1/ Before I get into this, the discourse right now sometimes gets treated as an invitation to speculate on people's genitals. You know what you don't have to do? THAT! But since we're talking gender affirming policy, here's a study about trans healthcare

2/ All binary trans people in the survey (which had a small N, so don't generalize too aggressively) said they would at least consider hormone therapy. 22.9% of non-binary (NB, pronounced "enby") people ruled it out, with another 40.0% unsure
3/ The takeaway if you're supporting legislation: Access matters a lot, but not every non-cis person wants to access it
4/ No transmen surveyed said they were set against top surgery, but a quarter of transwomen said they were. Hormones often work better for transwomen here, so that makes sense
I misread the columns; 18.5% of NBs, and 22.9% of genderqueer people. The conclusion is unaffected by this, though
5/ Interestingly, more transwomen have ruled out top surgery than NBs and genderqueer people. I wouldn't have guessed that
6/ Policy takeaway: Access to top surgery is important to a lot of non-cis people
7/ Only a third of trans people have ruled in bottom surgery, with a full third against. The reasons for this are many, but suffice it to say, these surgeries are less desired
8/ Policy takeaway: Access to bottom surgery is important to non-cis people
9/ Cultural takeaway that should inform your policy understanding: A lot of people are trans or nonconforming without any gender affirming health care, but many trans people want greater healthcare access
10/ The study now turns to barriers to care. ALSO SUPER IMPORTANT TO TALK ABOUT
11/ "Financial, insurance, and employment barriers" Even getting the psychological evaluation is expensive, and you don't need a primer on how much US health care sucks if you can get access to it
12/ "My insurance also doesn't cover this, so I've been saving money for nearly three years to pay for the cost of phalloplasty. If my insurance did cover the operation using their usual 80/20 split I would be able to afford it. I currently have 23% of the costs saved up."
13/ General healthcare reforms will help with this to a degree---including ambitious ones like MFA---but making sure gender affirming care can't be capriciously excluded in any system is important
14/ "Availability of care." Having more doctors trained to provide sensitive, effective care matters too. More people are coming out, and that's great, but it can be hard to find a trans-positive doctor taking new patients
15/ "Issues within medical and mental health fields" Jesus Christ, of course there is a section on transphobes becoming doctors. If you can't serve your whole community, what are doing in medicine
16/ Sorry, I would have CN'd this at the top if I'd read the study before Tweeting. Tweet 17 is going to summarize some sexual assault
17/ (CN: Sexual assault) One woman details finding out her repeated breast examinations were medically unnecessary. He also grilled her about her sex life
18/ Policy takeaways: More emphasis on trans-positive care in training and more doctors should lose their licenses for abuse of power
19/ Hating your gender as a child is a common but by no means typical experience and doctors don't have to reinforce that:
20/ “Then uncomfortable doctor questions about my childhood where I pretended I'd always hated my body and ‘always’ knew I was a boy. I didn't -- I had a fine girlhood, and now I have a fine manhood.”
21/ "Interpersonal barriers" This is something you don't need your state legislature's help on; don't be the reason trans people in your life don't seek care. Don't ask invasive questions and don't be judgey. Learn those pronouns quickly. Yes, that's on you
22/ "Barriers related to emotions and worries" This butts into a lot of the stuff that's gone before; having sensitive doctors willing to give good, open, honest advice and let the patient weigh choices is critical. We're a long ways off
23/ Skimming the rest, I think I'm going to start getting very repetitive if I list them all. I think the study is pretty readable if you're curious
24/ So, to repeat, don't embarrass yourself by thinking any trans person wants to discuss their genitals out of the blue. The circumstances where cis people might are about the same
25/25 About 1 in 10 non-cis people don't even plan to get any gender affirming medical care. For the remaining 9 in 10, improving access and quality matters. If you do any kind of healthcare advocacy at any level, you should look into including trans people in your strategizing

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More from @ProofofBurden

27 Feb
I guess what I'll say about any apparent link to an Odal rune a certain stage might have is that's a pretty deep cut from Nazi iconography and there are a lot more overt things said by CPAC attendees that require far less parsing and have far less plausible deniability
On the one hand, you literally have to ignore part of the stage to see a strict Odal rune so color me doubtful. On the other hand, if conclusive evidence of this theory emerges, I'm not going to be sitting here going, "Nazis! At CPAC! Well I never!"
A bunch of people who I would bet money did not know about Norse runes or their link to Nazi symbolism are saying that someone in the planning should have seen this and I really do not buy that we all need to have the Elder Futhark rattling around in our heads to prevent this
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26 Feb
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This is the first time I've ever seen Uygur talk about an MOC in less than vitriolic terms

I cackled a vengeful, inappropriate cackle when I saw, "Don't listen to Biden!" Harris has the ultimate authority here, though Leahy would probably wield it as a practical matter

Read 11 tweets
26 Feb
1/ Yesterday I spent way to much mental energy on this very tiresome man insisting we must DO SOMETHING bout Greene calling for adjournment. He eventually called me a Nazi sympathizer for thinking she had no power here ImageImage
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26 Feb
I'm also increasingly disenchanted with the term "culture war". I think it's a good political science term, but its popular use is increasingly to mean, "Distractions from *real* issues" which are usually the speaker's personal interests
I agree that there is a political class cynically elevating TERFism for political gain, but I also think a significant number of people, both in leadership but especially among voters, now count the oppression of trans people as one of their personal interests
Even if it is some kind of "false consciousness", it's still an immediate threat to the physical, mental, and economic well-being of trans people in our communities and downplaying that because it would require your metaphysics to account for what is happening now is wrong
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26 Feb
I think it's...interesting...that a lot of people are very convinced that there is no motivated reasoning on the left and also very convinced that the science is settled on a large minimum wage hike
The disagreement among economists isn't particularly ideological; it comes down to whether or not you think it's appropriate to have a certain kind of dummy variable when comparing data from a natural experiment
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25 Feb
1/ Disney+ has now dropped two shows in the once weekly format and tried to tell me I would have been less happy if they had dropped it all at once. No, incorrect
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