It really does though. Medicine is far too siloed and far more specialized now days than most people realize. This makes it nearly impossible for someone to really be able to determine medical necessity outside of their specialty. I would never trust a surgeon on endocrine issues or an emergency physician on primary care. The skill set and knowledge is just so wildly different.

There is a reason physicians are trying to get laws passed that would require peer to peers be conducted by people in the same specialty.

Lots of them definitely are. I'm noticed a lot more Texan transplants up in WA over the last few years than in the last 3 decades I've lived here.

No they don't, when you include Islamic attacks (which are absolutely right wing as they are religious authoritarian extremists) the number jumps to 96%.

Yeah, actively trying to eradicate is not what I'd call "indifferent."

Ask about ventrogluteal. Its a spot on your lateral hip.

Its less painful than the thigh and there isn't anything important to hit like the posterior glutes.

It really is. <1-2% of people de transition and of that over 90% cite bigotry and transphobia as the reason. So, 1/1000 to 1/500 is pretty fucking rare. Medical interventions are recommended based on number needed to treat, stains for heart attack need to treat 60 people to prevent one person having a heart attack, for strokes is 238. The NNT for trans people is 1, transition is literally the best supported and effective treatment in medicine.

It’s super variable. Travel nurses in OB at my hospital were making $225 an hour. This was in rural CA where the average nurse made low $100k a year though. Some in red states are still in the $50k range though.

Hey, born in WA, changed my name while living in Shasta county. I filed my name and gender change request with the county court and a few months later had a court order with the new name and gender. Then I used that court order to change my WA birth certificate.

Definitely agree with getting extra certified copies. The WA DOL will not return the copy you send them.