An Empty Gesture for Trans Students, or “Why the new VHSL policy on transgender student athletes helps no one.”

Policies about transgender students have been in the headlines for months, largely due to the signing and subsequent backlash against California’s AB1266, which significantly advanced protections and freedoms for transgender students throughout the state. Recently, the Virginia State High School League (VHSL), the state’s governing body for high school athletics, announced new rules that they claim allow the inclusion of transgender athletes on teams of their identified gender. They’ve pretty quick to congratulate themselves for being so progressive, and the mainstream press has given them a lot of credit for updating their policies for “inclusiveness”.

Unfortunately, either no one in the VHSL did even the slightest bit of research about trans issues, or the entire rule was designed to give the appearance of inclusiveness without actually making real changes. You see, the rule requires that students have undergone gender confirmation surgery (specifically genital surgery) in order to participate. The rule reads as follows:

Virginia High School League rules and regulations allow transgender student-athlete participation under the following conditions:

A. A student-athlete will compete in the gender of their birth certificate unless they have undergone sex reassignment.

B. A student-athlete who has undergone sex reassignment is eligible to compete in the reassigned gender when:

1. The student-athlete has undergone sex reassignment before puberty, or

2. The student-athlete has undergone sex reassignment after puberty under all of the following conditions:

a. Surgical anatomical changes have been completed, including external genitalia changes and gonadectomy.

b. Hormonal therapy appropriate for the assigned sex has been administered in a verifiable manner and for a sufficient length of time to minimize gender-related advantages in sports competition.

c. If a student-athlete stops taking hormonal treatment, they will be required to participate in the sport consistent with their birth gender.

C. A student-athlete seeking to participate as a result of sex reassignment must access the VHSL eligibility appeals process.

[Emphasis Mine]

 

That’s a pretty huge problem for many reasons. The largest of these is the current Standards of Care of the World Professional Association for Transgender Health (WPATH). The Standards of Care function as the guiding documents for pretty much all health professionals involved in trans medical care, and their guidelines for surgery are very specific (and almost no surgeon is willing to go against them). They read:

Criteria for metoidioplasty or phalloplasty

in FtM patients and for vaginoplasty in MtF

patients:

1. Persistent, well-documented gender dys-

phoria;

2. Capacity to make a fully informed decision

and to consent for treatment;

3. Age of majority in a given country;

4. If significant medical or mental health

concerns are present, they must be well

controlled;

5. 12 continuous months of hormone therapy

as appropriate to the patient’s gender

goals (unless hormones are not clinically

indicated for the individual).

6. 12 continuous months of living in a gender

role that is congruent with the patient’s

identity

[Emphasis mine]

In the US, the age of majority is 18. Last time I checked, there weren’t exactly a ton of 18-year-olds running around high schools- just a few seniors with really early birthdays. That’s not very many students who have even a glimmer of hope of meeting all the criteria of this policy. Given that genital surgery has quite a long recovery period (stretching months after the surgery), I don’t quite see how this policy is going allow pretty much ANY trans students to participate in high school sports in Virginia. If the members of the VHSL had bothered to ask a practitioner specializing in trans health, or to even just read the WPATH Standards of Care, they’d have been aware of this fact.

As a corollary, this policy isn’t even based upon anything approaching actual medical science. Last time I checked, the mere presence of a penis didn’t make you run faster, jump higher, or give one any other advantage in athletics. Hormonal transition, particularly in adolescents, fundamentally alters body phenotype and shuts down sex hormone production in the gonads, meaning there’s no competitive advantage is gained by simply HAVING your birth gonads. The changes in response to hormone are particularly rapid and profound in adolescents, so any arguments about requiring GCS to mitigate “competitive advantage” are pretty much scientifically bunk.

Furthermore, even IF the WPATH criteria didn’t preclude minors from having GCS, it remains an extraordinarily expensive medical procedure that is rarely covered by insurance, and only a minority of trans people will complete it in their lifetime, let alone someone still under the care of their parents. Lastly, this policy is horrifically ignorant just what a major decisions having GCS is for a trans person. Not only is it very invasive and full of risks, but it has a lifetime of physical consequences, and it puts a permanent end to a person’s ability to have biological children. It’s a decision that full-grown adults in their 30s struggle with, and it’s complete unreasonable to expect a teenager to make such a decision simply to play a game.

And really, what we’re talking about is high school sports, a bunch of teenager playing a game…not big-money college athletics or professional/world-class athletes. High school sports are supposed to be primarily about learning team-work, sportsmanship, keeping teenagers physically active, and providing a factor to drive student body unity. (Yes, I’m aware that lots of people take them FAR more seriously than that, but that’s another essay topic entirely). At the end of the day, the stakes are embarrassingly small to be this paranoid about someone having a competitive advantage, or to deny trans students the opportunity to participate in an activity that gives them the opportunity to integrate with cisgender peers.

So, really, what can we conclude? Either the VHSL is woefully ignorant about trans issues and far too lazy to actually research a topic before issuing a rule that affects an already heavily discriminated-against student population, or they were seeking the praise and hoping to appear “progressive” and “forward-thinking” without actually making any changes that would allow trans athletes to participate. In either case, it’s a big disappointment for trans students in Virginia, who deserve much better than this sad, lip-service-at-best policy.

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Some Horrible Science Journalism, or “You shouldn’t write about science and medicine if you don’t have a basic grasp for how science works.”

Autism May Start in The Gut, Study Finds – Autism Center – Everyday Health.

So basically, the above article is a pile of horseshit that completely perverts the study that was actually done. I’m absolutely disgusted and enraged reading it.

The basic finding of the ACTUAL research is that there a decrease in the diversity of intestinal flora in people on the autism spectrum, and the researchers believe that it may play a part in why autistics suffer from a lot gastrointestinal disturbances. What the article implies, however, is that somehow a change in intestinal flora is RESPONSIBLE and CAUSATIVE of the autism, and that perhaps by fixing this problem, we could cure autism. This is NEVER discussed by the researchers in their publication, and it doesn’t even make sense from a medical/science standpoint.

I have a lot anger and frustration at science journalism in the US, particularly when it comes to medical research. There is a constant tendency to over-read the research findings, draw false implications, and fail to understand the extremely basic premise that correlation does not equal causation. It’s a sensational form of journalism, and it’s wholly inappropriate for medical journalism. The public as a whole does not have the background to read the research itself, and when the data is sensationalized, you can create all kinds of public health scares and complications for the medical community.

But with autism, I think there’s an even bigger problem. Parents are often desperate for any explanation for why their children are autistic, and it’s already incredibly challenging to sift through the huge piles of information out there. Sadly, much of the information is misleading bordering on out-and-out falsified bullshit. Articles like this only add to that complication. And it really takes away from the fact that this IS a pretty major step forward. There are a number of unusual physical maladies that plague the ASD community, and GI problems are chief among them. If this research leads to a way to reduce just the GI problems that we have, that’s a wonderful thing and it will improve our lives. There’s no need to dig deep for false hope for some sort of miracle cure to come out of it.

When it come to science journalism, let’s stick to facts and appropriate conclusions and not twist the words of the researchers to fit the narrative you’re looking for.

SB5 Rises from the Grave, or “Rick Perry really loves fetuses and hates women.”

Rick Perry Calls Second Special Session To Pass Abortion Restrictions.

Alright, so the title might be a little political hyperbole, but only just. After the heroic, body-wrecking filibuster of Sen. Wendy Davis prevented the passage of the insanely over-reaching Texas abortion legislation know as SB5, Governor Rick Perry is going to call the legislators back for ANOTHER special session and to try this again. Sadly, the law allows Perry to do this over and over again until he gets what he wants. In the end, SB5 will likely become law in Texas, because Gov. Rick seems to think trampling women’s rights and violating Roe v. Wade is more important fixing the myriad of problems in Texas.

My only hope is that enough voters in Texas are paying attention to this ridiculous sideshow, and might be willing to help throw these jerks out on their cans come election time.

A girl can dream, right?

But seriously, I think Wendy Davis has done a fantastic job of galvanizing women and progressives in Texas and it might be enough to get some changes down there.

And of course, there’s also the hope that the generally more sane Federal court system will quash this garbage before it has the chance to harm anyone.

Anyway, I still stand with Wendy, and her efforts on behalf of Texas women are to cheered as loudly as we can manage.

Texas SB5 is Dead, or “Wendy Davis -and all women- win, even after they tried to silence her.”

Texas Abortion Bill Filibustered By State Senator Wendy Davis Is Dead.

So yesterday I blogged about Wendy Davis’s incredible filibuster on the floor of the Texas State Senate to block the passage of sweeping abortion prohibitions in Texas. The entire thing was live-cast via YouTube and over 200,000 people were watching at one point, and the Twitter-verse was a buzz as the final hours clicked down to the midnight deadline for passage.

Just after 11:00pm central time, the presiding officer of Senate decided (wrongly and for the direct purpose of shutting her up, in my opinion) that Wendy had violated the rules of “germaineness” in her speech three times, and declared the end of the filibuster. A flurry of motions followed and extensive debate ensued on the nature of the rules of the Texas Senate, stretching the time down to the final 15 minutes. As the presiding officer attempted to call for a roll-call vote, the viewers in the gallery rose to their feet and created such a ruckus that the sheer noise prevented business from continuing. And they kept this up right through midnight, even as the Texas GOP tried to find a way around it. Eventually, a roll-call vote was taken, but it was announced this morning that it was officially recorded after the midnight deadline, and therefore invalid.

So despite the attempts of the Republicans to silence her, Wendy Davis won her battle yesterday, and the women of Texas retain their access to safe, legal abortions. Sadly, Gov. Rick Perry has signaled that he will yet-again call for a Special Session for the Senate to try to pass this bill. I can only hope that another brave Democrat will take to the floor, and that gallery is again packed with voices for women’s rights. Pay attention, Texas GOP. Those voices you hear in shouting at you from above are the people you represent.

I STILL Stand With Wendy!

The Bravery of Wendy Davis, or “One amazing woman has the guts to call the Texas GOP on their misogynistic bullshit.” [I Stand With Wendy!]

Badass Texas Senator Launches Intense Filibuster Against Abortion Bill.

So if you’re a feminist and you haven’t heard about SB5 in Texas, then you are probably living under a rock. But if you are just recently coming out of coma or something: the Republican legislators in Texas are attempting to push through sweep legislation that would ban abortions after 20 weeks (much like this bullshit legislation before Congress) and close all but 5 abortion providers in the state.

The measure has already gained passage in the state House, and it came to the state Senate floor today. One awesome and brave female state Senator has taken on the task of filibuster this horrific piece of legislation. Wendy Davis took the floor and as of the moment I’m posting is still standing strong. And Senator Davis isn’t just reading a phone book up there…she’s been actively destroying the “merits” of this legislation for the entire duration. She’s pulled apart the language, read court opinions, provided medical research, and shared the stories of dozens upon dozens of women.

Making this feat even more impressive are the particularly difficult rules governing filibusters in the Texas Senate. She must remain standing the entire time, without so much as leaning on the rostrum. She can take n breaks for food or the bathroom. The GOP has been looking for ways to force her off the floor, but she’s remained steadfast in her effort.

I am so blown away by Wendy Davis’s dedication to fighting for women’s right to control their bodies. I’m proud to declare her my hero of the month! If you’d like to share your story with her, you can tweet her @WendyDavisTexas or show your support by tweet with the hashtag #StandWithWendy.

A Victory for a Young Lady in Colorado, or “Really, are we STILL talking about where people can pee?”

via Rights Unit Finds Bias Against Transgender Student – NYTimes.com.

So, I am poking fun at the whole situation of the trans bathroom complicated in the title. But at the same time, as much as other people want to get up in arms about how dangerous and scary it is to have trans people in our public bathroom, all we really want is to void out bladders in relative safety with minimal hassle. I’ve already given some significant effort to discussing the trans bathroom “problem” elsewhere in the blog, but that article was driven primarily towards adults.

What’s going on here is some poor child is being forced to endure some very adult complications because of her gender identity. She’s six years old and was assigned a male gender at birth, but currently identifies as a girl. She presents as a girl and is identified as such at school. And some parents freaked out at the notion of her using the girls room and the school forced her to use a separate bathroom in the nurses office. Today, the Colorado civil rights division found that the district had discriminated against her, and ordered the school to allow her to use the girls bathroom.

Now, the challenges of appropriately handling children and students (particularly very young ones) who do not identify as their birth sex are numerous and complicated, and too much to cover in this particular post. I’ve sketched out some writing on that topic in particular that will be making an appearance as one of my usual biweekly essays some time in the coming weeks. But the important thing to point out is that the general consensus is that children should be allowed to explore their cross-gender feelings and/or identities as want, and that those who do are generally much healthier.

So I’m very happy for Coy that she can return to school and be comfortable being who she is. That’s a wonderful victory for her. But there’s language in the ruling that I think is important beyond just what it means for this brave little girl. From the article:

But the state’s ruling went even further, saying that evolving research on transgender development showed that “compartmentalizing a child as a boy or a girl solely based on their visible anatomy, is a simplistic approach to a difficult and complex issue.”

Depriving Coy of the acceptance that students need to succeed in school, Mr. Chavez wrote, “creates a barrier where none should exist, and entirely disregards the charging party’s gender identity.

This speaks to a significant level of research and understanding of the issues surrounding gender identity by the Colorado civil rights commission. And that’s huge. It means that at least in some places, the people in power are taking notice of trans issues and learning about the. And not just the basics, but actually developing an understanding of the deeper complexities of gender and gender identity. While Colorado is a relatively left-leaning state, it still gives me hope that this kind of though will continue to spread and genuinely improve the lives of trans people everywhere.

So my hat is off to the Colorado civil rights commission, and a big congratulations to brave miss Coy on her victory.

Big News and a Significant Step for the US Government on Gender, or “The SSA is no longer concerned about what’s between your legs.”

Social Security Removes Surgical Requirement for Gender Marker Change | Advocate.com.

This one came as a complete shock to me, and it’s incredibly encouraging. Today, the Social Security Administration announced it would no longer require documentation from a surgeon that Gender Confirmation Surgery had been performed in order to change the gender marker in an individual’s Social Security record. Now, all that is required is “medical certification of appropriate clinical treatment for gender transition in the form of an original signed statement from a licensed physician.”  This change in policy, along with a similar recent change for US passport documents is a huge leap forward for the federal government in recognizing that GCS is not an appropriate way to mark the change from one gender to another. In many senses, this means that a letter from an appropriate physician is all that is required for the US government to legally recognize you as your new gender.

I’m absolutely overjoyed by this news. Not only because it will directly make my transition process easier, but because it represents an awareness of trans issues at a national level. So many thanks to everyone who works so hard lobbying for these changes and striving to improve the every day lives of the trans community.

With any luck, a simplified process for changing gender markers on state-issues driver’s licenses is not far behind.

AMP v. Myriad Decision, or “Hey, our genes belong to us again…sort of.”

U.S. Supreme Court Rules On Gene Patents | Popular Science.

I held off on posting a full-length article yesterday, as I knew this decision was being handed down today, and I like being topical!

[Disclosure: I am a member of the Association for Molecular Pathology]

Being a scientist, I can’t NOT talk about one of the most important Supreme Court cases involving my field..well..ever. Today, the AMP v Myriad Genetics ruling was handed down,  and it’s earth-shattering for those of us who work in the areas of genetic and molecular biology. For me, I think there’s a lot of good, but it’s far from what I was hoping for.

I’ll start with some background. I’m not going to teach a whole intro genetics or molecular biology courses here…if you aren’t familiar with the basics of genetics or DNA, you want to spend some time reading through the material here first. Important for this discussion is to understand that genomic DNA or gDNA is the raw, unchanged strands of DNA isolated from cells. cDNA is a form of “synthetic” DNA that does precisely match the sequence in the genome (most frequently it has had the introns cut out, but I’ll get to this in a minute). Years ago, Myriad Genetics discovered the existence of two genes (BRCA1 and BRCA2) that have a significant impact of breast cancer risk. The applied for and were awarded patents covering everything having to do with these genes. From there on out, they required licensing fees from anyone who wanted to do ANYTHING with BRCA1 and BRCA2, from screening tests to research and more. Many other whole-gene patents have been granted since, effectively giving a number of companies exclusive domain to test people for changes in the genes they hold patents for. It’s been a practice fraught with controversy for many years. Some have argued that not allowing patents removes incentives for investment in genetic research, as the patent allows the firm that discovered it to recoup its costs through direct testing sales and/or licensing fees (not unlike the model for the pharmaceutical industry.) Opponents have argued that US law specifically excludes “unaltered products of nature” from being patented, and that allowing these patents to continue restricts research progress and hampers medical advancements. A few years back, a major professional organization in genetics- The Association for Molecular Pathology (AMP)- sued Myriad to challenge the validity of their patents. The case wound its way through the Federal court system, and eventually was taken up by the Supreme Court earlier this year. Today, the SCOTUS handed down their ruling. The very basic interpretation of what the court held is that genes themselves cannot be patented, however cDNA sequences can. Most people who have been following this case for a while expected a ruling along these lines. This invalidates a large portion of Myriad’s patent control of BRCA1 and BRCA2 and seriously weakens the patent positions of a number of companies with important gene patents.

I have long argued against the idea of gene patenting. Like many other in my field, I have never been comfortable with a number of the implications, the largest being the idea that a company someone holds control over my ability to learn information about the one of the most basic parts of my body, my genome. Please don’t misunderstand, as a scientist, I full understand the importance of intellectual property protections. However, my DNA belongs to me, and I hold strongly that I’m the one who should have ultimate control over its analysis. Furthermore, I feel that gene patents fail another crucial test: you cannot invent “around” them. A hallmark of the concept of the patent is the idea that whatever is patented can still be improved upon. If you’re intelligent enough to design a way to get to the same endpoint by different methods, then you’re in the clear (and can even be granted a patent of your own). However, granting complete patent control over the gene itself removes that “invent around” possibility, which (to me) is a violation of the basic tenants of patent law and patentability.

The decision has some pretty important implications as genetic and genomic technology race forward. So called next-generation sequencing technology is rapidly bringing down the costs of large scale sequencing of the human genome (as well as exome and transcriptome, which again, we’ll cover shortly), and whole gene sequencing is staged to move from an extremely complex, expensive, and time-consuming test to something relatively routine within just the next year or so. This technology will allow us to sequence entire genes (and soon entire genomes) of large numbers of individuals and give us insights into genetic function and variability beyond out wildest dreams, as well as significant advancements in personalized medicine. If gene patents had been allowed to stand, it would have created a nightmare of licensing complications for interpreting complete genome sequences. Companies wishing to offer complete genome testing would have been required to negotiate licenses (and fees) with every single holder of a patent on a human gene. Not only would this have been an administrative nightmare and a constant risk of litigation, it would have almost certainly made this kind of testing prohibitively expensive to all but the richest of patients, turning a potentially paradigm-shifting medical advancement into a niche sector.

The decision isn’t perfect however. The upholding of cDNA patents leaves a number of complex issues in place. The largest among these (at least from my reading of the case law) is transcriptome research. One of the most common places where cDNA is made is from messenger RNA (mRNA). mRNA’s function within the cell is to provide instructions to produce proteins. mRNA is isolated from cells to study the changes in these signals (generally known as gene expression). The sum of all these mRNAs from a cell is known as the transcriptome. Current technology allows us to examine large portions of the transcriptome to monitor gene expression in cells, tissue, and ultimately organisms, and it has wide-ranging applications in medical research, particularly in complex situations like heart disease, diabetes, and cancer.  Again, as the technology in molecular biology advances, we are able to examine much larger portions of the transcriptome and gain a much deeper understanding of the mechanisms at place in many processes, both cellular and throughout an organism and the potential for major advancements in human health is huge. However, if the cDNA made from the mRNA of a particular gene remains under patent, we again run into the issues of licensing for this kind of work. It seems to me that it’s more the wording of explanation of what cDNA is that skirts the “natural products” restriction, not any significant difference in fact. cDNA is essentially a copy of a natural product (mRNA); it just so happens that the particular method in which nucleic acids replicate (through complimentary sequences) gives it appearance of something novel. It’s still essentially a patent on something innate to my body (the genes it’s expressing, rather than the basic instruction set). It still fails at the “invent around” test, and I believe these patents should have (at least as they apply to mRNA) been overturned as well. I believe the repercussions of allowing these patents to remain will significantly stifle research in gene expression and the transcriptome for years to come.

I think the AMP v Myriad ruling is an important step forward, and a correction to a major standing error in US intellectual property law. I believe it will open to door for major advances in many areas of medicine and basic science, and it maintains an individual’s absolute control over the content of their genetic code. However, the upholding of cDNA patents is a sticking point for me, and I’m anxious to see how this plays out in research community and in IP litigation.

Doctor Appointments and HRT Progress, or “Medical students say the darndest things!”

For those of you keeping track (no one, I hope…that’d be creepy) today is day +99 since I was initiated on hormone therapy. So, what would be the best way to celebrate such an arbitrary occasion? How about taking a day off work and going to a bunch of doctors appointments. Clearly, I’m a girl who KNOWS how to have fun.

First up was my very first appointment with a brand new primary care doctor. I haven’t had a primary care doc in nearly five years, because I have tendency to fire them for any number of things. The most common reason has been an obnoxious obsession with my weight, but others have been fired for giving me transphobic nonsense, or not being willing to work around some of the anxiety triggers I have. But my therapist has been pushing me to be a little better about taking care of general health type things, and did the leg work of tracking me down a trans-friendly family medicine specialist. So, I figured the least I could do was give her a chance. Since I use an academic hospital for most of my medical care, I pretty much always have to endure the physical and verbal prodding of a medical student and/or a resident. I endure with a smile because I recognize that I represent a good learning opportunity for these soon-to-be doctors. Today was no different, and I had my initial exam and history done by a very friendly young female student. While I can often tell when I’m someone’s first transgender patient, this young woman went about our time together as if it were absolutely nothing she hadn’t done a hundred times. I’m very grateful for it, as I was already fairly nervous about the whole encounter. She was honest about the skills she was still practicing, apologized for her cold hands, and engaged me in actual human conversation. All in all, I was fairly impressed and encouraged. After this, I got finally meet my new doctor, and I was also pleasantly surprised. She was supportive and encouraging, and had none of the fat-hating overtones that I had grown accustomed to with other doctors. She even took the time to ask me about my triggers AND note them in my chart. It feels so good to have a doctor who is on my side, and is actively interested in working with me, instead of just treating me like another patient to hurry out the door. Anyway, I got a clean bill of a health (other than the couple of known little problems), and a big pile of blood tests run to make sure there’s nothing weird hiding and to check my hormone levels, plus my responsible adult STI screening. It will be really nice to have a general doctor I can rely on when general health issues come up, and not have to risk an urgent care or something similar unless it’s serious.

Next up on my agenda was a trip to my endocrinologist for my first HRT check-up. Once again, I had the pleasure of chatting with a young medical student. This one was a little more nervous talking to me, and she rambled during the history to cover her nerves. I felt a little bad for her. She lost her head for a second when her notes got the reproductive systems review portion, and she asked when my last period was, then panicked and blurted out “Oh wait, you don’t have a uterus, right?” Still not the most awkward encounter I’ve had with a med student, but still kind of silly. In the end, hopefully she learned something, and will be better able to handle her next transgender patient. Anyway, after my chat with nervous med student, my doc came in to do our quick check of progress and side effects from my current HRT regimen. I really enjoy talking to my endocrinologist. He’s been working with transgender patients for twenty years, and he seems so genuinely excited and happy to be a part of our transition. Anyway, I had my moved up my Estrace to 4 mg for 2 months, and then to 6 mg after that. But I don’t have to come back for 4 months, which is wonderful to hear given how busy my life is going to get here shortly. My estrogen levels are at 93, which is fairly good for a 2 mg dose. Testosterone is now well below normal male range, but still higher than is preferred at 1.1. But the increased Estrace dose should help push the T down even more, and the hope is that I’ll be essentially hormonally indistinguishable from a genetic female.

All in all, not a terrible day for having to spend a lot of it at medical appointments. It would have been nice to have gotten my eye appointment done today too, but alas, I couldn’t get in, so that’ll have to wait a week. I’m pretty excited about that one…I haven’t had an eye exam in about 5 years, so i’m sure my script has changed, and my new vision coverage has a pretty nice frames allowance. Hopefully I’ll be able to get some cute new glasses!

+60 Days from HRT Initiation, or “Hey ma, no testosterone!”

It’s now been 2 months since I started on hormones. I’m still on the “intro” regimen of 2mg Estradiol and 200mg of Spironolactone. I’ve generally been very good at not missing doses…just the occasional forgotten morning dose of spiro when I’m running late. Overall, side effects have been minimal…some cramping and some acne and a little more swing in my moods.

Noticeable effects so far are mostly mental. While I’m a little more emotional, I’m also a lot more…peaceful? Less inner conflict, more fuzzy hearts. My libido is absolutely in the toilet. It’s just not even something I think about pretty much at all (a far cry from life a guy). But there’s been a definite uptick in my cravings for physical affection…cuddles, hugs, etc. I’ve also noticed that my “drive” to want an emotional partner is stronger. Less aloof, more vulnerable. My body hair growth has slowed a bit. And I’m definitely starting to feel the tell tale signs of “development”, mostly sensitivity and a lot of soreness. Not much in the way of growth yet, though. Appetite is DEFINITELY way down, which I assume is due to my lowered metabolism. There have also been some odd changes to taste…less tolerance for the taste of greasy foods.

I should have had another endo appointment, but work got in the way and I had reschedule, pushing it back out to the 30th of May. I also have an appt with my new (trans-friendly) PCP that day. i’m very much hoping she’ll be able to take over my hormone maintainence eventually, since a visit with her is much less likely to trigger a cranky rejection from my insurance company than my endocrinologist, since he’s technically an OBGYN. I’m just hoping she’s fat-friendly/fat-accepting too. I’m getting really tired of every doctor on earth telling me that everything in world is caused by being overweight.

In other words, so far so good!