If You Want/Need To Talk/Vent, I Am Always Open.

To all of my trans friends followers and mutuals. I love you.

They will treat us with utter inhumanity no matter what we do, so we have to love each other. even if we have never spoken, even if we will never speak. I love you. I love you and the world is so much brighter for having your light in it. Stay alive, survive, grow, thrive, every day every hour that they cannot take from you is hard won victory in the face of pure evil.

You are beautiful, you are a wonderful being and no matter what they do or say, they cannot take that essence from you.

Every line your face grows, every wrinkle in your skin. Every moment of your life etched into you is divine and incredible.

🏳️‍⚧️ TRANSGENDER DAY OF VISIBILITY 🏳️‍⚧️

disabled person who cannot 'keep it together' I love you

disabled person who straightforwardly can't do certain things I love you

disabled person who thinks they should be doing more I love you

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.

If submission is forcibly taken. It's abuse.

If submission is coerced. It's abuse.

Submission can be revoked at any time for any reason.

Take your medications that you need to!

Get up, stretch, walk around a bit!

Get some food and water if you haven’t in a while!

Plug in your device!

Feed any pets!

If it’s between 10 pm and 7 am and you have no reason to be awake besides being up on your phone, go to sleep or at least get comfortable and start trying to sleep!

Check around you and stack any dishes and bring them to the kitchen! Including plates, cups, bowls, and utensils!

Do a quick look around and pick up any trash and put it in the bin!

Message anyone to check in on them and yourself! Respond to any messages you may have gotten, answer some asks if need be, let your family know that you’re safe, whatever you need to do!

If you need to and are able to, go take a shower! Or clean your face! Get changed at the very least, put your clothes in the dirty hamper, and feel better about it!

Black, Brown, and Indigenous people in America, I love you.

Women and pregnant people in America, I love you.

Trans men and women and non-binary folks in America, I love you.

Immunocompromised, disabled, and neurodivergent people in America, I love you.

Palestinians and Jewish People, I love you.

All those who voted blue in a red state, I love you.

This is the single largest project I have ever worked on as an artist. I had to do SO many things I have never done before, and, to my credit, I think I did pretty fucking good.

This, in all, was two months of work, mixed with over 50 hours of drawing. The full file, with every panel together, is 246MB. For reference, last month's was 21.4MB. They were both drawn on the same aspect ratio, using the same brushes, on the same program.

Real talk, I remember having this dream when I first had it, and it was really comforting. I've never had an experience where I've "spoken to myself" in this kind of way before. Sure, I talk to myself all the time, but I've never been two mes at once. Before anyone asks, no, I'm not plural. I'm pretty confident in that, and that's why this dream stuck with me, and will stick with me as this comic. Is there more fancy effects I could've done? Probs. But, then again, 56 hours of one, singular, comic work has me ready to clock out until February.

Call the insurance company and tell them you want to speak with the “HIPPA Compliance/Privacy Officer” (By federal law, they have to have one)

Then ask them for Names as well as Credentials of every person Accessing Your Record to make that decision of denial. By law you have a Right to that informantion.

They will almost always Reverse the Decision very shortly rather than admit that the committee is made of low paid H.S. Graduates, looking at all “criteria words,” making the decision to deny your care. Even in the rare case it is made by medical personel, it is unlikely that it is made by a board cerified doctor in that specialty and they Do Not Want You to Know This!