thank you ❤️

No worries!! It’s true that sometimes there are medically relevant differences, though I don’t think anything was relevant in this instance. Also, my trans status is was in their medical file, and they saw I was on estrogen and could have read that I have gender dysphoria and have medically transitioned. I just think the ER staff didn’t read my file closely, and operated on the assumption I was cis. If I thought being trans could be relevant, I would certainly disclose that, though.

Separately, you should know trans women tend to have brains that function more like cis women’s brains (and become even more like cis women’s brains once on estrogen), so the way drugs interact with my brain would probably be more like a woman’s brain would react than a cis man’s brain, for example.

It’s a similar story with my body - assuming I’m 100% biologically male is the wrong take-away, my body is hormonally female for example. A lot of sex differences are mediated through sex hormone levels (and resultant body composition differences) - but in both of those cases I’m more like cis women than cis men. And this matches my experiences, drugs absolutely absorb, metabolize, and feel different since I have medically transitioned.

Also, my body was different from a cis man’s from birth in other ways, for example I did not go through typical male puberty and I couldn’t grow a beard until my mid 20s. My guess is that I might have mild androgen insensitivity syndrome, which is a common genetic condition in trans women.

Obvious other differences between the sexes with regards to drugs is more about concerns about possibly impacting a fetus in women (hence the unnecessary pregnancy questions in my case), and differences in weight / stature and thus dose. But they were able to get relevant information to make the right decisions (they didn’t give me anything but a single dose of toradol).

Disclosing I am trans in medical contexts is mostly relevant for screening prostate cancer (which is at a much lower risk in trans women on estrogen, not only is estrogen actually a treatment for prostate cancer but male levels of testosterone, one of the reasons prostate cancers develop, are absent in my body), and there is not much else relevant to providers. (That’s actually the only time my doctors indicated I need to disclose that I’m trans, to ensure I get prostate screenings.)

All that said, if you have some information about other instances where those differences matter or situations you think it would be really important to disclose that I am trans, I’m all ears!

yes, I was telling my partner that all the gender affirmation made the whole thing worth it 😅 I felt pretty happy yesterday, not only did I narrowly escape death and severe injury, but I got rewarded for it with a lot of “ma’am”, “miss”, and “are you pregnant?” 🥰

thanks! 😄

for real, though - worth it 😆

Dysphoria before I knew it was dysphoria:

• 4 years old, I won a girl’s doll at a fair, the attendant wouldn’t let me have it, and they gave it to one of my sisters - I was devastated and felt it was unfair to deny me the doll because I was a boy - I wanted to play with the doll.
• 5 years old being told my family expected me to be born a girl and they were surprised when I was a boy, I thought it was a genuine mistake I had been born a boy, that I was somehow secretly meant to be a girl instead - that the universe made a mistake (and that maybe someday it would be corrected or work itself out).
• 5 - 10 years old, I was jealous of my sisters and felt excluded, I wanted to be included as a peer. Didn’t think about the gender relevance of this, just didn’t like the way being a boy alienated me.
• 10 - 15 years old, I was absolutely miserable having male friends, I felt huge relief when my family moved and I lost my friends, and made mostly female friends from then on, though that was frustrating, I didn’t want to be a “male friend”, I wished I could just be accepted as one of the girls
• 15 years old, dark hairs growing on my legs, despite feeling insecure about not being masculine enough (and desiring “normal” male development) and feeling unsafe being targeted for being too feminine, I secretly shaved my legs with a razor nobody knew I had access to
• 16 - 17 years old, I kept trying to find a way to take a selfie of me that felt OK, nothing worked. The things I tried to make it better were adding a cute leaf to my hair, using hair pins, etc. - feminizing intuitively seemed to be what helped, but it wasn’t enough. I hated pictures of me as long as I could remember, no photo of me ever looked right. I didn’t know why, I didn’t have the thought that it was related to gender.
• 19 years old, tried makeup but hated the way it felt like a contrast between a feminine expression on a male body, it made me feel so much worse every time I would see myself in the mirror after trying something feminine. Nonetheless, I was wearing skirts and women’s clothing, and going to stores to buy them. No idea how to explain it, I didn’t know what to think - I just thought skirts felt more comfortable and right. I even wore women’s jeans and pants, etc. They just fit better, I liked them and they were more comfortable.
• 20 - 30 years old, once or twice I tried makeup again. Makeup always made me feel worse, as my body finally masculinized in ways it hadn’t before (my puberty was slow to kick in and weak, I never developed body hair on a lot of my body and I couldn’t grow a beard until my 20s). The makeup clashed more and more with my increasingly male body. My shoulders became broad from manual labor jobs. My hands became calloused mitts. My voice masculinized more, I started growing a beard. I felt afraid and insecure in my masculinity, and in my 20s I started to really “pass” more as a genuine man, I learned how to dress and act more like a man. I hated it, but I always felt disconnected from my body and it was safer than being targeted as a feminine man, perceived of as gay. I liked that my beard hid my face. I wore dresses and skirts secretly at home, the only clothes that felt “right”, they just were comfortable. Didn’t make anything of it.

Once I realized I am probably trans (at which point I thought I had no dysphoria), the realization suddenly melted a lot of my coping mechanisms like extreme dissociation and just ignoring everything as much as possible.

I went to Sephora and took a private class in how to apply makeup (expensive, but was so helpful for me), having the right products and knowing how to apply makeup to feminize my face made it helpful for the first time.

I started to get laser hair removal, and afterwards my face would be so puffy and raw, I would feel acutely suicidal from it. Makeup actually helped me regain some semblance of my face and reduced dysphoria somewhat.

Dysphoria is still hard for me to identify, esp. when it initiates with dissociation. During sex this is often the case, I didn’t realize I had bottom dysphoria until I realized I always dissociated during sex. Sometimes bottom dysphoria just feels like being really embarrassed about my genitals. Sometimes it means leaving my body and having a hard time being present. Sometimes it means suddenly feeling bad and breaking down crying.

My testes and scrotum have always felt more overtly dysphoric - like revolting alien appendages on my body. Orchi helped a lot, esp. when walking or wearing clothes, but the presence of a scrotum still makes me quite dysphoric.

I personally think one reason the dysphoria kicked in so hard after transitioning is that I went from feeling like society expected me to having these genitals to starting to feel like these were the “wrong” genitals, that I should have different genitals. So there are many sources and pressures that impact the severity and nature of the dysphoria. It’s complicated and hard for me to really understand.

I typically get laser on my face once every 5 weeks, and two weeks after an appointment the hair starts to fall out. I have a week or two where I feel much better, and then as the beard shadow comes back I increasingly feel worse about myself. That was a surprising aspect of dysphoria - even a subtle or small beard shadow has a lot of power over my mood and self-perception, and in ways I didn’t directly link except that it became a recurring pattern that was noticed.

I remember being a teenager feeling desperate to not be in my body any more. I had no idea it was gender dysphoria, I just knew my body felt wrong. At the time I just wished I could extract my brain from my body and interact with the world through a computer interface instead - I think it was too painful to consider my desires to be a woman, those thoughts weren’t on a conscious level.

bidet 🤭

It’s true, I think it’s that being a freak stimulates people’s hyper-individualism, while the “man in a dress” (the feminine gender expression on a “male”) stimulates certain men’s homophobia (fear they might accidentally find me attractive) and insecurities in their masculinity (a generalized tendency to engage other men in a way that puts down femininity and promotes hyper-masculinity).

For the most part I was only ever bothered by overly aggressive men who would probably have been assholes in the world generally - it seemed to me the problem was with them and their fragile masculinity more than anything else.

lol, a little bit - it’s like a slant rhyme!

Glad China prioritizes low homelessness, but it would be nice if there were more regulations on quality, buildings are often unstable and collapse too frequently. Same problem with lack of regulations on pollution and air quality.

gay

Dvorak

I actually can’t type in QWERTY anymore.

was trying to figure out what the stats are on vision impairment, and found this:

https://www.nih.gov/news-events/news-releases/study-finds-most-americans-have-good-vision-14-million-are-visually-impaired

A National Institutes of Health (NIH) study has found that although 94 percent of Americans aged 12 and older have good vision, the remaining six percent, or 14 million, are visually impaired.

So 6% of Americans are visually impaired, and of those, 3/4 can be corrected with glasses.

gonads that produce the correct sex hormones

it really do be bad - though obviously violence exists against all LGBT+ identities, by the numbers it hits trans women of color the hardest, and these women are more likely to be sex workers, more likely to contract HIV, and more likely to be victims of crime. Women in general are at greater risk of being a victim of violent crime.

I feel you, I live in the South in the U.S. in one of the most transphobic states. I was terrified to come out, but it ended up going much better than I expected. For the most part people just didn’t care, and the worst I got were stares usually from older or hyper-masculine men.

EDIT: this made me think that a lot of that fear was oversized, more in my head than reality. Transphobic violence is real, but is mostly targeted against poor trans women of color.

my larynx goes up high when I sneeze and usually I sound pretty cute, this was actually a problem for me pre-transition

coughing on the other hand, is harder - I always want to open my chest and lungs and cough deeply, which uh, sounds not feminine

what country? I’ve heard there is an organization called the rainbow railroad that helps people escape certain places

if I lived in Colorado, but my AG is actively and enthusiastically participating in the erasure of trans people, so I will not be interacting with them at all