Medications

"I'm ready," you say, extending your arm. "No more questions. Let's do this—I want to get to the pharmacy before it gets late."

Dr. Okafor nods, already moving. "Efficient. I like that." She wraps the tourniquet around your upper arm with practiced speed, tapping the inside of your elbow to find the vein. "Make a fist for me."

You clench your hand. The needle slides in—a quick, clean pinch—and you watch the dark red fill the first vial with a strange sense of detachment. This is your blood. Your baseline. The last measurement of the hormones that have been running your body wrong for twenty-one years.

Last time this blood looks like this, you think.

Dr. Okafor fills three vials total, labeling each with efficient strokes of her pen. She presses a cotton ball to the puncture site and slides a band-aid over it.

"Hold pressure for a minute. Results back in forty-eight hours—I'll call if anything's off." She's already writing the prescription, her handwriting quick and angular on the pad. "Estradiol patch, point-one milligrams daily. Change it every three and a half days—twice a week, essentially. Apply to clean, dry skin on your abdomen or upper thigh, rotate sites. Spiro, one hundred milligrams daily, take with food."

She tears the prescription from the pad and hands it to you.

"Ridgewood Family Pharmacy is directly across the street. They're open until six. If you have questions about side effects, call the clinic—Faye at the front desk can usually answer most things, and I return calls within twenty-four hours." She stands, extending her hand again. "Three-month follow-up. Sooner if anything concerns you. And Riley?"

"Yeah?"

"The first few weeks, you might not feel different at all. That's normal. The changes are slow and cumulative. Don't measure yourself against a clock." Her smile is brief but warm. "You've waited long enough. A few more weeks won't undo what you've already decided."

You shake her hand. Your fingers are slightly trembling.

"Thank you, Dr. Okafor."

"Thank yourself for showing up."

You walk back through the hallway, past the waiting room where the young man with paint-stained jeans has been replaced by an older woman reading a magazine. Faye Whitaker—the receptionist with the close-cropped hair—processes your sliding scale paperwork with minimal fuss, takes your thirty-five dollars in cash, and hands you a receipt.

"First time's always weird," she says, almost offhand, as she slides the receipt across. "Gets easier."

You blink. She's not making eye contact—just typing something into her computer—but the acknowledgment lands somewhere soft in your chest.

"Thanks," you manage.

Outside, the October air is cool against your face. The pharmacy is literally across the street—a small brick building with a green awning and a window display of vitamins. You cross at the light, prescription folded in your crossbody bag, and push through the door.

The pharmacist—a balding man with wire-rimmed glasses—takes your prescription without comment. "Estradiol and spironolactone. Insurance?"

"No. Paying cash."

He types something. "Forty-seven eighty-two."

You hand over the cash from your bag—the remainder of what Margot advanced you. The pharmacist bags two boxes and an amber prescription bottle, staples the receipt to the bag, and slides it across the counter.

"Patch application instructions are in the box. Take the spiro with food. Any questions, call the number on the bottle."

You take the bag. It weighs almost nothing.

This is it. This is the thing that changes everything.

You step back outside into the late afternoon light, the pharmacy bag clutched against your chest, and open your phone to order an Uber home.