Erika R. Shira, LMHC, MT-BC

I currently have a few slots for urgent needs and can accommodate a few with non-urgent needs in the next few weeks.

Also, @4transfutures.bsky.social is collecting stories of people who've been affected. Particularly families who were not actually contacted other than the mass mailing and families of kids who were cut off of progestins prescribed for ob/gyn reasons: please reach out!

Kid didn't even claim to have a specific disorder. "Anxiety" is just a human experience. When in the history of the planet has anyone claimed to experience it but actually was completely chill? That's not a thing. Anyway, now the kid has a diagnosis. I should probably give the school one too. 2/2

I'm used to families having a school or provider freak out that they're mentioning a condition that's been suggested but not 100% formally diagnosed. But this is a new one; school livid that kid claims to have anxiety because no formal diagnosis on file. Self report is 5000% valid for anxiety. 1/

With alt

@alt-text.bsky.social

YES! There is a huge difference between "we are looking to reduce ableism" (which is inherent in all spaces) and "someone called us ableist are we ableist?"

Yep. A place my family is affiliated with gets these, coming from people who normally don't believe that gender/race/etc. play into interactions whatsoever, yet strangely require these things on their "anonymous" surveys. Our family is the only one among thousands with our particular intersections.

Donald Trump is choosing to cut off S AP benefits for 1 million people in Massachusetts.

More than a million people in MA rely on SNAP — mostly children, seniors, and people with disabilities.
 
None of them will get the help they need on November 1 if Donald Trump refuses to act. 
 
The money is there. The hunger is real. Cutting off SNAP is a choice — and it’s the wrong one.

a trans girl in vermont was kicked off her swimming team and committed suicide and at the very same time, the discourse in d.c. today is about whether the democratic party should’ve abandoned her sooner in order to win votes

a day in an american life

"Not everybody enjoys physical activity": A qualitative social media stufy of the barriers experienced by autistic adults Andrew M. Colombo-Dougovito, Scott W. T. McNamara, Henny Kupferstein, A. Josephine Blagrave "Not everybody enjoys physical activity": A qualitative social media stufy of the barriers experienced by au...

We hope this one does everyone justice: paperpile.com/shared/sJ6WH...

We. Get. Tired! Recovering From Situational Autistic Burnout — THINKING PERSON'S GUIDE TO AUTISM Parents need to know that autistic kids get TIRED. We autistics need rest, more frequently and in greater durations than non-autistic people.

How can autistic people recover from short-turn autistic burnout? @mx-joyner.bsky.social has very specific, tried-and-true strategies that might help you or your autistic loved one, at TPGA (and yes this includes kids and adults with high support needs).

thinkingautismguide.com/2025/10/we-g...

Resist blanket rules that certain types of illness or injury are required for absences or accommodations -- this can make folks feel super anxious when they feel they may end up unable to do something but won't be excused. Work with folks supportively to determine what they can and can't handle. 7/7

We can support folks by validating they do experience something distressing even if they can't determine what. "I feel off" is enough. Sometimes just knowing someone else is aware and checking in can help. 6/

It's really about finding a balance between when we need to reassure ourselves and try work through unclear discomfort and when we need to make peace with deciding we really can't deal even if we can't determine exactly what's wrong. 5/

This is of course not entirely reliable, as some neurodivergent folks have autonomic systems that are so off that they won't have the typical symptoms (my kid's OT said to remind people that kid is so low tone and hypermobile most injuries won't appear swollen on exam). 4/

For people who tend to panic and overrespond, it can be helpful to practice self-validation, that what I feel is valid and I have a brain that does this, while also reality-testing that a serious medical issue would generally involve a fever, swelling, and other signs besides "feeling wrong." 3/

Some strategies that help some people are doing a body scan to narrow down the area of the body and type of issue, using a list of things that might need fixing (Kelly Mahler has a good list of these) and taking a moment to really tune in and assess how strong the alarm bells are. 2/

For many with interoception difficulties, these signals all register simply as "something is wrong." "I'm a little dehydrated" or "I need to use the restroom" or "my sleeves are too tight" all feel the same. Having appendicitis or a stress fracture might also feel the same as these things. 1/

Autie-biographical Comics Flashback Friday: Originally posted January 24th, 2021 When you hide your child's diagnosis you're doing them zero favours. You're not saving them from being bullied or isolated. Trust me, as a late....

"When you're open about [your child's autism] diagnosis, not only will they have an answer as to why they behave the way that they do, but they'll be more accepting of themselves."

TY @autiebiographical.bsky.social, image description in post.

www.facebook.com/autiebiograp... #autism #autistic

I had no idea this was...such a thing.

Scrolled to make sure this was here!

I want more people to care that SNAP benefits are being cut off on November 1. 40% of SNAP beneficiaries are children. This is callous and vile.

🎵 Kol ha'olam kulo...tzfardeah gadola... 🎵

Remember that people may need to use electronic devices in order to read or write, and these usually aren't a dedicated device. "Put it all away and use analog everything" isn't inclusive, and it's not even typical for nondisabled folks in 2025. Teach mindful electronics use, not "put it away." 3/3

Also, if you are giving study tips or mindfulness tips, don't just teach "put devices away" -- make sure to include how to use focus modes or similar so people who need apps available can set it up to only have access to their magnifier and DBT reminders app, or whatever it is they need. 2/

Normalize saying "please put away electronic devices unless being used for a disability, and please silence electronic devices to the extent possible."

People shouldn't need to explain they have it out because they are using a magnifier, insulin pump, AAC, hearing device controls, and so forth. 1/

Please share. I’ve got several places that have confirmed they can prescribe and a few that can serve as the primary care provider. Several Fenway patients confirm they’ve still gotten no communication beyond the original portal message.

Hi thank you so much for weighing in. So, a lot of people weren’t even given that. They got a portal message and that’s it.

Person holding sign that says- You are not alone. we’re got you. Transhealth logo. Transhealth Renains Committed and Open for Care. Response to Fenway Health’s Move to Stop Gender-affirming Care for People Under 19

Transhealth has released a statement in response to Fenway Health’s decision to stop gender-affirming care for people under the age of 19.

Read our statement at transhealth.org/transhealth-remains-committed-and-open-for-care