The Fool

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.

So if y'all got a couple bucks y'all could throw our way, we'd be super grateful so that we could go get some fast food for supper (all of our food at home has to be cooked 😭)

"I don't want to be a burden anymore", your hat answers. "You are always carrying me around, and I can't carry you. That's not fair."

"I don't mind carrying you, little idiot", you tell your hat, "you hardly weight anything at all, and you shelter me from the sun."

"But that's different", your hat protests. "I don't mind the sun scorching on me. That happens anyway. It's literally no trouble for me to shade you too."

Flamingos can survive in low oxygen, high altitude, high temperatures, low temperatures, high alkaline, they can and will drink boiling water and they can be completely frozen at night and still get up the next morning

(animal death) this is a real undoctored photograph (*though the body was stood up for the shot) of a dead flamingo on the surface of lake natron, a lake so salty and so alkaline that it’s naturally carbonated like soda and would eat through your stomach lining if you drank from it.

When this photo went viral years ago, most people assumed this poor flamingo must have been killed by the lake.

It is actually the lake where 75% of its global population are hatched. This is a photo from the same lake:

RATING: RELIABLE

Flamingos can survive in high altitudes, hypersaline conditions, and caustic lakes.

Source: ‘All flamingo species have evolved to live in some of the planet’s most extreme wetlands, like caustic “soda lakes”, hypersaline lagoons or high-altitude salt flats.’

They can survive water so alkaline it burns human skin.

Source: ‘More than a million lesser flamingos breed in Tanzania’s Lake Natron, for instance, a lake fed by hot springs with water so alkaline that it can strip away human skin (one pioneering flamingo researcher named Leslie Brown spent months in Nairobi General Hospital after burning his legs wading out to observe where the birds nested).’

They can drink water at near-boiling temperatures.

Source: ‘They can drink water at near boiling point to collect freshwater from springs and geysers at lake edges. If no freshwater is available, flamingos can use glands in their head that remove salt, draining it out from their nasal cavity.’

The lakes they inhabit can freeze overnight, and the flamingos can survive once it thaws in the morning.

Source: ‘The birds may seem to epitomize the tropics, but they also live in the Andes, 15,000 feet above sea level, where they rest on lakes that freeze around them overnight.

“You’ll see them sitting there like snowballs, frozen on ice,” Dr. Arengo said. “And as the temperature warms up, they thaw out, fluff themselves up and go about their business.”’

The photo is indeed from Lake Natron, taken by photographer Nick Brandt. The content of the lake chemically preserves animal corpses that die there. You can see more photos of this here.

It is also true that 75% of Lesser Flamingos are hatches on Lake Natron.

Source: ‘The lake’s landscape is surreal and deadly—and made even more bizarre by the fact that it’s the place where nearly 75 percent of the world’s lesser flamingos are born.’

Some species of Flamingo eat cyanobacteria or algae.

"Us? Oh, of *course* our Dachshund sleeps inside- we just let him out in the morning and make sure he comes back for dinner. He just does his own thing, no worries."

"Um, you know it's not humane to keep a chihuahua confined to an apartment? They're dogs, they're natural predators. They need to experience hunting behaviors or they get depressed. No we don't leash ours, he absolutely hates it, we just let him come and go whenever."

Yall get how fucking stupid that sounds, right? So stop letting your goddamn cats get eaten and attacked and infected and hit by cars

A toddler would probably love full unattended access to the neighborhood too, but we don't do that either, do we

GIRL THE EGG COLUMN IS NOT A GOOD IDEA. YOU DO NOT NEED CONVINCING YOU NEED CONVICTION.

IS REASON ENOUGH. BE A

GIRL TODAY RIGHT NOW

"I'm pretty sure that fella ain't here legally."

"Well, that ain't your business Chip, it's his."

They hate being preached to. If you pull out words like 'gender wage gap' they'll tell you you're brainwashed by the far left media.

"He's one of them transgenders."

Shut down the conversation without reacting.

"His dick, not mine" will get you much further to shutting that guy down than "well it's really inappropriate to call someone a slur while I'm the job site".

I knew a rapist who was an absolute ride-or-die friend to his gamer bros. Like, give the last dollar from his pocket to a friend who got a flat tire, and then turn around and go rape a Freshman that evening.

I knew a vicious child abuser who wept like a baby when her dog died.

The nastiest human being on the planet nevertheless feels obscurely melancholy sometimes, or has high spirits when they step out doors on the first warm day of spring, or has opinions on their favorite TV show and which side the toilet paper should hang on and whether or not the room should be cold or warm when you go to sleep.

We're all still just people. Complex, with fully-realized interior worlds.

None of that will save you from becoming a monster, if you decide to do monstrous things.