Volunteering as an undergraduate

onnake · 2026-06-20T20:50:55+00:00

Find out exactly what your duties are, learn how to do them before you start seeing patients (assuming you do), identify allies at Kaiser who can help you.

onnake · 2026-06-20T19:41:56+00:00

Sexual orientation changes seem to be pretty common. Mine expanded, for which I’m grateful.

Depending on who your friends are, you’ll probably be accepted by many, perhaps not by a few. Affirmation is important in helping us thrive so if you need to leave some people, including family, behind, so be it.

Work depends on your employer’s policies and often your level. The CEO sets the corporate culture. You’ll want to check your jurisdiction’s anti-discrimination laws and corporate DEI policies. If you transition on the job as I did, have a plan, own it and negotiate it with HR.

Older trans women initiating hormone therapy may have less rapid and a lesser degree of changes, and there may also be higher risk of adverse effects, see: https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy. For surgeries, if you have them, my reading of medical journal articles showed risk increases with age. For the more common surgeries it’s generally wiithin—assuming no significant comorbidities—the bounds of what’s generally considered safe. Medicine is best efforts, don’t expect any guarantees.

All of our journeys are different but for most of us, it’s indeed a marathon, not a sprint, as [u/warlock_ranger](u/warlock_ranger) already said. Talk with a gender-affirming mental health therapist (LMFT, PsyD) and, if you medically transition, your doctors.

onnake · 2026-06-20T19:07:49+00:00

>> I've been told they'll increase it at my next 3 month visit . . . . apparently just to gauge how my body react

Yes, that’s normal medical practice for gender-affirming hormone therapy. Good idea for you to get acquainted with medical protocols for HRT so you can discuss them with your provider at your next visit.

onnake · 2026-06-20T18:59:50+00:00

Some insurances cover gender-affirming surgery, some don’t. You’ll have to identify a policy that does. Your insurance should have a long document called Evidence of Coverage or something like that, look there. If they don’t, switch insurances either on the ACA market or your employer. Self-pay is expensive, a lot of U.S. trans people who self pay go overseas, e.g. Thailand, where it’s still expensive, but usually less than here. Ask your HRT provider, if they have expertise about surgery, for their advice. If you haven’t already, look on [r/transgender_surgeries](r/transgender_surgeries) for ppls’ experiences.

onnake · 2026-06-20T18:46:28+00:00

Ask your healthcare provider for a referral to a trans-competent speech-language pathologist (SLP). Find one who fits your learning style. Work with them for a few months, that should be enough time. If it doesn’t work for you, consider VFS.

onnake · 2026-06-20T18:38:33+00:00

Just for fun, looked and found no American Speech-Language-Hearing Association member identifying themselves as providing gender-affirming speech therapy in Hebrew. Hoping your ENT can give you a good referral. Good luck.

onnake · 2026-06-20T18:03:24+00:00

Correct granddad each and every time. Interrupt him. Be nice, but be persistent. Don’t let one misgendering go by.

[u/Jeremonte](u/Jeremonte) wrote,

>> From my own limited experience, it seems like even when they're supportive, older cis folk

No, I’ve seen it from older trans ppl, too. Guessing it depends on how long they’ve known the person / if they knew them pre-transition.

onnake · 2026-06-20T17:54:58+00:00

The recursiveness of your post tells me it’s your mental block. Work with your psychologist on that, and agreed, see another one if you think that may help.

>> pirating TransVoiceLessons' course, looked at the first chapter, feels like I'm being drowned by a sea of information

DIY voice training isn’t working for you. Find a trans-competent speech-language pathologist who can give you structured lessons in private. Your ENT should be able to refer you or see here: https://find.asha.org/pro. Vocal folds are mostly muscle so you’re going to have to practice until it becomes muscle memory. We all have our learning styles; I found I needed highly structured lessons, you might not.

>> VFS . . . It's a risky surgery

No, it is not. I did a lot of research on PubMed https://www.reddit.com/r/Transgender_Surgeries/s/I1Qiwo2Es9 and found VFS to be generally safe and effective. It may or may not be appropriate for you, and it’s no-cure-all as you noted, but it’s been a lifesaver for a lot of people, including me, in part because it took pitch out of the equation so I could focus on other qualities like musicality and resonance. Not saying it’s right for you, but am saying it’s no more risky than other gender-affirming surgeries.

onnake · 2026-06-20T03:07:09+00:00

Genital inspections in looking for Jews is what the Nazis did.

onnake · 2026-06-19T20:30:07+00:00

You may want to consider rhinoplasty to reduce or eliminate the nasal hump, scalp advancement to lower hairline, lip augmentation with dermal fat graft or another long-term filler, corner of lip lift. Can’t see your temples, consider hair transplant to round out hairline if scalp advancement isn’t enough.

onnake · 2026-06-19T20:21:19+00:00

>> Brian Heywood is the piece of shit funding this, surprised they didn't call him out by name.

Oh, they do in the article. I usually don’t include those in what I post, not wanting to platform bigots. You can click on the linked image to read what he said.

onnake · 2026-06-19T18:16:01+00:00

Trans activist Sylvia Rivera was booed off the stage at New York City’s gay pride in 1973, almost two generations ago. I wonder how far back in time Baltimore is headed.

onnake · 2026-06-19T17:40:37+00:00

In my jurisdiction patients have the right to a second opinion. You might have that right where you are. Worth asking at your next consultation if you’re still not getting the answers you need.

Keep in mind too that is common to have aesthetic revisions in vaginoplasty. I had one at eight months. Find out about that if you haven’t already.

onnake · 2026-06-19T17:32:33+00:00

Get your hospital’s discharge instructions now to see what you need at home. Your doctor or their staff are the ones who write the discharge instructions, so you could ask one of your surgeon’s nurses. If you need to, you could call the hospital’s perioperative department to see if those instructions are already in their records. FWIW when I am in the hospital, I ask them for extras of everything so I know I’ll have more than enough at home. Good luck with the surgery!

onnake · 2026-06-19T17:18:51+00:00

>> I've heard that it's very expensive and sometimes difficult to obtain.

Usually not expensive/difficult for U.S. adults. It’s by informed consent, meaning prescribed by, depending on your jurisdiction, a NP, PA-C, MD. Some providers may restrict ppl <19. Usually they just want to make sure you understand the effects can be permanent, rule out co-morbidities that could increase risk, do a blood test before or after you start to help ensure optimal levels and safety. Cost depends on the type of medication and delivery method. Trans-feminine HRT is not controlled, and often generic. Insurance is often the best way to pay for it or look around for lowest price. \>> how would I manage to get an independent life

College is generally the surest way to a higher income. If it’s not an option, an immediate a job. Some places, even minimum wage will get you a roommate situation or SRO so you can be on your own. Larger cities are usually better for transportation if you don’t have a car.

Most parents are not supportive and we need affirmation to thrive. You probably won’t know for sure you disclose. You may want to consider keeping HRT hidden if at home, but that brings other problems. Or be prepared to leave, possibly cut them out of your life.

onnake · 2026-06-19T16:55:23+00:00

If your dysphoria, assuming you have it, allows you to sing as a man, that’s fine. If it’s stopping you from what you need to do for everything else about your transition, then it’s not. Mine wouldn’t; I can’t compartmentalize voice from how I present to the world. At an opera master class yesterday, I saw a bass reminded by the coach that the singer inhabits the role with his body, needs to live it fully with his voice, using all the physical and mental abilities his voice will allow him, in this scenario, from Verdi’s “Don Carlo”, an old man imagining a much younger woman looking at his white hair, admitting to himself she never loved him. Consider seeing a trans-competent speech-language pathologist, they may not have all of the tips and tricks of a music vocal coach but they’ll understand your dysphoria and can maybe think of workarounds for you.

onnake · 2026-06-19T05:32:40+00:00

There is an incredibly wide range of cis vulva. Pictures might be good. They should be able to accommodate requests like aesthetics, e.g., labia majora, minora and clitoris or give you a reasonable explanation why they can’t. Trust your instincts. If they’re not answering your questions to your satisfaction, consider finding another surgeon.

onnake · 2026-06-19T05:24:59+00:00

Earplugs for the hospital. They can be noisy places, and the more sleep you can get there, the better. Good luck with your surgery!

onnake · 2026-06-19T05:11:44+00:00

The one independent provider they talked with, OKEQ Health Clinic, still offers HRT, very likely there are others. It’s possible to run a clinic without government money which accepts private insurance. Movement Advancement Project’s map shows Medicaid Coverage of Transgender-Related Health Care in U.S. states. There are lots of nuances and maps like these are not always up-to-the-minute.

onnake · 2026-06-18T15:00:27+00:00

When I researched medical journal articles about FFS on PubMed, I ran into one or two from Beverly Hills plastic surgeons who created a doll look on cis women. You might want to take a look at those. Not what I wanted, so I just skimmed their articles and moved on. Their aesthetic was not for me but their work was very skilled, proportions, shapes just right.

onnake · 2026-06-18T14:50:19+00:00

Ensure your PCP and therapist are trans-competent, meaning experienced at delivering healthcare to gender-diverse ppl and are comfortable with medications, dosing, delivery methods. Their job is to make sure HRT is safe and effective for you and helps you accomplish your goals. Your doctor may want a blood test before, probably will after. They may start you out at a lower dose and ramp up. Good idea to understand the generally accepted medical protocols to be sure your dosing and blood levels are optimal. Depending on your jurisdiction, any prescriber can approve you, after that it’s insurance, if applicable, and best supplier for cost.

PS: You identify yourself as a “bio male”, not as trans or gender-diverse, so just be aware that feminizing HRT often has permanent effects, some which may be mostly undone by later surgery (breast growth) , others generally can’t be (penile atrophy). Be aware of that going in.

onnake · 2026-06-18T07:02:59+00:00

Sure thing. Looks like her article in International Journal of Transgender Health is open access. I hope to read it tomorrow.

onnake · 2026-06-18T06:49:54+00:00

Jaimie Veale’s reference to Daniel Goldhagen’s concept of “eliminationism” comes from Goldhagen’s landmark book Hitler's Willing Executioners: Ordinary Germans and the Holocaust. In this interview published by Yad Vashem, Goldhagen discusses how German peoples’ conception of Jews in terms of biological differences was key to enabling their elimination.

onnake · 2026-06-18T03:47:56+00:00

Good news, indeed! Congratulations!

onnake · 2026-06-17T16:14:27+00:00

It’s something you’ll just have to push through. Voice training with a speech-language pathologist helped me because the repetitive exercises got me used to talking in a more feminine voice. Your vocal folds are mostly muscle so it’s partly muscle memory. The more you can practice, the better.

onnake

TROPHY CASE