A game about gatekeeping for transgender women. 

Originally made in twine. This is the unity remake to get it closer to how I originally intended it to be. 

Epilogue can be viewed here:


Twine Version remains playable here for archival purposes and lower end pcs/mobile:


Rated 4.5 out of 5 stars
(108 total ratings)
AuthorTaylor McCue
GenreVisual Novel
Made withUnity
Tagsgatekeeping, LGBT, LGBTQIA, medicine, Mental Health, psychology, Queer, therapy, Transgender
Average sessionAbout a half-hour


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As a Trans girl I can't force myself to deny HRT...I just can't

It's okay, this is a game where you are given the option to do something extremely cruel. 
Choosing to not do that thing is 100% a reasonable option.

Found this very well written. Love the shitty instructions (an accurate description) at the start as a condemnation of these systems. Incredibly confused by how the Steam reviews read this.


It was a very early game for me written when I was super early in starting out. I don't really think I was prepared for steam player's reactions at all.

Everyone has to start somewhere but when you're used to pro devs then it's easy to get angry at someone starting out. I am glad that I continued to try to make games.

the world sucks bro


this hits so hard... i'm an AMAB transfeminine person who's gone through this same thing for several years, although i quit my therapist about 2-3 months ago when she gave me the same spiel about needing to meet even MORE criteria to even be diagnosed with gender dysphoria so i can go through the process of being approved for hormones! amazing game, i'm satisfied with the ending i gave Arle and honestly don't want to see any of the other endings. ignorance is bliss <3


Oh, wow you played a lot of my games today including the super obscure ones. Thank you!

If you gave Arle a happy ending, that's all she needs.

Therapists can be awful and it's so hard for people outside the trans community to understand the systemic trauma that they've inflicted on us.

Your therapist from back then in particular sounds really rough and I am sorry you have to deal with that. It seems to be a pattern I've seen happen again and again over so many years. It's horrible. 

Anyways, thank you again for playing my games today, it means a lot to me.

this is such a good game


I would give this 100/5 stars if I could. I'm just non-binary but this.. its nice. As someone who handles meds I think I would wanna make sure I'd wanna do something this big and be double sure. I ran through the game about 3 times for the endings. I was very upset tho that.. its so realistic with having to sell things and do stuff just to be able to get what you need.. it's sad but overall this game is amazing even if its small. The artstyle? MWAH! MWAH MWAH!!! <3


Somehow I found comfort in playing this. I've been seeing a specialist and a therapist for HRT, but I've never told my primary doctor because he also happens to be my dad's best friend. I've been nervous about my next doctors appointment (it's next week), thinking of all the excuses I'll have to say in order to justify my decision when he sees my interest in HRT in my medical record. Thank you so much for this game. <3 I haven't had the heart to play the other routes -- just watching the epilogue gutted me hard... I just want to see Arle live her best life.  

I played nice to start with and my heart sank when they said they struggled to afford the session. I realised it was going to get worse...and hoo boy does it get worse. Between this and the epilogue, yeah, that's distressing. Very sobering, good work. I'm going to pretend that the best end is true end now, lol.


Just commenting to send some love for this game. Played it years ago and recently played the steam version too. As a trans person in the UK, who is 3 years into a waiting list for a first appointment at a gender clinic, and several years away from not having to source my own HRT... well, I can relate to this. <3

Sorry for the previous comment (Nerves ate at me when I tried to play the first time). I was a little jittery at the idea of even a fictional character being permanently hurt by my actions.

I ended up (having the perspective, seeing what Arle was about to do) caving. Better safe than sorry, and she was serious—something that's hard to tell, unless you really get to know someone. I love the inspiration for her name, on a lighter note. (Fellow gamer? Awesome!) If it were possible to see the outcome, and to decide based on that, the world would be so much easier...but so much less rewarding as well, one supposes.


This is such a good and realistic game. The epilogue was chilling. I'm baffled by all the bad reviews on Steam from people who completely missed the point. I honestly don't get how anyone could miss the point, I just don't. This is clearly about what trans people have to go through just to be able to access HRT. This is a clear critique of a medical system that just doesn't understand transness at all and that claims to "protect" us while actually harming us by denying us legal means to transition.

Thank you for making this!


When I first got the steam response, I cried for a long time. Each comment I got just really hurt.

This is going to sound really nerdy but I once played a game that had a game designer in it as a character. He said:

"You don't need a knife to kill a game developer, you just need to tell them their game sucks."

I think that is absolutely true to some degree. At the same time, after getting all those steam reviews and crying a whole lot, and almost quitting game dev... I eventually kinda just picked up my keyboard and tablet pen and kept making stuff.

I think now after those experiences, I'm absolutely floored when anyone says anything nice about anything I make. It blows my mind every single time.

I can't say I am immune to being told my game sucks or that mean comments don't hurt my feelings, but I still want to make games even if people think I suck. 

I think part of the reason people got angry is that the game made them feel uncomfortable to wield power like that. No one wants to be the bad and I think that made people lash out. 

That's kinda why I'm really shocked my most recent game didn't solicit another huge group of people who think I suck and am a terrible person and scum.

I really thought I was absolutely doomed and I just don't get it. 

(Also I wanted to say one more time, thank you for being all "grrr" about that guy. I don't want to wreck anyone's careers or life but it was nice to see someone care. 

When my steam stuff first came out I had a perfect 100% negative rating for a long time and it was really hard feeling like no one cared so thank you.)


I'm so sorry you had to go through all that, I don't think you deserved any of it regardless of whether people liked the game or not. And I'm so glad you decided to keep making games.

You know, I made a youtube account once, i wanted to post game guides to help other people who were getting into the same game i liked, so i posted my first video... and all i got were mean comment telling me it sucked, that i understood nothing and that i should never try to make a guide again. It crushed me. I've never tried making another guide again, because I had put so much effort into that video, got all the footage myself, and I thought it was good. I can't imagine how it must have felt when all the negative reviews for your game you put so much effort into started coming in, and the strength it took to keep creating.

I'm no game dev (yet!) but this gave me the impression that Steam is a more hostile site for this kind of small indie games... what with achievement hunters only downloading short free games they dont care about for easy achievements and then leaving bad reviews and all that. And I think due to how many big AAA titles are on Steam, ppl expect big long polished games by big studios, and everything else they see as "trash"... that doesn't mean it's true though. I think every small indie game has value. And I found much value in your games. Some people will never understand, but many others will.

And, no need to thank me, honestly when I reply things like that to someone being a jerk it's mostly with the hope it will make them reconsider their attitude. Being a small indie gamedev who enjoys telling other small indie gamedevs that their games suck is... not going to help him in the long run, so it's best if he reconsiders that attitude early on. Tbh if i didnt like a small indie game i just wouldn't leave a comment, I wouldn't tell the dev that "it sucks", because they put effort into it. I just dislike jerks who dont care about others' feelings at all. So... sorry if my reply to that guy seemed too hostile, but I'm not going to lie, I'd do it again, that's just how I am...

I'm sorry you didn't have anyone who stood up for you at first, you deserve to have people on your side who will defend you and your games, because you didn't do anything wrong to begin with. I know what it's like when it feels like nobody's on your side and I don't want anyone to have to feel that way.

And uh idk how to end this reply but, thanks for letting me know some extra info about the choices you made during development in other replies! It was very interesting! I also played a few games that iirc I saw you recommend, like Madotsuki's closet and Everything is going to be ok (that one made me cry! i loved it), so even tho u didnt recommend them to me directly, thanks for the recs anyway! :3


this is extremely well written. i can't relate exactly but it's chilling to see the similarities in trying to access hormones to this day where i live to this? seeing that even though it got a lot better, i too  have to go through useless expensive protocols to prove i deserve hormones or surgery.

i'm sorry about the steam comments. i value a lot your games for being honest. i especially appreciate the epilogue for talking about how dehumanizing this is.

Oh my god, you are pretty much the only person who played the epilogue! The amount of people who ever saw that epilogue is so tiny and idk it means so much that someone would look at the whole thing and give me that amount of time.

The steam comments were brutal but at the end of the day I think they toughened me up as a gamedev because now I just mindlessly release games with no expectation of kindness. Dropping that expectation helped me just let go of that stuff and freed me to focus on making games for my own sake.

I think that our medical system with therapists and confirmation letters is not actually meant to help trans people access hormones or surgery but hinder and punish them. That hasn't changed no matter how many years have passed, it's just ebbed and flowed depending on which side the pendulum is on for trans people. I wish I could say doctors and therapists are our friends and allies but I often find they would rather dominate and control and it's extremely painful to be under someone like that.


Excellent writing, beautiful art, and doesn’t hold back. This reminded me a lot of my first time going to a therapist like this back in ’02. I really like the way you handled the content warning, too!


Thank you so much, things have hopefully changed since this game was written but back then people were horrific as therapists. I hope someday a game like this is just unimaginable irl.


I just played this game after listening to an interview of you on kritiqal.com and I really, really enjoyed both the podcast and this game!

It’s so raw and powerful and I love your art. The first route I took was the happiest one, then I timidly refused to give Arle her prescription and discovered the worsening impact of these decisions on her life. I couldn’t bring myself to refuse to give her the letter at her 3rd appointment though.

As the game greets you with the sentence “You have to decide who is transgender or not”, you realise how much the therapists’ decisions is going to impact the patient’s life.

Also, fuck the mean comments on Steam, your games deserve recognition just as much as you deserve love. <3


Thank you, that is really really kind of you to say. 

I mostly leave steam alone as I don't want to influence reviews there but it was pretty upsetting to read and made me afraid to keep releasing games. I'm getting over that though and I'll have something to release sooner than later.

Therapists have a lot of power and I don't think people realize that or think about it much. 

I don't really know what to say but thank you so much for being around and stopping by.

Great little game. I love that the experience actually started for me when I went back through the choices and explored the (increasingly terrible) torment that Arle endures. It was heartbreaking but important. Thanks for making this.

Thank you so much for playing this game. It wasn't a fun game but I felt it was really important to make even if it was made in a flawed way.


Greetings! Is this game the same as Steam (https://store.steampowered.com/app/1277310/Saving_You_From_Yourself/) one or some sort of demo version? Thanks in advance.


Same as steam, just a web version. 


Cool, thanks for quick reply!


I'll write a little more because your game deserves it.

The art is adorable and I'm glad that every scene in the story gets its own unique drawing or animation.

The accompanying animation to this hit me pretty hard.

I really like how this turned out, I think you did a great job making it. Maybe I'll show it to the people in my life to explain to them the harm that the healthcare system is currently putting me through, so they can really understand it, because right now they seem ambivalent, or seem to think that I should be more patient.

As always, thank you for your work. I appreciate all the art that you've made.


Hi, I am currently really overwhelmed with social situations so I've been taking a break from replying to people until I can get stable again. I read your comment though and it meant so much to me that I wanted to reply.

I wanted to be able to explain to people quickly why the healthcare system was so damaging even if it was done poorly. A lot people cannot understand the harm because to them the entire concept of months or years of your life waiting are a thought experiment. To many people I've talked to it's just a puzzle to think about, not something real.

This has been going on for decades now, where therapists get to control the lives of trans people based on policies made in the 60s. There are exceptions like consent based hormone providers but they're mostly in highly liberal places that cost far more to live in. For people who are poor and trapped where they live you can't just leave and go.

I hope one day to make a game that explains this better than I have now but I'm trying to clear the skill gap I need to do it right first. I am really sorry you're struggling in the healthcare system to get things that genuinely do not need to be a struggle to obtain. I hope some day we can have a more just healthcare system for everyone until then, I hope we can both continue to live as best as we can.

I hope you can excuse this reply if it is a mess. I struggle with mental illness and it is difficult for me to do things like this when I'm out of it.

Thank you for the details in your reply, and I hope you can stay strong in spite of all the difficulties that you face. If you ever need a stranger to talk to, you can reach me at https://cadence.moe/about/contact if you like, but there's absolutely no pressure to do so, especially since as you said, you're taking a break from replying to people. Still, if you need someone in the future, offer's always open. :)


I honestly can't see through the negative endings of this game, since I think my heart would just shatter into pieces. Congratulations on the compelling writing.

I cannot download this game, yeet

It is buggy in the downloadable form as it is meant for web but if you need a downloadable version I can try to remake the game and make it downloadable. 

Loved the art in this! Only got the good ending. I'm happy for Arle!


That's all that you need really. Also you seem really cool and my life is a mess right now but I like the stuff you seem to be up to.

Also HEX CODE COVEN seems really cool. You seem cool. 

I'm really tired and my brain is fried but I just kind of want to be like idk hi!

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Hello!!! 😁
I think you and your games are cool, too, and I hope you can make more video games for as long as it brings you joy! Brains do be fried sometimes.


I hope so, I have a few games I want to finish before I die. I've been in a bad place lately but I think I'm going to be okay.

It's really cool being part of itch and getting to see others floating around doing really cool stuff and getting to meet them. 

I hope we both keep doing what we love, this space is small and we will probably intersect again. :)



I really enjoyed this game. Naturally I defaulted to giving Arle her letter immediately, which was a quick but sweet ending, but then I replayed in order to see the other outcomes. Very thoughtfully written with some great art and a solid aesthetic sensibility. 


Thank you so much. This is such a good comment like idk it really means a lot to me when people actually like the games I make. T_T 

I have to say, I didn't respect the rules of the game, and I just did what I wanted. Super Happy Arle got what she wanted right away. zero regrets, except for feeling like I didn't respect you work. Sorry. I'm sure the rest is well written, but I don't have the gut to play it right ^^*. But I'm happy with what I did <3, and the way you write the path I chose.


Hi, thank you so much for playing my game. 

I think you played it the right way. Arle doesn't need to suffer and I appreciate that you didn't make her suffer. I feel like if more people were like you then I wouldn't have needed to make a game like this in the first place.

(Also your game Gender Quest is really good!)


This reminds me a lot about my worries and feelings when I was trying to get my own letter so I could start HRT... each session $100, having to sell stuff or ask people for money just so I could afford to go there the next month, over and over. Thank you for making this, and letting other people see what this can do to someone.


Thank you so much for playing and idk saying something kind back. The reaction this game has gotten has been kind of hard on me.

The cost of therapy, laser, and other various things that weren't covered by insurance were really difficult to deal with. Trying to explain that to cis people over and over again was just so draining. I really wanted people to be able to understand.

It sounds weird to people who have never experienced it but selling your possessions to survive can be really upsetting.  

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The first time I tried to play I bailed because I was uncomfortable with the weight of making decisions that affect someone's life so much, even in the context of a game. I eventually came back and I'm glad I did, this was really thoughtful, well-done, and had a lot of power to it. Thank you for making it.


Thank you so much for writing this. I get a lot of hatemail for having made this game and sometimes it's really hard to keep writing after reading them. Comments like yours really help to make me feel like I can keep trying.


I'm not a good commenter but I just want to say, thank you for creating this game. You can get a lot of hate for making a game that includes LGBT issues, but you still make it until the end. 

Arle sold half of her video games just to get a letter of approval for hormons, showed that she truly serious about the transitioning.


Your comment is actually really good. I'm sorry about not replying sooner, I got a little overwhelmed with comments and needed a break from social media.

I really really appreciate that you get the selling your video games thing. I think it's a really weird part of being poor and nerdy that some people will never experience but it's really painful.

Thank you for creating this. These are experiences I think a lot of people can relate to, and its so important to have cultural touch points like this one to relate to one another through. I did think the game would include more patients, and would like to encourage you to consider gathering more stories and adding them.

The game was originally going to have three patients but they were cut. There was going to be a waiting room effect where you'd see their stories in a sequence and see how various social determinants of health would change your patient's lives.

Unfortunately that created exponential amounts of work and size. I hope once I have a little more skill to revisit the concept and do it justice. 

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Thank You. I think your art style has a lot of character. Your writing is creative and engaging. This looks like it took a lot of work. I hope you enjoy your time making more games as much as I enjoyed playing :)


Thank you! :) 

I cried a lot making this game but it helped me heal a lot. While it's not fun I find it really rewarding to make games.

The message of this game is great, and I personally like the artwork, just wish it escalated more slowly.

Trying to get to know Arle, yet being judged so harshly for it, felt terrible (though not a fraction as terrible as someone in Arle's situation would feel).


One day I hope to make an expanded version of the game concept that explores administrative violence and power over trans people. 

At the time I wanted to at least complete something that could be shared. I hope once I have a bit more experience and skill to revisit the concept and do it right.


Criticism is nice, but please do not dog on this game. Everyone needs to have a starting ground and simple saying its a shitty game doesn't help. Here is some genuine criticism, I do think some of the images are a little blurry and hard to convey. Other than that its a wonderful starting point and an amazing game. :)


Thank you.

It's true that as a person it's really hard to read comments like that and continue to make things. Despite that I plan to keep trying.

That being said I do read every review regardless and think about them, even the ones that say my game is terrible. Ultimately I'm grateful for even those, sometimes the most brutal thing is to just suffer in silence. I'm glad at least that it let them feel something.


I'm routing for you pal! Can't wait to play all your new games >:) 

just remember that criticism is important but rude comments are just people behind a screen


Thank you for writing this game. It makes me feel a little less alone, and I appreciate you writing it in a way that might speak to well-meaning gatekeepers.


this was terrible. and i dont mean it in that "denying trans women hrt is terrible oh nooo dont make me cry owo uwu :(" way, this is genuinely not a good game. the art style is all over the place, the gui is hard to read, the fonts are garish and the story is very binary and linear. if anyone calls me transphobic for not liking this ill go feral

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Please don't turn this page into a internet brawl for fun. 

Go protest if you want to fight injustice or do anything productive, otherwise please just chill. 

I don't want my game page to turn into the equivalent of a youtube comments section. 


I know I suck at making games. I'm still learning and starting out and struggling with a lot of shit. 

Everyone has to start somewhere but I read all of the criticism I get and though I don't usually respond but I am trying to improve. It just takes time. 

That being said please don't bait people into internet fights. You can like or dislike whatever you want please chill. 


Hi, I'm a person within the LGBT community interested in majoring in computer science, though I'm still learning. I don't know if I'm exactly the best with constructive criticism, but I'll tell you this about making games...

You've done a good job for someone starting out. I understand that you may think your games aren't that good, and that's okay when you put it into perspective of all the other games that initially come to mind when you think of games. (You may or may not have heard this before, but keep in mind those games usually involve big development teams to create them. Don't let that deter you from game development if that's what interests you since you can still make some pretty cool things regardless.) From what I've seen from other starting creators, they usually wind up create small games considering outside events like the time they have to create them, debugging things, etc., so you're not alone here.

GUI is hard to manage when you want to put it into an interesting and unique style for your game, (although I personally don't think the game's GUI is that hard to read,) and a game's art doesn't necessarily have to be good nor consistent to declare a game a good one. When it comes to games like these, I think it's about getting the point across, especially in terms of story, and while I have to agree that it is, indeed, pretty linear, you still accomplished that and that's what matters. You hit the nail right on the head for what's needed in these types of games.

Regardless, this a nice short game for a starting game creator. It takes a more direct approach at the concept (of gatekeeping), but gets the job done nonetheless. I really enjoyed how you gave glimpses into the patient's personal life in the story to give more of an impact to the player's choices. If I could make a suggestion, music could really help in this game, although I know most twine games don't include music. Music does wonders to story-related games, adding to the atmosphere of the user when playing. Regardless, I hope this was useful, and great job! (By the way, if it helps, I made an account just to comment on this. You did well!)

Hi, I have mental illness so after the attention this game got I ended up getting overwhelmed and hid in a hole for a bit until things calmed down.

The fact that you made an account to post that comment is really really kind. I read your comment and your advice was really useful.

I'm still working on new games. I hope that they will show growth and reflect some of the changes that you advise. If I can I'm going to try to utilize sound in some form in the next game. 

I've gotten some pretty brutal comments offsite so I struggle sometimes with replying but messages like yours really make a difference to me.


5/5 would bail at the warning screen again


I'm glad, I setup the warning screen for that exact reason. 


I live in a state where you talk to a person at planned parenthood, "I want hormones" and get it. :/ Safely. My condolences, and solidarity with those not so lucky, or those who cannot afford healthcare at all. My heart goes out to you.


I don't live in a place like that but I hope one day everyone does live in a place where that is possible.

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This is a good post and story. Thank you for sharing.

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Playing evil made me uncomfortable but I knew that I had to see the full story to enjoy this piece of art fully. The "today you did your job" monologue is incredibly chilling and what's worse is that I've been face to face with such "professionals" several times in my life. Be it psychologists, psychiatrists, gender therapists (I believe that's what they are called in English?) or just average doctors. These people have not but a shred of empathy, sympathy nor compassion in them. They may understand their work but they fundamentally do not understand people or feelings. They are cold, sometimes outright hostile, and unfit to do their job. The ones who firmly believe that they are some kind of saviours are infinitely more creepy than the ones who will at least admit that they don't care about people in my opinion. The latter at least appear to be self-aware.


I really appreciate that you get it. I share that experience and I wanted to make a game that explained it in a quick way without having endless debates and explaining. 

I'm really glad you shared your comment here.


This is a very short but nicely playable piece. It reflects well some of the thoughts and feelings that can occur when going through the gatekeeping process of gender care. I would assume that the game is thought-provoking and somewhat eye-opening especially for someone who has never been in the position of the patient themselves. Bonus points for the mind-warping point of view that is presented both in the very beginning and the bad ending, about being a therapist "saviour". There's a reason patients may not return, and it's never a "victory".


I'm glad you got the point in the ending. Some people were confused by how I phrased it and took it literally. 

Thank you for playing the game.

it´s a little hard to give an opinion of this game only with the sources of this game, because i´m not a person who know much about transgender people and i´m looking for some awareness to empathize better with them. So, by this terms, if this is a game about bringing some awareness about gatekeeping, it does his job, i didn't even knew that term before,and even when the player is at the "evil" side, you can be empathic with both sides 

i know i'm not the target of this game
i'm not a creator (yet)
i know i'm not polite with the following opinion, but i didn't like that such a complex problem (such as transphobia, not only gatekeeping) had solutions in only binary options. such a redux works well in specific problems because gives the most probable end to things, but being so optimist about that and being so simple makes me feel that it's far from reality

even with all this, i enjoyed learning about something new. thanks


It's a five - thirty minute game and I get where you are coming from but it's difficult to make a game that short and cover everything.

That being said I hope to one day develop an expanded version that expands on it. Until then I would recommend reading some short essays and books on the topic if you would like more nuance and information. 

For a longer text on the topic I'd recommend:

Normal Life: Administrative Violence, Critical Trans Politics, and the Limits of the Law by Dean Spade.

For a shorter essay I'd recommend: 

Passing and the Managed Achievement of Sex Status in an Intersexed Person (1967)

by Harold Garfinkel

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It can still be... so disheartening, and sickening even, to remember that there are people who go through so much trouble, and still get denied. As if anyone can tell you who you are, and what is right for your body. If you're struggling, please don't give up. Keep searching, keep reaching out to friends. There's an answer, and you deserve the life you want. <3


You're a kind person. Thank you for playing my game.

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