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 Post subject: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 3:07 pm 
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Dr Bronners, MD
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Dys4ia

Interesting.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 5:33 pm 
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I know the person who made this (in real life)! We've kinda lost touch but we used to be really good friends. I should write to her. She also happens to be vegan. :D

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 5:42 pm 
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Dr Bronners, MD
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It's a pretty neat way of expressing something that somebody without gender dysphoria can find very difficult to really understand. (That is to say, I have a better idea of what it entails now than I did before I played through it.)

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 9:05 pm 
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Chip Strong
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That was a cute and fun way of relating her experience. I appreciated that she made clear that it was her experience only. I have never felt that sense of dysphoria, so any new ways of describing how it feels will hopefully help me understand it a little bit better.


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 10:57 pm 
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Amazing. It gave me chills at the end.


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Mon Mar 12, 2012 11:27 pm 
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Good stuff. Thanks for sharing.


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 2:10 am 
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Very heartfelt and well-made. I'm glad I got to see that, thanks for sharing!

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 8:50 am 
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Thanks for sharing, that was super interesting!


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 11:50 am 
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That was interesting, and a really neat way to "discuss" the issue. I'm curious, though, about the blood pressure thing. Maybe I got the wrong impression, but it seemed like the author thought the blood pressure thing was an attempt to thwart her attempts to get hormones, which seemed a bit weird because it's pretty standard to be cautious with estrogen where conditions like high blood pressure, strokes, migraines, etc. occur. Did I interpret that part of it wrong? Is that a thing trans people tend to experience with doctors?

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 12:05 pm 
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As I understand it, she thinks the high blood pressure was a result of the stress of the gender dysphoria itself, and that hormone treatments would help with that since it would reduce that stress.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 12:11 pm 
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Ah, that makes sense.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 3:38 pm 
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jordanpattern wrote:
That was interesting, and a really neat way to "discuss" the issue. I'm curious, though, about the blood pressure thing. Maybe I got the wrong impression, but it seemed like the author thought the blood pressure thing was an attempt to thwart her attempts to get hormones, which seemed a bit weird because it's pretty standard to be cautious with estrogen where conditions like high blood pressure, strokes, migraines, etc. occur. Did I interpret that part of it wrong? Is that a thing trans people tend to experience with doctors?


The issue that comes up is that doctors will sometimes outright refuse to give someone hormones if they have high blood pressure, and for a transgender person who needs those hormones in order to feel okay enough about themself to get through the day, that's unacceptable. The acceptable course of action is to continue prescribing the hormones and treat the high blood pressure...not to deny access to hormones. There may be different protocol when estrogen is used to treat conditions in cisgender women for which there are other treatment options -- so like, if the person doesn't get estrogen, they could try a different treatment with lower risk for their blood pressure or something -- but when we're talking about hormone therapy for a transgender person, the alternative is to get the hormones illegally or not get them at all, which are not acceptable alternatives.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 4:14 pm 
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choirqueer wrote:
jordanpattern wrote:
That was interesting, and a really neat way to "discuss" the issue. I'm curious, though, about the blood pressure thing. Maybe I got the wrong impression, but it seemed like the author thought the blood pressure thing was an attempt to thwart her attempts to get hormones, which seemed a bit weird because it's pretty standard to be cautious with estrogen where conditions like high blood pressure, strokes, migraines, etc. occur. Did I interpret that part of it wrong? Is that a thing trans people tend to experience with doctors?


The issue that comes up is that doctors will sometimes outright refuse to give someone hormones if they have high blood pressure, and for a transgender person who needs those hormones in order to feel okay enough about themself to get through the day, that's unacceptable. The acceptable course of action is to continue prescribing the hormones and treat the high blood pressure...not to deny access to hormones. There may be different protocol when estrogen is used to treat conditions in cisgender women for which there are other treatment options -- so like, if the person doesn't get estrogen, they could try a different treatment with lower risk for their blood pressure or something -- but when we're talking about hormone therapy for a transgender person, the alternative is to get the hormones illegally or not get them at all, which are not acceptable alternatives.


But isn't the medical risk the same? I definitely sympathize with the frustration, but my understanding is that estrogen can be very dangerous for people with high blood pressure, potentially leading to things like strokes. It's definitely a tricky issue, but I'm uncomfortable with blaming doctors for not doing something they know to be potentially dangerous or fatal...

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Tue Mar 13, 2012 5:06 pm 
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jordanpattern wrote:
choirqueer wrote:
jordanpattern wrote:
That was interesting, and a really neat way to "discuss" the issue. I'm curious, though, about the blood pressure thing. Maybe I got the wrong impression, but it seemed like the author thought the blood pressure thing was an attempt to thwart her attempts to get hormones, which seemed a bit weird because it's pretty standard to be cautious with estrogen where conditions like high blood pressure, strokes, migraines, etc. occur. Did I interpret that part of it wrong? Is that a thing trans people tend to experience with doctors?


The issue that comes up is that doctors will sometimes outright refuse to give someone hormones if they have high blood pressure, and for a transgender person who needs those hormones in order to feel okay enough about themself to get through the day, that's unacceptable. The acceptable course of action is to continue prescribing the hormones and treat the high blood pressure...not to deny access to hormones. There may be different protocol when estrogen is used to treat conditions in cisgender women for which there are other treatment options -- so like, if the person doesn't get estrogen, they could try a different treatment with lower risk for their blood pressure or something -- but when we're talking about hormone therapy for a transgender person, the alternative is to get the hormones illegally or not get them at all, which are not acceptable alternatives.


But isn't the medical risk the same? I definitely sympathize with the frustration, but my understanding is that estrogen can be very dangerous for people with high blood pressure, potentially leading to things like strokes. It's definitely a tricky issue, but I'm uncomfortable with blaming doctors for not doing something they know to be potentially dangerous or fatal...


I'm not sure if it's known what the difference in medical risk is, but the psychological damage for a transgender person to be denied hormones is the issue at hand. A lot of times, transgender-related treatments are treated like cosmetic procedures, and they're really not. A transgender woman who needs to be on estrogen needs to be on estrogen, whether she's got high blood pressure or not, just as a cisgender woman needs the estrogen her body already makes even though that can cause high blood pressure too. Lots of medications include high blood pressure as a risk factor, but it's quite rare that a doctor will refuse to prescribe a needed medication just for that reason. But for some reason, hormones for transgender people are treated as "optional", and for many of us they really aren't optional at all.

Fortunately, more doctors are becoming better informed about transgender-related care and will use informed consent models of treatment, in which the patient is informed about the risks and then can make their own decision; so like, when I go get my hormones, my doctor says "Do you know that this can put you at higher risk for [long list of things]?" and I say "Yup" and sign a consent form and then I get my hormones, and if there's some other condition that also needs to be treated in addition to me getting my hormones, we can treat that also.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 6:37 am 
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Re the blood pressure thing...I can only speak anecdotally as one of my best friends is transtitioning... but the first clinic that she went to (NHS funded) flatly refused to give her hormone treatment without her giving up smoking as the increase in blood pressure and thrombosis was too high (plus a thrombosis would jeopardise her surgery). The second clinic (also NHS funded) were ok with it and gave her a different hormone.

I think (and I don't think this is limited to transgender treatment) for any treatment, there is always going to be a risk/benefit analysis and if the doctor feels that the risks outweigh the benefits, then they won't proceed.

Mat.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 9:28 am 
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matwinser wrote:
Re the blood pressure thing...I can only speak anecdotally as one of my best friends is transtitioning... but the first clinic that she went to (NHS funded) flatly refused to give her hormone treatment without her giving up smoking as the increase in blood pressure and thrombosis was too high (plus a thrombosis would jeopardise her surgery). The second clinic (also NHS funded) were ok with it and gave her a different hormone.


Well, isn't smoking something they try to get women to stop before starting hormonal birth control pills for just that same reason?

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 9:29 am 
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I was told by a 35 year old smoker, that if you are over 35 and smoke, they will not proscribe estrogen for birth control. That was just her experience, but I think it's fairly standard.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 10:02 am 
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But since there are other non-estrogen bc options, presumably a doctor would discuss alternatives with their patient and not just say, "well, too bad. Come see me when you quit smoking.". Since there aren't other options for most trans women who want to pass, its not really the same situation.


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 10:41 am 
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I agree electric_claire. I wasn't at all trying to suggest that "too bad, sucks to be you" was the answer. And it's about more than wanting to pass, it's about being comfortable in one's own body. I would hope that a Dr. would say something like "Here are the risks. I strongly suggest you quit smoking first. Here are some other things we can do to help manage the risks. Ultimately it's up to you."

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 10:46 am 
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It's important that she stopped taking blood pressure medication without (I guess?) talking to her doctor about it. "I need this for my well being and I don't care that I also need this for my well being" doesn't strike me as a good way of approaching the problem, and self-medicating isn't a good solution.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 11:49 am 
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I do think it depends on the dr, like I said, the first place were determined not to, even to the point of mouth swabs for cigarette traces and the second were ok about it.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 1:22 pm 
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Rhizopus Oligosporus wrote:
I agree electric_claire. I wasn't at all trying to suggest that "too bad, sucks to be you" was the answer. And it's about more than wanting to pass, it's about being comfortable in one's own body. I would hope that a Dr. would say something like "Here are the risks. I strongly suggest you quit smoking first. Here are some other things we can do to help manage the risks. Ultimately it's up to you."


I would hope a dr would say that too. Unfortunately, too many doctors are not nearly empowering enough for any patients, and particularly for trans patients if they're not used to working with trans folks.

I thought about if "wanting to pass" was the right thing to say, but I'm going to stick with it, because I assume that for anybody that doesn't feel comfortable in their body, wanting to be recognized by others as the appropriate gender is a big part of that. And I know more gender-queer identified trans folks than I do strictly female or male identified trans folks, who have a range of desires to pass or not, a range of comfort with their bodies, some who are or want to be on hormones and others for whom that doesn't seem to me to be a priority. (But then, I don't ask people about their hormone practices unless they bring it up, so what the hell do I know, really.)


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 1:39 pm 
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Oh, and also on "passing"- it seemed like an important part of the issue because trans women have a much harder time, generally, passing without taking estrogen than do trans men. And that can also be an important part of feeling safe, job discrimination, etc etc. in addition to just being about an intrinsic comfort with one's own body.


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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 3:52 pm 
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I liked the game though. I wish there were more art games for experiences and feelings.

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 Post subject: Re: A short game about gender dysphoria
PostPosted: Wed Mar 14, 2012 5:14 pm 
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just mumbles wrote:
I liked the game though. I wish there were more art games for experiences and feelings.


Oooh?

Lemme see. This is probably worth a new thread.

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