For The Most Part, My Approach To Prescribing Hormones Is “sure,” But I Will Note That The One Thing

For the most part, my approach to prescribing hormones is “sure,” but I will note that the one thing I lean HARD on patients about is smoking. If you’re transgender, and you’re on hormones, the number one thing we want to protect is your cardiovascular health. That’s frankly the number one thing I want to protect in all my patients, but anyone taking exogenous hormones is at higher baseline risk. And the best thing you can do for your heart is DON’T SMOKE. It’s a bitch to quit, and I didn’t even smoke much or long before I quit in my late teens, and I STILL didn’t enjoy quitting and had smoking dreams for years. It’s harder to quit than just about anything else up to and including crack and heroin, and that’s coming from a patient of mine who recently passed in her early 60s who’d done all of those things—for years and years—but eventually was able to quit everything except smoking. And that killed her. She developed severe COPD and eventually called to say her blood oxygen saturation was dipping into the 70s, which is incompatible with life. She was lucid enough to decline medical care, including refusing to call 911 or go to the ER. A week later, after both I and one of our outreach nurses had contacted her to ask her to please go to the ER, I got a notification that she’d been found dead. She had been so frustrated that she wasn’t a candidate for a lung transplant.

One of my oldest trans patients is in her late 50s. She’s had blood clots that went to the lungs. Repeatedly. Smoking raises that risk. Estrogen raises that risk. She’s a veteran with PTSD; of course she smoked.

These aren’t theoretical. These are humans I’ve cared for over years of their lives. I have been rooting for them—my beloved former addict, who spoke without shame about her years of homelessness and drug use in the city; my queer elders, who are slowly trading in their motorcycles for power scooters. I want everyone to live their fullest, best life.

Smoking doesn’t fit into that. Please don’t smoke. I don’t want you to die like that—not now and not later. I want you to have the future that you may not be able to see yet, but exists.

Since I moved home as an out queer, word got out, and there’s a whole apartment complex of lesbians in their 60s to their 80s who come see me—sitting next to their wives in the office, nagging about blood pressure meds, tattling about not having gotten the shingles shot they said they would. To be clear, when I was growing up in town, I knew no lesbians. Not one. I knew one gay kid in my class, which eventually turned into two. We were it. To see these women living decades with their wives and being able to squabble like any couple in my office over who was supposed to bring their home blood pressure cuff in for us to check it… it means the world to me.

More Posts from Math-crimes and Others

1 year ago

Tobey Maguire Spider-Man "it's a hard knock life" fancam hours


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2 years ago

Oh and quick note for writers:

One difference between this strike and the last one is that there are a lot more fellowships targeted at early career tv writers than there used to be (there have always been some, but the fellowship model is way more commonplace these days)

Studios are about to make a ton more of these opportunities and advertise them widely as a way to break into the industry, and they will be very specific about the fellowship not technically counting as a writers room or a tv job

THIS IS A TRICK TO GET YOU TO SCAB

Sharing any written content with a studio (even if they route it through a 3rd party "foundation" or development org or something) IS SCABBING

What you do in regards to the strike is your business, but the WGA has been very clear that anyone who scabs will be BANNED FROM JOINING THE UNION FOR LIFE. That means even if you get hired, that's no health & pension and no union protections for your entire career. This shit is serious

So please please double check and dig into any new submission opportunities you see in the next weeks. Playwrights especially be careful - many studios are finding their writers through play scripts these days so be very careful about how and where your work is being shared

No writing going to the studios means NO WRITING of any kind

(if you see suspicious fellowship stuff being passed around let me know, I'd love to keep an eye on that for my peeps)


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1 year ago

could you imagine being a man, a sis gender man, who is really into sounding other men. It's just the only way for you to get off really. But one day you meet a man that you really like, and you just connect with him on a whole other level. And you guys finally get to the point where not only are you in the bedroom with each other, but you're starting to get more open with each other too. About all the things like. The only issue is, is that this man is transgender. He does not have a penis he has never pursued any sort of bottom surgery. So he still has the whole set, the labia menorah menorah the majora Little China adequate Torres. And he also has a urethra. Now he's willing to indulge in your special weird little thing. You're sounding. And you guys finally get to the bedroom and you have your little sounding pole or whatever it is they use. But you realize some thing very quickly. Do you know where the clitorises you know where the clitoris is, but where… Is the urethra? Riddle me this Batman

i've tried answering this ask in three different ways and each time it deleted whatever i added. labia menorah menorah the majora Little China adequate Torres. Every time i try to find a new angle to work on this answer with i read another sentence that makes me wince so hard i forget 3/7ths of the english language. labia menorah menorah the majora Little China adequate Torres. i literally am trying to think of any kind of response but verbally i keep repeating it. "labia menorah menorah the majora Little China adequate Torres." it's like a spell. it's fucking addicting. it's the only way i know a human being sent it because that was for fucking sure speech to text happening right there for a single sentence. labia menorah menorah the majora Little China adequate Torres.

2 years ago
Just In Case

Just in case

1 year ago

Fantasy culture where instead of bouqets or whatever, a bride carries the carved skull of one of her ancestors, inlaid with jewels, so that their spirit blesses the marriage.

For brides without a family skull, an animal skull can be substituted. Wolf and deer skulls are the most popular, but one queen started a trend of weird wedding skulls when she carried the skull of a draft horse for her wedding to her sixth consort. There were opals set into the eyes.


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3 years ago

I want to live by myself when I move out of my parent's place but I'm really afraid of money problems? I'm afraid that the only place I can afford will be in the ghetto and it'll all be torn apart and I'll only be allowed to eat one granola bar a week. I'm really stressing out about this. I don't know anything about after school life. I don't know anything about paying bills or how to buy an apartment and it's really scaring me. is there anything you know that can help me?

HI darling,

I’ve actually got a super wonderful masterpost for you to check out:

Home

what the hell is a mortgage?

first apartment essentials checklist

how to care for cacti and succulents

the care and keeping of plants

Getting an apartment

Money

earn rewards by taking polls

how to coupon

what to do when you can’t pay your bills

see if you’re paying too much for your cell phone bill

how to save money

How to Balance a Check Book

How to do Your Own Taxes

Health

how to take care of yourself when you’re sick

things to bring to a doctor’s appointment

how to get free therapy

what to expect from your first gynecologist appointment

how to make a doctor’s appointment

how to pick a health insurance plan

how to avoid a hangover

a list of stress relievers

how to remove a splinter

Emergency

what to do if you get pulled over by a cop

a list of hotlines in a crisis

things to keep in your car in case of an emergency

how to do the heimlich maneuver

Job

time management

create a resume

find the right career

how to pick a major

how to avoid a hangover

how to interview for a job

how to stop procrastinating

How to write cover letters

Travel

ULTIMATE PACKING LIST

Traveling for Cheap

Travel Accessories

The Best Way to Pack a Suitcase

How To Read A Map

How to Apply For A Passport

How to Make A Travel Budget

Better You

read the news

leave your childhood traumas behind

how to quit smoking

how to knit

how to stop biting your nails

how to stop procrastinating

how to stop skipping breakfast

how to stop micromanaging

how to stop avoiding asking for help

how to stop swearing constantly

how to stop being a pushover

learn another language

how to improve your self-esteem

how to sew

learn how to embroider

how to love yourself

100 tips for life

Apartments/Houses/Moving

Moving Out and Getting an Apartment, Part 1: Are You Sure? (The Responsible One)

Moving Out and Getting an Apartment, Part 2: Finding the Damn Apartment (The Responsible One)

Moving Out and Getting an Apartment, Part 3: Questions to Ask about the Damn Apartment (The Responsible One)

Moving Out and Getting an Apartment, Part 4: Packing and Moving All of Your Shit (The Responsible One)

How to Protect Your Home Against Break-Ins (The Responsible One)

Education

How to Find a Fucking College (The Sudden Adult)

How to Find Some Fucking Money for College (The Sudden Adult)

What to Do When You Can’t Afford Your #1 Post-Secondary School (The Sudden Adult)

Stop Shitting on Community College Kids (Why Community College is Fucking Awesome) (The Responsible One)

How to Ask for a Recommendation Letter (The Responsible One)

How to Choose a College Major (The Sudden Adult)

Finances

How to Write a Goddamn Check (The Responsible One)

How to Convince Credit Companies You’re Not a Worthless Bag of Shit (The Responsible One)

Debit vs Credit (The Responsible One)

What to Do if Your Wallet is Stolen/Lost (The Sudden Adult)

Budgeting 101 (The Responsible One)

Important Tax Links to Know (The Responsible One)

How to Choose a Bank Without Screwing Yourself (The Responsible One)

Job Hunting

How to Write a Resume Like a Boss (The Responsible One)

How to Write a Cover Letter Someone Will Actually Read (The Responsible One)

How to Handle a Phone Interview without Fucking Up (The Responsible One)

10 Sites to Start Your Job Search (The Responsible One)

Life Skills

Staying in Touch with Friends/Family (The Sudden Adult)

Bar Etiquette (The Sudden Adult)

What to Do After a Car Accident (The Sudden Adult)

Grow Up and Buy Your Own Groceries (The Responsible One)

How to Survive Plane Trips (The Sudden Adult)

How to Make a List of Goals (The Responsible One)

How to Stop Whining and Make a Damn Appointment (The Responsible One)

Miscellaneous

What to Expect from the Hell that is Jury Duty (The Responsible One)

Relationships

Marriage: What the Fuck Does It Mean and How the Hell Do I Know When I’m Ready? (Guest post - The Northwest Adult)

How Fucked Are You for Moving In with Your Significant Other: An Interview with an Actual Real-Life Couple Living Together™ (mintypineapple  and catastrofries)

Travel & Vehicles

How to Winterize Your Piece of Shit Vehicle (The Responsible One)

How to Make Public Transportation Your Bitch (The Responsible One)

Other Blog Features

Apps for Asshats

Harsh Truths & Bitter Reminders

Asks I’ll Probably Need to Refer People to Later

Apartments (or Life Skills) - How Not to Live in Filth (The Sudden Adult)

Finances - Tax Basics (The Responsible One)

Important Documents - How to Get a Copy of Your Birth Certificate (The Responsible One)

Important Documents - How to Get a Replacement ID (The Responsible One)

Health - How to Deal with a Chemical Burn (The Responsible One)

Job Hunting - List of Jobs Based on Social Interaction Levels (The Sudden Adult)

Job Hunting - How to Avoid Falling into a Pit of Despair While Job Hunting (The Responsible One)

Job Hunting - Questions to Ask in an Interview (The Responsible One)

Life Skills - First-Time Flying Tips (The Sudden Adult)

Life Skills - How to Ask a Good Question (The Responsible One)

Life Skills - Reasons to Take a Foreign Language (The Responsible One)

Life Skills - Opening a Bar Tab (The Sudden Adult)

Relationships - Long Distance Relationships: How to Stay in Contact (The Responsible One)

Adult Cheat Sheet:

what to do if your pet gets lost

removing stains from your carpet

how to know if you’re eligible for food stamps

throwing a dinner party

i’m pregnant, now what?

first aid tools to keep in your house

how to keep a clean kitchen

learning how to become independent from your parents

job interview tips

opening your first bank account

what to do if you lose your wallet

tips for cheap furniture

easy ways to cut your spending

selecting the right tires for your car

taking out your first loan

picking out the right credit card

how to get out of parking tickets

how to fix a leaky faucet

get all of your news in one place

getting rid of mice & rats in your house

when to go to the e.r.

buying your first home

how to buy your first stocks

guide to brewing coffee

first apartment essentials checklist

coping with a job you hate

30 books to read before you’re 30

what’s the deal with retirement?

difference between insurances

Once you’ve looked over all those cool links, I have some general advice for you on how you can have some sort of support system going for you:

Reasons to move out of home

You may decide to leave home for many different reasons, including:

wishing to live independently

location difficulties – for example, the need to move closer to university

conflict with your parents

being asked to leave by your parents.

Issues to consider when moving out of home

It’s common to be a little unsure when you make a decision like leaving home. You may choose to move, but find that you face problems you didn’t anticipate, such as:

Unreadiness – you may find you are not quite ready to handle all the responsibilities.

Money worries – bills including rent, utilities like gas and electricity and the cost of groceries may catch you by surprise, especially if you are used to your parents providing for everything. Debt may become an issue.

Flatmate problems – issues such as paying bills on time, sharing housework equally, friends who never pay board, but stay anyway, and lifestyle incompatibilities (such as a non-drug-user flatting with a drug user) may result in hostilities and arguments.

Your parents may be worried

Think about how your parents may be feeling and talk with them if they are worried about you. Most parents want their children to be happy and independent, but they might be concerned about a lot of different things. For example:

They may worry that you are not ready.

They may be sad because they will miss you.

They may think you shouldn’t leave home until you are married or have bought a house.

They may be concerned about the people you have chosen to live with.

Reassure your parents that you will keep in touch and visit regularly. Try to leave on a positive note. Hopefully, they are happy about your plans and support your decision.

Tips for a successful move

Tips include:

Don’t make a rash decision – consider the situation carefully. Are you ready to live independently? Do you make enough money to support yourself? Are you moving out for the right reasons?

Draw up a realistic budget – don’t forget to include ‘hidden’ expenses such as the property’s security deposit or bond (usually four weeks’ rent), connection fees for utilities, and home and contents insurance.

Communicate – avoid misunderstandings, hostilities and arguments by talking openly and respectfully about your concerns with flatmates and parents. Make sure you’re open to their point of view too – getting along is a two-way street.

Keep in touch – talk to your parents about regular home visits: for example, having Sunday night dinner together every week.

Work out acceptable behaviour – if your parents don’t like your flatmate(s), find out why. It is usually the behaviour rather than the person that causes offence (for example, swearing or smoking). Out of respect for your parents, ask your flatmate(s) to be on their best behaviour when your parents visit and do the same for them.

Ask for help – if things are becoming difficult, don’t be too proud to ask your parents for help. They have a lot of life experience.

If your family home does not provide support

Not everyone who leaves home can return home or ask their parents for help in times of trouble. If you have been thrown out of home or left home to escape abuse or conflict, you may be too young or unprepared to cope.

If you are a fostered child, you will have to leave the state-care system when you turn 18, but you may not be ready to make the sudden transition to independence.

If you need support, help is available from a range of community and government organisations. Assistance includes emergency accommodation and food vouchers. If you can’t call your parents or foster parents, call one of the associations below for information, advice and assistance.

Where to get help

Your doctor

Kids Helpline Tel. 1800 55 1800

Lifeline Tel. 13 11 44

Home Ground Services Tel. 1800 048 325

Relationships Australia Tel. 1300 364 277

Centrelink Crisis or Special Help Tel. 13 28 50

Tenants Union of Victoria Tel. (03) 9416 2577

Things to remember

Try to solve any problems before you leave home. Don’t leave because of a fight or other family difficulty if you can possibly avoid it.

Draw up a realistic budget that includes ‘hidden’ expenses, such as bond, connection fees for utilities, and home and contents insurance.

Remember that you can get help from a range of community and government organizations. 

(source)

Keep me updated? xx

2 years ago

cdream got kicked out of the vriska poll (characters who have a shit ton of discourse for being morally grey) because............. he had too much discourse


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1 year ago
ITS GREAT LAKES AWARENESS DAY!!!!!

ITS GREAT LAKES AWARENESS DAY!!!!!

On this excellent day, be aware that this is the largest group of freshwater lakes in the world, covering over 95,000 square miles and reaching depths of over a thousand feet. They are beautiful freshwater seas.

Also when you die in these lakes, the very cold, oxygen-poor conditions at the bottom preserves you perfectly for all eternity. You will not rot and nothing will eat you. You will exist for as long as the Great Lakes do. Many shipwrecks still have the crew on board. Be Aware.

2 years ago

You’re a renowned portrait artist, painting portraits for politicians, celebrities, you name it. Late one night, there’s a knock on your door. A nervous young man stands outside, pale, with elongated canine teeth. He’d like a portrait. Hasn’t seen his own face in over a century.


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math-crimes - Untitled
Untitled

I fucked up making my blog 6 years ago and didn't notice, and now it's too late to fix. My actual main blog is here: mathematicalfelony

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