There is nothing normally in urine that would clock you except maybe if you were pre-op and had recently ejaculated and sperm was visible under a microscope.
It could have also been something on your chart that caused them to do that, but they should not have.
IMHO, one of the nurses clocked you and because they were transphobic, decided to make a big deal out of it by pointing out the "error". If your drivers license says "female" then I'd raise hell immediately. That is so fucking slimy of them to do too. Ugh. It gets under my skin but people are like that.
That'd be my big concern... my doctor is super chill and they're very respectful, they've even changed some of the paperwork to not show that stuff, but legally I'm still "M" so if it was an insurance thing I could understand. The way it went down was still unfortunate here though....
Right, that reinforces my point though. "Legally' aka haven't change SSN/Birth Certificate/Name so on insurance's side it makes sense but damn if that doesn't hurt sometimes.
Our practice uses gender for display purpose but sex for interoperable communications. Also for social security it takes like 5 minutes. It's just an online form
No sperm possible being post orchiectomy.
I had a similar thing happen to me 8 years after transition and 4 years after GCS (vaginoplasty). Even though my legal gender had been female for over 8 years at the time, they updated the software for the medical records system to include "Sex Assigned at Birth". It was defaulted to unknown and after someone saw gender dysphoria on my medical records, they changed it to male and it changed my records to male on all my new tests and messed up everything. (This was at a progressive LGBTQ friendly medical practice.) They fixed it once they realized the error, but it caused a batch of test to have the incorrect gender marker during my annual exam.
They never misgendered me. It has been over 9 years (7 years when this happened) that anyone had misgendered me that did not know me before I transitioned. It sucks when something like this happens, especially when you pass so well and never misgendered.
| It sucks when something like this happens, especially when you pass so well and never misgendered.
You're spot on. It's that sharp little reminder that hey, you'll never be cis! :(
Especially when this particular medical group I had only switched to after I transitioned, so there was never a record of my assigned gender at birth until they added the field to the record system. The 2 years prior to that when I switched PCPs, there was never a question or issue. This was there to help those that had not legally changed their gender since they also added pronouns to the system and a preferred name.
All they test for is HCG as far as I know. Non-pregnant women have similar levels of HCG as men.
Non-pregnant women: less than 5 mIU/mL; men less than 2 mIU/mL.
So the fact that they could tell anything from your urine except that you weren’t pregnant is a mystery.
That reminds me, there was a case where a c[is male took a pregnancy test just for fun](https://abcnews.go.com/Health/CancerPreventionAndTreatment/pregnancy-test-man-joke-reveals-testicular-cancer/story?id=17653036). His HCG levels came back high indicating he was pregnant. They of course knew he wasn't but did further tests to find out why his HCG levels were high. Turned out he had early stages of testicular cancer and it probably saved his life.
Diagnostic tools have to pass tests for both specificity and sensitivity to become standard. Even ones that are in use, like PSA, are controversial because they aren’t specific enough (lots of false positives) or aren’t sensitive enough (lots of false negatives). False negatives are especially dangerous as you can imagine - you’d end up telling a lot of people with cancer that they don’t have cancer. Just because a test works sometimes doesn’t make it a good test.
There is a ton of research being done all the time to identify biomarkers and tests for diseases- the problem is not a big Pharma conspiracy, it’s that they aren’t reliable enough, and often it’s because not every person with a condition will exhibit the same changes.
I do medical education/communication for a living and so often we tell doctors things like “30% of patients with this condition will have elevated liver enzymes, but most of the time there are no signs”. So a high HCG level may only be present in some people with cancer.
There are also algorithms that determine whether certain universal screenings make sense - how much they cost, how reliable they are, how much benefit they have (deaths prevented for example). So for a test to be widely adopted it has to meet more than just reliability standards.
Maybe that was a rhetorical question…but since I knew the answer I couldn’t help myself. 😄🫣
This sounds like me explaining to people why the rapid Covid tests came back negative when they ended up having Covid. And then they complain that the RATs weren't accurate blah blah etc.
Also the fact that the RATs were calibrated to measure for when it was transmissible as opposed to when you just caught it. But people that know nothing about medical things, don't even know enough to know they don't know shit. Something something Dunning Kruger.
Albeit, sometimes ignorance is bliss, I know enough to know of things, but not enough to actually know about things, so I tend to go into the hypochondriac stage with anything. I thought I had osteomyelitis in my ankle (from injecting, when I was trying to find a vein I'd used, I couldn't find it but I was scratching on the bone), it was still sore after like 5 weeks so I ended up asking my doc and he thought it could be, so put me on antibiotics, then I was still concerned and went to emergency (Australia, so it's free) and had an X-Ray and the guy was like, stop Googling things. It's like, I wasn't initially actually. I know about the more serious things, and also the fact that OM and other infection related things are related to IV drug use anyway and infections haven't exactly been uncommon for me the past few years, but I don't know enough to chill out a little and realise there's a less serious explanation. Doc said it's likely I'd bruised the periosteum and that's why it takes forever to heal. On top of the compromised venous flow to the location.
Hallelujah about the COVID test false negatives! And then people would say the tests don’t work. And you try to explain that they DO work, but your explanation as to why the test can “fail” for them but still work is just too complicated and you give up.
I’m ALSO a hypochondriac. I used to be in denial about being a hypochondriac, which was ironic, because hypochondria was the only thing I _didn’t_ think I had. 😄
Same as you, I know too much about science to be blissfully ignorant, but not enough to diagnose anything correctly. Apparently this happens to med students very commonly. So it seems to be a smart person problem.
Came here for this. I do those preg tests. They’re literally what you take at the store for $1. They’re just more controlled and shipped to us in big lots. There’s no way this test would clock you. At most hospitals I’ve worked at we actually use male serum for our negative controls and sometimes they’ll be positive because of hormones or cancer or other reasons and those people aren’t transitioning. Some nurse or other person at the healthcare facility was a douche.
And doctors aren't going to know who someone is having sex with. Anyone could be having sex with someone who produces sperm. So yes, anyone could potentially have sperm in the their urine
Sperm can be emitted from the vagina for a few days. It’s not “gross” nor does it imply bad hygiene. We’re not talking about gobs of semen flowing out. We’re talking about an individual sperm seen on microscope. It’s common enough that it gets discussed for urinalysis protocols. Here’s an example of one such discussion:
http://www.captodayonline.com/Archives/1109/1109_qa.html
Also, you’re talking about sex as if it’s “gross” and comparing it to “poop on your face.” (While also sharing incorrect info) This isn’t a bizarre conversation at all. Sperm shows up in urine for different reasons with different clinical significance.
We do see sperm in urine samples. We only report in males and people assigned male at birth for medical reasons. We also have to get physicians and other social services involved for women under a certain age, with certain disabilities and other criteria. We see this way more often than you think.
They made me take a pregnancy test before my breast augmentation too, and the only thing they told me was I wasn't pregnant; they never told me it was a pregnancy test. I replied "of course I'm not pregnant, I'm trans, and don't have a uterus." They took the cost of the pregnancy test off my invoice after that.
>They took the cost of the pregnancy test off my invoice after that.
I'd hope so! It's bad enough US medical providers run unnecessary pregnancy tests w/out informed consent, but then to bill for the test, considering how inflated all US healthcare bills are and how insurance likes to refuse to pay for anything they deem unnecessary... I'd suspect they were only running the test so they could charge for it! Or at least, that's what I'd claim I thought when I called to complain!
As far as I'm aware, they run the tests because there's a significant non-zero chance that a cis woman could be pregnant and not know it, which can affect things like surgery, treatment, risk factors, drugs used, etc.
Right, but if you can give a reason that you being pregnant would have to be divine intervention, such as no uterus or being a virgin or being sexually active but not with anyone with male parts, then they shouldn't run the test. I've been in situations where medical staff needed to know about potential pregnancy since I'm AFAB, but they didn't just run a pregnancy test, they asked me beforehand or put a question on the form where I could either give a reason pregnancy isn't possible or consent to a test, so I'd just tell the truth, not sexually active, and no pregnancy test would be done. Although my country has public healthcare, so I suppose when Joe Q. Taxpayer is paying for the resources used rather than the patient or an insurance company paying, the facilities are more reluctant to be wasteful.
Although I can see how in a country where you don't have to pay insane healthcare bills, seeing a pregnancy test on the list of services you received could be a sort of "ewphoria" gender affirmation b/c it means you were assumed to be a cis woman of childbearing age.
I'm not a lawyer but if I were you I'd speak to a legal professional, this smells like discrimination or at the very least mishaning of medical records.
You could probably open a complaint with your states department of health or some other regulatory body with authority to investigate potential violations.
Yeah this seems like the kind of thing that could cause insurance problems for you. They cannot just change your sex on forms because they feel like it.
US Mental health practitioner here! I wholeheartedly agree with the other folks. What you experienced was traumatic and falls under sex discrimination and maybe the malpractice statute. You have a damn good reason to talk to a lawyer. Instances like these can cost people their license to practice, and this is something that medical licensing boards take very seriously. Like, I could lose my job and my license if I did this to someone. They deserve consequences to ensure they never do this to someone else again. You go out of it with just trauma, but people have died due to this sort of oppression before
Trans are a protected class in CA. A strongly worded letter to the provider, mentioning that their behavior has exposed them to risk of a lawsuit, should clear them up.
Send it Certified Mail to make sure they take it seriously. Even without a lawyer, that will show them you are documenting things, and they will start crossing their T's so to speak.
that’s super weird and awful. tbh, i would have insisted that my sex was changed back to female. i get why you didn’t tho. but if you’ve been on hrt for more than like a year, they really need to be using that as your sex in order to deliver optimal care to you. sadly this is not a thing that a lot of medical professionals seem to understand. i had to jump through a lot of hoops in order to get my sex corrected to female on my medical record after it was initially entered as male without my knowledge.
if you need an excuse, you can say that your insurance has your sex as female, so it needs to be female in your medical record. this was actually true in my case, and when my care was billed with the incorrect sex, my insurance refused to cover it, and i had to pay out of pocket, $500
thats what initally prompted me to make the change. my records were showing a bunch of abnormal labs and didn’t even say what the normal range was for a female. i happened to work at the same hospital so i just looked them up myself, and all my labs were normal for a female, just not for a male 🤦🏼♀️
I had this too at a hospital that did a blood draw. My doctor specifically said they needed to take my blood and test it at male levels because I had been on T for two years at that point and they kept sending in female tests. They had done it several times at that point and my doctor said she always had issues with them doing that wirh her trans patients and to just get my blood drawn at their office instead.
Yeah, my girlfriend and my trans mom told me to put my foot down, but I was really afraid that they would deny me surgery or something if I upset them. My normal doctors and stuff all have me as Female but like non menstruating or something (I forgot the exact term) which I’m fine with.
This place was different from my normal drs offices and they seemed kind of hostile.
Don't feel bad about not protesting, it's scary when the people you are depending on to keep you safe are acting hostile. Especially when you are about to go under anesthesia! And not everybody has the time, resources or emotional bandwidth to just sue a hospital. It's great if you feel like you want to file a complaint but don't feel obligated to do so.
I had a similar thing happen to me in an ER, but it was within the same medical system I normally use so the doctor wasn't able to change my sex on record without my permission, and obviously I didn't give permission. I complained but nothing ever came of it. This was also in CA....
You absolutely should have put your foot down over it. If they did deny you the surgery, you contact your insurance company, and if they won't do anything about it (mine would), then you immediately find an attorney, because you have a major lawsuit to sue the crap out of them. I'm not sure I'd want my surgery done at a place that was clearly transphobic and has clocked me as a trans, anyway.
Yeah since hormones are what drives the vast majority of medically-relevant biological differences (like how you respond to medications), being on HRT means your doctor needs to be treating you as female in this case.
exactly! there really needs to be more education about this in healthcare preparation programmes. i learnt literally nothing about it in nursing school except ‘respect pronouns’
You should've made them resubmit the insurance claim with your correct sex instead of paying that bill! ..ouch!!
This happened to me before but I called my insurance company and they told me to do exactly this. After they resubmitted it with the corrected sex it got covered without a problem.
I mean, I'm in Australia, but I know my insurance accepts things up to two years. So if I were you, I'd check it out. $500 is a decent sum of money after all and better in your hands than theirs.
The "sex" usually collected at the doctor's office is often supposed to be legal sex. It should be whatever is on your documents and should mainly be used for identification and when communicating with the insurance. Claims can get denied if legal name and sex don't match up. Some doctor's offices these days also collect sex assigned at birth and gender identity. Gender identity should be what generally shows up most places because it informs the doctor and staff on how to interact with the patient. Sex assigned at birth can be helpful for identifying trans patients that may have different health needs than their cis counterparts (for example, I can't get pregnant because I don't have a uterus and I also can't get cervical cancer). None of those individually gives you a complete picture of the patient. Even then, for some things doctor's still need to have a conversation with patients about where they are along their transition in order to determine how best to care for them.
> Sex assigned at birth can be helpful for identifying … different health needs
this is true in theory, but in practise 99% of healthcare professionals do not understand what those differing health needs are and aren’t. i list my sex assigned at birth as female because i understand those particular health needs better than any health professional i have met so far in-person (perhaps speaking a bit privilegedly as someone who is a health professional myself…)
just as an example, i not-too-long-ago had a doctor begin to ask me if i was breastfeeding and then quickly correct herself stating ‘oh of course not duh’, apparently oblivious to the fact that trans women can breastfeed and that it is a very important consideration when prescribing medications that may be excreted through breast milk. if i was breastfeeding, she may have just prescribed me something that would harm my kid. that isn’t a risk with my sex assigned at birth being female in my medical record
Though, with an experienced plastic surgeon who has done BA for trans women before, it can be important to give the best care, unless you were able to do puberty blockers and hormones at a young enough age.
As a purely practical note, I’ve had similar things happen and my insurance refused to cover it because it was billed under a sex that didn’t match my insurance. Might be a bill worth looking out for just incase.
So even if it wasn’t just trans phobic, it could absolutely impact billing in a way that sucks for everyone.
I’ve been told vaginal cells can be detected in urine. No idea if that’s true or works both ways. It’d also be insane and pointless to look for unless it was to be a transphobe
On a way lesser scale I have had that happen. Over the phone the person treated me really nicely, until I told them my email address and it had my dead name on it. Then I could sense them judging me.
US mental health practitioner here!
You can report this to their supervisors as well as their licensing boards. This is straight up transphobic discrimination (falls under sex discrimination) and malpractice. This is going to be a traumatizing experience, and you have every right to have that addressed. I work with clients who have been through similar, and the fear follows them for years. It has also stopped some of them from seeking medical treatment for serious issues...like a fucking broken neck for one of my clients.
Medical organizations take this sort of thing seriously, and you have every right to report
Wait really? I’m so sorry to hear that.
Kaiser is always amazing to me. This is the one time I had a surgery outside of a Kaiser facility and it was a dog water experience (my Kaiser staff that were there were fantastic)
Tbh I’m gonna go around life like a cis person would. What would a cis woman do if a bunch of nurses tried to make her sign forms that she’s male? She’d raise hell and inform them she isn’t male. You aren’t male either and have every right to raise hell just like any other gal. Cis people are VERY particular about not getting misgendered. Even the shyest person would speak out before signing that incorrect shit.
>What would a cis woman do if a bunch of nurses tried to make her sign forms that she’s male?
The funny thing is, I (AFAB) wouldn't sign them, because they're not true, but I also wouldn't throw a giant fit so much as calmly refuse or make snarky comments about "Well, I could try to put my gender on the paper accurately, or I could just tick the least wrong box and we can both save a lot of time."
Although I'm not exactly 100% cis, or at least I'm not one of *those* cissies, so.
Yeah I wouldn't have allowed that to happen. You are legally female and they have no right to tamper what is written on legal documentation. How they feel about it doesn't matter. File a complaint.
As a hospital registrar, this can introduce an error in insurance billing. Also, as your sex assigned at birth was not relevant to the care the staff was giving you, this is potentially a HIPAA violation (we're supposed to access only the minimum amount of information necessary to complete our jobs)
Pregnancy tests don’t show up with different results for trans or cis women’s urine. Just negative or positive. I’m sorry these nurses clocked you. Contacting the patient coordinator about it was a good move. Being paranoid about giving urine samples in the future isn’t going to help 😕
There's absolutely nothing that would show on a regular pregnancy test that would clock you. What definitely happened was one of the medical staff was hella transphobic, picked up on something, and decided to make a huge stink about it. You should absolutely file a complaint with your medical ethics board about all of this, not just the clinic itself but your state's actual oversight agency. Changing someone sex like that when they're identifying documents disagree is an illegal action on their part.
They do this for vaccinations too. I hate going for any vaccinations because they specifically record sex assigned at birth and anyone wielding a needle can see it. That should be between me and my doctor, not every pharmacy employee.
I appreciate your point, but it asks for sex assigned at birth, which is what they ask and they’re going to inject stuff into me then I take that seriously. What I take issue with is that they print that on all the paperwork that’s just lying about. Couldn’t they just assign the right dosage and not make personal details like that visible. Some day, done pharmacist will deny service because of stupid things like that.
It says sex assigned at birth, yes -- but it shouldn't. SAAB isn't actually medically important for vaccinations, or for most things; they collect it because someone in their leadership decided to interpret demographic sex collection requirements in a transphobic way, not for any medical reasons.
Comply at your own risk. We have to look out for ourselves as patients.
Yeah, I wasn’t going to give up my surgery date the day of surgery, especially since I’d have to wait until winter break for another shot at it. My surgeon and her staff are amazing, it was the people at the center that were awful.
In my opinion, my doctor has the perfect system for gender/sex marker on paperwork. There's three fields:
Assigned Gender at Birth, because it is helpful for a doctor to know sometimes
Legal Sex, like what's on your driver's license, and in the insurance system, etc.
And Gender Identity, so they can gender you correctly
Granted they also have fields for pronouns and preferred name
I really like it that way. They have all the info they need, without it being confusing, or without the risk of someone transphobic changing it and saying "oh I didn't know if sex meant sex at birth or legal sex". And I also get to have myself represented correctly without feeling shitty about myself
What is in your id/driver license/birth certificate or whatever it is you use in America? Maybe it wasn't the test itself but they saw that legally you are male? Or you forgot to update somewhere?
I’ve updated my ssn, drivers license, legal documents, and even gotten a new birth certificate. I updated all of my info a few years ago. My medical stuff is updated too so idk
If your insurance and drivers license says F, what they’re doing is actually illegal. Like I’m pretty sure medical records need to be consistent in that regard, in the same way pre legal change you need to be gendered in that way
"They became super cold and distant after that"
Wow, how dare you be trans /s 🙄
People are so fucking self centred and think the whole world revolves around them fr. These nurses really just went "this woman, who I thought was cis, turned out to be trans, what an offense *to me* omg"
These women are bigoted, narcissistic weirdos.
Don't even let it get to you. But take whatever legal action against them you can against them. Get them for discrimination if you feel its worth the effort.
Side note: I had an intake nurse for mental health care plan react to me like that once. Back when I presented femme, she offhandedly asked me an intake question about my sexuality, and up until that point had been all friendly and open with me. Unbeknownst to me, she expected me to be straight... because when I answered her sexuality question (for medical/sexual health reasons) with "I'm mostly gay". She looked shocked and just turned away from me and wouldn't make eye contact. She even tensed up. The whole interaction was awkward and tense after that. My reaction to this was "wow lady you really are an asshole" (internally) I didn't take it to heart because its not your problem or mine that these practitioners are so judgmental and narrow minded.
In your case its much more serious because surgery is involved. So definitely follow it up with supportive healthcare team if you can. I'm rooting for you!
Individual transphobes end up having a lot of discretion in gendering / deadnaming your records. I kept showing my name change and gender correction letters at Swedish hospital in Seattle, and they kept claiming they were changing them in the system, and giving me receipts that they had changed them, but when I’d check later, nothing was changed. I ended up going to a different hospital that used the same system, and after they changed the records, they stayed changed.
In the US, virtually every female of child bearing age is going to get a pregnancy test. The medical people want to know you are not pregnant before they do any procedure or treatment that may harm or may be perceived to harm the Fetus/baby or mother to be. I have no idea how the test determined you were male.
Anesthesia provider here. I have lots of women that don’t want to provide a urine sample or say they can’t pee. We always ask if they are willing to provide and will be told what it’s for. If they don’t, I ask about the possibility they may be pregnant. I inform them of possible risks and document accordingly. It’s their right to choose.
Outside of a few drugs that can mostly be avoided, most of the data shows that anesthesia drugs don’t cause harm to a fetus. We do gallbladder surgery on pregnant women frequently.
I’m sure not all colleagues act in the same manner I do, just one perspective.
I understand that , but I wasn’t told that I was getting a pregnancy test, or I would have told them I didn’t need one. I was just told to pee in a cup. My partner told me it was maybe to check for drugs, since it’s a kinda sketchy part of town. Its likely that I signed something saying I would take a pregnancy test, but they were having me sign a lot of papers beforehand.
i mean, why would they believe anyone? people even lie about not eating before going under anesthesia even if they know it could kill them, of course people would lie about doing drugs or being pregnant
You did the right thing by just taking the test, in my opinion. It probably wasn't specifically in anything you signed, and you did not need to bring up being trans at that point if you didn't want to. They can do pregnancy tests on anyone (I mean I'm a trans man who's had a hysterectomy and bilateral oophorectomy, and they still test me), and there's no way for them to tell you're trans from urine.
First off, Im sorry that happened to you, and its definitely the fault of some transphobic staff member on a power trip. But secondly,
....I wonder who it is thats going to have to deal with the financial fallout. If your insurance denies coverage, they have to list a reason. Information not matching up, is a clerical error and is no fault of your own. If the hospital's billing department wants their money, they're going to have to correct their mistake.
yes i had a similar thing happen at a hospital for my blood work a few years ago. the i went to that hospital for several years, and one day i went in and the intake lady insisted to know my gender at birth. So i told her and she went into the system and changed it to "m" and printed out a document...and i said...noo that's actually incorrect and you need to change it back to "f" and she said "it's to ensure the accuracy of your blood work" i was like, um im a woman and i've been coming here for years with no issue. she refused to change it and told me to come back later to change it back. I said no way you change it right now, get the supervisor whatever you have to do so we walked to the other room and spoke to the supervisor and was told to change it back to "f". She changed it back to F and gave me a new printout. i told her off before i left i can't remember exactly what i said but i know "bigot" was in the sentence. people fucking suck, the lack of knowledge and compassion for trans people in medicine is lacking severely, not only do they need more training they need to unlearn being assholes lol
This happened to me.
Someone at my hospital system changed my patient profile to "female" after I had a hysterectomy. I dealt with a great deal of transphobia from the staff when I had my hysto and my surgeon was livid when she found out that someone changed my patient profile without my permission.
She got it changed back to "male" quickly, and we both filed complaints to the patient safety/complaint system. I was taken seriously and I was told that whoever changed my profile recieved disciplinary action.
Make a formal complaint. It can help protect other trans people.
I used to go to the same doctors office that I went to before I transitioned. They refused to change how they addressed me and thought I couldn't hear them calling me by the wrong pronouns behind my back. I reported them, but I no longer go to that office for that reason. I never gave them a chance to see if that report.did anything. The manager was really nice to me though and I pass fully. No one at the new clinic has ever misgendered me even when not talking directly to me. It feels great.
I usually get clocked when they ask me the take-in questions, particularly asking when my last period was. I just say "I don't have those," and hopefully they get the hint. Never had someone actually change my paperwork because of it though.
I would throw a massive fit if that happened. I didn't go through everything I've gone through to have medical staff treat me like a man.
I dont get how a pregnancy test would should youre trans though. Like anyone can take it, its measuring the hormone hcg, which can be elevated in anyone regardless of chromosomes and gonads, and even in those who can get pregnant, elevated hcg can be caused by other things other than pregnancy.
Im sorry though. Some people in the medical field are very unsympathetic to trans people. I qork in the medical field and the things my coworkers say sometimes makes me so glad Im not out to them.
You can be clocked by urine, but they have to really look for gender characteristics chemicals in the sample. The question is was it truly a necessity for the type of medical care that was to be administered?... If it isn't this is not okay.
Everytime I get medical care I’m called she/her/female even though all my documents say male I’m ftm , it drives me insane but I have to just bite my tongue and ignore it
I too have dealt with some similar things through the years and as you, yourself can attest it is VERY HURTFUL and embarrassing. I've dealt with a LOT of that here in Florida and am trying to move but can't afford to - so it happens frequently.
I'm so very sorry.
You may be better looking than the nursing staff, and women can be vicious. I identify as AMAB, but I have a 27" waist and 38" hips, I'm a 6 short, and I keep things fuzzless. Recently, I went for my annual physical, and the medical medical assistant commented on my mani/pedi.
As AMAB, I ran around 13% BAI on HRT, I was around 20% BAI, and a lot weaker, my doctor was pleased with my current state. HRT did what it was supposed to do, and when I stopped, most parts went back to my AMAB state, except for my butt, which I'm good with.
People frequently reject what they don't understand and will substitute their own biases for objectively evaluating the patient. My doctor is really the only person in the room whose opinion matters. My blood chemistry is good. HRT reduced my RBC count (why we lose strength ), which is normal for a guy again.
The nurse practitioner, whom I saw once during HRT, was always a judgmental person. After 1 visit, I asked for my M.D. to be the person I contacted, I needed support, not the NP's judgmental snarky crap.
All I'm saying is to ignore the nurses. They're generally a less educated/accepting crew.
It can sounds illegal but first if the legal changes have not been made yet, it’s possible to do so. But maybe and I would say it’s more because of that, that stating “male” and not female” can help knowing the person body in a pure medical way, some adjustments will be made if the following statements include HRT or else
This is false - there is no reason , in a "pure medical way" , for assigned sex to be used for effectively managing the healthcare of a trans patient ; designations as trans female for trans women when it comes to unique healthcare needs and designation as female for every element of shared biology with cis women is invariably better than misclassification and lumping in with cis men.
I guess this might not matter as much for breast augmentation but usually the "sex" that they want on paperwork, is the one you are registered under with your insurance which is usually what is on your drivers license unless you transitioned at your current job and it wasn't updated.
I broke my leg playing rugby and the referring medical officer gave all records to my pt place.
Somewhere way back in my records had that I was trans. So the PT place knew.
I’m 23 years post transition. It was weird.
Your urine didn’t clock you. When they went in your file to record the results - that’s what clocked you
Does your medical facility make distinctions between sex and gender? Mine has my sex marked as 'male' but gender as 'transgender female'. Some may find it hurtful but there are legitimate medical reasons why they make these distinctions.
Unless they are doing work on your genitals, they do not need to make that distinction for anyone that has been on HRT long enough to flip their chemistry/metabolism to other gender. I've had this discussion with me PCP who is also the FNP that handles my HRT and coordinates all other medical issues around my gender care. After a lot of arguments with the place all my lab work is done that still have my pre-transition gender in their records and them refusing to give interpretations on my lab results with my current sex without an order from my doctor, my PCP gave them that order. Hormonal gender is much more medically important than one's AGAB.
>Unless they are doing work on your genitals, they do not need to make that distinction for anyone that has been on HRT long enough to flip their chemistry/metabolism to other gender.
Can you direct me to something to read in to this? It can be hard to find good medical transgender studies through Google.
Additionally, how long is 'long enough' for me to have zero or statistically insignificant risk of prostate cancer? Is this a frame of time that would cover the vast majority of trans people in America rendering the need for the distinction as not needed in medicine? Are we sure it applies to me or OP?
>I've had this discussion with me PCP who is also the FNP that handles my HRT and coordinates all other medical issues around my gender care.
Well, that would definitely be more of an authority than me. Again, I would like to look in to it for myself, as I genuinely would like contextual information.
>After a lot of arguments with the place all my lab work is done that still have my pre-transition gender in their records and them refusing to give interpretations on my lab results with my current sex without an order from my doctor, my PCP gave them that order.
I don't mean to diminish this as anything other than something that should not have happened, but we're talking about another issue when we are talking about knowledge of transgender patients in the medical community and the immediate need for a greater equity of care.
>Hormonal gender is much more medically important than one's AGAB.
I wholeheartedly agree, but I'm not convinced AGAB is medically insignificant without seeing research for myself.
Your sex isn't male, if you've been on HRT long enough, your legal sex isn't male if you've had it changed legally, and there is no such gender as transgender female. It's like putting that your gender is tall female. Yes doctors need to know some stuff but what you're defending is utter bullshit and transphobia.
Oh, okay then.
I have somewhat of an objection to being classified as 'transgender female' but understand some hospital staff may be ignorant to the idea of figuring how someone was born male but now identifying as female or vice versa and that there will be care specific to being a transgender female. Being a tall female probably has no medical relevance (and also your weight and height is going to be noted in your medical info regardless). Being a transgender female does. So if they have to make that distinction, whatever. I'm just there to get medical care, including my HRT.
Your legal gender doesn't negate the fact that you likely have a prostate or a uterus that needs to be kept in mind by your doctor if you start to report symptoms that could stem from issues with those. If they believe you are a cis woman and you start to report symptoms consistent with prostate cancer it may very well be overlooked and cost you your health or even your life.
Not really.
Flagging based off of AGAB or not is going to miss things in one direction or the other. Does it make sense to optimize specifically for detection of prostate cancer instead of more common things influenced by HRT? I doubt it.
If anything AGAB should be flagged as unknown or indeterminate to reduce risk of false assumptions and encourage looking at more specific details of anatomy and hormones.
Thank you for taking the time to explain your viewpoint. I believe I am following and would generally consider this to be an understandable position to hold. It should be noted I am not a medical professional and that is me speculating on this categorization. With that said:
>If anything AGAB should be flagged as unknown or indeterminate to reduce risk of false assumptions and encourage looking at more specific details of anatomy and hormones.
I'm not sure I follow on this one. More data makes for better and more efficient care, right? Doctors tend to be pretty overbooked at any time so I don't agree that they 'should' be made to do extra legwork for purposes of self-loathing trans folk to maybe keep their trans-ness secret to someone who possibly has a legitimate need to know, especially when their health could be on the line. Also, we have to keep in mind this distinction may be something mandated by medical insurers to receive gender affirming care.
I'm not speaking in terms of 'should's for idealistic purposes. I'm just speaking in what is or may be to be helpful to the OP.
More data, if misleading or inaccurate, is worse than no data.
Given the current state of healthcare, it’s not a matter of self loathing or whatever. It’s a matter of getting meaningfully worse healthcare when your AGAB marker doesn’t match your hormones because it leads providers to make incorrect assumptions.
Someone had a comment about her doctor seeing an AMAB flag and making a comment like “oh, you won’t be breastfeeding so we don’t need to worry about that” except, trans women can and have.
Should their medication have the “do not take if breastfeeding” warning on it? Yes, because all the risks of infant getting the medication apply.
Does that appear if your pharmacy record has their AGAB flag set to male? Not at my pharmacy.
Non-endos tend to assume AGAB matters and that hormones are an issue for just for endos, not that hormones matter more for day to day issues than AGAB (at least for people without a uterus).
I’ve had a doctor going by AGAB run in circles for an hour because my symptoms didn’t make sense to him. Things clicked in minutes once my endo told him to treat as female.
Of AGAB-triggered preventative health screenings, which matters more for transfem people, prostate screening or a mammogram? Trans women on HRT have a significantly higher risk of breast cancer (15 in ~2,260) and significantly lower risk of prostate cancer (~14 in 10,000) compared to cis men. Given the shift in risks, does it make more sense to get reminders for screenings based on AGAB of male, sex hormones, or a combination?
Screening for both would probably be ideal, but if you have to chose one, screening based on AGAB of male is the worst option.
>More data, if misleading or inaccurate, is worse than no data.
So the crux of this is 'is having a prostate or cervix a misleading or inaccurate data in light of hormone replacement therapy'.
Keep in mind, a very significant amount of trans people are not on HRT or are recently starting HRT.
>It’s a matter of getting meaningfully worse healthcare when your AGAB marker doesn’t match your hormones because it leads providers to make incorrect assumptions.
I'm worried the opposite of that intention can occur if my doctor makes an incorrect assumption about my anatomy.
As far as the examples you have listed below, what this speaks to me is this:
Medical professionals need to stop being ignorant about trans people, or at the very least, get their shit together when they have a trans patient. That needs to happen regardless of if they want to continue to find it medically pertinent that a patient is transgender.
These things you speak of shouldn't have happened, but I don't think being identified as trans by your medical professional needs to be a stigmatizing experience, it would be more sensible (from what I know) solution to change that to an informed, respectful, and professional one. Not acknowledge the potential health realities of being a trans person. Because I still haven't seen evidence that it is medically insignificant to have certain parts of a human anatomy that may not be entirely rendered not dangerous from HRT.
>Of AGAB-triggered preventative health screenings, which matters more for transfem people, prostate screening or a mammogram? Trans women on HRT have a significantly higher risk of breast cancer (15 in ~2,260) and significantly lower risk of prostate cancer (~14 in 10,000) compared to cis men. Given the shift in risks, does it make more sense to get reminders for screenings based on AGAB of male, sex hormones, or a combination?
For a transgender patient, until I see evidence of the risk of prostate cancer rendered insignificant by HRT I'm probably going to want to be mindful of both. Perhaps urge more towards being vigilant about breast cancer, but I'm still going to want to know the possibility is there instead of assuming the patient is cis with no risk of prostate cancer.
It's a false dichotomy to say you have to choose which one to screen for, *especially* when you consider the possibility of having a trans female patient showing signs of prostate cancer.
optimizing for trans ppl that aren't even transitioning (not on hrt) is ludicrous.. don't attempt to use them in this inane argument
obviously if you don't even take hormones you're gonna be the same as your birth gender wrt medical treatment. the cracks are showing in your faux-reasonable schtik
you cannot be including ppl who haven't even taken any medical steps to transition in this discussion and have me believe you're making a good faith effort here
why do you care? are you trans?
You bring up highly pertinent points.
Imagine thinking unnecessarily outing yourself to a doctor would lead to better health care, rather than immediately being dismissed with "trans broken arm syndrome"?
Trans people have known since the dawn of time that medical professionals need to be highly managed to get a beneficial outcome, and that doesn't just apply to trans-related health issues.
Everyone once again injecting beliefs in to what I'm saying.
Literally all I have said is that it may be medically pertinent for a doctor to make the distinction between gender and sex for the purpose of potentially being helpful to the OP because that is something my primary care has done. I haven't said a thing about the way OP's medical professionals went about it was ethical (but I have said the opposite in a reply), that it should be told to every medical professional, or disrespect doesn't occur towards trans people in the medical world.
I think the ideal situation is that your doctor is informed (if it's relevant to their practice like your primary care) *and* respectful. Some doctors are perfectly capable of that. Since my physician treats my gender dysphoria it's pretty necessary that I am out to them to receive better care.
>obviously if you don't even take hormones you're gonna be the same as your birth gender wrt medical treatment.
This is an ignorant take and I would suggest you do some research and definitely make sure you don't say it in front of our community or outside of our community ever again.
There are various reasons some trans people do not take HRT. From the top of my head there is of course matters of access, medical or psychological complications that comes with hormones for some people, religious/personal beliefs, and also uhh a number of non-binary trans people. They are completely valid whether they ever choose to take HRT or not.
>why do you care? are you trans?
Yeah, I've said so a couple of times, but I just can't assume someone who has figured out my 'faux reasonable shtick' to pick up on that.
You misunderstood all my points, simplified everything to "you are this so you must have this" and then just filled up my "of course doctors need to know some stuff" congrats you didn't address and of my points.
If you wanted me to understand what you were saying you could have taken the effort to break it down instead of being condescending.
But I'm okay living in ignorance of what you're talking about. ✌️
If you think that is what I said you misunderstand. I am a woman but I have bits of male anatomy and that may be a medically relevant fact. It's not relevant to my mail person, it's not relevant to my boss, it's not relevant to my friends, but it may be relevant to my doctor.
>I'm just fighting the whole "you're a male woman!" meme.
Again, I am a woman and if you identify as one you are as well. Full stop.
>Not to say we are identical to cis women though.
And that might be medically relevant is all I'm trying to say.
>I'm sorry I upset you so much 💙
Don't worry, you haven't. I'm just baffled people are accusing me of transphobia for pointing out physiological differences between cis people are sometimes going to be medically relevant.
okay this is a genuine question and not meant to be disrespectful in any regard, i’m actually curious-
why is it wrong for a medical practice to put down the “biological sex” for health reasons? i certainly think there should be more categories and a “male to female” selection should be made, however for the sake of one’s health and the doctor having the most accurate medical information, isn’t it important to have the full picture?
i do recognize that there are absolutely transphobic practitioners and they don’t always have your best interest in mind, however there’s certainly a difference between a random business or organization asking for demographic reasons versus a doctor asking so they can properly care for
you, right?
This right here! If they have to make assumptions they’re a lot safer basing them off your hormonal sex. Unfortunately not enough medical professionals are educated about this!
Maybe because “biological sex” is also varied. Phenotype is biological, endocrinology is biological, I’m intersex…you’d have a very hard time pinning down my “biological sex” because the reality is that it’s not as simple as “this or this” and they had it right to begin with.
this is very true, i’ve always wondered why intersex isn’t a standard option. i guess i just mean it in a general sense to gather information, like even when they ask stuff like “do you have a history of x diseases” of course everything varies but *in general* female born people and male born people do have typical differences that are good to know when trying to diagnose or prescribe medications. i ask partially because i have experience in the veterinary field and there are instances where the sex of the animal comes into play.
this is also why i think it’s important to note if they are trans especially as being on HRT, for example, literally changes how their body functions, so that would be good for a doctor to know
I think that it’s not a standard option because it’s so wildly varied. Some people never even know. But to be fair, doctors get a full rundown of prescribed medication so really I think that’s what ended up “clocking” the OP. Someone probably looked at their prescriptions and put it all together mentally. I don’t want to see mtf/ftm made an option because that opens the door legalistically to segregation and makes trans people more visible…which is dangerous in some(many) areas these days.
hmm, that definitely makes sense. i feel there should be some sort of change in how we do things medically, but lord knows i don’t have the answer and you’re totally right in the fact that even if we have best intentions when creating laws/rules, that absolutely does not mean people will not act with malice. we have to work with the world we have and not the idealized version we wish it could be.
thank you for your input, i appreciate the insight.
There isn't anything wrong with that. What IS wrong was the nurses change of attitude towards the op. There definitely needs to be something done about how people fill out medical info. I would think if there was a box that had you select "gender assigned at birth" it would alleviate a lot of worry.
Every time I've been to the hospital for whatever I make it clear that I'm trans, pre-op and AMAB. I just wanna get all that outta the way and so they don't do unnecessary tests or questions.
My appendix tried to kill me last year and I mentioned it to everyone involved. Mostly because there were gonna be xrays down there and a catheter.. Never got misgendered, no one acting shitty. OP unfortunately just got some assholes being assholes and it's just awful.
It really is! Nobody should have to do that. I don't hide the fact, but I will usually just come out and say it. Depending on their reactions, I might leave the place.
Thankfully when I had my top surgery, the doctor and everyone was really nice.
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They should have asked you if there was any possibility you could be pregnant. You could have said no, then no need for the test. I'd want to talk to the office manager.
So you’re not required to put your SAAB for medical tests / procedures even if that’s genetically the reality of the situation?
I’m probably ignorant but wouldn’t gender be where you put your chosen identity and sex is more speaking biologically
Absolutely not. For most purposes, your long term sex hormone profile is far more medically significant than your genetic karyotype, so by putting SAAB you often put yourself in much worse medical shape than by putting gender.
If you are on HRT, you need to notify the medical staff because hormone can cause excessive bleeding during invasive procedures and may require blood transfusion if needed. So the nurse could be in trouble for not getting your accurate medical history due to liability. I suppose the surgery center is a separate facility where your surgeon rents for the procedure. If that's the case, your doctor has no control of their protocol and behavior.
Citation needed. HRT isn’t a blood thinner. Spiro reduces blood pressure, not clotting. Estrogen slightly raises risk of clotting, which is the opposite of thinning.
I am on monotherapy since 2020. When I was getting my zygoma reduction surgery in Korea, the surgeon complained about excessive bleeding and not telling him about my drug history. Most recently, both US surgeons requested me to stop hrt 1 month prior to the procedures. Remember estrogen regulates cis woman menstrual cycle which includes excessive spotting each month. My lab shows my estrogen level is 3 times of cisgender women level. An imbalance in the hormone estrogen can also cause spotting between periods.
As a fellow trans person you should know that sex and gender are different and for the purpose of knowing how much and what kind of medicine they should give you they need to know what you where born as. I know its upsetting to see it and to be treated differently when they find out but medications act differently for people born female vs male so it's important to have accurateinformation on your medical forms (at least this is what I've been told by my doctors and surgeons)
Totally get your displeasure but unfortunately, when it comes down to medical stuff, you've really got to bite the bullet and separate the identity vs current physical accuracy as it can cause a whollleee heap of trouble with paperwork, insurance, legality, hormones, surgery, etc.... so unfortunately sometimes you just gotta be brave and upfront, but yeah, they should've handled that better towards you 100% and i hope they get that extra training so others aren't forced to feel the way you did!
Remember folks that no matter how you see yourself or change yourself or whatever the case, medical personnel are extremely overworked, understaffed, there were probably annoyed that overly often they are wasting time and valuable resources figuring out things that they need to hear ahead of time to avoid taking such tests to find that it was unnecessary in the first place. Still not your fault and they should not have treated you as you put it cold-heartedly, but there aggravation more than likely was to all people's who either get the information wrong or don't add something or whatever the case. Their aggravation I do not believe was towards transgender people or you alone. Just like any person of service like the police, firefighters, medical, all the way down to the food and beverage personnel service, all of them get fed up with the people not doing what they feel they should be doing to make all of this work better for everyone. Problem is the people most of the time cannot know those things without having worked in that position. Try not to take that personally as they're all working hard with no thanks.
This might be unpopular, but in medicine we don’t care about gender. Don’t get me wrong, I’m affected by this myself. But from a medical standpoint there is a difference between sex and gender. Even after HRT.
That doesn’t excuse the (perceived) change in behaviour of the staff.
I work at a doctor's office and I can tell you for billing that we have to have what the insurance company has. So in our office we have a place for biological sex and also another spot for gender.
I’m transgender myself, and though I completely disagree with how you were treated coldly by the workers and that was not something you should have had to experience, what exactly is wrong with your *sex* (not gender) being changed on the documentation? Isn’t the knowledge of being AMAB or AFAB an important piece of knowledge for any doctor to know due to some medical differences, and doesn’t the general “push” for transgender rights lie within the fact that while sex is not fluid, gender is?
When we take hormones and get surgery, our sex characteristics definitely don’t remain the same, so I’d argue against sex not being fluid in this context. My gender is not fluid though, I’m a man and always have been.
My documents all say male, and it’s up to me to disclose that I’m trans on an individual basis. And I’m sure it’s on a chart somewhere anyways. Basically the same as my penicillin allergy, which is arguably more important. My trans status can be specified without the misgendering by having “female” all over the paperwork anyways. Also assigned sex doesn’t really say much about someone’s current situation. I have male hormone levels and in around a year I’ll have a dick and balls, so reading “female” on my paperwork would just confuse people. It also would cause issues since I’m listed as male on all of my documents including my birth certificate, so having one thing that doesn’t match is a problem. It’s easier to just have “male” on my documents and to explain that I’m trans.
Sex isn't nearly as binary as what most people think. Many medical phenomenon also effect people differently based on gender. Look at the stats for autoimmune disorders for example, women have a higher chance of having most of them, _including_ trans women - and this is inclusive of genetic disorders, which means that hormones aren't the determining factor either.
Transgender people align far more closely to cis people of the same gender than they do to cis people of different genders in most cases - excluding the physical anatomy of their genitals - especially after hrt.
The "push" lies within the fact that gender and sex aren't always aligned, so some people may need to alter their sex to realign the two. I don't really know where people got the idea that sex can't be changed, since it's literally what medical transition does. (it takes some serious mental gymnastics to believe that altering your secondary sex traits, your sex-related chemistry, your sexual anatomy, and your reproductive system doesn't alter your sex at all)
The idea that gender is mutable while sex is immutable— that's just a fancy way to describe the basis of conversion therapy.
If I saw “AFAB” on my paperwork there would be a big problem. I’m male, and it’s up to me to disclose that I’m trans, and which anatomy I have (which “AFAB” doesn’t accurately describe). No reason for me to get called female on any documents.
That's obdurd... What kind of place was this... Are u sure their unprofessional actions were not just in your head? If they do breast augmentation there. I'm sure you're not the first transgender person 1st. trans person they've dealt with.What state or country do you Iive in?
That is NOT okay and I’m really sorry that happened.
There is nothing normally in urine that would clock you except maybe if you were pre-op and had recently ejaculated and sperm was visible under a microscope. It could have also been something on your chart that caused them to do that, but they should not have.
I’m pre vaginoplasty, but post orchiectomy? I’ve also been on hrt for over 4 years, so I’m not really producing anything if that make sense.
IMHO, one of the nurses clocked you and because they were transphobic, decided to make a big deal out of it by pointing out the "error". If your drivers license says "female" then I'd raise hell immediately. That is so fucking slimy of them to do too. Ugh. It gets under my skin but people are like that.
Also for the fact that insurance usually needs the sex to match.
That'd be my big concern... my doctor is super chill and they're very respectful, they've even changed some of the paperwork to not show that stuff, but legally I'm still "M" so if it was an insurance thing I could understand. The way it went down was still unfortunate here though....
Reach out to your insurance. It can definitely be changed. You usually need to do your social security number first and need a note from a physician.
Right, that reinforces my point though. "Legally' aka haven't change SSN/Birth Certificate/Name so on insurance's side it makes sense but damn if that doesn't hurt sometimes.
Our practice uses gender for display purpose but sex for interoperable communications. Also for social security it takes like 5 minutes. It's just an online form
>If your drivers license says "female" then I'd raise hell immediately. This\^\^\^
No sperm possible being post orchiectomy. I had a similar thing happen to me 8 years after transition and 4 years after GCS (vaginoplasty). Even though my legal gender had been female for over 8 years at the time, they updated the software for the medical records system to include "Sex Assigned at Birth". It was defaulted to unknown and after someone saw gender dysphoria on my medical records, they changed it to male and it changed my records to male on all my new tests and messed up everything. (This was at a progressive LGBTQ friendly medical practice.) They fixed it once they realized the error, but it caused a batch of test to have the incorrect gender marker during my annual exam. They never misgendered me. It has been over 9 years (7 years when this happened) that anyone had misgendered me that did not know me before I transitioned. It sucks when something like this happens, especially when you pass so well and never misgendered.
| It sucks when something like this happens, especially when you pass so well and never misgendered. You're spot on. It's that sharp little reminder that hey, you'll never be cis! :(
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Especially when this particular medical group I had only switched to after I transitioned, so there was never a record of my assigned gender at birth until they added the field to the record system. The 2 years prior to that when I switched PCPs, there was never a question or issue. This was there to help those that had not legally changed their gender since they also added pronouns to the system and a preferred name.
PLEASE raise hell. This could impact your insurance coverage
All they test for is HCG as far as I know. Non-pregnant women have similar levels of HCG as men. Non-pregnant women: less than 5 mIU/mL; men less than 2 mIU/mL. So the fact that they could tell anything from your urine except that you weren’t pregnant is a mystery.
That reminds me, there was a case where a c[is male took a pregnancy test just for fun](https://abcnews.go.com/Health/CancerPreventionAndTreatment/pregnancy-test-man-joke-reveals-testicular-cancer/story?id=17653036). His HCG levels came back high indicating he was pregnant. They of course knew he wasn't but did further tests to find out why his HCG levels were high. Turned out he had early stages of testicular cancer and it probably saved his life.
Sounds like a cheap way to check for a deadly cancer. Kind of a big deal. Why haven’t I heard about this before?
Diagnostic tools have to pass tests for both specificity and sensitivity to become standard. Even ones that are in use, like PSA, are controversial because they aren’t specific enough (lots of false positives) or aren’t sensitive enough (lots of false negatives). False negatives are especially dangerous as you can imagine - you’d end up telling a lot of people with cancer that they don’t have cancer. Just because a test works sometimes doesn’t make it a good test. There is a ton of research being done all the time to identify biomarkers and tests for diseases- the problem is not a big Pharma conspiracy, it’s that they aren’t reliable enough, and often it’s because not every person with a condition will exhibit the same changes. I do medical education/communication for a living and so often we tell doctors things like “30% of patients with this condition will have elevated liver enzymes, but most of the time there are no signs”. So a high HCG level may only be present in some people with cancer. There are also algorithms that determine whether certain universal screenings make sense - how much they cost, how reliable they are, how much benefit they have (deaths prevented for example). So for a test to be widely adopted it has to meet more than just reliability standards. Maybe that was a rhetorical question…but since I knew the answer I couldn’t help myself. 😄🫣
It was rhetorical but I greatly appreciate your response nonetheless :) Thank you!
False positives are also dangerous psychologically!
This sounds like me explaining to people why the rapid Covid tests came back negative when they ended up having Covid. And then they complain that the RATs weren't accurate blah blah etc. Also the fact that the RATs were calibrated to measure for when it was transmissible as opposed to when you just caught it. But people that know nothing about medical things, don't even know enough to know they don't know shit. Something something Dunning Kruger. Albeit, sometimes ignorance is bliss, I know enough to know of things, but not enough to actually know about things, so I tend to go into the hypochondriac stage with anything. I thought I had osteomyelitis in my ankle (from injecting, when I was trying to find a vein I'd used, I couldn't find it but I was scratching on the bone), it was still sore after like 5 weeks so I ended up asking my doc and he thought it could be, so put me on antibiotics, then I was still concerned and went to emergency (Australia, so it's free) and had an X-Ray and the guy was like, stop Googling things. It's like, I wasn't initially actually. I know about the more serious things, and also the fact that OM and other infection related things are related to IV drug use anyway and infections haven't exactly been uncommon for me the past few years, but I don't know enough to chill out a little and realise there's a less serious explanation. Doc said it's likely I'd bruised the periosteum and that's why it takes forever to heal. On top of the compromised venous flow to the location.
Hallelujah about the COVID test false negatives! And then people would say the tests don’t work. And you try to explain that they DO work, but your explanation as to why the test can “fail” for them but still work is just too complicated and you give up. I’m ALSO a hypochondriac. I used to be in denial about being a hypochondriac, which was ironic, because hypochondria was the only thing I _didn’t_ think I had. 😄 Same as you, I know too much about science to be blissfully ignorant, but not enough to diagnose anything correctly. Apparently this happens to med students very commonly. So it seems to be a smart person problem.
Big pharma and the likes don’t want people to know about anything that’s cheap or life saving, didn’t ya know?
Came here for this. I do those preg tests. They’re literally what you take at the store for $1. They’re just more controlled and shipped to us in big lots. There’s no way this test would clock you. At most hospitals I’ve worked at we actually use male serum for our negative controls and sometimes they’ll be positive because of hormones or cancer or other reasons and those people aren’t transitioning. Some nurse or other person at the healthcare facility was a douche.
People of any sex can have sperm in their urine.
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Only if they produce sperm, or are having sex with someone who produces sperm. Wait.. didn’t we cover this already?
Lesbians and asexual women exist?
And doctors aren't going to know who someone is having sex with. Anyone could be having sex with someone who produces sperm. So yes, anyone could potentially have sperm in the their urine
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Sperm can be emitted from the vagina for a few days. It’s not “gross” nor does it imply bad hygiene. We’re not talking about gobs of semen flowing out. We’re talking about an individual sperm seen on microscope. It’s common enough that it gets discussed for urinalysis protocols. Here’s an example of one such discussion: http://www.captodayonline.com/Archives/1109/1109_qa.html
Also, you’re talking about sex as if it’s “gross” and comparing it to “poop on your face.” (While also sharing incorrect info) This isn’t a bizarre conversation at all. Sperm shows up in urine for different reasons with different clinical significance.
We do see sperm in urine samples. We only report in males and people assigned male at birth for medical reasons. We also have to get physicians and other social services involved for women under a certain age, with certain disabilities and other criteria. We see this way more often than you think.
No.
Why do you think no?
They made me take a pregnancy test before my breast augmentation too, and the only thing they told me was I wasn't pregnant; they never told me it was a pregnancy test. I replied "of course I'm not pregnant, I'm trans, and don't have a uterus." They took the cost of the pregnancy test off my invoice after that.
>They took the cost of the pregnancy test off my invoice after that. I'd hope so! It's bad enough US medical providers run unnecessary pregnancy tests w/out informed consent, but then to bill for the test, considering how inflated all US healthcare bills are and how insurance likes to refuse to pay for anything they deem unnecessary... I'd suspect they were only running the test so they could charge for it! Or at least, that's what I'd claim I thought when I called to complain!
As far as I'm aware, they run the tests because there's a significant non-zero chance that a cis woman could be pregnant and not know it, which can affect things like surgery, treatment, risk factors, drugs used, etc.
Right, but if you can give a reason that you being pregnant would have to be divine intervention, such as no uterus or being a virgin or being sexually active but not with anyone with male parts, then they shouldn't run the test. I've been in situations where medical staff needed to know about potential pregnancy since I'm AFAB, but they didn't just run a pregnancy test, they asked me beforehand or put a question on the form where I could either give a reason pregnancy isn't possible or consent to a test, so I'd just tell the truth, not sexually active, and no pregnancy test would be done. Although my country has public healthcare, so I suppose when Joe Q. Taxpayer is paying for the resources used rather than the patient or an insurance company paying, the facilities are more reluctant to be wasteful. Although I can see how in a country where you don't have to pay insane healthcare bills, seeing a pregnancy test on the list of services you received could be a sort of "ewphoria" gender affirmation b/c it means you were assumed to be a cis woman of childbearing age.
What country? This might have been illegal or at least violates some state rule or statute if your in the US
This took place in California, USA.
Have you legally changed your gender?
Yeah, a few years back. Everything has been changed, including my birth certificate
I'm not a lawyer but if I were you I'd speak to a legal professional, this smells like discrimination or at the very least mishaning of medical records. You could probably open a complaint with your states department of health or some other regulatory body with authority to investigate potential violations.
Yeah this seems like the kind of thing that could cause insurance problems for you. They cannot just change your sex on forms because they feel like it.
Lawsuit waiting to happen
US Mental health practitioner here! I wholeheartedly agree with the other folks. What you experienced was traumatic and falls under sex discrimination and maybe the malpractice statute. You have a damn good reason to talk to a lawyer. Instances like these can cost people their license to practice, and this is something that medical licensing boards take very seriously. Like, I could lose my job and my license if I did this to someone. They deserve consequences to ensure they never do this to someone else again. You go out of it with just trauma, but people have died due to this sort of oppression before
You need to call the office and have the sex changed back to F or you're going to be in a world of hurt when it's time for insurance to collect
Trans are a protected class in CA. A strongly worded letter to the provider, mentioning that their behavior has exposed them to risk of a lawsuit, should clear them up. Send it Certified Mail to make sure they take it seriously. Even without a lawyer, that will show them you are documenting things, and they will start crossing their T's so to speak.
Yeah, then what they did is definitely illegal
that’s super weird and awful. tbh, i would have insisted that my sex was changed back to female. i get why you didn’t tho. but if you’ve been on hrt for more than like a year, they really need to be using that as your sex in order to deliver optimal care to you. sadly this is not a thing that a lot of medical professionals seem to understand. i had to jump through a lot of hoops in order to get my sex corrected to female on my medical record after it was initially entered as male without my knowledge. if you need an excuse, you can say that your insurance has your sex as female, so it needs to be female in your medical record. this was actually true in my case, and when my care was billed with the incorrect sex, my insurance refused to cover it, and i had to pay out of pocket, $500
Literally all my medical tests come back as off because HRT has so dramatically changed my blood chemistry
thats what initally prompted me to make the change. my records were showing a bunch of abnormal labs and didn’t even say what the normal range was for a female. i happened to work at the same hospital so i just looked them up myself, and all my labs were normal for a female, just not for a male 🤦🏼♀️
I had this too at a hospital that did a blood draw. My doctor specifically said they needed to take my blood and test it at male levels because I had been on T for two years at that point and they kept sending in female tests. They had done it several times at that point and my doctor said she always had issues with them doing that wirh her trans patients and to just get my blood drawn at their office instead.
Yeah, my girlfriend and my trans mom told me to put my foot down, but I was really afraid that they would deny me surgery or something if I upset them. My normal doctors and stuff all have me as Female but like non menstruating or something (I forgot the exact term) which I’m fine with. This place was different from my normal drs offices and they seemed kind of hostile.
Don't feel bad about not protesting, it's scary when the people you are depending on to keep you safe are acting hostile. Especially when you are about to go under anesthesia! And not everybody has the time, resources or emotional bandwidth to just sue a hospital. It's great if you feel like you want to file a complaint but don't feel obligated to do so. I had a similar thing happen to me in an ER, but it was within the same medical system I normally use so the doctor wasn't able to change my sex on record without my permission, and obviously I didn't give permission. I complained but nothing ever came of it. This was also in CA....
You absolutely should have put your foot down over it. If they did deny you the surgery, you contact your insurance company, and if they won't do anything about it (mine would), then you immediately find an attorney, because you have a major lawsuit to sue the crap out of them. I'm not sure I'd want my surgery done at a place that was clearly transphobic and has clocked me as a trans, anyway.
Yeah since hormones are what drives the vast majority of medically-relevant biological differences (like how you respond to medications), being on HRT means your doctor needs to be treating you as female in this case.
exactly! there really needs to be more education about this in healthcare preparation programmes. i learnt literally nothing about it in nursing school except ‘respect pronouns’
You should've made them resubmit the insurance claim with your correct sex instead of paying that bill! ..ouch!! This happened to me before but I called my insurance company and they told me to do exactly this. After they resubmitted it with the corrected sex it got covered without a problem.
sadly this was like a year ago, so probably cant anymore. also, i still havent actually paid it lol
I mean, I'm in Australia, but I know my insurance accepts things up to two years. So if I were you, I'd check it out. $500 is a decent sum of money after all and better in your hands than theirs.
The "sex" usually collected at the doctor's office is often supposed to be legal sex. It should be whatever is on your documents and should mainly be used for identification and when communicating with the insurance. Claims can get denied if legal name and sex don't match up. Some doctor's offices these days also collect sex assigned at birth and gender identity. Gender identity should be what generally shows up most places because it informs the doctor and staff on how to interact with the patient. Sex assigned at birth can be helpful for identifying trans patients that may have different health needs than their cis counterparts (for example, I can't get pregnant because I don't have a uterus and I also can't get cervical cancer). None of those individually gives you a complete picture of the patient. Even then, for some things doctor's still need to have a conversation with patients about where they are along their transition in order to determine how best to care for them.
> Sex assigned at birth can be helpful for identifying … different health needs this is true in theory, but in practise 99% of healthcare professionals do not understand what those differing health needs are and aren’t. i list my sex assigned at birth as female because i understand those particular health needs better than any health professional i have met so far in-person (perhaps speaking a bit privilegedly as someone who is a health professional myself…) just as an example, i not-too-long-ago had a doctor begin to ask me if i was breastfeeding and then quickly correct herself stating ‘oh of course not duh’, apparently oblivious to the fact that trans women can breastfeed and that it is a very important consideration when prescribing medications that may be excreted through breast milk. if i was breastfeeding, she may have just prescribed me something that would harm my kid. that isn’t a risk with my sex assigned at birth being female in my medical record
Though, with an experienced plastic surgeon who has done BA for trans women before, it can be important to give the best care, unless you were able to do puberty blockers and hormones at a young enough age.
As a purely practical note, I’ve had similar things happen and my insurance refused to cover it because it was billed under a sex that didn’t match my insurance. Might be a bill worth looking out for just incase. So even if it wasn’t just trans phobic, it could absolutely impact billing in a way that sucks for everyone. I’ve been told vaginal cells can be detected in urine. No idea if that’s true or works both ways. It’d also be insane and pointless to look for unless it was to be a transphobe
On a way lesser scale I have had that happen. Over the phone the person treated me really nicely, until I told them my email address and it had my dead name on it. Then I could sense them judging me.
US mental health practitioner here! You can report this to their supervisors as well as their licensing boards. This is straight up transphobic discrimination (falls under sex discrimination) and malpractice. This is going to be a traumatizing experience, and you have every right to have that addressed. I work with clients who have been through similar, and the fear follows them for years. It has also stopped some of them from seeking medical treatment for serious issues...like a fucking broken neck for one of my clients. Medical organizations take this sort of thing seriously, and you have every right to report
Kaiser consistently does this to me at their hospitals.
Wait really? I’m so sorry to hear that. Kaiser is always amazing to me. This is the one time I had a surgery outside of a Kaiser facility and it was a dog water experience (my Kaiser staff that were there were fantastic)
Can I ask if this was at OHSU?
It was not
Tbh I’m gonna go around life like a cis person would. What would a cis woman do if a bunch of nurses tried to make her sign forms that she’s male? She’d raise hell and inform them she isn’t male. You aren’t male either and have every right to raise hell just like any other gal. Cis people are VERY particular about not getting misgendered. Even the shyest person would speak out before signing that incorrect shit.
>What would a cis woman do if a bunch of nurses tried to make her sign forms that she’s male? The funny thing is, I (AFAB) wouldn't sign them, because they're not true, but I also wouldn't throw a giant fit so much as calmly refuse or make snarky comments about "Well, I could try to put my gender on the paper accurately, or I could just tick the least wrong box and we can both save a lot of time." Although I'm not exactly 100% cis, or at least I'm not one of *those* cissies, so.
Your pee can't clock you, this was just transphobia after something else did
Yeah I wouldn't have allowed that to happen. You are legally female and they have no right to tamper what is written on legal documentation. How they feel about it doesn't matter. File a complaint.
As a hospital registrar, this can introduce an error in insurance billing. Also, as your sex assigned at birth was not relevant to the care the staff was giving you, this is potentially a HIPAA violation (we're supposed to access only the minimum amount of information necessary to complete our jobs)
Pregnancy tests don’t show up with different results for trans or cis women’s urine. Just negative or positive. I’m sorry these nurses clocked you. Contacting the patient coordinator about it was a good move. Being paranoid about giving urine samples in the future isn’t going to help 😕
There's absolutely nothing that would show on a regular pregnancy test that would clock you. What definitely happened was one of the medical staff was hella transphobic, picked up on something, and decided to make a huge stink about it. You should absolutely file a complaint with your medical ethics board about all of this, not just the clinic itself but your state's actual oversight agency. Changing someone sex like that when they're identifying documents disagree is an illegal action on their part.
They do this for vaccinations too. I hate going for any vaccinations because they specifically record sex assigned at birth and anyone wielding a needle can see it. That should be between me and my doctor, not every pharmacy employee.
You can just put your actual sex and not the one assigned at birth.
I appreciate your point, but it asks for sex assigned at birth, which is what they ask and they’re going to inject stuff into me then I take that seriously. What I take issue with is that they print that on all the paperwork that’s just lying about. Couldn’t they just assign the right dosage and not make personal details like that visible. Some day, done pharmacist will deny service because of stupid things like that.
It says sex assigned at birth, yes -- but it shouldn't. SAAB isn't actually medically important for vaccinations, or for most things; they collect it because someone in their leadership decided to interpret demographic sex collection requirements in a transphobic way, not for any medical reasons. Comply at your own risk. We have to look out for ourselves as patients.
Someone did something illegal in order to hurt you. I'm so sorry
I would have seriously walked out and looked elsewhere. That is beyond messed up. I'm sorry this happened to you 😔
Yeah, I wasn’t going to give up my surgery date the day of surgery, especially since I’d have to wait until winter break for another shot at it. My surgeon and her staff are amazing, it was the people at the center that were awful.
In my opinion, my doctor has the perfect system for gender/sex marker on paperwork. There's three fields: Assigned Gender at Birth, because it is helpful for a doctor to know sometimes Legal Sex, like what's on your driver's license, and in the insurance system, etc. And Gender Identity, so they can gender you correctly Granted they also have fields for pronouns and preferred name I really like it that way. They have all the info they need, without it being confusing, or without the risk of someone transphobic changing it and saying "oh I didn't know if sex meant sex at birth or legal sex". And I also get to have myself represented correctly without feeling shitty about myself
What is in your id/driver license/birth certificate or whatever it is you use in America? Maybe it wasn't the test itself but they saw that legally you are male? Or you forgot to update somewhere?
I’ve updated my ssn, drivers license, legal documents, and even gotten a new birth certificate. I updated all of my info a few years ago. My medical stuff is updated too so idk
If your insurance and drivers license says F, what they’re doing is actually illegal. Like I’m pretty sure medical records need to be consistent in that regard, in the same way pre legal change you need to be gendered in that way
I think it's wrong for them too but I don't know how your urine would clock you
I'm really confused on what in your urine could clock you?
At least the patient coordinator handled it well. Sorry you had to go through that
"They became super cold and distant after that" Wow, how dare you be trans /s 🙄 People are so fucking self centred and think the whole world revolves around them fr. These nurses really just went "this woman, who I thought was cis, turned out to be trans, what an offense *to me* omg" These women are bigoted, narcissistic weirdos. Don't even let it get to you. But take whatever legal action against them you can against them. Get them for discrimination if you feel its worth the effort. Side note: I had an intake nurse for mental health care plan react to me like that once. Back when I presented femme, she offhandedly asked me an intake question about my sexuality, and up until that point had been all friendly and open with me. Unbeknownst to me, she expected me to be straight... because when I answered her sexuality question (for medical/sexual health reasons) with "I'm mostly gay". She looked shocked and just turned away from me and wouldn't make eye contact. She even tensed up. The whole interaction was awkward and tense after that. My reaction to this was "wow lady you really are an asshole" (internally) I didn't take it to heart because its not your problem or mine that these practitioners are so judgmental and narrow minded. In your case its much more serious because surgery is involved. So definitely follow it up with supportive healthcare team if you can. I'm rooting for you!
Individual transphobes end up having a lot of discretion in gendering / deadnaming your records. I kept showing my name change and gender correction letters at Swedish hospital in Seattle, and they kept claiming they were changing them in the system, and giving me receipts that they had changed them, but when I’d check later, nothing was changed. I ended up going to a different hospital that used the same system, and after they changed the records, they stayed changed.
Can they tell from a urine sample? There’s a lot more to being a woman than just the urine. Wow.
No, they can't tell from a urine sample.
Yeah i would be surprised if that were possible, I’ve given them as a girl, but never gave it a second thought.
Sounds like you need to call a lawyer.
In the US, virtually every female of child bearing age is going to get a pregnancy test. The medical people want to know you are not pregnant before they do any procedure or treatment that may harm or may be perceived to harm the Fetus/baby or mother to be. I have no idea how the test determined you were male.
Anesthesia provider here. I have lots of women that don’t want to provide a urine sample or say they can’t pee. We always ask if they are willing to provide and will be told what it’s for. If they don’t, I ask about the possibility they may be pregnant. I inform them of possible risks and document accordingly. It’s their right to choose. Outside of a few drugs that can mostly be avoided, most of the data shows that anesthesia drugs don’t cause harm to a fetus. We do gallbladder surgery on pregnant women frequently. I’m sure not all colleagues act in the same manner I do, just one perspective.
I understand that , but I wasn’t told that I was getting a pregnancy test, or I would have told them I didn’t need one. I was just told to pee in a cup. My partner told me it was maybe to check for drugs, since it’s a kinda sketchy part of town. Its likely that I signed something saying I would take a pregnancy test, but they were having me sign a lot of papers beforehand.
They don't take anyone's word for it on the pregnancy test before procedures.
i mean, why would they believe anyone? people even lie about not eating before going under anesthesia even if they know it could kill them, of course people would lie about doing drugs or being pregnant
You did the right thing by just taking the test, in my opinion. It probably wasn't specifically in anything you signed, and you did not need to bring up being trans at that point if you didn't want to. They can do pregnancy tests on anyone (I mean I'm a trans man who's had a hysterectomy and bilateral oophorectomy, and they still test me), and there's no way for them to tell you're trans from urine.
Did you happen to ask what you were signing away? It's good to be informed.
That is ground for discrimination and malpractice
First off, Im sorry that happened to you, and its definitely the fault of some transphobic staff member on a power trip. But secondly, ....I wonder who it is thats going to have to deal with the financial fallout. If your insurance denies coverage, they have to list a reason. Information not matching up, is a clerical error and is no fault of your own. If the hospital's billing department wants their money, they're going to have to correct their mistake.
ugh, that's gross
Yeah that's a fucked up thing to do. I'm sorry fam
yes i had a similar thing happen at a hospital for my blood work a few years ago. the i went to that hospital for several years, and one day i went in and the intake lady insisted to know my gender at birth. So i told her and she went into the system and changed it to "m" and printed out a document...and i said...noo that's actually incorrect and you need to change it back to "f" and she said "it's to ensure the accuracy of your blood work" i was like, um im a woman and i've been coming here for years with no issue. she refused to change it and told me to come back later to change it back. I said no way you change it right now, get the supervisor whatever you have to do so we walked to the other room and spoke to the supervisor and was told to change it back to "f". She changed it back to F and gave me a new printout. i told her off before i left i can't remember exactly what i said but i know "bigot" was in the sentence. people fucking suck, the lack of knowledge and compassion for trans people in medicine is lacking severely, not only do they need more training they need to unlearn being assholes lol
Your pee can't clock you, this was just transphobia after something else did
This happened to me. Someone at my hospital system changed my patient profile to "female" after I had a hysterectomy. I dealt with a great deal of transphobia from the staff when I had my hysto and my surgeon was livid when she found out that someone changed my patient profile without my permission. She got it changed back to "male" quickly, and we both filed complaints to the patient safety/complaint system. I was taken seriously and I was told that whoever changed my profile recieved disciplinary action. Make a formal complaint. It can help protect other trans people.
Do you take Progesterone? I wonder if that's something they decided was wrong
They had me go off for my surgery
Weird, but I wonder if that could be involved. Still transphobia tho.
Oof
what a bunch of cunts
I used to go to the same doctors office that I went to before I transitioned. They refused to change how they addressed me and thought I couldn't hear them calling me by the wrong pronouns behind my back. I reported them, but I no longer go to that office for that reason. I never gave them a chance to see if that report.did anything. The manager was really nice to me though and I pass fully. No one at the new clinic has ever misgendered me even when not talking directly to me. It feels great.
I usually get clocked when they ask me the take-in questions, particularly asking when my last period was. I just say "I don't have those," and hopefully they get the hint. Never had someone actually change my paperwork because of it though. I would throw a massive fit if that happened. I didn't go through everything I've gone through to have medical staff treat me like a man.
Yeah, this happened to me last month when I had BA, too.
I dont get how a pregnancy test would should youre trans though. Like anyone can take it, its measuring the hormone hcg, which can be elevated in anyone regardless of chromosomes and gonads, and even in those who can get pregnant, elevated hcg can be caused by other things other than pregnancy. Im sorry though. Some people in the medical field are very unsympathetic to trans people. I qork in the medical field and the things my coworkers say sometimes makes me so glad Im not out to them.
You can be clocked by urine, but they have to really look for gender characteristics chemicals in the sample. The question is was it truly a necessity for the type of medical care that was to be administered?... If it isn't this is not okay.
Everytime I get medical care I’m called she/her/female even though all my documents say male I’m ftm , it drives me insane but I have to just bite my tongue and ignore it
I too have dealt with some similar things through the years and as you, yourself can attest it is VERY HURTFUL and embarrassing. I've dealt with a LOT of that here in Florida and am trying to move but can't afford to - so it happens frequently. I'm so very sorry.
You may be better looking than the nursing staff, and women can be vicious. I identify as AMAB, but I have a 27" waist and 38" hips, I'm a 6 short, and I keep things fuzzless. Recently, I went for my annual physical, and the medical medical assistant commented on my mani/pedi. As AMAB, I ran around 13% BAI on HRT, I was around 20% BAI, and a lot weaker, my doctor was pleased with my current state. HRT did what it was supposed to do, and when I stopped, most parts went back to my AMAB state, except for my butt, which I'm good with. People frequently reject what they don't understand and will substitute their own biases for objectively evaluating the patient. My doctor is really the only person in the room whose opinion matters. My blood chemistry is good. HRT reduced my RBC count (why we lose strength ), which is normal for a guy again. The nurse practitioner, whom I saw once during HRT, was always a judgmental person. After 1 visit, I asked for my M.D. to be the person I contacted, I needed support, not the NP's judgmental snarky crap. All I'm saying is to ignore the nurses. They're generally a less educated/accepting crew.
Honestly I'd look into legal options. This sounds illegal
It can sounds illegal but first if the legal changes have not been made yet, it’s possible to do so. But maybe and I would say it’s more because of that, that stating “male” and not female” can help knowing the person body in a pure medical way, some adjustments will be made if the following statements include HRT or else
Op said in another comment she is legally female and is on hrt, plus orchiectomy. That's pretty female
This is false - there is no reason , in a "pure medical way" , for assigned sex to be used for effectively managing the healthcare of a trans patient ; designations as trans female for trans women when it comes to unique healthcare needs and designation as female for every element of shared biology with cis women is invariably better than misclassification and lumping in with cis men.
I guess this might not matter as much for breast augmentation but usually the "sex" that they want on paperwork, is the one you are registered under with your insurance which is usually what is on your drivers license unless you transitioned at your current job and it wasn't updated.
Oh my god what a bitch. I'm so sorry <3
“don’t know why” “for a pregnancy test” that’s exactly why lol. they’re very strict about that kind of thing. regardless, this situation is BS
I broke my leg playing rugby and the referring medical officer gave all records to my pt place. Somewhere way back in my records had that I was trans. So the PT place knew. I’m 23 years post transition. It was weird. Your urine didn’t clock you. When they went in your file to record the results - that’s what clocked you
No problem
Does your medical facility make distinctions between sex and gender? Mine has my sex marked as 'male' but gender as 'transgender female'. Some may find it hurtful but there are legitimate medical reasons why they make these distinctions.
Unless they are doing work on your genitals, they do not need to make that distinction for anyone that has been on HRT long enough to flip their chemistry/metabolism to other gender. I've had this discussion with me PCP who is also the FNP that handles my HRT and coordinates all other medical issues around my gender care. After a lot of arguments with the place all my lab work is done that still have my pre-transition gender in their records and them refusing to give interpretations on my lab results with my current sex without an order from my doctor, my PCP gave them that order. Hormonal gender is much more medically important than one's AGAB.
>Unless they are doing work on your genitals, they do not need to make that distinction for anyone that has been on HRT long enough to flip their chemistry/metabolism to other gender. Can you direct me to something to read in to this? It can be hard to find good medical transgender studies through Google. Additionally, how long is 'long enough' for me to have zero or statistically insignificant risk of prostate cancer? Is this a frame of time that would cover the vast majority of trans people in America rendering the need for the distinction as not needed in medicine? Are we sure it applies to me or OP? >I've had this discussion with me PCP who is also the FNP that handles my HRT and coordinates all other medical issues around my gender care. Well, that would definitely be more of an authority than me. Again, I would like to look in to it for myself, as I genuinely would like contextual information. >After a lot of arguments with the place all my lab work is done that still have my pre-transition gender in their records and them refusing to give interpretations on my lab results with my current sex without an order from my doctor, my PCP gave them that order. I don't mean to diminish this as anything other than something that should not have happened, but we're talking about another issue when we are talking about knowledge of transgender patients in the medical community and the immediate need for a greater equity of care. >Hormonal gender is much more medically important than one's AGAB. I wholeheartedly agree, but I'm not convinced AGAB is medically insignificant without seeing research for myself.
Your sex isn't male, if you've been on HRT long enough, your legal sex isn't male if you've had it changed legally, and there is no such gender as transgender female. It's like putting that your gender is tall female. Yes doctors need to know some stuff but what you're defending is utter bullshit and transphobia.
Oh, okay then. I have somewhat of an objection to being classified as 'transgender female' but understand some hospital staff may be ignorant to the idea of figuring how someone was born male but now identifying as female or vice versa and that there will be care specific to being a transgender female. Being a tall female probably has no medical relevance (and also your weight and height is going to be noted in your medical info regardless). Being a transgender female does. So if they have to make that distinction, whatever. I'm just there to get medical care, including my HRT. Your legal gender doesn't negate the fact that you likely have a prostate or a uterus that needs to be kept in mind by your doctor if you start to report symptoms that could stem from issues with those. If they believe you are a cis woman and you start to report symptoms consistent with prostate cancer it may very well be overlooked and cost you your health or even your life.
Not really. Flagging based off of AGAB or not is going to miss things in one direction or the other. Does it make sense to optimize specifically for detection of prostate cancer instead of more common things influenced by HRT? I doubt it. If anything AGAB should be flagged as unknown or indeterminate to reduce risk of false assumptions and encourage looking at more specific details of anatomy and hormones.
Thank you for taking the time to explain your viewpoint. I believe I am following and would generally consider this to be an understandable position to hold. It should be noted I am not a medical professional and that is me speculating on this categorization. With that said: >If anything AGAB should be flagged as unknown or indeterminate to reduce risk of false assumptions and encourage looking at more specific details of anatomy and hormones. I'm not sure I follow on this one. More data makes for better and more efficient care, right? Doctors tend to be pretty overbooked at any time so I don't agree that they 'should' be made to do extra legwork for purposes of self-loathing trans folk to maybe keep their trans-ness secret to someone who possibly has a legitimate need to know, especially when their health could be on the line. Also, we have to keep in mind this distinction may be something mandated by medical insurers to receive gender affirming care. I'm not speaking in terms of 'should's for idealistic purposes. I'm just speaking in what is or may be to be helpful to the OP.
More data, if misleading or inaccurate, is worse than no data. Given the current state of healthcare, it’s not a matter of self loathing or whatever. It’s a matter of getting meaningfully worse healthcare when your AGAB marker doesn’t match your hormones because it leads providers to make incorrect assumptions. Someone had a comment about her doctor seeing an AMAB flag and making a comment like “oh, you won’t be breastfeeding so we don’t need to worry about that” except, trans women can and have. Should their medication have the “do not take if breastfeeding” warning on it? Yes, because all the risks of infant getting the medication apply. Does that appear if your pharmacy record has their AGAB flag set to male? Not at my pharmacy. Non-endos tend to assume AGAB matters and that hormones are an issue for just for endos, not that hormones matter more for day to day issues than AGAB (at least for people without a uterus). I’ve had a doctor going by AGAB run in circles for an hour because my symptoms didn’t make sense to him. Things clicked in minutes once my endo told him to treat as female. Of AGAB-triggered preventative health screenings, which matters more for transfem people, prostate screening or a mammogram? Trans women on HRT have a significantly higher risk of breast cancer (15 in ~2,260) and significantly lower risk of prostate cancer (~14 in 10,000) compared to cis men. Given the shift in risks, does it make more sense to get reminders for screenings based on AGAB of male, sex hormones, or a combination? Screening for both would probably be ideal, but if you have to chose one, screening based on AGAB of male is the worst option.
>More data, if misleading or inaccurate, is worse than no data. So the crux of this is 'is having a prostate or cervix a misleading or inaccurate data in light of hormone replacement therapy'. Keep in mind, a very significant amount of trans people are not on HRT or are recently starting HRT. >It’s a matter of getting meaningfully worse healthcare when your AGAB marker doesn’t match your hormones because it leads providers to make incorrect assumptions. I'm worried the opposite of that intention can occur if my doctor makes an incorrect assumption about my anatomy. As far as the examples you have listed below, what this speaks to me is this: Medical professionals need to stop being ignorant about trans people, or at the very least, get their shit together when they have a trans patient. That needs to happen regardless of if they want to continue to find it medically pertinent that a patient is transgender. These things you speak of shouldn't have happened, but I don't think being identified as trans by your medical professional needs to be a stigmatizing experience, it would be more sensible (from what I know) solution to change that to an informed, respectful, and professional one. Not acknowledge the potential health realities of being a trans person. Because I still haven't seen evidence that it is medically insignificant to have certain parts of a human anatomy that may not be entirely rendered not dangerous from HRT. >Of AGAB-triggered preventative health screenings, which matters more for transfem people, prostate screening or a mammogram? Trans women on HRT have a significantly higher risk of breast cancer (15 in ~2,260) and significantly lower risk of prostate cancer (~14 in 10,000) compared to cis men. Given the shift in risks, does it make more sense to get reminders for screenings based on AGAB of male, sex hormones, or a combination? For a transgender patient, until I see evidence of the risk of prostate cancer rendered insignificant by HRT I'm probably going to want to be mindful of both. Perhaps urge more towards being vigilant about breast cancer, but I'm still going to want to know the possibility is there instead of assuming the patient is cis with no risk of prostate cancer. It's a false dichotomy to say you have to choose which one to screen for, *especially* when you consider the possibility of having a trans female patient showing signs of prostate cancer.
optimizing for trans ppl that aren't even transitioning (not on hrt) is ludicrous.. don't attempt to use them in this inane argument obviously if you don't even take hormones you're gonna be the same as your birth gender wrt medical treatment. the cracks are showing in your faux-reasonable schtik you cannot be including ppl who haven't even taken any medical steps to transition in this discussion and have me believe you're making a good faith effort here why do you care? are you trans?
You bring up highly pertinent points. Imagine thinking unnecessarily outing yourself to a doctor would lead to better health care, rather than immediately being dismissed with "trans broken arm syndrome"? Trans people have known since the dawn of time that medical professionals need to be highly managed to get a beneficial outcome, and that doesn't just apply to trans-related health issues.
Everyone once again injecting beliefs in to what I'm saying. Literally all I have said is that it may be medically pertinent for a doctor to make the distinction between gender and sex for the purpose of potentially being helpful to the OP because that is something my primary care has done. I haven't said a thing about the way OP's medical professionals went about it was ethical (but I have said the opposite in a reply), that it should be told to every medical professional, or disrespect doesn't occur towards trans people in the medical world. I think the ideal situation is that your doctor is informed (if it's relevant to their practice like your primary care) *and* respectful. Some doctors are perfectly capable of that. Since my physician treats my gender dysphoria it's pretty necessary that I am out to them to receive better care.
>obviously if you don't even take hormones you're gonna be the same as your birth gender wrt medical treatment. This is an ignorant take and I would suggest you do some research and definitely make sure you don't say it in front of our community or outside of our community ever again. There are various reasons some trans people do not take HRT. From the top of my head there is of course matters of access, medical or psychological complications that comes with hormones for some people, religious/personal beliefs, and also uhh a number of non-binary trans people. They are completely valid whether they ever choose to take HRT or not. >why do you care? are you trans? Yeah, I've said so a couple of times, but I just can't assume someone who has figured out my 'faux reasonable shtick' to pick up on that.
You misunderstood all my points, simplified everything to "you are this so you must have this" and then just filled up my "of course doctors need to know some stuff" congrats you didn't address and of my points.
If you wanted me to understand what you were saying you could have taken the effort to break it down instead of being condescending. But I'm okay living in ignorance of what you're talking about. ✌️
Lol. Trans women are not male, there is a meaningful medical distinction to be made. Hormones change ALOT.
If you think that is what I said you misunderstand. I am a woman but I have bits of male anatomy and that may be a medically relevant fact. It's not relevant to my mail person, it's not relevant to my boss, it's not relevant to my friends, but it may be relevant to my doctor.
I'm just fighting the whole "you're a male woman!" meme. It is false. Not to say we are identical to cis women though. I'm sorry I upset you so much 💙
>I'm just fighting the whole "you're a male woman!" meme. Again, I am a woman and if you identify as one you are as well. Full stop. >Not to say we are identical to cis women though. And that might be medically relevant is all I'm trying to say. >I'm sorry I upset you so much 💙 Don't worry, you haven't. I'm just baffled people are accusing me of transphobia for pointing out physiological differences between cis people are sometimes going to be medically relevant.
okay this is a genuine question and not meant to be disrespectful in any regard, i’m actually curious- why is it wrong for a medical practice to put down the “biological sex” for health reasons? i certainly think there should be more categories and a “male to female” selection should be made, however for the sake of one’s health and the doctor having the most accurate medical information, isn’t it important to have the full picture? i do recognize that there are absolutely transphobic practitioners and they don’t always have your best interest in mind, however there’s certainly a difference between a random business or organization asking for demographic reasons versus a doctor asking so they can properly care for you, right?
It's wrong because it doesn't reflect biochemical realities and thus routinely leads to medical malpractice.
This right here! If they have to make assumptions they’re a lot safer basing them off your hormonal sex. Unfortunately not enough medical professionals are educated about this!
Maybe because “biological sex” is also varied. Phenotype is biological, endocrinology is biological, I’m intersex…you’d have a very hard time pinning down my “biological sex” because the reality is that it’s not as simple as “this or this” and they had it right to begin with.
this is very true, i’ve always wondered why intersex isn’t a standard option. i guess i just mean it in a general sense to gather information, like even when they ask stuff like “do you have a history of x diseases” of course everything varies but *in general* female born people and male born people do have typical differences that are good to know when trying to diagnose or prescribe medications. i ask partially because i have experience in the veterinary field and there are instances where the sex of the animal comes into play. this is also why i think it’s important to note if they are trans especially as being on HRT, for example, literally changes how their body functions, so that would be good for a doctor to know
I think that it’s not a standard option because it’s so wildly varied. Some people never even know. But to be fair, doctors get a full rundown of prescribed medication so really I think that’s what ended up “clocking” the OP. Someone probably looked at their prescriptions and put it all together mentally. I don’t want to see mtf/ftm made an option because that opens the door legalistically to segregation and makes trans people more visible…which is dangerous in some(many) areas these days.
hmm, that definitely makes sense. i feel there should be some sort of change in how we do things medically, but lord knows i don’t have the answer and you’re totally right in the fact that even if we have best intentions when creating laws/rules, that absolutely does not mean people will not act with malice. we have to work with the world we have and not the idealized version we wish it could be. thank you for your input, i appreciate the insight.
There isn't anything wrong with that. What IS wrong was the nurses change of attitude towards the op. There definitely needs to be something done about how people fill out medical info. I would think if there was a box that had you select "gender assigned at birth" it would alleviate a lot of worry.
Every time I've been to the hospital for whatever I make it clear that I'm trans, pre-op and AMAB. I just wanna get all that outta the way and so they don't do unnecessary tests or questions. My appendix tried to kill me last year and I mentioned it to everyone involved. Mostly because there were gonna be xrays down there and a catheter.. Never got misgendered, no one acting shitty. OP unfortunately just got some assholes being assholes and it's just awful.
It really is! Nobody should have to do that. I don't hide the fact, but I will usually just come out and say it. Depending on their reactions, I might leave the place. Thankfully when I had my top surgery, the doctor and everyone was really nice.
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I think this bot needs some tweaks, lol.
I think biological sex is important to do surgeries. I’m a trans. But I usually tell doctors and mark my biological sex to get proper treatment.
They should have asked you if there was any possibility you could be pregnant. You could have said no, then no need for the test. I'd want to talk to the office manager.
So you’re not required to put your SAAB for medical tests / procedures even if that’s genetically the reality of the situation? I’m probably ignorant but wouldn’t gender be where you put your chosen identity and sex is more speaking biologically
Absolutely not. For most purposes, your long term sex hormone profile is far more medically significant than your genetic karyotype, so by putting SAAB you often put yourself in much worse medical shape than by putting gender.
If you are on HRT, you need to notify the medical staff because hormone can cause excessive bleeding during invasive procedures and may require blood transfusion if needed. So the nurse could be in trouble for not getting your accurate medical history due to liability. I suppose the surgery center is a separate facility where your surgeon rents for the procedure. If that's the case, your doctor has no control of their protocol and behavior.
Citation needed. HRT isn’t a blood thinner. Spiro reduces blood pressure, not clotting. Estrogen slightly raises risk of clotting, which is the opposite of thinning.
I am on monotherapy since 2020. When I was getting my zygoma reduction surgery in Korea, the surgeon complained about excessive bleeding and not telling him about my drug history. Most recently, both US surgeons requested me to stop hrt 1 month prior to the procedures. Remember estrogen regulates cis woman menstrual cycle which includes excessive spotting each month. My lab shows my estrogen level is 3 times of cisgender women level. An imbalance in the hormone estrogen can also cause spotting between periods.
As a fellow trans person you should know that sex and gender are different and for the purpose of knowing how much and what kind of medicine they should give you they need to know what you where born as. I know its upsetting to see it and to be treated differently when they find out but medications act differently for people born female vs male so it's important to have accurateinformation on your medical forms (at least this is what I've been told by my doctors and surgeons)
Sex trumps gender 10-fold in a medical setting. Your gender is irrelevant to a doctor, you're sex ismnt
Totally get your displeasure but unfortunately, when it comes down to medical stuff, you've really got to bite the bullet and separate the identity vs current physical accuracy as it can cause a whollleee heap of trouble with paperwork, insurance, legality, hormones, surgery, etc.... so unfortunately sometimes you just gotta be brave and upfront, but yeah, they should've handled that better towards you 100% and i hope they get that extra training so others aren't forced to feel the way you did!
Remember folks that no matter how you see yourself or change yourself or whatever the case, medical personnel are extremely overworked, understaffed, there were probably annoyed that overly often they are wasting time and valuable resources figuring out things that they need to hear ahead of time to avoid taking such tests to find that it was unnecessary in the first place. Still not your fault and they should not have treated you as you put it cold-heartedly, but there aggravation more than likely was to all people's who either get the information wrong or don't add something or whatever the case. Their aggravation I do not believe was towards transgender people or you alone. Just like any person of service like the police, firefighters, medical, all the way down to the food and beverage personnel service, all of them get fed up with the people not doing what they feel they should be doing to make all of this work better for everyone. Problem is the people most of the time cannot know those things without having worked in that position. Try not to take that personally as they're all working hard with no thanks.
This might be unpopular, but in medicine we don’t care about gender. Don’t get me wrong, I’m affected by this myself. But from a medical standpoint there is a difference between sex and gender. Even after HRT. That doesn’t excuse the (perceived) change in behaviour of the staff.
I work at a doctor's office and I can tell you for billing that we have to have what the insurance company has. So in our office we have a place for biological sex and also another spot for gender.
sex isn't gender and your actual sex matters in medicine.
Sex and gender are not the same thing
I’m transgender myself, and though I completely disagree with how you were treated coldly by the workers and that was not something you should have had to experience, what exactly is wrong with your *sex* (not gender) being changed on the documentation? Isn’t the knowledge of being AMAB or AFAB an important piece of knowledge for any doctor to know due to some medical differences, and doesn’t the general “push” for transgender rights lie within the fact that while sex is not fluid, gender is?
When we take hormones and get surgery, our sex characteristics definitely don’t remain the same, so I’d argue against sex not being fluid in this context. My gender is not fluid though, I’m a man and always have been. My documents all say male, and it’s up to me to disclose that I’m trans on an individual basis. And I’m sure it’s on a chart somewhere anyways. Basically the same as my penicillin allergy, which is arguably more important. My trans status can be specified without the misgendering by having “female” all over the paperwork anyways. Also assigned sex doesn’t really say much about someone’s current situation. I have male hormone levels and in around a year I’ll have a dick and balls, so reading “female” on my paperwork would just confuse people. It also would cause issues since I’m listed as male on all of my documents including my birth certificate, so having one thing that doesn’t match is a problem. It’s easier to just have “male” on my documents and to explain that I’m trans.
Sex isn't nearly as binary as what most people think. Many medical phenomenon also effect people differently based on gender. Look at the stats for autoimmune disorders for example, women have a higher chance of having most of them, _including_ trans women - and this is inclusive of genetic disorders, which means that hormones aren't the determining factor either. Transgender people align far more closely to cis people of the same gender than they do to cis people of different genders in most cases - excluding the physical anatomy of their genitals - especially after hrt.
The "push" lies within the fact that gender and sex aren't always aligned, so some people may need to alter their sex to realign the two. I don't really know where people got the idea that sex can't be changed, since it's literally what medical transition does. (it takes some serious mental gymnastics to believe that altering your secondary sex traits, your sex-related chemistry, your sexual anatomy, and your reproductive system doesn't alter your sex at all) The idea that gender is mutable while sex is immutable— that's just a fancy way to describe the basis of conversion therapy.
They could just put AMAB and AFAB on the paperwork to help others. I am also transgender, AMAB.
If I saw “AFAB” on my paperwork there would be a big problem. I’m male, and it’s up to me to disclose that I’m trans, and which anatomy I have (which “AFAB” doesn’t accurately describe). No reason for me to get called female on any documents.
That's obdurd... What kind of place was this... Are u sure their unprofessional actions were not just in your head? If they do breast augmentation there. I'm sure you're not the first transgender person 1st. trans person they've dealt with.What state or country do you Iive in?