Biology matters in medicine - medicine failing trans individuals

So many people seem to think that the difference between a man and woman is simply that one has a dangly bit between their legs and the other has two dangly bits on their chest. Rather than practically everything about them being subtly different in a myriad different ways

See all the threads about "penis portions" (aka people don't understand that men need more calories per day than women). See the speculation about womb transplants (it's not just some bag that can be popped into a male body and hey presto).

I had rather hoped that the medical profession was a bit smarter than to get gender and sex mixed up

This TED talk by a leading geneticist was recently linked on a thread and I found it fascinating

Men, regardless of race, share 99.9% of their genome with other men.
Women, regardless of race, share 99.9% of their genome with other women.

But men and women share only 98.5% of their genome. AND THIS AFFECTS EVERY CELL IN THEIR BODIES.

The implications are huge for the study and treatment of disease.

Thismmakes a huge

One of the speeches at the WPUK Cardiff meeting was about this issue - the importance of recognising and researching differences between the sexes when it comes to symptoms and medical treatment.

Obviously according the the TRAs the fantastic speaker was just a TERF for feeling this was an important issue, even though it's just as important for trans people

Apparently you can ask to have a marker on your medical records to state your biological sex, that avoid problems like this. Quite relieved to find some common sense prevailing!

I think that even with a fully transitioned person for medical records they should always be recorded as biological sex. Also, records of their transition because the absence of a womb or testes could be medically relevant.

It might hurt somebodies 'feelings' if they get 'mis-gendered' but prostate cancer hurts more.

If the medical record says male, and the patient claims to be male, then the medical staff will believe them to be male and not ask. Why would they ask?
Blood tests, scans etc etc can mostly be done without any need for a person's biological sex to be revealed / physically seen.
(Ditto if the claim is that they are female).

So if a trans man turns up at a UK hospital legally a man, at what point - and how - do doctors determine they are actually a woman?

If medics fear being labled as 'transphobic' are they likely to ask for clarification if they're unsure? Dr's and nurses are so risk averse so might avoid offending the patient for fear of complaints?

Oh my goodness me. The world has gone mad.

That's very worrying, DJLippy, given the all-knowing image that many medics project.
Patients may "withhold information" unintentionally because they believe the doctor or nurse already knows it.

I wonder if the patient had the situation re the sex differences in kidney disease properly explained to them, by medics.

That’s correct. A few times a year when I’m feeling really crazy, I’ll have a Margarita with my Mexican meal. Closest I come to happy recreational drugs.

DH now knows his usual peak flow, DJLippy, but this was his first bad attack.

Yes I work in NHS and can confirm paperwork is always patchy. It's not like you have a master file with all your medical appointments and illnesses. They rely on self reporting by the patient. If a patient withholds information who is to blame if something goes wrong?

I'm assuming E is oestrogen, NotTG, rather than happy recreational drugs?

Good grief.

DH once came near to medical calamity because he did a peak flow test for asthma and the GP misread the chart for his height (by a good foot - he's tall) and missed how low he was reading for so large a chap. If they'd misread it for sex as well...

My transgender 20 year old has had medical records changed to say the opposite of their birth sex, with a discussion with the GP who said remember you won't be called for cervical screening now, so if you want it make sure you ask. Has had no physical changes or hormones to date. It is insane.

This is insanity. I brought this up as a potential hazard on a recent thread and was told by a UK medic that it could never happen, as doctors are always aware of our biological sex and that takes precedence.

I don't believe that a health system that is prescribing hormones and performing surgery on individuals doesn't know their sex. There is a world of difference between changing a marker on a screen so a receptionist calls a patient Mr or Ms, and a medic having to give appropriate treatment.

My bloodwork is compared to both male and female norms. I didn’t have surgery that took months to heal just to drop dead because of my feels and refusing to acknowledge what body I was born in.

I want to live and enjoy life with my family. If they told me that I needed to drop E tomorrow, guess what I would do? Wouldn’t be happy, but people are told medical news that isn’t ideal every day.

I try to be an adult.

Wasn't there a Twitter thread in regards to "no such thing as a transgender broken arm"

People really do fail to see how any medication or any hormonal imbalances could affect healing and/or alter decisions 're surgery. I'm not sure if being male or female affects anaesthetic? I would assume that lung capacity and heart size could play a factor in working out dosages?

Ectopic pregnancies can be fatal sex is vital to know surely?

Would someome really worry about feeling if a person was unconscious?

What about hear attacks they present differently in women?

Surely an unwillingness to withhold vital info could be considered being suicidal?

The Drs aren't even allowed to discuss yoir case with the general public so no one would even know you told them you were biologically different to how you present ?

Many people jumped in to defend this position, accusing me of bigotry - saying I was not seeing the person, just seeing their sex.

If I rock up with stage three kidney failure I have no need of any medic knowing my opinions on life, the universe, sexuality, baroque music or cat food. It’s irrelevant. My eGFR is very relevant. My second is relevant (and for once in this case her race would be relevant too.)

I just need them to objectively assess my kidney function and take the best course of action.

Collusion of medics towards people attaining Darwin awards is basically eugenics, innit.

There comes a point where, if someone is absolutely hell-bent on qualifying for a "Darwin Award" there's not a lot that you can do about it. But medics should not collude in this behaviour.

Surely even in the lalaland of alleged 51% suiciding (which I'm guessing is why they don't want her T stopped?), it should be bloody clear to the TRAs that the risk is tiny compared to a 100% chance of dying of untreated severe kidney disease?!

One wonders how must not belittle trans status at all costs they'd be if it was a biological male who was about to die because of something similar...?

Debating this on a twitter thread recently and I was accused of trans-phobia for suggesting that knowing the sex of your patient was a pretty basic requirement. Many people jumped in to defend this position, accusing me of bigotry - saying I was not seeing the person, just seeing their sex. It was like I was in the twilight zone. OK I understand arguing about the nature of gender but denial of male/female biological difference is bizarre. Saying that including this information in a healthcare assessment is phobic now? It really bothered me because these zealots obviously don't care about the health and well-being of trans patients. I was even told that sending smear test reminders was wrong because it would be 'triggering.' How can you argue with that?