iiinova — where your digital self keeps evolving

Erika R. Shira, LMHC, MT-BC @erikashira.com · 11/09/2026

Still not fixed. Still no answers why it’s acceptable for MassHealth to have programmed their website to flag providers with a non-cis gender. @gladlaw.bsky.social @massago.bsky.social @massgovernor.bsky.social @aclum.bsky.social

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 28/08/2026

I appreciate that the @americanredcross.bsky.social plays music at their sites to muffle screening questions for privacy, but I recommend they review the literature as to what aspects of music increase/decrease heart rate. I was ineligible for a pulse 2 bpm high taken while fast dance music blasted.

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Eric Michael Garcia @ericmgarcia.bsky.social · 26/07/2026

In honor of #ADA36, who is a person with a disability in history most people don’t know but should?

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 26/07/2026

PLEASE SHARE 🏳️‍⚧️ 🏳️‍🌈 LGBTQ Dungeons and Dragons! 🧚🏿‍♀️ 🔮 🧙🏾 Ages ~12-17 Zoom 5pm-6:30pm EDT Mondays Our 5-week campaign starting tomorrow is low on players, and I hate to disappoint our teen DM. No experience necessary. $10 a week, able to slide as low as you need. email erika at erikashira dot com

Image is a player's handbook with polyhedral dice lying on it and two buttons that say "be gay do crimes" with a rainbow D20 and "be gay play DND" also with a rainbow D20. The buttons and the photo are from Etsy shop TeaWeltzer who I am not in any way affiliated with but whose stuff I think is really cool and highly recommend.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 20/07/2026

More LGBTQDND coming up! By request, I've added a section that works better for European/Middle East time zones as well. Please feel free to share in your spaces. blog.erikashira.com/2026/07/low-...

blog.erikashira.com

Low-cost Zoom D&D groups for tweens and teens starting soon

Image: roleplaying dice and stones reading "magic" and "strength," lying on a six-color pride flag Groups meet weekly on Zoom for 90 minut...

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eeka @eeka1313.bsky.social · 07/07/2026

LGBTQDND! Please share.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 07/07/2026

Summer D&D groups starting soon. Ages 8-12 and 13-17. Open to people anywhere in the world. Sliding scale available. Also hiring more teen/young adult dungeon masters to co-lead future groups with me. blog.erikashira.com/2026/07/low-...

blog.erikashira.com

Low-cost Zoom D&D groups for tweens and teens starting soon

Image: roleplaying dice and stones reading "magic" and "strength," lying on a six-color pride flag Groups meet weekly on Zoom for 90 minut...

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Alejandra Caraballo @esqueer.net · 01/07/2026

The term "biological sex" was adopted widely only in the last decade as a reaction to mainstream acceptance of trans people. It was rarely if ever used before that. By any metric, from legislative usage to search query usage, it's plainly evident this is a novel term only made popular by the right.

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aslynn is just a ghoul 👻 @aslynnromano.com · 23/10/2025

ahhhhh my trade name acceptance went through! Neurospace: Affirming Psychiatry & Counseling is now officially a DBA for my company, Aslynn J. Romano PLLC do you have a therapist? do they know I exist? would you like to tell them, especially if you live in a state I am licensed in? thanks so much!

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 30/05/2026

This is a somewhat valid concern (I’ve written about this; will link below), but we have plenty of high-support-needs autistics with sufficient language to serve as the experts in this area. We don’t need neurotypical “autism mommies” speaking for autistic folks.

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Johnathan Perkins @johnathanperk.bsky.social · 22/05/2026

White people truly believe the distinction of whether they’ve just said something racist is open to debate and opinion. I truly cannot fathom being white and ARGUING with a Black person who’s just called out my racism.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 21/05/2026

PLEASE SHARE: There is currently no waitlist for several of my weekly low-cost LGBTQ youth Zoom groups. These spaces are particularly needed for our youth right now. Note that no records are kept and youth register with just a first name. blog.erikashira.com/2025/06/no-w...

blog.erikashira.com

Some sections of LGBTQ youth groups currently have no waitlist

Alt: heavily edited photo of rainbow umbrellas and banners at a pride parade weekly Zoom groups for LGBTQ youth 8-18 open to folks located ...

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 16/05/2026

And it's just an ableist construct. It doesn't actually provide useful shorthand for support needs. I know many autistic folks (and some folks with other diagnoses) who require 24/7 significant support, can't go places alone, and don't have intellectual disability/can do academics/employment. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 15/05/2026

Young people running conferences: I love the enthusiasm and the tech skills, but I beg of you, stop using our e-mail boxes like your personal social media feed! We do not not need several e-mails per day full of hashtags and gimmicks begging us to "upgrade our ticket" and all this. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 28/04/2026

100%. Professionals, STOP ENCOURAGING THIS. The MA state agency that handles adoptions is particularly awful with "the parent is bringing up 'adult matters' that the child hasn't initiated" when foster/kinship/adoptive parents mention information that is the child's right to have.

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Thinking Person's Guide to Autism @thinkingautism.com · 15/04/2026

“We recommend listening to neurodivergent people to find out about their preferences and using the words that they prefer, instead of solely being led by traditions which have developed without the input of the communities we are referring to.” theconversation.com/what-neurodi... #neurodiversity

theconversation.com

What neurodivergent people really think about the words used to describe them

Research reveals a clear preference for how neurodivergent adults want to be described, though not everyone agrees.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 15/04/2026

So I have e-mails that confirm that the behavioral health network Masshealth uses has intentionally programmed their website to flag clinicians with a none/other/nonbinary or trans status on their CAQH profile and give an error message. Folks are OK with this?

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 08/04/2026

So Carelon has written back after months and said that, yes, their website is programmed to flag clinicians with a none/other/nonbinary or trans status on their CAQH profile and not let them apply, but they assure me they are committed to inclusion and there was nothing queerphobic here.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 20/03/2026

I swear, if I see another flyer for a social event for disabled folks that either requires people to attend with a caregiver or to stick with the group the entire time regardless of needs... Can people not wrap their heads around how people with the same disability can have varying skills? 1/

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Chantal James @chantalalive.blacksky.app · 18/03/2026

Suicide prevention is not telling suicidal people to call a number for cops to take them to the psych ward. It’s being community for people. People suffer alone. You abandon your sad & mentally ill & lonely friends because they bum you out. We’re the ones with the duty of caring for each other.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 19/03/2026

Yes! When I first got trained in writing gender letters 20+ years ago, the aim was to gatekeep that the person had absolutely no psychiatric disability. It's shifted some, but not enough. It's ridiculous, because it's not the standard we use for deciding someone can't make other life decisions. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 18/03/2026

It also likely reflects low expectations. People constantly say this in response to observing basic language skills or self-help skills that are typically displayed in early childhood. It also often means “I expected a disabled person to be disruptive/unpleasant and you weren’t.”

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 12/03/2026

Is any action being taken re: state agencies that still refuse to have three gender/sex options years after Massachusetts enacted this? I know several of the state disability agencies refuse to update in addition to Masshealth. @gladlaw.bsky.social @masstpc.org @massgovernor.bsky.social

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 11/03/2026

So I've finally gotten someone to respond. They had a workaround for the broken code. But apparently to take Masshealth you must disclose your "biological gender." That's...not a thing. And pretty sure it violates MA laws as we can self-select three legal sexes. @massago.bsky.social @masstpc.org

Screenshot from Carelon provider application, showing a required field of "biological gender" with dropdowns of female and male.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 10/03/2026

Can't get anyone to even respond anymore. Provider website for Carelon (thing that manages Masshealth mental health) has broken code in it so I can't get past the first page. @massgovernor.bsky.social @massgov.bsky.social any interest in MH providers actually being able to see Masshealth kids?

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 06/03/2026

Two weeks later, still can't log onto this thing. Carelon and Availity are sending me back and forth to each other and blaming each other. I'm an available provider trying to see some people with Masshealth who are on my waitlist, but I can't. @massgovernor.bsky.social we need single payer.

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Eric Michael Garcia @ericmgarcia.bsky.social · 24/02/2026

NEW: Just weeks after the FDA removed its webpage warning about fake autism "Cures" that could harm autistic kids, RFK Jr. nominated numerous members to the government's autism advisory committee that promote those same crank cures. www.independent.co.uk/news/world/a...

independent.co.uk

FDA removes warning of crank autism cures–RFK Jr. appoints their promoters

Robert F KennedyJr says his new appointees will help him ‘fight autism.’ But, Eric Garcia writes, many of them also contributed to his presidential campaign

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Gravel Influencer @gravelinfluencer.bsky.social · 24/02/2026

People in Massachusetts should know that Seth Moulton is still standing by his transphobic comments about youth sports. In this interview with @catsonacouch.bsky.social he says he didn't "intend" to hurt anyone but never apologizes for what he said. 1/

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thee agnes de buffle @vanadiumzest.bsky.social · 23/02/2026

disabled people apologize all the time for unintentionally causing harm. you would know this if you didn’t become an ableist warrior yesterday because you think it provides an excuse for spewing racial slurs. it doesn’t. listen to more disabled people.

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Bratty Kat @brattykat.bsky.social · 22/02/2026

It doesn’t matter if it’s something that can’t be helped When harm is done, then effort needs to be made to make amends. And it’s actually ableist to treat a disabled person like a child and exempt us from making those amends

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 23/02/2026

Yes. If someone's condition puts other people at risk, they sometimes don't get to be places. HOWEVER, we should also understand that people with Tourette's can experience intrusions/compulsions re: the worst possible thing to say in a situation. It isn't an indication of someone's "true thoughts."

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 19/02/2026

@wbur.org likes to run stories about how there's a shortage of clinicians who take MassHealth. I've spent hours of today messaging with the help desk at Availity, which you have to use to interact with Carelon, which handles most of Masshealth's behavioral health. They all blame each other. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 28/12/2025

100% agreed with how this shouldn’t be put out there in mass media as clickbait nonsense, but hypotonia is much more prevalent in autistic toddlers/preschoolers than in the general population, and lordosis/APT posture is one of the markers in hypotonia evaluation.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 23/12/2025

Well-meaning white women™: You are doing disabled kids, especially Black and brown ones, a disservice when you make these posts about how enlightened you are that you are completely unfazed when a dysregulated child is swearing and destructive. This is some privileged nonsense. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 21/12/2025

This is so frustrating in the context of an agency that already doesn't remotely follow its own meager policies regarding respecting gender and sexuality of children or parents. Most workers I interview for court evals tell me they would never ask kids or parents about gender or sexual orientation.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 02/12/2025

PSA: Chanukah is a minor holiday and all we do is light candles. It's well-meaning to offer to cancel meetings and such, but it's also frustrating coming from organizations that don't ever acknowledge Shabbat or the major holidays when we ARE forbidden to work. 1/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 12/11/2025

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

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 12/11/2025

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/

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Governor Maura Healey @massgovernor.bsky.social · 28/10/2025

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.

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

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jae holzman @jael.bsky.social · 27/10/2025

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

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Thinking Person's Guide to Autism @thinkingautism.com · 25/10/2025

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...

thinkingautismguide.com

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.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 25/10/2025

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/

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Thinking Person's Guide to Autism @thinkingautism.com · 23/10/2025

"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

facebook.com

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....

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jenn m. jackson @jennmjacksonphd.bsky.social · 22/10/2025

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.

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 21/10/2025

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/

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Erika R. Shira, LMHC, MT-BC @erikashira.com · 18/10/2025

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.

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Transhealth @ourtranshealth.bsky.social · 16/10/2025

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

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Brian Liberge/Freddie (she/he) 🔜 NotAConCon @brianliberge.bsky.social · 17/10/2025

10/17, 4 PM. Outside Fenway Community Health. We stand together and make it clear that we will not abandon our trans youth and young adults. We do not bend a knee to the unlawful threats of wannabe tyrants. This is Boston. We do not comply in advance.

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