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Feminism: Sex and gender discussions

BBC Article about why Transgender People are Ignored in Medicine

132 replies

gardenbird48 · 19/08/2020 10:37

www.bbc.com/future/article/20200814-why-our-medical-systems-are-ignoring-transgender-people

I’m a bit mystified by this - the patient in question is a trans man who passes really well. He has updated his medical records to show male and has essentially obliterated any history of being female.
He became ill with a kidney problem but because doctors were using the higher male thresholds for various tests, they didn’t start treatment in time and he nearly died.
I’m wondering how said patient expected the doctors to do anything different given the information that was provided to them. On one hand the transgender people actively want to obscure any reference to their biological sex and even transgender status but on the other hand doctors find that information essential in order to treat them safely. I feel very sorry for doctors.

OP posts:
endofthelinefinally · 21/08/2020 08:44

Before I retired I looked after a couple of M tF transgender patients. This fact was recorded on their medical records. There was no problem, but this was about 5 years ago, before it all got so silly.

DuDuDuLangaLangaBingBong · 20/08/2020 23:00

Exactly, MissLucy!

It’s a bonkers bit of legislation that is so busy ‘affirming’ an untruth that it puts the actual health and well-being of transpeople at risk.

This is what happens when you let niche activists (ie Press For Change, Whittle and Burns) write laws: blind spots. They were so busy shitting on the sex based rights of women and girls that they didn’t notice the shit on their own doorstep.

MissLucyEyelesbarrow · 20/08/2020 22:36

@GoldenBlue

NHS systems should record sex and administrative gender.

Sex being biology and used for pathology, pharmacology, screening etc.
Gender can be used for letters etc for politeness/kindness

The risks associated with the loss of medical history is high and even allowing patients to knowingly make this decision is a real concern

That won't happen because the geniuses who drafted the GRA made it a criminal offence for a HCP to disclose the bio sex of someone who has a GRC without consent. (people always disbelieve me about this so here is a lawyer, explaining it)

So no one in the NHS is going to record trans people's sex - and so risk getting a criminal record and the sack.

PumbaasCucumbas · 20/08/2020 21:38

@ThinEndoftheWedge

there are two sexes and two surgically and hormonal altered variations that may have different medical needs than what they would have had if they'd stick to their natal configuration.

There are two sexes. Period.

All our medical needs are based on a complex combination of sex, presenting medical complaints, past medical history, past medical interventions/operations and current medications. Some have no past medical history - others have complex ones.

Transgender past medical history/interventions etc is but one example of many healthcare needs medics come across daily e.g cardiac/ lung disease/ cancer etc.

Doesn’t change the fact that there is still two sexes.

This.

It takes a lot of self absorbed naïveté to think that altering sex data on medical records or keeping quiet about hormone treatments etc is justified because of your profound specialness and it’s the doctors job to second guess this. If myself or one of my children had a weird blood group or a severe allergy or a back to front heart or whatever, I’d be telling every doctor in every conversation to make sure no mistakes happened.

Antibles · 20/08/2020 21:29

The NHS should only be asking for Sex: Male or Female.

Gender ideology should not be given any further credence.

Staff are busy enough without being confused and gaslit.

Hormones and surgery come under medications and procedures, previous medical history. If somebody wants to lie about that, on their own head be it.

ThinEndoftheWedge · 20/08/2020 21:11

there are two sexes and two surgically and hormonal altered variations that may have different medical needs than what they would have had if they'd stick to their natal configuration.

There are two sexes. Period.

All our medical needs are based on a complex combination of sex, presenting medical complaints, past medical history, past medical interventions/operations and current medications. Some have no past medical history - others have complex ones.

Transgender past medical history/interventions etc is but one example of many healthcare needs medics come across daily e.g cardiac/ lung disease/ cancer etc.

Doesn’t change the fact that there is still two sexes.

LillianBland · 20/08/2020 20:58

transgender have unique needs and the health care system needs to recognise this.

Yup, they need to honest about their born sex, past history of operations and any medication they’re on, to the health professionals. Just like the rest of us have to. That way they’ll get the correct treatment.

Singasonga · 20/08/2020 19:16

Midclegs, there are two sexes and two surgically and hormonal altered variations that may have different medical needs than what they would have had if they'd stick to their natal configuration. There is genuinely a problem in the lack of knowledge anyone has bothered to accumulate about what trans people are doing to themselves long term, not at all helped by the TRAs who've spent ages screaming at anyone who wanted to look into it.

midclegs · 20/08/2020 19:04

@Singasonga "As someone above has said, if the goal had set out to have citizen records to have recorded sex as male, female, transman, transwoman, and a field for gender identity as masc, femme, non-binary, none, other [fill in], we'd have both made the social cues more inclusive AND ensured better care for transgender people AND possibly not spent the past six years having to explain that women's rights and child safeguarding are worth keeping."

Transman and transwoman are NOT sexes. There are only 2 sexes; Male and Female.

DuDuDuLangaLangaBingBong · 20/08/2020 18:57

Based on the female cut-off, he would have been allowed a transplant immediately. But he’s registered as a man on his medical records, and this meant his doctors used the male eGFR level.

But, but! The transactivists keep telling us that ThErE Is nO sUch THinG aS bIoLoGIcaL SeX.

Complete privacy (such as not being able to ask for a GRC) is what people like Stephen Whittle campaigned for. Shame it’s so fucking dangerous to the actual health of the people Whittle was supposedly campaigning FOR.

Al1Langdownthecleghole · 20/08/2020 18:36

@MorrisZapp

I'm calling it. I honestly think this is a Daily Mail style dog whistle. All those word salad sentences which they know fine well will be read by most people as 'look at the state of this epic twat. Calls himself a professor but was more concerned with' passing' than with remaining alive. And some people are even worse! They call themselves 'non binary'! Fkin shit show or what lads?'

They absolutely know what they're doing.

I'm inclined to agree.

Although this wasn't UK healthcare, I am struggling to believe that the clerking medic didn't obtain a medical history, drug history and examine the patient.

And I don't believe that investigations wouldn't have shown up a shortened urethra and other sex specific findings.

Of course the patient had a responsibility here to give their history. But clinical assessment would have picked up anomalies.

Siablue · 20/08/2020 17:31

@IrenetheQuaint

I thought it was a good article that made very clear that both sex and gender need to be captured on transpeople's medical records (with detail about any past or present meds/surgery too). Transmen have a fundamentally female biology but testosterone can affect the way their body processes meds etc so it is crucial that this is taken into account (and vice versa with transwomen).

I would hope this would be fairly uncontroversial, but clearly not!

I also thought it was a good article and of course transgender have unique needs and the health care system needs to recognise this.
andyoldlabour · 20/08/2020 17:09

If somone's medical records are changed from recording the patient as "Male" instead of "Female", does that mean they will be called for prostrate examinations instead of cervical smears?
What a confusing world we now live in.

GoldenBlue · 20/08/2020 16:52

NHS systems should record sex and administrative gender.

Sex being biology and used for pathology, pharmacology, screening etc.
Gender can be used for letters etc for politeness/kindness

The risks associated with the loss of medical history is high and even allowing patients to knowingly make this decision is a real concern

Signalbox · 20/08/2020 15:59

Gosh you don’t have to look very far to see why people may not think it’s necessary to inform health professionals about their medical history. Lumping LGBT all together. As if not disclosing that you are gay is the same as not disclosing you are transgender!

patient.info/news-and-features/should-you-come-out-as-lgbtq-to-your-doctor

"Someone's sexual orientation or gender identity may have an impact on their health needs, so as long as a person feels safe to do so, it's a good idea to share this with a doctor or healthcare professional. However, many LGBT people do not feel comfortable sharing this with healthcare staff, and coming out is not something that anyone should ever feel pressured or forced into doing," explains Laura Russell, Director of Campaigns, Policy and Research at Stonewall

JellySlice · 20/08/2020 15:14

If being transgender isn’t considered a medical issue, yet people do receive medical treatment in the form of surgery and/ puberty blockers or cross sex hormones,

Being transgender may not be considered a medical issue, yet, by receiving medical treatment in the form of surgery and/ puberty blockers or cross sex hormones, transgender people create a medical issue for themselves.

I don't know how medical insurance worried in the US. I know that in the UK pre-existing conditions are not generally included. Could it be that Cameron did not declare their transgenderism because it was not covered?

When their medical history was taken, did they not declare the testosterone supplementation? When medications are declared to HCPs, and it is not immediately obvious why they are being taken, the HCP will ask. Eg if I, a 50+ woman am very ill in the middle of the winter, and tell the doctor that I'm taking HRT, Pimecrolimus and Piriton, they're not going to ask why I'm taking HRT, but they're definitely going to ask about the other meds!

Totally self-inflicted, and made worse by the bizarre collusion of establishment in individual delusion. I can't help wondering, also, whether HCPs correctly identified Cameron as female, but were effectively gagged by the policy of collusion.

LillianBland · 20/08/2020 14:16

I used to work in insurance, so I know that underwriters will look for any reason whatsoever to not pay out, and failure to disclose long term treatments is one they pounce upon.
So, legally not having to disclose sex makes no actual difference, you still won’t get a payout because you’ve deliberately withheld information from the insurer. Bit of a Pyrrhic victory, then...

I was wondering about that. When I was working for others, I had payment protection in place to cover illness, but they wouldn’t have paid out, bad I not been honest about any medications, previous operations or underlying conditions. By not telling the hospital about their previous operations and medications, I assume their, if they had it, payment protection won’t have paid out?

gardenbird48 · 20/08/2020 13:28

it is very concerning that someone's dysphoria is so extreme that they deliberately withhold vital information from doctors that could put their health and their life at risk. It almost sounds like a type of self harm in that context.

This person would have had to have had many conversations with doctors regarding their birth sex and the procedures needed to change their appearance so effectively so it seems that post-surgery the dysphoria hasn't improved and could be viewed to have become worse to the extent where their life is put at risk. From an insurance point of view it could end up with doctors refusing to treat people unless they have a DNA test first to determine sex due to the risks if information is withheld.
In which case, they could actually cut out the delay to treatment and have a fixed sex marker on medical records that accurately reflect a patient's sex.

OP posts:
Vermeil · 20/08/2020 12:38

@CharlieParley
Interesting. But the potential problems I outlined are still there. If being transgender isn’t considered a medical issue, yet people do receive medical treatment in the form of surgery and/ puberty blockers or cross sex hormones, then they will still have to tell the insurer or their policy is invalid, as it will be information that will put a weighting on any premium. This would apply to life insurance, and to travel insurance as well. Failure to give such info invalidates the policy, and in the case of travel insurance could result in the insurer refusing to pay out for medical treatment while abroad, even if it’s for something as unrelated as a broken leg, I used to work in insurance, so I know that underwriters will look for any reason whatsoever to not pay out, and failure to disclose long term treatments is one they pounce upon.
So, legally not having to disclose sex makes no actual difference, you still won’t get a payout because you’ve deliberately withheld information from the insurer. Bit of a Pyrrhic victory, then...

merrymouse · 20/08/2020 11:44

A document which said sex: female, gender: transman would give the doctors more chance of saving their life.

Often people with invisible conditions like diabetes wear jewellery incase they are involved in an accident. However, that can only work if there is no stigma attached to diabetes, and if there is acceptance that having diabetes is a neutral fact, not an identity.

andyoldlabour · 20/08/2020 11:42

The narcissism surrounding this is astonishing. The patient makes every effort to not appear as their true sex, including having their medical records changed to reflect their chosen gender (something which should never happen IMHO), lies about everything, then blames the NHS when it all goes wrong.
Then we have the BBC, refusing to acknowledge this. They are so not fit for purpose.

CharlieParley · 20/08/2020 11:40

That was in response to Vermeil

CharlieParley · 20/08/2020 11:39

You're quite right, and insurance was a big point of discussion in the run-up to the GRA. The industry got some exemptions then, but a 2010 judgement in a European Court of Human Rights case found that basing insurance premium calculations on the empirical data showing real statistical differences between men and women was discrimination.

So now, even in insurance products where sex makes a difference to actual risk, affecting premiums and benefits, insurers in the EU are no longer allowed to take sex into account. And haven't been since the end if 2012.

OldCrone · 20/08/2020 11:33

Trans people are being let down by the medical profession, but not in the way implied by the article.

If someone wants to medically transition, their doctors have a duty to make sure they understand that they can't change sex. That they will always be the sex they were born as and that when seeking any medical treatment it's important that they let their doctors know their biological sex.

Any doctor who gives the false impression to their trans patients that post-transition (hormones and/or surgery) they can ignore their biological sex when in need of medical attention is negligent. I know that doctors are put in an impossible situation here because of the shouts of 'transphobia', and I don't know what the solution is. Their professional bodies and the government should support them to do what is right for the welfare of their patients despite the reality denial of the transactivists.

Governments which have allowed people to change their sex marker on their official documents have made this situation even worse. So if someone like Whitley had been in an accident or was suddenly taken ill and was unconscious, looking outwardly male, and with documents which state 'sex: male', they would be (medically) treated as male, which could kill them. A document which said sex: female, gender: transman would give the doctors more chance of saving their life.

Vermeil · 20/08/2020 10:27

While this focuses on the medical treatment side, there is another area where the insistence on biological sex denial will have major repercussions, and as it involves large sums of money and the financial industry, I can’t see them having much truck with it all.

Life Insurance.

Lying about your biological sex when taking out life insurance will invalidate your policy. If you die from or develop a preventable yet serious sex-specific condition that qualifies for a payout, but you lied and therefore didn’t have the necessary treatment for your condition, then you will get nothing.
Feel as validated as you like, but the underwriters won’t care. Take them to court? It’ll be down in black and white that you lied, you won’t stand a chance. As to hoping that a court case will bring some legal change where insurers can no longer ask for your sex, it won’t happen, at least not in your favour. Neither the pile-on brigade nor Stonewall have the financial or legal or lobbying muscle to take on the big insurers.
I would be interested in how insurers are currently dealing with this, as for all the insistence that it’s not a medical condition, it often involves an awful lot of medical treatment, which you will have to declare when taking out a policy. The long-term effects of cross sex hormones are still unknown, and insurers are very risk-averse. It must make for a very expensive premium.

As time goes on we’re going to see more and more unavoidable brick walls like this cropping up, and it will become ever more glaringly obvious that you can’t escape your biology.

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