BBC Article about why Transgender People are Ignored in Medicine

I do feel extremely sorry for medical staff in all of this. They already have so much to contend with... Try A&E on a Friday night...

trying to get accurate information from patients who may be unconscious or unable to communicate, who may be having a mental health episode, who may be high, abusive or decide to lie for whatever reason, are all fairly common scenarios.

Having to be clairvoyant about someone’s birth sex while maintaining correct pronouns at all times and gaslighting other vulnerable patients about the gender of the person in the bed next door just adds a whole new dimension of stress to a busy shift, and potentially damages the level of care that patients get. Obviously patient dignity is important, but pronouns and notions of inner gender matter a lot less when you’re fighting to save someone’s life.

What about something like

“What is your sex? (We need this as some treatments are specific to your biological sex)

How do you wish to be referred to? (Woman, man, transman, transwoman, other (please elaborate in the box provided))

Would this work? So a transman would be called for screenings they would require but would be referred to as male?

It's a sad story, in the sense of being a classic tragedy.

My understanding is that the entire trans argument hinges off the idea that people are so deeply socialised to treat men and women differently that the only way to have your actual personality (oh fine, "inner gender identity") respected is to actually change your body AND its styling. And then you must work on fooling people into never realising who you actually started off being. The entire thing being based on the validity of deception to get a "just" result is based on a argument that society will never stop expecting women to Be Pretty and men to Do Things, so if you're an un-pretty, doing things kind of women you might as well be a man.

Now, after being astonishingly successful in mainstreaming this idea, transfolk are finding that they have set up a system that can continue to pile on risk and pain based on the deception they insisted was absolutely necessary in the first place.

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.

So many typos in that post 🙄

What happens if an emergency situation occurs for a current patient who can't answer as too unwell, yet the doctors are relying on NHS records saying this patient? Yes - Cameron is so wrapped in their delusion that they've 'changed sex' so it's 'cute' to feel validated as a transman (read, in Cameron's head, Male).
But the NHS also need to sort out their medical forms. When asked tip fill in Gender - most often their options are 'Male, Female, transgender, non-binary'. The latter two ARE about gender identity and and the former two about biological sex! Which is what doctors need to know to treat the patient!

The NHS needs to re-write their forms such that they capture accurate information. My thoughts are:

1. Biological sex; Male or Female
2. Gender Identity; None (ie like many of us we are just 'us'), Transgender, Non-Binary, Other (then free text)

If any other than the None option of q 2 is selected then it should then list Q 3, being:

3. Are you taking puberty blockers or cross-sex hormones; Yes / No and provide free text to explain what

This information needs to be captured via GPs and all NHS services such that questionnaires be consistent across the board.

It's crazy that people are allowed to change the sex on their birth certificate via the Gender Reform Act. We know from this article you simply cannot change sex. The Govt is ultimately failing ppl who identify as trans because they've let people believe they can officially change to 'the opposite sex'. Medicine doesn't care about how you feel in your head.

Cameron is at fault, yes, because they should've been honest. It's sad that medical practitioners feel they have to play along with the game as they're worried they'll lose their jobs. There's nothing cute about dying.

You only have to read "Invisible Women" to know that vast swathes of medicine ignore women and evidence suggests that black women are even more unheard, especially in relation to pregnancy and birth. I would like to see the BBC reporting more about these issues, which affect far more people than healthcare for transgender people.

They could also report on the often shocking treatment that adults with learning disabilities and/or autism receive. An actual vulnerable minority that is overlooked by pretty much everyone. And despite there being many scandals about the poor treatment (and often outright neglect) that vulnerable adults with learning disabilities have been subjected to, it's something that largely goes ignored by the media.
Ditto with the lack of funding for mental health services. All way more important than pandering to the trans minority.

I found the mainstreaming of certain ideas in the piece interesting. For instance, the long history of transgender individuals existing, something I never heard about before with the exception of cross-dressing men.

And then the idea that we might as well be called by some chopped up female organ in calls for health screenings because that is a good thing for transgender individuals. I don't want to be called by my organs.

Delving deeper, I always come to that point where I try to understand why sexist views about what men and women are is so foundational for these arguments but the sexes those views are actually hung on is erased. How would that work in reality? I would think the concept of genders would collapse if people, indeed, somehow stopped seeing someone's biological sex.

That's not going to happen. I always hoped that we would be able to loosen gender roles and erase some of the worst gender stereotypes, and that seemed to be the only feasible way toward a more egalitarian society between male and female human beings. But we are reversing at high speed.

Patient lies to doctors; blames them. I'm all out of sympathy. This is what false records and forcing everyone else to lie gets you.

From the article One solution to these issues is to introduce an option to register as transgender or non-binary

Clearly it makes sense for a patient to tell medical staff that they are transgender but non- binary?

What difference does that make if there are no surgical or pharmacological interventions.

I'm still not clear how, while it was cute and awesome for the HCPs to assume Cameron was male, the fact that a scan revealed a uterus didn't lead to some fairly blunt questioning.

If anyone is responsible for Cameron nearly dying (and I'm so glad they got a kidney), then it's Cameron and a system which TRAs have created which doesn't allow anyone to ask questions.

I suppose if someone passes well and their privacy is maintained at all times (as in guidelines on one of the Scottish nhs threads). Is it possible, on change of shift or a different nurse coming to do an observation, that “male” is assumed and a blood sample submitted accordingly, even if trans history is buried somewhere in their notes?

This person has no-one to blame but themselves.

Did the patient not state that they were on Testosterone for 20 years and why? Did they feel that that particular fact may also not have relevance? And yes, surely you have to answer to questions about major surgery like mastectomies...

Just reiterating this. You get bombarded with questions when you are first booked in for any procedure - including are you taking any medication?

I find it very hard to believe the medical staff was so remiss they omitted to ask a question which is 100% routine.

So, when the doctor asked - and they always do ask - whether Cameron was taking any drugs or other medication, did he not think to mention 20 years' worth of testosterone? And explain why?

Problem sorted.

But the point is, we don’t have those studies, those standardised ranges made by clinical trials of thousands of patients. Reference ranges can even vary between labs or the type of machine used etc.

So for example, you start with a geriatric female patient... parameter reference range a-z, you know she’s on ACE inhibitors and warfarin, so that might explain a slightly higher/lower reading for value v and r for example, a medic can put all that into the clinical picture and make sense of it.

Not if someone actually ticked male or adolescent on the submission form... then the results are meaningless for that patient. This is effectively what happened here.

So there are two issues here:

• medical staff not knowing that a trans person was born, and is biologically, a different sex as this is not recorded. And not all trans people are willing to be open and upfront about this - despite medical confidentiality. I have little sympathy with this argument, medical staff are not psychic - there is a reason they ask about medical history (o/w gender reassignment surgery or medication is relevant).

• a lack of research into the impact that taking sex hormones can affect presentation and progression of medical conditions. This I have huge sympathy with - but as a small population with great diversity in how medical transition has been effected, and an unwillingness to allow accurate data to be collected - i struggle to see how this can be easily resolved.

@PumbaasCucumbas Would it definitely not have an effect on these things? Sex hormones do a lot of stuff. And they talked in the article about how knowing what ranges should be used for various stats was difficult. I'm guessing that part of the problem is that being trans and making bodily changes makes things more complicated. That doesn't mean doctors and patients shouldn't work together to do the best they can. While at the same time accepting that things might not be as easy as for other patients.

But deciding you are trans presumably doesn’t change your glomerular filtration rate or protein:creatinine ratio or whatever, these are tangible, measurable values... unless the trans lobby is now advocating that as well as calculating reference ranges for biological parameters based on age and sex, we now need to study the individual effects of every combination of male/female hormone treatments on every organ system in the body, to come up with some trans reference range?

You only have to read "Invisible Women" to know that vast swathes of medicine ignore women and evidence suggests that black women are even more unheard, especially in relation to pregnancy and birth. I would like to see the BBC reporting more about these issues, which affect far more people than healthcare for transgender people.

Yes, the sex of a patient's body matters, but so does gender identity - if that gender identity means that they have had surgery / hormones. If your sex is female but gender is man and you are taking testosterone then a doctor needs to know that. Just as a doctor needs to know about other medically relevant details. So I think it's not quite right when people say it's sex, not gender that counts. As so often, it's more complicated than that.

Part of the problem is a failure of the medical system to treat us as individuals. This happens all the time. Sometimes, the practitioner/system is at fault, other times it's just that we have to go on averages because we can't have everything expressly calculated for every individual. But, for example, an asthmatic might know that their own peak flow doesn't drop in a classic way. It's important that they work with the doctor and communicate that so that appropriate treatment can be given or not. And that's a responsibility on both sides.

With the kidney case, there probably aren't reference cases for trans men and women, because research has been done on the big, obvious groups of men and women. But that's an argument to collect more data on a diverse group of people and do more research. You can't do that research if you don't collect accurate data.

I have a strong urge to go read that thread again now.

This is a problem entirely of their own making Yup.

It's the trans version of cutted up pear.

The crisis in trans health care appears to be about people suddenly realising that all this cosmetic surgery and hormones is not good for you, nor is lying about your sex.

Instead doctors must rely on their patient to tell them.

”Sometimes this can be okay,” says Dina Greene, a clinical chemist and expert in transgender health at the University of Washington, Seattle. In many cases, if someone is going to see a medical expert where gender seems irrelevant, patients might not want their doctor to know they are transgender, she says. "It’s stigmatised.”

Well make up your bloody mind! Either you want the medical professionals to know you’re transgender or you don’t! Your ‘Gender’ may appear to be unimportant during an appointment, but your sex may make the difference between life and death.

Women often present differently with heart conditions than men, so for a clinical chemist to suggest that someone identifying themselves as not being of their born sex, may not be important, is extremely irresponsible.

It certainly reads more like a reluctance to be straightforward and honest, causing the medical staff to make dangerous decisions. Or maybe they honestly thought that a small amount of testosterone completely negates a female biology.... And they are supposedly educators....