The Medical University of South Carolina initially said it wouldn’t be affected by a law banning use of state funds for treatment “furthering the gender transition” of children under 16. Months later, it cut off that care to all trans minors.

One Saturday morning in September 2022, Terrence Steyer, the dean of the College of Medicine at the Medical University of South Carolina, placed an urgent call to a student. Just a year prior, the medical student, Thomas Agostini, had won first place at a university-sponsored event for his graduate research on transgender pediatric patients. He also had been featured in a video on MUSC’s website highlighting resources that support the LGBTQ+ community.

Now, Agostini and his once-lauded study had set off a political firestorm. Conservative activists seized on one line in particular in the study’s summary — a parenthetical noting the youngest transgender patient to visit MUSC’s pediatric endocrinology clinic was 4 years old — and inaccurately claimed that children that young were prescribed hormones as part of a gender transition. Elon Musk amplified the false claim, tweeting, “Is it really true that four-year-olds are receiving hormone treatment?” That led federal and state lawmakers to frantically ask top MUSC leaders whether the public hospital was in fact helping young children medically transition. The hospital was not; its pediatric transgender patients did not receive hormone therapy before puberty, nor does it offer surgical options to minors.

  • CherenkovBlue@iusearchlinux.fyi
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    The “they will die if they don’t get gender affirming care” narrative is so harmful. Women who should qualify for gender affirming care (eg, hair removal from PCOS-induced hirsutism) aren’t considered the same way. Do their feelings matter less? Are they really commiting suicide in large numbers because they do not have this treatment (perhaps it’s unaffordable because health insurance doesn’t cover it)?

    • Chetzemoka@startrek.website
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      Do you know a lot of girls with PCOS who are being bullied to the point of violence? Because that’s exactly what happened to the trans girl I grew up with 30 years ago. Long before she ever said she was a girl or presented as a girl in public. When she just “looked like” an effeminate little boy, another child wrapped her scarf around her neck and around a piece of playground equipment and started pulling her off the ground by her throat.

      You know why? Because she was wearing a glittery purple scarf. And you know what the school administration did about it? Not one fucking thing. Her mother and my mother had to go on a crusade to even get the incident acknowledged.

      Yeah, I wonder why trans kids have such high suicide rates. It’s not magic, you ignorant FART. You’re part of the problem driving these kids to experience high suicide rates.

      (Feminism Appropriating Radical Transphobe, for anyone who isn’t familiar with this much more appropriate acronym for a TERF.)

      • nugmeister64@lemmy.world
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        bro that’s fucking horrible and nobody should have to go through that but making people go through irreversible chemical, hormonal, and physical “treatments” instead of even trying to help their mental anguish is even worse. That’s literally saying that cutting body parts off and gaslighting yourself into being okay with it is a reasonable fix toward feeling uncomfortable in your body, they should have the root issue addressed rather than having the entire medical field shit on them by making them think mutilating themselves is the right and empowering choice. they’ve fooled everyone including you, and it’s all for money, because these “treatments” rake in ridiculous amounts of money and would bring in more money than just fixing their real issues so they can live a happy life phisically and chemically intact.

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          I knew this child from BIRTH. She’s the same age as my younger sister and they were very good friends growing up. From the instant this kid could express preferences - I’m talking 18 months-2 years old - we knew something was up because here’s this little boy who wants to wear dresses, play with dolls, and sneaks into mom’s high heels and makeup at home.

          We just assumed she was a gay boy because none of us had ever even heard of a transgender person 30-35 years ago. Believe me, everyone discouraged this. The constant battle finally met a stalemate agreement to just keep it at home. Even then, this kid was irrepressible, hence the glittery purple scarf at school.

          When she told us in high school that she was really a girl, it was the most face-palmingly obvious thing, like of course that’s what we’ve been seeing your entire life. That makes so much sense.

          SHE initiated that conversation. No one EVER pushed her to do anything. She was a very active participant in her own medical decisions, which is medically appropriate for a teenager. (I’m a nurse. Teenagers should participate in their own medical decisions.)

          She started puberty blockers, started living openly as a girl in RURAL OHIO 30 YEARS AGO and it was not a big fucking deal until you assholes suddenly decided it was a few years ago. She didn’t receive any permanent medical treatment for transition until she was 18.

          Believe me, son, she’s PERFECTLY INTACT, happier than you, and you can fuck the fuck right off with that horse shit terminology.

          • nugmeister64@lemmy.world
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            what part of any of those things is female? you don’t have to be female to enjoy “stereotypically” female things. that’s pretty sexist and shortsighted of you, so I’m not surprised why, when surrounded with assumptions like that, they would feel the need to justify those preferences with being “female”. maybe if you and the rest of their family were more open minded and accepted them for who they are, they wouldn’t feel they had to transition in the first place.

            • Chetzemoka@startrek.website
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              Oh fuck off. You know damn well that 90% of society would raise an eyebrow at a 3 year old boy trudging around in high heels and getting into mom’s lipstick.

              NO ONE TOLD HER SHE WAS TRANS. SHE SAID THAT.

              What part of this was self-determined is hard for you to understand? Transition was 100% initiated and driven BY HER. It’s what she wanted because it’s what she understood herself to be inside her own mind.

        • NιƙƙιDιɱҽʂ@lemmy.world
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          PSA: Anyone this far gone is not worth arguing with. They’re so deep into the ignorant conspiracy shitbox that they’re not coming out.

          • nugmeister64@lemmy.world
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            Okay buddy, I’m glad you’re content with the way the world is and clearly don’t care to see improvement in people’s mental health without having to go through a whole body mod process first

            • NιƙƙιDιɱҽʂ@lemmy.world
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              I’m sorry you’re so willfully ignorant, and don’t bother to educate yourself on topics you clearly have strong opinions on, even though it doesn’t directly affect you. I hope things get better for you.

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          Umm… You have fallen for some massive misinformation friend. The first stages of a transition are a trial period where one figures out what their individual needs are. Medical providers are actually pretty cagey about regret so if you are a trans youth this involves a therapist and a social worker who talks woith thw kids and their guardians.

          As an adult this means basically doing dry runs of everything. Name change, social transition, binding, packing and talking to other trans people to see what worked for them. Inside the community itself there’s a lot of people don’t medically transition ever. For a solid chunk the social aspects alone give them the tools they need to get by okay…which is why if someone is pointing to someone and screaming about how their pronouns are going to destroy society it’s really not great! Adding pressure by removing all the mental tools they need to get through their day in the body they have and telling them they are fake and just wanting attention doesn’t achieve the aim of dissuading people from desiring medical transition. Quite the opposite.

          Look a little bit further into non-binary identies and you will find a lot of trans people who have embraced halfway transition. Sometimes it’s just a single sex characteristic you can’t get over, sometimes your sense of identity isn’t stable over the long term so a medical transition doesn’t work for you. The point being is there’s a lot of different trans people out there who have all approached being trans very differently. What works for one doesn’t work for all so you share your experiences to find differences and similarity, experiment, really drill down into how you react to everything and I mean EVERYTHING… You lay out your values, fears, life goals, relationships, body image issues, spirituality - all of it and you itemize it. You figure out what you really want out of life, what you stand to lose and what you hope to gain by either staying as you are or pursing something else.

          Trying to figure out your gender identity happens as a period of self experimentation over the course of years before you go to a doc about a physical transformation and pushing someone towards a medical transition as the only option is a subsect of “trans medicalism” which inside the community itself is generally policed as an asshole thing to levy at someone.

          So when you come out the gate with “The first thing they do is chop off their bits!”… No. That is not how any of this works.

          • nugmeister64@lemmy.world
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            I understand your point of view, it’s good that there’s a lot of care taken to make sure the mental impact of transitioning is minimal, but the point is this is a huge amount of work to help someone try and cope with “being” something that doesn’t align with what what they were born and biologically formed as. It’s a noble sentiment, but we should be approaching the whole issue in a way that helps people realize that they don’t have to change to be themselves.

            • darq@kbin.social
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              we should be approaching the whole issue in a way that helps people realize that they don’t have to change to be themselves.

              That is literally the first thing the majority of transgender people try. Usually for years if not decades, before they finally accept who they are and transition.

              • nugmeister64@lemmy.world
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                I guess my question is why doesn’t the medical field try harder to actually properly fix the suffering they’re experiencing instead of just helping them with the part of the process that keeps them buying hormones for the rest of their lives to fight their own body’s hormone production and sometimes involves painfully mutilating themselves?

                • darq@kbin.social
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                  Because they have tried everything else, it didn’t work. We’ve done all the things you are asking. We have tried every therapy you can imagine. It’s not effective.

                  You are working on the assumption that there is some other treatment that works that we are just ignoring. What exactly do you think it is?

                  The truth is that transition works, it alleviates distress, and it’s a very simple and safe treatment option.

                  • nugmeister64@lemmy.world
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                    I’m sorry if it came off that way,

                    I’m well aware that there’s not much else available because the medical field clearly doesn’t care enough to give you a more effective treatment option. I remember hearing about a drug that eliminated the feeling of gender dysphoria, but now I can’t even find anything about it on the internet, and to be completely honest, it feels suspicious, because even the idea of innovating toward simply treating the core emotion of gender dysphoria is shunned, even though it’s the most rational and straightforward treatment anyone could have.

                    The point is that a medication that could eliminate the root cause of dysphoria should and possibly did exist, but clearly something is strange with the world if even the idea of directly fixing someone’s mental anguish is seen as hateful and bigoted. You should not stand for those keeping you away from genuine relief and contentness, instead of this half baked excuse for a treatment that is destructive to your body, emotions, and fights your hormones.

                • RubberElectrons@lemmy.world
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                  You’ve asked this same question repeatedly, with other people providing reasonable research links, anecdotal evidence, etc.

                  It’s hard to avoid concluding that this is just some very civil trolling on your part. I appreciate that you’re trying to be civil, but perhaps think, do some more reading and reanalyze your conclusions vs the boring solution of digging in one’s heels and irritating people.

            • Drivebyhaiku@lemmy.world
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              You kind of have it backwards. When you’re trans there’s a lot of work that you have to do to try and align with your physicality. The mental aspect is often very isolating because you don’t see yourself as having very much in common with people of your phenotypic sex. Like you can be friends with them and feel close emotional connections but your brain doesn’t register as them being like you the same way it does with cis people of your gender. Your brain also rewards you with a huge dopamine hit when someone actually recognizes who you are inside. It’s a feeling like being invisible and nobody even knows you’re there and then someone actually notices you.

              Seriously a cashier just automatically coding me as my gender makes my whole gorram week. It’s like someone shot sunlight directly into my brain and I get to carry that around for a few days.

              The jealously of physicality is also not super subtle. I am riddiculously jealous of people with fairly unremarkable features. We’re not talking movie star levels of beauty just- has a sex characteristic I want. I did not medically transition and chose to keep my birth sex characteristics because my partner really isn’t attracted to the opposite set of characteristics. I value that romantic attachment enough that I would easily take a bullet for them. If I could make that sacrifice I figure essentially living in a body I wish every day I didn’t have to live in tolerable. But so much has to be going right in my life for this to be okay.

              But even then sometimes it’s a lot. Like I know I will never not be hideous to myself. I might very well die having never really liked the way I look. I have a massive issue going to weddings and formal events because when I try to look good to myself it brings to light how even when I try it’s so very far off from what I wish I could look like on a good day. People are actively mislead from how I would prefer to be treated, referred to and recognized because of my body and putting up with that takes additional energy and frustration daily. If I don’t want people reminding me of the body I am in I have to tell everyone I meet to please use different pronouns for me and think of me differently so I can try my best to not be reminded of my body.

              A lot of people when they come out as trans do so because they are already tired of trying so hard. A lot go through a stage where they try to be the best version of their birth sex they can be to try and make it work and find it has done nothing to make them happy. Part of why so many of us are complete hot messes when we socially transition is because by the time we give up trying to pretend to be cis we realize that we are dying from being so invisible and isolated from the people who we see as being the closest to us. That nobody actually knows us.

              Even with my close friends who know my deal I sometimes see the wall that keeping this physicality maintains. Your brain does a lot to code everyone you meet as male or female and that translates unconsciously into how people reacts to you. Your brain prioritizes that information and we trans folk intimately know this. We can tell who is humouring us as best they can because they want to do the right thing by us and who actually has the switch flipped to their brain properly recognizing us as who we are… There is a cognitive load on the people who deal with us and we recognize that and a lot of that is based on our physicality. We see that cognitive work cis people go through lessen as we change. We see it in ourselves when we deal with other trans people who transition around us. (There is actually a kind of really funny thing with trans people who pass perfectly as a cis person where the transphobes have to fight the cognitive dissonance in the opposite direction. You see it in the micro hesitations they when they use a pronoun associated with somebody’s birth sex and they get around it more by saying “they and them” more often, something we refer to as “the coward’s they” because they are actively fighting their own brain’s mechanisms that register the proper gender to maintain their meaness)

              We recognize that gulf in you but we can’t change you. The only thing we have the power to change is ourselves.

              • nugmeister64@lemmy.world
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                i’m genuinely sorry you have to deal with that. The world would be a better place if there was a greater focus on helping people feel comfortable in their own skin rather than seemingly embracing those cold feelings and letting trans people suffer through things like that.

                I understand your viewpoint and that you understand how many people feel, and wish that core discomfort you feel could just be destroyed and replaced with the warmth that should fill you without having to make compromises to yourself or others.

                You and everyone else deserve to be happy the way you are, and the medical field is doing you wrong by focusing on the wrong part of the issue, and I’m sorry so many people are so hateful toward those who suffer from that without understanding what they’re going through. I’m sorry if what I’m saying is coming off as hateful, but I just want to see that core, inner coldness be replaced with happiness without people having to change themselves, and without that issue being ignored or glorified.

                • Drivebyhaiku@lemmy.world
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                  Yeah, you don’t get it. Even when people try it’s hard because they aren’t the full problem. We react to our own bodies and we have an inner sense of gender. That’s hard to communicate to a lot of cis people because they don’t have an inner compass that registers gender. A lot of them figure their sex means basically nothing to them and it’s like trying to explain color to the blind when you have an inner sense. There are cis people who do experience gender euphoria and deep connection to their gender but they are kind of rare and a lot of people don’t really explore something when it works.

                  Moreover… The medical field actively resists people who want to medically transition. We have to prove beyond shadow of a doubt that it is what we want before anyone even starts considering it. YOU focus on the wrong part of the issue. You are not our therapists and endocrinologists. You aren’t a researcher or a parent or partner of a trans person. Our medical transitions aren’t your business. You have been lead to believe you know better than we do because when you only listen when other cis people talk about us in ways that register your confirmation bias from being cis that feels true to you because you are primed not to see us as reasonable. You have probably been informed we are delusional or crazy and thus unable to make our own informed choices. You want to try and save us from ourselves… But you do not know us you have just been lead to believe your opinion is reasonable because no joke being trans is really hard to empathize with properly.

                  When you say " I just want to see that core, inner coldness be replaced with happiness without people having to change themselves" you basically are just saying "I just wish you weren’t trans. " If someone gave me the option of changing my gender to match my birth sex just so that I was happy in this body, I would not do it. Because gender lies so close to the core of who you are to just change it would be so fundamentally violating to my sense of self I would essentially stop being me anymore. For as long as I remember my gender has consciously or subconsciously colored every relationship and social interaction I have had in my life. It is in the bones of how I think about myself and my life. For all the frustration of not having the body I want this IS me. Changing my body is nothing by comparison.

                  • nugmeister64@lemmy.world
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                    saying that I wish you weren’t trans by wanting to see your anguish disappear simply doesn’t compute to me. From what I’ve been hearing from each of you, being trans is a response to what is being clearly acknowledged as discomfort with yourself.

                    The point is that you and everyone else said they are not content with their sex, which is an issue because you shouldn’t have to feel like the opposite sex to feel they way you are.

                    If you’re a biological male, you should not have to feel that you must label yourself as female in order to present yourself the way you feel and vice versa. In fact, having to feel the need for a gender separate from your sex shouldn’t even be necessary, because you should be able to just present yourself without essentially stating you’re a different sex.

                    Men can be as stereotypically feminine as they want, and women can be as stereotypically masculine as they want.

                    The point is that you shouldn’t have to present yourself just the way you are and then justify it to society by labeling yourself as something other than your sex in order to conform with it.

                    Just be yourself. The issue is that you seem to think you have to justify it by labeling yourself differently.

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          After I had my mastectomy I woke up briefly out of anesthesia, looked down, smiled and went back to sleep. I didn’t gaslight myself into being okay with it. Every time I get to go swimming or running without a shirt, every time I get a pizza from the door in an A-top and cargo shorts, I feel amazing in my body. I used to wear nothing but hoodies and jeans, covering every single inch of my body. I grow out a Duck Dynasty beard if I don’t shave for a couple months, it’s absolutely spectacular.

          I don’t feel fooled, I’m not spending ridiculous amounts of money. It’s ~$25 a month for my shots, I paid $5500 for the mastectomy years ago. I see my primary care doc twice a year to get blood work done, the only issue with my T is that I make too many red blood cells and need to donate blood occasionally.

          I’m a neckbeard that likes craft beer and D&D - that is my real self. The “real issues” that prevent me from a “happy life” are entirely related to being part of a group that fascists have decided to scapegoat.

        • darq@kbin.social
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          they’ve fooled everyone including you, and it’s all for money, because these “treatments” rake in ridiculous amounts of money

          No they don’t.

          Most HRT is less than $50 a month. And trans people make up 1% of the population. Surgery is expensive, but even fewer trans people get those, they tend to be one-offs, and are only performed by a few specialists.

          In comparison, therapy costs $100 a week.

          You think medical and research organisations in countries all around the world are all risking their reputations to obscure the truth on a highly scrutinised treatment, in order to… Make less money than if they suggested therapy? To take less than fifty bucks a month from one percent of the population?

          • nugmeister64@lemmy.world
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            just because it’s less expensive doesn’t mean it’s right either, just hacking off your body parts to feel “right” in your own body is even cheaper but that doesn’t make it tight, because you shouldn’t have to feel that way in the first place.

            • andros_rex@lemmy.world
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              The fact that you describe “hacking body parts” off is already an indicator that you have no idea what you are talking about. Many, many trans people never even have surgery and surgeries are not really just chopping bits off. My mastectomy was an outpatient procedure where they sucked some fat out through a tube - essentially what they would do if I was cis and had gynecomastia. Plenty of cisgender men have low testosterone and take the same injections I do.

              • nugmeister64@lemmy.world
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                except low test men aren’t doing it in an attempt to fix a core discomfort with their own identity, you deserve real help instead of bandage fixes.

                • andros_rex@lemmy.world
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                  I have zero discomfort with my own identity. I am a man whose body doesn’t produce enough testosterone. Conversion therapy is not “real help” and is not effective.

            • darq@kbin.social
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              No no, don’t move the goalposts.

              You made a claim of conspiracy, that people are being lead to transition because the treatments “rake in ridiculous amounts of money and would bring in more money than just fixing their real issues”.

              That claim is complete nonsense, and you pulled it out of your arse.

              Acknowledge that.

              • nugmeister64@lemmy.world
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                okay, I acknowledge that maybe it’s not prohibitively expensive for the end user. You don’t think the development of new products to sell you also makes money for other companies in the chain? They have to develop the product, ways to harvest or synthesize the chemicals in it, deliver it, test it, and refine and iterate upon it.

                Now that I’ve acknowledged that, are you going to acknowledge the moral implications of encouraging people to physically and chemically deform themselves to feel comfortable in their own bodies, whether they’re okay with it or not?

                I still stand by my point that it’s like putting a band-aid and topical anesthetic on a 3rd degree burn and saying it’s okay because the victim doesn’t have pain anymore.

                • darq@kbin.social
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                  okay, I acknowledge that maybe it’s not prohibitively expensive for the end user.

                  No.

                  Acknowledge that you were parroting a ridiculous conspiracy theory.

                  There is not enough money in this to justify what you are suggesting.

                  You don’t think the development of new products to sell you also makes money for other companies in the chain?

                  What new products?!

                  It’s testosterone and estrogens, that’s it.

                  They have to develop the product, ways to harvest or synthesize the chemicals in it, deliver it, test it, and refine and iterate upon it.

                  Every drug and procedure trans people take was developed for cisgender people first.

                  There are basically zero new, trans-specific products.

                  I cannot say this strongly enough: what you are saying is a ridiculous conspiracy theory that has zero basis in reality.

                  • nugmeister64@lemmy.world
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                    so you’re going to ignore the clear moral implications of forcing your body to be something it wasn’t designed to be and instead hyperfixate on me mentioning the cost of the treatment. You can’t call it a conspiracy theory that the medical industry isn’t earning money from it. Any marketable product is a source of income and clearly hormones are in high demand, and as mentioned by another user, something that is purchased regularly throughout the life of the person. Also, you don’t know anything about what areas of hormone production are or aren’t profitable. I can assure you that somewhere down the supply chain, there is a company profiting from it, otherwise it wouldn’t be available in the first place.

        • Tywèle [she|her]@lemmy.dbzer0.com
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          Nobody is forcing trans people to go through medical transition. But medical transition is what helps them relieve their mental anguish.

          Being transgender is not a mental illness.

          • nugmeister64@lemmy.world
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            if destroying the physical and chemical makeup of one’s body is necessary to make them feel “right” in it, then it’s definitely not a non-issue either, the fact that someone feels that way in the first place goes against their genetic and chemical makeup, as well as their physical formations resulting from that makeup, which gives you the undeniable truth of what you “actually” are, rather than any thoughts or emotions one might have.

            • ObliviousEnlightenment@lemmy.world
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              The emotions are entirely and completely immovable, the body is not; this treatment is the best of a shit situation. And even if we could transplant our brains into different bodies entirely, you’d just start calling us Frankensteins Monster

              • nugmeister64@lemmy.world
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                I strongly disagree. Our minds are the most malleable part of ourselves and should be the focus of any fixes the medical field innovates toward. The fact that you feel they are so immovable is proof that the medical field is failing to truly fix what plagues so many people with those feelings. If the proper treatment target had been identified from the beginning, you wouldn’t be suffering in the first place.

                • zazo@lemmy.world
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                  Why do you think people actively choose to adapt their bodies to better fit the idea of themselves if they could just “change their minds”? And do you really think most haven’t tried that first?

                  This to me feels very much like shaming a depressed person for taking antidepressants by telling them “the medical field has failed you by giving you pills, have you considered just being happy?”

                  • nugmeister64@lemmy.world
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                    I’m very much not shaming anyone, I’m trying to tell you that the “treatment” you’re receiving is actively detrimental to your body and only exists because the medical field doesn’t care enough about you or is too scared to give you a real fix. I understand that you might find any sort of criticism as an attack against you, and I apologize for it, but the truth is that you should be demanding more from the system that’s using you without you realizing it.

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                1 year ago

                This is an attempt to normalize an issue people are suffering from. This is something that should be addressed and fixed, rather than left for the victim to deal with as if it’s something acceptable to be forced to suffer in the era we live in, with the medical innovations we (should) have.

        • andros_rex@lemmy.world
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          1 year ago

          After I had my mastectomy I woke up briefly out of anesthesia, looked down, smiled and went back to sleep. I didn’t gaslight myself into being okay with it. Every time I get to go swimming or running without a shirt, every time I get a pizza from the door in an A-top and cargo shorts, I feel amazing in my body. I used to wear nothing but hoodies and jeans, covering every single inch of my body. I grow out a Duck Dynasty beard if I don’t shave for a couple months, it’s absolutely spectacular.

          I don’t feel fooled, I’m not spending ridiculous amounts of money. It’s ~$25 a month for my shots, I paid $5500 for the mastectomy years ago. I see my primary care doc twice a year to get blood work done, the only issue with my T is that I make too many red blood cells and need to donate blood occasionally.

          I’m a neckbeard that likes craft beer and D&D - that is my real self. The “real issues” that prevent me from a “happy life” are entirely related to being part of a group that fascists have decided to scapegoat.

          • nugmeister64@lemmy.world
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            1 year ago

            Honestly that’s pretty cool, and I’m glad you’re happy with how you are now, I just wish we lived in a world where you didn’t even have to go through that process to feel happy with yourself. People deserve to be able to feel happy the way they’re born

            • andros_rex@lemmy.world
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              1 year ago

              My little brother was born with a hole in his heart which had to be corrected via surgery. No one demands that he be happy “the way he was born.”

              • nugmeister64@lemmy.world
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                1 year ago

                Having a hole in your heart is not a deep seated mental anguish that is being socially normalized to the detriment of its victims, it is a physical issue inhibiting the proper functioning of a vital organ.

    • Girru00@lemmy.world
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      1 year ago

      LOL, PCOS hirsutism has available pharmacological and non- pharmacological treatments. What is your point here?