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this post was submitted on 31 Oct 2024
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Precisely.
Gender isn't binary, there is no such thing as a male or female nipple. That distinction is something that Humans made up.
To the extent that men can lactate! It's one of the possible side effects of risperdal, which I have to be aware of because I give it fairly regularly. It's all the same structures it's just a matter of the hormone signals they're getting.
This got me curious whether the milk would be any different and, if I'm reading this study correctly, there's practically no difference in content
Said study: https://pubmed.ncbi.nlm.nih.gov/7462406/
Yep. Same software, same hardware, just different config files.
In 2024? Why? Risperdal is such a blunt instrument with respect to its broad affinity for receptors.
Dude sometimes we still give thorazine. And tbh ime the 3rd gens don't do shit for my typical patient. For context also though, I'm essentially providing ICU level care, so when you say the word "symptom control" it's often referring to like, fists.
We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I've actually seen quite a few pregnancy delusions and they're almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn't take it anymore she would just come scream at me for the thorazine.
I'm unsure if you don't work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that's flush with people stuck in a cycle of drugs / homelessness so I'm also not going to tell you that any of this is the best solution, just that it's the only one avaliable to any of us right now due to shitty government policies.
Acute care, understood.
i.e. "I need Olanzapine [broad receptor affinity, highly anti-cholinergic, well-tolerated], but, like, faster." I'm surprised that particular aspect of the side effect profile comes into play with acute usage.
Ah, yes, this happens a lot. No, I don't work in the medical field at all. I just know things, for reasons.
i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.
On a different note, have you heard about Cobenfy yet?
https://www.npr.org/sections/shots-health-news/2024/09/27/g-s1-25089/karxt-cobenfy-schizophrenia-psychosis-fda
It obviously isn't suited to the needs of your practice. But I'm really glad we're making progress on alternative treatment approaches, especially novel ones like anti-muscarinics.
Hopefully the new glutamatergics can reach your setting soon.
Well obvs. It's basically,"idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later."
Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn't heard of it, and I'm hopeful, but after seeing abilify get approved for acute agitation I'm... skeptical.
Yeah a lot of people don't realize the damage is additive, both people w/ these disorders and unrelated laypeople who think "talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils" is a cool story.
I'm mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you're trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I've actually never seen it used and while I can't tell you why for certain, I do have a guess.
If you have a patient sick enough that you're considering an LAI, you don't want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I've had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it's less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.
Not true! The female nipple is actually useful.
Biological males can also lactate, it just takes a lot more effort.
Great, just another thing to make me feel like a failure at.
It takes effort but you have to milk it for all its worth!
Define useful.
Just a rhetorical request, I'm not expecting an answer.
I don't understand this. We have two genders, how is it not binary and how is it made up? Honest question.
I'll take this as a good faith question, and the short answer is that gender is a lot more complicated than that.
Yes there are two archetypal roles involved in sexual reproduction, but even that isn't so simple. There isn't just one feature that defines male or female, but a combination of traits including chromosomes, gametes, anatomy, hormones, etc. In the real world, some folks are born with features that don't all agree with one or another archetype. Intersex people aren't common, about 1 in 2,000, but their existence proves that sex isn't just a binary. There's diversity to sex that requires a more complicated scheme to account for everybody.
Gender, likewise, doesn't follow the one-or-the-other model. Most folks are cisgender, but some folks have a gender that doesn't agree with what people assume their sex is, or no gender at all, or a gender that doesn't fit into the man/woman spectrum. It gets complicated quickly because gender is where sex and society intersect. Some cultures have different expectations based on gender, and some even have more than two recognized genders. That's why we say "gender is a social construct", because we all get to define for ourselves what it means to be a man, woman, or otherwise. And that's also how gender is constructed, it's a social project we all engage in collectively whether we realize it or not. Most just pass along the traditional gender roles that were passed to them, but those can change rather rapidly as society changes, like when clean-shaven faces became "manly" in response to WW1 soldiers having to shave so that their gas masks could maintain a good seal.
I think it's fine that everyone gets to say what their gender is, as long as the archetypal roles stay the same - man or female.
Gender can be a word for how people define themselves, as long as we instead use "archetypal roles" to define what our physical body looks like.
I think what is frustrating is when people start to say that we shouldn't include our physical body type at all in discussions. That's taking it too far in my opinion. Going to the doctor and not telling what body type you are makes diagnosis impossible in same cases. And for what reason? That part doesn't make any sense to me. Race, body type, and other things are important to know in many cases.
But otherwise, sure, people can define their gender how they like.
I'm noticing a contradiction here.
And for those of us who don't fit those archetypes?
Generally, it is considered impolite to talk to strangers about one's genitals.
The medical setting is one of the few contexts where talking about one's anatomy isn't considered a faux pas.
Do you want the historical explanation of how puritainism affected our culture?
They're relevant a lot less often than you'd think.
This argument has always struck me as odd as in virtually every other discussion we would accept that the exception ‘proves the rule’.
Humans have two hands, except when they don’t due to something impacting fetal development.
Humans have two kidneys, except when they don’t due to an error in fetal development or as a result of disease or injury.
Or just let the exceptions be exceptions with no social stigma rather than refusing to recognise that the vast majority of humans, and mammals, can be accurately identified as one of two distinct sexes.
Sure. Let's just apply that consistently then. Atoms are binary, the vast majority (with fewer than 1% of atoms being exceptions) can be accurately identified as one of two distinct elements, hydrogen or helium.
I'm not quite certain the point you are making here. Is the implication that because humans typically have two hands, those that do not are not a group that can be described? Or that they can be, but only should be as the product of developmental errors?
We don't generally, where we know exceptions exist, refuse to acknowledge their existence. Saying sex is a binary is saying there are only males and only females. That's literally what binary means. Like binary notation either uses 0 or 1. If it was possible for sometimes to have a 2, it wouldn't be binary anymore. That's a different thing.
This is especially true for something like sex that is based on a grouping of traits, genes, expressions, etc. which are not universally 0 or 1. Sure, we generally agree on a category when some are different, but there's some points where it's not so stark. Hence, the binary fails because there can be overlap and grey.
Nobody is saying we have to stop using male and female to describe sex in most cases, especially in a medical setting. But if you had a child born intersex, and the doctor turned to you and said, "Nah, my gut says male. Nothing will be different," you'd probably ask for a second opinion.
I think I was fairly clear, it is a binary system that has some rare exceptions.
In healthy examples of mammals where development has occurred normally this is true.
This whole ‘its a spectrum’ argument is like saying humans aren’t bipedal, there’s a spectrum because some people are born without legs! It doesn’t make any sense.
That doesn’t mean that society should refuse to accept, include and support people born without the ability to walk.
Then it's not a binary system. It's a system with two extremely dominant members. Those are different things. You can be more binary in specific contexts e.g., gametes and egg vs sperm.
I'd be very cautious about the healthy description in reference to intersex people. I don't believe you are trying to say anything nefarious, but there's a reason it shows up in eugenics arguments.
I didn't say sex was a spectrum, though perhaps someone else you were speaking with did. I wouldn't use spectrum for sex, since there are multiple differentiating factors with differing measures.
It feels like underneath all this, it's actually about people refusing to be marginalized and they want to be accepted as everyone else. But I think instead of trying to change words and ban conversations, maybe it's better to teach people to accept and even enjoy more variations?
Because right now it's a bit ridiculous. We are told to ignore obvious differences between people so nobody feels marginalized. That's likely to make it very difficult to even have a conversation.
It's like when you can't describe someone as black or white, or fat or thin, and it just becomes really humorous in the end, as you are struggling to find other words that are identifying the person.
This is naive.
How are we supposed to teach people to accept variation when they insist that there can be no deviation from the norm?
I don't understand the point you're trying to make here. Just a moment ago you were complaining that the language we use to talk about this topic was a problem, now we're supposedly telling people not to talk about it? Pick a lane!
Who are you talking about that is insisting there can be no deviation from the norm? And maybe you don't realize how teaching works.... You need someone willing to learn to be able to be able to have a teacher. Banning words and discussions is absolutely the wrong way to go. History has shown this many times.
And my point is very simple. Don't ban words. Have open discussions. Don't support censorship of opinions or words. Don't be afraid of what people are actually thinking of things. Stop trying to control what people should think, and stop trying to teach them what you think is right.
People will not read something online and change their minds. Just like you are currently reading my words here, and you will not agree or change your mind. Neither will I. That's how it works.
I can't be your teacher unless you want to be my student.
Never have, I was talking about the people you were referring to.
I'm confused about what you mean, because the only people doing that are the "Don't Say Gay" Florida Republicans.
I get the feeling that you're going to be angry when I point out that the only people banning words are the ones who want to make it illegal to teach kids that people like me exist.
Make up your mind, do you want to censor Nazis so that we can actually have open discussions or do you think that avoiding censorship of the "opinions and words" of discriminatory groups is more important than the presence of the groups they discriminate against?
...
What do you think "teaching" is?
Biological sex != gender. There's not even 2 classes of biological sex. There are men born with biological female organs and women born with biologically men's organs. We all as humans do share common organs, one of which happens to be the nipple.
Regardless of what your actual biological sex is a gender is simply a social construct used to identify someone. A person who is "non-binary" feels that their gender does not conform to what you would typically expect of either male or female based on appearances or behavior.
Sure but there are two major biological sexes. I can understand how gender can be defined as something else though.
Non-binary can decide what gender they feel like.
Anyone can decide what gender they feel like. Most people identify with one of the major genders, but many people don't for multiple possible biological reasons. Nobody is in good faith identifying as a gender they don't actually feel like.
Sure. If you define the word gender as identifying what you feel like, then it makes sense from that perspective. If I felt like my gender is someone who feels like a cat, that would be my gender then.
I gave you the benefit of the doubt that you had a genuine question, but I now feel that was a mistake.
It was a genuine question, and I listened to your opinion. My own opinion differs from your own. This happens sometimes in conversations. To me, that doesn't mean that we need to leave the discussion or downvote eachother. :)
The thing is, these conversations usually go the same way. People like yourself try to step in and guide people who ask questions. And if they don't 100% share your own opinion, then you feel it's a waste of time. And also you think you know me. I must be a troll. Right?
It's a bit funny, you have to admit. Online discussions are not sniper battles. Or they shouldn't be.
Maybe I have a different point of view on this because of my own upbringing and my own experiences. Seems pretty likely, no? And maybe one comment online will not change all of that in an instant. Also makes sense, no?
So just relax... We don't have to fight online. I promise.
Nor in person. Just let people be, right? If it doesn't harm, let people do it.
Everyone on here is stupid and wrong.
Cartman is that you?
Poster below gave you all the answer you'd ever need on this question you beg... If you have any integrity, add a note to your original comment to clarify that you were mistaken in your initial assumption and why.
But, doesn't seem likely that you will.
I don't sound angry. It's the internet, there isn't sound in posted text? It seems you must just read everything in your head with an assumed angry tone applied, because maybe you are a perpetual victim who thinks the world is against them?
No I'm generally happy :)
[Smiling]
Probably, for as long as you feel persecuted at least- Provides relief for the perpetual guilt you feel carrying that ignorance around day to day and displaying it with such unearned pride (a facade that every person you attempt to "own" sees right through without a second of hesitation).
[/Smiling]
Ok this is officially the strangest thread I've been in since Lemmy started. :)
You are acting a bit strange, honestly...
It could be a good idea to meet some actual people outside of this computer thing, just saying....
Their argument is that "gender is just a social construct", without acknowledging that some of the most paramount aspects of human existence are "social constructs" (i.e language) and that gender is one of them. And without addressing why sexual taboos (like public nudity) are gendered - to them its a form of irrational injustice. But expore the social ramifications -through real and hypothetical examples- and you quickly find that it is indeed rational to treat bodies different according to their gender, and that human social psychology does have strong roots in human phsyiognamy.
From the person I talked to above, they are using gender to describe how they feel about who they are. So maybe it's just a word difference.
I'm very downvoted for being in this thread though and so are you. It's a bit funny.
A mod deleted my comment it seems.
Anyway, guess I leave this strange thread and leave people here with their beliefs.