deleted-
i jest,
US healthcare is not free, but access to trans affirming healthcare is easier in california when you do pay, and those without means to pay, can get access to it through government/ employer schemes (LA friends of mine use this but i am jesting, oversimplifying). where in the uk, healthcare is free at the point of service, but the environement and access hurdles leads the overwhelming majority to pay for it, and then it's not the best treatment when it's recieved.
current waiting lists mean many men and women in the uk are driven to private routes which are often equally, or more expensive than the US while not providing adequate informed consent models and outdated care plans, or people are forced into community care collectives.
to share personally, out of all the trans men and women i know, seeking trans healthcare - i am the only one i know who recieves it through the NHS. before this my bill out of pocket was about 3 grand a year for just hrt drugs, that's not inclusive of blood tests, check ups, or surgery i may or may not want!
when you factor in trans people are more likely to be unemployed or under employed, 3 grand is unachievable to many, let alone costs on top of that.
(im sure many americans will say this sounds quite cheap, but i'd like to say this was a bit tongue in cheek originally, there are differences; that most the costs of what makes up healthcare are not included in this figure - nor is there any "insurance" one can take out to absorb them)
even once one reaches the nhs channels (current waiting lists in excess of 4 years for a initial review (there are 2 rounds then titration negotiations(if you have any issues with the care you then have to wait for the gic again, gps wont touch you))) they may be rejected or put into surgery / care waiting lists for further years - or in the case of trans men waiting for select bottom surgeries, may have no nhs provider at all!
this also only factors in binary transition paths, if you're say, a non binary afab and could not neatly fit into "trans man" - services are nearly impossible to access - even being free - speak to any non binary afab about struggles to get contreception or speak about pathways for gender affirming surgeries, GICs (gender identity clinics) reject you because you're not "trans enough" and cosmetic surgeons reject you because "you sound a bit trans and need the paperwork". leading many to persue either unmonitored routes which can cause longer term health effects - or pay through the teeth for private referals which might ultimately be rejected by a surgeon.
the uk model is also largely outdated and relient on data from the 1980's - simply put - the plan you do eventually get from a nhs healthcare professional will be one which might not be an optimal route for your transition
(blocker vs no blocker, the type of blockers, progesterone vs no progesterone are all discussions you do not get to have on a nhs pathway - again, we do not have informed consent which is not just important for trans healthcare, but it's also important for stuff like disability care, womens reproductive health, mens reproductive health, hell even every day decisions of health care. if you speak to any person who has sought help for something like endomitritus they'll have a similar story of inaccessability of "free at the point of service" to tell)
not really gravel related, but happy #PrideMonth
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Maj
la cycling seems wild, because they always include like...20 miles of riding next to a motorway but frame it as
"this is good, actually - desirable, yes i love having to ride on the pavement because there is 7 lanes of traffic to my left and a motorist can legally run me over, it's actually satisfying"
like sure, unlike riding 10 miles of A road in london, if you survive the white van men, taxi drivers and nissan qashquis you get to a lovely mountain, instead of windsor great park where they ask you to dismount your bike. but like damn, they post the view from the top and all you see is this haze.
i tried to turn my youtube back to 1080p before realising it was smog
but alas, at least they do get easy access to nice looking bikes and parts, that and trans healthcare.