obstinate sinner

happy to announce that this post is at the top of the taylor swift tag, meaning this is the most widely shared opinion regarding Taylor on this website at the moment.

For the most part, my approach to prescribing hormones is “sure,” but I will note that the one thing I lean HARD on patients about is smoking. If you’re transgender, and you’re on hormones, the number one thing we want to protect is your cardiovascular health. That’s frankly the number one thing I want to protect in all my patients, but anyone taking exogenous hormones is at higher baseline risk. And the best thing you can do for your heart is DON’T SMOKE. It’s a bitch to quit, and I didn’t even smoke much or long before I quit in my late teens, and I STILL didn’t enjoy quitting and had smoking dreams for years. It’s harder to quit than just about anything else up to and including crack and heroin, and that’s coming from a patient of mine who recently passed in her early 60s who’d done all of those things—for years and years—but eventually was able to quit everything except smoking. And that killed her. She developed severe COPD and eventually called to say her blood oxygen saturation was dipping into the 70s, which is incompatible with life. She was lucid enough to decline medical care, including refusing to call 911 or go to the ER. A week later, after both I and one of our outreach nurses had contacted her to ask her to please go to the ER, I got a notification that she’d been found dead. She had been so frustrated that she wasn’t a candidate for a lung transplant.

In addition to the fact that it kills you and the people around you, you should quit because Big Tobacco are smug, queer-hating assholes who named their campaign to hook gays “Operation SCUM” and, cross my heart, I am not shitting you. They also made the playbook used by Big Oil and antivaxx conspiracy theorists.

my boy he has a pussy but he doesn't have a heart

Something that gave H.P. Lovecraft nightmares is the work of my favorite artist. In "At the Mountains of Madness" he specifically mentions "the strange and disturbing Asian paintings of Nicholas Roerich."