Its awesome how many studies about trans men are like “>70% of trans men interviewed continue to experience menstrual-like cramping while on testosterone therapy even though menstruation has stopped” and the three conclusions drawn are either “this is probably something we should look into to see if we need to change something about how we do HRT for trans men to make it better for them,” (which gets ignored by the medical community) “I need research funding to prove that HRT is mutilating and killing our poor teenage girls,” or “if its over 70% its probably fiiiine lmao”
The person I reblogged this from brought up pelvic floor tightness in the tags, and I just want to second that there’s more movement from trans informed medical professionals that the cramping is most likely caused from pelvic floor tightness.
I’ve made great progress on my own pelvic tightness, there’s exercises you can look up online to loosen your pelvic floor. There’s also this sex toy specifically designed for people with tight pelvic floors. It’s done wonders to loosen mine.
Back before there was more people in the medical community flagging the pelvic floor as the culprit, and it still happens sometimes with less informed medical professionals, any hint that a trans man was getting cramping was chalked up to “uterine atrophy.” And trans men would be sent to get a hysterectomy, sometimes without even an ultrasound first, or a second opinion. Which disturbs the fuck out of me, for a number of reasons.
A trans dude on a local transmasc Facebook group posted a while back, about how he’s been getting cramping and his doctor wanted him to get a hysterectomy just based on his descriptions of symptoms alone. I don’t even think his doc even did a physical exam, and he definitely didn’t send him to a [trans friendly] gynecologist, or to get an ultrasound.
So I relied being like, “woah. It sounds like your doctor isn’t informed around current health care for trans men. Recommending a hysterectomy without doing a full exam, or sending you to a specialist, or at least ordering an ultrasound, is a huge red flag to me. I use to have your exact symptoms and mine ended up being my pelvic floor. Please ask your doctor for a referral to a trans informed gynecologist.”
And they were really grateful because the idea of going in for a surgery just like that was scary.
So ya, if you’re a trans dude with bad cramping even though you don’t get your period, or if you’re sexually active/use toys on yourself but find certain positions/certain angles of penetration intolerably painful, look into pelvic floor tightness. Oh, also, another symptom of mine that not everyone gets, but if you find you can’t pee everything at once.
Oh yeah that was me, I sent an ask to @nothorses when he copied my tags but I’ll expand here as well:
The current view from medical providers I’ve talked to is that the relationship between atrophy and cramps is more complex than just “cramps = uterus atrophy, take it out”. For example, vaginal atrophy might change the stability of the pelvic floor and make other muscles engage more to compensate. So just getting a hysto might not fully treat it.
Also, cramps aren’t necessarily a result of things like endometriosis like some doctors think. A retrospective study of gender-affirming hysterectomy patients [1] found that chronic/cyclical pelvic pain was NOT a reliable endo symptom, because it had a high incidence in patients who didn’t have endo. (The reliable indicator of endo was abnormal bleeding). This is important because sometimes gynaecologists can get really focussed on endo or other reproductive health conditions and might not consider pelvic muscle dysfunction as a cause of cramps.
The pelvic floor muscles mainly start at the front of the pelvis and run all the way back to the tailbone. This means that as well as trouble peeing, trouble pooing can also be a symptom of pelvic floor dysfunction (also ✨butthole cramps✨), especially if you don’t have any other conditions that could be causing it or you can feel stool getting “trapped” in there. You can get a vicious cycle where straining on the toilet makes the muscles tighten up more. Definitely talk to a pelvic physiotherapist if this is a problem for you; a “squatty potty” footstool may also help.
One catch with looking up info online is that a lot of it suggests Kegel exercises, which are a strengthening move that may not help for cramps and tightness issues. My physio specifically banned me from them. Based on discussions with physios and doctors, my understanding is that the increased muscle bulking from T also applies to the pelvic floor, leaving a lot of trans people with pelvic muscles that are strong but too tight (it’s possible for them to be weak and too tight). This can create new issues, or worsen existing ones; some patients don’t realise they have an overtight pelvic floor until the bulking from T starts making it painful.
Other things that I tried out were:
Botox injections into the pelvic floor. I got mine done under general anesthetic but you can also get it as an outpatient procedure. Best for if you’re getting pain throughout the entire pelvic floor, since they get put in the middle and it can break up “chain reactions” with muscles setting each other off.
Biofeedback. Kind of a subset of physiotherapy, you get given a machine or toy that connects to an app and shows you how your muscles are activating. I have a hard time connecting to the “feeling” of them, so this helps me actively relax them.
Medical cannabis (if you can get it). I used a low-dose 1:1 THC:CBD edible. This worked better than most other pain relief both because it’s a muscle relaxant, and because my doctor was comfortable with me taking it as soon as I felt any indication of a flare (rather than waiting until I was “sure I needed it”), so it was easier to do good pain control.
Swimming (if you can) and walking. Some of the muscles in the pelvic floor start at the lower back, run down through the hips, and out the front (hip flexors). These can get super tight if you spend all day sitting. Walking and swimming (esp. front crawl and backstroke) help stretch these out.
Treating my other “unconnected” medical problems. Getting sleep apnea surgery made a HUGE difference to my pain levels even though it wasn’t the “cause” of the pain. Turns out that when your body is struggling on a day-to-day basis, that can make your pain conditions worse. Wild.
Yeah! So when your muscles contract, they give off electrical signals. (Electrical signals can also force them to contract, as demonstrated by this youtuber shocking his muscles to force himself to dab [1]). Biofeedback devices measure these signals and translate them into a feedback form that’s easier for the patient to interpret. This can be a screen with a game where the character moves based on muscle contractions, audio tones that tell you when you’re contracting the muscles the right amount, etc. This helps people get better at noticing when they’re holding tension in their muscles, and improve their ability to consciously relax them (at my first physio appointments I literally could not tell when my pelvic floor was tense or relaxed).
For pelvic pain, this requires a device that either has a part that gets inserted into the vagina or anus, or insertable probes that attach to an external device. I personally went for one with probes because the software for the all-in-one devices talked mostly about strengthening, whereas the device with the probes is a more general biofeedback device that can do strengthening and relaxation equally well (biofeedback is used as a treatment for all sorts of things).
Evidence-wise, biofeedback has been well established as a treatment for anorectal pain (✨butthole cramps✨), and there’s positive evidence for it improving other kinds of chronic pelvic pain too [2]. These devices can sometimes be loaned out by physiotherapists who offer biofeedback treatment, especially if they’re like the type I bought where you can get the probes separately for pretty cheap.
(Keeping all the info, cause v v important, but ai want to touch on the actual physical treatment-)
When it comes to pelvic floor treatments- THIS SHOULD INCLUDE TREATING ALL MUSCLES THAT ATTACH TO YOUR HIPS. This means all your thigh muscles, half your back muscles, and all of your abdominals. That means that a *regular massage* and ESPECIALLY a Myofascial Massage can actually help!! Especially abdominal massage.
If any muscles on your hips are injured, atrophied, tight, etc. It ends up affecting ALL of them.
(Im a trans guy who is a massage therapist and I worked at a pelvic floor therapy place for a while and I specialize in Myofascial massage specifically due to my own muscular pain.)
A lot of people in the US are super worried about the Supreme Court axing Roe v. Wade, but what they might not know is that some states have laws in place that will protect the right to reproductive choice and abortion if that happens. One of these states is the state of Illinois. In 2019, a law was passed that protects abortion rights within the state even if the federal right to an abortion falls. This means that if Roe v. Wade is overturned, abortion will still be a protected right in Illinois. Even before Roe, Chicago was a haven for safe abortions- you just called and asked for Jane.
Now, safe abortion access is the law of the land in IL, and there are several groups who can help you. This post is long, but I think it’s worthwhile. Even if you don’t read all the way through it, maybe save it for later. You or someone you know might need it. If you want to stop now, the TL;DR is this:
f you’re a minor and you can’t tell your parents, get a waiver of notification from the IL Judicial Bypass program.
Schedule your appointment.
Contact abortion funds to get financial aid. Your home state might have s fund, and the Chicago Abortion Fund can help.
Secure housing for the procedure through the Midwest Access Coalition or by talking to the intake staff at the clinic of your choice.
I’d like to start by saying that the closer to home you get your abortion, should you need one, the easier it will be for you… probably. It depends on your individual situation AND your safety. If I still lived in Indiana and I needed an abortion, I’d probably leave to get it done, even though there are abortion providers in Indiana, because Indiana is super hostile and there’s lots of clinic protestors- for example, when I was taking my GRE my senior year at Notre Dame, the testing center was in this little strip mall in Mishawaka next to Planned Parenthood. Despite the fact that the PP in Mishawaka does not provide abortions, there were protestors who yelled at me for going in there. I wasn’t even going to PP. I’d like to say that I said something devastatingly cool but I just ran in flustered. Point being: It really, really would have sucked if I was there for healthcare instead of a standardized test for graduate school. And that’s a very tame, mild situation! Real abortion clinic protests are often much more devastating!
ANYWAYS. The less you have to travel, the easier things tend to be, if it’s safe to get an abortion where you are and if your state will have protected abortions if Roe is overturned. If you’re not sure what might happen in your state in that case, this map has a clear, succinct overview of the legal status of abortion in each state and all US territories. You will want to click through to that link, because this image isn’t interactive.
[ID: a map of the US with states and territories sorted by their legal protections for abortion into four categories: expanded access in the case of Roe v. Wade being overturned, protected, not protected, and hostile. IL is highlighted.]
So let’s say you live in any of those red states. (Yellow and blue are safe- abortion access is protected there.) Let’s say, worst case scenario, Roe gets overturned and you get pregnant and you want to terminate. You will be able to do that in IL, and it’s relatively easy to do that in Chicago for a relatively low cost and with the benefit of a robust support network of people who want to reaffirm your reproductive choices.
First, if you’re a minor and you don’t want to tell your parents because it’s not safe for you to do so, get a judicial waiver of parental notification. The IL ACLU has a judicial bypass hotline. This will come at no cost to you. Do this ASAP, because it takes time to get it set up! You can do this by calling the hotline at 877-442-9727, texting 312-560-6607, or emailing [email protected].
Next, you need to get an appointment set up. You could get a referral from someone local to you, but this can be tricky- 87% of counties in the US don’t have an abortion provider, and google can lead you to a crisis pregnancy center. They will not help you. If you have a local Planned Parenthood, call them. Even if they don’t provide abortions, they can refer you to someone who can. If you’re coming to Chicago, which this post… kind of assumes you are… you can call any of these groups to talk about your options and what clinics can help you. I recommend starting with FPA or PP; those are two actual clinics. MAC and CAF are funds- they can direct you but they can’t schedule an appointment for you.
You might want to shop around and see which clinic costs the least, and is the most practical for you to get to. FPA has a lot of patient resources, as does PP. Don’t be afraid to ask for financial assistance. The people staffing those organizations have extensive networks and deep compassion for their patients- if the clinic can’t help, they might know who can.
Once you’ve made an appointment, now’s the time to start gathering financial aid. Some insurance, including IL Medicaid, covers it. If yours does not, or if the copay is still too much, this is where abortion funds come into play. Many states have their own abortion funds for state residents, so you might have to look around to see who can help you. I’d start with the National Network of Abortion Funds.
You also need to figure out transportation and housing while you’re in the city to get your abortion. This isn’t super necessary if you’re just coming for the pill abortion, but if you’re coming for a d and c or other surgical procedure, you will be staying for a couple of days. THIS is why I’m writing this up, because abortion funds typically only are able to help cover the financial cost of the procedure. It’s expensive to stay somewhere and it can be absolutely terrifying if you’re on your own! Navigating while you’re in pain from the procedure can be an absolute devil of a time, too! However, Chicago has MAC (contact info above), which is a practicalaccess fund, which means that they help pay for transportation to the city (bus tickets and train tickets) and around the city (volunteer drivers or volunteers who take rideshares with clients), food, aftercare medicine (painkillers, etc.), and housing, and there’s also free access to emotional support staff throughout your stay. This is not just open to IL residents; it’s open to anyone coming to the city for an abortion. ALSO if you go through FPA, they have a partnership with the Hampton Inn a block away from their location where their patients get a discount. If you go that route, just talk to FPA about housing and they’ll hook you up. This can be super helpful if you need some evidence that you’re on a “business trip” or something like that- if you are in a position where you need an excuse for your safety, that might work well.
Hopefully you won’t need this post- but if you do, I hope it helps. Feel free to share it around. If you have anti-choice opinions and you feel the need to share, don’t. This isn’t the space for it; you will be blocked and your comments removed. And then remember that criminalizing abortion won’t stop abortion. It’ll just stop safe abortions. Also, increased access to abortion, funnily enough, tends to be the thing that lowers abortion rates, because increased access to abortion comes part and parcel with increased access to birth control and general health and sex education.
Reblogging this because it’s always relevant… and because an administrative decision by MAC’s incredible leadership means they don’t just do bus and train tickets anymore. They will also help pay for airline tickets if you need to fly. If you are in the US and need to come to Chicago for an abortion, MAC’s got your back.
Your sexual and reproductive health care can’t wait — even during the COVID-19 pandemic. Many Planned Parenthood health centers across the country are still open and providing health care, including testing for STDs, like HIV. And many health centers are offering virtual appointments.
You’re doing your part by staying inside and only going out for essential things like groceries and medicine, but you can still make HIV testing a priority. The only way to know for sure if you have HIV is to get tested. Luckily, HIV testing at home is quick, easy, and painless.
You can test yourself for HIV using an at-home HIV testing kit: With the OraQuick In-Home HIV Test, you swab your gums and test the sample yourself. You get your results in 20 minutes. With the Home Access HIV-1 Test, you prick your finger to get a small amount of blood. You then mail your blood sample to a lab and get your results in about a week. At-home tests are totally anonymous — you’re the only person who will know the results. And both types of tests help connect you with counselors who can give you support and advice about treatment if you test positive.
These are uncertain times for everyone — we’re here with you. Picking up an HIV test the next time you’re at the grocery store or pharmacy is a small thing you can do to stay on top of your health.
-Chelsea at Planned Parenthood
[ Image description: Portrait of a person from nose to shoulders, holding an OraQuick HIV test to their mouth. ]
Anonymous asked: Please tell me you’re at least not one of those people who thinks it’s okay to lie to your partner about your STI status when they ask, denying them the chance to make their own informed medical decisions, just because you think a specific STI is “not a big deal.”
For the record, I personally don’t have any STIs. I had HPV once, but it fully cleared and now I’ve got nothing to disclose. Weirdly, as of my last test I didn’t even have HSV-1. (I have not spent my whole life being ultra-super careful. I’m just lucky.)
But anyway: HSV-1 is not an STI. HSV-1 is cold sores, and can be spread by kissing or sharing a drink. I do not think there is a duty to disclose your HSV-1 status, unless you’re also disclosing your CMV and toxoplasmosis statuses.
HSV-2… yeah, I think people should disclose it, but I also think people should chill the goddamn fuck out when it’s disclosed to them, because frankly, there’s at least 30% odds you’ve got it already anyway. I’ve seen way too many people fly into a rage and end relationships over herpes when neither one of them even had a single breakout. It’s not about the actual symptoms and risks of the disease. It’s about the belief that STIs are uniquely dirty and shameful in a way no other disease is.
Like I said, I do think people should disclose it, nevertheless. But HSV literally is not a big deal, please note the part where 80% of carriers have zero symptoms, and disclosure would be a whole lot easier if more people understood that. It’s unethical not to tell your partners your STI status, but it’s also unethical to make people feel like shit when they disclose.
My partner had HSV-1 when we started going out, and legitimately believed up, down, and sideways that they told me about this. I didn’t know until I got my first cold sore and was bitching about how I’d never had one before and didn’t know what to do about it but it was uncomfortable and my partner was like yeah, odds are extremely good you were gonna get it eventually with how long we’ve been together, we talked about this.
And like. I was annoyed? But I was “person who has a seasonal cold sneezes and touches lots of things in my office meaning I’m likely to get sick now” annoyed. Because it’s REALLY not a big deal and some extremely massive percentage of the world has it at this point because it’s so easy to spread. In the 6 years we’ve been together, I’ve had two cold sores, which sucks and are also the only ones I’ve had in my life but like.
So the fuck what honestly.
HSV-1 can kill infants. It might not be a big deal for adults, but a lot of people think it’s okay to have a cold sore and kiss a baby. It’s not. It can put the infant in a fight for their life.
It’s just something to keep in mind if you or loved ones have this.
Here’s the thing tho. That’s also true of that cold. It’s kinda why I made the comparison. It IS important to be aware of when you’re having an episode and be cautious around anyone with a compromised immune system (infants, elderly, cancer patients, auto immune conditions, etc) and use appropriate safety protections and judgement.
But that doesn’t change the fact that the stigma of all herpes conditions INCLUDING HSV-1 is wildly disproportionate to the actual needed precautionary steps and significantly contribute to people being unlikely to share that info about themselves.
The condition is NOT a big deal. The state of having a compromised immune system IS. Being aware of those two facts does much better at protecting immuno-compromised members of society than making HSV-1 out to be something you’re forced to admit to every dating partner you ever have (especially since - as stated above - HSV-1 isn’t an STI and therefore only informing romantic or sexual partners would do a woefully inefficient job of stemming transmission). So unless you’re of the opinion that anyone with a cold sore should inform everyone around them who could possibly have it transmitted to them of that condition rather than say taking appropriate precautions and avoiding any transmissive acts with immunocompromised people like one would with a cold or flu…….
You’re playing into some pretty significant stigma and misinformation with that particular objection to what’s being said here. Because no one in this post is saying “spread your germs all over everyone and say nothing”. We’re saying “the specific act of verbally informing romantic and sexual partners of a cold sore is not actually taking responsibility for your medical condition and given the stigma around herpes-type conditions is probably just going to expose you to bullshit without actually protecting anyone”.
And by the way. I say this as someone who has since developed a pretty significant compromise to my immune system and with whom my partner has to take great care not to transmit any kind of illness, let alone just sexually transmitted ones. I am ~intimately~ aware of how important it is for people to be respectful of that with their own health and precautionary measures, and I ~do~ share that information with anyone who has a significantly increased likelihood of transmitting illness to or from me. But like. It doesn’t take any HSV-1 specific precautions to avoid transmitting it to an immuno-compromised person. It really doesn’t. It takes….actually less than it would to avoid spreading a cold or flu to that person.
So no. While the specific content of your statement may be technically accurate (i seriously question your assertion that lots of people think it’s fine to kiss a baby while they have an active sore, but the risk to the infant if that is done is accurate), the underlying implications of how you said it and in what context are not.
