Transman loses baby during hysterectomy

It sounds like this baby was lost either way in this sad tale. But I don’t believe being trans and undergoing ‘transition’ is irrelevant. She talks as though she might be pregnant (considerations of getting a pregnancy test in advance), of not wanting to delay surgery (rushed into a decision not to delay and go on testosterone first). I do wonder what she wrote to those ministers; when she says ‘everyone should have HCG checked’ is she talking about men too? About removing sexed language? Pregnancy is only one aspect of sexed care, I imagine anaesthesia also needs sex to be clear.

I wonder if....

She didn't say she'd had sex with a man a few months before. It is possible that when being questioned, she didn't want to admit to sex with a man because that may have invalidated the operation, as she clearly wasn't living as a man, sexually.

I must be missing something because if a woman wants to be a man, and has elective major surgery for that, why was she having heterosexual PIV sex with a man only 4 months ago?

If she had transitioned enough to have surgery, it's odd she was ovulating still as usually she'd be given drugs.

And, if she believed 'she' was male, would she not want gay sex with another man?

It's all bonkers.

It seems that there are surgeons and clinics out there who are prepared to perform all sorts of surgical operations without following any of the established protocols to ensure that the procedure is absolutely necessary.

I hope that eventually some sort of class action will catch up with them.

So this procedure saved the person's life, then? As the placenta was growing into the scar tissue, which would have caused rupture and catastrophic bleeding -the nine hour surgery and ITU stay suggests how life threatening the pregnancy was.

Had the surgery not been performed or was cancelled due to a positive test, wouldn't that mean the first they'd have known about the issue would have likely been a rupture - and then there would have been an emergency hysterectomy performed under less optimal circumstances (ie, bleeding out) with a worse outcome for the patient and the existing children?

Naturally, there will be some posting on SM shaking and crying because they had a pregnancy test performed on them at the hospital - and I think that should be a tough shit situation - but in the long run, this person is extremely fortunate to be alive and wouldn't have ended up with a child at the end of it, whether there had been a test performed or not.

I’m astonished to which is why I don’t believe the patients version of events it’s just so elementary. I don’t believe it could’ve happened without the patient outright refusing to have a pregnancy test and intimidating the HCP into not pushing the matter.

It’s not a narrative of the woman lied. It’s a narrative of the patient lied and my god they do. It’s just usually you can say dont be so bloody stupid now piss on that stick.

I'm not trying to be goady, and it may be daft. I am no expert in any of this

"In my experience women are always given pregnancy tests before surgery"

Yes, they are but:

1. the hormone doesn't give a positive once you're further into pregnancy, so a test wouldn't necessarily show as positive, even when pregnant.
2. perhaps as this woman was identifying as a man, the hospital didn't even test or scan or check first - if this is the case, that is utterly negligent and horrifying.

DrLightman
If they are meant to live as a man, then surely that does not include having a penis put inside their vagina

As gender critical as I am, I have to say that this comment is (a) not relevant and (b) daft.

@VickyEadieofThigh

The context is relevant though. Had the patient admitted to PIV sex they may not meet the psychological criteria for removal of their womb and ovaries as part of their sex change. It's naive to think someone in that position, who is presumably very strongly invested in having their surgery, would admit to recent PIV sex.

What the utter fuck.

I had to repeatedly tell the hospital nurse 'there is no point in me having a pregnancy test then waiting for results before gynae surgery, because I am 60 and waaay past menopause'.

How the hell has the medical profession gone so down the rabbit hole that they've forgotten a pre-menopausal member of the female sex, no matter how much they may deny that immutable fact, can get pregnant?

They can't claim they didn't realise the patient was female - they were doing a hysterectomy.

I’ve had 40+ surgeries - my last was 8 weeks ago, with a further General Anaesthetic last week for some tests… In most of those cases, I was asked if there was a chance I could be pregnant. My answer was no, and that was it (no blood tests or urine tests for pregnancy were done).

Same with my MRIs (35+), I’ve only ever been asked if I was pregnant, there were never tests done…

Thanks @Wenfy, I stand corrected.

The royal womens hospital do ops for intersex people, which might be why the confusion came into play. But the procedures were def not followed

No, this is the Royal WOMEN'S Hospital. They don't take patients of the male sex.

The patient's gender identity is not relevant here, save for being the reason for the hysterectomy. The hospital procedures were at fault, as has been admitted and remedied.

Frankly, I'm astonished that a major teaching hospital, specialising in women's health, would be so lax. I can only imagine it was a cost-saving measure. I was always taught that a female patient of childbearing age must be assumed to be pregnant until proved otherwise.

They asked questions about sexual activity and menstruation. Obviously, these questions are never going to be sufficient to determine a pregnancy!

Women forget, periods can be irregular.

It's a bit mind blowing that this hasn't happened before.

Mr Pohlner has written letters to Victorian Premier Daniel Andrews, Minister for Equality Harriet Shing, Health Minister Mary-Anne Thomas and Housing Minister Danny Pearson but is yet to receive any replies.

why haven't they replied?

Absolute bullshit and an insult to the medical professionals who carried on to the exact standards they would’ve under normal circumstances just under 10 times more pressure.

The exact standards? I'm not sure that's the zinger you think it is, given that those exact standards led to the medical professionals failing to carry out a pregnancy test before performing a hysterectomy.

Alright, then, listed.

The term is also defined on Wiktionary, among other places. So not just listed by JCCT.

Sounds like severe negligence on the part of the hospital.
But were they negligent because they took team trans into account or would this have happened to any woman on the day...

We need to see the questions and answers to know but I'm guessing this is personal data.

And I'm guessing we all know what answers will generate a "not pregnant" response after piv sex. If the sex question was correctly answered at the time. People can forget.... add a bit of trying hard not to offend and mix in the possibility of hormone replacement and I think this was a disaster waiting for the right circumstances. I really don't think any other woman would have had this happen to them without telling outright lies... being trans and how the hospital or nurse reacted to this is pertinent in this case.

Like all things healthcare related, the biological sex should have overridden all other concerns to keep everyone safe... the hospital will need to forego feelings in future...
This is a disaster.

Someone who calls themselves a man, who is actually a women, is lying yes.

In this instance, is it clear what made the nurse say that a test was not needed?

If not then it could be policy, it could be ommission or it could be lies.

I think the fact that they haven't specifically stated suggests that it could well be that she said she was a man that swayed the nurse into saying one wasn't needed. So probably policy.

But if that is not the case, it could be an ommission [ie not asking the right questions in the first place] or a lie to a question that was asked.

Its why we document interactions surely? So that these can be revisited when things go wrong.

This is a 'never' event.

Questions shouldn't be asked with a hysterectomy. Who the hell thinks thats sufficient?

Gender is irrelevant. Patients won't necessarily tell the truth especially in the presence of a partner. Infidelity, concealment or denial of pregnancy, abuse or assault being difficult to talk about are factors that exist regardless of gender.* *Being trans gender simply may have made these factors more likely.

No hysterectomy should be done without the relevant tests and checking for pregnancy. No exceptions.

JCCT didn't "recommend" any words.

They published a glossary for HCPs to list words that patients may use about themselves.

I could direct you to discussions on terms which Jo's Cervical Cancer Trust recommended for use by health care providers - well, one term in particular.

You'd think so.

My friend was in a straight marriage, actively TTC and they didn't ask or test her before a procedure. She was six weeks pregnant with a history of MC - luckily he clung on!

I had a particular medication denied me because they'd run out of tests at the GP, and they couldn't verify if I was pregnant.

It seems astonishing when test strips can be 5 for a quid