Kei-emji - Brainworm Hive

Okay, I know I've already talked briefly about how I think the perception of Kichijoji changes for Joker after 11/20 in a different post, but today has me thinking; how does it change for Akechi?

Are the colors dimmer for him too, both in vibrancy and in light? Does he find himself walking around and looking through shops as if he's passing time while someone's still on the train? Does he automatically go to stand by Penguin Sniper before remembering that there's no one who will meet him? Does he go to the Jazz Jin and feel like it's too quiet?

Does Muhen ask him about the boy he would come with? Does he fumble for an answer? Does he keep thinking of a conversation topic and looking up, only to see an empty chair? Is the realization so terrifying that he goes home and works too late, sustained by anxiety and the worst coffee he's had in months?

Does it extend beyond Kichijoji? When going on Momentos runs just to blow off steam, does raising his gun remind him of a boy in an arcade, or one sitting in an interrogation room? When he sees Sae at work, does he think of how her sister reacted to the news? After school, does he find himself almost taking the train to Yongen-Jaya? When putting on his gloves, does he get the urge to pull the right one just a bit tighter?

Is it hard for him to look down at his desk from an certain angle? Do certain voices in public catch his attention? Does he see a Shujin uniform and panic? During interviews where they ask the audience for input, does he keep preparing himself for a mini debate?

Does he look up that boy's parents, trying to find their contacts so he can tell them that their son is dead? Does he find the original court case that resulted in a probation and realize that Shido had been to thank for yet another thing? Does he buy or steal cheap liquor from any store he can, pouring it down the drain just to drown out the smell of coffee that hangs on everything he owns by now? Does he think back to every conversation they've ever had, playing his rival's words over and over again in his head to search for some signal that he knew this was coming and he knew how to get out?

Does everything look dimmer to him, too? Does life just feel more bland?

(When he realizes that Joker is alive, is the tiniest part of him relieved? Does he crush that part of him, or does he ignore it? Do the lights in the studio look just a little more vibrant? Does he even realize any of this before it's too late, bleeding on the other side of a bulkhead door? Does he?)

So today I want to talk about puberty blockers for transgender kids, because despite being cisgender, this is a subject I’m actually well-versed in. Specifically, I want to talk about how far backwards things have gone.

This story starts almost 20 years ago, and it’s kind of long, but I think it’s important to give you the full history. At the time, I was working as an administrative assistant for a pediatric endocrinologist in a red state. Not a deep deep red state like Alabama, we had a little bit of a purple trend, but still very much red. (I don’t want to say the state at the risk of doxxing myself.) And I took a phone call from a woman who said, “My son is transgender. Does your doctor do hormone therapy?”

I said, “Good question! Let me find out.”

I went into the back and found the doctor playing Solitaire on his computer and said, “Do you do hormone therapy for transgender kids?” It had literally never come up before. He had opened his practice there in the early 2000s. This was roughly 2006, and the first time someone asked. Without looking up from his game of Solitaire, the doctor said, “I’ve never done it before, but I know how it works, so sure.”

I got back on the phone and told the mom, who was overjoyed, and scheduled an appointment for her son. He was the first transgender child we treated with puberty blockers. But not, by far, the first child we treated with puberty blockers, period. Because puberty blockers are used very commonly for children with precocious puberty (early-onset puberty). I would say about twenty percent of the kids our doctor treated were for precocious puberty and were on puberty blockers. They have been well studied and are widely used, safe, and effective.

Well. It turned out, the doctor I worked for was the only doctor in the state who was willing to do this. And word spread pretty fast in the tight-knit community of ‘parents of transgender children in a red state’. We started seeing more kids. A better drug came out. We saw some kids who were at the age where they were past puberty, and prescribed them estrogen or testosterone. Our doctor became, I’m fairly sure, a small folk hero to this community. 

Insurance coverage was a struggle. I remember copying articles and pages out of the Endocrine Society Manual to submit with prior authorization requests for the medications. Insurance coverage was a struggle for a lot of what we did, though. Growth hormone for kids with severe idiopathic short stature. Insulin pumps, which weren’t as common at the time, and then continuous glucose monitoring, when that came out. Insurance struggles were just part and parcel of the job.

I remember vividly when CVS Caremark, a pharmaceutical management company, changed their criteria and included gender dysphoria as a covered diagnosis for puberty blockers. I thought they had put the option on the questionnaire to trigger an automatic denial. But no - it triggered an approval. Medicaid started to cover it. I got so good at getting approvals with my by then tidy packet of articles and documentation that I actually had people in other states calling me to see what I was submitting (the pharmaceutical rep gave them my number because they wanted more people on their drug, which, shady, but sure. He did ask me if it was okay first).

And here’s the key point of this story:

At no point, during any of this, did it ever even occur to any of us that we might have to worry about whether or not what we were doing was legal.

It just never even came up. It was the medically recommended treatment so we did it. And seeing what’s happening in the UK and certain states in America is both terrifying and genuinely shocking to me, as someone who did this for almost fifteen years, without ever even wondering about the legality of it.

The doctor retired some years ago, at which point there were two other doctors in the state who were willing to prescribe the medications for transgender kids. I truly think that he would still be working if nobody else had been willing to take those kids on as patients. He was, by the way, a white cisgender heterosexual Boomer. I remember when he was introduced to the concept of ‘genderfluid’ because one of our patients on HRT wanted to go off. He said ‘that’s so interesting!’ and immediately went to Google to learn more about it. 

I watched these kids transform. I saw them come into the office the first time, sometimes anxious and uncertain, sometimes sullen and angry. I saw them come in the subsequent times, once they were on hormone therapy, how they gradually became happy and confident in themselves. I saw the smiles on their faces when I gave them a gender marker letter for the DMV. I heard them cheer when I called to tell them I’d gotten HRT approved by insurance and we were calling in a prescription. It was honestly amazing and I will always consider the work I did in that red state with those kids to be something I am incredibly proud of. I was honored to be a part of it.

When I see all this transgender backlash, it’s horrifying, because it was well on the way to become standard and accepted treatment. Insurances started to cover it. Other doctors were learning to prescribe it. And now … it’s fucking illegal? Like what the actual fuck. We have gone so far backwards that it makes me want to cry. I don’t know how to stop this slide. But I wrote this so people would understand exactly how steep the slide is.

In Two Years, He will be the same age as when they started to scrutinize Biden's age being not competent enough anymore to hold the house. Hold that over his head.

inspired by boop day, reblog this post if its ok for people to send you random asks and interact on your posts with no judgement. i want to talk to people.

Today on "am I hitting a spiraling state of despair and frailty or did I forget to drink water again and body is mad at me"

normal halloween fantasy world w/ vampires & monsters & all that good jazz but the skeletons are just normal people who happen to be deceased but stuck around

like ghosts get the option to stay w/ their corpses instead of passing on so now everyone’s family is made up of like 3 living generations and your great-aunt Bernadine

arcane but what if it's a corny hallmark romcom about lesbians

thanks @seagreenwaves for fashion refs and the equally corny tagline

was for ShuAke Week of 2023 <3

Arcane season 2 ending made me too sad so yk what, everything is fine actually, Viktor is now a teacher at the Academy and he mentors young Zaunite students. That's how I choose to cope.

ghost rain