Meet the Other Phone. Flexible and made to last.

Meet the Other Phone.
Flexible and made to last.

Buy now

Please or to access all these features

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:
Clymene · 19/08/2020 11:58

Where is their responsibility? If you change your medical records to being a sex you're not, then that's on you surely? And at any point during the treatment, Cameron could have told the HCPs that they were biologically female but chose not to.

We have people who complain of a hate crime when they're correctly identified as their birth sex so of course the medical professionals aren't going to ask them. They're probably terrified of mentioning it in case they get a lawsuit slapped on them.

thehumanformerlyknownasfemale · 19/08/2020 12:01

Sex and gender both need to be recorded, NO ONE should have the option of erasing their sex/history. It's lying.

Women were being berated for wanting to keep the word 'woman' in health campaigns because it's apparently detrimental to trans men. No. THIS is the real danger, being in complete denial about your biology and being allowed to lie about it to healthcare professionals.

LillianBland · 19/08/2020 12:01

@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!

But many don’t want the fact that they are trans, recorded, because that’s transphobic and othering. They don’t want their born sex to be known anywhere. This person had many many opportunities to tell those in charge of their treatment that they were born female, but were too busy thinking It was really cute and awesome that I was treated as male. At any stage, including when they demanded that all references to their born sex was erased, they could have said, “could you make a note somewhere clearly stating that I’m born female, but identify as trans?” There are many things added to a person’s medical notes, so that important details aren’t missed. Mine has allergies in a prominent place. My child has the fact that she is not neurotypical and needs me to speak for her. It really isn’t difficult. Trans people need to take responsibility for their own decisions, instead of bla,I gotta everyone else if they mess up.
Gottalife · 19/08/2020 12:01

@LittleBearPad

When the doctors were taking Cameron’s history he should have mentioned he was born female - simple!
Absolutely. When it's a matter of life or death. Any medical history will be treated as confidential.
LillianBland · 19/08/2020 12:03

instead of bla,I gotta everyone else if they mess up.

instead of blaming everyone else if they mess up.

Muttonindistress · 19/08/2020 12:07

@LittleBearPad

When the doctors were taking Cameron’s history he should have mentioned he was born female - simple!
But, but, it was ‘so cute and awesome to be treated as a male’.
Winesalot · 19/08/2020 12:09

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?

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...

I find it hard to believe that there was such an issue around the lack of clarity in the collection of medical data here. Was it not thorough enough? Surely it would not have been confounded by the patient themselves? Weren't they an associate professor of sociology? (isn't how women being neglected in medical research and why it matters something that sociology might touch on?)

AnyOldPrion · 19/08/2020 12:09

One day, I hope all this will pass. Clinicians who use transitioning as a tool to alleviate distress due to GD (assuming that continues - it may not as currently there is a paucity of evidence) will acknowledge that changing sex is impossible, and will go back to explaining the limitations and ensuring patients have sufficient capacity to understand.

Clymene · 19/08/2020 12:09

@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!

We have an absolute dearth of research into medical conditions in women. Women's health is extraordinarily poorly funded compared to that of men.

If people choose to take hormones and lie to their doctors, that's on them

“It was really cute and awesome that I was treated as male”

Yeah, really cute to nearly dieHmm

MorrisZapp · 19/08/2020 12:11

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.

ThinEndoftheWedge · 19/08/2020 12:15

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.

Or

'A wise woman on Mumsnet floated the idea of a "male/female" tickbox - the idea being that you are invited for screening based on which sex you are, rather than your gender'

A lovely body organ checklist - not the slightest bit dehumaising or sinister.

Gender fucked up our healthcare - so can we fuck up everyone else's healthcare too??!!

ThePurported · 19/08/2020 12:21

I don't think recording both sex and 'gender' is the solution. Look at the BBC headline - people still use the two words interchangeably. NHS already has the capability to record both, but if you check your record, it might state your sex under 'gender' (identity), and 'sex' has been left blank.

medium.com/@anneharperwright/sex-gender-the-nhs-bb86b0c3ebb
Your Medical Record and your Ladybrain

InvisibleDragon · 19/08/2020 12:25

This part is particularly frustrating:

It’s widely and erroneously reported that black transgender people have a life expectancy of just 35. But in reality, scientists have no idea what it is – because no one has ever checked.

It's not possible to collect data about the number of transgender people, of any ethnicity, or their life expectancies, because there are no records that reliably record both sex and gender identity.

I agree that this should be rectified, but it's literally impossible to do that without maintaining a distinction between biological sex and gender; which many transgender people are actively campaigning to remove.

TreestumpsAndTrampolines · 19/08/2020 12:32

The lack of knowledge as to how cross sex hormones affects healthcare is a huge issue.

And it should be explained to people on experimental treatments, that this is a huge issue, that no-one actually knows what cross-sex hormones are doing to you long term, or what effect they might have on everything else that's going on day to day in your body.

How is it in any way informed consent, or medically ethical, not to explain this to people who are being given these hormones?

ThePurported · 19/08/2020 12:33

@Kantastic

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.

Undoubtedly. Slightly OT but look what happened with the IOC and women's sports - it was decided that males can compete as women if they reduce their testosterone to the low end of the typical male range.
SnuggyBuggy · 19/08/2020 12:34

It shows that you can't change sex. It's not bigoted it's basic biology.

Thinking about it shouldn't people on sex reassignment hormones be having regular endocrinology appointments in the same way anyone with abnormal levels of hormones for their biological sex would?

JellySlice · 19/08/2020 12:42

body organ checklist

What, like smear tests for cervix-havers?

Hmm
JellySlice · 19/08/2020 12:42

@JellySlice

body organ checklist

What, like smear tests for cervix-havers?

Hmm

The hell with feminine socialisation!

AngryAngry

Packingsoapandwater · 19/08/2020 12:45

I read the article and half way through, I got the sudden thought that what we are seeing here are the circumstances that will lead to the creation of a third "sex".

Not male, not female, but both and neither simultaneously -- a chimera.

In medical terms, there is no other way you can approach it. You can't treat a transman as a biological female because of the presence and impact of synthetic x-sex hormones, but you can't treat a transman as a biological male either.

Treating transgender individuals as a separate group to biological male or female is the only way you will be able to set down policies that scale appropriately for systems as large as healthcare.

JGACC · 19/08/2020 12:46

@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 think I'm with you there @MorrisZapp

I couldn't read that as anything other than a complete piss take? Surely no one could write that seriously?!

CharlieParley · 19/08/2020 13:46

A few of the more questionable quotes, although the whole article is nuttier than a squirrel's diet.

But here again, Whitley hit a snag: his doctors were in need of another vital piece of information – and without it, they couldn’t work out how often he would need this treatment. They had to guess; they got it wrong; he became yet more unwell.

Help me out here, why did the doctors have to guess? Is it because they were incompetent and modern medicine so woefully inadequate or is it because the patient deliberately withheld that vital piece of information?

But most healthcare has evolved with a straightforward dichotomy of gender in mind.

No. It has not. It actually evolved based on the default human, ie males, treating females differently only in relation to reproductive health and functions.

This has meant and continues to mean worse outcomes for females.

For a very long time women have been fighting for the medical establishment, including medical science and research, healthcare and the pharmaceutical industry to accept that there is a clear distinction between males and females in how our bodies work, how illnesses manifest, how they are diagnosed, how we respond to treatment and how we recover.

Just as this is finally happening, progress is being threatened by transgender ideology.

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

In medicine, male and female are entirely appropriate boxes. Creating little box inserts for "male transsexual" and "female transsexual" would solve the worst problem presented here. But in the UK at least that solution has been rejected. By trans rights organisations.

The article unfortunately swings between healthcare in the UK and the US, which have vastly different systems. Access is a huge issue in the US, where those who identify as trans can legally be refused treatment for no reason other than their trans status. This is simply not allowed in the UK. A more conscientious journalist would have made this clear.

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. He wasn’t put on the list until he reached it – a decision that ultimately delayed the surgery by over a year, and very nearly cost him his life.

And whose fault is that? Given that gender dysphoria has been redefined and is no longer considered a mental health condition, then there should have been nothing stopping the patient from telling the doctors this vital piece of information.

“It was really cute and awesome that I was treated as male, but in being this way, they didn’t necessarily take into account the body,” says Whitley, who points out that, though he has been taking testosterone for around 15 years, it’s a relatively small dose. “I was born female and I identify as male – they should have probably have set my limit as somewhere in the middle.”

I'm sorry - "cute"? "awesome"? - this strongly suggests a patient who was not able to prioritise the most important issue. Which was not affirmation of identity but treatment of a serious medical condition.

Even Whitley’s dialysis was complicated by the current lack of knowledge about transgender medicine – the calculation that’s used to work out how regularly it needs to be done is based on another sex-specific assumption.

Because male bodies and female bodies work differently, even when the organ in question is not part of the reproductive system. Again, a simple solution here was to give the doctors all of the information they needed to decide on the appropriate treatment regime.

When you factor in the large data gaps in everything from the average life expectancy of transgender people to the right dosages of medications for their bodies, along with the widespread lack of knowledge among doctors about how to address them – let alone treat them – and the high chance of them being refused treatment outright, it soon becomes clear that transgender medicine is in crisis. Few groups experience such significant barriers to healthcare, and yet their struggles are going largely unnoticed.

And whose fault is the lack of data? Who resists collecting data in a way that allows it to be disaggregated by sex and trans status?

In some cases, the issues are baked right into the heart of our medical systems.

Consider this: if you were to look through every single medical record in the UK – all 55 million – you won’t find a single record labelled as belonging to a transgender person. This is also true for those assembled by many providers in the US.

That is because trans rights organisations insisted it be done this way. It was a demand made repeatedly at the time the Gender Recognition Act was designed. By trans rights organisations who rejected all warnings of negative outcomes for people who identify as trans.

“You can register as male or female, but you can still only choose between these two options – you can’t say if you are transgender or non-binary,” explains Kamilla Kamaruddin, a doctor who works for the National Health Service (NHS) and transgender woman. “So that’s quite difficult.”

See above. The option to register as trans was expressly rejected by trans rights campaigners. The suggestion that a patient should be able to register as non-binary on medical records is abject nonsense. There are no non-binary bodies.

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.”

Gender is mostly irrelevant when it comes to healthcare. Sex always matters. It may seem irrelevant, but it never ever is.

Gender, in the sense of behavioural patterns more commonly associated with one or the other sex, may indeed matter on occasion. Such as with smoking. But sex is the decisive factor here.

But this rigid male-female dichotomy also has some bizarre, and much less desirable, implications. “There are lots of simple things, like our medical record systems often cancel pregnancy tests if they're ordered on men,” says Greene.

That's because men cannot get pregnant.

jellyfrizz · 19/08/2020 14:01

It's not possible to collect data about the number of transgender people, of any ethnicity, or their life expectancies, because there are no records that reliably record both sex and gender identity.

I agree that this should be rectified, but it's literally impossible to do that without maintaining a distinction between biological sex and gender; which many transgender people are actively campaigning to remove.

Yes. Sex and gender identity has to be the way to go otherwise it is literally erasing trans people.

testing987654321 · 19/08/2020 14:01

I found the article very confusing, It refers to gender when they mean sex,

I fully understand that gender stereotypes are different to actual sex, but I think we need to stop worrying about sex and gender being conflated. If the words that denote both your sex and your gender are man/woman, male/female then ultimately many people including the bbc are saying that it's possible to change sex and it's the doctors who need to be psychic to treat you properly.

ChattyLion · 19/08/2020 14:04

Oh, the absolute irony. BBC article says

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

Yes. Finally- this is what women have been complaining of. We’re trying to break down the sexist gender boxes to free everyone. That’s not what the BBC meant though of course. Sad

JellySlice · 19/08/2020 14:37

"I was born female and I identify as male – they should have probably have set my limit as somewhere in the middle.”

Why? Because that's what you think is 'fair'? Because that's how much you are willing to compromise with reality? Let me break some news to you, oh believer in the ideology of 'No Debate': reality does not compromise. Reality has no sense of fairness. Reality does not do 'Be Kind'. Your limit should have been set at the correct limit for females. (I won't explain why, as that might get me deleted.Hmm)