Jul (they/she)

I have a pretty aggressive ad blocking and reddit, YouTube, etc. Don’t like that. Also, I dumped most of the social media that explicitly spies on you or implemented policies that LGBTQ+ and immigrant hate speech is excluded from their moderation topics and thus allowed. That all was motivation enough for me.

I do still often need to see some posts for information that is only there for the most part. So I use the LibRedirect plugin for Firefox/Ironfox so i don’t have to log in for read-only purposes.

I was undiagnosed as a kid. Right now I have a formal ADHD diagnosis, but I’m 99% sure there’s also autism in there. It runs in my family and my psyc and therapist definitely agree, just it’s very hard to diagnose as an adult and the few doctors who could always have long wait lists. And maybe that’s for the best in case I need to flee the US (I’m trans) and resident visa processes don’t usually take kindly to disabled people. I take Adderal for my ADHD, and that gives me the spoons to deal with the anxiety much more. So I’m more able to mask in public. And I have a friend group that I don’t gave to mask much with.

Point being, I had the opposite treatment. My parents just threw me to the wolves so to speak. I would get panic attacks being force to go to the store myself, especially if I was doing something I knew was wrong, like my step-grandmother would always try to get me to pick up cigarettes for her when I was a child/preteen. Breaking rules always was difficult for me. Or being locked out of the house and told no dinner and no coming back inside until I learned how to ride the bike they got for me. Meeting new people, driving, etc., same issue.

Anyway, although I see the disadvantages to coddling, I think I would have preferred that extreme to the opposite extreme.

Different meds work differently for different people. Or if you aren’t actually ADHD they may be less effective for you. Better I ask a doctor, but Adderal works best for me.

It’s an ideological issue. Some people need someone they feel superior to to distract them from how the people who consider themselves to be better than them are abusing them, by saying that some other group is actually responsible for the problems they are actually causing.

Thus the rich, conservatives in charge who are cutting jobs and creating immense inflation by allowing anticompetitive behavior by large corporations they make money from, blame the losses on immigrants. And immigrants have no way to fight back as they have no rights.

Ideological issues are more difficult to use as a distraction these days. It’s just harder to convince people that their inaction in failing to repress or murder people who are just trying to live their life will cause their deity or whatever to be disappointed or disown them and keep them out of paradise or whatever they believe. So, it’s not as effective to just say they’re evil, anymore, they need to invent things those people are doing to them even if they aren’t doing anything in reality. Problem is it’s becoming more and more apparent that trans people aren’t actually a threat, so they need to invent things like statistics saying that 50% of major mass shootings are done by trans people by inventing criteria to make only 8 or 9 of the thousands of mass shootings to be considered “major”, and thus the 4 mass shootings they found that were by trans people become 50%. As long as they keep repeating those numbers and isolating their audience from real statistics, it’s easy to maintain control that way. But the internet makes that difficult these days. Plus the economic issues are much more common among conservatives than having trans children. And trans people aren’t quite as historically repressed as POC who were slaves or immigrants who were running from horrible conditions, so its more difficult to keep them repressed. Same was true of gay, lesbian, and bi people a couple of decades ago. They were repressed, but not as economically repressed as POC and immigrants making them more likely to fight back and easier for conservatives to identify with.

And the US supreme court is about to start hearing some cases that will allow them to declare state laws banning conversion therapy to be unconstitutional. It’s really sad that conservatives will torture and murder children to create an enemy for fascism to bring people together against whether its LGBTQ+ children or immigrant children.

UI should have one menu for global actions and where applicable, one menu or set of buttons or whatever for context specific actions that activate when you select an item(s) to take action on. And that’s it.

As for forms in general, paper or electronic, I agree they often are not specific enough about context to understand what they’re looking for. This is a failing of instructions, either in context or a separate page of them should exist for every single form. There are some where the title is self explanatory in context like “first name” in a selection labeled “patient demographics” is documentation enough, but otherwise there should usually be at least a few words explaining each field or set of fields. Paper and ink is cheap, screen space is cheap, put a few words.

As for tax forms, I think for US taxes it’s fine until you get to business income and expenses which are purposely vague and complex to allow for essentially fraud that’s harder to detect, whereas personal stuff is more specific to make sure they get every cent from people not wealthy enough to write off living and luxury expenses as business expenses. But it’s too complex for the average person without basic logic skills. Like temporarily renting out a property until I could sell it after I had to move was ridiculously complex to figure out what I could and couldn’t deduct. The forms are very generalized and the details are obfuscated by filling in your own descriptions on worksheets that often are not actually filed, only retained for audit, whereas in personal expenses almost every single detail has a place to put it on a form that is actually filed.

Not really my thing. I definitely want to have as natural of a body as close to what it was supposed to be as possible, but with the way the fetus’s life is now given priority over a mother’s, it’s just not worth it to me.

Yeah I will say the hormones are easier here. I had thought the clinics also helped them coordinate surgery, but I don’t really know well, just going off of something I read and it’s possible that it was just one clinic that happened to offer that service, too.

For hormones here the hardest part is finding a therapist and/or psychiatrist to write the letters and in some places, finding a doctor willing to prescribe and monitor and fill out a support letter and all the paperwork to get prior authorization for the off-label-use dosage since you need more than a cis-woman which is often all that’s covered by default and often isn’t covered at all by default if your birth gender marker is M. When my plan changed this year I had to start getting the prior auth every 6 months because I exceed the max covered dosage by 3x.

I was lucky to have a primary care doctor that was experienced, though she moved on now. And I found a list of therapists willing to write the support (gate-keeping) letters with only a single, virtual appointment, though I had to pay cash and needed 2 of them (one at least PhD level and one at least MA level) for the surgery. For me the hormones only required one and could be MA level, though. I was on waiting lists for both therapists and psychiatrists at the time, so that list saved me. There’s a shortage of mental health providers around here, too.

And the letters technically are supposed to require the mental health providers to know you well, but a lot of providers know that’s just gate-keeping. And, some insurance still requires the even older WPATH recommendations that you get one that does and one that doesn’t know you. My insurance is only one version behind, though, using version 7, but some use 6 or even 5 still.

It’s not much better in the US and there isn’t a unified “gender clinic” to coordinate things. And travel for surgery and recovery is expensive, especially when most insurance doesn’t pay for that and things are so spread out in the US, so most have no option or if near a major city are stuck with the one or two overbooked options close enough to them that they can get a ride to.

I had to travel to another major city to even get on a waiting list for my first surgery since in the major city where I live, the one clinic that has a surgeon was totally unresponsive on how long their waiting list was after taking my doctor’s referral.

And I had to pay around $4,000 for a month at an AirBnB plus flights, food, and necessities we couldn’t fit in the now strict 50lb weight limits on luggage for me and a care person. I couldn’t bring a carry-on since I wouldn’t be able to carry it on the way home and you can’t put the heavier liquids in there anyway like soaps, shampoos, hair products, lotions, etc. And paid several thousand out of pocket to cover deductibles and coinsurance despite having the most expensive health plan my company offers which costs about $400 every other week from each paycheck despite the fact I work for said insurance company. And that was only one surgery.

Next surgery is a 1 year wait for a consult and no clue how many years before surgery and another one is at least a 3 year wait for consult and at least 4 year wait for surgery after the consult. I can’t afford to travel again for those. Had to take out a home equity loan for the first one. And I still have to pay for the mental heath visits for the gatekeeping WPATH letters each time both for the consult and again for the surgery since they each expire after a year. I really wish there was someone to help coordinate it all. For example, if I end up with the waiting lists ending too close to each other I’ll have to go back on the beginning of the list assuming the surgeon is still scheduling new surgeries because you can’t get too many too close to each other and they’re totally separate offices.

And traveling internationally is too dangerous right now with my passport being forced to be my birth gender and my genitals not matching for the x-ray, so unless things improve it is likely I’ll be too old to get most of the surgeries by the time I get through the lists. I’m already starting later in life due to lack of care. Plus I need other small surgeries for some unrelated issues which I can’t find providers for in my insurance network taking new patients and can’t afford to schedule too far out, just in case I get to the top of the gender care surgery wait lists.

Make sure to do a test during peak and a test during trough.

I do that and then average them. They are always significantly different and i use patches which give a more steady dose than injections.

Also, I’m not entirely convinced that the values most doctors who are not specialists use are correct for trans people. If you aren’t seeing an endocrinologist with at least a little specialty in sex hormones, I’d do that and see if they can recommend the right levels for your body rather than the general numbers that were always very conservative, and came from cis women’s levels rather than what trans people need since there’s usually no funding to research trans people.

I was lucky enough to start HRT with a general practitioner with a lot of experience with trans people during her residency and most of her career. But she moved on to another specialty due to the difficulty making ends meet as a good doctor. I’m on the lookout myself for an endo with good experience to consult one of these days.

Then that should be the questions asked, not some arbitrary “sex” question with only some of the possible answers as options.

It should be apparent, especially now, that those things never were never enough to determine these things anyway. There are tons of types of intersex people which are not an insignificant percentage of the population.

So, there are some things that loosely follow AGAB for the majority of people, but the assumptions made based on that, end up causing more trouble for those whose bodies don’t conform. And that’s not a small portion of the population. Basically between intersex people and trans people who have had HRT and/or surgery are at very, very conservative estimates, around 3%, but since there’s no finding and it’s now unsafe to track even in the US and UK and other western countries, it’s likely much higher in reality. These people are poorly served by the current system of AGAB only.

For me, many of my lab tests show abnormal because it should ask what is my body’s primary sex hormone or ask to select for the specific test, what range is normal for my body if they want to get it really right. And honestly, body weight is more impactful on a lot of things anyway, why aren’t we asking that of every person (rhetorical question, but essentially asking if you were born with or the doctors modified your body at birth to have something that looked closer to a penis than a vulva, should be just as uncouth)? Also, insurance won’t pay for gynecology/urology kind of stuff or mammograms or prostate cancer screenings even if you have the right body parts to need it, if your AGAB is wrong without a long and drawn out process each and every time to prove you have the right part. Heck it’s not even good for marketing if you have the wrong one listed because it has to be your AGAB rather than the gender you present as and thus the high profit products you’re most likely to use.

So it really has a low usefulness compared to asking more relevant questions whether for medical or commercial reasons.

Same. I have had a few types of headache issues most of my life and no one believed the pain was that bad because I don’t express it the way people expect when in severe pain. So, I always thought I had a low tolerance until a doctor freaked out at some severe tibial stress fractures that I was still being asked to run on them. And it took faking a painful yell when the doctor was manipulating it in the first visit to get the bone scan ordered to get to that freak out. I just don’t uncontrollably verbalize severe pain or fully shut down or things like that like neurotypicals.

Yeah, I have an X on my ID so even though it’s technically valid for air travel, I brought my passport instead which has my AGAB and wore really loose fitting clothes. Fortunately I didn’t have to go through the x-ray that would give away that my body parts don’t match my passport.

I wiped all of my devices in case I was detained, not that I have anything to hide, but I don’t want to out any of my friends as trans for them to get targeted.

And I’ve been staying away from public bathrooms despite having a hard time holding my bladder due to some medical issues retaining salt and water. Considering getting a catheter or something for when I’m in public for more than a few hours because dehydrating myself all the time isn’t good for my health.

It’s really scary right now even living in a fairly progressive leaning state. I won’t even think about traveling to my hometown to visit family where it’s more conservative. I’m really hoping on the flight back I’m able to slip through security again. It’s going to be a lot of paperwork to get my birth certificate changed to what isn’t actually my gender since that’s not an option, but more closely matches my body parts.

It’s sad that just existing means you are classified as a terrorist and have to avoid interacting with society to survive.

Stay away from the US if you can if you are trans, intersex, non-binary, or even cis if you just have some facial traits that make you look a little less like your AGAB. It’s only getting worse every day.

It will go the opposite way. The far right justices already have multiple times shown they don’t care about precedent or the intention of laws, only finding strict literal interpretations that fit their ideological views to take away rights.

If it’s POSIX compliant then it will work on all versions of Linux/Unix. Otherwise it depends on specific implementations that have branched for decades.

Again, adverse effects doesn’t mean death, the fact that the description you posed has that last sentence is the alarmist thing and only applies to certain drugs, of course.

The difference in absorption rates between oral and rectal administration can be as much as double or triple or more in some cases. For example I remember reading a study from the 70s or 80s on methylprednisolone. The absorption rate orally was about 90%, but rectally was only around 35% likely due to bacteria in the rectum decomposing the drug before it could make it into the blood.

So, over the long term the difference in dose could have a significant impact on health. Getting 3 times more or less of any drug, even something relatively safe, will likely mean “adverse effects”. With estradiol this could mean greatly increased side effects for overdose like nipple soreness or mood swings, or greatly decreased effect for underdose meaning testosterone takes over again and hair loss and body hair growth restart. These are “adverse effects”, but are not likely to be deadly, but still considered overdose/underdose.

Nope I don’t agree. Language has meaning to people, and has no obligation to past meanings or logic. If it did then we wouldn’t have been able to reclaim the use of the word gay which has changed meanings multiple times just in my lifetime.

Overdose doesn’t mean die, it means getting a larger dose in your blood than the labeled dosage. Over a long period of time dosing too high, there may be side effects. Sorry if I used medical terminology, but I work in healthcare so it’s common terminology there. I sometimes forget that the media has warped the meaning of some of these terms.

But that’s how language works. Things mean what the majority of people say they mean. Otherwise, everyone would still be using the n word because it wouldn’t have a negative meaning. It’s about communication, not absolute logic.

Can and should are two very different things. The two have different absorption rates for different things. You may overdose or it may be totally ineffective. There may be toxic contaminants that taken orally might not be absorbed much, so its relatively safe, but taken rectally might be absorbed into the blood stream. There’s also the sanitation issue. The mouth is generally better at capturing and keeping infections out of the body than the rectum, so you may need to sanitize the pills which might be difficult if you don’t want them to dissolve. And relatedly, there’s the matter of the inactive ingredients. They’re designed to be swallowed, but may cause issues left behind in the rectum. Most pills that are swallowed just use starches which isn’t a big deal, but to make things dissolve quickly there are other ingredients including sometimes sugars which could encourage microorganism growth if you don’t sanitize them or some ingredients may trigger diarrhea or other reactions.

There’s usually not research done on a drug taken sublingually as to how it would affect a person rectally, so it’s usually not going to be well known.

That said, ask your doctor. If there is any data about doing it, they would be more likely to know.