The Doctor

had the GP appointment. physical examination and she reckons its a false positive 🎉. has asked for it to be done again but the probable diagnosis is IBS. it's a diagnosis by exclusion though so lots of tests to rule anything more serious out first before a formal diagnosis

really don't understand how Cucarella is an international footballer and plays for Chelsea, dudes positioning seems all over the place

$15 on Bidens inauguration day. honestly that's more likely to be him paying a forfeit from a bet with friends on the election than anything else.

Dude decided to use the new powers the supreme court found the president to have, but Seal Team Six were busy washing their hair?

not saying I do, but what I will say is there isn't a fascist dictator in history that's been stopped by voting, and with Republican bigwigs going in on this project 2025 stuff, that is the route that an America where trump wins in November is heading

Importantly, it also has little to no support from academics in the field. It was a truly abysmal piece of work, the antithesis of a metareview, grossly misapplying academic study grading criteria (you cannot double blind studies on puberty blocking, transition or surgery for very very obvious reasons - kids can very easily see when they're going through puberty, and we don't put cones of shame on human patients), choosing to evaluate inappropriate criteria (you will not find improvement of mental health in trans kids given puberty blockers compared to their baseline prior to puberty blocking, it's a pause button - the appropriate comparison is against those who don't go on puberty blockers) and applying inappropriate controls (it holds up Ruuska et al, which misassigns mental health interventions as a confounding variable rather than a mediating one to hide a statistically significant higher suicide rate among gender diverse kids as a result of widespread discrimination). As a consideration of healthcare goes, it completely fails to engage with appropriate stakeholders - to quote PATHA, the New Zealand Aotearoa medical body for trans healthcare: "It’s shocking to see such a significant inquiry into transgender health completely disregard the voices of transgender experts. It would be like reviewing women’s health with no women, or Māori health with no Māori involved." Like if you want to seriously ask about the state of trans healthcare in the UK, you need to engage with patients and find out the issues. You might then find out that the current projected wait time for some of the GICs is measured not in weeks, but decades, resulting in a situation where the majority will try to go private instead. For those who are genuinely interested, I would recommend reading the absolute savaging that Yales legal and medicine departments, in association with multiple other academics in the US, have given it: https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf

Not entirely true. Following the cass review (which was a stitch up as admitted by Badenoch, and is getting shredded by academics), the NHS stopped prescribing outside of clinical trials. Cass didn't recommend a ban, but declared there wasn't enough evidence of efficacy for them to be prescribed on the NHS. the outgoing health secretary implemented a temporary ban on obtaining them by private prescription until september, Weasel Streeting wants to make that permanent.

the checks and balances are long since gone in the US, let's be fair. political appointments to the supreme Court and judges that won't recuse themselves in cases of conflicts of interest (AoCs introduced articles of impeachment for two of them), it's set up for a complete power grab

no worries. 75% is also the low end. it's what the NHS cite, but there's other studies that put it up in the 90-97% range so my odds are pretty good, particularly given my results are on the lower end of abnormal (wouldn't be flagged in the general screening programme the NHS runs for those over 60, only because I'm reporting GI symptoms that it warrants follow up) and I don't have any other common symptoms - training hard for a triathlon later this year and even despite that I'm not seeing any significant weight loss. Pretty high probability it's something else, just need to keep telling myself that until the GPs can actually see me to stave off the anxiety.

What else is he gonna do on a Thursday afternoon?

that's the test I've done and has come back abnormal. it just tests for blood in your shit and that can also be haemorrhoids, chrons, ulcerative colitis, or just having swallowed some blood. Need to see my GP for a follow up and then I guess a colonoscopy to confirm

in a smaller grievance, the NHS is proper annoying me this week. Had GI issues for a couple of years, would flare up on a pretty consistent cycle of every ~6 weeks. spent a year tracking foods trying to spot a correlation and couldn't see one, but of course a lot of foods can have a bit of hidden gluten/lactose/whatever. went to the GP to get some tests done, they pushed for a FIT (faecal immunochemical test). results of that came back abnormal, which has like a 1 in 4 chance of being bowel cancer, with a note to speak to a gp asap. Called on Wednesday, was supposed to get a call back from my GP, didn't, or yesterday. called again today "oh he's gone on holiday and will pick it up when he gets back". can't tell me when he'll be back or put a timeframe on when I can expect to organise something... like I'm pretty bullish about it not being cancer, there's a 75% chance it isn't just off a positive test and I've got no other symptoms, but kinda hacked off that they've put that on my notes, gone on holiday and not referred it to another GP in the group practice.

I mean the dude might want to look in the mirror if he wants to work out why the 4B movement exists and why Korean women won't prop men up anymore

might as well, he's already betrayed his promise to put Scotland at the heart of a labour government:

I mean, kinda seems like Jon is trying to prejudice a police investigation there... if it turns out the arrested is a) guilty of counter terrorism offences and b) is connected to Shockat, then yes, questions have to be answered but right now it comes across as a massive bunch of sour grapes with this level of speculation

ok but look at America - the MAGA extremists have got more and more attention and it hasn't shifted Trumps poll numbers at all. if we're honest at this point the concept of sunlight as the best disinfectant has ceased to be true, and has instead become greater reach for them instead

if the evidence became that there were other similarly effective treatments I would entertain a debate around patient autonomy, invasiveness and cost-benefit. Still at no point would calling it mutilation be appropriate and not inflammatory

settle in, the Tories are gonna be a popcorn sideshow for the next few years.

"She said many Tories were clearly still traumatised. She said Suella Braverman, former home secretary, appears to be having a 'very public' nervous breakdown"

yea I know where you're going with this, and the antithesis of a systematic review, commissioned by the Tories to give them an excuse to attack healthcare, with such brazenly stupid methodology as to act like surgical studies can be double blinded (what are you doing, putting a cone of shame on the patient until the study ends?) that's being shredded by international academia, is not sufficient evidence for anyone who isn't looking for post-hoc justification for beliefs they've already decided on.

if people want to argue against the evidence they can do so, the simple facts of the matter are that genital reconstruction surgeries have high satisfaction rates and are associated with improved health. that is ultimately the goal of any medical treatment, improved health and quality of life for the patient. shouts about "irreversible damage" are for the birds.

*obnoxious philosopher voice* ah, but can you define help? in all seriousness I find debate about what it means to be a woman and the nature of gender and sex interesting given it pulls heavily from biology, sociology and feminist scholarship, but they do need a grounding in more than just "but I learnt at primary school"

I'm gonna say this as clearly as I can - medicine does not care about philosophical disputes about what gender is, it cares about what is effective and safe. whether you believe "trans" exists, whether surgery is an appropriate intervention, quite simply does not matter, because the evidence base we've got is that psychotherapy to reconcile the mind with the body is not effective, and that surgery/hormone therapy to reconcile the body with the mind is. Any arguments based on philosophy (which is what you're making) have zero value, and using language like mutilation to attack evidence based medicine is fear mongering and contributes to an environment of hate.

so the problem with that is that medicine goes with what works, not on the value judgements of individuals. the most effective evidence based treatment for gender dysphoria is transition, so really it doesn't matter if someone with no expertise in the topic thinks it should be treated with psychological interventions. the other thing you appear to have missed is the concept of consent. the framing of "surgically removing the reproductive organs of somebody suffering from some form of mental illness" is deliberately emotive and conjures images of a Mengele style experiment, when nothing could be further from the truth, people knowingly and freely consent to the procedure having jumped through all the hoops to qualify for it.

Mutilation is not a value neutral word, to use it clearly indicates that it's damaging and violent. would you describe any other surgery as mutilation? while some will no doubt crow about "healthy tissue", it's a very emotive and unsound argument - we remove "healthy tissue" routinely as a preventative measure against it becoming unhealthy, and whether a body part is healthy or not is a subjective position anyway, is it still healthy if there's nothing wrong with the tissue but it's causing health problems in other parts of the body (including the mind). even if you don't accept the premise that you can change gender, nothing changes. Healthcare doesn't depend on metaphysics, the question is does the surgery have beneficial outcomes for the patient, and the long term satisfaction rates are pretty conclusive. to call it mutilation is a value judgement in which you value the ability of a body to fit into your belief system higher than you value the personal well-being of the owner of that body