The pain hits like someone's driving a knife through my lower back, twisting it with every breath I take. I'm doubled over on my couch, phone clutched in my sweaty palm, trying not to scream. "Maya," I gasp when my sister answers. "I need you to take me to urgent care. Now." "Ethan? What's wrong?" Her voice shifts immediately from casual to concerned. "Kidney stone. I think. God, it hurts so bad I can barely—" Another wave of agony cuts me off mid-sentence. "I'm on my way. Ten minutes. Hang on." Those ten minutes feel like ten hours. I've had cramps before, bad ones, but this is different. This is glass shards grinding through my insides. I know what it is because my dad had kidney stones twice. The symptoms match perfectly—the radiating pain, the nausea, the feeling like I'm going to die right here on this ratty apartment couch. Maya arrives in eight minutes. She's always been like that, my fierce little sister who treats every crisis like a mission. She practically carries me to her car, her arm around my waist, whispering reassurances I can barely hear over the roaring in my ears. The urgent care waiting room is packed. Saturday afternoon, of course. Probably half these people have the flu, the other half sports injuries. Maya helps me to the reception desk where a middle-aged nurse with severely pulled-back hair and bright pink scrubs looks up with a practiced smile. "Name?" "Ethan Rivers." She types, frowns. "I don't see you in our system." "It might be under my legal name still. I haven't had a chance to update everything yet." I give her my birth name, the one that makes my skin crawl every time I have to say it. Her eyebrows rise as she looks at her screen, then at me, then back at the screen. "This says female." "I'm transgender. Male. But my documents aren't all updated yet. Look, I really need to see someone. I think I have a kidney stone and—" "Mm-hmm." Her tone has changed entirely. Cold. Suspicious. "And when did you have your surgery?" "What? I haven't had bottom surgery. That's not—can I please just see a doctor?" She stands up, crossing her arms. "Sir, or ma'am, or whatever you prefer to be called, we need accurate medical information. What procedure did you have done and where?" "I haven't had surgery. I'm on hormone replacement therapy, testosterone, but that's not relevant right now. My kidney—" "Testosterone?" Her voice rises, carrying across the crowded waiting room. Several people look up from their phones. "You're injecting steroids? Where did you get them?" "They're prescribed. By my doctor. This has nothing to do with—" "I need to know what clinic performed your procedures. Were they licensed?" Maya steps forward. "Excuse me, my brother needs medical attention. He has a kidney stone. His transition has nothing to do with—" "A kidney stone." The nurse's laugh is sharp and dismissive. "Honey, I've been doing this for twenty years. I know what complications from cosmetic procedures look like. These unlicensed clinics, they do these surgeries in the back room, and when something goes wrong, patients come here with stories about kidney stones or appendicitis or—" "I haven't had surgery!" My voice cracks. The pain is getting worse, and now humiliation burns through me as every person in this waiting room stares at us. "Sir, I'm trying to help you. But I need the truth. What clinic did this to you?"