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The Rainbow White Coat — uvm medicine

Today is National Coming Out Day! “Happy NCOD” seems to be the standard greeting, but I prefer to co-opt a phrase from Yom Kippur: “May you have an easy NCOD.” Recently I mentioned to a friend that I sometimes have doubts about when and how to talk about being queer in medical school. His immediate response was, “Well, are you out?” For him, it was a simple question. For me, it skated over so…

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Alma Mater, Bayit, Community (and a decision)

Continuing to dust off old drafts. I wrote the first half of this in fall 2012, when I had just graduated from Oberlin and moved to Chicago to spend a year with AVODAH: The Jewish Service Corps. How to finish the post didn’t start to make sense until more recently. The bayit, fall 2012 I. When I left home Saturday morning (to walk to the brown line to take the El downtown to walk to Union…

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A Change of Pace

Hello! It’s been a while since I’ve posted anything… let’s fix that! Last fall I had just left my beloved job at a sexual & reproductive health clinic, in order to do a premed postbac program. Since then I’ve started and finished a job as an emergency department scribe, taken a lot of classes, biked down the Oregon coast, moved back across the country to my hometown, set up a lovely cooperative…

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snowysauropteryx

Can you lick the science? An abbreviated list.

Genetics: Do not. Unless cheek swabs?

Chemistry: NO!!!!! DO NOT!!!!!!

Archaeology: Perhaps. But might be human bone.

Geology: Sometimes needed, sometimes dangerous

Psychology: Best not.

Physics: ????????? How??????

Zoology: In zoology, science licks you.

linearbbq

Important clarification: baby archaeologists who are having trouble telling the difference between rocks and potsherds* are often encouraged to lick them. Ceramics are (generally) more porous than rock and will stick to your tongue.

* don’t laugh, this is harder than it sounds!

If I gave you my Tumblr username at TIC yesterday: hi, it was good to meet you! I’m not actually around here all that often, but if you send me an ask/message I’ll let you know how to reach me via Facebook and email.

athenagray

sourcedumal

[snip]

This is important. Ella works for everyone. Plan B is not effective for people over 176 pounds. Protect yourself

madnessinthemist

Everyone?

Boosting the shit outta this.

the-goddamazon-deactivingsoon-d

Plan B is not effective for people over 176 pounds.

cosmic-noir

BOOST BOOST BOOST

linearbbq

T einzwitterion:

Hey friends (all 198k of you who’ve liked or reblogged this), let’s be responsible about our use of tumblr to spread health-related information. Lucky for you, this one is true. Here’s a source: Planned Parenthood says so. Statements like this that are not backed up by legitimate sources are dangerous. What if this were not true? I had never heard of the weight restriction before, so I looked it up. Please fact check your shit and include references before posting stuff that is going to worry a lot of people. They deserve to know if you are telling the truth or making things up. What did we learn from our after-school specials about not trusting strangers on the internet?

Love, your local academic who cares about your reproductive health

::perks up:: Internet misinformation about emergency contraception? My specialty!

It’s true that Plan B becomes less effective with increasing weight, but the “176 pounds” figure is misleading. It’s much more useful to talk about EC in terms of BMI. (Planned Parenthood uses pounds in some of their resources, but BMI in others.) Plan B (and other levonorgestrel-based EC, like Next Choice) is less effective for people with a BMI over 25, and not effective for people with a BMI over 30. ella is a better choice for people with a higher BMI, but does become less effective for people with a BMI over 35. (so, ella is not effective for everyone -- but it’s better than Plan B!)

So where did 176 pounds come from? 176 pounds is the cut-off for a BMI of 30 if you are 5′4″ (the average height for FAAB people in the U.S.). It’s an oversimplification based on the fact that a lot of people don’t know off the top of their head what “BMI of 30″ means for someone of their height.

Why does this matter? I’m 5′0″. That means that for me, Plan B stops being effective when I hit 155 pounds. On the other hand, someone who is 5′9″ and weighs 180 pounds would be totally fine to take Plan B. Saying “176 pounds” instead of “BMI of 30″ overstates Plan B’s efficacy for shorter people, and understates Plan B’s efficacy for taller people.

(EC is one of my favorite sexual health nerd topics. See also this post, which has a lot more general information...)

menandtheirdogs

(Submitted by dannydevitoe) My boy Jackson. Rare to get him not drooling and/or humping

jayme-allen-deactivated20180324

ricamora

transguys

Coinciding with Cervical Health Awareness Month, Robert Eads Day on January 17 honors the memory of Robert Eads and raises awareness for preventative care and early detection of cancer and HPV in trans men. Robert Eads (December 18, 1945 – January 17, 1999) was a trans man from Toccoa, Georgia, whose life and death was the subject of the award-winning documentary Southern Comfort (2001). Eads transitioned later in life and was advised not to seek hysterectomy due to his age. He was diagnosed with ovarian cancer in 1996 and more than a dozen doctors refused to treat him fearing that taking him on as a patient might harm their practice. When he was finally accepted for treatment in 1997 the cancer had “already metastasized to other parts of the body, rendering any further treatments futile.” Robert Eads died on January 17, 1999. Robert Eads was denied medical care in the United States just 19 years ago. His story is a tragic reminder to trans men to take charge of their health, as well as a call to action to the medical community to fight against trans discrimination in health care and to improve the accessibility of preventative care and early detection of cancer and HPV in trans populations.

linearbbq

This is super important (and reminds me that I still haven't seen Southern Comfort -- you can actually watch the whole movie on YouTube here.)

But also: I'm a little worried that using Robert Eads Day to talk about HPV and Pap smears may mislead people about ovarian cancer, which is what actually killed Robert Eads. So, a few quick facts (ha, whenever I say this it never ends up being quick):

- Pap smears can detect cervical cancer, but they don't detect ovarian cancer (or any other kind of cancer). Ovarian cancer is not strongly linked to HPV the way that cervical cancer is, and it isn't prevented by the HPV vaccine.

- Ovarian cancer is about twice as common as cervical cancer and causes three times more deaths. Because the symptoms are often vague or nonexistent and there isn't a good screening test, it's notoriously difficult to detect early.

- Ovarian cancer generally appears at a later age than cervical cancer. However, a) we should all know how to take care of our health as we age, and b) there is virtually no research into how long-term testosterone use affects the risk of ovarian cancer for trans men and other FAAB trans folks. A few studies have found that cis women who take androgens or drugs that increase androgen levels have a higher risk of ovarian cancer. In addition, Nick Gorton's awesome book Medical Therapy and Health Maintenance for Transgender Men is a little out of date at this point, but he notes that of the few published cases of trans men with ovarian cancer, all were younger than the median age of ovarian cancer development for cis women, and none had a family history of ovarian cancer.

- The most common signs and symptoms of ovarian cancer are pelvic pain, bloating, feeling full quickly while eating, and needing to urinate more frequently. Yep, these symptoms are annoyingly vague and are linked to tons of other health conditions! If you have any of these symptoms persistently, it's a good idea to see a doctor.

- People have increased risk of ovarian cancer if they have endometriosis or PCOS, or if they have never given birth or used birth control pills. Anecdotally I'd guess that all of these factors are more common among trans men and other FAAB trans folks, although as with almost every area of trans health, it's hard to find data!

- People with close relatives who have had ovarian cancer may want to look into getting tested for BRCA1 and BRCA2 (genes associated with ovarian cancer and breast cancer) and/or HNPCC (associated with ovarian cancer and colorectal cancer). Not only are these good things to know about our health, but they can also help persuade an insurance company to cover a hysto with oophorectomy (removal of ovaries).

The CDC, the American Cancer Society, and MNOCA all have good information about ovarian cancer, although the text is very gendered. I'm happy to pull out info for people who have questions but don't want to wade through those pages.

mooiefietsennicebikes

life hack:

1. open the top drawer of your desk, you know, that long shallow one that's full of broken rubber bands and old bus passes.

2. place a beverage (or smoothie, cup of soup, etc.) in it and close the drawer almost all the way but not quite.

3. put one end of a long straw into the beverage. put the other end of the long straw into your mouth.

4. type/write for hours on end without needing to disengage your hands for trivial things like remaining hydrated!

... yes, the semester just started and I already have a lot to do, how did you guess?

lasmaracuyas

Race is not a biological category that naturally produces health disparities because of genetic differences. Race is a political category that has staggering biological consequences because of the impact of social inequality on people’s health.”

Dorothy E. Roberts, Fatal Intervention (via betheintrepid)

thesexosaurus-deactivated201511

Which morning after pill available in the US do you recommend? I'm thinking about getting plan B, and then getting Next Choice when I turn 17. I assume that because Next Choice has an age requirement it's more effective. Am I wrong, is it just health risks or side effects associated with it that restricts it to <17 ppl? I just want a safe and reliable MAP to pair with condoms.

I don’t really know much about Next Choice, but I assume the age requirement is more to do with side effects.

Well, I heard about this one, and I couldn’t find any mention of an age requirement on the website. You need a credit card to get it, so that might make it less feasible for you. BUT one thing that it has going for it that Plan B doesn’t is that it works for heavier people. Plan B only works for those under 180 pounds. I don’t know if that’s an issue for you, but I thought I’d put it out there. If you want to go with Plan B, though, here is a link to a printable coupon for it.

Also, I have a /tagged/emergency_contraction page if you want to check that out for some general info.

That’s pretty much all I can think of to offer at the moment, but if anyone has anything to add, that’d be great. I hope this is helpful. :)

linearbbq

Couple quick facts about emergency contraception:

First of all, keeping some EC around as a back-up just in case is smart and responsible and awesome!

Age requirements for EC in the United States are overwhelmingly related to politics, not to efficacy or side effects. Emergency contraception pills are safer than Tylenol. Check out this kick-ass article on "The Politics of Emergency Contraception" from the New England Journal of Medicine -- it's a few years out of date, but still on point.

Plan B, and generic pills like Next Choice, Take Action, and My Way are different brands of the same drug, levonorgestrel. Levonorgestrel-based EC should be taken within 3 days of a pregnancy risk, and is less effective for people with a BMI over 25-30. In the U.S. it's available over-the-counter without an age restriction (see here for more info about who can buy it [anyone!], whether they need to show ID [no!], and how much they can buy at a time [as much as they want!]).

ella is a form of EC based on ulipristal acetate. Unlike Plan B, there are no generics available. It can be taken up to 5 days of a pregnancy risk and is more effective than levonorgestrel, particularly for people with BMIs in the 25-35 range, though it still loses efficacy with increasing weight. In the U.S., ella requires a prescription, but there are no age restrictions on who it can be prescribed to. (If you see a doctor for a routine check-up, they can write a prescription for ella for you to have on hand just in case; if that's something that you want and they don't offer, feel free to ask!)

The most effective form of emergency contraception actually isn't a pill: it's Paragard, the copper IUD. When it's inserted up to 5 days after a pregnancy risk, Paragard is over 99% effective at preventing pregnancy -- that runs circles around both ella and Plan B. Not only that, but it isn't affected by BMI and continues to be >99% effective at preventing pregnancy for twelve years. Obviously getting an IUD is a bigger decision than taking a pill, and you aren't going to keep a Paragard in your bathroom cabinet just in case, but many clinics (including the one where I used to work!) offer same-day walk-in appointments to people who want a Paragard for EC.

Planned Parenthood has a great table summarizing the different forms of EC. It includes the sticker prices, but many Planned Parenthood clinics and other community health centers can provide EC at low or no cost (even if you're under 18 and don't have parental permission).

gracklesong

the extreme radfem reaction to Leelah Alcorn’s death is disgusting but 100% predictable. It’s important to remember these people wouldn’t have an audience anywhere near as large as they do if there wasn’t a large community of feminists willing to tolerate a background buzz of transmisogyny for pithy radfem posts.

At the same time, there are people calling Leelah by the right pronouns and describing her death as a tragedy while simultaneously proclaiming her suicide as a direct product of ~rigid gender binaries~ with no acknowledgment that trans women and girls are especially hated and marginalized in this society. They view calling people by the right names and pronouns as an indulgence for the mentally ill that can be revoked at at any time, not a issue of fundamental, non-negotiable respect. They repost suicide hotlines for trans people but are against the presence of trans women in women’s shelters, schools, bathrooms, at least not until those women have met some arbitrary set of qualifications. Let’s be frank; if they had met Leelah Alcorn before they knew who she was, they would not accept her in their spaces, they would accuse her of siphoning resources from “real” women, they would have chastised her for not recognizing her male privilege, they would analyze her appearance and experiences for evidence that she was trying hard enough to really experience life as a woman, and she would have failed their analyses. They think this has nothing whatsoever to do with her death, and the fact that they are willing to say, “Oh, but they shouldn’t have to kill themselves” is not proof that they are not fundamentally and unapologetically reinforcing the society that killed Leelah.

thearetical

This is (one reason) why I love the internet.

thefingerfuckingfemalefury

I AM SO HAPPY THAT ROAR THE LION BEAR FOUND HIS WAY HOME :)

jordancat

This is the cutest thing! i’mm reblog it again!

ceallaig1

For all the crap that happens on the net, with something like this, you’re glad it was discovered.

gaytransguys

San Francisco-based Trans Lifeline has collected an all-trans staff of volunteers who aim to make the crisis hotline experience more comfortable and accessible for trans callers.

suicide hotline with all trans* staff

lawrencegullo

May be important for some of you guys as we head toward holiday season. Be safe.

lawrencegullo

reblogging again because it’s another holiday where some folks have to be put in uncomfortable family situations. Believe me, I have been there. Even at home, where people love you (or are supposed to) you feel trapped in enemy territory. It sucks. Please reach out for help if you need it and know you are not alone.

linearbbq

hugely important, and also please notice this from the website (emphases mine):

"This line is primarily for transgender people experiencing a crisis. This includes people who may be struggling with their gender identity and are not sure that they are transgender. While our goal is to prevent self harm, we welcome the call of any transgender person in need. We will do our very best to connect them with services that can help them meet that need. If you are not sure whether you should call or not, then please call us at +18775658860."

in other words: if you need support, please do not be afraid that you are not "trans enough" or not in a serious enough crisis to use this resource.

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