Sex differences in asthma

[ArabellaScott]

A rant on Reddit from a male who identifies as a woman complaining that a 999 call handler asked for his sex (described at 'gender assigned at birth') when discussing symptoms.

https://www.reddit.com/r/transgenderUK/comments/1f9cq5s/had_to_just_call_999_as_asthma_was_terrifyingly/

Comments are furious at this 'transphobia'.

I checked, and guess what? Sex has a major impact:

'Asthma is a heterogenous disease, and its prevalence and severity are different in males versus females through various ages. As children, boys have an increased prevalence of asthma. As adults, women have an increased prevalence and severity of asthma. Sex hormones, genetic and epigenetic variations, social and environmental factors, and responses to asthma therapeutics are important factors in the sex differences observed in asthma incidence, prevalence and severity. For women, fluctuations in sex hormone levels during puberty, the menstrual cycle and pregnancy are associated with asthma pathogenesis. Further, sex differences in gene expression and epigenetic modifications and responses to environmental factors, including SARS-CoV-2 infections, are associated with differences in asthma incidence, prevalence and symptoms. '

www.ncbi.nlm.nih.gov/pmc/articles/PMC8783601/

I don't suppose anyone is keeping track of the health impacts on people who don't accurately report their sex when seeking care?

I've called 999 on many occasions

hmmmm

One of the most basic parts of asthma management is measuring PEFR - one of the key factors in determining “normal”? An individual’s sex 🤦‍♀️

"For suicides, strokes, car crashes, assaults, and a random body... etc"

What an awfully unlucky man.

Complaining is MADNESS.
The handler didn't ask "do you have a pee-pee?", just asked RELEVANT questions.

I'm glad to hear that those questions are asked, despite the ridiculous tantrums being had.

Have you read one of the replies to that post:

"I am female I was born female, the doctors got it wrong by just briefly looking at baby body. After being on HRT for so long my body is female too. So when asked I say female and only give further information if it very relevant."

The mind boggles at the utter asinine pretzel logic that this person goes through every day to convince themselves that they're a 'real girl'.

At this point, I say they deserve the healthcare that they receive if they are wilfully obfuscating facts.

Interesting article. I need to read more slowly, though - my initial reading of it as 'asthma parthenogenesis' gave me a bit of a start.

And of course medics need to know actual sex. It affects so many symptoms, test thresholds, drug metabolism rates etc.

Oh well, if they believe in the fiction of changing sex so much that they damage their health ... what can anyone do?

as long as health care professionals ignore these loons and continue to ask what sex people are where that is relevant (which when it comes to bodies is pretty much 100% of the time)

Fuck sake!

I didn't bother to read the Reddit but if you're an asthmatic you probably check your peak flow regularly.

The difference in lung capacity between sexes is enormous.

So if he's a ladeee and his peak flow is normal for a woman he's in grave danger as a man.

Does that make sense? I'd love to know how he measures his peak flow!!

Ridiculous. And if they could go on a rant at the 999 caller they probably didn't need an ambulance for asthma. More attention seeking.

Wow slightly missing the point but I am asthmatic and have the peak flow numbers of a man according to that chart.

I don't understand why even if you are choosing to live as another gender, why you wouldn't have an inkling that your birth sex would impact your health outcomes.

According to the poster’s previous comments they started their transition at 42 and are now a 44 year old lesbian. I’m not confident that they don’t recall what AGAB they were given, so possibly a call to the GP re memory loss is also something they should consider!

Perhaps he is in the running for a Darwin Award.

@Imalongtimepostingmum
Are you a singer, brass or woodwind player? All those boost PEFR. Being tall - crucially, tall & long of torso - also bumps PEFR up. I have numbers suited to a woman about a foot taller than me courtesy of being a woodwind player & [choral] singer.

The most important thing is knowing your own “normal” & having an asthma action plan to help reduce the likelihood of having a severe attack. I know it’s away from the point of the post, but anyone with asthma really should have one - in the UK they can be created by your Consultant/one of their team or your GP/practice nurse (often there’s a specialist asthma clinic available). Asthma + Lung UK produce a paeds plan too. If you’re not in the UK, the American Lung Association produce one; Asthma Australia, Asthma Canada, & Asthma Foundation New Zealand. Deutsche Atemwegliga have one but I couldn’t find one from France - so here’s one in French courtesy of the Canadians,

@NitroNine i played the trombone (and other brass instruments) until I was a teenager so maybe that helped. And I do have a good length torso! That's really interesting. I can't get on with my asthma nurse, I find her very patronising. But I've never needed to go to hospital with my asthma and I know what ill looks like for me - drop of 50-100 points and I'm in steroid/anti biotic territory.

I'm going to have a look at those links you sent. Thank you!

Thank you!

And it's not away from the point - one of the reasons I posted was because I thought it might be useful info for anyone with asthma, although I lack this in depth knowledge. 🙂

Dying but still able to come up with a sarcastic answer in between breaths 🤨 what an attention seeking twat

Excellent advice @NitroNine

I was late diagnosed but now know that some symptoms were there in childhood. I managed it well in teens with woodwind and also later in adult hood with swimming.

It's winter and viruses and smoke for me and I don't wheeze so it was missed for a long time. (Till the pneumonia started becoming rather regular 😂)

When diagnosed I was beginning to get into the early discussions here and the first think I spotted was the massive difference in peak flow between men and women,

I am a former (very out of practice) woodwind player and a singer. I have asthma but I get a cough and it never seems to decrease my peak flow. I've just had a major lightbulb moment.
Unlike this bloke apparently.

And the correlation with teen boys able to have a better peak flow than adult women at their peak!

For anyone with asthma may I suggest looking into chronic overbreathing and 'buteyko' breathing. Lots of videos on youtube. May be of interest to some.

Very glad that my contributions weren’t considered a derail & indeed were found actively helpful 😊

@ArabellaScott and @NitroNine so it looks like I am 'not controlled' though when I read the Canadian article, I have some parts green, some parts Amber and some parts red..!

But my peak flow is stable at 600 🤷🏼‍♀️ I've tried changing to several of the new inhalers but they don't give you the immediate hit of a ventolin in so far as they don't ease tightness immediately.

I could do with my asthma nurse retiring so I can go and speak to someone else about it!

@NitroNine definitely useful. ☺️

Had a quick flick down that Reddit thread - wow! The level of bodily ignorance is stunning, there genuinely seems to be a consensus that the ONLY difference between a male body and a female body is the genitals, and taking cross-sex hormones makes them actually female.

One thing I did pick up though is that it seems to be 'new' to be asked. They are interpreting that as transphobia, I am interpreting it as the NHS finally realising that if they choose not to confirm the sex of a patient, they may be held liable for any sex-inappropriate treatment they give.

Almost every post showed a stubborn determination to lie to medics, because they believed the question is prompted by transphobia and not by medics wishing to medically treat their bodies appropriately. They do not realise the danger they are putting themselves in. Can't remember the details any more, I read it years ago: a transman was being treated for something in ?US/Canada? and was effectively over-treated because the level of something in her blood was too low so they kept upping the dose. Hospital got worried (hence it being written up) because despite best efforts the level stubbornly refused to be within normal parameters and they started investigating for what could be causing that. Of course, the levels were within normal female parameters. The treatment and unnecessary investigations she was subjected to luckily caused no lasting damage, but there's plenty of other conditions where trying to get a female body to achieve male levels of what floats round in our blood could be downright dangerous.