I have a medical condition which, were I born in another time, would have killed me, most likely before I was 40. But due to advances in science, it's easily treatable with a few blood tests and a monthly venesection (in plain english: I donate blood).

This isn't uncommon. I know two or three others with my condition, never mind many dozens of others with different things that'd have killed us over the course of our lives.

Then there are those of us who were saved from childhood illnesses, even without knowing it, because of vaccination or various other practices that have, all in, meant that my previous likely lifespan (~40 years) which would have been pretty standard centuries ago, would have instead had me dying 'young'.

We're lucky. Very lucky.

It's not like this is perfect, of course. There are many, many more conditions or problems that medical science doesn't yet have an effective answer for. The kind which would cause a snide comment like "What is this, the dark ages?" from Bones in Star Trek were he to see what we have done to us to save our lives.

(Random aside: a little girl I grew up with had a heart condition that was then untreatable. I've no idea if it is now. But it meant her lifespan was to be measured on a few hands. And, indeed, she died, if some time later in life than anyone expected her to live.

I remember her because she was the happiest child I'd ever met. A few years younger than me, and seemed entirely unencumbered by the neurosis and issues that most of my other friends dealt with. While I realise she was too young to have come to some epiphany about her short life and have been happy as a result of that, I do wonder if it was those of us around her that did this for her. Knowing she had a very short time on this planet, we were perhaps kinder?)

Beyond zero-sum 'alive or dead' medical science, you have something else - you have antidepressants, anti-anxiety medications... lots of things which are pretty demonstrably things that make many of our lives bearable, or even pleasant in a way that we aren't without them.

Thing is, I increasingly see this - medicine and science saving and extending our lives - also being true as a trans person.

While not the same thing as my medical condition and the simple solution of donating blood, I thought about ending my own life more than I ever wanted to admit to people. It's not that I thought I was depressed - it's that I knew I wasn't. I knew precisely why I found life so tough, and why I so frequently found myself "over it all". And I was ashamed of that reason. I'd had masculinity beaten into me and forced onto me by society, and this despite a family who never did anything of the sort.

There's an awkward joke in Monty Python's Life of Brian where "Stan" (Eric Idle) sheepishly admits that he wants to have babies. It's awkward comedy, but something I found hugely, hugely uncomfortable to watch. Because it's how I felt. Not just 'having babies' explicitly (although I can't describe how jealous I am of my friends who get to bear children themselves), but feeling that my life was 'wrong'. It wasn't the way I was supposed to exist.

I tried to imagine being a father, and it horrified me. Something about that particular 'role' as it was defined felt fundamentally wrong to me. So I told people I didn't want children. It was easier, and being that the world saw me as male, I didn't suffer the same pressure to have children that I would were I seen as a woman.

I'm still not sure I actually want children, but at least my complex feelings on the subject make sense now, and no longer loathing my body and the way people treat me has made my life better. It's made the idea of self-harm a distant memory. I have bad days - even terrible days - but it's no longer because of a gnawing self-loathing that wouldn't go away.

Hormone therapy isn't a simple process. Even today, in Australia, it's not that easy to attain - and medically it's uncomfortable, complex and takes time. It's not perfectly effective, either. Even if I get reassignment surgery, I (almost certainly) won't ever have a womb or be able to give birth, and I won't ever have had the experiences my cis woman friends had growing up female - for better or for worse.

But it's responsible for saving my life as much as my monthly blood donations are.