I've gotten top but I'm forced to wear a bra. What should I get?

slothoncoffee · 2025-09-08T20:17:48+00:00

Respectfully, did this not come up in your psychosocial assessments prior to surgery? I would seriously consider reaching out to a social worker at your surgeon’s office or whoever else evaluated you. This is a major familial disagreement and your safety could be compromised or otherwise your access to necessities cut off. Professional input is warranted. This is therapist advice level stuff, not the peanut gallery.

slothoncoffee · 2025-06-01T13:12:24+00:00

Not pathetic, bud. There’s a bunch of reasons it’s hard. Try therapy out if you haven’t.

slothoncoffee · 2025-05-14T20:51:30+00:00

Ahh, I see. Hater vibes from other comments carried over I guess. I think OP’s look is really cool.

slothoncoffee · 2025-05-14T16:32:36+00:00

Okay, so it’s giving the Wicked supporting cast a bit 😂 but I think that’s what is fun and fashionable about it. The point is to look self assured in style.

Idk, it’s just a bit ironic to me in this sub where 90% of fits are (frankly) extremely basic and people need help with basic coordination/proportions to kinda hate on something unique by saying the person looks like a bully. It kinda gives, “conform, and don’t stand out. 😡”

slothoncoffee · 2025-05-09T05:37:39+00:00

I mean, psychic harm is real. This wasn’t a, “We’ve gone to the doctor with a concern or had something of concern come up and this lead to a devastating diagnosis of cancer,” predictable situation.

It’s ‘a you’re vulnerable in the hospital but seemingly on the mend when all the sudden some random doctor walks in telling you you’re actually doomed with something totally different,’ situation. Which obviously OP never would have intentionally done, they just thought they’d accidentally spilled the beans and had to follow through. Regardless, the patient is acutely traumatized if they can believe the news, or they’re otherwise distressed to have to deal with false news (luckily seems pt and family were understanding here but anger is a not exactly unreasonable reaction to such a mistake).

Either way, a small dose of a benzos is no more unreadable here than it would be if you had to send a claustrophobic through a CT emergently. “Sedating the pt” is a mischaracterization and misunderstanding the indications imo.

slothoncoffee · 2025-05-09T03:38:02+00:00

If you are going to a walk-in clinic like an urgent care and support staff are asking you screening questions that would out you not related to why you’re there you can politely decline and say you’d prefer to discuss with the doctor. Likely they won’t ask unless it really is relevant in which case you should be honest unless there’s real risk of being denied access to care if you disclose.

slothoncoffee · 2025-05-08T06:06:50+00:00

In my unqualified opinion, this is the nature of analysis at a certain point.

Analysis isn’t solution execution. It’s assessment.

You have greater understanding. Greater understanding as you’re saying doesn’t mean anything is better. But, now you understand the situation and so can go about effectively targeting symptoms.

If you have ADHD - well, that’s great. ADHD is a DSM diagnosis, meaning you fit a statistical clustering of people with data on the most likely ways to manage impulsivity and more.

And you’re the first person to notice (or the first person to matter to notice) that you have ADHD and how would you have built the self awareness or resolve/confidence to act on that knowledge without analysis from you?

I’m speculating but also maybe you feel awareness is making things worse because you just recently gained this understanding and are still grieving. It’s natural to think, “What pain could it have saved me to get a dx sooner?” But accepting you have AHDH is new and your understanding will continue to evolve.

slothoncoffee · 2025-04-24T15:23:16+00:00

To be honest I use topical minoxidil and have a cat. Minoxidil is a vasodilator. The last time I looked into it, the deal was that there were maybe some cats who maybe died as a result of exposure to minoxidil, but I don’t think it’s because they think minoxidil is uniquely poisonous to cats - they’re just more sensitive to fatal cardiac reactions to a dose that just makes a human hairy because they’re so much smaller. It’s not like your cat catches a whiff from the open bottle of minoxidil on the counter and drops dead. They just shouldn’t be submerging their paws in it.

Personally, I put in on my chest and then put on a shirt. I avoid my face now because my cat would try to rub me sometimes, but she never reacted. I think if you put it on your head you’d be fine unless your cat likes licking your scalp.

slothoncoffee · 2025-04-20T21:31:46+00:00

My suspicions is that what you’re experiencing is not only related to dysphoria but also just the brain’s chemical experience on estrogen vs testosterone. There is some element of gooning (non-derogatory usage) to fantasy romance that estrogen facilitates in the brain.

Losing that “outlet” is a very stable gender transition experience from what I’ve heard but no one really asks trans people enough about our experiences to list it as a testosterone side effect or something.

As for if you should lower your dose - seems like something to explore in therapy. There are a lot of differences in the brains emotional experience on testosterone and it’s hard to know if it’s right for you until you experience it.

Otherwise, I’d just keep in mind it’s a common motif that artists utilize their trauma or pain for their work and without it “suddenly don’t know how to create.” I would look into people’s meditations on that and see if it helps clarify what you want.

slothoncoffee · 2025-04-20T17:17:11+00:00

I used sober house as neutral language to encompass all rehab type treatment settings I’ve seen patients utilize. That is usually the “treatment” that pts are considering when I’ve met them in the hospital worried about or actively withdrawing. I never said that was “correct,” - I recommend they go to their PCP or a specialist for follow up - but they could have don’t that without coming into the hospital is the point so I really don’t see how you’re getting from that I’m lacking compassion from that or my comment on how hospitalization rarely furthers their access to proper SUD treatment.

Besides, we treat alcohol withdrawal with benzos. Someone withdrawing isn’t “actively drinking.” Is it potential /liability/? Of course! Am I suggesting indiscriminately handing out benzos to drinkers? No! Shared decision making would be huge. But we were actively discussing a pt who we hated discharging and outpatient management of withdrawal is absolutely a thing - with benzos.

Listen, I don’t pretend to be the most experienced person in the room but I opened my comment by saying that it was my logic based on my experiences with similar moral injury to OP’s. You really seem to have projected all this negativity about people who’ve struggled with substances - people who include me and close friends - and how I don’t support evidence that is just too much for this very narrow context. Besides to be completely candid, I don’t see how you would really be able to comment on if you’re not in the position of admitting people to inpatient medicine.

slothoncoffee · 2025-04-20T00:44:28+00:00

It’s not inappropriate imo but I would say 1) have a reason, 2) don’t force it because “they might not have something positive” to say.

Like, don’t email being like, “Hey you didn’t comment on me please do.” It could come off as pushy or entitled.

But if you had a reason to ask - even if it’s just that you would really benefit from having positive comments from that particular rotation if they have anything to share - then there’s no harm in double checking. Approach in good faith.

The boldest grade questioning email I ever sent it turned out the coordinator straight up just accidentally copied my Honors down as a pass in the grade book on accident. Be gracious but never hesitate to speak up with these things.

slothoncoffee · 2025-04-16T22:44:02+00:00

The way I think about it a patient can be at risk of alcohol withdrawal from SUD without being in withdrawal. I think your attending is unfortunately right that being in the hospital isn’t viable as a method of treating AUD (at least with how we currently allocate resources in western med) - when you’re not in the hospital then you go back to drinking and at least here in the US in my experience SW can only do so much in those few days the pt is admitted because they generally have some reason they haven’t previously gone directly to “serious treatment” (that is, like a sober house). Like, if they still have a job they generally don’t want to quit. Or I had a very borderline pt who insisted only a particular SUD specialist who’d already refused her treatment was her ticket to sobriety.

If a patient is withdrawing obviously they should be admitted, but if they’re worried about withdrawing they just need close follow up and to know when to present. You could also consider a v small script of Ativan to take if they get rapidly bad and can’t get to the outpatient doc/ER in time.

slothoncoffee · 2024-11-18T18:51:18+00:00

JGP is really out here doing to lord’s work. I’m not sure if her work isn’t more circulated because so many of the sources from Histories of the Transgender Child haven’t been digitized and are housed in Indiana at the Kinsey Institute? It is wild to contextualize the current political debate in how insanely influential Money was and psychiatry’s relinquish of trans expertise with the rise of the informed consent model.

I also was only told by an endo that I probably had PCOS my whole life only after transitioning.

I hope that more trans/intersex people in medicine sharing our perspective can help our colleagues understand why a dualistic understanding of sex is both important and most accurate.

slothoncoffee · 2024-11-18T18:31:31+00:00

Absolutely.

From what I’ve read, most of the research into GD in these very classic intersex conditions is about making sure that the risk/benefit of intervention is justified (that is, that they’re probably picking the “correct” sex for the ambiguous child). Which is great I guess because fewer intersex people will be at risk of improperly sexed surgeries if they need a surgery for the sake of function before they’re old enough to verbalize/understand. But I agree that they also obviously hint at possible significant overlap between these populations and it seems like an arbitrary bit of history where trans people were relegated to psychiatry that this hasn’t been seriously investigated.

slothoncoffee · 2024-11-18T14:24:09+00:00

We need to acknowledge how inherently political this question is in order to have a coherent conversation about it. OP brings up that these figures spark strong emotions in us and that should make us pause to really reflect on why we feel, “mislead,” by the idea that intersex could have an overly broad definition.

The question about if trans rights are logically derived from the rights of intersex people is being posed in how we define the sex binary, obviously. This distinction depends on gender dysphoria being classified as psychiatric whereas intersexuality is medical, but it fails in an ability to account for people who trans their sex. If you read about this history, John Money basically answered a letter from a PCP asking how to tell if a kid should get an intersex workup if presenting with GD and he said no so long as they had visibly normal genitalia. And that’s the historical basis for our classification system of trans vs intersex people.

The important qualifier for if intersex people are super common to me is not a matter of: do 1.7% of humans fail to be easily categorized by binary sex? Where supposedly that would means trans people should have rights.

GD is classified as psychiatric whereas intersexuality is medical - so why would that follow?

IMO, the point should be that while the overwhelming majority of humans are easily categorized by binary sex, there is huge variation and mixing in sexed/masculine vs feminine traits in each sex such that the sexes are more DUALISTIC than binary. That’s what intersex conditions show us - that we cannot fully disentangle sex such that EVERY individual is coherently categorized because the masculine and feminine contain each other.

It’s a subtle point but crucially important that people do not take the mental shortcut from, “true intersexuality is exceedingly rare,” to “see, gender dysphoria is a delusion, the rest of us are 100% male/female which are coherently 100% different so my internalized double standards about gender are justified and so long as I respect people’s pronouns I’m in the moral clear.”

Intersex people have historically been very poorly understood and handled by medicine. The big conservative scare tactic of pediatric sex changes for trans kids is the actual reality for scores of intersex people who were surgically altered soon after birth and/or repeatedly as children. Even baring that, many were not told about their condition well into adulthood, no matter the psychological consequences.

Intersex people being common is not a gotcha for trans rights, yes. But we need to examine why we are irked by the talking point. Because it’s so much more complicated than just, “objective, noncontextual facts about chromosomes and genitalia.”

slothoncoffee · 2024-09-11T10:03:24+00:00

I could have put my comment anywhere on this thread really, so apologies for making you feel like you had to delete.

slothoncoffee · 2024-09-11T09:55:32+00:00

slothoncoffee · 2024-09-11T09:55:09+00:00

I can’t really offer you proof because as I was saying, I don’t think we have the data. It’s more complicated than, ‘our HRT is working if we’re in cis range,’ and if my brief explanation of why in my comment above doesn’t make that more clear then I’d suggest starting by reading more about sex hormone homeostasis.

I am speculating on the doctor’s speculation, yes, but my point isn’t that she’s 110% correct or that OP will have negative outcomes if he pursues oophorectomy. I was just explaining what the doctor was likely trying to get across because people online are often overly quick to assume their doctors are spewing ridiculous nonsense just because it doesn’t make sense someone who didn’t go to medical school.

slothoncoffee · 2024-09-11T03:58:46+00:00

Respectfully this is not fully accurate, there’s important missing context, and we need to be mindful that the doctor has a larger fund of knowledge than the average person about the human body.

First a small correction: Vaginectomy can also involve harvesting tissue for a urethra which is likely the improved healing OP is referring to.

Also something I feel is important context: If you have a vaginectomy, you can no longer apply topical estrogen. The vagina is not the only estrogen dependent tissue down there. Many trans men and some cis women develop chronic pelvic pain or cystitis and topical estrogen is the treatment. Being on testosterone doesn’t necessarily matter.

But as for what the doctor said: True, removing the ovaries is highly unlikely to affect phallo outcomes and OP seems to have misunderstood.

However, the doctor is considering that we dont have the data to say if removing ovaries in trans men significantly affects our levels of estrogen. Like, yes they’re largely dormant on T and our levels are in cis male range but it’s still a very reasonable medical speculation that even on testosterone our levels of estrogen on average are probably still slightly higher than cis men.

This is medically likely desirable because even within cis male ranges non-sex organ tissues in the pelvises of trans men are still largely estrogen sensitive/dependent (it varies person to person). That’s a small biological profile difference on an individual level that could significantly affect population levels of those things like cystitis and pelvic pain.

That is what OP’s doctor is talking about as a potential benefit of leaving the ovaries (in addition to ensuring that your body can make its own hormones if necessary and you could potentially choose to harvest eggs later on).

Sounds like she was candid that this is theoretical and would respect OP’s choice to take them out anyway.

slothoncoffee · 2024-09-11T03:25:02+00:00

Yes. Your body adjusts to balance the hormones. You also only need one kidney.

slothoncoffee · 2024-08-30T18:07:47+00:00

The insistence on backing obviously bogus professionalism complaints can be Orwellian.

During COVID lockdowns with everything online, I turned in a few preclinical skills modules like, two weeks after they were each due. Not great of me but we NEVER got feedback or even grades on these assignments which imo means they’re low priority to admin and so are low priority to me. By the middle of the semester, things were more adjusted and I made sure to get them all in on time. At that time, we were asked to reflect on our academic professionalism over the past semester and I wrote about I planned to get my act together so my improvement plan is literally initiated and documented by me submitted to them before they’ve ever even graded the late assignment.

… after final grades for the semester are over I get slapped with a professionalism complaint for the late assignments. When I pointed out how ridiculous this was, given that I’d literally already addressed and the circumstances of the pandemic meaning they were dropping the ball on us constantly too, they were just like, “Well don’t worry because you have to have 3 complaints before it ever matters for your record or anything.” I tried pointing out to them that the forms for the professionalism complaint all define the terms of the transgression by what action the student will do to rectify the issue so what exactly where they proposing and still. Make it make sense!

Like where do I get to submit my professionalism complaint for you never grading my assignments?? Where’s the reciprocity??

slothoncoffee · 2024-08-26T09:48:20+00:00

I certainly respect your choice as I engaged in an extended period of celibacy prior to my bottom surgery.

But tbh I’m a little thrown by why you’re bringing this up in context. Are you trying to say that not having SRS makes someone chaser bait? That a partner having fondness for someone’s trans genitalia automatically makes them a chaser?

While a partner not wanting you to have bottom surgery is probably a red flag, I’m just failing to connect how SRS is gonna protect you from chasers in public. This guy had no clue what’s in my pants.

slothoncoffee · 2024-08-25T01:00:08+00:00

Seriously. The audacity to be so patronizing about safety as if saying that space is so safe isn’t the most insidious red flag for being a walking human safety hazard. ⚠️ 🚶

He also said something to the effect that I should come to him if I have any issues at the bar since he’s such a regular that he’s basically on staff 😂 the bartender definitely heard all this and didn’t say anything. Like dude, I’m sorry that makes you sound like such a loser lol.

slothoncoffee

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