Since we _don't_ have that ... the existing approximations don't really seem like a good idea for me, all things considered?
-As a computer programmer, I have learned to fear complexity and dependencies. If you've ever wondered why it seems like [all software is buggy and terrible](https://danluu.com/everything-is-broken/), it's because _no one knows what they're doing_. Each individual programmer and engineer understands their _piece_ of the system well enough that companies can ship products that mostly do what they claim, but there's a lot of chaos and despair where the pieces don't quite fit, and no one knows why. (Or _someone_ could figure it out in a reasonable amount of time, but the user who is suffering and in pain has no way of buying their attention.)
+As a computer programmer, I have learned to fear complexity and dependencies. If you've ever wondered why it seems like [all software is buggy and terrible](https://danluu.com/everything-is-broken/), it's because _no one knows what they're doing_. Each individual programmer and engineer understands their _piece_ of the system well enough that companies can ship products that mostly do what they claim, but there's a lot of chaos and despair where the pieces don't quite fit, and no one knows why. (Maybe _someone_ could figure it out in a reasonable amount of time, but the user who is suffering and in pain has no way of buying their attention.)
-But computing is the _easy_ case, a universe entirely of human design, of worlds that can be made and unmade on a whim (when that whim is specified in sufficient detail). Contrast that to the unfathomable messiness of _biology_, and I think I have reason to be wary of signing up to be a _lifelong medical patient_. Not out of any particular distrust of doctors and biomedical engineers, but out of respect that their jobs—not necessarily the set of tasks they do to stay do to stay employed at actually existing hospitals, but the idealized forms of _their jobs_—are _much harder_ than almost anyone realizes.
+But computing is the _easy_ case, a universe entirely of human design, of worlds that can be made and unmade on a whim (when that whim is specified in sufficient detail). Contrast that to the unfathomable messiness of _biology_, and I think I have reason to be wary of signing up to be a _lifelong medical patient_. Not out of any particular distrust of doctors and biomedical engineers, but out of respect that their jobs—not necessarily the set of tasks they do to stay employed at actually existing hospitals and corporations, but the idealized Platonic forms of _their jobs_—are _much harder_ than almost anyone realizes.
_All_ drugs have side-effects; _all_ surgeries have the potential for complications. Through centuries of trial and error (where "error" means suffering and disfigurement and death), our civilization has accumulated a suite of hacks for which the benefits seem to exceed the costs (given circumstances you would prefer not to face in the first place).
-In a miracle of science, someone made the observations to notice that human females have higher levels of [(8R,9S,13S,14S,17S)-13-Methyl-6,7,8,9,11,12,14,15,16,17-decahydrocyclopenta[a]phenanthrene-3,17-diol](https://en.wikipedia.org/wiki/Estradiol) than human males. In a glorious exhibition of mad science, someone did the experiments to notice that artificially synthesizing that ...-iol and administering it to males successfully pushes some aspects of their phenotype in the female direction [TODO: describe effects and risks of HRT]
+In a miracle of science, someone made the observations to notice that human females have higher levels of [(8R,9S,13S,14S,17S)-13-Methyl-6,7,8,9,11,12,14,15,16,17-decahydrocyclopenta[a]phenanthrene-3,17-diol](https://en.wikipedia.org/wiki/Estradiol) than human males. In a glorious exhibition of mad science, someone did the experiments to notice that artificially synthesizing that ...-iol and administering it to males successfully pushes some aspects of their phenotype in the female direction: [breast growth and fat redistribution and agreeableness—at the cost of increased risk of venous thromboembolism and osteoporosis](https://srconstantin.github.io/2016/10/06/cross-sex-hormone-therapy.html).
For all that my body is disappointingly male and therefore ugly, it _works_. It makes the hormones that it needs to function without me needing to dissolve a pill under my tongue every day—without saddling me with extra dependencies on the supply chains that make the pills, or the professional apparatus to draw my blood and tell me what pills to take—without me needing to know what "hormones" _are_.
For all that my penis is boring at best and annoying at worst, it _works_. The organ does the things that it's designed to do; it lets me pee while standing up, and reward myself while pretending that it isn't there.
-Did you know that trans women have to dilate their neovagina after surgery? Yeah. There are these glass tubes of various widths, and you're supposed to stick them up there for a [TODO: details] I'm told that there are important technical reasons why it would be objectively wrong to use the phrase _open wound_ in this situation, but the body doesn't know the important technical reasons and you still need to dilate.
+Did you know that trans women [have to dilate their neovagina after bottom surgery](https://www.mtfsurgery.net/dilation.htm)? Yeah. There are these hard tubes of various widths, and you're supposed to stick them up there multiple times a day after surgery (and weekly indefinitely) to prevent the cavity from losing depth. I'm told that there are important technical reasons why it would be objectively wrong to use the phrase _open wound_ in this situation, but the body doesn't know the important technical reasons and you still need to dilate.
I am glad that these interventions _exist_ for the people who are brave and desperate enough to need them. But given that I'm not that desperate and not that brave, would it not be wiser to trust the proverb and not look a gift man in the mouth?
My [laser hair removal sessions](/tag/lasers/) were ... arguably a waste of money, since I still have to shave even after 13 treatments?—but it at least got the density of my ugly–gross facial hair down a bit. Trying it was definitely a _smart move_ given what I knew at the time, and I _just might_ be rich enough and disgusted-by-facial-hair enough to go back for more density-reduction. (Electrolysis gets better results than laser, but it's more expensive and a lot more painful.)
-Men get cosmetic surgery sometimes, right? I guess if I grew a little braver and a little more desperate, I could imagine wanting to research if and how "mild" facial feminization surgery is a thing—just, selfishly, to be happier with my reflection ...
+People get cosmetic surgery sometimes for non-sex-change-related reasons. I guess if I grew a little braver and a little more desperate, I could imagine wanting to research if and how "mild" facial feminization surgery is a thing—just, selfishly, to be happier with my reflection ...
-But _staying_ on HRT indefinitely—doesn't seem like a smart move? Even though I would be happy with the fat-redistribution effects, I don't expect the health effects to be net-positive, and I don't expect the psychological effects to be net-desirable (even if I wasn't self-aware enough to notice much besides libido change during my five-month experiment).
+But _staying_ on HRT indefinitely—doesn't seem like a smart move? Even though I would be happy with the fat-redistribution effects, I don't expect the health effects to be net-positive, and I don't expect the psychological effects to be net-desirable (even if I [wasn't](/2017/Jan/hormones-day-33/) [self-aware](/2017/Jul/whats-my-motivation-or-hormones-day-89/) enough to notice much besides libido change during my five-month experiment).
-And _social_ transition—really doesn't seem like a smart move? If we _actually had_ magical perfect transformation technology, that would happen automatically (people are pretty good at noticing each other's sex), and I would expect to be very happy. (After some socio-psychological adjustment period; remember, in the real world, I didn't even manage to change _nicknames_.) But given that we _don't_ have magical perfect transformation technology, the main objection here is that I _don't expect to pull off_ that kind of ... perma-[LARP](https://en.wikipedia.org/wiki/Live_action_role-playing_game). I'm sure it would be _possible_ to do well with a lot of work ([voice training for trans women](https://en.wikipedia.org/wiki/Voice_therapy_(transgender)#Voice_feminization) is a thing!), but it's not clear why I would want to put in all that work, when overall, my life is fundamentally _okay_ as ... a man? An adult human male? As a matter of objective _fact_, which doesn't care about my feelings.
+And _social_ transition—really doesn't seem like a smart move? If we _actually had_ magical perfect transformation technology, that would happen automatically (people are pretty good at noticing each other's sex), and I would expect to be very happy. (After some socio-psychological adjustment period; remember, in the real world, I didn't even manage to change _nicknames_.) But given that we _don't_ have magical perfect transformation technology, the main objection here is that I _don't expect to pull off_ that kind of ... perma-[LARP](https://en.wikipedia.org/wiki/Live_action_role-playing_game). I mean _really_ pull it off—everyone in Berkeley and Portland will be very careful to respect your pronouns the minute you come out, but [_they will be lying_](/2019/Dec/reply-to-ozymandias-on-fully-consensual-gender/), and I know because I lie—saying "she" when [the intelligent social web](https://www.lesswrong.com/posts/AqbWna2S85pFTsHH4/the-intelligent-social-web) requires it, even when I don't really believe it.
+
+It's definitely [_possible_ to pass alright](/2018/Oct/the-information-theory-of-passing/) with a lot of work ([voice training for trans women](https://en.wikipedia.org/wiki/Voice_therapy_(transgender)#Voice_feminization) is a thing!), but it's not clear why I would want to put in all that work, when overall, my life is fundamentally _okay_ as ... a man? An adult human male? As a matter of objective fact, which doesn't care about my beautiful pure sacred self-identity feelings.
How dumb would I have to think you are, to expect you not to notice?
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