#medical gatekeeping

"Hunter, come up here and stop it from struggling!"

Hunter didn't have to be asked twice. Abruptly pulling her neurolink plug free from the base of her skull, she wrenched open the door to Paleblood's cockpit, paying no mind to the wailing of the bound, ruined creature that served as her control panel. That thing was always like this, always complaining. It should be glad it still gets to pilot in some capacity. Blinking in the light, she steadied herself as a bout of lightheadedness threatened to sweep her off her feet, but she couldn't let it get to her. She had orders, and that was all that mattered.

She clambered up the stairs two at a time onto the gantry. Once she was in range, she practically leapt through the open maw into her packmate's cockpit. She was always struck by the difference in ambiance between Paleblood's and Pulsar's cockpits. Where her machine carried a soft, comforting scent of old books and rainfall, this one had an entirely unpleasant olfactory whine of machine oil and dust, and already Hunter couldn't wait to leave. Inside, two regular soldiers were embroiled in battle with a whirlwind of fists and gnashing teeth. They had guns, but Hunter understood why they weren't using them. After all, the threat of guns only has weight when one can still differentiate between weapon and person.

She calmly approached the raging fistfight. Liger's eyes were unfocused. Cables still trailed from the back of its head. She hadn't even been unplugged properly. Hunter rolled her eyes and calmly walked forward into the madness. Liger's gigantic hands, rippling biceps and huge shoulders didn't mean anything when she didn't fear injury. She stepped aside as one of the soldiers was thrown off-balance, and took her shot.

One hand brought to rest on the cheek was enough to end the madness.

There was a brief moment where Liger's eyes were almost human again. What had only just been the wide-eyed, wild, frantic darting about of an animal on the razor edge of life and death was instantly the soft, scared, quivering look of someone terrified finding the only strength and solace they'd known since the horrors began. As her thumb softly brushed over a cheek, careful not to touch the muzzle whose wearer so disobediently resented, the woman who Hunter had once loved gazed back into her eyes. She knew that look. She'd seen it a thousand times, in all their most intimate moments, when the taller woman had confided all her fears, all her sorrow and pain she felt for everything she'd lost. A tear began to well up.

Taking the opportunity, one of the guards stuck a needle in the big hound's neck, and with a single sob any light behind its eyes was promptly snuffed out in a wave of painkillers and sedatives. Hunter immediately removed her hand from Liger's face and turned to leave. Her duty was done. She cared, once. But after so many failures on the mission, so many times Liger had squandered its responsibilities that had forced her hand to bail it out, she was done. Done making apologies for it, done making excuses to herself and Handler for Liger's defection. As this was far from the first time this had happened she was familiar with the interior of the cockpit. She barely needed to look at what she was doing as she wrapped a hand around one of its Pulsar's great golden teeth and pulled herself up, the adrenaline from the mission still overdriving her muscles.

Once again she was in the bright white lights of the hangar, and there, with a halo framing her perfect golden hair was Handler.

Immediately her knees dropped to the griplate surface of the gantry, as she'd been trained. Her eyes filled with tears. Tears of relief, surely. Not pain at the unforgiving metal beneath her soft body, but happiness that she could obey Her. Obedience was not simply a choice. It was the driving principle that governed her life, the one paradigm around which everything revolved. Obey Her, and be rewarded. Obey Her, and be rewarded. Obey Her. Just keep obeying Her and maybe this time She'll give you what you signed up for in the first place.

“Well done, Hunter. Ridiculous that we have to go to these lengths to keep your packmate under control, but you always had a way with that one.” Hunter nodded and wept solemnly. Yes, it was ridiculous, wasn't it? Ridiculous how the enemy pinpoint targeted all of Pulsar's weapon systems, leaving Liger helpless. Ridiculous how Liger had been surrounded and all it had left were fists and tackles, throwing itself at the enemy just to make it out alive. Liger was always fucking up on missions like that. Holding her back.

“Heel.” Handler whipped around, Her blonde ponytail following, and strode along the gantry towards the exit. Hunter immediately fell in at her right hand side, finally comfortable. At least she was the good dog. At least she was Handler's favourite. Surely this time, Handler would see that whatever had gone wrong on the mission wasn't her fault, it was that complete failure Liger. Too tall. Too strong. Too butch. A terrible excuse for a girl, really. One of these days, she'd have her sweet, sweet revenge on Liger.

Now, I don't disagree that people should be informed on the cons to mobility aids as well as the pros. They should also inform themselves of the proper way to use whichever aid they're considering. However. I think when we tell people to go to a doctor to get assessed for a mobility aid, we are putting perhaps too much faith in the medical system. Of course it's ideal to have a doctor helping you manage your disability, but not only are medical visits expensive, doctors. can be. wrong. There is a stigma around mobility aid usage that doctors are not exempt from perpetuating, especially toward young people, or other groups that are likely to have their pain dismissed [fat people, people of color, etc].

In my own experience: I am hypermobile [possibly HEDS], and I was initially fitted with knee braces as my foremost issue was knee hyperextension. These kept my knees from hyperextending, but not much else. They were uncomfortable due to my sensory issues, contributed to my overheating, and did not provide the extra stability that I needed... stability that I only learned I needed when I tried out a cane and found how much it helped me walk, all because I saw a Tumblr post encouraging people to try using a cane. A few years on, using a cane has only made me more mobile, more capable of exercise and more confident in my stride. There was a week a few months back where I injured my arm and couldn't use my cane, and I was shocked to find how much more pain my legs were in when I tried to keep up the same level of movement unaided.

There is a middle ground between "waiting for doctor permission" and "doing what a Tumblr post tells you without further research." Before I got my cane, I researched if and how it could be helpful for hypermobility, how to walk with it properly, and what options were available to me. Disabled people are capable of researching our own health.

I think gatekeeping through thorough examination and therapy and evaluations to access transitioning measures is important/needed. Informed consent the way I see it in the US is failing, one meetup with a doctor is not enough. I do understand how debilitating dysphoria can be but it is important to not just take what's seemingly best and be as quick as possible, but to sit with those feelings for some time and maybe explore other root causes before going through medical treatment that will inevitably change you irreversibly. I think medical transition should be seen less as a fun side activity but for what it is: medical treatment. And it should be taken seriously as such.