Bread C.A.T.

1. Progesterone: not for everyone, but for many people it may increase sex drive and WILL make your boobs bigger. Also effects mood in ways that many find positive (but some find negative). Most doctors won’t prescribe this to you unless you ask. Most trans girls I know swear by it.

2. Injectible estrogen: is more effective than pill or patch form. Get on it if you can bear needles bc you will see more effects more quickly.

3. Estradiol Cypionate: There is currently a shortage of injectible estradiol valerate. There is no shortage of estradiol cypionate. Functionally they do the same shit.

The concerns surrounding venous thromboembolic events as a side-effect of hormone replacement therapy can mostly be traced back to one particular study known as the Women’s Health Initiative. This study was an enormous undertaking which, unfortunately, demonstrated significant adverse effects of the hormone therapies studied. As a result of this the use of hormone replacement therapy in postmenopausal cis women was dramatically reduced as the medical community began to question whether or not the therapy caused more harm than good.

Naturally, trans women have been suffering from this fall-out ever since.

What physicians seem to fail to recognize is that the study examined a very specific hormone regimen which was, arguably, outmoded at the time the study was conducted: It examined the use of conjugated equine estrogen (Premarin) with or without the use of medroxyprogesterone acetate. Neither of these drugs is regularly used for the treatment of transgender women.

The estrogen most commonly used to treat transgender women nowadays is 17β-estradiol either in pill form or in the form of a sticky patch that you apply to your skin. Esters of estrogen (e.g. estradiol valerate) are also sometimes used either in a pill form or as an intramuscular injection.

Transdermal estradiol patches are the gold standard when it comes to treating women who are at high risk of a venous thromboembolic event. It simply does not increase the risk of developing a venous thromboembolism. The only thing you should keep in mind is that patches are not always well tolerated because of the lifestyle changes required to keep them from falling off and the fact that they tend to irritate the skin.

Fortunately, oral 17β-estradiol appears to be safe, regardless of the increased risk. At least one large study has shown that the use of oral estradiol in trans women is not associated with venous thromboembolic events. An individual woman’s risk would need to be substantial in order to contraindicate the use of oral estradiol.

For those who have significant risk of venous thromboembolism because they have had a previous thromboembolic event, because they are paralyzed, or because of some other factor it is good to know the relative risk between oral and transdermal estrogen. The latest research indicates that the use of transdermal estrogen lowers your risk of a thromboembolism to 80% of what your risk would be using oral estrogens.

It’s difficult to find hard numbers regarding the relative risk of venous thromboembolic events with regards to hypertension. The best I could find after an hour or so of searching was this study regarding VTE in lung cancer patients. Hypertension increased the risk by a factor of 1.8.

However, to put that into perspective being of African descent increases your relative risk for deep vein thrombosis by a factor of 1.3 when compared to Europeans. Europeans are, themselves, at increased risk when compared to Asians and Pacific Islanders by a considerable margin: a four-fold increase.

I should point out that being ‘male’ is also a risk factor for developing a thromboembolism and hormones are likely to be a contributing factor. Also, menopause is another serious risk factor. Given this information it is likely that the use of transdermal estradiol will lower your risk of thromboembolic events significantly.

As far as the anti-androgen is concerned: The primary use for spironolactone for cisgender people is as an antihypertensive.

Even if the risk of thromboembolism was truly significant with modern hormone replacement therapy it wouldn’t justify what your doctor is doing to you. The fact is that mortality in the transgender community from suicide–caused in part due to the lack of access to hormone therapy–is substantial. The quality of life lost when a trans woman is denied hormone therapy is substantial. The fact that your doctor does not appear to be taking this into consideration when they weigh the risk of thromboembolism against not receiving necessary medical care is deeply concerning.

I strongly recommend that you seek a doctor who is more sensitive to your medical needs as a transgender woman.

because even as a non-profit organization, ao3 still needs money in order for it to function. a non-profit organization does need money in order for it to run and operate.

being a non-profit organization does not mean "we don't need money to run it yay". it does not mean "we pay everything out of our own pockets, so we don't need any donation" — that's not how it works.

as for palestine, the site doesn't "forbid things that are related to palestine only". it forbids "anything and everything that 1. is not fanwork 2. involves money" — which happens to include palestine-related stuff.

ao3 is a site for fanfiction (and original works, which according to them, counts as fanworks). the only things ao3 allows are fanfiction and original works — aka FANWORKS ONLY. NOTHING ELSE.

palestine-related posts are not fanworks, therefore they are not allowed.

political statement is not fanwork, therefore it is not allowed.

anything that is not fanwork (fanfiction or original work) is not allowed.

as for your question about donation — a non-profit organization can (and they do) ask for donation, because a non-profit organization cannot function without the donation money keeping it going.

"so why don't they allow users to earn money through their site too? why don't they allow users to raise money for palestine too?"

the answer is because:

be it the money you earn and keep for yourself or donation money meant for other organizations, to a non-profit organization like ao3, that is the same thing. it's still "users earning money through their site" or "users using their site to promote ways for other organizations (someone else) to earn money". intention or who gets the money doesn't actually matter here. anybody or any other organizations earning money through ao3 is NOT allowed.

"people donating to ao3 to keep the site going" and "fanfic writers monetizing works about other people's copyrighted characters" are NOT the same thing.

"people donating to ao3 to keep the site going" and "fanfic writers using ao3 to promote ways for other organizations to earn money" are NOT the same thing.

but "fanfic writers monetizing works about other people's copyrighted character" and "fanfic writers using ao3 to promote ways for other organizations to earn money" ARE the same thing.

"people donating to ao3 to keep the site going" is allowed because... without the donation money, ao3 would not have existed in the first place, it would not have existed today, it would not have been able to continue functioning.

"fanfic writers monetizing works about other people's copyrighted character" and/or "fanfic writers using ao3 to promote way for other organizations to earn money" are NOT allowed because fanfiction is already in a legally grey area. the only reason ao3 and fanfic writers are not being sued by companies like disney or netflix is because "no one is monetizing fanfiction, and ao3 is not used as a tool for users — or any other organizations — to earn money in any way, shape or form".

that's the only reason ao3 isn't being forced to shut down by companies like disney or netflix, the only reasons it's not being bombarded by lawsuits. "no money is involved because the characters belong to their respective studios". fanfic writers just have fun with them. but they are NOT being monetized. NOTHING that is posted on the site can be used to earn anybody — be it the writers or any other organizations — any money.

so no "please donate to xyz". no "commission is open". no "here's my patreon".

be it directly or indirectly, if it involves money, it's against ao3's terms of service.

"but what about original works? they are the writers' original characters. can we monetize our own original works on ao3 or can we promote ways for people to donate to xyz under our original works on ao3?"

no, you still cannot mention or even imply donation or commission on ao3, even if it's your own original works. why? because ao3 doesn't differentiate original works from fanfiction — since it's impossible for them to do that. now I know it's super easy to distinguish between fanfics and original works. but the real issue is that ao3 is KNOWN AS A SITE FOR FANFICTION. it allows original works, yes. but its main purpose is still fanfiction. it hosts millions of fanfiction about other people's copyrighted characters. so basically the entire site is "fanfiction site" — therefore, for legal reasons, anything that involves money cannot be allowed.

the measure ao3 takes to ensure nobody can sue them and force them to shut down is to forbid any mention or implication of money on their platform. it's like them telling companies like disney and netflix "hey, I'm cool here. no one monetizes anything on our site / our site isn't being used as a tool for anybody or organization to earn money." which is the main reason it's not being sued left and right by these companies.

their rules are very simple:

they're a non-profit organization. they're run by people's donation.

they do not allow any monetization or any mention/implication of money on their site, this is how they avoid lawsuits.

anything that isn't fanwork is not allowed on their site, as their site was made only for fanworks.

respectfully, ao3 is NOT a social media platform. it is an archive meant to host fanworks.

No. Just NO.

More rarer images of Neil, my beloved:

20 years.

I find it so beautiful that this little rat's life has been remembered with love for 20 years and will be hopefully for decades to come. Truly a marvel of the internet.

It's probably already been spread around here enough already, but in case anyone's missed it; 7 hours after launch, commander Reid Wiseman, dealing with tech issues, uttered the generational quote "I have two Microsoft Outlooks and neither one of those are working."

After fixing the issues that were afflicting the onboard toilet, mission specialist Christina Koch (who has quickly become my favourite of the four) laughingly said “I’m the space plumber, I’m proud to call myself the space plumber.”

On Easter Sunday, the Artemis II crew hosted a makeshift egg hunt, by hiding packets of dehydrated scrambled eggs around their Orion capsule.

The way the crew always makes sure to make it very clear they're in space when doing interviews. From stuff like Wiseman just hanging out floating sideways on screen or Koch letting her hair loose so it can freely span out flowing around her.

While in transit, the crew decided to record a parody of those bad 80s sitcom intros where everyone turns and smiles at the camera.

When the crew reached the furthest point from Earth in the mission, they jokingly clambored over each other in an effort to get to the far side of the capsule, so that they could individually claim to be the furthest person from earth.

At the same time, on the ISS which was at the time on the other side of earth, the 7 astronauts onboard had a light-hearted race to the far side of the station, making jokes about being the furthest humans from Artemis.

On the way back to earth, NASA actually managed to establish an audio call between the crews of the ISS and Artemis II (where they shared the above info), and Koch called one member of the ISS crew, Jessica Meir, her "astro-sister" as the two of them previously spacewalker together in 2019. Meir then responded I'm so happy that we are back in space together, even if we are a few miles apart" (a few here being 230,000).