 

Here’s where your credibility would fall apart. Your nails dug into your palms as you willed him to believe you.

“Sometimes if I stand too quickly, it feels loose. Sometimes it pops, and is so painful that I can’t put any weight on it.”

He stared at you for a moment, and you fought not to recite a list of excuses, to try to explain why it hurts when you’d never been injured before. 

“And your right knee?”

“Oh, it’s not bad right now. It used to swell sometimes, and was really painful. But it’s not as bad as it used to be.”

“Did you sustain any injuries?”

“N-No. None that I can recall.”

His lips quirked a bit before he reviewed your chart.

Believe me. Believe me. Believe me.

“You’ve reported your shoulders as being your most pressing concern. Why is that?”

His eyes were almost painfully sharp as he scanned you, focusing on your face as you answered him. He’d sat backwards on the rolling chair, his arms folded across the back with his legs spread wide to either side.

“They’ve been acting up recently. They often feel… loose. That’s how it feels to me. Sometimes if I move a certain way it almost feels like they pop out of place. But I can still move them after, it’s just incredibly painful. And then it’s weak, and I can barely hold anything.”

“What are some of the activities that have caused this to happen?”

He was impossible to read. But you couldn’t lie. He wouldn’t be able to help you if you lied.

“Um, brushing my hair. Taking off a jacket. P-Putting a sports bra on.”

“Did you used to have longer hair?”

“What?”

“Do you keep your hair above your shoulders to prevent shoulder pain? Or does brushing it still cause issues at this length?”

“Oh. Yes, actually. I used to have much longer hair.”

“I imagine you’ve adjusted many aspects of your life to cope with this pain.” 

Warmth flowed into that deep voice, and you shivered as you watched him steeple his fingers against his lips for a moment. 

“If you are comfortable, I would like to run through a few simple movements to check your flexibility. Many of which you can do on your own, but I will check in again if you are comfortable with me touching you for the others. You can always let me know if you would like to stop.”

“Okay.”

The doctor dug through a drawer to pull out a clear measuring device, almost like two rulers connected at one end. He adjusted it, creating an angle before setting it aside. 

He never picked up the device again, and you fought not to shake. He looked at your elbows, your knees, your thumbs, your pinkies, frowning slightly as you followed his instructions.

“Now, please bend over, and try to touch your toes. Just go as far as you– hm.”

Your palms were flat on the ground, just as they’d always been able to go. You could even put the back of your hands down, and stretch them along the ground behind you if you wanted to. 

“Doctor?”

“You can take a seat.”

Wincing as you sat, you shook out your legs, feeling his eyes as he watched your every movement. 

He stood, towering over you as he came close.

“For this next part of the examination, I will be touching you with my hands, and in some cases leaning or holding parts of your body against mine so that I can check the range of motion in your joints. I may also massage certain tight muscles to help you relax as we move through the problem areas. You have quite the list for us to get through, but if at any time you wish for us to stop, just let me know. Do you understand?”

“I do,” you breathed, your face angled up to meet his.

“Do you consent to me touching you?”

His voice came out softer once again, and you couldn’t hold in a shiver as you consented.

Those fingers…

His long fingers were so gentle as they crept across your body, testing, pushing, pulling. You fought to listen to his commands, pushing against or holding your body how he told you. 

“I imagine that seeking treatment has been challenging for you,” he rasped as he leaned over your face, his fingers gently massaging your shoulders. 

The pain and pleasure of his hands testing you had brought up a strangely emotional pressure, almost like tears in your throat.

“It has.”

“I’m sorry, Y/N. It must be incredibly difficult to suffer so much pain, and not be believed.”

You started to nod to keep your voice from cracking, but he pressed his fingers into your skin just a bit.

“Can you keep still for me,” he whispered, and it sounded so close that you opened your eyes.

“Just relax,” the doctor soothed as he stepped away, pulling a few tissues out to press against your cheeks and temples, catching the tears that had spilled when you’d opened your burning eyes.

“I’m sorry, doc–”

“No need to be sorry, Y/N. You have been suffering, been living with pain for years. It’s all those doctors that left you like this that should feel ashamed.”

His fingers had returned to your body, still relaxing, and testing.

“Thank you, doctor.”

“Please, call me Law.”

He was pressing gently along your collarbones as his name rolled over you, a small sound escaping your throat as you melted beneath him. 

“Do you have a good support system? People in your life that can help you with this?”

“I mean, my mom and my boyfriend help me. They’re supportive.”

He took those fingers away, and you mourned them, wishing you could feel that soothing touch forever.

“I’m going to test your hips now, Y/N. Please tell me if you experience any pain.”

“Okay,” you agreed, feeling self conscious of your breathy voice. His words just kept pouring over you, his voice so relaxing, so good. 

“How does that feel, Y/N?”

“Fine.”

He had your leg stretched along his torso, your foot dangling over his shoulder. You clamped your eyes shut. The sight of him between your spread legs, pushing your leg toward you, had you biting your lip, trying not to make any more embarrassing noises. 

“How’s this?”

“Fine.”

He hadn’t gotten close to your limit, but he went agonizingly slow. You could feel his firm abs warming your thigh through your clothes, his thin shirt not doing much to keep the press of him at bay. 

“You said that your mom and your boyfriend support you. How do they do that?”

“Oh, uh,” you shook your head, trying to focus on the question, and not the gentle rocking motion he’d started as he pushed you even further.

“They help me when… They help me when I’m having bad days. They listen. They both do little different things when things are bad.”

“How’s this?”

“Still fine.”

“You can go further?”

“Yeah, I can–,” you had reached for your thigh, planning to pull it toward your chest to show him, but his eyes above you stopped you before his voice did. 

“I’ll get you there, Y/N. You can hurt yourself if you rush. Can you take it slow for me?”

“Perfect,” he praised when you nodded, still gently rocking your body forward and back as he pushed, finally reaching the limit. 

“That is quite the range of motion,” he noted, carefully laying that leg down to move to the other side. “May I?”

He set himself up again, moving slow as he used his body to stretch you.

“You said that they help you on bad days, is that right?”

Meeting his sharp eyes, you took a minute to understand.

“Yes, they do.”

His face tilted a bit as he pressed closer. He started that gentle rocking motion, almost thrusting against you to help your body relax. 

“But Y/N, from what I’ve seen today, it seems like all of your days are bad. Aren’t they?”

“I…”

“All these years with no one to believe you. It must be hard to believe yourself sometimes. Do you think they really believe you, Y/N? Do they believe how much pain you’re in as you struggle through each day? As you stand up too fast, or brush your hair? Do you think they understand?”

He’d pushed closer, looming over you as he held your thigh against him. 

“Why are you–”

“I need to make sure that my patients have the support systems they need.”

His voice had smoothed back now, from almost heated to cool and detached.

He’s the only person that’s ever seemed like they understand. He must believe me. Of course he would be passionate about it, he’s a doctor. A doctor that believes me.

Closer and closer, his eyes watching yours.

“Do they believe you?”

“I think,” you started, eyes wide as you fought more tears, “I think they try to believe me. They just… They don’t know what it’s like. They don’t understand.”

“How’s this?”

“It’s fine.”

“Alright, last push.”

Your thigh was pressed between your bodies, and he stayed there.

“Does this hurt, Y/N,” he rasped, his breath warming your face. 

“No.”

He helped you stretch your leg out on the table, sitting backwards in the rolling chair before he told you to sit up.

“I believe I understand the cause of your pain, and why you’ve had a difficult time obtaining a diagnosis.”

“Can you fix it?”

Your thrill of excitement got caught in your throat at the look in his eyes, his palm up to halt your questions. 

“I believe it may be a connective tissue disorder, which would explain your hypermobility, as well as the complications you’ve had with many parts of your body. You've already met the criteria for one type based on our examination today. I would like you to come back tomorrow so that we can review more of your symptoms to be sure, and to discuss treatments.”

“You can do surgery, right? Can you fix it?”

You had gestured to him, your body panicking with failing hope. A gasp left your throat as those tattooed fingers caught your hand, his thumb rubbing over your skin as his voice went low.

“I’m sorry, Y/N. This is not a condition that can be cured,” he confessed, squeezing your hand as your body slumped. “Connective tissues run throughout our entire body, and if I am correct, yours may be weaker than most. 'Loose,' as you said. Unfortunately, there is no known way to repair or replace those tissues.”

A weight fell over you, and you found yourself not quite in your body. Your body that you’d fought so hard to fix.

That can never be fixed.

The doctor pressed your hand between his, smoothing over and warming your fingers until you were present enough to meet his eyes.

“It may not be curable, Y/N, but it can be managed. You don’t need to suffer alone in such pain like you have been. I’ll do everything I can to ensure that things are better for you. Do you trust me?”

There was something so intense about his face. The way he looked at you felt heavy, like he really did see the weight you’d carried all these years. You sank into those gray eyes, and realized you did.

“I trust you, Doctor.”

“Please. Y/N,” he hummed, releasing your hand, “call me, Law.”

Likes and reblogs bring me much ✨dopamine✨ thank you so much!

a/n: Thank you for reading! I hope you enjoyed it! Welcome to my frustration with the health care system 😅

Tag List: @shewrites02 | @jadeddangel

Part 2

| masterlist | about me | rules | ao3 |

[xkaidaxxxx]

Pt2 for Zuko x Chubby reader?

Zuko x chubby reader pt.2

Mentions: body shaming, foul language, angst, aggression, lying, fluff

Simple! :) sorry for the errors.

"One day there will be an amazing man who will fall in love with you. He'll love everything about you." Katara said. You smiled and hugged her. "Awe" Aang and Sokka said in unison. You are very fortunate to have wonderful supportive friends. Katara's words came true. Years later. When you dumped Zuko that was the day Zuko and Mai decided to leave. You missed him more than anything. Once the war was over you went back to your parents. People still judged them for taking a water bender into their family.

"Well I'm off mama," you said. You turned to the door and your father was blocking it. "Dad please don't start." he smiled rolling his eyes as he added a blade into your bag. "Just in case y/n. Now run along," he said moving away. Your dad is very protective.

You didn't want to be late for your business. Since you learned how to heal with water bending back in the war you finally found it useful in the fire nation. You saw soldiers at your place. "Excuse me soldiers...is there a problem?" you asked and crossed your arms. They turned to face you. Zuko was right at your door waiting. He thinks he can show up because he's the Fire Lord. You gladly ignored him. Opening up and walking inside. His eyes widened as the door slammed in his face. A little boy giggled. "Your girlfriend is mad at you?" he then gasped realizing Zuko was the fire lord, bowed, and ran off. He walked inside waving off the soldiers. "I'm here to see Y/n." He spoke looking around. You're a doctor. "Zuko get the hell out of here. You can seek help elsewhere." he frowned. After you went separate ways he never forgot about what you did for him. How many sacrifices have you committed? You left your family..your home...You always put him first. " My heart is aching Y/n...ever since the day we went our separate ways. I never lost thought of you. My mind kept replaying how many times you showed me all your love and support. You're the one. It took me a while to know that." he confessed. "Zuko...you're losing your mind. You obviously need to see a therapist." you continued looking at your list of incoming patients. He held your hand, gripping it lightly. He now has your undivided attention. " Y/n I'm in love with you. I need you in my life. I know you still have feelings for me." he said hoping you'd kiss him or hug him. "I don't have feelings for you Zuko. I'm flattered by your confession." you pulled away and started organizing your files. " Then why do you still have the ring I gave you on our 2nd date..and the necklace too." he called you out on it. He's willing to make it up to you even if it takes long. He frowned as you placed the necklace and ring in his hand. "Here I should've given them to you that day," you said with a shakey voice. You did still love him. More than anything. "I love you y/n. why...why did I have to break something I love too much?" those words made you cry. "you..love me Zuko?" he looked up in hope you'd let him back into your life. He nodded. "I..I love you too. Always had. Now give me those back!" you yelled snatching the ring and necklace. He blushed as you put them back on. " I want to meet your parents." you smacked his arm. "way too soon. We need to take things slowly ya know.." your first patient walked in with her lovely daughter. "Hi little one are you ready for your treatment today," you asked as you carried her. Zuko was already thinking about how many kids you'd be willing to have.

Taking things slowly was revoked. Within a month he met your parents and 5 months later you're married and living in the palace. "so..how many kids are you willing to have with me?" he asked as he undressed you for a bath. " When the time is right I'll know," you replied. You already knew the answer to that. 4.Eventually, you had a little boy. He has his Daddy's black hair and his Mommy's pretty dark brown eyes. "Daddy this hard," Akio complained and started crying. "Akio momma said no fire bending yet. wait...where did you get this scroll?" Akio pointed a the wall. Where a portrait of Iroh was placed. "Uncle is yours," Akio said. Zuko carried Akio and sighed. " yes now let us go to momma. She's waiting for us to head into town." Akio giggled excited to attend the festival. Before leaving Zuko looked at the portrait and smiled.

Once you all got to the festival you met up with your friends. " Oh, he's so adorable." Katara said holding out her arms to carry him."Akio this is my best friend Katara." you said. He hid his face in your neck. Sokka chuckled. "Ha, he doesn't like you." Katara smacked him. "Shut up." "Not in front of my son." Zuko scolded her. Katara dedicated herself to getting Akio to call her auntie. Sokka bought a small teddy bear just the right size for Akio. He was too shy to grab it at first from Sokka. "It's yours bud," you said and he grabbed it. "What do we say?" Zuko spoke to him. "Thank yous." Akio said. "Hey, kid. You look a lot like your dad. I'm Aang." "This kid is my son Akio,"Zuko said. He's grateful to Aang but boy can he be so annoying. "Right Akio. Hey!" that sudden loudness made Akio cry. "Dada" "Sshh shh it's okay come here." Zuko took him from you. He's such a daddy boy. All your friends were shocked. A kid does change people. Zuko was more open-minded and a little carefree. He's a good dad and husband. "let's go get sweets not tell momma okay." he whispered to Akio. You knew what he told him because he quickly stopped crying. Sweets. It's Akio's weakness. " we'll be back baby love you." They left. "He looks like such a good dad," Aang commented. Sokka and Katara agreed. "Yes, he is and will be again. I plan on telling him tonight. Although I think he already knows.," you replied.

[ciderjacks]

ngl I was ranting to my friend about this but I think the worst part of becoming physically disabled for me is not the shock, not the pain or shitty doctors or rescheduling or confusion or fear, but the way people start fucking treating you.

I have had so many people, good people, people I’ve known for years, start treating me completely differently. And not in like an oh it’s awkward now and sometimes they ask dumb questions way. I mean they’ve started observing my every movement, trying to find some inconsistency and “catch me lying”, calling me out openly and accusing me of faking, trying to prove I’m not really disabled. More than one person who I know has done this. I don’t know if abled people understand how insanely awful that is to do to someone. I don’t know what’s wrong with my body either, but I know what I can and can’t do. The idea that they know my body better than me is already shitty. Not only that, these people who I know and have known (often for years), are now telling me to my face that they think I’m the kind of person who would do something like faking a disability for attention. like are you fucking serious? Did you always think that low of me, or is it just because I’m a cripple now that you feel comfortable assuming that?

The main reason I’m avoiding getting a wheelchair even though my crutches aren’t working well for me anymore is because it will get worse. I can take most ableism, that attitude is not one I can take easily. It makes me nervous to exist in public, makes me nervous to do what’s right for my body.

Like, it’s disgusting, it pisses me the fuck off. How dare you treat me like I’m not a person anymore just because I’m disabled. And don’t pull that “well it’s hard for people to accept” bullshit. Shut up. You think that’s hard? I was a physically healthy person who went on walks everyday before this. Do you want to imagine being 17 in the middle of senior year and randomly losing that, and having no idea why, as it slowly progresses and doctors keep being useless? Does that sound awful to you? I bet it does- so then imagine you go through that, but the whole time your best friends and family are standing there and instead of supporting you, they’re obsessing over your movements and telling you to your face with no shame that they think you’re a lying attention seeking asshole. Imagine how terrible that would be. Imagine how betrayed you’d feel.

Idk, I wanna emphasize again that the people who do this are good people, because y’all seem to not want to acknowledge how normalized this treatment of disabled people is. You see it in media, comedy, conversation, everywhere. Abled people don’t want us to exist, so they accuse us of being fake and it seeps into everyone.

[of-mutton-and-wool]

Fellow Kallamar enjoyer I love that squid so much so you have hcs about him 👁️👁️

I HAVE BEEN SUMMONDED

Alright

First of all AHEM

- before becoming the god of pestilence, kallamar lived a fairly unremarkable life, eventually becoming a field medic in the middle of a war between gods

- he doesn’t remember his family well (it’s been thousands of years) He remembers having a sister, with his mother and father both being priests to the great Fowler and (insert former blue crown bearer)

- unfortunately then the war catches up to them. The temple in which these gods and his family resides are massacred. Kallamar survived because he hid.

- seeing the blue crown unguarded, kallamar decides to take the opportunity. In the moment he seeks it required for survival, but in the present, he realizes how that the lust for power is just too great to ignore.

- he meets shamura about a few weeks later! It started out as like a resource alliance (shamura needed crystals and kallamar needed, everything not underwater really)

- but then it kinda evolved into a sibling like bond due to some shit that happened to both of them

- his cowardice isn’t without reason. Being cocky gets you killed in the deep

- he used to be WAY more sassy and talkative before narinder’s banishment.

- oh and the scar on his face was shamura doing (it was accidental)

- the viel narinder wears is made by him!

- kallamar is a poly king and we love him for that (kinda cannon? Not sure how cannon the Valentine’s Day things are. But it’s cannon in my heart)

- oh and I hc as bi well.

- for some reason I’d imagine his followers call him the lord or just lord kallmar

- he runs his cult via fear mongering!

- AND! He recruits followers by sending out doctors into nearby oceans to urge people to come towards old faith settlements for treatment

- if I had to be fr kallamar would be the worst person to be tortured by because man’s a doctor, he knows how the body works, and he knows how to keep you ALIVE during it as well.

- as a follower, kallamar is hard of hearing (it isn’t total silence, but everything sounds like it’s underwater and thus, impossible to understand. Basically he’s aware of sound but can’t understand anything if that makes sense?)

- he also ends essentially living in the med tent because 1) he’s the token doctor 2) he’s very sickly

- he expresses affection by gift giving!

- kallamar is VERY passionate about weapons and decor. Hes VERY particular about where things go and that’s why he’s banned from decorating the cult because he’ll be there for hours. He can also tell you a lot about weapons and what kind of damage they do!

- Before coming into contact with the crown, kallamar could breathe water only. Durring and after his time with the crown, he can breathe both water and air (what crown juice does to you. Being a bishop leaves a lot of effects)

- Kallamar’s people are blessed to have a similar situation. It’s sorta a national holiday that takes place on the first day of summer in the bishops land. It’s basically where anyone that’s willing can get mass blessed and go live in the ‘holy lands’ of anchordeep

(You don’t have to. Kallamar has many beach front settlements and temples. Though your neighbors would be the folks in silk’s cradle).

- he’s a jewelry kinda guy. LOVES earrings

Anyways that’s enough rambling from me

[ceiling-karasu]

Alright! So the dormouse OC was apparently going to happen!

I keep thinking about him, so I'm going to have to turn that Tokgasi mouse deserter from chapter 3 into a new OC, and maybe include him in another chapter before his own AU.

After doing some more research this weekend, I guess I headcanon 'field mice' as being dormice (maybe specifically Japanese dormice). Dormice are more closely related to squirrels and beavers than they are actual mice, apparently.

They are also relatively rare. Which would make the Weasel Unit see them as perfect spies to sneak into Flower Hill disguised as squirrels, since it is unlikely that Flower Hill would know about the species. Any quick check while infiltrating a unit or town would prove that the tails were real anyway, so another dormouse infiltration AU could be a go.

It would easy enough for a dormouse who was used to living in poverty to desert to Flower Hill and try to live unnoticed among the populace, either because of horrible treatment at the hands of the weasels and Tokgasi, or because they are just seeking a better life than what was offered.

As for his name, the alternative name for a dormouse is 'sleepy mouse,' since they hibernate during the winter, so I am naming him Jollin (Sleepy).

Of course, there is the danger of what would happen if someone were to find out about who he really is, or if Tokgasi ever finds him again.

Obviously, I already have Flower Hill knowing who and what he is, and capitalizing on having him continue to receive orders, while sending back some true but somewhat useless information to his handlers.

I see him as having a calm, laid back job as a mail-carrier and supply deliverer between a group of small villages. Kind of like some BBC Masterpiece Theater series with a subplot about the kindly neighborhood fixture hiding a dark past. Which is what I said about the weasel doctor pretending to be an otter, so I might just be thinking about those types of plots a lot.

But Jollin could be good at solving mysteries and disputes between neighbors. He himself is a very frightened individual, and tends to act like a typical scared mouse. Everyone assumes it is some type of trauma from losing his village and family, and try their best to make him feel welcome. Still , he is determined enough to go through with Tokgasi's training in order to become a scout and escape the clutches of the weasels to begin with.

But where do his true loyalties lie? Will he turn against Flower Hill and rejoin the Weasel Unit should his luck change, or if Tokgasi forces him to join again with no way out? Or will he stay in an uncertain future where everyone in his new home may turn against him?

In a remote area, Jollin could listen to all the gossip of the neighbors and also report back on that if he gets any important information. Or, he could be innocent, and desperately trying to avoid attention. Which would allow the Flower Hill Commanders to send dismantled weapons and ammunition to the villages through him, since he would be the only one not to actually inspect why so many packages were going through the area.

Just a fun little AU.

[theautisticdoctor]

Entry #012

Hypermobility

A problem many autistic fellows of mine, including me, are suffering from is hypermobility. It's a underdiagnosed, underrecognized part of autism.

I personally deal with Ehlers-Danlos Syndrome (EDS), which runs in my family. My great-grandmother, grandmother, and mother all have it, and so do I. It comes with a host of symptoms: atrophic scars, mitral valve insufficiency, postural / orthostatic tachycardia syndrome, gastric motility disorder, pelvic and bladder dysfunction, extremely soft and stretchy skin, and, of course, extreme hypermobility. I can bend my joints in ways that I only learned in medical school was abnormal, and I’ve often felt like a bit of a freak during skills practices. I remember asking an orthopaedic surgeon during training why people couldn’t do 90 degrees flexion and extension with their forefeet, only to be met with confusion. When I demonstrated what I meant, the look on his face was one of pure astonishment. This highlights how different our experiences can be and how misunderstood they often are.

One of the most frustrating parts is not being taken seriously by some doctors. I’m lucky to have a medical degree and trusted colleagues I can consult, but many autistic individuals don’t have this luxury. Too often, our symptoms are dismissed or attributed to our mental health, leading us to delay seeking help until things get really bad. Please, don’t wait. The longer you put off seeing a doctor, the harder it becomes to treat your symptoms. Find a physician who listens and takes you seriously. Hypermobility doesn't necessarily mean you have EDS, but hypermobile or not, moving and living isn’t easy. Chronic exhaustion is real and debilitating. I touched on managing energy levels in entry #003 with routines based on my modified spoon theory, which I call the cutlery theory. I’ll dive deeper into this in a future post.

Living with hypermobility means constant joint pain, frequent dislocations, and early arthritis. I’ve never known a pain-free day, and overdoing it physically just makes things worse. Recovery takes time, and I’m still figuring out if physical and mental fatigue recover together or separately. Overstraining definitely not only impacts physical, but also my mental state. Not everyone can access rehabilitation programs, but there are steps you can take on your own to make it a little easier or better. Start by tracking your symptoms to identify patterns. This can help you find ways to support yourself. Working with a physiotherapist or occupational therapist is ideal, but you can also use trial and error to find what works for you. I’m always here to brainstorm and offer support.

I’m a big believer in creative therapy. One exercise is to color in a body image to show where you feel comfortable, uncomfortable, or in pain. This helps you and your healthcare providers understand your condition better and develop a personalised treatment plan.

Also, braces can be a lifesaver for dislocated or overstretched joints, even though I hate wearing them. They help prevent further injury and aid in recovery. Despite the awkward looks and comments, they’re definitely worth it.

In conclusion, hypermobility is often a comorbidity of autism. It can cause mental fatigue and chronic pain, among other symptoms. Don’t suffer in silence, but find ways to accommodate yourself and make life easier. Medication and surgery aren’t always the answers, although they can help. Awareness and lifestyle adjustments can make a big difference too. Talk to your physician, physiotherapist, occupational therapist, and fellow patients to find what works for you.

[justinspoliticalcorner]

Erin Reed at Erin In The Morning:

Over the past few weeks, Dr. Hillary Cass has begun giving interviews in the United States to defend her report targeting transgender care. The Cass Review has faced criticism for its alleged anti-trans political ties, biased findings, promotion of conversion therapists, and poor treatment of evidence regarding transgender care. In an interview with NPR, Dr. Cass claimed that transgender individuals' care should be judged by their "employment," rather than their satisfaction with the care received. Later, during an interview with The New York Times, Cass misleadingly stated that she had not been contacted by any lawmakers or U.S. health bodies, despite having met with political appointees of Gov. Ron DeSantis to discuss banning trans care before her report was published. In response, both the American Academy of Pediatrics and the Endocrine Society have categorically rejected the review as a justification for bans on care and have challenged many of its alleged findings. In a statement released by the Endocrine Society, they reiterated that they stand by their guidelines around the provision of gender affirming care for transgender youth: “We stand firm in our support of gender-affirming care. Transgender and gender-diverse people deserve access to needed and often life-saving medical care. NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care… Medical evidence, not politics, should inform treatment decisions.”

[...]

Similar sentiments were shared by Dr. Ben Hoffman, president of the American Academy of Pediatrics, who responded to the Cass Review, “What we’re seeing more and more is that the politically infused public discourse is getting this wrong and it’s impacting the way that doctors care for their patients. Physicians must be able to practice medicine that is informed by their medical education, training, experience, and the available evidence, freely and without the threat of punishment. Instead, state legislatures have passed bills to ban and restrict gender-affirming care, which means that right now, for far too many families, their zip code determines their ability to seek the health care they need. Politicians have inserted themselves into the exam room, and this is dangerous for both physicians and for families.”

Transgender care saves lives. A Cornell review of more than 51 studies determined that trans care significantly improves the mental health of transgender people. One major study even noted a 73% lower suicidality among trans youth who began care. In a recent article published in the Journal of Adolescent Health in April of 2024, puberty blockers were found to significantly reduce depression and anxiety. In Germany, a recent review by over 27 medical organizations has judged that “not providing treatment can do harm” to transgender youth. The evidence around transgender care led to a historic policy resolution condemning bans on gender affirming care by the American Psychological Association, the largest psychological association in the world, which was voted on by representatives of its 157,000 members.

Interestingly, Cass herself advocated against care bans in her most recent New York Times interview released today, where she stated, “There are young people who absolutely benefit from a medical pathway, and we need to make sure that those young people have access,” although she added a caveat that those young people should be forced to consent to research in order to access care, leaving many to question the ethics of such an approach. Regardless of Cass’s statements, her review is being used to justify bans in the United States and worldwide. 

Both the Endocrine Society and the American Academy of Pediatrics came out to reject bans on gender-affirming care in the wake of the anti-trans Cass Review by Dr. Hilary Cass.

Dr. Cass herself advocated against bans on gender-affirming care in a recent New York Times interview; however, her report is being used as justification for bans on gender-affirming care worldwide.

See Also:

LGBTQ Nation: Cass Review author says leading medical org only supports trans health care under “political duress”

[beloved-31-proverbs-women]

🖤 To the depressed and anxious- I’m sorry you’re hurting. You matter. Tell someone. You’re not alone. No judgement. Just love. Seek help until you get the treatment and healing you need and deserve.

💔 To the lonely and broken hearted- you are never alone and you are loved by me, because Christ swells in me. It will get easier. Time doesn’t heal all wounds, but love still can heal a whole lot. You will not hurt forever.

🤍 To the woman who lost her baby- your baby was real. You were and will always be a mother. It wasn’t your fault. You will see your child once again. You are courageous. You will always be a mother.

💛 To the ones feeling the weight of the world- slow down. You don’t have to carry it all on your own. Hand your burdens to Christ. His blood was shed, so yours wouldn’t have to be. You are more than a conqueror.

❤️‍🔥 To the ones in ministry- the enemy can try, but he won’t win. What seems broken in your life, is simply to be rebuilt by Him. You’re not demolished. You’re under construction. Expansion is yours.

🧡 To the single parents- you’re doing a wonderful job. I see you. You are appreciated. I know it’s hard. It’s OK to ask for help. You can do this.

💚 To those struggling with finances- your value is immeasurable. Wait on the Lord. May the Lord make a way and may all past due money owed come forward and may jobs open in your favor.

🖤 To those sick and suffering- diseases are not yours. They can afflict you, but they cannot destroy who you are in the spirit. Don’t claim what God didn’t hand you. He wants you healed and whole.

💜 To the church hurt- don’t stop seeking God just because you’ve found little evidence of Him in a church. You are the church! You don’t need a building to have a relationship with God. Start building your foundation.

💙 To the backsliden- we have all fallen short. Take my hand. There’s no limit on redos. Go forward once again. Stay consistent. He left the 99 for 1. You are the 1.

🖤 To the betrayed- He will never leave you not forsake you. He will judge and convict your advisories. Keep walking in love and leading by example.

💔 To the ones with a broken family- remember that blood is thicker than water, but covenant is always thicker than blood. There’s always a place at His table.

🤎 To the ones unable to sleep- may sweet sleep and peace fall upon you. You are surrounded by angels. Rest in His promises.

🤍 To the ones exhausted in every way- your help comes from above. Float in the water instead of treading in it. You’ll reach the shoreline either way. Don’t fight the current when you don’t have to.

💙 To the ones feeling ugly or worthless- you are not defined by how you look or what you can give. You are a child of God and you were created for a purpose greater than you can see.

💜 To the domestic violence victims- you do not have to remain a victim. There is a way out. You are strong enough. You are worthy enough. You deserve love and safety. You can be free. Please don’t wait to report it. You are precious to God.

💛 To parents- perfection isn’t required. It’s OK you have t showered and done laundry. Your child is blessed to have you. You are irreplaceable.

🧡 To the teachers- you make a difference. You do change lives. You’re needed and you’re of great value. Thank you for pouring into our children.

❤️ To the armed forces- you are heroes to us everyday. We are alive and free because of your sacrifice. Some may have forgotten you, but many will never forget. Thank you for all you do.

🖤 To the first responders- thank you for showing up. You are an angel to many. Your courage is honorable. Thank you for your time. It is precious.

💛 To doctors and nurses- protect and save all life- no matter how big or small. Your wisdom is needed. I pray that for the endless hours you spend serving others, that someone serves you. Thank you.

❤️‍🩹 To the rape survivors- it wasn’t about what you wore or anything your said or may have said. It wasn’t your fault. Shame isn’t yours. You are brave and you empower others when you share your survival story.

💝 To the world- we all have fallen short of the glory of God. None of us deserve His love, but He pours it into us anyway. He will never leave you and He knows how many hairs are on your head. He knew you before you were in your mother’s womb. He can handle anything that comes your way. Don’t lose hope. Walk in Faith. Preach without words, and love one another. Life can be hard to live, but love is easy to receive and even easier to give. 🩸❤️🙏🏼☝🏼

[coochiequeens]

“There is no centralized tracking of blocker prescriptions in the United States.”

By Megan Twohey and Christina Jewett

Nov. 14, 2022

The medical guidance was direct.

Eleven-year-old Emma Basques had identified as a girl since toddlerhood. Now, as she worried about male puberty starting, a Phoenix pediatrician advised: Take a drug to stop it.

At 13, Jacy Chavira felt increasingly uncomfortable with her maturing body and was beginning to believe she was a boy. Use the drug, her endocrinologist in Southern California recommended, and puberty would be suspended.

An 11-year-old in New York with deepening depression expressed a desire to no longer be a girl. A therapist told the family the drug was the preteen’s best option, and a local doctor agreed.

“‘Puberty blockers really help kids like this,’” the child’s mother recalled the therapist saying. “It was presented as a tourniquet that would stop the hemorrhaging.”

As the number of adolescents who identify as transgender grows, drugs known as puberty blockers have become the first line of intervention for the youngest ones seeking medical treatment.

Their use is typically framed as a safe — and reversible — way to buy time to weigh a medical transition and avoid the anguish of growing into a body that feels wrong. Transgender adolescents suffer from disproportionately high rates of depression and other mental health issues. Studies show that the drugs have eased some patients’ gender dysphoria — a distress over the mismatch of their birth sex and gender identity.

“Anxiety drains away,” said Dr. Norman Spack, who pioneered the use of puberty blockers for trans youth in the United States and is one of many physicians who believe the drugs can be lifesaving. “You can see these kids being so relieved.”

But as an increasing number of adolescents identify as transgender — in the United States, an estimated 300,000 ages 13 to 17 and an untold number who are younger — concerns are growing among some medical professionals about the consequences of the drugs, a New York Times examination found. The questions are fueling government reviews in Europe, prompting a push for more research and leading some prominent specialists to reconsider at what age to prescribe them and for how long. A small number of doctors won’t recommend them at all.

Dutch doctors first offered puberty blockers to transgender adolescents three decades ago, typically following up with hormone treatment to help patients transition. Since then, the practice has spread to other countries, with varying protocols, little documentation of outcomes and no government approval of the drugs for that use, including by the U.S. Food and Drug Administration.

But there is emerging evidence of potential harm from using blockers, according to reviews of scientific papers and interviews with more than 50 doctors and academic experts around the world.

The drugs suppress estrogen and testosterone, hormones that help develop the reproductive system but also affect the bones, the brain and other parts of the body.

During puberty, bone mass typically surges, determining a lifetime of bone health. When adolescents are using blockers, bone density growth flatlines, on average, according to an analysis commissioned by The Times of observational studies examining the effects.

Many doctors treating trans patients believe they will recover that loss when they go off blockers. But two studies from the analysis that tracked trans patients’ bone strength while using blockers and through the first years of sex hormone treatment found that many do not fully rebound and lag behind their peers.

That could lead to heightened risk of debilitating fractures earlier than would be expected from normal aging — in their 50s instead of 60s — and more immediate harm for patients who start treatment with already weak bones, experts say.

“There’s going to be a price,” said Dr. Sundeep Khosla, who leads a bone research lab at the Mayo Clinic. “And the price is probably going to be some deficit in skeletal mass.”

Many physicians in the United States and elsewhere are prescribing blockers to patients at the first stage of puberty — as early as age 8 — and allowing them to progress to sex hormones as soon as 12 or 13. Starting treatment at young ages, they believe, helps patients become better aligned physically with their gender identity and helps protect their bones.

But that could force life-altering choices, other doctors warn, before patients know who they really are. Puberty can help clarify gender, the doctors say — for some adolescents reinforcing their sex at birth, and for others confirming that they are transgender.

“The most difficult question is whether puberty blockers do indeed provide valuable time for children and young people to consider their options, or whether they effectively ‘lock in’ children and young people to a treatment pathway,” wrote Dr. Hilary Cass, a pediatrician leading an independent review in England of medical treatments of adolescents presenting as transgender.

On her recommendation, England’s National Health Service last month proposed restricting use of the drugs for trans youths to research settings. Sweden and Finland have also placed limits on the treatment, concerned not just with the risk of blockers, but the steep rise in young patients, the psychiatric issues that many exhibit, and the extent to which their mental health should be assessed before treatment.

In the United States, though, there is no universal policy, and the public discussion is polarized.

Republican governors and lawmakers in more than a dozen states are working to limit or even criminalize the treatments, as some in their party also seek to restrict access to sports and bathrooms, ban discussion of gender in public schools, and call into question whether transgender identity even exists. (This month, the Florida medical board banned medications and surgeries for new patients under 18.) Meanwhile, the Biden administration describes transgender medicine as a civil right. And some advocates criticize anyone who questions the treatments’ safety.

Long-awaited research funded by the National Institutes of Health could provide more guidance. In 2015, four prominent American gender clinics were awarded $7 million to examine the effects of blockers and hormone treatment on transgender youth. In explaining their study, the researchers pointed out that the United States had produced no data on the impact or safety of blockers, particularly among transgender patients under 12, leaving a “gap in evidence for this practice.” Seven years in, they have yet to report key outcomes of their work, but say the findings are coming soon.

Many young patients and their families have concluded that the benefits of easing the despair of gender dysphoria far outweigh the risks of taking blockers. For others, the limited studies and politicization of trans medicine can make it difficult to fully evaluate the decision. A Reuters examination of a range of transgender treatments also found scant research into the long-term effects.

Three years after starting the drugs, Emma Basques believes she’s on the right path.

Jacy Chavira, now 22, decided that the medical treatment was not appropriate for her and resumed her female identity.

And the New York adolescent had such a significant loss in bone density after more than two years on blockers that the parents halted use of the drugs.

“We went into this because we wanted to help,” the mother said. “Now I worry that we got into a situation with a very powerful drug and don’t understand what the long-term effects will be.”

‘Time to Start’

It didn’t take long for Cherise and Arick Basques to realize that their toddler was different. The child rejected pants, toy trucks and sports in favor of dresses, Barbie dolls and ballet. When Ms. Basques ran into a friend at a restaurant in their Phoenix suburb and introduced her then-4-year-old as her son, the child shouted: “No! I’m your daughter!”

The couple worked with children — Ms. Basques as an occupational therapist, her husband as a teacher and school administrator — but this was unfamiliar territory. None of the therapists the parents called felt equipped to help. Their pediatrician offered only that things could change once the child started school, Ms. Basques said. Eventually, the couple discovered a local support group for parents of transgender children.

The next year, they allowed the child, then 5, to begin using the name Emma, grow longer hair and take other steps to socially transition. In 2019, when Emma turned 11, a physician at a local gender clinic advised starting blockers.

“At the first subtle signs of puberty, it was like: ‘Yep, that’s it. Time to start!’” recalled Ms. Basques. Along with her husband and Emma, she asked that their full names be used because they consider themselves advocates of the treatment.

For decades, transgender medical treatment in multiple countrieswas restricted to patients 18 and older. But in the 1990s, a hospital clinic in Amsterdam began treating adolescents.

Puberty blockers can be given as an injection or an implant. (The best known is Lupron, made by AbbVie.) They were being used in the United States and elsewhere, with approval by the F.D.A. and its counterparts overseas, to treat prostate cancer; endometriosis, a painful disease that causes uterine tissue to grow elsewhere in the body; and the unusually early onset of puberty, typically age 6 or 7. If blockers were safe for patients with that rare condition, known as central precocious puberty, the Dutch doctors reasoned, they were likely to be safe for trans adolescents too.

The first trans patient treated with blockers, from age 13 to 18, moved on to testosterone, the male sex hormone. Halting female puberty had offered emotional relief and helped him look more masculine. As the Dutch clinicians prescribed blockers, followed by hormones, to a half-dozen other patients in those early years, the medical team found that their mental health and well-being improved.

“They were usually coming in very miserable, feeling like an outsider in school, depressed or anxious,” recalled Dr. Peggy Cohen-Kettenis, a retired psychologist at the clinic. “And then you start to do this treatment, and a few years later, you see them blossoming.”

In 1998, she worked with a small international group — which would later expand and become known as the World Professional Association for Transgender Health, or WPATH — to include puberty blockers and hormones for adolescents in their treatment guidelines.

The Dutch doctors had yet to publish any research findings, she acknowledged. Some other physicians, including the one overseeing transgender medical treatment in England, were wary of potential harm.

But doctors in the group considered the early results from Amsterdam as reassuring enough to move forward. They were eager to treat the psychological distress observed in many trans adolescents.

Doctors debated about whether “starting the puberty blockers would somehow damage the children,” recalled Dr. Walter Meyer, a Texas pediatric endocrinologist and psychiatrist involved with the 1998 standards of care.

“The Dutch were saying, ‘Oh, no, it’s not causing a problem,’” said Dr. Meyer, who continues to support the use of the drugs.

Dr. Cohen-Kettenis hoped physicians in other countries would adopt the Dutch protocol, and document and share the outcomes as she and her colleagues in Amsterdam planned. Her clinic treated only patients who had consistently presented as transgender since early childhood and did not suffer from distinct psychiatric disorders that could interfere with diagnosis or treatment. They had to be at least 12 for puberty blockers, with the option of moving on to hormones at 16.

The international standards of care advised similar criteria. But they were recommendations, not requirements. Soon, the use of puberty blockers spread. In the United States and Canada, countries without centralized health systems, protocols were largely left to the discretion of individual clinics and practitioners. Dr. Spack, the pediatric endocrinologist who led U.S. adoption of the treatment, opened the first American clinic in 2007 at Boston Children’s Hospital; others eventually followed in nearly every state.

Some started children on blockers at the first signs of puberty and prescribed testosterone or estrogen to patients 14 or younger. Doctors believed that earlier treatment would lead to more successful medical transitions, and wanted to spare patients the difficulty of watching their peers develop while their own bodies remained unchanged.

The doctor in Arizona who treated Emma, for example, tells preteen patients that if he prescribed blockers and didn’t start hormones for five years, they would look 12 at age 16.

Transgender activists across the country pushed for early and easy access to the treatment. At a 2006 Philadelphia medical convention, Jenn Burleton, an advocate from Oregon, heard Dr. Spack describe his experience starting to treat adolescents with blockers. Like others of her generation, Ms. Burleton, now 68, could not medically transition until adulthood, and puberty had been traumatic. Treating adolescents with blockers was “game-changing,” said Ms. Burleton, founder and program director of the organization now known as the TransActive Gender Project at the Lewis & Clark Graduate School for Education and Counseling.

Back home, Ms. Burleton prodded pediatric endocrinologists to adopt the practice for their patients. “We have a chance to prevent them from being emotionally broken,” she recalled saying.

Advocates successfully pushed Oregon, Massachusetts, California and other states to allow for Medicaid coverage of puberty blockers for adolescents identifying as trans. They also helped win approval in Oregon for a variety of medical workers — doctors, nurse practitioners, naturopaths — to administer blockers if overseen, even long-distance, by an endocrinologist.

“It went so quickly that not even centers but individual clinicians, people who were not knowledgeable, were just giving this kind of treatment,” said Dr. Cohen-Kettenis, the Dutch psychologist. “There was a great concern.”

By the time Emma Basques began taking blockers in 2019, multiplemedical groups had endorsed their use for gender dysphoria. Among them were the American Academy of Pediatrics and the international Endocrine Society, which in 2017 had described the limited research on the effects of the drugs on trans youth as “low-quality.” Still, the organizations were encouraged by what they saw as a promising treatment.

Many doctors point out that it’s not unusual for research to lag behind the launch of new treatments and for drugs to be used off-label on patients without F.D.A. approval, especially in pediatric medicine.

An F.D.A. spokeswoman said in a statement that doctors have the discretion to do so, but also noted that just because a drug has been approved for one class of patients doesn’t mean it’s safe for another.

There is no centralized tracking of blocker prescriptions in the United States. Komodo Health, a health technology company, compiled private and public insurance data for Reuters, showing a sharp increase in the number of children ages 6 to 17 diagnosed with gender dysphoria, from about 15,000 in 2017 to about 42,000 in 2021. During that time, 4,780 patients with that diagnosis were put on puberty blockers covered by insurance, the data shows, with new prescriptions growing each year. But the data does not capture the many cases in which insurance does not cover the drugs for that use, leaving families to pay out of pocket.

Some leading American practitioners asked AbbVie and Endo Pharmaceuticals, maker of another blocker, to seek F.D.A. approval for the drugs’ use among trans adolescents. The drugmakers would have to fund research for a patient population that made up just a small part of their market. But the physicians argued that regulatory approval could help establish the safety of the treatment and broaden insurance coverage of the drugs, which can cost tens of thousands of dollars a year. In the end, AbbVie and Endo said no. The companies declined to comment on the decision.

Emma Basques was on blockers for two years. Then, after she turned 13 in October of last year, a doctor in the Portland, Ore., suburb where her family had moved, prescribed estrogen, starting her transition. It had become increasingly awkward to feel left behind as her classmates physically matured. And she felt confident that she was ready.

“It was just really exciting,” Emma said. “I finally got to be who I was.”

‘We Need to Give This a Chance’

The 11-year-old in New York, who had begun puberty and started at a new school, was increasingly distressed — refusing to bathe or go to class and, for the first time, expressing a desire to no longer have a girl’s body.

When the parents consented to blockers in 2018, they hoped the drug would bring emotional stability and time to consider next steps.

“If everyone thinks this will help, and it’s reversible, then we need to give this a chance,” said the mother, who asked that her name be withheld to protect the family’s privacy.

‘We Need to Give This a Chance’

The 11-year-old in New York, who had begun puberty and started at a new school, was increasingly distressed — refusing to bathe or go to class and, for the first time, expressing a desire to no longer have a girl’s body.

When the parents consented to blockers in 2018, they hoped the drug would bring emotional stability and time to consider next steps.

“If everyone thinks this will help, and it’s reversible, then we need to give this a chance,” said the mother, who asked that her name be withheld to protect the family’s privacy.

A full accounting of blockers’ risk to bones is not possible. While the Endocrine Society recommends baseline bone scans and then repeat scans every one to two years for trans youths, WPATH and the American Academy of Pediatrics provide little guidance about whether to do so. Some doctors require regular scans and recommend calcium and exercise to help to protect bones; others do not. Because most treatment is provided outside of research studies, there’s little public documentation of outcomes.

But it’s increasingly clear that the drugs are associated with deficits in bone development. During the teen years, bone density typically surges by about 8 to 12 percent a year. The analysis commissioned by The Times examined seven studies from the Netherlands, Canada and England involving about 500 transgender teens from 1998 through 2021. Researchers observed that while on blockers, the teens did not gain any bone density, on average — and lost significant ground compared to their peers, according to the analysis by Farid Foroutan, an expert on health research methods at McMaster University in Canada.

The findings match what practitioners of the treatment have seen, including Dr. Catherine Gordon, a pediatric endocrinologist and bone researcher at Baylor College of Medicine in Houston. “When they lose bone density, they’re really getting behind,” said Dr. Gordon, who is leading a separate study on why the drugs have such an effect.

Many doctors caring for young trans patients are reassured by the rebounds seen in the children who take blockers for unusually early puberty. In most cases, their bone strength fully recovers after they stop the drugs at about age 11 and resume full puberty, which can last up to five years. But patients identifying as trans take the drugs later, interrupting their normally timed puberty and limiting that crucial period of development.

“That’s the difference,” Dr. Gordon said. “You shorten that critical window of puberty.”

So far, only two small studies, published by Dutch doctors, have tracked the bone development of trans patients from beginning blockers through early hormone treatment. In both studies, dozens of patients started blockers at 14 or 15, on average, and began estrogen or testosterone at 16. The participants, followed in one study through age 18, and in the other through age 22, saw their bones strengthen, on average, once on hormones. Still, most patients continued to lag behind their peers; trans men neared average levels, but trans women fell far below.

“I think there’s a false sense of security,” said Dr. Khosla, the Mayo Clinic specialist, who is skeptical that all trans patients can catch up.

Dr. Khosla and Dr. Gordon don’t believe the effects on bones are reason for medical providers to halt use of the drugs in adolescents. But they think the risks should be factored into patient decisions and that bones should be carefully monitored.

If any harm resulted from the use of blockers, it likely would not be evident until decades later, with fractures. However, for children who already have weak bones as they start treatment, the dangers could be more immediate. While there is no systematic record-keeping of such cases, some anecdotal evidence is available.

After more than a year on blockers, a 15-year-old in Texas, who had not had a baseline scan, showed spinal bone density so low that it was below the first percentile for the teen’s age and weight, indicating osteoporosis, according to medical records from earlier this year.

A transgender adolescent in Sweden who took the drugs from age 11 to 14 with no bone scans until the last year of treatment developed osteoporosis and sustained a compression fracture in his spine, an X-ray showed in 2021, as reported earlier in a documentary on Swedish television.

“The patient now suffers from continued back pain,” medical records note, describing a “permanent disability” caused by the blockers.

Some practitioners in the United States and Australia do not provide the drugs to patients who are well into puberty, concerned that the treatment poses the greatest threat to bones in that period.

“You’re potentially taking on risks that I felt should be avoided,” said Dr. Stephen Rosenthal, medical director of the University of California, San Francisco, Child and Adolescent Gender Center.

He won’t prescribe blockers as a stand-alone treatment to anyone over 14. That includes the growing number of nonbinary youths who don’t want to mature into either male or female bodies. “We make it very clear that no one stays on a blocker,” he said.

Dr. Rosenthal is a principal investigator in the yearslong N.I.H. study, which also involves gender clinics in Los Angeles, Chicago and Boston. Asked why they have yet to report on key outcomes, he said their research was delayed when the pandemic halted in-person treatment. Papers on the effects of blockers on bones and other findings should be published next year, he said.

Like many physicians, Dr. Rosenthal believes the benefits of using blockers to alleviate gender dysphoria are much greater than any risks to bones. (He was among the doctors who filed statements in a lawsuit against an Alabama ban on medical treatment of trans youth.)

Emma Basques, for example, takes calcium, makes an effort to exercise and has undergone scans that showed her bones are healthy. “I can’t even imagine how life would be for Emma,” said her mother, Ms. Basques, “if she was not given blockers and had to go through male puberty.”

Emma added: “I wouldn’t like my body at all.”

But the parents in New York insisted on ending treatment for their teen, who has yet to have a follow-up scan to see if bone density has improved since going off blockers.

“I don’t think we have the science behind them to be prescribing these drugs,” the mother said.

‘I Wish There Had Been More Questions’

Jacy Chavira, in Southern California, had already cut her hair short and begun binding her chest when she was prescribed blockers at age 13. A therapist and her parents agreed that gender dysphoria, a condition Jacy learned about from a magazine, could explain the mounting anxiety and discomfort that she was experiencing during early puberty.

Once on blockers, Ms. Chavira said, she became fixated on moving ahead with a medical transition. She was thrilled shortly after turning 16 when her pediatric endocrinologist prescribed testosterone. But soon she started having doubts. Her body was growing more masculine, but she was secretly putting on dresses. At 17, in a consultation for breast removal, she worried aloud about the potential loss of feeling in the nipples. To her, this was a sign of not wanting to go through with the surgery.

She came to realize that her anguish had stemmed from a larger inner conflict, and that continuing with a gender transition would be a mistake. “I believe it was an issue with my identity, accepting who I was, and not just the physical female portion of it,” she said.

Like Ms. Chavira, most patients who take puberty blockers move on to hormones to transition, as many as 98 percent in British and Dutch studies. While many doctors see that as evidence that the right adolescents are getting the drugs, others worry that some young people are being swept into medical interventions too soon.

Over the past decade, growing numbers of medical providers have lowered the ages at which they prescribe the treatments. Today, the WPATH and Endocrine Society advise that blockers can be prescribed at the first signs of puberty and hormone treatment, in some cases, earlier than 16. The American Academy of Pediatrics says blockers can be provided anytime during puberty and hormones from “early adolescence onward.”

Some doctors and researchers are concerned that puberty blockers may somehow disrupt a formative period of mental growth. With adolescence comes critical thinking, more sophisticated self-reflection and other significant leaps in brain development. Sex hormones have been shown to affect social and problem-solving skills. It’s believed that brain growth is connected to gender identity, but research in these areas is still very new.

In a 2020 paper, 31 psychologists, neuroscientists and hormone experts from around the world urged more study of the effects of blockers on the brain.

“If the brain is expecting to receive those hormones at a certain time and doesn’t, what happens?” said Dr. Sheri Berenbaum, head of a gender research lab at Penn State, and one of the authors of the paper. “We don’t know.”

The physicians in the Amsterdam clinic, where the treatment began, have lowered their minimum ages for starting blockers and hormones. But they are very cautious in selecting patients.

“Our concern is always: When is gender identity fixed or not fluid anymore? And when do you fully understand the lifelong consequences of such treatment?” said Dr. Annelou de Vries, head therapist at the clinic.

For some medical professionals across the country, there are too many uncertainties about the effects of blockers to provide the treatment.

Among them are seven pediatric endocrinologists and pediatric endocrine nurse practitioners in Florida who recently wrote to the state health department that evidence to support the use of those treatments in adolescents “is simply lacking” and asking that it be confined to research settings.

“Without much data, it’s hard to make a conclusion that we’re doing the right thing,” said Dr. Matthew Benson, an assistant professor of pediatrics at Mayo Clinic College of Medicine in Jacksonville and an author of the letter. (He also voiced concerns at a state hearing in July on whether to stop allowing Medicaid coverage in Florida for transgender medical treatment.)

Even enthusiasts, like Emma and her parents, acknowledge it can be hard to fully grasp all the potential results of treatment. Infertility is among other lasting effects for patients who start blockers at the first stage of puberty and proceed to hormones and surgery. Emma was advised that, to possibly preserve fertility, she would need to pause treatment at some point down the line, with the hopes of developing and freezing sperm.

“I knew what I wanted,” Emma said of her medical transition. “But all this other stuff was kind of just confusing.” Her father said, “We worked really hard to talk to her at her age level to make sure she understood some of these more complicated things.”

When Dutch doctors launched the use of blockers and hormones on trans youth decades ago, they warned in their early papers of the possibility of “false positives” — patients who medically transition, then later declare they are not transgender.

There’s no official tracking of those cases and many practitioners believe the total numbers are small. So far, scores of accounts have emerged in social media, news stories and published research.

Keira Bell, who was prescribed blockers at age 16, then moved on to testosterone and breast-removal surgery, no longer identified as transgender five years after starting to transition. She sued the Tavistock gender clinic in London where she had been treated. (A judge ruled that patients under 16 were unable to consent to puberty blockers — a decision later overturned on appeal.)

Jacy Chavira, looking back on her own experience, thinks that drugs were prescribed too quickly. At 18, she halted her medical treatment and resumed her female identity. Now, she is left with a voice that sounds like a man’s and other enduring physical changes.

“I wish there had been more questions asked by the doctors,” she said. “I wish I hadn’t been steered into transitioning the way I was, and that I had been told there were other ways to cope with the discomfort of puberty.”

Alarmed by the uncertain number of cases like Jacy’s, as well as the rising numbers of patients with gender dysphoria and the psychiatric disorders many display, Sweden is working to standardize adolescent transgender medical treatment and restrict it to research settings.

Finland is also limiting treatment, more closely following the Dutch protocol, and doctors there remain concerned about the physical effects of blockers, including on brain development, said Dr. Riittakerttu Kaltiala, chief of adolescent psychiatry at a gender clinic in Tampere. (Dr. Kaltiala testified this fall before the Florida medical board as it was considering its ban on treatment.)

As European countries continue to examine and tailor their treatment, in the United States the public discourse about transgender care is growing more incendiary.

Last month, the American Academy of Pediatrics and other medical groups wrote to Attorney General Merrick B. Garland, urging the Justice Department to investigate growing threats of violence against physicians and hospitals that provide transgender medical treatment to adolescents. As more Republicans frame the treatment as child abuse, some doctors have become wary of discussing their work for fear of becoming targets.

More than a dozen doctors declined to be interviewed for this article, and several who spoke to The Times — some who support treatment, others who question it — asked not to be named.

The climate could have a chilling effect on research, said Dr. Natalie Nokoff, assistant professor of pediatric endocrinology at the University of Colorado, who recently conducted a soon-to-be-published study showing that a longer treatment period on puberty blockers was associated with a lower bone density.

“It’s leading to concerns that people’s well-intentioned scientific research could be misconstrued” and exploited for political gain, she said.

The prospect of such an outcome is disheartening for the families of Emma Basques, Ms. Chavira and the teen in New York. Despite their differing experiences, they share the same hopes for transgender medicine: less vitriol, more science.

Methodology

The analysis commissioned by The Times examined the findings of seven observational studies from the Netherlands, England and Canada, documenting the association between puberty blockers and bone density in about 500 adolescents.

In each study, bone density was measured at the spine and the hip using Dual-energy X-ray absorptiometry, or DEXA scan. The analysis looked at group means, because not every study released individual person data. Each study’s findings were weighted based on its number of participants.

The change in bone density while adolescents were on blockers was observed to be zero. The analysis also showed that the adolescents’ Z-scores, a measure of bone density that is benchmarked to peers, consistently fell during treatment with blockers.

The studies included are:

“Bone Mass in Young Adulthood Following Gonadotropin-Releasing Hormone Analog Treatment and Cross-Sex Hormone Treatment in Adolescents With Gender Dysphoria,” Klink et. al, Journal of Clinical Endocrinology & Metabolism, 2015

“Effect of Pubertal Suppression and Cross-Sex Hormone Therapy on Bone Turnover Markers and Bone Mineral Apparent Density (BMAD) in Transgender Adolescents,” Vlot et. al, Bone, 2017 

“The Effect of GnRH Analogue Treatment on Bone Mineral Density in Young Adolescents With Gender Dysphoria: Findings From a Large National Cohort,” Joseph et. al, Journal of Pediatric Endocrinology and Metabolism, 2019

“Physical Changes, Laboratory Parameters and Bone Mineral Density During Testosterone Treatment in Adolescents With Gender Dysphoria,” Stoffers et. al, The Journal of Sexual Medicine, 2019

“Bone Development in Transgender Adolescents Treated With GnRH Analogues and Subsequent Gender-Affirming Hormones,” Schagen et. al, Journal of Clinical Endocrinology & Metabolism, 2020

“Short-Term Outcomes of Pubertal Suppression in a Selected Cohort of 12- to 15-Year-Old Young People With Persistent Gender Dysphoria in the U.K.,” Carmichael et. al, PLOS One, 2021

“Pubertal Suppression, Bone Mass and Body Composition in Youth With Gender Dysphoria,” Navabi et. al, Pediatrics, 2021

Julie Tate contributed research.

Megan Twohey is a prize-winning investigative reporter and a best-selling author who has focused much of her work on the treatment of women and children. @mega2e • Facebook

Christina Jewett covers the Food and Drug Administration. She is an award-winning investigative journalist and has a strong interest in how the work of the F.D.A. affects the people who use regulated products. @By_Cjewett

[v--143]

Tword Fic Prompts/Thoughts 🐥

*These are mainly thoughts or scenarios I’ve thought about for the past… 17 years🫡 the list will grow as time goes on most likely. Feel free to use it when requesting!

More specific / Out of the ordinary

Breaking into the house scenario. Alone at home for the night, someone appears. Scared shitless and trying to run away from them and hide to stay quiet. They find you and discover your sensitivity soon enough, they use it against you whether it be to find where valuables are at or to get important information out.

Kidnapped Scenario. You get taken, whether it be in public or from your home. You’re subjected to being tied down and enduring it in a secluded space for who knows how long.

Haunted House, maybe a bit more on the extreme side. You have to sign a waver to be let in and say you allow them to touch you. Various forms of being held down and wrecked while also being scared. Hands that come out the walls to grab your wrists and hold you against it, vines that wrap around your ankles and drag you to a private room with zombies waiting to wreck you, it’s endless.

Hide and seek but from a monster. You have to stay quiet and there are forms used against you to try and make you make noise. If you do, the monster can find and get you.

Trapped under rubble or some form of heavy building that can’t be lifted, preferably having your chest down exposed while your shoulders and up are immobile; allowing people to go ham on your lower half without you being able to do anything about it.

Clowns. Taking a walk and one (or many) appear, you get chased into a woods/forest like area and you’re extremely scared. But your crying soon turns into something else as they realize how sensitive you are.

College!! Moving in the first day and having an awesome roommate, being upset towards the end of the day at leaving your family and friends. They notice this and try to cheer you up, maybe hopping onto your bunk bed while you’re sad or frustrated and going at it. It’s a completely new person too, so they do it purely out of wanting to cheer you up!

Sleep Paralysis Demon. Being in bed very late at night and you just see it at the corner of your room. You close your eyes in hopes it goes away, but instead just appears on your ceiling staring at you. Again, you’re literally scared shitless, but as this thing gets on you, you realize it feels like a cold feathery cloud rather than something awful, and it grazes your skin. It notices.

Laser Tag with sensitivity stickers on the body, like those muscle stimulators that stick onto a persons abs and arms, except when they’re shot with lasers, they vibrate and have small rods poke and vibrate into specific spots.

Doctors/dermatologist visit goes wrong, they have to feel over your back/stomach and they find something off, it has to be examined but there’s no anesthesia left, however it’s for the pain…

Bullies corner you in some private area, you expect some form of shame or pain to go your way until they find out how sensitive and jerky you are to other kinds of touches, use this against you instead, but they go all out and make you scream/on the verge of passing out

Ghosts/Playful ghosts! Something you could maybe befriend too, there to help you when you need cheering up or just someone to talk to and make you laugh

Vlive! While people/idols are live and are asked questions/to test out another’s yknow, or another member provokes the person that’s live into wrecking them and they show the person on camera laughing and stuffjdoksnsjks

College Hazing 🙉🙉🙉

More general / Common

Cute fluff fics to the point. Cuddling in bed, during a movie, etc!

Person A ate Person B’s food they’d been saving for the longest time. Chased and attacked.

Person A uses silent treatment against Person B, gets frustrated and attacks to get them to talk

Teasing across Person A’s body acting oblivious that it’s affecting them and waiting for them to show it

Person A getting chased by Person B for being annoying/frustrating, person B ends up absolutely wrecking them for it

[crippledasinfuckyou]

Hi Stevie. I hope this is okay to ask as I wasn't sure where else to turn, or if there's other blogs suited to this sort of ask. I saw a post you reblogged about being chronically exhausted and struggling due to being exhausted all the time/with small tasks versus what's a normal amount of tired and realized I may have been living with something for a long time that I didn't know wasn't normal, but I didn't know who to ask for advice since the original poster has left Tumblr and most of the notes were just saying it wasn't normal to have all of them but not how to get help. I was going to seek out a doctor but didn't know what specialists to consult as I've dealt with so many doctors who say my health problems are in my head or "you're too young to have this" only to go through years of testing and FINALLY find the thing that's wrong on some tiny test or other that they didn't think/want to try.

Since this chronic exhaustion crap is ruining my life as it gets worse I don't want to wait years and years to even potentially be heard/get help that isn't being told it's fake or just being told to get even more sleep. I'm losing emotional support of people in my life who think it's laziness or me "not trying" when really it's exhausting and takes a couple hours just to get up and moving at the start of a day much less anything else. Sorry to send such a long ask when I know it's probably a lot and I hope you're having a nice day, thank you for running this blog!

Hi, im sorry this took forever to get to. I know exactly what you're going through and i know how much it sucks.

I dont know if youre looking for advice or just venting, so if you're just venting- I'm here. I know the pain and I will always be willing to listen- If you'd like a quicker response than I give to asks, message me here or on my main @turnaboutstevie, I will always answer DMs asap.

If you're looking for advice, I'll put it below the cut:

One thing I learned, both from my appointments and from my time as a carer is that doctors are more likely to get off their asses and do something useful if you have someone with you when you ask them to. Another person can back you up, can corroborate what was said in the appointment and can help you to complain. Take a friend, family member, someone from a local disability group or even ask the surgery for a chaperone. You are in safer hands if you're not alone.

Secondly, write EVERYTHING down. write what you want to say and what you are experiencing before you go in. Keep a symptoms diary if you can. In the appointment write down what you say, what your doctor says, what treatment course is mentioned etc. Try to get it exact as you can. It is much easier to keep your head if you have what you want to say in front of you, and much easier to push back or lodge a complaint when you have what is said in writing. If they say theyre going to refer you somewhere, ask them to send you a copy of the referral letter. By email or post, it doesnt matter. Just keep it safe. If they refuse, make sure you get in writing why they are refusing to share the details of your care with you. That's information you have a right to. Document EVERYTHING, so that you're never left either not sure you remembered correctly- or in the worst case where you need to complain, without evidence.

Similarly, ask for an explanation for everything. If you're given a reason why you can't be experiencing it, ask for an elaboration. Write it down. If they choose not to test, ask why. Write it down. If they are testing, ask what they think the tests will help detect. Write it down. If they refer you, ask who to and how they might be able to help. And yes, write it down. Understanding exactly what is happening in terms of your care will help you pinpoint things that aren't helping. If they run a blood test and it shows nothing and next time you bring it up they say they'll blood test, its way easier to explain why you don't want another one if you know why you had the first. Many doctors are unfortunately, shit, and will try to do the bare minimum and pull the wool over your eyes to shut you up. Don't let them.

Finally- if they aren't helping, ask for someone else. Most doctors surgeries will have a staff page on their site, listing credentials and specialties. See if there is anyone at your surgery who specialises in what you're going through and ask to see them. Hell, change surgeries if you have to. You can always ask for better care or a better doctor- its YOUR health. Not theirs. You are in charge.

[stadiumfamilydentistry]

How to Find the Best Emergency Dentist in Ann Arbor

Are you experiencing a toothache that just won't quit? Or maybe you've had an unfortunate dental emergency, like a broken tooth, and need immediate care. Whatever the case may be, finding the best emergency dentist in Ann Arbor is crucial for getting the prompt and quality treatment you deserve. In this blog post, we'll equip you with valuable tips and tricks to make sure you're well-prepared when faced with a dental crisis.

From searching through online directories to seeking recommendations from friends and family, we'll guide you on your quest to find the perfect emergency dentist who will put your smile back on track in no time!

How to Choose an Emergency Dentist

If you find yourself in need of dental care during an emergency, your best bet is to find an emergency dentist. Here are some tips to help you choose the right one for you:

Research your options: When looking for an emergency dentist, be sure to do your research. There are a lot of great options available, so it’s important to identify which ones fit your needs.

Ask around: If you can’t find a reputable dentist online or through friends and family, ask around for recommendations. You may be surprised at just how many people have had positive experiences with an emergency dentist.

Consider location and accessibility: Remember that not all dentists are located in major cities – some may be based out of regional hospitals or clinics that are more accessible if needed during an emergency situation. Also keep in mind whether the dentist is open 24/7 or not – some may only be available during specific hours on weekdays or weekends, so it’s important to plan ahead if possible.

Inquire about insurance coverage and payment plans: Some dentists offer discounted rates for those who have health insurance coverage, while others may accept payment plans that work well for you financially (either cash or credit). It’s always a good idea to check with the doctor before making any arrangements so there are no surprises down the road!

How to find an emergency dentist in Ann Arbor

If you ever find yourself in need of a dentist during an emergency situation, be sure to look for an emergency dentist in Ann Arbor. There are a number of dentists in the area who are equipped to handle any kind of dental emergency, and they will be able to help you get the care you need as soon as possible.

One way to find an emergency dentist in Ann Arbor is by using the dental directory that is available online. This directory will list all of the dentists in the area, as well as their contact information and hours of operation. You can also call your local hospital or health center and ask if they know of any dentists who can provide emergency services.

If you don't have access to online directories or telephone numbers, you can also try searching for Emergency Dentist in Ann Arbor on Google or Yelp. These websites will allow you to search for dentists based on various factors, including location, insurance coverage, and specialties. You may also want to consider checking with your local hospital or health center to see if they know of any dentists who provide emergency services. In any case, make sure that you choose a dentist who is qualified to handle dental emergencies!

If you are experiencing tooth pain or have any other dental emergency, your best bet is to find an emergency dentist in Ann Arbor. Here are a few tips to help you locate one:

Try Looking Online: There are many directories and search engines that can help you find an emergency dentist in Ann Arbor.

Next, ask friends or family if they know of any good dentists who could help you out. You might be surprised at how many people know someone who can assist with an emergency situation.

Look through the phone book or yellow pages and see if there is a listing for an emergency dentist in Ann Arbor. Many times these businesses will put themselves forward as such, so it's important to look for them.

Source: American Dental Association (ADA)

What to do if you need to find a new dentist immediately

If you need to find a new dentist immediately, here are some tips:

Check online reviews: Many dentists have websites where patients can leave reviews. This can help you find a good dentist if you're on a tight timeline.

Ask friends or family members for recommendations: They may have had great experiences with certain dentists and recommend them to you.

Check out local directories or newspapers for listings of dentists in your area. You can also use online resources like Yelp to search for dentists in your area.

Call around several dentists and ask which ones they typically see emergency patients from the area. This will give you an idea of which dentists are most likely to take care of you quickly and without delay.

Tips for Finding an Emergency Dentist in Ann Arbor

Looking for an emergency dentist in Ann Arbor? Here are 10 tips to help you find the best one for you:

Do your research: Before visiting any emergency dentists, be sure to read reviews online and ask friends for recommendations. Look for a dentist with a good reputation and experience in dealing with dental emergencies.

Call ahead: If you can, schedule an appointment ahead of time so that you can get a sense of how busy the office is likely to be.

Ask around: Talk to your family and friends who know people who have used emergency dentists in the past. They may have some great recommendations for you!

Make a list of potential candidates: Once you’ve narrowed down your search, make a list of potential emergency dentists that meets your criteria. Consider whether the dentist has been successfully treating dental emergencies in the past if they offer affordable rates, and if their office location is convenient for you (consider public transportation options).

Check out their website and testimonials: Review their website and read customer testimonials to get a sense of what their practice is like from someone who has already used them. This will help put your mind at ease before making an appointment!

Get insurance information if needed. Some emergency dentists require patients to have supplemental health insurance in order to be treated on-site (this varies from dentist to dentist). Make sure you know this

If you are experiencing pain in your teeth or gums, it is important to find an emergency dentist as soon as possible. By doing so, you can minimize the potential for long-term damage and ensure that you receive the best care possible for your dental needs. To find a dentist who specializes in emergency dentistry in Ann Arbor, use our search engine above.

From there, we will provide you with a list of dentists who have been specifically trained to handle such cases. With this information at hand, all you need to do is pick the one that meets your needs and book an appointment as soon as possible!

[cosmicangel888]

And Jesus Said....'why must all be proven'

And Jesus said; 'why is it that you cannot understand my speech' and which I have offered for years, at a time, to the multitudes at a time, who I am, the workings of the energy, the Universal flow, the Wisdoms of the divine, and in the envy, jealousy, the ego disbelief that a woman, a mother, of being such - in disrespect, disregard, I had to work through resurrection of the weekly, monthly, sacrifices and ceremony of black magic against me to bring down all that is the glory to be enjoyed - that only I offered for and free to all.

Why is it dear ones, a woman, a divine mother, cannot be known as sacred and true, of the great minds and leadership of the new world in peace, unity, and highest gifts of the Heavens ~ so that she work profoundly in devotion twice as hard, with consistent, persistent effort and as she said 100 times before; 'I am that I am' - explaining the Heavens, God, Source, in soft and gentle pure and loving ways, with codes, activations, and divine offerings, and she still must offer and say her speech over and over and over with the rolling of the eyes and scoffing and laughing - until the black magic does not work, the infinite times of being used, abused, taken from and stolen from, being sacrificed all to have the Heavens, stop all of it, return it all and still the selfish and misogynistic set ways still down play all that she is, and exudes; ©

Why?

This is global discrimination and I will not enable the distaste, the disarray of what has always been equal, 1/2 of a universal energy needed on every aspect of life; the DF energy is required for all life and balance, health, and manifestation to all life, the traversing the universe and all else - this is not a fanciful thing; DF is a must for all universal life and abundance - period and we have been written out of our own creational story, with 0 role models that have brought all young girls up to feel less than, unimportant, and the most abhorrent misguidance that at the earliest of ages they are barely dressed and seek plastic surgery in their efforts to feel heard, seen, and recognized; these are deep and sick imprints of our social world and I will be a wave that shifts this;

I will not be a vessel for use, and abuse, and word 100 times harder to be heard in a court of law for the simple request of liberating myself from a stagnant non-giving marriage that was one way and false. The man can deceive on documents of court and be dealing with many behind the scenes and deceit on every level that was meant to be held as sacred union - and yet the woman sits and is played with, berated, teased, and taken from - how fair, how just, how ridiculous the monies and time wasted; the resources wasted in black magic and voodoo doctors and groups, gangs trying to take down 1 woman that simply speaks truth?

To the false elite families and deeply studded ways to warp and twist and games and schemes, and then spell cast to keep the smoke and mirrors and rights and wrongs twisted; Money is not my power; Spirit is. Money is not my beauty, spirit is; and God will lift that which is truly divine and truly righteous - and so too judgment is of all - I am that I am - true from the moment I spoke it and those that betrayed me, used me, bid on me, and made money on me, and when I began to stand in my power, regain any semblance of self peace and self direction, I was gang stalked and impaled a treacherous path of such mess in magic that most would not have survived. Was it not enough to know that just in that; I am that I am; purify of that which warps the pure and sacred, the corrupt will fall and it will fall again - money will not save that which is not truthful and sacred; God knows, sees all - truth is. God is also a woman.

The disrespect and misguidance of eons of unjust and unfair treatment and malice against all that is sacred; at some point - the earth will awaken - who are you, what do you exist within, what exists within you.

This is my story - dear ones, I am 1 woman, of the of sick and torturous jokes of false community 'leaders' and those that have deep pockets to pay off those in service positions to support their stories and corruption - a woman can only rely upon 1 thing and know it is far more powerful than a world in corruption --> God is. I walk with the Heavens, and no amount of lawyers, paid off groupies, or twisted slight of hands will ever write and know more than what and how God is; this is the Alliance with Light.©

The word on the corruptive street; for light worker, a healer, and someone known with a name, of grace and good will, and held high to the heavens, that would have such a bid on her head; and in my experience, the lies, deceit, and games, and themes of who, how much, the using and abusing of my name in sexual deeds and porn revenge video's, doppleganger, and the ploy playing of what sex would be like, and how much bets would be a thing of play;

The most low vibrational distasteful things for a true divine feminine that is of Holy Sanctified by the Heavens; and yet treated like trash here upon earth;

The Mother, The Divine Feminine, seen and not heard, laughed at and not bowed to, and dishonoured in every possible way that I have experience and not only has their been such disgusting treatment - there is the slander and even more spell work, schemes, and targeting when you do stand and speak on your own behalf and to seek any semblance of justice. We are no longer defiling 3D energies of all be less than besides the 1% of the population that is the white man; any person in power, are all handed power to the man, the words spoken as true even though the divine feminine has stated in 100's of emails, statements, and truth of what hides behind the masks and while being given less than 1% of what is legal, there are still the arrogant arguments to not give at all - for how would a woman ever have earned to be seen, known, truthful and worthy.

My role, my path, my destiny - is to me and God. only.

None shall write and no spell will bring down that which God raises.

My truth has been.

My word has been.

I will not sit and be a vessel to bid who may semen their darkness and callousness; (as if I would allow you in my sacred space) the degree of ignorance to even think a queen, a goddess would ever offer such a person that would think, conjure, say and be in such energy into her space - shows you the immaturity, penis driven disregard for who we have been, will always be, and how may every moment, every woman from here on out - choose for herself, never stand down to that which is in disrespect and truthful.

I have no desire to be someones 'bitch, hoe, side piece, toy, claimed piece, to be taken off the market, or be the topic of conversation in the 'who hit it and quit it' water cooler disgust......those that think they know me - you know me not, nor did you - those that are driven to drive me, own me, claim me, envision me riding you into the sunset; you have selfishly been so ignorantly mistaken.

I connect and walk with Source; I will not play 3D second hand tools and toys to those have not done even an ounce of work, or men that think magic and cohersions, entrapments, and degrading a woman until there is nothing left to say; no thank you - I choose me, I hold myself high, as God does.

I write for the forgotten ones, the ones being trafficked and enslaved for the all mighty dollar to be spun back into the pockets of the again the sick and imbalanced cycle of 'the man' - the worlds economics and the worlds corrupt systems, be it judicial, policing, medicine or pharmacare; we have a lot of work to do and will we continue sick and toxic cycles - or will we ask of divine and heavenly aligned leaders? Have we had enough of the fear, control mongers, and wars and imbalanced violence and conformity of children harming, and being enslaved to such low vibrational potentials?

All have a choice, and all will eventually to awaken to what true value and morals, and integrity is; all play a part of every dark way that will ever be unfolding for all to re-write - this is our healing and it has been highly unjust and corrupt.

This is not feminism; this is basic human honour and just.

Children, nature, wildlife; women, elders, all have been treated with disregard and abhorrence - this is the new dawn - all are equal, and all are divine in our presence, purpose, value, and importance.

Period.

And so be it,

Joanna

JoannaCosmicAngel@yahoo.com

#ascension

#enlightenment

#healinghumanity

#justice

#healingourchildren

#values

#5Dearth

#healingdivinefeminine

#healingbrokensystems

[rockheadcd]

OPERATOR FILE 2: STONEDGE

RECORD

A mixed early generation son of Byron and Asago, Roark hails traits from both Sargon and Higashi, whose family sought better lives in Columbia. However, due to the nature of the work available, namely originium mining, Roark grew up watching oripathy claim his mother’s life and his father’s health, despite his tougher-than-steel way of handling things. Constant, high exposure to originium particles during his early adulthood left him infected in under a year of constant work, alongside Byron and their coworkers. Many of them, unsurprisingly, are also infected, some expressing oripathy more aggressively than others.

Roark himself takes after his father, trying to bear with the crystallization, but as it targeted his spine, the mobility is more and more difficult over time, and by the time he turned 20, Byron makes the recommendation to pursue treatment at Rhodes, if only to keep what life he has left, and to not go down his path of handling oripathy. Roark promises to do his best, eventually seeking out Rhodes with Birdy as his liaison.

Roark's infection threatened primarily to consume his mobility, but for his treatment on Rhodes, he asked not to have the overgrowths removed, and instead opt for more procedural removals of crystals in between vertebrae in order to regain some of his mobility with his tail and lower back. The recovery overall took some months to space out post-operation observations, but it was well worth it considering Roark's expressed desire to keep spelunking as his primary hobby—he wanted to learn about the world he'd never have seen if he stayed to suffer in Columbia, and his interest in his own heritage ( especially having seen the general disposition towards archosauria ) had led to some scientific questions that he seeks to answer after prolonged discussions with medical staff. Having some choice mobility back, in addition to artificially halting the assimilation of originium and blood, allowed him to set off on excursions beyond the landship, curious about what's buried beneath the wastelands. While Rhodes moves, so do his little excavation projects.

Of course, that's all in between when the Doctor needs him to roll some heads.

ARTS, CLASS &. COMBAT

Roark's Arts is by all means standard, capable of utilizing originium as a conduit for strength and defenses. Based on his prior work, his examination results, and how he can most comfortably manipulate his arts, he opted to train as a defender to be a first line of defense between enemies and more vulnerable but powerful ranged allies. He shows quite the comradery on the field, and although misplaced at times, his morale often boosts others.

His heritage including ancient races lends him to being susceptible to oripathy, but in return for how easily he was infected, such sensitivity to originium particles allows him to manipulate their energy more easily. His arts allows him to manipulate the earth, but not to the flexibility as seen with other operators such as Mudrock and Earthspirit. Although he is deeply invested and intrigued by fossils, rocks, and the landscape Rhodes treads over, his special interests lie closer to archeological timelines more than geodetic ones, even if they are closely tied.

Alas, Roark's Arts can sturdy him, hardening skin and muscle to take the impacts required of defenders on the field. He becomes the shield, rather than carries one. Usage of such arts without an Arts Unit expresses the crystals that adorn his reptilian skin, as seen in his examination. On the offensive, however, using his arts allows him to hit like a boulder, no pun intended. It is suspected his body may have adjusted to these conditions while mining in Columbia. To reuse muscle memory from swinging a pickaxe, Roark picked a two-handed hammerpick, similar to the weapons chosen by fellow Juggernauts, just simply larger, heavier, and longer. Inside the head of his weapon is the Arts Unit, utilizing physical contact as a means to express his Arts. If he does not need to buff himself, swinging his weapon into the ground allows him to briefly force stone to bend to his will, creating jagged spikes or obstacles depending on the situation. More training in his adaptability will likely foster new growth in this area.

LANDSHIP / BASE SKILLS

Comraderie - When this Operator is assigned to a Dormitory, self Morale recovered per hour +0.55, and restores +0.1 Morale per hour to all other Operators assigned to that Dormitory. Self Morale further increases an additional +0.45 when Wildcharge is assigned to the same Dormitory (Only the strongest effect of this type takes place).

Roark gets along with just about every department and operator that is willing to humor his presence. Naturally easy-going and friendly, he mingles with fellow comrades when he's not busy holed up in one of his rooms, happy to chat and give someone a little boost to their day. Anyone could ask him to make something to eat and so far, he hasn't said no. He's often sharing something with the engineering department or even anyone with him in the workshop when assigned there.

Safety Protocol - When this Operator is assigned to the Workshop to process Orirock-type material, the production rate of byproduct increases by 70%.

Prior experience mining originium and personal, high contact with it's variants have made Roark quite useful when refining the material. Wasteful methods tend to spread dust around, so Roark has devised ways to try to keep offsets solid as to keep Rhodes' uninfected staff less likely to come in contact with particles as operators enter and exit the workshop. He's been happy to teach people his methods as well.