2B…it Was An Honour To Fight With You. Truly.

anyways can we start recognizing adhd as an actual and serious disorder that

can affect on functioning in every day life so badly that it interferes with taking care of very basic human needs

is not 10 yrs old white boy exclusive disorder

is not a fake disorder created to benefit medicine companies

definitely should not be reduced to “kid who cant sit still and wont stop screaming” stereotypes because adhd has a whole fuckton of symptoms ranging from serious memory issues to fine motor control difficulties

Mr. Robot - 4x13 - Come on. This only works if you let go too.

S01E01 / S04E11

Trans folks in the US

If you haven’t legally corrected your name and gender markers, I would highly recommend doing so as soon as possible. Don’t procrastinate this. If you’re not sure how to change your documents then this map will walk you through the steps necessary in your state (or the state you were born in). This link breaks down exactly how to change the gender marker on your passport. If finances are preventing you from changing your documents then you can apply for a fee waiver to potentially reduce or eliminate the cost, though this is up to the judge’s discretion. You can also reach out to local or national organizations that provide financial assistance for trans people changing their documents. For example, the Trans Relief Project (national), Name Change Project (Colorado), or Kim and Elise Beaudoin Memorial Name Change Fund (Maine). I’ve procrastinated this myself and now, nearly 6.5 years into my transition, I’m finally taking the steps to amend my birth certificate.

I know it’s hard for you to believe this right now, but trust me, by the end of this day, you and I are gonna be best friends.

Just some ADHD moods:

i have never done anything in my life and im not starting now

everyone hates me because of this One Thing I Said/Did

WHY AM I NOT DOING ANYTHING

i am playing my favorite game in the world and im still FUcking BORED

EXXXXCCCCCIIIIIIITTTTEEEEEDDD!!!!!!!!!!!!!!!!!!!!!!

this is all im talking about for the next ten hours whether you like it or not

this is all im THINKING about for the next ten hours whether i like it or not

Why Don’t I Have Anything To Chew On

I LIKE MAKING NOISE!!!!

if anyone says anything im going to kill them

time to shake

i heard or made a weird sound and now it is echoing through my head please make it stop

i have done………. nothing all day i wish for death

I WANNA DO SOMETHING STUPID

if i dont do this now im never going to do it *spends 30 hours hyperfocused on it*

if i dont do this now im never going to do it *doesnt do it*

its been 16 hours and i havent eaten and im not hungry

its been 3 minutes since i ate and i want SO MCUH MORE

all i want is CAFFEINE

*gets a drink* *doesnt drink it*

this sensation is bad and i will wash my hands until it goes away

if i didnt have adhd, i would be too powerful

if i didnt have adhd, maybe i would be able to do this

why did i SAY THAT i want to SHOVE MY FOOT IN MY MOUTH NOW

im never speaking again

DONT!! YELL!! AT!! ME!!! I’LL DIE!!!!!

i dont like this person because 6 years ago they said my hyperfixation was dumb

WHY!! DO I!! CARE!! SO!! MUCH!!

why am i crying

why am i NOT crying

sorry im really happy and excited and i know you’re sad but im very happy and i have forgotten how to be sympathetic

Lee says:

I’m copying the WPATH-SOC’s guidelines for medical transitioning here.

Puberty Blockers

Adolescents may be eligible for puberty suppressing hormones as soon as pubertal changes have begun. In order for adolescents and their parents to make an informed decision about pubertal delay, it is recommended that adolescents experience the onset of puberty to at least Tanner Stage 2.  

In order for adolescents to receive puberty suppressing hormones, the following minimum criteria must be met:

The adolescent has demonstrated a long-lasting and intense pattern of gender nonconformity or gender dysphoria (whether suppressed or expressed);

Gender dysphoria emerged or worsened with the onset of puberty;

Any co-existing psychological, medical, or social problems that could interfere with treatment (e.g., that may compromise treatment adherence) have been addressed, such that the adolescent’s situation and functioning are stable enough to start treatment;

The adolescent has given informed consent and, particularly when the adolescent has not reached the age of medical consent, the parents or other caretakers or guardians have consented to the treatment and are involved in supporting the adolescent throughout the treatment process.

Hormone Replacement Therapy (estrogen or testosterone)

The criteria you have to meet to start hormone therapy is as follows:

Persistent, well-documented gender dysphoria;

Capacity to make a fully informed decision and to consent for treatment;

Age of majority in a given country (if younger, follow the Standards of Care outlined in section VI);

If significant medical or mental health concerns are present, they must be reasonably well controlled.

The recommended content of the referral letter for feminizing/masculinizing hormone therapy is as follows:

The client’s general identifying characteristics;

Results of the client’s psychosocial assessment, including any diagnoses;

The duration of the referring health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date;

An explanation that the criteria for hormone therapy have been met, and a brief description of the clinical rationale for supporting the client’s request for hormone therapy;

A statement about the fact that informed consent has been obtained from the patient;

A statement that the referring health professional is available for coordination of care and welcomes a phone call to establish this.

For providers working within a multidisciplinary specialty team, a letter may not be necessary, rather, the assessment and recommendation can be documented in the patient’s chart.

Chest Surgery

One referral from a qualified mental health professional is needed for breast/chest surgery 

e.g., mastectomy, chest reconstruction, or augmentation mammoplasty

Criteria for mastectomy and creation of a male chest in FtM patients:

Persistent, well-documented gender dysphoria;

Capacity to make a fully informed decision and to consent for treatment;

Age of majority in a given country (if younger, follow the SOC for children and adolescents);

If significant medical or mental health concerns are present, they must be reasonably well controlled.

Hormone therapy is not a pre-requisite.

Criteria for breast augmentation (implants/lipofilling) in MtF patients:

Persistent, well-documented gender dysphoria;

Capacity to make a fully informed decision and to consent for treatment;

Age of majority in a given country (if younger, follow the SOC for children and adolescents);

If significant medical or mental health concerns are present, they must be reasonably well controlled.

Although not an explicit criterion, it is recommended that MtF patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.

The recommended content of the referral letters for surgery is as follows:

The client’s general identifying characteristics

Results of the client’s psychosocial assessment, including any diagnoses;

The duration of the mental health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date;

An explanation that the criteria for surgery have been met, and a brief description of the clinical rationale for supporting the patient’s request for surgery;

A statement about the fact that informed consent has been obtained from the patient;

A statement that the mental health professional is available for coordination of care and welcomes a phone call to establish this.

For providers working within a multidisciplinary specialty team, a letter may not be necessary, rather, the assessment and recommendation can be documented in the patient’s chart.

Genital Surgery

Two referrals – from qualified mental health professionals who have independently assessed the patient – are needed for genital surgery 

i.e., hysterectomy/salpingo-oophorectomy, orchiectomy, genital reconstructive surgeries

If the first referral is from the patient’s psychotherapist, the second referral should be from a person who has only had an evaluative role with the patient. 

Two separate letters, or one letter signed by both (e.g., if practicing within the same clinic) may be sent. 

Each referral letter, however, is expected to cover the same topics in the areas outlined below.

(Note: there’s an open letter to WPATH about genital surgery here you can sign, or reblog a link to it here)

Criteria for hysterectomy and ovariectomy in FtM patients and for orchiectomy in MtF patients:

Persistent, well documented gender dysphoria;

Capacity to make a fully informed decision and to consent for treatment;

Age of majority in a given country;

If significant medical or mental health concerns are present, they must be well controlled.

12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones). The aim of hormone therapy prior to gonadectomy is primarily to introduce a period of reversible estrogen or testosterone suppression, before the patient undergoes irreversible surgical intervention.

These criteria do not apply to patients who are having these procedures for medical indications other than gender dysphoria.

Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients:

Persistent, well documented gender dysphoria;

Capacity to make a fully informed decision and to consent for treatment;

Age of majority in a given country;

If significant medical or mental health concerns are present, they must be well controlled;

12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones).

12 continuous months of living in a gender role that is congruent with their gender identity;

The recommended content of the referral letters for surgery is as follows:

The client’s general identifying characteristics

Results of the client’s psychosocial assessment, including any diagnoses;

The duration of the mental health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date;

An explanation that the criteria for surgery have been met, and a brief description of the clinical rationale for supporting the patient’s request for surgery;

A statement about the fact that informed consent has been obtained from the patient;

A statement that the mental health professional is available for coordination of care and welcomes a phone call to establish this.

For providers working within a multidisciplinary specialty team, a letter may not be necessary, rather, the assessment and recommendation can be documented in the patient’s chart.

Transitioning While Mentally Ill

It’s possible to transition while struggling with mental illness. It can be harder , especially if you’re severely mentally ill or if you have stigmatized disorders like a schizo-spectrum diagnosis, but it isn’t impossible to do.

The WPATH guidelines say:

“Any co-existing psychological, medical, or social problems that could interfere with treatment (e.g., that may compromise treatment adherence) have been addressed, such that the adolescent’s situation and functioning are stable enough to start treatment"

The presence of co-existing mental health concerns does not necessarily preclude possible changes in gender role or access to feminizing/masculinizing hormones or surgery; rather, these concerns need to be optimally managed prior to or concurrent with treatment of gender dysphoria. In addition, clients should be assessed for their ability to provide educated and informed consent for medical treatments.

When patients with gender dysphoria are also diagnosed with severe psychiatric disorders and impaired reality testing (e.g., psychotic episodes, bipolar disorder, dissociative identity disorder, borderline personality disorder), an effort must be made to improve these conditions with psychotropic medications and/or psychotherapy before surgery is contemplated.

Reevaluation by a mental health professional qualified to assess and manage psychotic conditions should be conducted prior to surgery, describing the patient’s mental status and readiness for surgery. It is preferable that this mental health professional be familiar with the patient. No surgery should be performed while a patient is actively psychotic.”

gif request meme @johnnysilverhand asked: mr. robot + favourite season » 3