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The walls are tall and foreboding. The Old Mormon Fort. It took a few days of traveling across the Mojave, and across fiend territory to get here. On a mission for medical care, you had been determined, however, to make it here. Lost in thought, a confident ghoul cheerfully welcomes you, bringing you back into reality.
“Howdy! You look a bit frazzled, hon. What can the Followers do to help?”
Your mouth suddenly feels like it has a wad of cotton in it, and the words feel stuck in your chest. You’d been waiting for this day for so long, but when push came to shove you froze up.
“I have, uh, an… appointment,” You finished, finally finding your voice.
“That’s wonderful! So often people come stumbling in, which is all well and good, but we are glad to have you nonetheless. Who do you have an appointment with?”
“Dr. Gannon, I think. I feel like I got that wrong.”
The ghoul breaks into a gentle, knowing smile.
”That sounds about right.” She gives you an up and down, briefly. Softer than before, she asserts, “You must be [Y/N]. Don’t worry, he’s not gonna bite.”
A wave of relief washes over you. After a lifetime of being called the wrong name entirely, the feeling of being called [Y/N] was pure bliss. It would never get old, you decided.
“You can wait over here until you hear your name called. Good luck, hun!” The ghoul gestures to a small seating area, which was composed of miscellaneous seating, including a dingy lawn chair, a park bench, an old rocker, and a kitchen chair. The rocker seems like the best bet, you can rock back and forth.
A voice calls out in your direction.
“[Y/N]? I’m looking for [Y/N,” The person who accompanies this voice is tall, blonde, and a bit stocky. They suddenly turn and face you.
“Hello! Are you [Y/N]?” It sounds almost like a song. He has a gentle and kind face.
You look back at him, nervous as can be. “Yep, that’s me. I uh. I’m here for that. Uhm. Appointment thing. I think the office was supposed to mail you something,”
He seems so sure of himself, confident, and relaxed.
“That’s great! I’m Arcade Gannon. It's so nice to finally meet you. I’ve heard a lot about you. Why don’t you follow me, and we can get to chatting.”
He beacons you follow him across the open yard, sunlight streaming in. As you pass by the stained and well-worn tents, you hope that you won’t get laughed out of the place. For starters, you weren’t actively bleeding, which is a step-up than most out in the Wasteland. However, you do get the feeling that this is the right spot to be, despite your anxiety.
“Well, this is our spot!” He gingerly lifts the tent flap of the most southwestern tent. “After you.”
You gently duck under, and he follows in your wake. There’s a few chairs, a desk, and a cotton cot with a fresh fabric cover. The room is sparse, yet is remarkably clean for a wasteland area. Despite the dirt floor, everything else looks scrubbed clean, with an attention to detail. A small metal rolling tray is carefully knolled out with several instruments and tools.
Gesturing broadly, Dr. Gannon notes, “Feel free to sit wherever. I get that some people feel weird about sitting on a cot, especially for something that isn’t a full procedure or anything.”
You decide that you don’t mind sitting on the cot, and sit facing him directly.
“So. You’re [Y/N],” Dr. Gannon starts, as if it was both a question, and a statement, wanting to hear more about you.
“Yeah, that’s me. I heard that the Followers can help with… a lot of kinds of stuff. It almost feels like magic or something. I dunno. I-” You pause, expecting to be cut off.
He says nothing. He gently smiles at you, waiting patiently. Expectantly.
“I heard that there were medical treatments for people like me,” You finish.
Arcade takes a deep breath in. “Yes, that’s right. The Followers of the Apocalypse try to help out everyone here in the wasteland, especially when it comes to medical care. I myself especially focus on the most vulnerable people here in the Mojave.”
“Dr. Gannon,” You begin, not sure where to start.
“You can call me Arcade, [Y/N]. It’s really okay. It feels less stuffy that way.”
“Alright, then, Arcade. I think somewhere in my early teens, something felt really off about me. Like, It’s sort of hard to explain. Even as a kid, thinking back, it felt like I had missed a memo or something. Something didn’t click, it didn’t gel, it just. Well. I dunno. It’s hard to sort of explain.”
“What did it feel like? Try.”
“Well, I remember the Followers had a doctor out visit to the area when I was a little kid. He had been there to help give some medical care, and to give out a few lectures and medical supplies and stuff. One of those talks, they had gotten all of the kids in the area, and brought them into a room or something. I don’t remember all of the details. This doctor told us about all kinds of stuff– why we shouldn’t play with the barrels that have the nuclear symbol, how to test water sources, and what to do if a friend gets a radscorpion bite. That kind of stuff.”
Arcade nods, silently listening. He seems so kind, and empathetic. You continue.
“Well, after some of the more basic stuff, he had asked to have all of the boys leave a bit, and then they would come back to have a special chat. There was a sinking pit in my stomach. I didn’t like watching them leave, I felt like an alien or an imposter or something. Once all of the boys had left, he explained that the girls would be going through puberty soon. He described how we would have periods, and our breasts would grow, and how we’d change. I felt so sick, like I had radiation poisoning or something. I remember I felt just this immense sense of panic and dread. I kepting on thinking, would that really truly happen to me?”
You leave out the part when you throw up in the trash can outside the room. That didn’t feel exactly necessary to the point you were trying to make.
Arcade silently nods again, letting you take the space you need.
“I didn’t want to be a girl. Was this really what I had to do, to go through? I don’t know what another option would be, I felt so trapped. I kept this feeling, whatever it was, down for so long. No matter how much I tried to be a girly-girl, It didn’t work. Ignoring it didn’t work either.”
Arcade sighs. He responds thoughtfully, “That sounds really exhausting. That feeling, the one that you are describing, sounds something like what we call Gender Dysphoria. It means that the way that you perceive your body, and your gender is different from the features that you were born with. It’s not a dirty thing to feel, or wrong. It may just be how you feel. Does that sound familiar to you at all?”
You nod, your eyes staring at your boots. You dig your heel into the dirt, letting small amounts of dirt quietly puff up around it. It did sound familiar. Why on earth was it so hard to talk about? You sit in silence, thinking of how to respond. Sheepishly, you are able to bring a few thoughts together.
“Yeah. The doctor that I spoke to at the Vegas followers clinic said it might be something like that. I felt like I was going to be called crazy or something like that.”
“I’m glad that you were able to go to our Vegas outpost clinic. That takes a lot of courage to do.”
“Yeah. I guess so. It just feels so new. The clinic sent me here– they told me that you have a lot of experience with this kind of stuff.”
“I suppose that I do. You know,” He pauses. You look up to him. He’s closing his eyes, pondering his next words for a moment.
“When I was younger… they didn’t see me for who I was either. They had a lot of strict rules about when men and women were, not a lot of wiggle room to be expressive. Let alone if you didn’t fall into just one category. After I got older, and left the…well, the place where I grew up, I felt much better. I could be myself completely. No more hiding.”
He sighs again, signaling the end of his thought. He seems to be contemplating something.
You are at a loss of words, wanting to comfort him. He was just like you? There was someone, right next to you, who had been where you had. It felt nice, to know that you weren’t alone. In a snap judgement, you start to stand up.
He puts out a hand, gesturing for you to resume sitting. “No, no, I’m alright. Just got caught up in the moment I suppose.”
“When you are out in the Mojave, it’s freeing. With that nuclear bomb, it erased a lot of things. Lives, research, homes, a lot of loss and grief. Horrifying, terrible stuff. But it also erased a lot of the social bounds that existed before. That’s a mixed bag, to say the least. We don’t have to go to endless egg-salad dinner parties and chat about the price of gasoline. However, we don’t get to have the same level of expected civility with most strangers. Do you see what I mean? Not all of it went away either. I imagine there’s still a lot of belief about what makes a man a man, or any of that garbage.
Now that there’s a lot less social pressure to act in such rigid ways, at least a lot less than before. I’d say there’s more of a degree of freedom of expression. In the Mojave Wasteland, you can be whoever you’d like to be. We have medicines and technologies, like you had mentioned before, that may make you feel more comfortable in your own skin.”
An ecstatic rush of excitement bubbles up inside you. It feels fizzy, almost like a Nuka Cola on a warm afternoon.
“How does it work? How does it happen?”
“One of the therapies we have is called ‘hormone replacement’. The reason why you went through puberty the way that you did is due to the hormone estrogen. It tells your body to grow your chest, and to start your menstrual cycle, and those sorts of changes. For those assigned males at birth, they have a hormone called testosterone. Are you following?”
“Yeah, I think so. That sounds kinda familiar.”
“If you had testosterone in your system, you’d start to have a lot of those secondary sex characteristics, the ones that you have in puberty, that are the same as males assigned at birth would have. This means your voice would slowly drop, you’d have more hair all over, you may even have facial hair. It’s likely that your menstrual cycle, your period, would stop too. How does that feel? What are your thoughts?” He is scanning your face for a response. His eyes are kind, and he has a gentle, knowing look.
It’s a lot to take in. Knowing that you could finally have the voice you’d dreamed of, and even a beard. You feel your eyes sting as they welled up with tears. It’s too many emotions, all at once. The tears start to stream quietly down your face.
Arcade soundlessly stands up from his chair, and sits next to you on the cot. He places his arm around you, encircling you in a hug. He smells of peppermint, disinfectant, and clean linen. “Woah, woah woah. Maybe that was maybe too much at once, huh?”
At this point, you are full-on sobbing. Your face is buried in his chest, feeling like a little kid.
“It’s completely alright to have a lot of feelings come up.”
“I didn’t know that this was… even an option. I don’t- I - well I-” There just aren’t words. The two of you sit in silence.
After what feels like ages, you are able to compose yourself. Arcade pours you a cup of clean water, a rarity elsewhere in the Mojave. As you wipe your tears away, he starts again. “So, what do you say? You don’t have to make any decisions at all today. You can think it over.”
“No, no. I’d wanted this ever since that presentation, I just didn’t know it even existed. I have so much to catch up on. Can I switch right now? Would you do it today? Change me, that is?”
“Woah there cowboy. Hold the reins a second. I love the enthusiasm– it’s great. So, hormone therapy is not speedy. It’s a type of medication that you take, for some people that’s until they get the desired changes they like, and for others, they are on it their entire lives, to keep up the changes they like, such as stopping your menstrual period. Some of the changes that testosterone brings are permanent, like your voice dropping, or growth in other spots. Other things, like your period stopping, or fat redistribution aren’t permanent, and that’ll mean you have to take it continuously if you want them to stay that way.”
A slightly dejected “Oh,” is all you have in response.
“I know, sport. It’s hard to wait, after hearing about something so cool, huh? I’d also have to mention that testosterone can’t decrease your chest, or give you any extra appendages." Arcade suddenly smiles. “Luckily, we do have treatments for those too. Julie Farkass, one of our other doctors here can perform surgeries that will help you feel more comfortable. You don’t have to ever have something like that done, or have testosterone, you can have as many or as few treatments in whatever combination would make you feel most like you”
Knowing that you had the option to get rid of your damn chest felt like a weight being lifted. “That’s beyond amazing. I want to try all of it!” you exclaim.
“I had a feeling you’d say that. Well, today I can start you on testosterone, and show you how to give yourself the medicine. How does that sound?”
You gleefully nod.
“I’d like to bring your attention to the supplies that make the magic happen. Are you ready to have some magic?” He giggles.
“Oh hell yeah!”
Arcade gestures to a carefully knolled arrangement of medical tools for the demonstration, something functionally unseen in the wasteland otherwise. There are needles, clean rags, a bottle of something alcoholic, a tidy bin, and a bandage.
“Testosterone is administered, that means taken, by injection. While it’s no picnic, it beats having periods, and it gets easier with time. I promise! It may look scary, but considering all that goes on in the wasteland, it’s not so bad,” He chuckles.
“Alrighty! So a few starting things. First, you’re going to want to find a spot that will be quiet and that you can go to at the same time each week. Maybe that looks like a tent, or some cleared out building. Although it’s hard to keep clean in the Mojave, I want you to wash your hands as best you can– avoiding irradiated water or dirty water if you can. One of our nurses can send you with some sanitizer, clean water or hooch that didn’t pass drinking muster. Whichever is in stock!"
He taps the vial. "We’ll also send you along with your prescription– make sure it isn’t cloudy or expired. We have our scientists working hard to make sure that it’s up to snuff. If anything looks off, come let us know, and I’ll be happy to switch it out. It’ll be good for future testing, even if we can’t use it in people. We will also give you sets of needles, and some of the old VaultTec sharps containers.
You follow? Pardon the pun.”
He pauses for a moment, and you feel a little dizzy. Maybe it’s the excitement from the possibilities. Maybe it’s the sheer volume of information. Maybe it’s the nervousness of the needles. You’d been mauled by radroach before, so a needle probably wouldn’t be a drop in the ocean. The radroach attack had also been more welcome than the dysphoria you had been feeling.
“Okay: also an important thing.” He continues, almost sternly with a hint of silliness, “I know that here in the wasteland it’s pretty common these days, but it’s important that you never, ever share a needle, or reuse one. If you do, you can contract many bloodborne illnesses, and that would be no-Bueno. I’d prefer to keep everyone as healthy as possible!”
He turns back to the carefully arranged tray.
“Alrighty, back to the main show. You’re gonna take the cap off of the vial here” He finagles the cap off with one hand. Impressive! “Then, you’re gonna wanna clean the stopper. I’m using a clean rag that’s been dipped in botched hooch, but they used to use alcohol swabs. He gently fans above the vial, “Let it dry,” he explains, “Take the top of your 18g needle, and pull it like this, until you get to your magic prescription dose. Then, stab it gently onto the top of your vial like this.”
Positioning the prescription bottle sideways, he expertly pierces the top, directly through the center. “Push in…” he pushes all of the air into the vial, and quickly inverts the vial upside down, his fingers trapping the needle and vial delicately like two mutated spiders.
“Annnnd….. Pull again,” He’s drawn up the correct dose, and gently knocks the air bubbles out of the vial, drawing in slightly and then drawing back to your dose. “After that, all you have to do is replace the 18g needle with a new one– it’s a bit dull now from drawing up your medication. And a dull needle is never a fun one, as I always say…Ta-Da!”
Presenting the prepared shot like a prize, he grins triumphantly, “That’s the complicated part done. How do you feel? Is that making sense?”
You can’t help but grin back. He’s clearly enamored by medicine, and teaching seems to fill him with such an energy that feels as contagious as the radiation flu!
“It’s all making sense!”
“Wonderful” He smiles warmly. “Now it’s time for the stabby bit.”
You feel a little sick to your stomach, but really excited.
“Again, I promise it’s not that bad. There are loads of spots to take your injection–in your arm, in your tummy, in your thigh, even in your rear– it usually hurts the least there. Anywhere squishable usually works though. Did you have a preference?”
“Not really.”
You truly don’t. It had never crossed your mind before.
“Well, I’m a thigh man myself— well, I mean, I usually inject myself in my thigh.” He quickly corrects. “We could always try that. How does that sound?”
“That sounds fine to me.” You blush just a little. Gingerly, you raise your shorts a few inches, preparing for the impending prick, closing your eyes.
“That’s not quite it, I’m afraid. If it’s okay with you, I’d like to show you, so you'd have to keep your eyes open, sport." He produces another rag that’s been dipped in hooch.
It’s cold and a little rough. Still, there’s something almost intimate about it. He’s a very professional doctor though, and doesn’t let anything slip. There’s a moment of silence as the patch of thigh dries in the air. The scent of alcohol lingers, and so does the feeling of excitement.
He pinches a tiny portion of your thigh, and with a quick motion, he pokes you directly at a 90 degree angle, plunging the medication in. It barely registers–the amount of injections he gives a day must make him some sort of needle god. In that moment, you start to dream of what Testosterone might do for you. You could finally be yourself.
Arcade seems to sense that you are lost in thought, and leaves you to it, disposing of the needle safely, and pressing a clean bandage onto your injection site.
“Well, that about covers it. Did you have any questions?”
You feel pretty confident about this new chapter of your life. No matter how hard it gets out in the wild wasteland, you know that you can truly be yourself, and that you'd have people who can support you.
"Thank you. Thank you for all of this!"
"I'm so truly honored to help. Well son, I have to attend to a few more patients today, but when you check out with our lovely staff, they can get you hooked up with your medication, and schedule you for more fun stuff in the future. I hope to see you around, kid." With a bright smile, he gently squeezes your shoulder before exiting the tent, leaving you alone for a moment to bask in the excitement of the afternoon's events.