Allium

For Tristan Martin, a 34-year-old trans man living in North Austin, that fear became a reality last week when a Walgreens pharmacist refused to fill his testosterone prescription. Martin says his pharmacist’s explanation for not filling his prescription was that she was uncomfortable with the doctor’s instruction that the medicine be administered subcutaneously, meaning as a shallow injection under the skin. But, as Martin explained to the pharmacist, he’s taken the same meds for four years, with the same method, and never heard such an objection. Plus, Martin said that the pharmacist was only being asked to provide the testosterone itself, not the equipment necessary to administer it. He later attempted to reach Walgreens’ pharmacy department and store manager to ask about the situation but wasn’t able to reach anyone and never got any calls back. A store employee told the Chronicle they could not address the dispute. Tristan’s wife, Hayden Martin, said she received an apology from a Walgreens regional healthcare supervisor, after the supervisor contacted her on May 23. “He said there was absolutely wrongdoing and that it’s going to get figured out,” Hayden said. “He said he was going to reach out to the higher-ups and he’s going to let me know by Friday what happens.” Hayden Martin told us she was able to contact the pharmacist in question two days after the refusal to fill the prescription. “She would not give a reason as to why she felt the doctor was wrong,” Hayden said. “And she said, ‘I’m not comfortable filling it for ‘her.’ So automatically the assumption is that it’s just an issue of her not being comfortable with the fact that it’s testosterone for a trans man. So I, of course, asked her if this was the reason – because he’s a trans man – and she got very defensive and denied it. And then I tried asking for her name and her license number and she said, ‘Well, that’s not important information.’”

Recently, one of our readers, who wishes to go unnamed, sent us the following email:

On the 24th when I went to pick up my testosterone prescription at the Walgreens on Lomas & Carlisle, I was asked by the pharmacist why I took it, and when I told him it was gender affirming, he told me he wouldn’t fill it going forward… I want other trans+ folks in our neighborhood to know that this is not a safe pharmacy (I don’t regret reacting by sobbing loudly in the middle of a Walgreens, but I don’t want anyone else to have to go through that), and I want all our cis neighbors to know that this is a thing that is happening.

We reached out to the Walgreens location, and the person who answered (and who we will keep anonymous) confirmed that there is a pharmacist on staff who refuses to fill prescriptions for gender affirming medication due to their beliefs. However, they clarified that other pharmacists at the location would fill a gender affirming prescription if they were on duty, or the prescription could be filled at other Walgreens locations. Unfortunately, they were not able to provide further information as to the pharmacist’s name or when their shifts might be.

A year after KC investigation, another trans customer turned away from Costco pharmacy

The city’s Civil Rights and Equal Opportunity Department launched an investigation in October 2022 after a Star report about five transgender and nonbinary people who said they were denied their prescribed testosterone at the pharmacy. Costco denied the allegations. [...] Dave, whose name has been changed in this story to protect his identity as a transgender man, was grocery shopping at the Linwood Boulevard Costco on Monday when he decided to pick up some syringes. Dave has used insulin syringes for years to take his prescribed testosterone — their thin needles make his regular injections less painful. These small syringes don’t require a prescription, making them easy to obtain — and Costco offers a bulk pack of 100 at a nice discount compared to other pharmacies. At first, the transaction was painless: Dave asked for a pack of syringes and an employee asked him his preferred size and gauge. But when he mentioned that he uses them to inject testosterone, the tone of the conversation shifted abruptly. “They got weird about it,” Dave said. “The pharmacist, I guess, overheard and she came out and she’s like, this won’t work for testosterone.” Dave explained that he has used these syringes for his testosterone injections for years — and has even bought the same syringes at that Costco pharmacy before for the same purpose. Insulin syringes are regularly used to inject low doses of testosterone. But despite being an over-the-counter product, the pharmacist insisted that Dave needed a prescription before she would sell them to him. “She’s like, well, we won’t sell it to you unless you have your doctor call it in,” Dave recalled. He stepped aside to call his doctor’s office, but they were closed for Monday’s holiday. “I didn’t feel like arguing (with the pharmacist). So I just left.” An assistant general manager at the Linwood Costco said Wednesday that he was not aware of the incident and couldn’t comment on it. A pharmacy employee said that she and her coworkers are not authorized to speak to the media. A request for comment from Costco’s corporate office was not immediately answered. Dave called the Missouri Pharmacy Board Tuesday and was told that syringes only require a prescription if they bear the label “for Rx only,” which his syringes didn’t. Beyond that, he said he was told that the state gives pharmacists discretion over what they choose to dispense, as long as they don’t violate federal anti-discrimination laws.

“Criminalization has made it easy for pharmacists to deny my [testosterone] prescription, which has happened to me many times,” Artemis McGettigan, a trans student in Dearborn, Michigan, told Filter. “[Pharmacists] have told me in the past that ‘It’s corporate policy, they’re not allowed to fill that type of prescription … but I knew that was false because other CVS locations, for example, were able to fill it.” A CVS media representative told Filter that its policies “do not prohibit our pharmacies from filling testosterone prescriptions.”

CVS Pharmacist refused to fill my T

I have been on T for coming up on 3 years. I’ve never had any problems with any pharmacy I’ve gone to. I recently had to switch pharmacies and for over two weeks this pharmacist at CVS has given me the run around. “I need to talk with your doctor about why you need it” (which I’ve never had happen before). And then the next day would say “I need prior auth”. It’s been so long without my T that my period came back today and I am freaking out. So I sent a very frantic message to my doctors office. They called me about an hour later telling me the pharmacist sounded fishy and said “I’m not comfortable filling this prescription.” Ok? Your job isn’t to judge my prescription your job is to give me the medication my doctor decided I needed. The doctors office was nice enough to transfer everything to a different CVS close by and even apologized for not getting the pharmacists name. We did call to get his name. My partner is very nice and called corporate to file a complaint and the corporate pharmacist on the phone said that they do have grounds to deny a prescription only if there is not enough info or it’s fake. So they reported it as discrimination. Unfortunately I can’t take legal action or I would. Sorry this is more of a rant than anything. This should be illegal and nobody should work in healthcare if they’re going to gate-keep health. I truly hope this man gets fired. I’m trying to file a report to the state board of pharmacists because he can have his license revoked for discrimination. Thanks for listening.

My pharmacy tried to deny me my testosterone

[This was partially written by @ashweather, another member of the A.N.I.M. team.]

Let me preface this by saying that I don’t think that the makers of Candela Obscura are morally evil, or that I think less of your moral worth if you’ve played or enjoyed this game. It’s just that, at best, the game has a really obnoxious and cowardly tone and at worst has a lot of shit in it that looks really bad if you think about it for more than 5 seconds. 

If you think that tabletop RPGS are art (and we do), then they can be analyzed like art. They can have unfortunate implications or reflect unexamined reactionary politics. This post is going to be taking screenshots from both the quick start guide and the full rulebook to make this point - while the text between the two is broadly similar, the quickstart guide is more overtly finger-wagging and hostile, saying the quiet part out loud. 

The thing about Candela Obscura is that it takes place in a fantasy 19th-century England/USA, but it really wants to pretend that it doesn’t. It wants the aesthetics of this setting and almost every trope that comes baked into it, but also wants to act like it’s above all that. It wants to have its cake and denounce it too. It’s so pants-shittingly terrified that it or the players might say or do something “problematic” that it loops back around to being incredibly offensive. 

To take just a few examples, the text is absolutely riddled with this kind of sentiment:

(What the fuck do they think an “explorer” is? Also, I think I have some bad news about 19th century doctors.)

Okay. Look. A lot of this is gesturing at principles that are unobjectionable or even useful to keep in mind when writing a setting like this. Yes, it’s ideal to have a non-Eurocentric historical understanding of technology and culture. Yes, refugees are human beings with their own valuable skills and perspectives. Yes, if you uncritically write an expy of Victorian England or late 19th-century New England, you’re gonna end up with a bunch of insane stereotypes (especially Orientalist ones) that you probably shouldn’t just blithely put to the page without thinking about them. And yes, bigotry is a bad thing, obviously.

The problem is twofold: The first is that Candela Obscura feels the need to take a patronizing tone towards its own readers, as though they were incapable of engaging critically with the setting or subject matter on their own terms. The second is that despite all of this finger-wagging, Candela Obscura absolutely does not present a setting with any critical thinking put into its basic construction. (We checked, by the way. None of what we are about to present is supposed to be in-universe propaganda. If it is intended to be, this is not made clear at all in the text itself.)

The game takes place primarily in the city of Newfaire and its surrounding environs - the Fairelands. The Fairelands are prosperous and idyllic, and all but outright stated to be “the good guys.” All of the “problematic” aspects of the societies the game is emulating are either scrubbed without thinking about the implications of scrubbing them.. 

(Don’t worry guys there’s no colonialism here, this version of fantastical New York was settled on a Terra Nullius where nobody lived, right over the ruins of an ancient society with a mix of Egyptian and Mesoamerican coding who practiced strange and corruptive magicks. Remember, reader, this game wants you to go out of your way to avoid reproducing any harmful stereotypes from the era.)

..or are present without any historical or structural reasons for them to be present:

(Don’t worry guys, sex work is lawful, profitable, safe, and socially acceptable! Oh yeah all the sex work happens in shady, spooky-looking crime districts that cops monitor, filled with drug-filled dens of illegal vice, though. By the way, there is no brothel listed in this district’s points of interests, or any further discussion of what sex work in Newfaire is actually like.)

There are so many examples of this that we could spill a novel’s worth of digital ink talking about it. (We just don’t have time to get into, for instance, their adventure inspired by the “radium girls” where the primary victim of the dangerous substance in question is a customer who is already dead when the adventure starts and not the workers who make the products.) Honestly though, this paragraph says more than we could in a hundred pages:

Here we find out that we are reading a TTRPG setting that has the same understanding of bigotry as the movie Crash. No institutionalized bigotry, just “bad actors who hold terrible beliefs.” Just bad apples, with no personal history or cultural roots to their ideas, who presumably sprung out of the ground one day declaring themselves Republicans. Not only do these bad actors come from nowhere, they don’t go anywhere either. They don’t belong to any social movements, they don’t get organized, they don’t push for regressive political changes, and if they ever do, they certainly never succeed at those goals. 

You see, despite these bad apples, the soil they grew from is pure. And you know something else about the idyllic, almost utopian Fairelands? They’re under assault.

That’s right! Hale (which the Fairelands is a part of) is under assault from the dastardly, corruptive forces of… uh, “Otherwhere.” (Yeah, do they all have hooked noses and recessed chins too?) That’s where all of the dirty foreigners invaders come from, who want to take away the prosperity of the Fairelands!

Oh, or maybe their whole culture were all coerced into doing it by an evil rock or something, which is definitely less xenophobic. But whatever, who cares what the reasons were. The Fairelands are under attack, and as the dominant power in the world, they need to defend themselves. Against the “colonists.” With nukes chain lightning.

(That last sentence continues on “tens of thousands..” You get the picture.) So, whew, glad that’s over! Otherwhere is still really dangerous, though. They might even be developing weapons of mass destruction of their own:

You know, if Candela Obscura were a person, I have a feeling I wouldn’t want to hear its thoughts on Israel. 

You might be asking, where do the PCs fit in this? Well. The PCs are members of the in-universe organization Candela Obscura. They are an enormously powerful and widespread secret society of sometimes-cops sometimes-vigilantes who fight against the corruptive forces of magick to keep humanity safe. They keep dark secrets, “perform questionable acts in the name of the common good,” and operate entirely without oversight or responsibilities to anyone other than this organization. We are assured that this organization has the best interests of the regions they operate in and of all humanity in mind.

It’s actually fine - cool, even! - that PCs are secret police/CIA agents who engage in morally dubious acts for the purported common good. Newfaire’s society being deeply flawed is fine! The Fairelands as a political entity furthering an explicit narrative of being persecuted is fine! The problem is not that any of these elements exist, the problem is that Candela Obscura is utterly allergic to examining them. The text seemingly does not understand the setting it has presented at all.

The game wants to be anti-conservative, but the only kind of story it can produce is one of heroes who are ultimately aligned with the dominant power of the world, preserving the good and righteous status quo by fighting against corruptive, foreign, magical forces. “Gay transgender women of all races can be holy knights secret police fighting to protect the good kingdom democracy from the endless hordes of the evil dark race that has threatened its borders for a thousand in recent years!”

On a first read a while back, I said Candela Obscura’s gameplay mechanics make it sound like a game more meant to create “actual-play” shows than to be actually played. On examining the text more closely, that’s more true than I even realized at the time. The reason the game has all these bits about how not to be problematic - all of these instructions for avoiding engaging with the more controversial aspects of the setting - is because it’s not really intended as a game to be played in a private environment. It’s intended as brand guidelines for putting on an actual play show. If you google Candela Obscura, the IMBD page for the actual play series appears before the store page for the rulebook.

It seems like the game really doesn’t want you to play a character outside of your own culture. And sure, as stated earlier, it is a good idea not to have a mysticized idea of other cultures, or represent them in a callous way. For a private game played at home, though, this is not really something you need to dedicate pages accounting for. Nobody outside the table has to hear a poorly-done accent or contend with a less-than-perfectly researched religious portrayal - and if there is a pervasive issue with someone being bigoted or leaning on stereotypes at the table, frankly, that is a problem that is outside the scope of a TTRPG to address.

However, if you are an actor on a show, portraying people from different cultures comes with a whole different set of (much more justified) baggage. Candela Obscura’s approach to player attitudes on the setting makes so much more sense as brand guidelines than it does as a codification of how to play a game. "Don’t have actors appear in insensitive costumes on camera." "Don’t have actors say foreign words they don’t know how to pronounce on camera." "Remember not to have your white actor do a Romani 'fortune-telling' scene on camera." "Don’t show anything that could negatively affect the perception of the brand."