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I’m seeing a lot of people saying this post changed their brain chemistry, and as a neuroscientist I wanted to say yes!!! Yes it does!
Wanting something requires dopamine signaling, but liking something doesn’t.
If you have a mental illness/disorder that affects dopamine, you might feel that you don’t want to do the things that you like. You do still like them. You will appreciate having done them.
Let your likes guide you.
(If you want to read more, here’s one experimental paper about it. https://pmc.ncbi.nlm.nih.gov/articles/PMC5171207/ This theory called the incentive-sensitization theory was originally created to explain behaviors in addiction but can be applied elsewhere as well)
Rewards are both ‘liked’ and ‘wanted’, and those two words seem almost interchangeable. However, the brain circuitry that mediates the psych
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this is what I mean about how right now in the united states (won't speak for elsewhere but feel free to lmk in the notes if you'd like) a lot of us trans adults who are able to access transition care can only do so at the direct expense of trans minors. this clinic would not have opened if they held the line and offered equal access to healthcare to trans minors.
"Martin announced the direct-care clinic, calling it “one of the first times a public health department has ever taken that step.” But when Cabán pushed back, pointing out that trans youth are the ones most under attack right now—noting that there are “almost no providers” left for youth the entire city—Martin indicated the clinic would not serve youth, citing the need to “strike a balance” between providing care and avoiding “clawbacks from the federal government.” This morning, EITM can directly confirm that the age cutoff is 19—matching the Trump administration’s executive order threshold, not the standard legal age of adulthood in New York."
a lot of the structural transphobia we are experiencing is hitting minors even worse. their care gets banned first. if you want a preview of what access to healthcare will look like for us trans adults in 2 years, look at what access looks like for legal minors right now.
please have the compassion to show them solidarity now. do for them what you hope a cis person will do for us. like at the very least, talk about it.
i do get pushing back on "mean girl nurse" being used in a lazy misogynistic way against a group of workers who are institutionally abused & their feminized labor underpaid.
that being said. can we not erase the fact the entire conversation began with disabled people talking about being medically abused pretty please. & also, iirc the post that first really blew up about "mean girl nurses" never said "ALL nurses are evil bitches who hate everyone and they deserve to be mistreated" it was saying "women who sought power over other people in high school go into careers where they can wield power over other people, same as men, and there are women who go into nursing and present themselves as kind and caring and maternal, who are motivated by a desire to have unquestioned authority over other people's bodies to make themselves feel powerful, again, same as men who do the same things in masculinized careers." & i just find it "interesting" how all that has been reduced down to "all nurses are mean girls")
i think nuance is always important & doctors and nurses do need better treatment and society frequently praises them while also supporting their abuse. and yet they are also universally recognized as vital important members of society & empowered to have immense control over the lives of people who are systemically vulnerable and seen as leeches who add nothing to society. and yet who has to deal with the impacts of their stress and their trauma and their anger and their burnout? the disabled people under their care.
again. Nuance! but i just cannot help but Side Eye In Cripple some things people say on this topic. it can both be true that nurses (& doctors) experience horrible working conditions and that, in my opinion, that any conversation about burnout and abuse of medical professionals needs to also criticize the authoritarianism of the medical field and how widespread medical neglect and abuse is, lest we simply fall back into "the poor beleagured doctor who is Jesus Christ On The Cross Himself, all-wise and all-knowing and forced to tolerate all these entitled know-it-all ungrateful patients!" which changes nothing for anyone.
like. look at this article. the actual context for the "mean girl to nurse pipeline" (that some women seek out power over people to control them and make themselves feel bigger, and women are likely to do this through caretaking in the role of nurse, teacher, mother, etc.) is not brought up at all. the fixation is entirely on "its mean to call nurses mean girls! they experience a lot of bullying! you don't REALLY know any mean nurses, just poor tired bullied ones!"
First, the phrase itself is unfair to women. Although nursing is a female-dominated field, this phrase focuses on women as being the “mean” ones to worry about.
like. do youuuu fucking see the erasure of medical abuse. the actual bullshit nurses do to real living human beings, which goes massively under-reported. & not just disabled people but people of color as well. god fucking forbid medical professionals are treated as anything but literal saints descended from heaven. god forbid white cisgender women are recognized to have the ability to be cruel and power-hungry and to hurt other people through traditionally feminine roles based on caretaking. like I genuinely do understand that nurses are subject to immense stress, bullying, and violence, and that providing better working conditions for nurses is vital to improving medical treatment for all patients.
but when the actual neglect and abuse nurses can do to their patients is ignored and drops out of the conversation entirely, in the name of complaining about nurses being called "mean"? sorry but it pisses me the fuck off.
(links to some sources on patient abuse under the cut since this is long enough as is)
Exclusive: Leaked internal document lays bare concerns of ‘toxic’ issues within watchdog that mean whistleblowers’ warnings are ignored — an
Nurses and midwives accused of serious sexual, physical and racial abuse are being allowed to keep working on wards because whistleblowers are being ignored, a damning new report has found.
Staff are too scared to report their concerns to the nursing regulator because of a “culture of fear” within the watchdog, documents seen by The Independent reveal.
One whistleblower, speaking to this publication, drew parallels with the Lucy Letby case, accusing the Nursing and Midwifery Council (NMC) of being defensive and trying to protect their own reputation.
They claim “deep-seated toxic conduct” within the NMC is leading to skewed and failed investigations.
A review of NMC guidelines was launched after The Independent highlighted concerns earlier this year by speaking to staff who complained that the NMC was leaving nurses accused of sexual assault and domestic violence free to work unchecked.
Incivility is one of the most prevalent forms of interpersonal mistreatment. Although studies have examined the full range of experiences of
Incivility is one of the most prevalent forms of interpersonal mistreatment. Although studies have examined the full range of experiences of incivility against nurses and other hospital personnel, very few studies examined the forms of incivility that patients face in a hospital. [...]
Participants most frequently reported experiencing insensitivity (38%) or affectively negative interactions. A majority explicitly used the word “rude” to describe their interaction. [...]
When the Doctor was a smart mouth and came in and said “congratulations you have a period” it ended up being a very serious infection. [Participant 290, 27 years old, Biracial, Woman].
Participant 290’s experience demonstrates some of the potential consequences of rudeness. In this case, the doctor was not only insensitive but gave an incorrect diagnosis. In addition, participants frequently indicated how insensitivity was also communicated through a “rough” touch when the doctor was examining them. The consensus was that insensitivity—verbal and physical forms—only made the participants feel worse when they are already in the hospital not feeling well.
Participants (15%) indicated experiencing rudeness because of their identities. Many individuals explained how their socioeconomic status (SES)—specifically lack of health insurance—was a significant factor in shaping the treatment they received:
I had a first time grand mal seizure and wrecked my vehicle. I do not have insurance, so the hospital I was taken to was so rude. I was brought in by an ambulance, they wouldn’t give me anything for the severe headache from the wreck and also from the seizure. They wouldn’t give me anything to keep me from throwing up. The only thing they did was give me an IV of Keppra to stop the seizures. After finding out I didn’t have insurance, they discharged me within 10 minutes. They took me to the bathroom to change clothes, they met me at the bathroom door, handed me my papers and pointed me to the door. I didn’t even get wheeled out after having a seizure and a wreck…[Participant 272: 28 years old, White, Woman]. [...]
…[I] was told in plain terms that those who don’t pay for their [insurance] have no right to complain about not receiving the best treatment [Participant 47: 34 years old, Latina/Hispanic, Woman]. [...]
Participants (26%) indicated what we categorized as containing elements similar to “gaslighting” or mistreatment in which participants’ experiences were minimized, doubted, questioned, second guessed, or denied by health-care professionals. [...]
…I was told I was lying about being sick. I was told that I had lost 45 pounds in 2 months because of a mild cold, and that I was wasting their time. They tried to make me feel like I was a burden, and I was taking away from other patients who they implied were sick. Turns out I was sick, and I needed surgery. Going to a hospital out of town, they diagnosed my problem within 1 visit. [Participant 275: 34 years old, White Man]
Patients adjust their behaviour based on what they experience in care relationships with nurses or the hospital care. It is crucial that pat
Most research on aggression in health care relates to staff experiences about patient aggression. Research on patients’ perceptions of aggressive and transgressive behaviour in care relationships with nurses is limited. [...]
When it comes to competent care, some patients told stories of how expertise of care providers was questioned. One patient described a nurse provided pain-relieving medication while he is allergic to that product. In response, the patient’s daughter attached a list to her father’s bed listing products he is allergic to. Despite this list, every time her father asked for pain relief, that same product he is allergic to was brought to him. Another patient described a nurse accompanied him for an examination. He asked where she was taking him to and when she said it was to Nuclear Magnetic Resonance, he said he was not allowed to because of his pacemaker. He indicated the nurse had not gone through his medical file and was putting him in danger [...]
Patients told stories of being ignored by nurses or not treated as human beings. One woman described the nurse criticized her for not having to have worked a day in her life because of her long-term illness. Another man described dinner was put in front of him without a single word, no ‘good afternoon’ or ‘enjoy’. Patients also provided examples of a lack of gen- uine involvement of nurses in the nurse–patient contact. Various patients mentioned they felt like a number:
. . .One thing that is very annoying is when two nurses are caring for you and they are conversing with each other over your head. That’s so annoying, you really feel like just a number. . .
Furthermore, various patients indicated nurses are more concerned about the way care is organized than they are about the patient’s request. Patients mentioned nurses stick to their routine and are reluctant to deviate from it. One nurse distributes medication while another checks parameters of all patients. Patients describe they cannot approach the nurse about matters that are not part of his/her task at that moment [...]
Various patients gave examples of situations where they were not acknowledged or heard with regard to their own appraisal or expertise concerning their illness and health. Patients stated they themselves felt what they could or could not do, but nurses kept emphasizing and imposing things, according to guidelines and protocols, they should be able to do at a certain point in time. Several patients felt they were not heard:
. . .I had two surgeries on my back. So the first day after the surgery, they said, ‘roll to the side and sit up’, of course that’s difficult. On the second day, they demand you get out of bed. But I felt worse, I couldn’t get out. And they didn’t believe me, the nurse didn’t believe it. ‘You’ve had surgery and according to the textbook, you should be able to get out of bed on the second day’. On the third day, they made a new scan and saw that those nerves had not been unblocked and on the fourth day I had another surgery. So they don’t listen, because that’s not possible, according to the ‘textbook’ you should be able to do this. . . [...]
When patients realize it is not self-evident to receive adequate care or do not feel in competent hands, they become more observant and vigilant. Patients describe they observe nurses carefully, check their medication and ask which examinations they are having and why. The care they receive is more outspokenly questioned:
. . .They came to collect me for my hip. Ah, you’ve got a scanner appointment. She says: ‘it’s an MR scan’. I say: ‘an MR scan? I can’t do that because I’ve got a pacemaker.’ And she says ‘And now you tell me?’ ‘Listen here, missy, you walk in here and tell me to come.’ You’d be in there if you wouldn’t have said something, wouldn’t you! The battery can generate voltage which could burn your heart, destroying your pacemaker. If you’re not paying attention, you’re done for. You constantly have to be on your guard. . .
You literally cannot find any information on abuse or racism perpetrated by nurses by searching up pretty basic terms, because the results are entirely full of abuse done to nurses. Which is important, but my god.
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im rereading it right now and in the foreword of the 2nd edition she very explicitly says that whipping girl was based heavily on her own experiences and was not meant to be a definitive work that covers every single trans experience.
like, she is not maliciously refusing to talk about the transphobia trans men face (in fact she acknowledged repeatedly in her various works that we are oppressed and experience transphobia) she just doesn't go super indepth because she is not a trans man.
the thing is, if your younger self was a bigot or an abuser, u can't make people forgive you. but you still gotta forgive yourself, like that's non-negotiable, dude. that happens before u can even ask the question of earning forgiveness from anyone lese
oops, in your attempt to martyr yourself out of respect for your victims you accidentally sabotaged your own ability to conceptualize yourself as anything but a perpetual evildoer who is always one bad day away from hurting everyone you love, all but guaranteeing history to repeat itself. rookie mistake
im gonna try explaining myself, cus im a gambling addict and im waiting for the day that it actually works.
"forgiveness" is personal, that's why I said in the post that you might inflict harm on people for which they can never forgive you, but that's their quest. if you abuse someone, you can't go no-contact with yourself. you actually keep living in your own head indefinitely, and ultimately you need to learn to live with yourself in order to continue living a full life without further harm. this is not necessarily an anti-carceral thought, although i am generally anti-carceral myself. I simply want people to like, fix their heart and atone for real with measured accountability & self love instead of dissociating, self-marking themselves forever and guaranteeing their recidivism.
You and a remorseful abuser would both think I'm giving the easy, coddling path. It's actually the tough pragmatic path in disguise.
The kinds of people who argue once you abuse somebody you can never, ever change and grow past it and stop being abusive are almost 100% of the time people who will contort themselves into intricate knots in an effort to justify any and all harm they cause to anyone else in order to make sure they never have to come to terms with the fact that they're equally capable of being abusive to others (and in a not insignificant number of instances I've seen people who do this be abusers themselves but they've convinced themselves their victims deserved it so they're still morally pure).
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i think people are starting to confuse class analysis with bioessentialism. like... no not all men do this, but Men as a constructed social class do do this. that's still okay to say. that is regular material analysis of the world around us.
this is true, but it is not bioessentialist. both cis & trans men WILL see a mouse & eat it. this is because it is in their best interest to eat mice. they benefit from eating mice. this is essential to their class position, not their biological makeup.
I don't really have any major thoughts or connecting threads on this but it is interesting wrt transness that both Mettaton and Spamton's like ideal scenarios involve simultaneously entirely transforming themselves physically and cutting off everyone they previously knew. And I guess this kind of mimics this like real reality for a lot of trans people of transitioning inevitably meaning cutting ties with loved ones who disapprove.
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