BBC Article about why Transgender People are Ignored in Medicine

[gardenbird48]

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.

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.

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.

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.

So many typos in that post 🙄

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.

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?

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.

While this focuses on the medical treatment side, there is another area where the insistence on biological sex denial will have major repercussions, and as it involves large sums of money and the financial industry, I can’t see them having much truck with it all.

Life Insurance.

Lying about your biological sex when taking out life insurance will invalidate your policy. If you die from or develop a preventable yet serious sex-specific condition that qualifies for a payout, but you lied and therefore didn’t have the necessary treatment for your condition, then you will get nothing.
Feel as validated as you like, but the underwriters won’t care. Take them to court? It’ll be down in black and white that you lied, you won’t stand a chance. As to hoping that a court case will bring some legal change where insurers can no longer ask for your sex, it won’t happen, at least not in your favour. Neither the pile-on brigade nor Stonewall have the financial or legal or lobbying muscle to take on the big insurers.
I would be interested in how insurers are currently dealing with this, as for all the insistence that it’s not a medical condition, it often involves an awful lot of medical treatment, which you will have to declare when taking out a policy. The long-term effects of cross sex hormones are still unknown, and insurers are very risk-averse. It must make for a very expensive premium.

As time goes on we’re going to see more and more unavoidable brick walls like this cropping up, and it will become ever more glaringly obvious that you can’t escape your biology.

Trans people are being let down by the medical profession, but not in the way implied by the article.

If someone wants to medically transition, their doctors have a duty to make sure they understand that they can't change sex. That they will always be the sex they were born as and that when seeking any medical treatment it's important that they let their doctors know their biological sex.

Any doctor who gives the false impression to their trans patients that post-transition (hormones and/or surgery) they can ignore their biological sex when in need of medical attention is negligent. I know that doctors are put in an impossible situation here because of the shouts of 'transphobia', and I don't know what the solution is. Their professional bodies and the government should support them to do what is right for the welfare of their patients despite the reality denial of the transactivists.

Governments which have allowed people to change their sex marker on their official documents have made this situation even worse. So if someone like Whitley had been in an accident or was suddenly taken ill and was unconscious, looking outwardly male, and with documents which state 'sex: male', they would be (medically) treated as male, which could kill them. A document which said sex: female, gender: transman would give the doctors more chance of saving their life.

You're quite right, and insurance was a big point of discussion in the run-up to the GRA. The industry got some exemptions then, but a 2010 judgement in a European Court of Human Rights case found that basing insurance premium calculations on the empirical data showing real statistical differences between men and women was discrimination.

So now, even in insurance products where sex makes a difference to actual risk, affecting premiums and benefits, insurers in the EU are no longer allowed to take sex into account. And haven't been since the end if 2012.

That was in response to Vermeil

The narcissism surrounding this is astonishing. The patient makes every effort to not appear as their true sex, including having their medical records changed to reflect their chosen gender (something which should never happen IMHO), lies about everything, then blames the NHS when it all goes wrong.
Then we have the BBC, refusing to acknowledge this. They are so not fit for purpose.

A document which said sex: female, gender: transman would give the doctors more chance of saving their life.

Often people with invisible conditions like diabetes wear jewellery incase they are involved in an accident. However, that can only work if there is no stigma attached to diabetes, and if there is acceptance that having diabetes is a neutral fact, not an identity.

@CharlieParley
Interesting. But the potential problems I outlined are still there. If being transgender isn’t considered a medical issue, yet people do receive medical treatment in the form of surgery and/ puberty blockers or cross sex hormones, then they will still have to tell the insurer or their policy is invalid, as it will be information that will put a weighting on any premium. This would apply to life insurance, and to travel insurance as well. Failure to give such info invalidates the policy, and in the case of travel insurance could result in the insurer refusing to pay out for medical treatment while abroad, even if it’s for something as unrelated as a broken leg, I used to work in insurance, so I know that underwriters will look for any reason whatsoever to not pay out, and failure to disclose long term treatments is one they pounce upon.
So, legally not having to disclose sex makes no actual difference, you still won’t get a payout because you’ve deliberately withheld information from the insurer. Bit of a Pyrrhic victory, then...

it is very concerning that someone's dysphoria is so extreme that they deliberately withhold vital information from doctors that could put their health and their life at risk. It almost sounds like a type of self harm in that context.

This person would have had to have had many conversations with doctors regarding their birth sex and the procedures needed to change their appearance so effectively so it seems that post-surgery the dysphoria hasn't improved and could be viewed to have become worse to the extent where their life is put at risk. From an insurance point of view it could end up with doctors refusing to treat people unless they have a DNA test first to determine sex due to the risks if information is withheld.
In which case, they could actually cut out the delay to treatment and have a fixed sex marker on medical records that accurately reflect a patient's sex.

I used to work in insurance, so I know that underwriters will look for any reason whatsoever to not pay out, and failure to disclose long term treatments is one they pounce upon.
So, legally not having to disclose sex makes no actual difference, you still won’t get a payout because you’ve deliberately withheld information from the insurer. Bit of a Pyrrhic victory, then...

I was wondering about that. When I was working for others, I had payment protection in place to cover illness, but they wouldn’t have paid out, bad I not been honest about any medications, previous operations or underlying conditions. By not telling the hospital about their previous operations and medications, I assume their, if they had it, payment protection won’t have paid out?

If being transgender isn’t considered a medical issue, yet people do receive medical treatment in the form of surgery and/ puberty blockers or cross sex hormones,

Being transgender may not be considered a medical issue, yet, by receiving medical treatment in the form of surgery and/ puberty blockers or cross sex hormones, transgender people create a medical issue for themselves.

I don't know how medical insurance worried in the US. I know that in the UK pre-existing conditions are not generally included. Could it be that Cameron did not declare their transgenderism because it was not covered?

When their medical history was taken, did they not declare the testosterone supplementation? When medications are declared to HCPs, and it is not immediately obvious why they are being taken, the HCP will ask. Eg if I, a 50+ woman am very ill in the middle of the winter, and tell the doctor that I'm taking HRT, Pimecrolimus and Piriton, they're not going to ask why I'm taking HRT, but they're definitely going to ask about the other meds!

Totally self-inflicted, and made worse by the bizarre collusion of establishment in individual delusion. I can't help wondering, also, whether HCPs correctly identified Cameron as female, but were effectively gagged by the policy of collusion.

Gosh you don’t have to look very far to see why people may not think it’s necessary to inform health professionals about their medical history. Lumping LGBT all together. As if not disclosing that you are gay is the same as not disclosing you are transgender!

patient.info/news-and-features/should-you-come-out-as-lgbtq-to-your-doctor

"Someone's sexual orientation or gender identity may have an impact on their health needs, so as long as a person feels safe to do so, it's a good idea to share this with a doctor or healthcare professional. However, many LGBT people do not feel comfortable sharing this with healthcare staff, and coming out is not something that anyone should ever feel pressured or forced into doing," explains Laura Russell, Director of Campaigns, Policy and Research at Stonewall

NHS systems should record sex and administrative gender.

Sex being biology and used for pathology, pharmacology, screening etc.
Gender can be used for letters etc for politeness/kindness

The risks associated with the loss of medical history is high and even allowing patients to knowingly make this decision is a real concern

If somone's medical records are changed from recording the patient as "Male" instead of "Female", does that mean they will be called for prostrate examinations instead of cervical smears?
What a confusing world we now live in.

@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!

I also thought it was a good article and of course transgender have unique needs and the health care system needs to recognise this.

@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'm inclined to agree.

Although this wasn't UK healthcare, I am struggling to believe that the clerking medic didn't obtain a medical history, drug history and examine the patient.

And I don't believe that investigations wouldn't have shown up a shortened urethra and other sex specific findings.

Of course the patient had a responsibility here to give their history. But clinical assessment would have picked up anomalies.

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.

But, but! The transactivists keep telling us that ThErE Is nO sUch THinG aS bIoLoGIcaL SeX.

Complete privacy (such as not being able to ask for a GRC) is what people like Stephen Whittle campaigned for. Shame it’s so fucking dangerous to the actual health of the people Whittle was supposedly campaigning FOR.

@Singasonga "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."

Transman and transwoman are NOT sexes. There are only 2 sexes; Male and Female.

Midclegs, there are two sexes and two surgically and hormonal altered variations that may have different medical needs than what they would have had if they'd stick to their natal configuration. There is genuinely a problem in the lack of knowledge anyone has bothered to accumulate about what trans people are doing to themselves long term, not at all helped by the TRAs who've spent ages screaming at anyone who wanted to look into it.