Skip Navigation
InitialsDiceBearhttps://github.com/dicebear/dicebearhttps://creativecommons.org/publicdomain/zero/1.0/„Initials” (https://github.com/dicebear/dicebear) by „DiceBear”, licensed under „CC0 1.0” (https://creativecommons.org/publicdomain/zero/1.0/)MO
Moobythegoldensock @lemm.ee
Posts 0
Comments 856
Psychiatrists aren't fulfilling the social contract that subsidized their training
  • This article is infuriating. Ok, so Medicare paid hospitals $106k-182k to train doctors in 2015… and as someone who graduated from residency in 2014, we were making $40k-55k. So the hospitals were pocketing 60-75% of the payments, and doctors are supposed to feel grateful?

    The solution is obvious: if you want psychiatrists to take Medicare, pay them. CMS has already shifted payments toward primary care because they know it’s necessary, but are dragging ass on psychiatry. They could easily fix the shortage of psychiatric services for low income patients by actually incentivizing it, if they actually wanted to.

    Replace the “social contract” with an actual contract and you’ll see results.

  • [Serious] What's your hot take?
  • Nah, being happy that others are happy isn’t egotism, it’s being a functional social creature. Making a charitable decision at your own expense is a good thing, and feeling good about the decision or being congratulated by someone else does not negate that.

  • Oklahoma state superintendent announces all schools must incorporate the Bible and the Ten Commandments in curriculums | CNN
  • Numbers 22:

    21 Balaam got up in the morning, saddled his donkey and went with the Moabite officials. 22 But God was very angry when he went, and the angel of the Lord stood in the road to oppose him. Balaam was riding on his donkey, and his two servants were with him. 23 When the donkey saw the angel of the Lord standing in the road with a drawn sword in his hand, it turned off the road into a field. Balaam beat it to get it back on the road.

    24 Then the angel of the Lord stood in a narrow path through the vineyards, with walls on both sides. 25 When the donkey saw the angel of the Lord, it pressed close to the wall, crushing Balaam’s foot against it. So he beat the donkey again.

    26 Then the angel of the Lord moved on ahead and stood in a narrow place where there was no room to turn, either to the right or to the left. 27 When the donkey saw the angel of the Lord, it lay down under Balaam, and he was angry and beat it with his staff. 28 Then the Lord opened the donkey’s mouth, and it said to Balaam, “What have I done to you to make you beat me these three times?”

    29 Balaam answered the donkey, “You have made a fool of me! If only I had a sword in my hand, I would kill you right now.”

    30 The donkey said to Balaam, “Am I not your own donkey, which you have always ridden, to this day? Have I been in the habit of doing this to you?”

    “No,” he said.

    31 Then the Lord opened Balaam’s eyes, and he saw the angel of the Lord standing in the road with his sword drawn. So he bowed low and fell facedown.

    32 The angel of the Lord asked him, “Why have you beaten your donkey these three times? I have come here to oppose you because your path is a reckless one before me.[a] 33 The donkey saw me and turned away from me these three times. If it had not turned away, I would certainly have killed you by now, but I would have spared it.”

    34 Balaam said to the angel of the Lord, “I have sinned. I did not realize you were standing in the road to oppose me. Now if you are displeased, I will go back.”

    “As you can see kids, the donkey represents the working class, Balaam represents the wealthy, and the Lord represents law. Whenever capitalism runs afoul of the law, the workers do the right thing while the rich respond by beating the working class. This goes on until until they’re confronted by the courts, at which point they make an insincere apology and learn nothing. And this is the core value upon which our entire economic system was founded.

    “Also, note that Balaam’s first response in the story is to argue with the donkey rather than say, ‘Holy shit! A talking donkey!’ That represents religious idiots’ willingness to about the stupidest things imaginable without a moment of hesitation.”

  • New poll finds strong majority opposes gender-affirming care bans for trans minors
  • I actually don’t think I saw any of your posts talking specifically about puberty blockers, so thank you for summarizing.

    I am not sure what you mean by “missed time” and “runs its remaining time out.” GNRH agonists work by downregulating the pituitary gland, which results in decreased hormone secretion. When those hormones stop, so does puberty. When those hormones resume, puberty resumes, typically 6-18 months after stopping the med. There is no magical set of checkboxes or hidden time schedule the body must follow: the entire process is hormone-mediated. “Arrest” is the correct medical term to describe this process, though “pause” is a good non-medical substitute.

    You are incorrect about the dosing: it is comparable to that for use in other conditions. For example, for leuprolide (one of the most common meds used,) the starting dose is 3.25 mg per month or 11.25 mg every 3 months with a max of 22.5 mg every 3 months. This is comparable to the dosing for adolescent endometriosis and fibroids, and lower than the dosing for central precocious puberty (7.5-15 mg monthly or 11.5-30 mg every 3 months.)

    Leuprolide has been used in children as young as 1 year old and can be continued until 11 or 12 for central precocious puberty. Endometriosis and fibroids are teen indications, so it has been used for children of all ages (as well as adults of all ages.) The result and intended effect are the same as central precocious puberty or for kids with growth hormone deficiency: to arrest puberty temporarily, at which point it can be safely resumed. The big difference is that the blocking for precocious puberty happens much earlier and for much longer, while the blocking for growth hormone deficiency happens at the same time (start of puberty.)

    It’s important to note that people who take a treatment are not “test subjects.” Test subjects are those enrolled in clinical trials. They are given informed consent related to the trial, enrolled with strict parameters, and followed-up on in a systematic way. “Leuprolide Acetate for Puberty Suppression in Transgender and Gender Diverse Youth: A Comparison of Subcutaneous Eligard Versus Intramuscular Lupron” (2022) is an example of a study that used test subjects. You going to the doctor and getting a medication is not.

    I’m willing to wager that you were perfectly fine letting endocrinologists use their medical expertise to judge whether giving medications like leuprolide to toddlers and young children is medically necessary, and that your objection to it and similar meds magically appeared when those same doctors judged it medically necessary to give these same medications to transgender early teens. If this is indeed the case, it raises the question of whether you’re actually concerned about these medications, or whether you’re actually using it as an excuse to block access to safe and effective medical treatments for trans teens.

  • New poll finds strong majority opposes gender-affirming care bans for trans minors
  • Forgive me if I’m misremembering as your original post appears to have been deleted, but I distinctly recall you mentioning an “irreversible” decision to medically transition. Though medical transition is actually partially reversible, I felt it was pretty clear we were both talking about medical transition (as opposed to surgical transition, which is irreversible.)

    Puberty suppressing medications have been used for a wide range of medical conditions for the last 40 years. They are not the same as medical transition, and they are reversible. So it appears you may be conflating two different therapies that are typically taken years apart.

  • New poll finds strong majority opposes gender-affirming care bans for trans minors
  • “People are saying” is not the medical standard of care, and medical transition does not counteract puberty. Regardless of what “people are saying,” doctors are not routinely offering medical transition to 12 year olds.

    If you want to have the conversation, as you put it, it helps to get the basic facts straight.

  • New poll finds strong majority opposes gender-affirming care bans for trans minors
  • Where are you getting that 12 year olds are medically transitioning? Standard of care is 16+ and only recently has WPATH given the opinion that down to 14 may be appropriate in some cases.

    Also, no one is “forcing” these kids into any sort of decision. These decisions are being made between the patient, parents, and doctor after thorough evaluation and discussion take place.

  • New poll finds strong majority opposes gender-affirming care bans for trans minors
  • You’re getting downvoted because you’re repeating false rhetoric.

    No, pretty much nobody thinks a child should be having a sexual relationship with whomever they want. However, teens do have those relationships, and most of us acknowledge it happens and are generally ok with it provided there aren’t clear signs of abuse.

    Likewise, no one thinks a child should medically transition. However, many of us think teens should be able to medically transition. In fact, decisions about transitioning are often happening several years later than decisions about sex.

    Your hypothetical example was to give people a mental image of 6 and 7 year olds when you know damn well the conversation is about 16 and 17 year olds. And if you genuinely weren’t aware, you are now, so it’s time to rethink your position.

    If you want to talk about these decisions in the age group where they’re actually happening, then sure, let’s talk. But it’s not going to be conversational if you’re not willing to start from a position of intellectual honesty.

  • would you do this?
  • It very much depends on you. I personally think most people should start with New Who, because it’s much faster paced and The Doctor starts out a lot more likable. I personally started with New Who, then started mixing in Old Who during Capaldi’s first season. Which turned out rather nicely, because early Capaldi actually resembles the First Doctor in many ways, and it was interesting to see how elements of the show unfolded.

    For reference, Old Who starts with An Unearthly Child (1963.) New Who starts with Rose (2005.)