[deleted]
Transgender patients should not have to disclose their previously assigned gender for medical reasons.
While this post is technically against the rules 5 of the sub I’ve allowed it and I’m considering changing the rule slightly to allow future posts like this.
Opening up the sub to intersex people was discussed recently
[deleted]
[deleted]
Oh I’m curious, why did you have to have the ovaries removed?
Also I think for many doctors vaginoplasty might remind them of MRKH before trans because that’s what they learned in med school. I haven’t tested it though.
[deleted]
Not disclosing use of hormones to a medical professional is a very bad idea.
Do you take any medications? No. Have you had any previous surgeries? No. When was your last period? Two weeks ago. Is there a chance you’re pregnant? No.
Please don’t lie. Just tell them. They’re professionals, you can report them if they treat you badly just because you’re trans, but that probably won’t happen. Don’t worry so much.
it’s not that simple. discrimination against trans people in healthcare is rampant. my girlfriend has even overheard an anesthesiologist joking about letting her die because she’s trans, during an unrelated procedure.
if it’s not relevant, it’s often safer not to mention it. in an ideal world, disclosing would not cause us any issues but that’s not the world we live in.
my girlfriend has even overheard an anesthesiologist joking about letting her die because she’s trans, during an unrelated procedure.
Fuck my life
It depends on country. In Ukraine, where I live, doctors are totally incompetent when it comes to help trans patients. And in general they do not interested to learn something trans-related. So I will hide it and will ask for help only in critical situations. As for hrt - DIY is the only option.
If you want to tell the truth do it. I won’t. You are not entitled to my medical decisions. Personally I’m not a fan of suffering discrimination.
Even if not explicitly asked it comes up every time they ask about menstruation... which is apparently critical for all conditions. Broken foot, when was your last cycle, cut my finger cooking, when did you have your period last, sore throat, and how long ago was your last menstruation
[deleted]
Every “intact” afab is considered pregnant until definitively proven otherwise. It’s gross and stupid but they will piss test you for pregnancy for everything , “just in case.” Gotta consider the needs of the yet-undetected-possible-fetus, y’know. /s As a trans-masc, it never fails to alienate me.
Yes, it causes me incredible dysphoria every time they ask. Ever since I was aware of puberty and pregnancy, I have wished that it was something I could experience. To be forced to admit that it is not something I will ever have is just cruel.
Must be a USA thing, no such thing in the UK, although I'm sure they ask if they prescribe you something on that visit.
In the UK they never ask that. Must be a USA thing.
[deleted]
Well sort of for prostate, for most younger age transitioners, the only about a decade of androgen exposure isn't considered enough to cause notable chances for prostate cancer so screening is more optional. Although older material doesn't really specify this so it can still be more common then probably warranted.
I have never heard this before, do you mind sharing a source? It's a weight lifted off my back for sure if I don't have to do it
I don’t believe you will find a source because i don’t think any doctor is going to risk telling you that you don’t need a prostrate cancer check.
The recommendation from the UK prostrate cancer charity is still to get checked. The risk is reduced but there no no studies to at say by how much.
https://prostatecanceruk.org/prostate-information/are-you-at-risk/trans-women-and-prostate-cancer
Source?
Prostrate is a different thing.
without androgens and especially with cyproterone acetate your chances of getting prostate cancer are extremely low. it's not really necessary anymore to check it for cancer, just like with many other parts of your body.
[deleted]
[removed]
Edited my comment. Removed the deleted part. I still think your suggestion is dangerous.
Removed. Rule 1.
This is a largely context driven situation for me. My PCP knows, my gynecologist knows. But I don't tell other doctors unless it's relevant.
The random doctor or NP seeing you at Urgent Care or in the ER for a cut, a broken bone or some sudden illness probably doesn't need to know you're trans. In fact, it can sometimes even make it worse because doctors can get tunnel vision and think EVERYTHING is related to your transness. And now (because of the Trump administration) you can be even be denied something as simple as antibiotics because it doesn't 'agree with the doctor's religion' or whatever, to treat you.
Edit: I agree that issues like the case linked below can happen and it's important for them to know in some instances, but the 'tunnel vision' i mentioned seems to be far more common. Just gonna leave this here: https://www.dailydot.com/irl/trans-broken-arm-syndrome-healthcare/
Yeah if you’re going to the doc for an ear infection, its just not necessary. Unless its an endocrinologist who needs to manage your hormones, or proctologist/gynecologist who helps examine your genital area, a doctor doesn’t need to know.
it doesn't matter until it matters
See the problem with this is, for this case there's 200, where when you say your a trans guy all they focus on is possible pregnancy first before other explanations...so keeping it context dependent may still be better.
Post op trans guys can’t get pregnant plus he told the doctor so I don’t see how that’s relevant
Not just how were you born, but also, when you started transitioning and presenting "full time". Trans-patients are more or less still pathologized just to get access to basic health care. I had to be declared of having a mental disorder (gender dysphoria) and living as a woman for an x amount of time before even being allowed to talk to a surgeon.
Thanks for sharing your thoughts and experiences! I agree with you that for the most part it is not relevant. Especially in regards to things that have nothing to do with the urogenital system.
However I do wish that the medical field would work to create an environment that makes it so more folks are comfortable disclosing. The bodies of trans folks and of intersex folks are not a monolith which means we need doctors not to group us and focus on our needs individually. Unfortunately a lot of doctors do not do that and we see this even among other marginalized populations like people of color and disabled folks.
Agreed, usually it’s the equivalent of autozone asking if you drive an automatic or a manual for windshield wipers
Honestly I can understand why its needed info. But it should just be on your medical file.
Well, there are certain conditions AFABs simply can't get, such as prostate cancer and penile cancer. Trans women can develop both even after SRS because the prostate is left alone and the tissue used to create the vagina is penile. Trans men (post-phallo) could be misdiagnosed with penile cancer when skin cancer is to blame. They're also incapable of developing testicular cancer or torsion but can develop breast cancer if cells are missed during radical mastectomy.
These are just a few examples of what can go wrong if you choose not to disclose your previously assigned gender to your doctor. These aren't likely to happen, but they still can , and the consequences can be lethal. That's reason enough for me to always disclose it to my doctor.
Should we be compelled to disclose it? No. Should we for our own sake? Well, yeah. Seems like a no-brainer to me.
It's not a no-brainer though because it's not a decision without consequences. For many doctors, especially older ones, disclosing your trans status if you're post-everything can actually lead to worse treatment due to the doctor's ignorance or biases. Ideally we all find PCPs we can trust but that isn't always possible.
Well, if they refuse to treat you, you'll know who not to go back to...and who to report. And even if they do treat you, they're usually really bad at hiding their biases. I can typically tell who's good and who isn't after spending 30 seconds with them. And that's with docs who actually prescribe HRT.
For sure but I meant more along the lines of the doctor won't know how to medically treat you as well, even if they're not consciously trying to discriminate. Like assuming you're closer to your birth sex than you really are and treating you differently from a cis member of your gender in situations where it's irrelevant. Older doctors never learned about trans people in med school so they're often going to make incorrect assumptions.
I totally agree with you in this case, but those are all conditions you might seek someone out for specifically or perhaps something you would see a pcp for who already would know you’re trans if they are prescribing hrt. I think the point here is not every doctors visit is about holistic health and there’s a weird tendency for doctors to try to categorize you differently which in my opinion can only really be discriminatory. For example, I live in Chicago and I signed up with the city to be notified when I can get the covid vaccine. The form made me put down my agab which is completely useless and stupid. All it serves to do is invalidate my identity.
That's an odd thing to ask on a form like that for sure.
As for the rest of it, yes, these are good points. I do have to wonder what other doctors you're referring to when you mention "doctors that try to categorize you differently", though. You already mentioned PCPs and specialists, so that takes them out of the running. The only ones left on the list are quick-clinic/urgent care staff, surgeons, and ER docs, and even they might need to know depending on what's going on (especially ER docs, who could accidentally flood you with medication that interacts negatively with estradiol valerate/cypionate).
Yeah I guess that is really what I mean. Practically as a young healthy person (lets Hopely stays that way!) I only really ever interact with a pcp for hormones and maybe occasionally an urgent care np or doctor. I totally see about medication interactions being a thing, but if I’m there for stitches? Tbh I have never felt the need to lie, but I do know trans people who when they have disclosed doctors have either refused to treat them, or they think hrt is the reason for all their problems (classic trans broken arm syndrome). I guess I think it’s a nuanced issue, but I think most trans people on hrt are medically knowledgeable enough (usually) to decide when it’s necessary and/or safe to disclose.
Up until the past year I only have told doctors i'm on HRT and they didn't even know about me being trans until I had to get something like a CT of my pelvis or I told them. The issue that's come up over the past year is that most medical chart systems (EHR's) like EPIC have become standard and they talk across different hospital network providers. Recently my ENT's office who i've been going to for years started using EPIC for their medical records. The staff there who've known me for years didn't know I was trans until my medical record from my doctors office who uses EPIC became visible in their system. A lot of EHR systems are now starting to cross talk between hospital networks and include things like what a patients gender was assigned at birth and how they currently identify.
I've had numerous talks with Novant Health and Atrium Health here in NC who use EPIC about allowing trans patients to opt out of having that on their medical records for privacy reasons. Especially after an incident I had in the ER with a PA who refused to treat me once they found out I was trans. They made me wait in an ER room for 4 hours till the next attending doctor came on shift before I got treated for heart issues that I ended up being admitted for. I also fight to not have it on my record because it's none of their damn business. If it's a prostate thing than that would be something that needs brought up with your PCP and not a damn ENT office or dentist. In the end both hospital networks said that they would consider my request but it's been over 2 months and not heard anything back from them.
Setting aside the propriety of withholding your trans status from your doctor, the computerized records issue is the one I've experienced the most. I've been outed by computer medical records multiple times without even realizing it. Seems like there's not much I can do about it either, it's so automatic that nobody seems to know how to stop it.
Did you look into the ER matter further? That should be news. What happened? What did other people working in the ER do?
I disclosed that I was trans to an angiologist and she treated me as a man during all the consultation. I'm in the early stages of my transition and am pretty much androgynous. I really regret it.
Agreed. Trans woman on hrt and with srs almost the same as any other woman with hysterectomy. She is a woman, not a man. (Opposite for trans men ofc.)
There’s no need for the majority of doctors to know for most circumstances. Especially since I’ve had surgery it’s just not relevant at all. Also on hrt even without surgery trans bodies are different than cis bodies so there can actually be issues if a doctor treats us as our agab
My doctor uses an "organ inventory" health chart system and my patient account just lists female. Seems more sensible to me than drawing up an history presentation within the health chart system.
Do you have a prostate? That might be important for a Dr to know about if you are having urinary problems though, especially if he overlooks the possibility of cancer because he doesnt know.
This is really interesting and insightful, thank you! Sometimes it seems like there's some animosity between intersex people and trans people, but I think there is a great opportunity for mutual support! Not to mention opportunities to learn from each other. :)
" When needed I list my hrt as medication, and my procedures under previous surgeries. "
So you are acknowledging you disclose your condition and treatments as needed? Seems like exactly what TG people do as well. No need to tell someone treating a cold my OEM equipment was testicles.
Specifically “as needed”, such as when needing a cancer exam, or checking for prior risks when having surgery, but even then, saying you have had treatments doesn’t mean one is trans.
They need to know whether to use the pink paddles or blue when you have a heart attack, obviously. Wouldn't want you to be embarrassed 😜
[removed]
[deleted]
[removed]
[deleted]
[removed]
[removed]
[deleted]
[removed]
[deleted]
[deleted]
Do not lie to your doctor. Nothing good would come from doing that.
How would I go about this? I'm considering transitioning soon
all 67 comments