Dear E,
Whew. It has been a wild couple of months. I haven't written as I had planned, so there is some catching up to do. The problem is I hardly know where to start. So many words, they have formed a sort of clot in my mind. Today is the 4th local protest against actions of our government. I will be there. My sign says on one side "trans rights are human rights" and on the other "we do not comply with fascists."
People have been illegally sent to a brutal Salvodoran prison without due process. The government has admitted in at least one case that the man was innocent but said they couldn't do anything about it. Major law firms have capitulated to Trump's demands and given him protection money.
5 days ago, Health and Human Services put out a ghastly "tip page" for "whistleblowers" against gender affirming care-- they labeled it "chemical mutilation of children" even though it is still federally legal. In my state it is not just legal but protected as a civil right. HHS is encouraging people to report providers, but they already have the information from claims data. DOGE already infiltrated those systems. I am going to hope you have access to enough historical information to look up these acronyms later.
So the only possible reasons for the tip page are 1) to scare prescribers and 2) to get people in the habit of reporting on each other and acting as agents of the state.
I admit to being scared. A friend asked me yesterday how I felt about it and I said "I'm scared", and she sympathized but said fear would attract danger. I hope that silly Law of Attraction business is obsolete when you're reading this. If I decide to be afraid a meteor is going to hit me, it isn't more likely to happen. That line of thinking creates victim blaming. We evolved fear for a good reason-- it is protective. There's a famous quote, "the only thing we have to fear is fear itself", from a former president, FDR, and he was dead wrong. Fear of fear creates anxiety, definitely a problem. But fear itself is useful information.
What we do in response to the fear is not necessarily dictated by the feeling. It's information, not the whole story. I am afraid and I am also determined. If I comply with fascists, my life will not be worth living in my own judgment. I have spent my adult life preparing to be brave if something like this happened, and if I caved it would be a betrayal of my own being. So I accept the fear as valid feedback. I am at risk. And I will proceed. If we didn't have fear, there wouldn't be any such thing as courage, just foolhardiness. Without fear, there wouldn't be any meaningfulness in doing difficult things.
Based on recent events, it seems highly likely that if this government remains in place, I will be imprisoned on false charges. They are going to go after trans kids by attacking their physicians. I have hopes that I would be pardoned eventually. Fascist regimes never last forever. I just have to try to outlive it. I am afraid I won't be able to see you while you are growing up if that happens, but I hope one day you will understand and agree with what I have tried to do for my patients.
I am continuing to prescribe hormone replacement therapy. This is just for a few teens, since being transgender is pretty rare. Most of my practice is asthma, ear infections, checkups, head colds, etc. The rarity makes it easier for some physicians to think they can avoid doing gender affirming care. But I took up this profession believing it was a profession, not just a job, and it includes ethical duties.
I don't know how much longer I will be free. I don't know if the feds are going to show up and haul me out of clinic next week, 6 months from now, or never. They aren't here now, though, so I am carrying on as usual with work and life. You are 36 1/2 weeks now, soon to be born. I hope I get to hold you soon!
Love,
Mimi
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