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assessmenthelps · 8 months
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Get Online Assignment assessment help in Australia
Get the Australia's greatest assignment assessment help to solve all of your academic problems and obtain the highest possible grade. For qualified academic paper solutions, we are the ideal choice for students.
Assessment help Australia
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Online Write My Assignment Help Remove The Perception Of Failure
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martinjack1 · 9 months
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Best Assessment Help Provider in Australia
📚 Struggling with assessments? We've got you covered! 🌟 Our Assessment Help Provider service ensures top grades and stress-free studying. Click the link in bio for instant assistance. Let's ace it together! 💪 #AssessmentHelp #StudySmart #TopGrades #LearningMadeEasy #SuccessAhead #ClickLinkInBio
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alfredaharnish · 10 months
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Say Goodbye to Stress: Pay for Assignments and Excel in Studies
As the academic journey becomes increasingly demanding, students often find themselves grappling with multiple assignments, tight deadlines, and complex subjects. The pressure to excel and maintain a balance between studies and personal life can lead to overwhelming stress. In such challenging times, seeking professional assignment help can be a game-changer. In this blog post, we'll explore how paying for assignments at MyAssignmentHelp can help students bid farewell to stress and pave the way to academic excellence.
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Read all the benefits of pay for assignment by clicking here.
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williambuyer · 2 years
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 College assignment are difficult and boring for every student,yet we need to finish it , to get a passing mark in your semester test.Don’t give burden to your mind.We are the best Education Assignment Help .We have other services also Essay writing service, Dissertation Help, Coursework, Assignment Help.
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Managing Finance within a Budget: Significance and What is it About?
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reasonsforhope · 13 days
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"The world’s coral reefs are close to 25% larger than we thought. By using satellite images, machine learning and on-ground knowledge from a global network of people living and working on coral reefs, we found an extra 64,000 square kilometers of coral reefs — an area the size of Ireland.
That brings the total size of the planet’s shallow reefs (meaning 0-20 meters deep) to 348,000 square kilometers — the size of Germany. This figure represents whole coral reef ecosystems, ranging from sandy-bottomed lagoons with a little coral, to coral rubble flats, to living walls of coral.
Within this 348,000 km² of coral is 80,000 km² where there’s a hard bottom — rocks rather than sand. These areas are likely to be home to significant amounts of coral — the places snorkelers and scuba divers most like to visit.
You might wonder why we’re finding this out now. Didn’t we already know where the world’s reefs are?
Previously, we’ve had to pull data from many different sources, which made it harder to pin down the extent of coral reefs with certainty. But now we have high resolution satellite data covering the entire world — and are able to see reefs as deep as 30 meters down.
We coupled this with direct observations and records of coral reefs from over 400 individuals and organizations in countries with coral reefs from all regions, such as the Maldives, Cuba and Australia.
To produce the maps, we used machine learning techniques to chew through 100 trillion pixels from the Sentinel-2 and Planet Dove CubeSat satellites to make accurate predictions about where coral is — and is not. The team worked with almost 500 researchers and collaborators to make the maps.
The result: the world’s first comprehensive map of coral reefs extent, and their composition, produced through the Allen Coral Atlas.
The maps are already proving their worth. Reef management agencies around the world are using them to plan and assess conservation work and threats to reefs...
In good news, these maps are already leading to real world change. We’ve already seen new efforts to conserve coral reefs in Indonesia, several Pacific island nations, Panama, Belize, Kenya and Australia, among others."
-via GoodGoodGood, May 2, 2024
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Note: You can see the maps yourself by going here!
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phoenixyfriend · 4 months
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That one post about great domestic policy and HORRIFIC foreign policy just does not stop being true
Domestic Policy Win: The American Museum of Natural History in NYC is closing down two entire exhibits of Native American belongings in order to comply with a federal order that requires museums to obtain the consent of indigenous nations in order to display artifacts of native origin. The linked ProPublica article specifies that the exhibits in question are the Eastern Woodlands and Great Plains Halls. To quote:
The new federal regulations, which went into effect this month, prohibit the display of items subject to NAGPRA without tribal consent and ban all research done without tribal consent. In addition, the regulations closed a loophole that had allowed museums such as the American Museum of Natural History to keep ancestral remains and burial items by claiming that they are “culturally unidentifiable” — meaning in their view they could not be connected to present-day Indigenous communities based on available evidence — and therefore could not readily be returned to tribes.
Foreign Policy Fail: The United States, the UK, and several other nations, in response to claims that several members of UNRWA were involved in the Oct. 7th attacks, have cut funding to the relief agency in question. The Al Jazeera article profiles the Palestinian response, and also specifies that this funding was pulled after the UNRWA launched an investigation in response to Israel's allegations that 12 members of the relief agency were involved.
Australia, Canada, Italy and the United States said they would halt funding to the agency, while European Union foreign policy chief Josep Borrell said the 27-member bloc would “assess further steps and draw lessons based on the result of the full and comprehensive investigation”. Germany, Finland, the Netherlands and the United Kingdom then also joined the list of countries pausing financial aid to the UN agency, whose facilities where displaced Palestinians sought shelter have been repeatedly attacked in Israeli air raids. Ireland and Norway, however, expressed continued support for UNRWA, saying the agency does crucial work to help Palestinians displaced and in desperate need of assistance in Gaza. - Al Jazeera
"One million displaced people are currently taking refuge in and around UNRWA buildings. They are the ones who will suffer as a result of this decision," said Mr Gunness, adding: "The curtailing of UNRWA services will also destabilise the region at a time when Western governments are trying to contain a regional conflagration." [...] The US, Germany and the EU are among some of UNRWA's biggest donors. - BBC
Unfortunately, the WSJ article is paywalled, so I can't access the full thing for a quote.
Anyway. Call your reps. I'm not even talking to just the Americans this time, call your fucking reps. If they aren't donating to UNRWA, then make them do something. Is the organization possibly a security risk, and the concerns legitimate? Maybe! But you cannot cut the funding that is keeping 2.3mill people alive on an already shoestring budget and not immediately put a backup security net in place.
Until then, pick a charity with a good rating, donate and signal boost it, and politely harass your politicians.
Politely as in "don't shout at or cuss out the staffers that man the phone lines," because they are not your reps, but also because your number is going to get blocked and then you won't be able to pressure them in the future. Do be firm, though.
I'm personally picking the PCRF this time, since one of the three remaining hospitals in south Gaza has been evacuated and shut down, and the evacuees reportedly include women who just got C-sections, which means the evacuees also include newborns, and medical care is in high demand. They're also currently focused on providing clean drinking water to the people of Palestine. That said, so is food, and shelter, and winter clothing. Pick a need, find a charity, and toss them some money.
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cloverstayy · 4 months
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Helloooooo, may I please request Chan’s reaction to reader having another groups tattoo?
I’m a Chan biased but have a Vernon inspired tattoo on my ribs
Thank you so much for this suggestion, Anon! I've got quite a few tattoos myself, (no SKZ ones...yet) one of them being a Fall Out Boy-related tattoo and I think I'd cackle listening to Pete freak out over me having another band's or group's tattoo. So, I kind of took the humorous route with this one and I hope that's okay! I also hope you enjoy it just as much as I did writing it.
I also apologize for how ridiculously long this got. 😂 I kinda let myself get carried away, but I think those kind of stories are the best anyways!
If you enjoyed this one, please, please reblog! I honestly do a little happy claps when I see anyone reblogging or interacting with my content. All the warm and fuzzies!
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STORY RATING E for everyone.
TYPE Slice of life...I think?
CONTENT WARNING Quite literally nothing to note. Use of explicit language, but tons of comedic humor and just a smidge of fluff!
W/C 6,063
“I can only imagine the photos she took of you, JK.” Chan snorted, leaning his head against his fist which was propped up on several pillows. 
JK stayed quiet for a moment, shaking his head at Chan before something began to develop across his expression, “Let me get back at her.” 
Chan sat up, a bit perplexed at the request JK was propositioning, “What’dya mean?” 
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Chan and you have been dating for the better part of a year and at this point, there isn’t much he hasn’t seen of you.
More than that, he’s asked about almost every single tattoo you have. Its honestly how you both became acquainted, actually. 
He saw your obnoxiously bright dinosaur tattoo from some distance away; making his way over to you and managing to pull one of the smoothest attempts you’d ever seen any man manage to use to get your attention. 
He was clearly successful, for transparency’s sake.
You were on vacation in Australia and enjoying your time beachside. Little did you know, Australia was his home country. There you were, minding your own business while waiting in line for a snow cone when Chan couldn’t help himself whatsoever from full bore running and stopping suddenly behind you in linewhen you immediately became aware of the labored panting of someone standing behind you.
Letting curiosity get the better of you, while still trying to play it off as complete disinterest, you turned slightly around to see a man bent almost in half as his eyes were glued on you. But don’t get it twisted, he wasn’t looking you in the eyes, not yet anyways. He was staring at you, his eyes feeling as though they were transfixed on your left arm.
Glancing around, expecting someone to have been chasing him or something…
Why the hell is this man panting so much?
After assessing your surroundings and realizing no one was actually chasing him, that he for some reason was behind you and panting up a storm like a dog after a run, you felt your brows furrow together before deciding to evaluate this seemingly poor man’s condition.
“Um, are you okay?”
It was only then his eyes snapped up to yours fully when he flashed one hell of a rage-inducing smile in your direction, sliding his hands from his knees and up to his hips as he stood up straight. 
Who does this man think he is smiling like THAT?!
“Yeah, yeah! I’m great. How are you?” 
Sheer confusion must’ve washed over your face as one of your brows pitched upwards, “Are you serious?” 
This man couldn’t get anymore attractive to you at this point, you’re sure of it, but all of a sudden you’re pretty sure you witnessed the heaven’s opening up and the sound of angels began to fill your ears.
Okay, thats a bit of an exaggeration. He was…he was giggling. And he was doing it at you.
“I’m quite serious, actually. You getting a snow cone, too?” 
“I’m in the line, aren’t I?” 
The giggling you still weren’t sure wasn’t the heaven’s choir belting out your new favorite song of the summer, picked up briefly before settling, “You are.” 
Shaking your head a few times, attempting to dislodge whatever spell this man had seemed to put you under, you just blink at him. Several times, “Can I help you with something?” 
There he stood, his stupid smile on his stupid face with his stupid laugh. And he just smiled at you again before you saw him quirk his head to the side, raising his eyesight above your head, “Can I get 2 pineapple and cherry snow cones, man?” 
Oh my god. 
Did he just? Yes. Yes, he did indeed step in front of you. And still dazed as you you were, you spun slowly around with your toes digging into the sand and saw that he definitely had ordered for you.
Well, maybe he didn’t. Its entirely possible he ordered 2 for himself. 
How long had you been looking at him like he had 2 heads and a halo?
Couldn’t have been more than a few seconds. But maybe it was longer than that and your turn had actually come up and instead of being vigilant, you waffled and he decided to just step ahead of you?
Amidst the poor attempt at logical reasoning you were facing in lieu of this man’s behavior, the smell of sticky sweet pineapple invaded your senses as you realized he was holding the other snow cone he’d ordered. But he was holding it in your face.
“Um, is that for me?” 
Blinking your way out of disassociation, you glanced at the snow cone held tightly in his hand before looking up to him for confirmation. 
“Sure is. My name is Chan, by the way. Or Chris. I honestly respond by both.” 
Still unsure of what this man’s intentions were, but not above refusing a snow cone that you didn’t actually have to pay for, your hand slowly moved to take the snow cone. 
Hesitantly, you wrapped your fingertips around the bottom part of the paper cone which cradled the sweet treat. Your hand inevitably came into contact with his as you did but…this man wasn’t letting go…not yet, anyways. 
“Name’s Y/n. Is this how you typically pick up the ladies or am I the exception?” 
Regaining your ability to speak and contribute to the conversation, you applied just a bit more force to the snow cone, pulling it out of his grip as he let out another angelic giggle before releasing it.
And the rest is history. Or so they say. 
He asked you about a 100 questions about your tattoos, at least the ones he could see with relative ease as you were wearing an off white sun dress that hit right below your knees. He admitted to you that he’d love to get an entire sleeve of tattoos, but had no idea where to start, but that he was amazed by yours. You were flattered, really.
Of those 100 questions, of course, 2 of them were him asking you on a more formal date and asking for your number. 
Up until this point, you knew Chan had seen all of you. You two had had sex. Showered together. Hell, you two had even cuddled naked together and how the hell had he never, ever noticed this one particular tattoo was beyond you.
You’re still not even certain how you’ve managed to make it an entire year without Chan having at least glimpsed at it. But there he was, arms crossed on the living room sofa, looking at you with one of the most unimpressed and unamused looks he’s ever given you. 
“Christopher.” 
“Y/n.” 
“What do you want me to tell you? I’ve had this tattoo for years. Its not my fault you ever noticed it.”
He huffed out a breath, “You never disclosed it, either.” 
You couldn’t help the bark of a laugh that ripped through you, almost sending you to the floor, “DISCLOSURE?! Christopher, you’ve got to be fucking with me right now.” 
“And what if I’m not?” 
“Then I’d asking you what in the fresh hell is actually wrong with you for being upset with me having a BTS tattoo!” 
If Chan could’ve managed to roll his eyes any further back into his head, you’re pretty sure you would’ve been making a call to the paramedics, fearing that either his retina’s had detached or he was experiencing a seizure. 
“Its not just a BTS tattoo, Y/n.” 
“Roll your eyes at me one more goddamned time or so help me god, Christopher.” 
His expression was so deadpan, you were certain he’d end up turning to stone with his appearance. 
“It’s not just a BTS tattoo, Y/n.” He repeated, doubling down by readjusting his crossed arms and exchanging his man-spread position on the loveseat to throwing one leg over the other. 
“This is because its about JK, isn’t it? Did he tease you about this or something?” 
His eyes widened, “Why would he tease me about your tattoo, Y/n?!” 
Oops. 
You may or may not have told Chan about the time you had met BTS years and years ago while working at a HYBE event prior to and most certainly before knowing Chan or even Stray Kids existed. 
And you most definitely did not tell him about the fact that you ended up working for BTS a few summers after having met them, doing event coordination for HYBE. And you were positive you never even mentioned to Chan that you got the tattoo as apart of a dare that you dared JK with. The means by which you managed to coerce JK into getting said tattoo was the embarrassing part.
It had never come up in conversation as he had clearly never noticed the tattoo you had on the inside of your right ring finger. Yes, it was small. But so was JK’s. 
Yeah. He most assuredly had no clue JK also had a tattoo that was very similar to the one you had, but also different. 
“Y/n…why would JK tease me about your tattoo?” He repeated, his arms slowly uncrossing themselves as he propped himself off the back of the couch with his hands. 
“Uh…I-uh…Ihonestlyhavenoidea?” You presented him with your best attempt at a shit eating grin as you could muster, choosing to slowly make your way to the armchair that sat opposite of the loveseat. 
“Should I just call JK?” 
There it was. The threat followed by the growing smirk bubbling across his face as he began to formulate the beginnings of how this tattoo made it’s way to your finger. 
“Oh gosh, Chris, no! You don’t have to do that!” You smiled again, placing both of your elbows on your knees as you threw your head into your hands and leaned forward into his space. 
“No?” He’d managed to shift all the way to the edge of the loveseat’s cushion before he began to lean into your space. 
“Nope.” You squeaked out as you began to slowly find yourself sitting back up, your hands removing themselves from under your chin as your back straightened. 
“Y/n…don’t lie to me.” 
“Chris, this is silly! It’s just a silly little tattoo.” 
Clearing his throat, he stood on his feet and looked down at you. You had to crane your head upwards to meet his glance, feeling all the bits of unease and panic he was forcing you to feel. 
Please do not call JK. Please do not call JK.
You kept uttering that phrase like it was some sort of new age mantra; repeating it over and over inside your head and hoping to whatever creator out there that Chan could hear you. 
You fucking knew he couldn’t. 
Like an 80’s montage but without the cheesy music and all the slow-motion action you could tolerate, Chan pulled his phone from his back pocket. And suddenly, the fast forward button had been activated as the speed with which he dialed JK was similar to that of a cheetah securing dinner for the evening. 
“Chris! Come on, baby. It is not that serious! Had I known you were going to react like this, I would’ve said something a LONG time ago!” You pleaded, jumping to your feet and wrapping your arms around his waist. 
He only glanced down at you before you heard the click of the other line and JK’s voice came through the speaker, “Yo, Chris! What’s up man?” 
Chan cocked an eyebrow as he took his free arm and wrapped it around your waist, all but securing your body against him as he spoke, “Hey JK! Nothing much. I’ve got a question for you.” 
A choked whimper was suddenly caught in your throat as you all but slammed your head into Chris’ chest, more or less embarrassed at the story he would be told about the origins of this stupid tattoo and less worried he’d be actually upset with you. 
“What’s up, man?” 
“Do you happen to know a Y/n L/n?” 
There was a brief moment of silence and what sounded like shuffling of some kind on JK’s end, “Yeah…yeah, I do. Wait, why do you ask?” 
Chan’s eyes looked down at you once again. He placed a perfunctory kiss to the top of your head because he couldn’t manage to make eye contact with your face to place one on your forehead. It was still pressed firmly to his chest as you now tried to wriggle out of his grasp. 
“Well, she’s my girlfriend and…” Chan was cut off almost immediately by JK. 
“Woah! Girlfriend?! You’re dating Y/n-ah? Bro, how long?” 
“Just a little over a year. I love her to absolute bits.” He spoke, his voice just above a whisper as he leaned his head down so his lips would brush right against your ear while he spoke. This said whisper rattled you way more than it should have, but you knew that was the sole purpose of Chan doing it in the first place.
“Christopher, I swear to god. Please. Don’t.” Your words were so muffled and you knew Chan couldn’t understand you, but he began to giggle. The same fucking giggle that reminded you of Baby Jesus and Holy Hymns and Angels and shit. 
“Congrats, man! She’s awesome. She worked for us for a bit!” 
Chan’s arm only tightened around your midsection as you acquiesced to his grip, slowly coming to terms with the fact that he would soon hold the exceedingly mortifying knowledge of how you obtained the very tattoo in question in just mere moments. 
“Oh, you don’t say!” He quipped, slowly turning the both of you in a circle by means of swaying side to side. 
“Yeah! We met her forever ago through an event HYBE was holding and she ended up doing some event coordination stuff for us for about a year or two. She was fucking phenomenal. She doing okay? Why’d you ask?” JK’s tone sounded equal parts concerned and confused. 
“Well, if I happened to say something about a tattoo, would that ring any bells?” 
And with that, the loudest and most obnoxious laugh tore through the speaker as JK broke out into a fit of laughter, which only caused Chan to all but pick you up with the arm wrapped around you. 
However, JK quickly managed to calm himself before you were actually lifted off the floor, “Oh man. Yeah, yeah that rings a bell. Why?” 
“Well, you know she’s got a lot of tattoos…” Chris pauses, awaiting confirmation from JK.
“Of course.” 
“And somehow, that little tattoo never managed to come up in conversation in the last year or so and well, today it has and I’m just curious about it. Y/n isn’t being as forthcoming about it as I’d imagined she would be.” 
“Well, that makes sense that she hasn’t been,” He let out another brief laugh,” Is she there with you right now?” 
Chan looked down at you, realizing that you had readjusted your head to keep your eyes on him, the pleading expression remaining permanently affixed on your face. The look he presented you with, however, was expectant one. And he expected you to answer. 
“Hey JK.” You squawked, pressing your forehead against Chan’s chest once again. 
“Y/n-ah! I had no idea you were dating Chan-ssi!”
“Well you know me, so good at keeping those secrets!” 
Chan squeezed you tighter as your eyes shot up to meet his, brows furrowing together. The force of his constant entrapment finally caused you to mouth the word “ouch” to him.
———
THE DAY PRIOR…
“Hey man, long time no see!” JK greeted Chan, bringing the other into his embrace via their joined hands, but only briefly before they broke apart just as quickly. 
“Oh, it hasn’t been that long, has it?” Chan pondered, questioning whether it had really been longer than he had remembered since he saw JK last. 
JK nodded, taking a seat on his couch, throwing his body against it and suggesting Chan take a seat in the couch opposite him. 
Chan obliged, pulling his keys and phone from his back pocket before doing so. However, once seated, he too fell backwards, allowing his back to meet the soft, plushy fabric of the couch as he settled in. 
“Its been,” JK paused, one eye squinting in thought before it popped open, “At least 6 months.” 
“6 months!” Chan chirped, grabbing the water bottle that had been set out for him. The sound of the plastic lid coming apart from the seal cracked under his palm as JK hummed in affirmation. 
“Yep, I mean, we’ve definitely talked since then but we haven’t properly hung out in a while. Dude, how have you been? You and the kids are killing it out there! I’m so proud!” JK smiled, his lip ring catching the shine of the overhead track lighting. 
Chan palmed the back of his neck, only slightly embarrassed at the compliment while briefly grabbing one ear before placing his water back on the living room table, “Ah man. Thanks. The kids work so hard, they deserve it.” 
JK shook his head, “You all deserve it. That includes you, Chan-ssi.” His eyes focused in on Chan, encouraging him to not argue in defiance of JK’s compliment. 
“I appreciate that. We all work hard.” 
JK glanced at Chan, a smirk crossing his lips before responding, “So, how are you and Y/n? I still cannot believe you snagged her.” 
Chan couldn’t help the small chuckle that bubbled up from his chest, the mere thought of you still gave him butterflies and made him nervous. How had he managed to snag you was still a mystery to him, but he was so thankful for you regardless. He tried not to make much sense of it because when he attempted to do so, he often found himself perplexed for hours, comparing and contrasting almost every detail of the last year and a half of your courting and the subsequent official ascension of the relationship. 
JK, surprisingly, had also been one of the first ones Chan had told about you. Well, of course after he talked with Lee Know and Changbin, who after meeting you only one time, were convinced you were the person Chan would eventually marry and only encouraged him to continue seeing you. Chan would hush them every time they made those comments, not wanting to even put that jinx out into the universe. Of course, he would want to make you his forever, but he knew the both of you needed just a bit more time together as boyfriend and girlfriend before he even thought about asking you to be his wife. 
“She’s fantastic,” The words left Chan a bit airy, almost as though he was describing how you managed to make him feel on a daily basis, “ We are doing great. She’s always challenging me and the kids, but is great at helping me decompress and she’s so, so creative. And well, utterly fucking beautiful.” 
JK smiled again, though his lips stayed softly pressed together before he spoke, “She’s good for you. I can see the difference.” 
Chan’s gaze shot up from his feet, where they had been planted while he spoke about you, “Really?” 
JK adjusted his position, throwing his legs over the edge of the couch as his feet firmly pressed against the stone flooring of his apartment, sitting up and leaning against the back as he did. 
“Yeah. You just have this air about you dude. You come across way less…encumbered with the weight of quite literally everything. Which, I suppose makes sense,” JK winked in Chan’s direction, “You’re not carrying it all yourself anymore.” 
Chan took a moment to really think about JK’s words and his gut response was to say that he was still the same old Chan he was before he met you. But, just as quickly as that impulsive assessment flew into his brain, it flew right out and was replaced with the knowledge that he was finally sharing the weight of life with…you. And sure, he let the kids carry some of the weight from time to time, but never wanted them to ever feel quite the same pressures he faced. He was the leader, after all, and that was his responsibility. But once you walked into his life, or rather he ran up to your’s, the weight eventually didn’t seem as heavy as it once did. And maybe that’s what JK really meant. 
Chan’s face had softened in thought, his eyes casting downwards once again as JK let a brief chuckle slice through the comfortable silence between the two men, “I mean look at you, dude. You’re head over fucking heels for this one. When’s the wedding?” 
JK always knew how to really wind Chan up, always saying just the kinds of things that would be only slightly out of pocket, but would still manage to make Chan flustered-or annoyed-depending on the context. 
“Dude, shut the fuck up. Its too early for that.” Chan threw a pillow at JK, who easily caught it with another laugh. 
“Just make sure I get an invite, yeah?” 
Chan rolled his eyes, “Yeah, yeah. Of course you’ll get an invite, you ass.” 
Both the boys laughed, sharing a moment of silence together before Chan was quickly reminded of something he wanted to ask JK about, “Y’know, that reminds me of something I wanted to ask you about.” 
JK perked up, “Alright. Hit me.” 
“So Y/n has this tattoo on the inside of her finger…on her right hand and I’m almost certain its the only one she’s never told me about. I remember seeing it one night when we were watching a movie on the couch. I was holding her hand and saw it and realized that it looked awfully familiar to one I’d seen before.” 
Chan took a sip of water before continuing, “I know you have something to do with this. So spill.” 
The almost instantaneous laugh that ripped from JK was jarring, causing Chan’s face to contort into a mixture of amusement and intense curiosity. 
Without missing a beat, JK leaned over the small distance between him and the coffee table, offering Chan a glimpse at the ring finger on his left hand, “Yeah, I know a thing or two about it.” 
Chan’s eyes focused in, brows pinching together while he really studied the small banana peel tattoo JK donned, “She’s got the banana.” 
Chan said it so matter of factly, not only because it was quite literally a matter of fact, but because it was so innocuous but also just really weird. Weird to the point that it drove Chan to to even ask JK about it in the first place.
“So she worked for us for almost 2 years, right?” JK inquired. 
Chan nodded his head, remaining silent. 
“Well, during that time she did mostly event coordination for us. So like, red carpet events, tour and hotel stuff, comebacks…all of that kind of stuff,” JK ran his hands through the mop of brown hair on his head, “Well, she also helped with the variety shows we do, but specifically the BTS one’s we did for Weverse and HYBE.” 
Chan signaled understanding, the look of amusement and curiosity only growing as JK continued. 
“We did this one show, and I can’t remember the exact details or…what the premise was now, but I was dressed up as a monkey.” 
Chan couldn’t help the boisterous cackle that slipped out of his lips, his hand immediately flying over his mouth at the thought of JK dressed up as a monkey, “A monkey?!”
It was JK’s turn to roll his eyes at Chan, looking at him through his brows, “Yeah. A monkey.” 
Chan was gasping for breath at this point, the mere thought of JK in such a predicament only creating a place just for this image in his brain to live rent free. JK, having finally tolerated enough of Chan’s squeaky laughter, threw a pillow at him and landed it square across Chan’s face. 
Chan flew backward a bit, caught off guard by the sudden feeling of fabric against his face. Chan caught the pillow and slammed it down across his lap as he forced himself to calm, realizing JK was waiting on him so he could continue, “Alright, alright. You can continue.” 
JK shook his head, “Well, a few days after we had done the recording for that episode, I came to find out it was her entire idea. Like, I’m talking the entire premise for the skit from start to finish. She even had me eating a fucking banana, bro.” 
Chan stifled the laughter that was threatening to spill, realizing that he didn’t want to be assaulted by anymore couch cushions, “That sounds so much like Y/n.” 
JK nodded, “Yeah. Well, when she found out I found out, I couldn’t stop giving her shit for it. It went on for months. At one point, I was calling her my Little Capuchin.” 
Chan’s eyes almost bulged out of their sockets as he threw his head back and finally allowed the laugh he was trying to suppress to come out. He threw both arms over his face as he let his head fall to the back of the couch’s edge. After a few moments, and after the heaving of Chan’s chest began to return to baseline, it was only then he sat back up, ruffling his hair before running both of his hands over his face, “So, the tattoo. How, how in the hell did that come about?” 
It was only then JK finally let out a brief fit of laugher himself, “A dare.” 
Chan’s eyes narrowed in on the man sat across from him, “A dare?” 
JK nodded, “It was close to her end with us as she was leaving HYBE to go do work elsewhere and we were all a little bit,” JK held up his pointer and thumb, almost pressing them together to exaggerate that they were the opposite of a little bit, “Drunk. It was then I suggested we get tattoos to signify not only the end of her time working with us, but one that would also make her laugh any time she looked at it. But Chan, when I tell you she was tipsy as hell, I’m honestly not exaggerating.” 
Chan had only heard the stories you’d told him about your time in college, driving several frat houses under the table, but he was certain you’d not divulged this particular piece of information about how you managed to acquire a banana tattoo.
He also knew that your days of drinking had come to an abrupt end once you began work in Korea freshly out of college, often times traveling back and forth to the states doing so. You soon realized mixing drinking of any kind and jet lag were things that should never go together. Fuck that, you’d told him. So, you only chose to drink on very, very rare occasions and only times when you knew you’d not be on a intercontinental flight. 
JK, noticing Chan’s slight confusion decided to provide a bit more clarification, “Let me preface that by saying, we were having a dinner celebration. Kind of like a send off. She’d only had 3 drinks, but for some reason they hit her hard.” 
Chan nodded, feeling a bit more clued in to the context of the situation, “So, it was a dare?” 
JK shook his head, “Yeah, kinda sorta? I mean, I was drunk, too. But I remember that I kept calling her Little Capuchin the entire evening and I also remember RM threatening to slap me if I wouldn’t stop.” 
JK shook his head, a smile blooming across his face briefly at the memory before he resumed, “I’m pretty sure it was just her and I that ended up going to see my artist because he was still in his shop late at night. I remember standing there with her in the parlor, debating with her on what to get when she basically shouted that we should get bananas.” 
Both Chan and JK erupted in laughter, agreeing that the entire situation most definitely sounded like you. 
JK took a sip of his water and set it back down on the living room table, “I told her I wasn’t going to get a banana tattooed on me and she dared me.” 
Chan held up his hand, waving it about to signal JK to pause, “Hold on. So she dared you?” 
JK confirmed with a quick nod, “Yup. And if I didn’t, she told me she’d post all the behind the scenes photos of us, including me in that monkey outfit, on Weverse. I balked at her but she told me HYBE had given her explicit permission to do whatever she wanted with the photos, even before the episode released. She took some real stupid photos of me, Chan.” 
JK palmed his forehead, shaking his head in the pithiest way possible before looking back up at Chan, “So there I was, getting a banana peel tattoo because she insisted I was the peel to her banana.” 
“I can only imagine the photos she took of you, JK.” Chan snorted, leaning his head against his fist which was propped up on several pillows. 
JK stayed quiet for a moment, shaking his head at Chan before something began to develop across his expression, “Let me get back at her.” 
Chan sat up, a bit perplexed at the request JK was propositioning, “What’dya mean?” 
“She doesn’t think you know a thing about this tattoo, right? Well, after she’d sobered up and I told her she basically blackmailed me into getting it, she was honestly mortified. She wouldn’t stop apologizing. It was only after I told her she was fine no less than 10 times and I wasn’t bothered in the slightest that she  finally decided to listen to me, but I know the whole thing still embarrasses the shit out of her. And thats probably why she’s never told you about it. Its small and she just assumes you’ve not noticed it yet, I bet.” JK explained, offering a very valid reason for Chan to agree to his request. 
“I mean, sounds entirely reasonable why she hasn’t then. So, what’s your idea?” 
———
Chan leaned down, pressing a curt peck on the tip of your nose as you were now unable to smash your face into his chest.
“So, she hasn’t told you about the tattoo?” JK’s voice trilled through the phone still snug in Chan’s hand. 
“Nope, sure hasn’t.” Chan’s less than impressed expression fell to you again, after he brought you down with him against the couch. You both fell against it with soft grunts, him forcing you to basically sit glued to his side. 
“Ugh! Do you both have to do this to me right now? Its just a stupid tattoo!” You bellowed, trying your best to turn inwards towards Chan to hide your face in any capacity you could. 
Both of the men began to laugh, almost in tandem. Almost like they both knew something you didn’t. Your suspicions only grew when Chan’s hold of you began to lessen to the point you were able to turn inwards and watch his face. 
He had set his phone down on the coffee table in front of you both, his face was red from laughter and slightly wet from the rather amused tears that quickly followed. You could only assume JK looked exceeding similar to the way your boyfriend did in that very moment. 
You sat up, straightening your posture and looked between the phone and your boyfriend several times before you realized the both of them were playing some sort of something with you still. 
“I cannot believe you two.” It was your turn to roll your eyes so hard, certain your retinas would detach as you scooted a few inches away from Chan and crossed your own arms. 
Chan heaved in a large amount of air, hearing what you said during the brief pause in both his and JK’s laughter that he turned to look at you. He noticed the considerable distance you had managed to make down the couch away from him as his laughter began to quell, JK’s soon followed suit. 
“Oh Little Capuchin, don’t be upset!” JK guffawed, himself being taken over by laughter once again. You glanced over to Chan, an eyebrow raised, and it was ever apparent he was suppressing additional laughter himself. 
“Fuck you, JK.” You felt the heat of embarrassment flood your face; your cheeks flushed a bright shade of crimson at the pet name you’d not heard in so long. 
“Aw, c’mon! You’re the banana to my peel!” He quipped, Chan only sporting one hell of an tickled expression. 
“I’m fucking done with you, two,” Your brows leveled in Chan’s direction, “You knew, didn’t you? He told you when you two hung out yesterday, didn’t he?” 
Chan only shrugged, a massive grin appearing on his lips, “I mean, we might’ve discussed it?”
“Bahng Christopher Chan! Jeon Jun-Kook! You both are menaces and I hate you both!” You stuck your nose up towards the ceiling, turning a quarter of the way away from Chan with your arms tightly crossed into one another. 
The boys continued their dumb giggling, Chan only taking just shy of a few more minutes before you heard him hang up the phone. The soft thud of his phone settling on the table was heard next, followed by the feeling of the couch dipping slightly behind you. 
Chan positioned himself behind you, pressing his chest to your back as his arms meandered their way around your midsection. His angular chin found purchase between your neck and shoulder before he spoke. 
“Baby girl, I knew you had that tattoo months and months ago. I had a feeling JK knew something about it because I remembered he had a very similar one to yours. I did ask him about it yesterday and he told me everything.” 
His words vibrated against your collarbone as he spoke and without any warning, his hold on you tightened as he fell backwards against the couch, pulling you on top of him still with your back against his chest. Instinctually, feeling like you were going to fall, you threw your hands out in a feeble attempt to catch yourself, but you weren’t falling. Chan had a strong hold of you. 
You let out a massive sigh, your chest pressing against the strength of Chan’s arms as you did before you broke the silence, “This is so fucking uncomfortable, Christopher.” You couldn’t help the exceptionally minuscule grin that began to creep its way through the hardened expression you were trying to maintain. 
“Well, seeing you genuinely embarrassed over something you shouldn’t feel embarrassed about is uncomfortable to me, baby girl.” He stated plainly, like this was a fact you should’ve known from Day 1. 
You turned your head towards his, which was now nestled into the spot between his neck and shoulder, your faces met briefly before you turned it back to look up at the ceiling, “God forbid.” 
Chan’s embrace stiffened as he applied a bit more pressure to your midsection, causing you to yelp out a large puff of air. 
The sound that emanated from you caused the both of you to erupt in your own fit of mindless cackling, “What kind of sound was that?!” 
Chan couldn’t help the yell of a laugh that flew from him as he managed to sit the both of you up on his lap, your hands bracing on either sides of his arms at the rather uncoordinated effort. Successful, nonetheless. 
“You squeezed the air out of me, Christopher!” You giggled, gently slapping the hand he had pressed against your abdomen. 
“I am sorry, baby girl! You okay?” He peppered a few kisses against your shoulder before placing one on your cheek. 
“I’m okay, Chris,” You paused as you wiggled your way off of his lap to sit next to him, though you left your legs draped over his knees, “You really got me going there for a second.” 
He brushed a few stray hairs out of your face, placing a few behind your ear, “Well, you set it up pretty well, baby. Walked right into it, even.” 
You rolled your eyes, not severely as last time and definitely lined with way more sarcasm that before, “Let me guess, it was JK’s idea?” 
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assessmenthelps · 8 months
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mysticmellowlove · 5 months
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Subby with Fem!Reader wife who is like the shit. I mean she is very well known around the world for her humanitarian philanthropic projects that she has made absolute bank from. With being the boss she is, she has to travel a lot for work and events.
But what about her poor little (he’s actually tall as hell) husband? She brings him along everywhere. Where ever she goes everyone will always see him there. Holding her hand in paparazzi pics, or standing on the corner of a stage when she is giving speeches.
He said he would be a househusband for her but because she has so much money(and let’s assume he has money from something) that she has house attendants and such so she doesn’t need him too. Instead, she puts him in charge of projects and basically makes him her lap dog that she carry’s in her Birkin everywhere she goes. He just loves being with her and traveling the world for work with her. What a dream.
note; just a lil something something
warnings; fem reader
You two are the world's power couple
With your organisation you usually were on the move all the time, getting to see the world in its most natural forms
Beautiful jungles, stunning deserts, the far reaches of the oceans, some of the most secluded islands... they were all in the palms of your hands.
You had been to Tuvalu most recently to assess the situation there, tornado victims in America, bushfires over in Australia... you had even raised awareness about oil drilling off the coasts of some of the most beautiful places on earth
And right next to you was your husband, a dedicated techie and an intense simp
He runs a tech start-up, one that tries to find alternatives to building and powering their products to lessen the strain on earth
This includes synthetic materials compared to earth's resources, implementing a solar-powered screen and trying to work towards an alternative to wind turbines in coastal areas.
That's why you two did collabs, it's why you two met.
You were drawn to his innovation and he was drawn to your passionate causes
Together you were almost unstoppable, two rich people who actually wanted to help others
Most of your shared money went to charities, building homes, helping the disadvantaged and putting in place plans for the future
Of course, you had a couple of vacation homes in some of your favourite places but those were also used as home bases for your travels.
UN meetings and WHO research, you two were the main funders of these branches and you attended nearly all of the meetings.
Sometimes things got busy though, so you'd send your devoted husband on a little trip
While you took care of things over in America he'd be over in Asia, networking with some of the best technology companies while also offering aid to humanitarian projects
There was hardly a moment when the two of you could actually be alone, either there was work to be done or your house's attendants would be buzzing away
When it was quiet though you two loved to spend some time together, just in each other's presence
He loved to massage you, not because it was an opportunity to touch you but because... it was an opportunity to touch you
His most favourite thing to do though was to rest his head on your tummy and let you play with his hair, he found it relaxing!
He'd let you do anything to him basically but you were always so gentle with him
He's a very spoilt man who gets almost everything he wants
All he has to do is give you puppy dog eyes and he's under the table eating you out while your heeled foot is stroking his cock
He loves being inside you as well, just cockwarming you
If you want him to do something all you have to do is ask but if you want to make things a little more interesting wear a short skirt and then ask, maybe bend over so he can see the swell of your ass
Such a needy man, he'd be on his knees begging for a taste
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hoe4sports · 2 months
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Ruesha Littlejohn | “Your love lifts me up like helium.”
A/N: Just wanted to do a little something with this song. Listen to it if you’d like, it was the inspo for this piece of art.
Trigger warning: Depression like feelings, mentions of feeling like there is no hope. Mentions of ending life. Panic attacks.
Two days prior to this moment, the Republic of Ireland had touched down in Australia. We had a week before the actual fifa program would start. It was great as it gave us time to explore as well as getting to know the humid climate down under. The practices were going great, and I was trying to fit in as much touristy things as I could. Ruesha on the other hand, had seen Katie and Caitlin Foord walk out of Katie’s hotelroom together at 5 in the morning leaving the gorgeous blonde once again crushed to pieces. And how was I doing you may wonder? Well, me and Ruesha was sharing a room. I weren’t getting much sleep, and for all the wrong reasons.
I was woken up just after midnight by Ruesha’s crying. “It was 6 years of my life” Ruesha sulked as I tried to comfort her again. She was leaning against me while we were both camping out on her bed. “6 years I’ll never get back..” she kept going. “Nobody is ever gonna love me like her, I���m too old now” she said as she sniffed and wiped her nose on her sleeves. “Ruesh, you’ll find someone” I said as I yawned. “What if she also cheats? I’m pathetic. I’m never gonna be enough for a lifetime” she sulked as I rolled my eyes. “Okay, maybe little Rushie needs to go to sleep, yeh? Here, I’ll help you.” I mumbled as I forced her to lay down on the soft mattress. “Sometimes feelings get bigger at nighttime. That’s why you should be gettin’ some sleep” I said as a stroked her hair. I tried to stand up slowly as she closed her eyes and her muscles relaxed, only to make it to the end of my bed before she started crying again. She hadn’t slept alone for 6 years, and for the last week she had been sleeping next to me. “Okay, pretty girl, how about we sleep next to eachother eh?” I said as I scooted in and held her as her sobs quietly stopped. She was fast asleep, even snoring as I kissed the top of her head. “I’m gonna get you through this Rushie”
The next nights were followed by the same crying, only it was escalating every night. Sobbing turned into crying turned into hysterically crying. Tonight was night 7, and tomorrow we were playing against Australia and Katie’s new girlfriend. Ruesha had skipped breakfast, lunch and dinner today, and I was worried. Her normally bright eyes were tired and heavy. Her clothes fitting visibly looser now than just 7 days ago. “I’m never gonna be happy again” . That was the first sign of her nightly crying. “Nobody will ever love me again, I’m unloveable.” she continued. “I don’t have a house, a job or even a girlfriend anymore” I sighted as I could hear her starting to rumble. “Ruesh, I think you need to see a psychologist.” she looked at me with fear in her eyes and she snapped immediately. “I don’t need no psychiatrist or whatever!”. She crossed her arms, and looked like I had just offered her drugs. “LEAVE ME ALONE!” She shouted as she threw a pillow at me. I couldn’t stand it anymore seeing as I was getting 3-4 hours sleep every night because of McBastard and her new toy. I turned my back towards Ruesha as I fell asleep covering my ear with a pillow to dim her cries.
I was woken up violently two hours later by Ruesha being out of breath. She was hyperventilating,ugly crying and was hysterical. She was screaming and wheezing at the same time shaking as if her last day had arrived. I assessed her for a few seconds to figure out what the hell was going on. “Rushie?” I asked carefully as she looked desperately at me. Oh my, she was having a full blown panic attack. I hopped out of bed and sprinted across the room to get to her as quickly as I could. I sat myself behind her and held her tight trying to decompress her. “Breathe Rushie, take a deep breath.” I encouraged as she shook her head. I had panic attacks as a young teen, and I used to drink something to get it to stop. I desperately looked around me, and grabbed the closest bottle I could find as I took the top off it. “Here, drink Ruesha. It will help, I promise!” I said as she shook her head once again. “N-no!’ I’m n-not! I-I-I don’t deserv-“ she cried as the panic continued and took over her breathing. Jesus, Katie has ruined her making her believe that she didn’t deserve fucking oxygen. “Hey, hey, you, come here Rue rue” I said as I sat myself infront of her. “Touch my hands please” I said as I reached out my hands. She grabbed my hands quickly as she panicked. “Squeeze my hands, as hard as you can” i commanded and she squeezed. “Now, put your hands on your head” i said as I demonstrated the movement hoping it would open her lungs up. She moved her hands and placed them on her head while still desperately trying to catch her breath. I scooted closer to her, so we our noses touched. “Ruesha, it’s okay. It’s just a panic attack. We are gonna get through this.” I said as I stared into her stunning eyes. I couldn’t even imagine how her eyes were so beautiful even at her worst. I reached out and pulled her into my lap, as I squeezed her hard moving the attention away for the breathing. I stroke her back with decent pressure and kept forcing her to breath in a square. After a few mins of breathing together, she calmed down and flopped toward me. Her body starved of energy. We sat there in silence while I held her tight.
“Rue?”
“Mm?”
“We are gonna get through this together. I’m not leaving you, ever.” I said as I kissed the top of her head. “But tomorrow morning, we are going to talk to the coaches about this, okay?” I said as she nodded and laid down.
She turned herself towards me laying in my warm embrace her face close to mine as she fell asleep. I waited a good 30 minutes before I dared to fall asleep fearing that she might start panicking again. I spent the time admiring her features. I could tell if even one freckle had moved. She was just so beautiful. When she slept soundly, I allowed myself some rest. But before i fell asleep I touched her peaceful face. I leaned in towards her ear and whispered;
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“When you hit the ground, I’ll be all you need Rue. I’ll love you everyday.”
*Ruesha pov*
I woke up at 7.30 confused. What had happened last night? I was confused as it hit me as a train. Panic attacks. Crying. Feeling like I didn’t deserve air. I turned around in the single bed finding Benedicte holding me as she slept soundly. She had been my bestfriend forever, even before I met Katie. I admired her before touching her face. It was first now that I noticed how beautiful her face was. Tan skin. Light pink full lips, all natural. Her light blue eyes shut as she slept. I decided to hold her as she turned around in her sleep as I realised that she had slept less than me as she was trying to fix what Katie had broken. I leaned in towards her ear and whispered; “Your love lifts me up like helium. I love you, B.»
Perhaps if I practiced while she slept, then I might work up the courage to tell her one day..
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By: Bernard Lane
Published: Apr 14, 2024
Nine of the 15 gender clinics in a landmark international survey for the Cass review have admitted they do not routinely collect outcome data on their young patients.
This survey, together with a new evaluation of treatment guidelines for gender dysphoria, gives unprecedented insights into the workings of gender clinics around the world offering puberty blockers and cross-sex hormones to minors.
In the 2022-23 survey, six clinics said they “routinely collected some outcome data”: one of these clinics gave no further detail; one noted the number of patients discontinuing treatment; another used measures of quality of life; two were taking part in cohort studies; and the sixth clinic repeated some baseline assessments. Nine clinics acknowledged “not routinely collecting outcome data.”
The report of the survey results1, published by researchers from the University of York earlier this month, identified clinics by country, not name. Of the clinics that took part, Australia and the Netherlands were prominent with five and four clinics respectively.
Poor data collection was central to the controversy over the London-based Tavistock youth gender clinic.
The Cass review had planned to run a data-linkage study—with help from adult gender clinics—to learn the outcomes of the Tavistock’s 9,000-odd former patients.
The missing long-term data would allow clinicians, young patients and parents to make informed decisions about treatment. The review said it was to be the largest study of its kind in the world.
However, six of the seven adult clinics refused to co-operate. One stated reason was that “the study outcomes focus on adverse health events, for which the clinics do not feel primarily responsible.”
Another adult clinic said, “The unintended outcome of the study is likely to be a high-profile national report that will be misinterpreted, misrepresented or actively used to harm patients and disrupt the work of practitioners across the gender dysphoria pathway.”
On April 12, however, The Times newspaper reported that the uncooperative adult clinics had “bowed to pressure to share [the] missing data”.
Mostly medical
In the York University international survey, ordered by the Cass review, all 15 youth gender clinics said they used a multi-disciplinary team, but researchers concluded there was a “paucity” of psychosocial therapy interventions such as psychotherapy or cognitive behaviour therapy. Five clinics did not offer any of these non-medical interventions in-house.
All gender clinics told researchers that “genital reconstructive surgery”—the creation of a pseudo vagina, for example—was “accessible only from age 18.” The youngest age for “masculinising chest surgery” (a double mastectomy) was reported as 16. In fact, there are documented cases in Australia of 15-year-olds approved for transgender mastectomy. Genital surgery is legally available to minors2 in Australia and practised in America.
“Only five clinics reported routine discussion of fertility3 preferences, and only two discussed sexuality4. Finland was the only country to report routinely assessing for history of trauma5,” the final Cass report says in its commentary on the survey.
In separate studies for the Cass review, three independent reviewers evaluated the quality of 21 guidelines for treatment of gender dysphoria in minors.
Included were international guidelines (from the Endocrine Society and the World Professional Association for Transgender Health or WPATH); documents from North America (for example, the 2018 policy statement from the American Academy of Pediatrics); from Europe (the guideline of the UK Royal College of Psychiatrists, for example, and Denmark’s); as well as guidelines from the Asia-Pacific and Africa.
“WPATH has been highly influential in directing international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour,” the Cass report says.
The York researchers chart patterns of “circular” cross-referencing between guidelines to create a misleading impression of consensus in favour of the medicalised “gender-affirming” treatment approach.
“The guideline appraisal raises serious questions about the reliability of current guidelines. Most guidelines have not followed the international standards for [rigorous and independent] guideline development. Few guidelines are informed by a systematic review of empirical evidence [the gold standard for assessing the evidence supporting a health intervention] and there is a lack of transparency about how recommendations were developed,” the Cass report says.
“Healthcare services and professionals should take into account the variable quality of published guidelines to support the management of children and young people experiencing gender dysphoria. The lack of independence in many national and regional guidelines, and the limited evidence-based underpinning current guidelines, should be considered when utilising these for practice.”
The Cass report says it is “imperative” that gender clinic staff be “cognisant of the limitations in relation to the evidence base and fully understand the knowns and the unknowns.”
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[ Chart: Number of youth gender clinic referrals over time by country. Source: Cass report ]
Bum steer
Staff at the Tavistock clinic misled patients and parents, or failed to correct their misconceptions, according to a new report from the Multi-Professional Review Group (MPRG) given oversight of treatment decisions from 2021.
These shortcomings of clinicians included playing down the extent of the unknowns of hormonal treatment; not explaining that puberty blockers are being used unlicensed and off-label; not challenging the reassuring but false parallel with the licensed use of puberty blockers for precocious (premature) puberty; not discussing the possibility that blockers will pause or slow psychosexual development; and not sharing figures showing the vast majority of children started on puberty blockers will go on to cross-sex hormones supposed to be taken lifelong.
The MPRG was also troubled by clinical documents showing misunderstanding of “the outcome of physical treatments” on the part of patients and parents.
In the York University study of treatment guidelines for gender dysphoria, only two were recommended for use by all three reviewers. These were recent, more cautious policies from Finland and Sweden. Both followed independent systematic reviews showing the evidence base for hormonal and surgical treatment of minors to be very weak and uncertain. Like the Cass review itself, the 2020 Finnish and 2022 Swedish guidelines recognise that puberty blockers are experimental and should not be routine treatment.
Although all the guidelines in the study agreed on the need for a multidisciplinary team to treat gender-distressed minors, the “most striking problem” shown by analysis of these documents was “the lack of any consensus6 on the purpose of the assessment process”, the Cass report says.
“Some guidelines were focused on diagnosis, some on… eligibility for hormones, some on psychosocial assessment, and some on readiness for medical interventions7.
“Only the Swedish and [the 2022] WPATH 8th version guidelines contain detail on the assessment process8. Both recommend that the duration, structure and content of the assessment be varied according to age, complexity and gender development.
“Very few guidelines recommend formal measures/clinical tools to assess gender dysphoria, and a separate analysis demonstrated that the formal measures that exist are poorly validated.”
Nor was there any consensus on “when psychological or hormonal interventions should be offered and on what basis.”
A survey of staff at the Tavistock clinic, undertaken as part of the Cass review, found specialists divided on whether or not “assessment should seek to make a differential diagnosis, ruling out other potential [non-gender9] causes of the child or young person’s distress.”
Arguing for an ambitious research program well beyond a possible clinical trial of puberty blockers, the Cass report says the field of youth gender dysphoria is one of “remarkably weak evidence” where health professionals are “afraid to openly discuss their views” because of vilification and bullying.
“Although some think the clinical approach should be based on a social justice model, the NHS works in an evidence-based way,” the report says.
“The gaps in the evidence base regarding all aspects of gender care for children and young people have been highlighted, from epidemiology through to assessment, diagnosis10 and intervention. It is troubling that so little is known about this cohort and their outcomes.
“Based on a single Dutch study, which suggested that puberty blockers may improve psychological wellbeing for a narrowly defined group of children with gender incongruence [or dysphoria], the practice spread at pace to other countries.
“Some practitioners abandoned normal clinical approaches to holistic assessment, which has meant that this group of [gender-distressed] young people have been exceptionalised compared to other young people with similarly complex presentations.”
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[ Chart: Age and sex on referral to the Tavistock clinic from 2018-2022. Source: Cass report ]
Who to trust?
The Cass report says the missing evidence “makes it difficult to provide adequate information on which a young person and their family can make an informed choice.”
“A trusted source of information is needed on all aspects of medical care, but in particular it is important to defuse/manage expectations that have been built up by claims about the efficacy of puberty blockers.
“The option to provide masculinising or feminising hormones from the age of 16 is available, but the [Cass] review would recommend an extremely cautious clinical approach and a strong clinical rationale for providing hormones before the age of 18. This would keep options open during this important developmental window, allowing time for management of any co-occurring [non-gender] conditions11, building of resilience, and fertility preservation, if required.”
The review stresses that “consent is more than just capacity and competence. It requires clinicians to ensure that the proposed intervention is clinically indicated as they have a duty to offer appropriate treatment. It also requires the patient to be provided with appropriate and sufficient information about the risks, benefits and expected outcomes of the treatment.”
“Assessing whether a hormone pathway is indicated is challenging. A formal diagnosis of gender dysphoria is frequently cited as a prerequisite for accessing hormone treatment. However, it is not reliably predictive of whether that young person will have long-standing gender incongruence in the future, or whether medical intervention will be the best option for them.”
Advocates for the gender-affirming approach assert that detransition and treatment regret are vanishingly rare, whereas suicide risk for those denied medical intervention is claimed to be very high.
The Cass report says: “It has been suggested that hormone treatment reduces the elevated risk of death by suicide in this population, but the evidence found did not support this conclusion.”
“The percentage of people treated with hormones who subsequently detransition remains unknown due to the lack of long-term follow-up studies, although there is suggestion that numbers are increasing.”
The report cites three reasons why the true extent of detransition is unlikely to be clear for some time—patients who decide medicalisation was a mistake may not wish to return to their former clinic to announce this fact; there is a post-treatment honeymoon period and clinicians suggest it may take 5-10 years before a decision to detransition; and the surge in patient numbers only began within the last decade.
Faced with uncertainty and a lack of good evidence, those with responsibility—from health ministers and hospital managers down to gender clinicians—rely on treatment guidelines supposed to advise on clinical practice according to the “best-available” evidence and expert opinion.
In the York University guideline analysis, the 21 documents were rated on six domains, the key two being the rigour of their development and their editorial independence.
“[Rigour] includes systematically searching the evidence, being clear about the link between recommendations and supporting evidence, and ensuring that health benefits, side effects and risks have been considered in formulating the recommendations,” the Cass report says.
Only the Finnish and Swedish guidelines scored above 50 per cent for rigour. Only these two documents, the Cass report says, link “the lack of robust evidence about medical treatments to a recommendation that treatments should be provided under a research framework or within a research clinic. They are also the only guidelines that have been informed by an ethical review conducted as part of the guideline development.”
“Most of the guidelines described insufficient evidence about the risks and benefits of medical treatment in adolescents, particularly in relation to long-term outcomes. Despite this, many then went on to cite this same evidence to recommend medical treatments,” the report says.
“Alternatively, they referred to other guidelines that recommend medical treatments as their basis for making the same recommendations. Early versions of two international guidelines, the Endocrine Society 2009 and WPATH 7th version guidelines, influenced nearly all the other guidelines.
“These two guidelines are also closely interlinked, with WPATH adopting Endocrine Society recommendations, and acting as a co-sponsor and providing input to drafts of the Endocrine Society guideline. The WPATH 8th version cited many of the other national and regional guidelines to support some of its recommendations, despite these guidelines having been considerably influenced by the WPATH 7th version.
“The circularity of this approach may explain why there has been an apparent consensus on key areas of practice despite the evidence being poor.”
Sometimes these gender-affirming guidelines seek to buttress a strong evidence claim with a citation to a study that is weak or involves a different patient group.
The Cass report notes that, “The WPATH 8th version’s narrative on gender-affirming medical treatment for adolescents does not reference its own systematic review [of the evidence], but instead states: ‘Despite the slowly growing body of evidence supporting the effectiveness of early medical intervention, the number of studies is still low, and there are few outcome studies that follow youth into adulthood. Therefore, a systematic review regarding outcomes of treatment in adolescents is not possible’.”
Despite WPATH insisting such an evidence review is not possible, this is precisely what health authorities and experts have undertaken since 2019 in several jurisdictions—Finland, Sweden, the UK National Institute for Health and Care Excellence, Florida, Germany, and University of York research commissioned by the Cass review.
Yet in the 8th and current version of its guideline, WPATH makes the confident statement that, “There is strong evidence demonstrating the benefits in quality of life and well-being of gender-affirming treatments, including endocrine and surgical procedures… Gender-affirming interventions are based on decades of clinical experience and research; therefore, they are not considered experimental, cosmetic, or for the mere convenience of a patient. They are safe and effective at reducing gender incongruence and gender dysphoria”.
But WPATH “overstates the strength of the evidence” for its treatment recommendations, the Cass report says.
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1 In the survey, there was one clinic each from Belgium, Denmark, Finland, Northern Ireland, Norway and Spain. The response rate was 38 per cent.
2 In Australia there is no good public data on trans surgery for minors.
3 Early puberty blockers followed by cross-sex hormones are expected to sterilise young people and may also impair future sexual function.
4 Some sizeable proportion of gender clinic patients might grow up in healthy bodies and accept their same-sex attraction were it not for trans medicalisation, according to testimony from detransitioners, clinicians’ reports and data.
5 Trauma from a history of sexual abuse, for example, or exposure to domestic violence is thought to be among the many possible underlying causes of what presents as gender dysphoria. The Multi-Professional Review Group (MPRG), given oversight of Tavistock treatment decisions from 2021-23, was troubled by the lack of curiosity by the clinic’s staff about the effect of a child’s “physical or mental illness within the family, abusive or addictive environments, bereavement, cultural or religious background, etc.”
6 Critics of the “gender-affirming” treatment approach say it is not mainstream medicine because the “trans child” in effect self-diagnoses while clinicians avoid differential diagnosis and attribute mental health disorders and other pre-existing issues to a “transphobic” society.
7 “In most cases [at the Tavistock clinic] children and parents were asking to progress on to puberty blockers from the very first appointment”, according to the MPRG.
8 In the MPRG’s opinion, the patient notes from the Tavistock “rarely provide a structured history or physical assessment, however the submissions to the MPRG suggest that the children have a wide range of childhood, familial and congenital conditions.”
9 Once referred to the Tavistock, patients typically were no longer seen by child and adolescent mental health services.
10 According to the MPRG, gender dysphoria in the diagnostic manual DSM-5 “has a low threshold based on overlapping criteria, and is likely to create false positives. Young people who do not go on to have an enduring cross-sex gender identity may have met the criteria in childhood. And early to mid-childhood social transition may be influential in maintaining adherence to the criteria. Sex role and gender expression stereotyping is present within the diagnostic criteria—preferred toys, clothes, etc—not reflecting that many toys, games and activities [today] are less exclusively gendered than in previous decades.”
11 The MPRG said it was “notable that until the child and family’s first appointment at [the Tavistock] they have received little, if any, support from health, social care, or education professionals. Most children and parents have felt isolated and desperate for support and have therefore turned for information to the media and online resources, with many accessing LGBTQ+ and [gender dysphoria] support groups or private providers which appear to be mainly ‘affirmative’ in nature, and children and families have moved forward with social transition. This history/journey is rarely examined closely by [Tavistock clinicians] for signs of difficulty [or] regret.”
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Critics have described "gender affirming care" - that is, sex-trait modification - as "medical experimentation." This is incorrect. In a medical experiment, you actually collect data and monitor the participants in the experiment. They don't do that. They're cowboys violating all medical ethics - "first, do no harm" - for ideology, money or both.
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rjzimmerman · 12 days
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Excerpt from this story from The Revelator:
How do you get people to care about something they can’t see?
That has always presented a challenge in environmental conservation messaging, where a consumer’s decisions can affect people or species on the other side of the planet. It can be hard to connect the dots between a candy bar containing palm oil sold in Indiana to the destruction of an orangutan’s habitat in Indonesia, or how purchasing a cheeseburger in Nebraska contributes to deforestation of the Amazon.
While advocates have had some notable successes communicating these threats, promoting similar efforts to protect ocean life has proven even harder — even for communities that live right next to those waters.
Two of the biggest threats to marine biodiversity come from unsustainable overfishing and habitat loss — both of which also threaten the food security and livelihoods of coastal communities.
To fight these threats, governments have increasingly turned to creating marine protected areas (MPAs), essentially underwater national parks that protect habitats and organisms that live within them.
What can we do to build local support for MPAs and enhance their success? Wootton and her colleagues tried using an innovative collection of virtual and visual tools to persuade people of the benefits of an MPA. It focused on beloved marine species that would be protected by an MPA network, which the researchers called the “Fab Five.”
Wootton and a team of marine scientists, in partnership with First Nations Sea Country peoples, wanted to assess what gets community members to care about the ocean and support an MPA. Working in South Australia, which has 26 commonwealth or state marine parks, they picked five iconic local species who benefit from the MPA, including the Australian sea lion (Neophoca cinerea), giant Australian cuttlefish (Sepia apama), white-bellied sea eagle (Haliaeetus leucogaster), great white shark (Carcharodon carcharias), and southern right whale (Eubalaena australis).
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