Big Bill Hell's Cars

Drive for 1 minute to the store, spend 2 hours shopping for all your groceries for the week, load your car up, and drive for 1 minute home.

Walk to the grocery store 1 time a day for a round trip of 15 minutes.

Similarly, unwalkable city also gives you two options:

Drive to the store, spend 2 hours shopping for all your groceries for the week, load your car up, and drive home.

If for whatever reason - including disability - you cannot drive or cannot spend 2 hours at the grocery store, you either have someone who can do such things for you, or you fucking die of starvation because you cannot access the only grocery store in god knows how many miles.

'Typical' pronouns can be silly and frivolous and fun and the gender equivalent of playing with toys. Being a man/boy/male/etc or a woman/girl/female/etc can be silly and frivolous and fun and the gender equivalent of playing with toys.

What matters is how you treat and discuss pregnant men outside of consensual sexual contexts.

Are you making jokes about men getting pregnant? Are you treating it as something that inherently emasculates them, something that inherently degrades them? Are you making jokes about impregnating men that are replacements for rape jokes? Are you implying that men getting pregnant is weird or gross or unnatural? Or even that it's something that only happens in fiction? Do you make omegaverse jokes about and to real men who can get pregnant? Do you tell trans and intersex men that pregnant man jokes are "not about them at all", do you pretend that pregnant man jokes only apply to men who cannot get pregnant?

They say that only doctors can diagnose, but that's wrong because there are many doctors out there that aren't acting in good faith. That is to say, they are ableist, or they believe in very outdated stereotypes about autistic people.

And this can make undiagnosed autistic people lose the opportunity to finally find out that they are autistic, and to also to gain access to services that only come with diagnosis. That is also partly the reason why i think people self diagnose, and that is pretty harmful.

There's a lot to unpack about their anti self diagnosis crowd. They're people who gatekeep, who are ableist and people who don't like changes. I understand that, but that's not an excuse to be doing the things that they are doing.

(Who, by the way, has been in drastically fewer things since he came out as trans while filming The Umbrella Academy in 2020, only one of which is live action/actually has him appearing on screen. He literally went from averaging 3-4 roles each year to 1.5 (x). Just look at allllllll that privilege)

I'll wait.

If trans men are wielding soooooo much power and privilege - if trans men are more or less positionally equivalent to cis men - why has only a single trans man ever openly held elected office in the US at the state level or higher??? vs. over a dozen trans women and three or four nonbinary people, for that matter! (x, x)

Where is the systemic privilege we're accused of holding? Where are we rewarded for becoming men? Where is our masculinity rewarded? Where are we enacting all this societal and legislative power over women, whether cis or trans?

I spoke with the patient and she was literally shaking with anxiety. I asked her to describe her prior experiences as well as what she liked about her IUD and what she didn't like. She said that she wished she didn't have to get it replaced so often, so I recommended we place a Mirena instead of just inserting a new Kyleena IUD. She was nervous about this because she didn't want an IUD that was big. I explained that the Mirena and Kyleena are essentially the same size but the Mirena lasts 3 years longer and would likely bridge her to menopause given her age whereas with the Kyleena she'd probably need another replacement to get there. She was okay with trying the Mirena.

I then talked to her about pain control during the procedure as this was what she was most worried about. I asked about her prior experiences and then laid out what I wanted to do to try and improve her experience during this procedure. I told her I planned to give her prescription strength ibuprofen, a heating pad, and a very dense anesthetic block in her cervix to hopefully make it a better experience. If she had had someone to drive her home I would've also given her an ativan because we have studies that show patients who report higher rates of anxiety surrounding a procedure also report higher rates of pain associated with it.

She was down for this plan. I gave her a very dense block, she only felt three small injections and then nothing else. She was shocked when I told her that her old IUD was out and the new one was in. She didn't believe me when I told her it was over.

I don't tell this story because I wanna brag about how amazing of a doctor I am because I'm not. I tell this story because this is the way IUD insertions SHOULD go and I want people to know that IUD insertions do not need to be traumatic. And I want other providers who may insert IUDs to know that a paracervical block should be your standard when it comes to IUD insertions.

When people find out I'm an OBGYN, complete strangers, acquaintances, etc. , the two things they like to tell me immediately are their horrible birth trauma story and their terrible IUD insertion story and I'm trying to at least make the latter one a little less common.

If you place IUDs and aren't doing a cervical block, you need to start. This should be the standard but over 90% of OBGYNs in the US aren't doing them and it's unacceptable. We are traumatizing people and it's entirely avoidable. We are scaring people away from one of the most effective and long lasting forms of birth control in a time when people are losing their ability to end unwanted pregnancies all for no justifiable reason.

"It takes too long:" No it doesn't, that visit took me 20 minutes with a highly anxious patient from start to finish.

"It's not worth it for such a short/small procedure." It's worth it for the patient.

"It's too expensive." You can do a paracervical block with just normal saline. You don't even need lidocaine if you use a generous amount of volume. And if you place Nexplanons I know you stock lidocaine in your office, stop being fucking cheap at the expense of women's pain.

"Patient's don't need it, they'll get over it." I'm telling you they do need it and they aren't getting over it as evidenced by literally everyone wanting to tell me about their terrible IUD insertion experience as soon as they find out I'm an OBGYN.

We should do better. The cervix has nerve endings, stop acting like it doesn't.

I have had people freak out and act like it was crazy that I once let a dentist give me a (very shallow) filling without novacaine. Yet it was less painful than itching a bad mosquito bite. The norm in dentistry is to give local anaesthetic before anything that might cause much pain, and use a numbing agent before the injection.

Rarely a dentist might offer to do something without anaesthetic like that one filling, but only if they really know what they're doing and think it's highly unlikely to be painful. And even then if you yell out, they'll stop and numb you if you want. 100% of the time.

> ask the people if it's objects or gambling

> they don't understand

> pull out illustrated diagram explaining what is objects and what is gambling

> they laugh and say "it's a good collectible sir"

> look up how to buy a collectible

Labubus are blind bags but they're also blind bags with some of the most insane dark patterns stacked on top. The online store for them has a thing where they tell you what you got the second you order it online so that you can immediately try again if you didn't get the thing you wanted.

You can buy confirmed/pre-opened boxes on from various ebay sellers.

"Oh well ADHD-" ADHD doubles the risk of premature death

Here are more sources if you don't believe me

Intellectually disabled people die on average 20 years earlier than those of average intelligence

Autistic people are more vulnerable to premature death across a range of causes

Individuals with tic disorders are more than twice as likely to die young as individuals without

Individuals with Cluster B PDs lose anywhere from 9-13 years of life expectancy due to their disorder, and 1 in 5 kill themselves

The mythes i am talking about are the stereotypes that autistic people are good at math, that autistic people are very intelligent, that we are gifted people. And that's wrong, that's overgeneralization.

I get that some autistic people are good at math, are highly intelligent or more intelligent than the average autistic, are gifted, but there are also autistic people who aren't good at math. Some autistic people who aren't intelligent, some who aren't gifted. There are autistic people who aren't good at everything because of their autism, because of many reasons.

For me, my reason for not being good at math is because i have Dyscalculia. That means that i basically suck ass at everything that's above grade 2 level math. Even some basic math questions i can mess up on, can do completely wrong. Because mental math is a struggle for me because of my memory issues.

So, when i see people saying that we're all gifted and not academically challenged in any shape or form, i do not like it. I feel left out by what they say. And i of course don't like feeling isolated. No one does.

And then below that is just a collection of transradfems / trf adjacent transfeminists stoking fear + hostility toward BITMOC , excusing the violence done to them, downplaying antiblackness and more. This is me just scratching the surface.

Just making sure they don’t retcon more shit. Black + Indigenous + other racialized trans people of ALL gender expanses have been pointing out how their theorizing fails us for years. They have disregarded, excluded, erased, discarded and demonized us for it for years.