Biology matters in medicine - medicine failing trans individuals

[KittyKlaws]

I was reading a feminist group I'm a member of and someone posted this article which comes from lascapigliata which some of you may be familiar with. lascapigliata is a feminist and a doctor and often comes at this with a medical perspective. In this case a trans man (TIF) was given inappropriate treatment due to gender identity rather than biological reality which led to further issues resulting in needing a transplant.

I found it interesting and demonstrative of why biology still matters very much. If you are interested you can read more here:

lascapigliata8.wordpress.com/2018/04/29/transgenderism-and-unethical-medicine/

Copied the post below from a related discussion. This has really disturbing ethical implications for the medical community.
www.reddit.com/r/GenderCritical/comments/8g6yke/transgender_man_being_evaluated_for_a_kidney/

This report shows the full depth of transgender delusion over basic biology.
"A 33-year-old female-to-male transgender individual (height, 5′1″; weight, 135 lb) presented"
"Laboratory results revealed an estimated glomerular filtration rate (eGFR)3 of 31 mL/min/1.73m2 if assessed using the male equation or 23 mL/min/1.73m2 if assessed using the female equation. On the basis of male categorization, the patient was diagnosed with stage 3 chronic kidney disease (CKD3), "
Fucking important note at this point: a kidney's function is to filter, so HIGHER filtration rates are better. The female equation gave a kidney disease stage of stage 4/'severe' (dialysis and transplant both likely required), the next step is 'end-stage', i.e. 'you're about to fucking DIE', whereas the male equation said she was only in 'moderate' kidney disease, which is controllable with diet.
"Renal transplant evaluation was initiated several months later. Corresponding male eGFR was 24 mL/min/1.73m2, but the corresponding female eGFR was 18 mL/min/1.73m2. Urine protein excretion was 3 g/day. Because transplant candidates require a GFR

Thanks Ova its the same text. So easier to access now you've copied it over. lascapigliata also has some other interesting cases on the blog and Twitter with medical implications. It makes for disturbing reading and I can't see how it is helping anyone.

Jesus Christ.

There was me thinking it'd be "just" transwomen demanding smear tests and not being diagnosed with prostate cancer...

The interesting thing is that the authors of the study are themselves transactivists. They said it was wrong to tell the woman to discontinue testosterone (because getting proper 'transgender therapy' is deemed more important than basic health), even though there's good evidence that taking testosterone is very harmful in patients with kidney disease.

Moreover, they explain that the doctors were confused about whether to treat her as female based on her body, reproductive structures, muscle, etc. or male based on her (artificial) testosterone levels, yet they resist discontinuing the artificial testosterone which would have completely solved this confusion.

Also the woman in question went to one hospital who stopped her daily testosterone injections, but she perceived this as transphobia, so she shopped for a different hospital who restarted her injections.

All the while her kidney function was declining rapidly, towards an early grave, but the important thing is the second hospital restarted her on the T, even though it might have worsened her kidney disease.

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.

The USA seems to have low standards of medical care compared to the UK. I'm very concerned about us adopting their system.

My god. What an utter balls up. Surely the logical thing to do would be to err on the side of caution and use the female measurements (and discontinue testosterone) in a small, slight, female patient? how would they possibly defend their decisions in a court of law?

The implication that medical ethics can be subverted due to pressure from the trans ideology is deeply disturbing.

Medicine is physical. It’s based on evidence and the physicality of the body you are treating. To ignore that physicality due to ideology is grotesque.

Could there be a more shocking example of opinion trumping reality? We are down the rabbit hole here.

While I don’t usually get onside with the ‘sue them all’ mentality I think this would be a very interesting case to test legally. Does the text say if this is going to court at all?

We cannot have a situation where medics are afraid to treat a patient according to the biological reality they see before them, where treating as the incorrect sex would damage the patient. It’s unthinkable.

While I don’t usually get onside with the ‘sue them all’ mentality I think this would be a very interesting case to test legally. Does the text say if this is going to court at all?

Probably not if what TerfinUSA says is true and she holds some of the responsibility herself in hospital shopping.

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?

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...?

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.

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

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.

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 ?

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.

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 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.

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...

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

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?

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

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.

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

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.