Erika R. Shira, LMHC, MT-BC
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erikashira.com
Erika R. Shira, LMHC, MT-BC
@erikashira.com
Boston MA USA. Account for professional and related content. Posts are my own unapologetically leftist views and are not any kind of advice. www.erikashira.com
I currently have a few slots for urgent needs and can accommodate a few with non-urgent needs in the next few weeks.
PLEASE SHARE: Able to provide neurodiversity-affirming diagnostic evals, accommodation letters, gender letters, safety plans, advocacy, second opinions, etc. to those living in Massachusetts with employer-sponsored insurance. Not part of a health network -- nothing can be seen by other providers.
Need documentation? Now accepting most private insurances (and trying desperately to take MassHealth with no success yet) for gender letters, disability documentation, and evaluations and consults of most anything within my scope.

www.erikashira.com/2011/02/2.html
November 12, 2025 at 7:16 PM
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/
November 12, 2025 at 5:37 PM
With alt
November 3, 2025 at 5:51 PM
Reposted by Erika R. Shira, LMHC, MT-BC
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.
October 28, 2025 at 2:11 PM
Reposted by Erika R. Shira, LMHC, MT-BC
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
October 27, 2025 at 11:27 PM
Reposted by Erika R. Shira, LMHC, MT-BC
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...
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.
thinkingautismguide.com
October 25, 2025 at 7:19 PM
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/
Autistic teens are nearly 2x as likely to have an anxiety disorder—not only due to social pressures and sensory overload, but also bc of interoception differences (ability to tune into internal bodily signals like toileting urges, or hunger). TY @craeioe.bsky.social:

crae.ioe.ac.uk/experiences-...
Experiences of interoception and anxiety in autistic adolescents
A reflexive thematic analysis Kiera Adams, Jonahs Smith, Mary Brown, Geoff Bird, and Polly Waite (2025) research gate We all know the feeling: your heart races before a big event, your stomach twis…
crae.ioe.ac.uk
October 25, 2025 at 7:48 PM
Reposted by Erika R. Shira, LMHC, MT-BC
"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
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....
www.facebook.com
October 23, 2025 at 6:38 PM
Reposted by Erika R. Shira, LMHC, MT-BC
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.
October 22, 2025 at 12:33 AM
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/
October 21, 2025 at 4:04 PM
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.
Posting here as I find places that can get minors in quickly for refills of blockers or HRT (as well as not-for-gender obgyn medications that Fenway is refusing to prescribe to minors any longer). Finding queer-friendly PCPs with openings is proving harder, but working on that as well.
October 18, 2025 at 2:00 AM
Reposted by Erika R. Shira, LMHC, MT-BC
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
October 16, 2025 at 7:11 PM
Reposted by Erika R. Shira, LMHC, MT-BC
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.
October 16, 2025 at 11:02 PM
Reposted by Erika R. Shira, LMHC, MT-BC
Boston - THIS IS TOMORROW!

Let’s get out there and let Fenway Health know how we feel about their cowardly abandonment of one of the most vulnerable trans populations!
October 16, 2025 at 11:15 PM
Reposted by Erika R. Shira, LMHC, MT-BC
Hi Erika, We are accepting new patients 21 & under for both gender-affirming primary care and specialty care- in-person and telehealth. We are about to open specialty gender-affirming care for adults as well. & we offer surgical letters. For more info folks should visit transhealth.org/new-patients
New Patients - Transhealth
Providers of gender-affirming primary care, pediatric care, mental healthcare, gender-affirming hormone therapy (GAHT), and surgical letters.
transhealth.org
October 17, 2025 at 1:16 AM
Reposted by Erika R. Shira, LMHC, MT-BC
www.trueuclinic.com

- All telehealth
- All private pay
- Confirmed they will see minors with parental consent
- Confirmed they will do obgyn hormonal meds
Gender-Affirming Hormone Therapy Online | True U Clinic
Start HRT from the safety and comfort of your home. True U Clinic offers inclusive, informed-consent hormone therapy for trans, nonbinary, and gender-diverse people — no gatekeeping, no insurance requ...
www.trueuclinic.com
October 16, 2025 at 8:28 PM
Reposted by Erika R. Shira, LMHC, MT-BC
www.syzygyhealth.org/faq

- Prescribes HRT ages 16+
- Telehealth available
- Takes Masshealth and most others
- Prescribes a range of obgyn meds and should be able to do progesterone etc. but I haven't confirmed
- Does not appear to do blockers/younger kids
FAQ — Syzygy Health
www.syzygyhealth.org
October 16, 2025 at 8:22 PM
Reposted by Erika R. Shira, LMHC, MT-BC
Posting here as I find places that can get minors in quickly for refills of blockers or HRT (as well as not-for-gender obgyn medications that Fenway is refusing to prescribe to minors any longer). Finding queer-friendly PCPs with openings is proving harder, but working on that as well.
October 16, 2025 at 8:19 PM
Reposted by Erika R. Shira, LMHC, MT-BC
I have a couple of other practices that will do telehealth visits to write bridge prescriptions. Masshealth and most everything else accepted. They don’t want to be listed publicly but schedule a consult through my practice website and I can get you referred ASAP.
October 16, 2025 at 11:30 PM
Posting here as I find places that can get minors in quickly for refills of blockers or HRT (as well as not-for-gender obgyn medications that Fenway is refusing to prescribe to minors any longer). Finding queer-friendly PCPs with openings is proving harder, but working on that as well.
October 16, 2025 at 8:19 PM
Reposted by Erika R. Shira, LMHC, MT-BC
With an email on Indigenous Peoples' Day and no ideas about resources besides "We'll call you soon"

to say what?

where will they go?

abrupt d/c of these meds can result in severe side effects, including suicide & also things like premature osteoporosis

these are prescription medications, fellas!
Under federal pressure, Fenway Health ends gender-affirming medical care for trans patients under 19 - The Boston Globe
The community clinic, long a key institution for the LGBTQ+ community, treated 5,000 patients transgender patients in 2023, although its unclear how many were minors.
www.bostonglobe.com
October 15, 2025 at 6:17 PM
Update: @clrhenrysantana.bsky.social's office is on it. #medsky prescribers licensed in MA, please let his office know and let me know if you can squeeze some kids in for refills ASAP (or if you're a trans-friendly/neurodivergent-friendly primary care provider who can take some kids on longer term).
So @boslgbtq.bsky.social @mayorwu.boston.gov @wutrain.bsky.social why is there no coordinated emergency response? A bunch of us providers are trying to get kids into places, but the health centers don't believe the news that Fenway bailed, or they're afraid to prescribe now that Fenway won't.
1. In a major capitulation to Trump, Fenway Health, a center ostensibly dedicated to LGBTQ+ healthcare, has ended its trans care program under 19.

It could have fought for its patients. It chose instead to roll over.

Community members are devastated.

Subscribe to support our journalism.
October 15, 2025 at 5:41 PM
Finally, someone from the city speaks up after two days. Proud to have supported @clrhenrysantana.bsky.social and looking forward to his office assisting us with emergency coordination.
October 15, 2025 at 5:00 PM