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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:
ThinEndoftheWedge · 19/08/2020 10:43

Gender is fundamental to many decisions in health care systems around the world – and this puts transgender people in a vulnerable position

Sorry - couldn't read further than the headline. Says all you need to know about the BBC.

Sex is fundamental to the incidence, symptoms, diagnosis, treatment and outcomes of disease, not gender.

Errors of healthcare which were based on gender only serves to underline the importance of sex in healthcare.

The BBC is turning itself into an embarrassment.

MadamBatty · 19/08/2020 10:45

I was hoping that somebody would post a link to this.

I found the article very confusing, It refers to gender when they mean sex, it speaks how trans gender people are badly treated in healthcare.

What do they want? For everyone to refer to them as the opposite of the sex they were born as, except except when it comes to healthcare despite the fact that they’ve done everything to erase details of the sex they were born as?

How would doctors do that? chromosomes? We all know that doesn’t work either right?

JellySlice · 19/08/2020 10:48

Cameron should have taken responsibility for themselves and told the doctors from the very first consult that they are female. (Dear god what an awkward sentence - purely because we are required to ignore the same biological reality that nearly killed this person.)

Should I complain that medical care ignores obscure allergies if I do not declare my allergy to HCPs and then get sicker as a result of incorrect treatment?

LittleBearPad · 19/08/2020 10:52

When the doctors were taking Cameron’s history he should have mentioned he was born female - simple!

GrandmaMazur · 19/08/2020 10:54

‘Rather than devising new ways to cope with changing social norms, transgender people are often shoehorned into inappropriate boxes instead.’

But it’s not the doctors doing the shoehorning is it?

Beamur · 19/08/2020 10:58

A large aspect of this article that is acknowledged though, is that a person being transgender is really important to what medical treatment they receive. This means however, that the trans person must accept it being recorded in some way.
Doctors will treat patients as to how their records reflect them. The main patient in this article risked their own life by not disclosing the fact they were born female, that was not the doctors fault.
The lack of knowledge as to how cross sex hormones affects healthcare is a huge issue.

MadamBatty · 19/08/2020 10:59

& what social norms should be changed?

This article is melting my brain, the dissonance is well it just is!

CharlieParley · 19/08/2020 11:08

No. Just no.

No, you cannot demand the right to have yourself registered as the opposite-sex and then complain that you miss vital screenings due those of your birth sex. And no, you cannot register as the opposite sex, not inform your doctors that you are in fact the other sex and then complain about medical malpractice.

This is a problem entirely of their own making. Very many people warned that changing the sex marker on medical records would lead to people receiving the wrong treatment and screening invites. But that was apparently transphobic in not acknowledging the identity of those who identify as trans.

Sex matters in healthcare. We've barely got the medical system to accept that women are not just small men with "boobs and tubes". That "bikini medicine" risks women's lives, health and wellbeing.

And now they demand that we create nebulous criteria to diagnose and treat that ignore sex? So those who have registered as the opposite sex don't have to acknowledge their birth sex at the doctors?

Thingybob · 19/08/2020 11:13

What do they want?

That all sex based reference figures in medicine are revised to include non biological males and females?

Babdoc · 19/08/2020 11:19

Adult patients are responsible for their own healthcare decisions. If they prefer to lie to doctors about their sex and use gender identity instead, then they will have to accept that it may cost them their life.
They are at liberty to make decisions that others would regard as crazy or unacceptable, as long as they are deemed to have mental capacity.
My only worry is that transgender patients might not realise that their deception could be life threatening. I think all such patients should be warned (preferably in writing) of the consequences of concealing their actual sex from their treating physician. It should be explained very clearly, that while one can change gender (which is a purely social stereotype), it is impossible for any human to change sex.
This has implications for transwomen who will still need prostate screening and transmen who will need cervical smears - they will not be registered or recalled for such tests if their doctor does not know their sex.

LillianBland · 19/08/2020 11:22

This born of female sex person who identifies as trans, demanded that the world treated them as a man, going so far as removing any and all references of being of the female sex, so shouldn’t complain that they got the treatment for their medical problems in line with male anatomy and physiology.

If a person demands that the world follows their teachings and some of their ardent followers call people bigots, threaten them with job loses, ostracisation, rape and death threats, if they refuse to conform, then they can’t complain, when people’s adherence to their demands, causes them harm.

It reminds me of when a toddlers throws their toy out of the pram, then screams blue murder, because they can’t reach it. Take some responsibility and stop blaming others, when your own actions cause you harm.

Winesalot · 19/08/2020 11:29

Does the type of negligence that this patient displayed about their own health (I assume they were fully conscious when going to the doctor in the first place) mean that needs to be done to confirm the sex of a patient before proceeding?

A ridiculous notion but if an individual will not take responsibility for looking after the needs of their individual body by being forthcoming about something so integral to that bodies needs, how does the NHS prevent the waste of time and effort. And I mean the waste of time and effort while running tests designed for the other sex.

Or maybe, when someone changes their sex marker it is made very clear that this may cause significant harm, even death due to the reality that male and female bodies are different and respond differently.

I think stonewall should be fighting to make sure that transgender health is of the highest standard starting with setting up records that do not seek to hide pertinent medical data. Not fighting for the right for right to obfuscate medical records.

When will this end.

Lovelydovey · 19/08/2020 11:35

This is why it is important to record sex of patients for medical purposes. By all means record gender as well, but gender is not a replacement for and cannot override biological sex. Bonkers article and easy solution.

Kantastic · 19/08/2020 11:39

This is actually infuriating to read. It's so easily solved! Record sex AND gender on NHS records. Do not confuse the two. The only reason it doesn't work like this at the moment is because of the trans activists fucking it up and doing their level best to prevent sex from being recorded at all.

Oppression isn't fucking oppression if you're doing it to yourself!!!!

Meanwhile, ofc, women are ACTUALLY ignored in medicine and not because we have campaigned to be.

ThePurported · 19/08/2020 11:44

The BBC is turning itself into an embarrassment
Yep.

The problem isn't in the healthcare systems. The problem is that transgender people as a group don't all want the same thing. Some are sensible and want their sex recorded correctly, others don't want it recorded but expect doctors to be clairvoyants when it matters.
The NHS doctor quoted in the article thinks that NHS should take into account nonbinary identities. What does that mean in a healthcare context?

Whitley thinks that their sex-dependent limits should have been set as 'somewhere in the middle' - by who, the doctors who didn't know Whitley's sex?
Should we all be recorded as 'somewhere in the middle', just to spare the feelings of a tiny majority who want to conceal their sex? I think that's where all this is heading, and we'll ultimately end up losing our knowledge about sex-based differences when they become taboo subjects.

LillianBland · 19/08/2020 11:46

My only worry is that transgender patients might not realise that their deception could be life threatening. I think all such patients should be warned (preferably in writing) of the consequences of concealing their actual sex from their treating physician. It should be explained very clearly, that while one can change gender (which is a purely social stereotype), it is impossible for any human to change sex.

It also shows that many people who want to identify out of their sex, have very little understanding of their own anatomy and physiology. Maybe part of their assessment should actually educating them on the differences between the two sexes. Or is there a concern that the numbers of those wanting to opt out of their own sex, would drop when they see that the differences between the sexes is actually more that their physical appearance? All the surgery in the world and no matter how much a person ‘passes’, means nothing when it comes to how their sexed bodies need to be treated, because of the the unchangeable differences between women and men.

Imnobody4 · 19/08/2020 11:47

One solution to these issues is to introduce an option to register as transgender or non-binary, rather than simply male or female. But others have floated the idea of a “body organ checklist” – the idea being that you are invited for screenings based on which organs you have, rather than your gender.

“I think that would be an incredibly intelligent way to invite people for these services,” says Berner, who explains that this could also be helpful for other reasons. “For a cisgender woman [one whose gender identity matches their sex] who has, for example, had a traumatic time with cysts, and perhaps lost a pregnancy as a result and had a hysterectomy – for them to get a cervical screening letter through would be particularly distressing as well.”

Ruddick, who was diagnosed with ovarian cancer in high school, and Manzano, who was diagnosed with melanoma, would also like to see health services become less gendered in general. “I don't think that I should have to go to the women's health clinic to go to the gynaecologist,” says Ruddick.

I'm rapidly losing all patience. If you have the mental capacity to choose life-changing surgery and treatment, it is fair to expect they understand all the ramifications and take responsibility.

Transgender medicine arguably began with the Roman emperor Elagabalus, who reigned from 218 to 222 AD and is considered by some to be the first person to seek sex reassignment surgery. He reportedly asked his doctors to construct a vagina inside his body. Not exactly a role model trans women would want to claim I would have thought.

The BBC have really left reason and common sense far behind.

Mrsjayy · 19/08/2020 11:48

Do people really believe when they eradicate their sex that it somehow changes their biology?

IrenetheQuaint · 19/08/2020 11:49

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!

LillianBland · 19/08/2020 11:50

@Mrsjayy

Do people really believe when they eradicate their sex that it somehow changes their biology?
Some of them will argue until they’re blue in the face, that it does. There are even people born of the male sex who identify as trans, who claim to have periods.
BaggarsBelief · 19/08/2020 11:51

I don’t understand. Did that person not think to mention that they were actually in possession of a surgically altered female body? Did the medical people not notice? I have been asked so many times if I’ve had any major surgery, blood products, am on any medication etc... at the Drs, dentists, gym etc. Surely to God any hospital admission for their kidney problems would have resulted in questions about what medication they were on - wouldn’t the fact they were on Testosterone have been a huge bloody clue?

Is it like a game? ‘I’m not going to tell, you’re going to have to work it out yourself’? Did they take responsibility for their own health by giving medical staff the info they needed? First appointment at the GP should go ‘as I’m a transgender man I will need a smear and other female checks as your patient can we make sure that happens please’. (But the obvious thing would be for their birth sex to be on their records anyway as, y’know, a matter of some relevance!)

It’s like the onus is on everyone else to second-guess but not admit they’re second-guessing because that would be invalidating/offensive/hateful.

If you are a transgender person take some responsibility for insisting on the necessary checks. Stop expecting people not to notice, but also notice, but not say they’ve noticed - speak up for yourself man/woman/non-binary person! You’ve obviously had the courage to make this fundamental change to your life, transfer a bit of that into providing the people who are there to look after you with some pretty critical information.

FlySheMust · 19/08/2020 11:52

All I can think of is Monty Python's Life of Brian. "Symptomatic of your struggle with reality"

Mrsjayy · 19/08/2020 11:56

Beggarsbelief that should be on a pamphlet somewhere. People need to take responsibility for.themselves and not "expect," miracles to happen Drs medical staff can only work with what they have got.

Kantastic · 19/08/2020 11:56

I think that's where all this is heading, and we'll ultimately end up losing our knowledge about sex-based differences when they become taboo subjects.

And of course the parameters won't be set "somewhere in the middle" if that happens they? It will go back to the way it was, the way it often still is... women being assessed by male standards, and dying as a result.

megletthesecond · 19/08/2020 11:57

The only person doing any shoe horning is him.