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Mar 17Liked by Róisín Michaux

Meloni is not just a conservative, she is from the far right. And south Italy is not just a nice place to live, that’s where I come from and it’s not a place I would recomand for women to live in. I am a radical feminist, I fight against trans activism as much as you do. But please, it’s not a fairy tale for women first, and for southerners as well : less job, les money, more poverty and more Mafia… Young people here are still leaving to go north or to go live abroad because of unemployment. We deserve to be treated well by foreigners and fellows feminists please.

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Mar 17Liked by Róisín Michaux

I'm starting a new comment here because this is a different topic and the other one got long. I was struck by the part of the discussion where you discussed who the activists were in Italy, and it was said that the doctors actually were the activists as opposed to outside activists converting doctors. My impression is somewhat different, just from listening to your story. It seems that these doctors are certainly, shall we say, engaged in a niche practice. But, it also sounds like they weren't terribly public about promoting themselves and their efforts since they weren't well known... Except to parents. It sounds to me like the parents are the activists here. If they weren't seeking doctors to prescribe for their kids, the doctors wouldn't be doing this work. It sounds to me like a case where a couple doctors saw a small but passionate "market" for a particular type of practice and decided to provide it, and that the parents and teens were already determined to find such a practice. Sort of like how illegal drugs always seem to be dealt everywhere, at least in the US. Not because anyone is actively promoting them, but more because a customer determined to get something seeks out someone who wants to provide it.

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This is interesting to listen to as a health care worker from the US, because our system works very differently. Here, many drugs are routinely prescribed "off-label," which here means a drug that is approved by our FDA for use, but not in the population or for the indication in which it's prescribed. There is nothing illegal about it and in fact most drugs are only approved for one or maybe a few indications but are often used for many more. It's particularly common in pediatrics because it's relatively uncommon for drugs of any kind to be studied in children before approval. After approval for one indication, it's rare for drug companies to go through the difficulty and spend the money to obtain additional approvals because the drug can be used without them. In fact, most drugs prescribed for children here are not approved for use in children at all. If that makes sense. I hadn't realized that "off-label" meant something different in countries with nationalized health systems.

Overall I'm getting the impression that doctors here have much more latitude than they have in national health systems and that therefore a privatized system has far fewer safeguards, although arguably some advancements in medicine are made by doctors who try different regimens with their patients, have success and spread the word through case studies. The differences between systems are fascinating to me to learn about.

I also hadn't realized that it was such a scandal in some other Western countries for kids-or anyone-to be prescribed blockers or hormones without therapy. Here, that's a very controversial subject, but it's extremely uncommon for any medications to be regulated to the extent that anything like that could or would be restricted like that. In fact off hand the only drug I can think of for which therapy is required by the government is methadone when used for drug addicts. While certain hospitals or programs or clinics for various conditions may have their own requirements, patients are free to just go elsewhere.

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