Male patients asked if they are pregnant at NHS Trust

[laughing dog]

The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.

~ George Orwell.

The current mantra of the GOP and Trumpsuckers LOL

 

[Emily Lake]

I'm not talking about mental health. I'm saying that it is not always obvious whether someone is male or female. Period. Full stop.
Having a standard set of patient questions helps avoid any mistakes.

Extending on this: Let's consider a concept from the programming world: Cyclomatic complexity. Basically, how many possible scenarios there are. Us programmers aim to minimize it because we understand that errors come from choices.

if (Patient.GetSex() == Sex.Female)
   AskAboutPregnancy();

is more complex than

AskAboutPregnancy();

The former has more decision points and more room for mistakes (Patient.GetSex() is non-trivial in many edge cases) and takes at least as long as simply asking.

I challenge your assertion.

AskSex()
If Sex = Female then AskPregnant()

The doctors actually need sex for far more than just pregnancy. It's a universally important element.

If you're running AskPregnant() on everyone, you're using the same amount of processing as AskSex() of everyone. But you are failing to collect materially important information which increases the likelihood of error.

On the other hand, If you're running AskSex() on everyone, you reduce the likelihood of error.

If you run AskSex() and AskPregnant() on every single patient, you're just wasting processing power, because AskPregnant() only applies to half of the runs.

 

[Emily Lake]

Not random, but they are a stranger.

The last person to photograph my innards had zero need to know what genitals I have nor would what she was doing have revealed them. Now, I don't care if she knew but some people would care. IIRC she didn't even ask--just the standard birthdate and name bit. I would have gotten the lead blanket in either case.

What are you basing this assumption on? What part of your innards was being imaged? Because I would bet that knowing how your internal organs are organized is meaningful to the person taking and interpreting the image. If you're a male and there's a fist sized unexpected thing mixed in with your intestines and bladder, that's a big fucking problem and people are going to be rightfully concerned. If you're female, though, that's completely expected because THAT'S WHERE THE FUCKING UTERUS GOES.

FFS people, Women are not just Men with different plug and play parts! We're actually arranged differently! Our abdominal organs are in slightly different places, with different types of attachments! Or pelvises are different! Our femurs join our hips at a different angle!

 

[Emily Lake]

How do you know the hospital asked all females? How do you know the hospital never asked males? What did the hospital do when intersex individuals were about to undergo one of the procedures the law was referring to?

Your arguments are based on the assumption that females were never overlooked, males were never incorrectly identified, and that it's so insulting to males to be treated exactly the same as females that hospital policies must always differentiate between the sexes even when it's more efficient to just ask everyone the same set of questions.

Have you never been to a fucking hospital in your fucking life? Seriously? This is getting absurd!

Every single time I have gone to the doctor, there has been a form to fill out, and every single one of those forms has asked my sex. My medical records contain my sex. When I went to the hospital unconscious, the EMTs in the ambulance did a goddamned blood test, and then TOLD the ER docs that I was female and not pregnant!

This pretense that sex is a mystery that nobody can tell, nobody checks... and also is totally irrelevant unless you're trying to have sex is completely irrationally idiotic!

 

[Jarhyn]

It's almost as if exactly the people who need to know whatever can politely ask exactly as much as they need to know about whatever they need to know about without asking or referencing what genitals folks have, except insofar as the exact information is necessary for the precise treatment being addressed.

Because it is exactly that.

It's interesting that those who directly invalidate the gender of others and fail to respect their privacy are using a bad faith argument. Not validating is different from direct invalidation. You refuse the right of others to direct validation, direct validation may be refused of you.

 

[Emily Lake]

The only way to determine a person's sex is through a fairly comprehensive examination

That's inane.

1) If person is conscious, they fill out a form and check the box for their SEX. Not their gender identity, their actual sex.
2) If person is not conscious, take a small blood sample and test for sex.

It does NOT require a "comprehensive examination". This is stupid. I feel like I'm trying to talk to aliens who only vaguely know what the fuck humans are and have never even seen another mammal.

 

[Emily Lake]

Unless you're actually trying to suggest that transwomen should go change in stalls and bath in their suits?

That's exactly what I'm suggesting.

How about I put it this way, "If you want me to respect your preference of gendered pronouns, then respect my preference to change clothes in a room without a penis."?
Tom

That would be fine.

That's how it used to work, with some basic respect and consideration all around. Transwomen would take care to keep their bits covered so as not to make women uncomfortable. And in return, we women would engage in the polite fiction of them being women, even if we were well aware of the great big adam's apple. It was all based on a reasonable accommodation and compassion for each other.

That changed though. And now there is no expectation of mutual respect and care, it's become very one-sided.

 

[TomC]

other is that sick patients do not always answer accurately. I've had people I knew were intelligent answer questions quite incorrectly because they were very ill or exhausted or worried or stressed out.

Also, hospitals sometimes mess up.

I remember a story a surgery that went terribly wrong.
A patient needed much of one foot removed. I think it was because of diabetes. Unfortunately, the surgeon was in a bit of a hurry. Didn't double check everything.
Surgeon not only removed the whole foot, IT WAS THE WRONG FOOT. It was a different patient or something.

Bottom line, to me, is have strict protocols and consistent policies. That might seem burdensome to folks who think that they already know everything about sex and gender, but I don't care much.
Tom

 

[Emily Lake]

Well, as Loren mentioned, it opens up the possibility of needing to ask two questions: What is your sex? Are you pregnant or planning to be pregnant? Instead of just the second question. Programmers and people who write forms do not like this.

The other is that sick patients do not always answer accurately. I've had people I knew were intelligent answer questions quite incorrectly because they were very ill or exhausted or worried or stressed out. One was my husband who was giving wildly inaccurate responses to the person taking his medical history.

I am not convinced that if you asked every single transsexual man what his sex was that he would answer female. Not out of a desire to be inaccurate or to mislead but because he embraced male as his identity. You'd be surprised by the number of people who do not think the way a medical person taking a history is thinking.

Sex affects far more than just the likelihood of pregnancy when it comes to medicine. Asking ONLY for pregnancy status is insufficient. Sex still needs to be asked - and it needs to be answered honestly.

Seriously, this is another area where self-declaration breaks down. In prior eras, the counseling and therapy for a person diagnosed with severe dysphoria and undergoing a transition included educating them on the fact that their sex remains unchanged, and that they need to be aware that they will still need sex-specific treatment, and they need to be honest with their doctors about their sex as well as their hormone intake because it impacts a whole host of things.

The newer crop of transgender people might be offended by the gatekeeping... but it prevented things like a transman "embracing his identity as a male" to a point where they don't tell the doctor that they're actually female.

 

[laughing dog]

How do you know the hospital asked all females? How do you know the hospital never asked males? What did the hospital do when intersex individuals were about to undergo one of the procedures the law was referring to?

Your arguments are based on the assumption that females were never overlooked, males were never incorrectly identified, and that it's so insulting to males to be treated exactly the same as females that hospital policies must always differentiate between the sexes even when it's more efficient to just ask everyone the same set of questions.

Have you never been to a fucking hospital in your fucking life? Seriously? This is getting absurd!

Every single time I have gone to the doctor, there has been a form to fill out, and every single one of those forms has asked my sex. My medical records contain my sex. When I went to the hospital unconscious, the EMTs in the ambulance did a goddamned blood test, and then TOLD the ER docs that I was female and not pregnant!

This pretense that sex is a mystery that nobody can tell, nobody checks... and also is totally irrelevant unless you're trying to have sex is completely irrationally idiotic!

In my health care facilities, I am asked my name and my birth date by everyone who is supposed to see me at that appointment. It is called insuring no mistakes. Even those who know me by sight. In my view, asking about pregnancy falls into that same category of effort.

It is not a big deal for anyone. If a healthcare facility wishes to be that careful, why should anyone give a flying fuck about it?

 

[Emily Lake]

It says the reason is because the Government removed the word "female" from the law governing some medical procedures and replaced it with "individuals", changing those who should be questioned from "females of childbearing age" to "individuals of childbearing potential", leading some hospital trusts to the perfectly reasonable conclusion that they should ask individuals seeking those medical procedures if they are or might be pregnant.

Have you stepped back and asked yourself whether or not that removal of the word "female" makes any sense whatsoever? Why would the government do it? What purpose would it serve? Does it make healthcare better for the majority of people? Or does it assuage a political lobby?

I actually have a problem with erasing the word female, especially within the context of medical settings but also legal and legislative settings. It's onerous enough that male seems to be taken as THE standard. It bugs the heck out of me to have official language be pregnant person instead of pregnant woman (or girl. Sadly, it can be pregnant girl).

That does not mean that I don't understand the reasons a medical facility would decide to ask the question of all patients.

It bugs me to a point where I now have a list of brands that I will not buy. I absolutely will NOT give my support or my money to Midol, since they've decided to refer to me as "a menstruator" rather than a woman. There's another company out there that I was interested in that has decided to call their customer base "bleeders". I'm not having it. I'd be perfectly happy for them to advertise to "women and transgender people" if they want to be inclusive, but I am not at all okay with being referred to by a bodily function. It's intensely offensive and dehumanizing.

And when it's coming from the medical profession, yeah, I'm going to hit the ceiling on that. Women are already underdiagnosed and our complaints are often ignored because doctors - both male and female - end up assuming that women are overreacting. Both my mother and I nearly died, we both needed invasive surgeries, to address problems we'd been complaining about for years and which our doctors had dismissed as "not a big deal". I hemorrhaged and nearly bled to death from a uterine fibroid, my mom got a massive infection because endometriosis formed a fistula between her small intestine and her uterus.

 

[Emily Lake]

It's almost as if exactly the people who need to know whatever can politely ask exactly as much as they need to know about whatever they need to know about without asking or referencing what genitals folks have, except insofar as the exact information is necessary for the precise treatment being addressed.

Because it is exactly that.

It's interesting that those who directly invalidate the gender of others and fail to respect their privacy are using a bad faith argument. Not validating is different from direct invalidation. You refuse the right of others to direct validation, direct validation may be refused of you.

This is word salad. You're not actually saying anything useful, just sort of casting out a wide net of insinuated evilness on people who recognize that SEX is important in a number of situations.

 

[Emily Lake]

How do you know the hospital asked all females? How do you know the hospital never asked males? What did the hospital do when intersex individuals were about to undergo one of the procedures the law was referring to?

Your arguments are based on the assumption that females were never overlooked, males were never incorrectly identified, and that it's so insulting to males to be treated exactly the same as females that hospital policies must always differentiate between the sexes even when it's more efficient to just ask everyone the same set of questions.

Have you never been to a fucking hospital in your fucking life? Seriously? This is getting absurd!

Every single time I have gone to the doctor, there has been a form to fill out, and every single one of those forms has asked my sex. My medical records contain my sex. When I went to the hospital unconscious, the EMTs in the ambulance did a goddamned blood test, and then TOLD the ER docs that I was female and not pregnant!

This pretense that sex is a mystery that nobody can tell, nobody checks... and also is totally irrelevant unless you're trying to have sex is completely irrationally idiotic!

In my health care facilities, I am asked my name and my birth date by everyone who is supposed to see me at that appointment. It is called insuring no mistakes. Even those who know me by sight. In my view, asking about pregnancy falls into that same category of effort.

It is not a big deal for anyone. If a healthcare facility wishes to be that careful, why should anyone give a flying fuck about it?

ASK FOR SEX

That should also not be a big deal. And if a person's sex is female, ask about pregnancy. That should also not be a big deal.

But males CANNOT get pregnant, and engaging in this pretense is a betrayal of rationality and objectivity.

 

[Toni]

other is that sick patients do not always answer accurately. I've had people I knew were intelligent answer questions quite incorrectly because they were very ill or exhausted or worried or stressed out.

Also, hospitals sometimes mess up.

I remember a story a surgery that went terribly wrong.
A patient needed much of one foot removed. I think it was because of diabetes. Unfortunately, the surgeon was in a bit of a hurry. Didn't double check everything.
Surgeon not only removed the whole foot, IT WAS THE WRONG FOOT. It was a different patient or something.

Bottom line, to me, is have strict protocols and consistent policies. That might seem burdensome to folks who think that they already know everything about sex and gender, but I don't care much.
Tom

Now, if one is going in for surgery, the surgical team verifies the procedure to be done, which body part, right or left, etc. and MARK it.

It is incomprehensible to me that a doctor who is even semi-competent and not in some substance altered state can see an appendage that is not diseased and decide that’s the one that needs removing.

 

[TomC]

It is incomprehensible to me that a doctor who is even semi-competent and not in some substance altered state can see an appendage that is not diseased and decide that’s the one that needs removing.

This is my point.

Medical professionals should check, double check, triple check sometimes.

Assuming that something is obvious and needn't be questioned is bad procedure. Which is very dangerous in the medical field. That patient didn't just get onions on a sandwich when they don't like onions.

And then there's this. If a patient who's questionnaire says male, then answers "Yes" to the question "Could you be pregnant?", there's a problem. Could be gender dysphoria, could be dementia, could be the wrong patient. Technician should pause and be sure that they know what they're doing before they do it.

I just do not see the problem with the NHS policy on this.
Tom

 

[ZiprHead]

The other is that sick patients do not always answer accurately. I've had people I knew were intelligent answer questions quite incorrectly because they were very ill or exhausted or worried or stressed out. One was my husband who was giving wildly inaccurate responses to the person taking his medical history.

I am not convinced that if you asked every single transsexual man what his sex was that he would answer female. Not out of a desire to be inaccurate or to mislead but because he embraced male as his identity. You'd be surprised by the number of people who do not think the way a medical person taking a history is thinking.

I suspect something like the second paragraph happened already and the patient almost got or did get the inapproriate imaging done. Thus the question of pregnancy became a necessary part of the standard intake.

Simple, really. But some just feel the need to turn this into a huge conspiracy theory.

 

[Jarhyn]

No I'm casting a specific net of explicit evilness on those who think that "SEX" is important when it is (pregnancy) and (may not become pregnant) that matter in the context, particularly when that extends beyond the bounds of reasonable privacy to go beyond (pregnancy), (may not become pregnant).

Sometimes those questions reveal some data, but only as much and explicitly when it must be for the sake of an immediate concern.

Still looks like word salad to me.

"Casting a specific net of explicit evilness on those..."
Seriously?
Tom

Yes, seriously. People have the right to not have others be looking at more information that they wish to divulge. Erring on the side of privacy is better than making everyone under sun and sundry aware of more than they need to be.

And of course, as other posters have pointed out, it's not always obvious.

 

[Loren Pechtel]

Nobody's getting mis-sexed. It's like the form I encountered recently--it simply asked about pregnancy. Being male doesn't make the question not fit. The answer is obvious but so what?

This isn't a form, as I've said approximately one million times. It's a question asked verbally to people about to get imaging done. It used to be asked only of females, and is still asked only of females in other NHS Trusts.

Did you not notice my post earlier about my wife being asked for a pregnancy test when she was 70? That was a hospital (outpatient surgery), the nurse asking for it had her file in hand--it's just they went on appearance rather than looking through the file. What if it was my SIL instead who has had multiple encounters with women who didn't think she belonged in the women's room?

What if it was? If your sister-in-law is female, she should be asked if she could be pregnant. I assume hospitals record the sex of patients, even in America.

The reality is mistakes happen. You set the system up to minimize them.

The system was already set up like that. The hospital asked all females if they were pregnant. The change was the result of trans-affirmation policy, not any defects in the previous policy.

You're not getting it. Combine the two examples I gave!!

1) Nurse asks my wife for a pregnancy test when she was 70. Obviously, the nurse was looking at her rather than looking at her chart.

2) SIL has had multiple encounters with women trying to kick her out of the women's room thinking she's male.

What happens when the nurse looks at SIL and doesn't ask for a pregnancy test because the nurse thinks she's a male?

The safe option is to simply ask everyone, just like the form I filled out did.

 

[Loren Pechtel]

There are no four sided triangles.

Some men might feel very sensitive about being mistaken for women. You've given the impression that you simply do not care about the feelings of men, but I do. A man being asked if he could be pregnant could be read to mean the person asking that question thinks he looks like a woman. It could also be read to mean the person asking the question isn't paying attention to their job.

The safe alternative is to ask the question of everyone. There could be some issues while switching, but people will in time understand and not be sensitive.

 

[Loren Pechtel]

This is entirely disingenuous. Unless you think all transpeople are complete morons, maybe? Or that nurses are absolute dolts? Or you've bought into the absurd argument that nobody can ever tell anybody's sex without investigating their nethers?

For 99% of people, their sex is readily apparent from their faces alone. Even the butchiest lesbian is still going to clock as a woman, because humans are *wired* to identify sex. Sure, some very few people are going to fall in that 1%. And if so, it is on them to inform the doctor what their sex is.

1) You're assuming the patient knows that sex is relevant to the situation.

2) I've already pointed out my SIL that has been thought male many times. I'm sure she's lesbian but in the closet even from herself.

It's on me to inform the doctor of my medical conditions. My medical forms used to have a box for sex, and EVERYONE understood that it was asking for your actual fucking sex, not your gender identity. A doctor or nurse should be able to ask a person their sex for the form, and get an HONEST answer. And then males do NOT need to be asked whether they might be pregnant, because MALES CANNOT GET PREGNANT. And if a transman is stupid enough to fucking LIE to the doctor about their sex because it hurts their emotions to admit that they are female... I don't see why EVERYONE ELSE IN THE WORLD should be expected to enable their fears and their emotional delicacy.

And they always look at the chart?? Upthread I've given an example where they clearly didn't.