Male patients asked if they are pregnant at NHS Trust

[Toni]

I agree that a great deal of information is gained from knowing biological sex, in terms of diagnosis and treatment. But this is not necessarily that simple: is the patient transsexual? Have they had gender conforming surgery? Do they retain testes? Ovaries? At what point—pre or post adolescence or mid, for that matter. Are they on a hormone replacement regime? And of course there are true intersex individuals or individuals who have a number of known anomalies—like I have which on only one occasion—which led to the discovery—had any effect on diagnosis or treatment. It’s really just something that I have filed away, to bring up and infirm a new provider.

A transsexual patient is still the same sex they were when they were conceived. If they are MtF, they still have a prostate, they still lack a uterus, and they will still have a male pelvis - even if they've had an orchiectomy and a vaginoplasty, that doesn't alter their sex. Likewise, if they're FtM, they will still lack a prostate and will still have a completely separate ureter and a female pelvis. Questions of whether they've had surgeries, and retain specific anatomies would be relevant in specific situations, and I would hope doctors are asking relevant questions. I think it would be absurd for a doctor to as a MtF transsexual whether they still have ovaries, seeing as they never had them in the first place. And it should be incumbent upon the patient to make sure their doctor is aware of ALL medications they are taking - including hormones!

I am with you 100% in sex does aftercare diagnosis and treatment.

I do not think asking about possible pregnancy is onerous or horrifying. I’ve seen the look on peoples faces when someone asks if that is a possibility when, until asked, it had not occurred to them that they might be pregnant. And they were pregnant!

I will bet you a thousand dollars that the person who turned out to be pregnant was NOT a male. Like I said above - asking about the possibility of pregnancy makes perfect sense for a female patient. It makes zero sense for a male patient.

I even know of someone who had been told she could not become pregnant, after years of trying and who later exhibited obvious signs of pregnancy but because her medical providers were so certain that pregnancy was impossible, it was ignored and she was given treatment that negatively affected the child she was carrying. No one even did a pregnancy test because they were convinced it was impossible. ( Yes, they were idiots and yes there was a lawsuit and yes, everyone has lived happily ever after—but it could have been even more devastating.)

Then her doctors have failed to do the very reasonable and responsible thing of verifying that a female patient is not pregnant, regardless of how unlikely they think it would be. But it still is ridiculous to extend that to asking male patients if they could be pregnant - they categorically CANNOT be pregnant.

It’s pretty obvious that I am a straight, cis woman of a certain age. But I do know that whether or not certain structures are present matter for more than structural reasons. The prevalence of certain hormones also affect how medications work and symptoms and their prevalence or absence can be diagnostic.

I honestly cannot figure out why it is so horrible to ask every patient if they might be pregnant. I think there are a lot of men, many of whom are medical professionals, who would benefit from needing to learn just how much such a possibility of pregnancy affects women’s lives and medical care.

 

[Metaphor]

I honestly cannot figure out why it is so horrible to ask every patient if they might be pregnant.

You don't need to figure it out. You've been told why.

 

[Metaphor]

I didn't realize that the UK Trust employed consultants from Australia to help then devise policy. Unless you were involved and had all the information, you are, once again, pulling responses out of your ass.

Reaching conclusions from evidence is not 'pulling responses out of your ass'.

 

[Metaphor]

Irrelevant to the point I made.

No, it's not. You may think you can't trust yourself to evaluate good policy from bad policy, or to be able to formulate policy that is unduly influenced by political taste, but I have a brain, and I can read, and I can reason.

And I don't need your permission to discuss public policy on this message board. So if you don't like discussing public policy, here is a hint: stay out of the thread.

 

[laughing dog]

I didn't realize that the UK Trust employed consultants from Australia to help then devise policy. Unless you were involved and had all the information, you are, once again, pulling responses out of your ass.

Reaching conclusions from evidence is not 'pulling responses out of your ass'.

No one said it was. Try again.

 

[TomC]

I honestly cannot figure out why it is so horrible to ask every patient if they might be pregnant.

You don't need to figure it out. You've been told why.

I've not seen that.

Being told that the NHS is being held hostage by political extremists or something isn't the same.

The policy of having one form for everyone, and requiring the technician to fill it out completely, seems like a good idea to me.
Tom

 

[Emily Lake]

I think there are a lot of men, many of whom are medical professionals, who would benefit from needing to learn just how much such a possibility of pregnancy affects women’s lives and medical care.

Okaaaayyyy.... I feel like I missed something here. How is asking male patients whether they might be pregnant accomplishing that?

 

[Metaphor]

Being told that the NHS is being held hostage by political extremists or something isn't the same.

I have explained the reasons it is bad policy and I won't do it again.

I also never said the NHS was being held hostage. I said it was institutionally captured.

 

[TomC]

I also never said the NHS was being held hostage. I said it was institutionally captured.

Feel free to explain the difference between "being held hostage" and "institutionally captured".

I have explained the reasons it is bad policy and I won't do it again.

You haven't explained why having one form that applies to every patient, and a technician responsibility to check off every box is bad policy.

It appears to me that you're making medical safety precautions a political football. That looks like a bad policy to me.

If someone with an M on their record answers "Yes" to "Could you be pregnant", would that send up a red flag? It would to me. People are strange and unpredictable and not particularly honest. I'm fine with checking, double checking, even triple checking sometimes. Why do you have a problem with that?
Tom

 

[Metaphor]

I also never said the NHS was being held hostage. I said it was institutionally captured.

Feel free to explain the difference between "being held hostage" and "institutionally captured".

People who are held hostage are held hostage against their will.

When an institution is institutionally captured, they has Stockholm Syndrome. Nobody is holding a gun to their head. They're holding the gun.

I have explained the reasons it is bad policy and I won't do it again.

You haven't explained why having one form that applies to every patient, and a technician responsibility to check off every box is bad policy.

There is no one form that applies to every patient and there never has been.

It appears to me that you're making medical safety precautions a political football. That looks like a bad policy to me.

It is the NHS that made it a political football by changing a standard policy for a new policy, with no justification for the change. The change to the policy was political, not the original policy.

If someone with an M on their record answers "Yes" to "Could you be pregnant", would that send up a red flag? It would to me. People are strange and unpredictable and not particularly honest. I'm fine with checking, double checking, even triple checking sometimes. Why do you have a problem with that?
Tom

Why do you believe I have a problem with checking things in general? I have repeatedly said on this thread I have no problem with the verification of information. I'm kind of tired of repeating myself about it.

But you don't need to verify that males are pregnant. It is impossible that they could be. You don't need to check the triangle to see if it has four sides. And people can't change sex.

This is a policy introduced to check if triangles have four sides.

 

[ZiprHead]

There was already a safe alternative that was jettisoned for political reasons.

Again, I ask for a citation for this assertion.

I'm sorry, you would have to read and process the article in the OP.

I have. Is there some particular point there to show what you are saying?

 

[TomC]

But you don't need to verify that males are pregnant. It is impossible that they could be.

Do you think that having an M on a piece of paper at the hospital makes you male?
Tom

 

[Metaphor]

There was already a safe alternative that was jettisoned for political reasons.

Again, I ask for a citation for this assertion.

I'm sorry, you would have to read and process the article in the OP.

I have. Is there some particular point there to show what you are saying?

I have already explained why I reached the conclusion that I did, more than once, in this thread. I am rather tired of repeating myself. However, I will provide the reasoning one more time for you:

• In 2017, regulations regarding imaging checks were updated by the Department of Health to be more inclusive – changing those who should be questioned from "females of childbearing age" to "individuals of childbearing potential".

Conclusion 1: the change from 'females' to 'individuals' is entirely ideologically driven. Only females can bear children. That is, the second formulation - 'individuals of childbearing potential' - can only include females. No male has ever had the potential to bear a child. The change to language to exclude women and females is consistent with other changes in the UK and elsewhere that seek to supplant sex for gender, even in cases where sex is obviously of paramount relevance.

• One of the NHS Trusts (the Walton Centre) has interpreted the above regulation to mean it should be asking every patient under 60 about their pregnancy status.
• "All patients under the age of 60, regardless of how you may identify your gender" are now asked whether they are expecting at The Walton Centre NHS Foundation Trust, in Liverpool, the Telegraph reports.

Conclusion 2: The hospital has a way to determine if a patient is under 60. I would assume this is because hospitals ask for and record your date of birth. I assume also that the hospital has asked for and recorded a patient's sex. The hospital has also interpreted the new directive to mean they should or must ask male patients about pregnancy status, even though no male is an individual of childbearing potential.

• There is absolutely no evidence of any imaging accidents that resulted from the previous policy.

Conclusion 3: If imaging accidents had arisen from the previous policy, I imagine they would have been mentioned as justification for the new policy. I conclude that there were no imaging accidents from the previous policy, and therefore no imaging accidents that this new policy would prevent.

• Only the Walton Centre trust has changed its policy to include asking males if they are pregnant.

Conclusion 4: If all the other NHS Trusts see no reason to ask males if they are pregnant, that means this particular Trust was specially motivated. One might argue they thought there needed to be more safety in their imaging, if they had somehow had a particularly poor record of accidentally imaging pregnant women. But, per Conclusion 3, there is no evidence of a single imaging accident.

• The new policy excludes asking the question to people over 60.

Conclusion 5: Even though, as some have pointed out, some women over 60 have been pregnant and given birth, the Trust does not regard that as worthwhile danger to guard against. However, there is a political movement to pretend that men can be women, and the Trust has changed its policy to ensure that a group of people for whom pregnancy is a biological impossibility is asked about their pregnancy status in accordance with the new political tastes, but nobody over 60 is asked, even though there is a vanishing possibility of pregnancy in that group.

If you can't acknowledge that the change was ideologically driven, I don't know what else to say to you.

 

[Metaphor]

But you don't need to verify that males are pregnant. It is impossible that they could be.

Do you think that having an M on a piece of paper at the hospital makes you male?
Tom

No. Being male makes me male. Being male also caused people to write an 'M' in all my documents from my birth onwards. And being male will also cause me to answer 'male' when I am asked to what my sex is.

 

[Toni]

I think there are a lot of men, many of whom are medical professionals, who would benefit from needing to learn just how much such a possibility of pregnancy affects women’s lives and medical care.

Okaaaayyyy.... I feel like I missed something here. How is asking male patients whether they might be pregnant accomplishing that?

Males cannot actually menstruate or get pregnant. They aren’t really aware of how much those things can dominate the life of a female person.

It is a really really big reach but just hearing the question might make a few of them think about what it must be like to have to worry about these things, or to have either of those be salient in your medical treatment.

Empathy seems to be a really big reach for some..

 

[Metaphor]

Males cannot actually menstruate or get pregnant. They aren’t really aware of how much those things can dominate the life of a female person.

It is a really really big reach but just hearing the question might make a few of them think about what it must be like to have to worry about these things, or to have either of those be salient in your medical treatment.

Empathy seems to be a really big reach for some..

What an unexpected benefit. Ask the question of males not because it makes sense, not because it is medically indicated, not because it will save lives or reduce trauma, but because men don't know what it's like to be worried about pregnancy!

I think another question should be added to the form, because of all the benefits that flow from asking unnecessary questions. TomC inspired me. We should ask everybody 'when did you last have an erection and ejaculate?'

Then we can be sure that all the women are paying attention to the questions, and if they give you a date you know something is amiss!

 

[TomC]

TomC inspired me. We should ask everybody 'when did you last have an erection and ejaculate?'

Umm...
Wut?

If one's last erection and ejaculation had anything to do with the medical procedure I'd be OK with asking. But it doesn't.
Pregnancy does. Regardless of how unlikely a pregnancy, some procedures can result in ugly effects on an unborn human. So the sensible thing to do is just ask everyone about to undergo the procedure.

Don't assume that the M on a piece of paper or computer screen is golden.
Tom

 

[Toni]

Males cannot actually menstruate or get pregnant. They aren’t really aware of how much those things can dominate the life of a female person.

It is a really really big reach but just hearing the question might make a few of them think about what it must be like to have to worry about these things, or to have either of those be salient in your medical treatment.

Empathy seems to be a really big reach for some..

What an unexpected benefit. Ask the question of males not because it makes sense, not because it is medically indicated, not because it will save lives or reduce trauma, but because men don't know what it's like to be worried about pregnancy!

I think another question should be added to the form, because of all the benefits that flow from asking unnecessary questions. TomC inspired me. We should ask everybody 'when did you last have an erection and ejaculate?'

Then we can be sure that all the women are paying attention to the questions, and if they give you a date you know something is amiss!

Nope. It makes sense to have a standard set of questions.

The admittedly extremely remote possibility of instilling even a faint glimmer of empathy is just a potential side benefit.

Maybe this is just a plot by makers of blood pressure meds to increase sales.

 

[Metaphor]

TomC inspired me. We should ask everybody 'when did you last have an erection and ejaculate?'

Umm...
Wut?

If one's last erection and ejaculation had anything to do with the medical procedure I'd be OK with asking. But it doesn't.

You specifically praised a side effect of the policy as its ability to point out when people recorded as 'M' give an unexpected answer.

Pregnancy does. Regardless of how unlikely a pregnancy, some procedures can result in ugly effects on an unborn human. So the sensible thing to do is just ask everyone about to undergo the procedure.

The vast majority of hospitals everywhere disagree with you.

Don't assume that the M on a piece of paper or computer screen is golden.
Tom

Whoever said I did? I have said multiple times I am used to verifying information in a medical setting.

 

[Loren Pechtel]

Irrelevant to the point I made.

No, it's not. You may think you can't trust yourself to evaluate good policy from bad policy, or to be able to formulate policy that is unduly influenced by political taste, but I have a brain, and I can read, and I can reason.

And I don't need your permission to discuss public policy on this message board. So if you don't like discussing public policy, here is a hint: stay out of the thread.

Nobody on your side has addressed the combination of two things:

My wife was clearly asked for a pregnancy test based on looks, not her chart despite her chart being in the nurse's hand at the time. My SIL has repeatedly been thought male by women in restrooms.

Combine these and you get a failure scenario in which a male-looking female doesn't get asked about pregnancy when they should have been.