The thirty second daily ritual of consumption that is taking my hormone pills is one that I often overlook, seeming at times more nuisance than privilege despite the incredible value they bring to my life. The Pearl Eater’s Toolkit seeks to reverse some of that, to attend to the deep personal value these small actions carry in my life. The toolkit and ritual expand the act of pill-taking into a near religious process of collection, destruction, and documentation that is performed in line with my daily life in the same manner as my pill taking. Each purpose-built tool plays a part in the ritual, and the process of performing it week by week is structured on the same terms as the management of medications. Each day that the toolkit is carried, the pills inside are consumed and replaced with pearl replicas through a process that draws out the normally short experience into a ten minute endeavor. Each ghost pill is hand pressed from pearl dust, collected after setting, and stored in the place of the pill just consumed. At the end of the week, the twenty one pearls produced are strung onto a continuous document of matching replicas, in order of their production. In full the toolkit allows me, as the Pearl Eater, to recognize the value of hrt through the destruction and reformation of a freshwater pearl, and to produce pearl replicas of hormone medication. In the process of transmuting pearl to powder to pill, the process of alteration that the pills enact on my body is echoed and ritualized. Through this ritual document, I am carrying a permanent physical trace of my body’s change and passage through time.