A month ago, I had a gut-adjacent issue that required me to present myself at my Large Local Healthcare Conglomerate for inspection. I’ve been living with IBS and associated intestinal nonsense for twenty years; I’m primed for the day that my gallbladder, my appendix, my-whatever finally gives up on me. Which means that, thanks to my husband’s great fucking health insurance, I’ll show up to the doctor for an errant sneeze. I’m not trying to present at the ER with full-on rotgut, which has historically been the practice of my white, Protestant, suck-it-up-until-you-die-of-it people.

This time, I actually was experiencing some errant sneezes.

Well, the sneezes weren’t the problem. It was just that whenever I did sneeze, it felt like someone was stabbing me, full Brutus-on-Caesar-style, in my right ribs.

The nurse practitioner I was seeing on this particular day took a look a me — literally, laid eyes rather than hands upon my body — and asked me if I was aware that I had gained seven pounds in about 14 months. Did that, she wanted to know, concern me? Considering my stomach pain? Considering my weight?

I did a double-take. The NP’s numbers sounded wrong to me, and frankly I’m always poised to bitch-back at a skinny medical professional who thinks I’m DOA of fat all the time, so I did the math: 14 months ago, I was in the grip of a multi-month bout of diverticulitis.

“The last weight y’all took was when I had gastric disease, wasn’t it?” I asked, after a minute. “I’d have been down a few pounds because I hadn’t eaten solid foods in about a month.”

At this, she reviewed my file more closely.

“Oh, yeah.”

A chest x-ray and a a whole-ass ultrasound turned up nothing, both of which I had to demand because “You’re fat” and “Would you like to speak to a nutritionist” were not satisfactory responses to my complaint of “Every time I sneeze, cough, or laugh, it feels like I’m being murdered in a swordy Shakespearean LARP.” I was subsequently referred to a sports medicine professional who finally diagnosed me with an intra-muscular abdominal injury that has nothing the fuck whatsoever to do with my body size. Indeed, after Dr. Sports Medicine determined that whatever the fuck was wrong with me had nothing to do with Behold! A Fat Lady, we had a great chat about my affinity for Peloton and yoga, because the thing I always have to do to reassure any doctor that I am not a miserable lump of rancid shit masquerading as a glorpy human person in Halara leggings is reassure them that I get off my miserable ass and pedal to absolutely the fuck nowhere several times a week. You know, in order to be taken seriously as a human being experiencing pain. Regular shit.

I keep thinking of this because the other kind of dismissive, victim-blaming bullshit I encounter on the regular is highly similar to the fat-shaming nonsense visited upon me by the medical establishment, to wit: “blue” and coastal-state liberals telling me and people like me that we should “just move” if we don’t like living under the oppressive, fascist politics of men like Greg Abbott and Ken Paxton.

“Just lose weight” politics and “just move” politics are borne of the same fuckery, the fuckery that puts the onus on people who are experiencing pain to solve a problem not of their own making, because the people who could actually help solve the problem can’t be bothered.

“Just lose weight,” say my doctors, when my problems have nothing to do with my weight. But they have everything to do with their inability to recognize the root causes of my pain, and my humanity as a fat person.

“Just move,” say the internet snarkers, when my problems have nothing to do with where I live. But they have everything to do with voter suppression and gerrymandering and the widespread, casual disregard for the humanity of people living in oppressive geographies.

Just move. Just lose weight.

This is the advice of people who have never had to decide between feeding their kids and uprooting them during the middle of the school year or the cost of losing months of rent and putting the deposit on a U-Haul. Of people who have never scheduled five different doctors’ appointments in the hopes that one of them doesn’t use BMI as a first-line diagnostic. Of people who have never stared down a person in power — whether it’s the doctor holding the prescription pad or the senator holding their rights in remove — and asked: Why don’t I count?

The answer to that question is: because it is easier for comfortable people not to count us. To not invest in us. To not move in solidarity with us. To not imagine being us. Because it is easier if we go away. Because it makes them feel better if we are not a complicated problem they have to solve, but rather a morally inert aberrance they can ignore.

The real answer to “Why don’t I count?” entirely upsets the idea that we can be good by just being good, even if being is something given to us, rather than earned. It’s eminently comfortable to believe that the way you were born — thanks to your geography or your body size — puts you automatically ahead of people who face challenges you’ve never encountered, but whose problems you have a simple solution for. Problems that, conveniently, involve nothing more than you being the person who holds the prescription pad. Problems whose solutions involve somebody else’s real sacrifice — their money, their actions, and their time — but never yours.

But here’s what: no matter what you weigh, somebody will find a way to make you feel too big, too gross, too glorpy. And no matter where you live, someone will find a way to take your rights, your freedoms, away from you. Because they started with somebody it was easier to target. Somebody who didn’t have an advocate. Somebody who was, has always been, written off — because they looked the wrong way, or lived in the wrong place. Somebody whose body didn’t matter.

Somebody’s body will be your body, someday.

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