Tag Archives: Health insurance

How to Succeed as a Millennial Without Really Trying.

Patchwork careers, debt and an indie soundtrack.

The Kids Are Not Alright

I DON’T KNOW ABOUT YOU, but I grew up being told that if I did well in school, participated in a slew of extracurricular activities, volunteered, didn’t “mess around” too much with the opposite sex, didn’t spend all my money on clothes and got into a good college, that I’d be “alright.

So, I checked off all those things and more on my Path to Success Checklist! and then—life happened.

When sophomore year of college I got sick. Really sick. It would take three years to figure out what was making me sick (spoiler: rotting appendix) but the point is, when LIFE interrupted my plan, suddenly that was it.

Game over.

Even as I was moaning in agony on a stretcher in the emergency room, I was still dutifully conjugating Russian verbs and sending reassuring emails to my professors, who were alarmed when I suddenly *gasp* missed a class. “I’m sure it’s nothing!” I told them, my lips curled up in a painful grimace, “I’ll be back in no time! Send me assignments, I can still do work. I can still be good. I can still matter. Nothing, and I mean nothing, is going to ruin this for me! Because I worked hard for this so nothing will take it away! Right?”

Well, that’s the thing that no one tells you when they’re filling your young mind with all these bullshit life equations:


Sometimes that’s true. On a small scale, mostly. You have to allow for a margin of error, an element of unpredictability. When we start reducing life to a series of concrete mathematical concepts—because it feels better than considering that which is unknown to us about the future — we are really setting ourselves up to fail.

After I began to heal, having lost everything that “mattered” in my life, I decided to just do something, anything to feel like I was rebuilding my life even in a small way.

I took jobs here and there. I moved around a little. I fell in love.

And then, I said to myself: what is the most important thing, from a practical standpoint, right now?

The answer, given my health, was health insurance.

So, I applied for a paper-pushing position in a hospital where I would be given health insurance and 40 hours a week of doing something. Best of all, if I had a flare up of illness, hey, I was just an elevator away from the ER.

I was given this job because someone believed in giving me a chance. I didn’t have a completed college degree, but I would do whatever needed to be done. In this case, what needed to be done was a lot of filing and staple pulling.

So, for 40 hours a week, I pulled staples.

For this I had (slightly) above a minimum wage, health and dental and vision, and the nagging feeling that I had sold my soul to the devil somewhere along the line and this must be some kind of hell.

So, I decided that I was going to work on top of work: while I pulled staples, I perked up. I listened hard. I learned. And when opportunities arose, I asked for them. I asked for more. I did everything I was asked to do, no matter how mundane, and I did it damn well. I didn’t complain (at work anyway) and I respected everyone from the guy who mopped the floors to the CEO of the hospital.

I didn’t act entitled to anything more than what I had, but I made it known that I was eager to learn— and would gladly take an opportunity to do so.

After six months, this was rewarded. I got a promotion. And from there, I just kept climbing up the ladder. And I went back to school on the hospital’s dime. And I started writing on the side for extra money. And soon my writing became part of my job.

And then, it was my job.

My day starts at 5:30 am, I spend a half hour responding to emails, Tweets, other social media interactions. I go get my morning coffee. I get in to my office at the hospital at least a half-hour before the eight hour clock starts, so I can organize paper, really listen (not just half-listen) to voicemails and chat with coworkers. For eight hours, I do some things that I really like and quite a few things that bore me beyond belief. For this, I am paid. Then, I go home and write. For this, I am also paid. I peruse Tumblr to de-stress. I read a few pages of a book. Then, I sleep. Many nights I have to take some kind of sedative to shut my brain down, but eventually, I am dreaming.

I’ve realized, though, that I benefit from that eight hour day of mindless tasks. My most creative ideas pop up when my hands are otherwise engaged and my mind can wander around to new places. Around the 50th staple, I get an idea for a novel I might write someday. By the time I’m home at night or on the weekend mornings when my coffee steams in my hand and the sun rises over the bay, I can crank out two or three solid articles— because for 40 hours I could think about how to craft each phrase while simultaneously flipping through large stacks of paper.

I work in a hospital all day and I write mostly about health and healthcare. I live and breathe my work, and it’s not always fun or interesting or “fulfillment” but my bills get paid — and then some. I have earned the freedom to write. I have some security that I didn’t have when I was on the former path to success. I created my own definition of success, and rapidly achieved it— because I was willing to improvise.

I’m twenty two years old. I have three jobs, a pension plan, health insurance, my own car, a nice apartment in a safe neighborhood, a partner who really gets me, and above all else, the slow by steady return of my health and sanity. I achieved all of this by not doing anything I was told would bring me this kind of success but instead, I just did what made sense to me in the moment . . . and hoped for the best.

That being said, do I have “free time?”

No. Not a lot of it. Do I want any? Not particularly. I worked hard to be able to combine my interests and passion into something that I can earn a living doing, so I have the satisfaction each day of knowing that I can get paid to do things that also feel good to me, and are enjoyable.

I didn’t achieve that by waving around a college degree or a proper resume. I got here by knowing my place, working hard and taking opportunities when they were given to me, holding them in my hands like delicate little eggs that did not guarantee any kind of real protection from cracks.

As Gen Y, we were really done a major disservice in our youth. Being constantly praised and built up to believe that we would all succeed if we did everything on our Checklist for Success!, we emerged expecting everyone to fawn over us when we had a college degree! Why no one prepared us for the far more complicated reality of Real World Living is beyond me; but here we are, struggling while our parents and teachers cluck at our “lost potential.”

We are a generation that grew up being promised we were special, and instead we entered adulthood already feeling we were just disappointments before we’ve even had the chance to really live.

I challenge you to shed the paradigm that you will be successful. Instead, think about what will make it easier for you to do the things that you want to do: if you can spend eight hours a day pulling staples so you don’t have to worry about healthcare and paying your rent, then you can and will find ways to do the things for which you have a firey passion.

If you are truly passionate about something, it will seep out of your pores and demand to be felt by everyone around you. Eventually, it will become part of your day to day routine, even if you think it’s impossible.

Passion always finds a way; but it has its own timeline, and anything you do to try to speed it up is only going to exhaust and frustrate you.

Don’t give up; not just on what you truly want, but also the seemingly useless and boring things that you have to do “just to get by” — everything has potential, every single opportunity is a piece of your puzzle. It’s just a matter of figuring out where it fits — and revealing the picture it creates.

Abby Norman writes and drinks coffee on the coast of Maine. Tweet her @abby__norman. You might like another piece of hers on Medium, Hush, the tale of an introvert trying to live as an extrovert.

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Do something useful with those recruiting emails



Like most people in the tech industry, I get a lot of cold emails from recruiters trying to hire me away. Sometimes it’s for a hot new startup that’s so stealth they can’t even tell me what it is; other times it’s for established names like Google or Facebook. Invariably, these emails are irritating, which is a shame, because we should all be thrilled to have constant reminders in our inboxes that no matter what, we’ve got a job somewhere. But many people find these emails to be more like unwelcome sexual advances:

Man. Sometimes recruiter emails feel like a date trying to skip dinner and a movie. “Don’t worry, I’m awesome. Come inside.” – @sprquish

Trying to think of a metaphor for when recruiters try to pitch jobs to you on LinkedIn by trying to friend you. – @Clampants
@Clampants OkCupid? – @MadMelvina

I’m going to leave that particular problem to more capable minds than mine; what I want to talk about is a little project I’m doing that uses these recruiting emails as an opportunity for activism—or, as I like to call it, “trolling for good.” Whenever I get an email from a recruiter, no matter what the position, no matter what the company, I reply (link included):

Thanks so much for reaching out. Quick question before we set anything up: are <company>’s health plans fully trans-inclusive?

Now, if you, gentle reader, are not familiar with the myriad ways that health insurance companies discriminate against trans people—and frankly, why would you be?—you might be wondering what the hell a “fully trans-inclusive health plan” is. So let’s digress for a moment to get you caught up, because this is some heinous bullshit and you need to know about it.

Unless an employer explicitly negotiates otherwise, health insurance companies will refuse to cover any medical treatment related to being transgender. This includes labs, hormone replacement, therapy and psychiatry, surgery, and more. Many plans include language that specifically excludes these treatments from coverage; those that don’t will often exclude them on the grounds that they’re “cosmetic.” (I am unaware of any cosmetic procedure that, when withheld, causes the people who need it to commit suicide in record numbers.) The upshot is that trans people either can’t get the care they need—care that the medical community, i.e. actual doctors, find so not controversial that they’ve codified it into a standard of care—or trans people have to lay out tens of thousands of dollars of their own money while their peers get all the help they need for $15 and a bus ride.

The only reliable way to ensure that a health plan will cover trans-related care is, as I said, for employers to specifically demand it from health insurance companies. And the only way employers will be motivated to do this is if employees or potential recruits demand it from employers.

That is why I reply to every recruiter who contacts me: to let them know that if they’re serious about getting people to work for them, they need to put some effort into making sure all of their employees are taken care of, not just the traditionally-married straight cisgender employees.

So if you’re in the tech industry and get a lot of cold emails from recruiters, don’t just roll your eyes and press delete: write back and ask them about trans-inclusive health care. Or if you have a different employment issue that’s near and dear to you, ask about that. The point is, stop letting these emails go to waste, and start using them to do something good that matters to you.

I’m collecting responses over on a wiki dedicated to this project. If you have a micro-activism project too, please feel free to contribute.

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Senior engineer on Twitter’s ads API, former lead engineer on Twitter’s client API, space nerd and licensed commercial pilot.

View story at Medium.com

Supreme Court Birth Control Cases: The Far-Reaching and Extreme Consequences

Last week, Obamacare’s contraception policy made headlines again when Supreme Court Justice Sotomayor granted a routine “time-out” in just one case. That case and another pair of Supreme Court contraception cases could ultimately have very far-reaching and harmful consequences. These cases could limit healthcare access for millions of Americans and radically redefine our religious liberty laws in a patently extreme manner.

First let’s be clear about what the Obamacare contraception policy actually does. In broad strokes, it requires insurance to cover contraception. To protect the religious concerns of those who are contracting for insurance, there is already a sensible and easy mechanism in place. Houses of worship are exempt from the contraception requirement, and religiously-affiliated non-profits, like hospitals or universities, don’t have to pay for contraception, arrange for it, or even tell their employees or students about it. The only thing those groups must do is fill out a simple one-page form stating that they object to contraception for religious reasons.

This one-page form is then given to the organization’s insurance provider who will then independently arrange for contraception coverage in a separate insurance plan. The result is women have the healthcare coverage that they need and the organization doesn’t compromise its religious beliefs.

The case that made headlines last week is about a group who is challenging this process. The group asserts an extreme argument: that it’s more than a “substantial burden” to religious beliefs to fill out that form and give it to their insurance company. It’s not. Keep in mind: the group in this case actually uses an insurance company that is not covered by basic federal insurance law, so the insurance company isn’t required to provide contraception anyway. The group is entirely fighting to not have to fill out a one-page form.

It is not too burdensome to religious liberty to ask a group to say, “I object based on religious liberty.” To argue otherwise is unworthy of our country’s great tradition of defending against truly significant violations of religious liberty.

Another pair of related, but even more important cases are pending before the Supreme Court and will be argued in March. These cases are brought by two privately held, for-profit corporations that don’t want to allow their employees’ insurance to cover birth control because, contrary to medicine and science, they believe some birth control causes abortions. These are not houses of worship or religious non-profits. They’re private, for-profit corporations—a craft store and a furniture company— that also want to not follow health insurance and employment laws, simply because of the boss’s personal view. Our religious liberty laws have never allowed that. The Supreme Court should not allow such an extreme and unprecedented change to our bedrock constitutional laws.

These cases could deny millions of women coverage of any or all forms of birth control, limiting women’s ability to control their reproductive health, plan their pregnancies, and manage their lives. As I testified to members of Congress, women also need birth control for other medical reasons, including relief of endometriosis. Those grave consequences are important enough for our laws to protect against them.

These cases are seeking radical changes to our religious liberty laws, changes that are wide-reaching and harmful. Allowing for private employers to excuse themselves from health insurance and employment law could upset the necessary balance of both religious liberty and laws for the public’s health, safety, and other needs. Depending on the exact ruling, any for-profit corporation could cut off its employees’ insurance coverage for blood transfusions, vaccinations, or HIV treatment— all of which some Americans have religious objections to. Any critical health coverage the boss doesn’t agree with could be eliminated. Any person or group with a religious qualm, even one as small as filling out a form, could refuse to comply with numerous critical employment laws, not just those related to health insurance. We could ultimately lose protections against employment discrimination, guarantees of equal pay, and on and on.

The impact of these extreme cases could endanger healthcare access for millions of women. These cases also threaten our society’s long-cherished protections for both religious liberty and the public welfare. When the stakes are that important and the cases this extreme, every one of us should be sounding an alarm.

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facebook.com/StandWithSandra | StandWithSandra[at]gmail[dot]com Press:FlukeRequests[at]skdknick[dot]com

Obamacare Removes Barriers For Women, Latino Entrepreneurs

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Two months ago Luz Rivas walked away from her job to work full-time on her startup, DIY Girls. As the founder and executive director of the group that is teaching girls about engineering and technology, Rivas had to solve for many variables as she transitioned to her dream job. Health insurance was at the top of the list.

On October 1 open enrollment for insurance under the Affordable Care Act (ACA), or “Obamacare,” began. A study published in May predicted that the ACA would have the effect of creating 1.5 million more entrepreneurs nationwide, but how many of those will come from populations that traditionally are under-represented in the entrepreneurial world?

Rivas is almost 40, unmarried, and a freshly minted female entrepreneur who said that to her, healthcare is a “big deal.” While she said that health insurance won’t be the one thing to deter an entrepreneur, it is something that can be difficult to put to the back of your mind if you’re a woman and a Latina.

Luz Rivas, DIY Girls

Luz Rivas

“I was concerned,” Rivas tells TechCrunch. “I think it’s important for me because my family doesn’t have a lot of money to cover me if something were to happen. I think that’s very common for some Latinas.”

Latinos have historically had one of the highest uninsured rates in the country, for example, and in some states more than 25 percent of adult women do not have health insurance.

For women entrepreneurs, healthcare is an important part of the decision to take the startup plunge — but it’s just one factor, said Shaherose Charania, CEO and Co-Founder of Women 2.0, which works to promote women in technology.

Charania said healthcare access is a huge building block to entrepreneurship, and the ACA is one step towards removing that barrier for women and minorities, but also people with pre-existing conditions. The wider availability of health insurance may not necessarily create a huge wave of change for women, she said — but it will be a positive change for everyone.

One big change the ACA makes that’s particularly pertinent to women is that one of the 10 essential health benefits every insurance plan must now cover is maternity care. Although gender and ethnic data is not available, thus far in California’s insurance exchange, health insurance applications for 777,000 people were started between October 1 and November 30; with an additional 144,146 applications the first week of December.

These plans will be available to people who make 400 percent above the poverty level or less, which is about $45,000 a year for an individual, according to Sarah Sol an information officer for the state’s insurance exchange, Covered California.

aca table croppedTo date, startups and entrepreneurs have dealt with the health insurance issue in a few different ways. Some have purchased individual plans, which for women may not have included maternity care in the event of a pregnancy (post-Obamacare, some of these individual plans may become more expensive). Others have opted to bite the bullet and pay high monthly fees for insurance plans that will cover them. Finally, a popular and unfortunate decision for some entrepreneurs, especially those who are bootstrapping, is to simply make do without it.

“I haven’t had health insurance in quite some time. It just came down to money: money in, money out,” said Jesse Martinez, co-founder of the Latino Startup Alliance. “It’s in the back of your mind — ‘What if something happens?’ Most entrepreneurs are doing that. If you can get by without it, people will, that’s the risk that they take.”

Those interviewed by TechCrunch could not make a definitive statement as to whether the ACA would push more minorities and women to pursue entrepreneurship, but the general consensus is that removing barriers like health insurance certainly wouldn’t hurt.

Jesse Martinez

Jesse Martinez

Patricia Martinez founded the women’s mobile health platform Healthgauge, and believes the ACA is opening the door to more market disruption and innovation by removing the barrier of health insurance, and allowing people to become self-employed more easily.

“A large number of women and Latino entrepreneurs and small business owners are parents and or possess pre-existing conditions,” she said, noting this is in great contrast to the idea of the young, white male entrepreneur.

“The ACA is removing this barrier for working mothers, Latinos with pre-existing diseases, and giving them the opportunity to join the rest of the startup community.”

African Americans are another group underrepresented in the nation’s startup community, but with the added problems of suffering higher rates of illnesses than other groups, especially cancer. And African American entrepreneurs aren’t as likely to have access to investment capital as their white counterparts, meaning they are more likely to forgo spending on health insurance, said Jewell Sparks, CEO and Founder of Strategic Diversity Group and BiTHouse.

Thus, removing the uncertainty of health insurance via the ACA will certainly help African-American entrepreneurs, but exactly how much has yet to be ascertained.

Jewell Sparks

Jewell Sparks

“I can’t say that having access to health insurance will inspire more minorities to become entrepreneurs, but I can say it will make decisions regarding the maintenance of one’s health care easier,” Sparks said.

Rivas and others believe health insurance access is an important win for women, Latino and African-American entrepreneurs. But in Rivas’ case, when it comes to getting her startup going, there’s plenty else to occupy her mind.

“I have enough funding to cover DIY Girls for eight months, but if eight months comes by and I haven’t raised any money, that’s it,” she said.

[Tables via Covered California and California Department of Health Services]


Exclusive: U.S. government urged to name CEO to run Obamacare market

By David Morgan

WASHINGTON Sun Dec 29, 2013 7:11am EST

Supporters of the Affordable Healthcare Act gather in front of the Supreme Court before the court's announcement of the legality of the law in Washington on June 28, 2012. REUTERS/Joshua Roberts

Supporters of the Affordable Healthcare Act gather in front of the Supreme Court before the court’s announcement of the legality of the law in Washington on June 28, 2012.

Credit: Reuters/Joshua Roberts

(Reuters) – The White House is coming under pressure from some of its closest allies on healthcare reform to name a chief executive to run its federal health insurance marketplace and allay the concerns of insurers after the rocky rollout of Obamacare.

Advocates have been quietly pushing the idea of a CEO who would set marketplace rules, coordinate with insurers and state regulators on the health plans offered for sale, supervise enrollment campaigns and oversee technology, according to several sources familiar with discussions between advocates and the Obama administration.

Supporters of the idea say it could help regain the trust of insurers and others whose confidence in the healthcare overhaul has been shaken by the technological woes that crippled the federal HealthCare.gov insurance shopping website and the flurry of sometimes-confusing administration rule changes that followed.

The advocates include former White House adviser Ezekiel Emanuel, the brother of President Barack Obama’s former chief of staff Rahm Emanuel, and the Center for American Progress, the Washington think tank founded by John Podesta, the president’s newly appointed senior counselor.

The White House is not embracing the idea of creating a CEO, administration officials said.

“This isn’t happening. It’s not being considered,” a senior administration official told Reuters.

Some healthcare reform allies say the complexity of the federal marketplace requires a CEO-type figure with clear authority and knowledge of how insurance markets work.

Obama’s healthcare overhaul aims to provide health coverage to millions of uninsured or under-insured Americans by offering private insurance at federally subsidized rates through new online health insurance marketplaces in all 50 states and in Washington, D.C.

Only 14 states opted to create and operate their own exchanges, leaving the Obama administration to operate a federal marketplace for the remaining 36 states that can be accessed through HealthCare.gov.

The marketplace is now officially the responsibility of the U.S. Centers for Medicare and Medicaid Services (CMS) and its administrator, Marilyn Tavenner. Healthcare experts say there is no specific official dedicated to running the operation.

A CMS spokesman said exchange functions overlap across different groups within the agency’s Center for Consumer Information and Insurance Oversight.

The lack of a clear decision-making hierarchy was identified as a liability months before the disastrous October 1 launch of HealthCare.gov by the consulting firm McKinsey & Co.

Obama adviser Jeffrey Zients, who rescued the website from crippling technical glitches last month, also identified the lack of effective management as a problem.


Former Microsoft executive Kurt DelBene has replaced Zients as website manager, at least through the first half of 2014.

“We’re fortunate that Kurt DelBene is now part of the administration – there’s no one better able to help us keep moving forward to make affordable, quality health insurance available to as many Americans as possible,” Obama healthcare adviser Phil Schiliro said in a statement to Reuters.

The White House appears, for now, to be concentrating on ironing out the remaining glitches in HealthCare.gov to ensure millions more people are able to sign up for coverage in 2014. Good enrollment numbers are seen by both critics and supporters of Obamacare as a key measure of the program’s success.

“So my sense is that they’re not thinking about appointing a CEO in the short term,” said Topher Spiro, a healthcare analyst with the Center for American Progress.

The CEO proposal calls for removing day-to-day control of the marketplace from the CMS bureaucracy and placing it under a leadership structure like those used in some of the more successful state-run marketplaces, including California.

The new team would be managed by a CEO, or an executive director, who would run the marketplace like a business and answer directly to the White House, sources familiar with the discussions say.

They point to insurance industry and healthcare veterans as potential candidates, including former Aetna CEO Ronald Williams, former Kaiser Permanente CEO George Halvorson and Jon Kingsdale, who ran the Massachusetts health exchange established under former Governor Mitt Romney‘s 2006 healthcare reforms. None of the three was available for comment.

Healthcare experts say the idea should have been taken up by the administration years ago.

“It’s the right thing to do. It’s just two years late,” said Mike Leavitt, the Republican former Utah governor who oversaw the rollout of the prescription drug program known as Medicare Part D as U.S. health and human services secretary under President George W. Bush.

“The administration is confronted by a series of problems they cannot solve on their own. They do not possess internally the competencies or the exposure or the information,” he told Reuters.

Emanuel, one of the administration’s longest-standing allies on healthcare reform, recommended a marketplace CEO in an October 22 Op-Ed article in the New York Times, calling it one of five things the White House could do to fix Obamacare.

“The candidate should have management experience, knowledge of how both the government and health insurance industry work, and at least some familiarity with IT (information technology) systems. Obviously this is a tall order, but there are such people. And the administration needs to hire one immediately,” he wrote.

The administration has adopted Emanuel’s four other recommendations: better window-shopping features for HealthCare.gov; a concerted effort to win back public trust; a focus on the customer shopping experience; and a public outreach campaign to engage young adults.

(Reporting by David Morgan in Washington; Editing by Karey Van Hall, Michele Gershberg, Ross Colvin and Will Dunham)



Amid Obamacare late rush, government says ‘don’t worry’

By Susan Cornwell

WASHINGTON Tue Dec 24, 2013 5:21pm EST

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U.S. President Barack Obama pauses while delivering remarks on the Affordable Care Act, commonly known as Obamacare, at an Organizing for Action grassroots supporter event in Washington, November 4, 2013. REUTERS/Jonathan Ernst

U.S. President Barack Obama pauses while delivering remarks on the Affordable Care Act, commonly known as Obamacare, at an Organizing for Action grassroots supporter event in Washington, November 4, 2013.

Credit: Reuters/Jonathan Ernst

(Reuters) – The U.S. government said it was still processing thousands of sign-ups for health insurance under President Barack Obama’s signature healthcare law on Tuesday as Americans made a final rush to obtain medical coverage in time for New Year‘s Day.

Citing nearly 2 million visits to the HealthCare.gov website and over 250,000 inquiries at call centers before Monday’s sign-up deadline, the government gave consumers an extra day to enroll by midnight on Tuesday for January coverage.

It added flexibility by encouraging consumers to contact government call centers if they had started but not been able to finish their applications, without specifying a deadline for completing those enrollments.

keep reading -> http://www.reuters.com/article/2013/12/24/us-usa-healthcare-idUSBRE9BL0AF20131224


On Turning 40 – Half down, half to go

I showed the pictures above to a close friend shortly after I took them. “How… 17,” she said, always the diplomat. A welter of social anxieties overtook me for a moment. But I’m 40 now and I let my emotional welters pass without too much concern. I paused, and then I told her, “I’m too old to worry about being mature.”

The first 20 years was damn rough. The next 20 was not easy, but I got to fight back, and sometimes I even won.

I’ve spent all 40 years living the tension between my interior self and and ever-rotating, ever-renewing cast of people and institutions wanting me to be a thing they’ve decided I would be better off as. Most often they want me to change for that most pernicious of reasons: my own good. I’ve failed to be other people’s idea of womanhood, of success, of decency, of qualified and educated. I’ve spent much of my life in technology, which made me too geeky for everyone’s “normal” friends.

But in the constant dick swinging of the tech world, I‘m not technical enough to really count. As a woman, you just about have to invent a new form of math to be able to prove you’re not a “fake geek girl.”


read more: https://medium.com/ladybits-on-medium/b9c7e9bb1b3a