Yes, it does matter in a medical context. Anyone who thinks otherwise is fucking ridiculous and not understanding the nature of reality.
I agree that it doesn’t matter in too many other places. But pretending it doesn’t matter in a medical context is quite frankly ridiculous.
It’s important for people with breast tissue to get screened for breast cancer.
It’s important for people with prostates to get screened for prostate cancer.
People who bleed each month often have lower hemoglobin levels that are not as immediately alarming as in people who don’t bleed every month.
It’s not rocket science. Enjoy not being treated for potentially deadly issues because you think biological sex is irrelevant to medical issues.
Look…express yourself however best suits you. I absolutely advocate people expressing themselves in whatever manner of gender that is truly them. But biology is incredibly important in a medical context.
“Biological sex” says jack shit about a trans person’s biological characteristics, especially deep into transition. It’s more often than not a dogwhistle that transphobes use to imply that trans women have the same violent sexual tendencies as many cis men, and to imply that those characteristics are somehow immutable.
The state does not need to get involved in a medical discussion between a trans patient and their doctor.
As someone who’s been transitioning for 12+ years, I guarantee my body fat and hormones are literally nowhere near “genetic male”. Medically confirmed in fact, repeatedly. You’re making big assumptions about trans bodies that aren’t necessarily true.
I’d love to see what emergency meds you’re talking about that are more dependent on body fat composition rather than something like BMI, allergies, medical conditions, or age. But even then- soft tissues are the most affected by medical transition and are more closely aligned to their cis targets. That’s kinda the whole point. Not to mention the medical expertise behind whoever is administering said drugs.
Edit: oh you’re from lemmy.ml, that explains a lot
Cisgender women have a naturally higher percentage of body fat than cisgender men, so lipophilic drugs have a larger volume of distribution in women. They sink into the fat tissue, stay in the body longer, and can take much more time to clear out. Overlooking sex-based variations in volume of distribution can be dangerous in an emergency situation, it absolutely can result in adverse drug reactions.
That kind of information can be a factor in an emergency medicine situation, it’s not worth pretending that it’s not the case.
Medicine is one of the areas where biological sex is actually relevant.
Emergency medication isn’t dosed by gender, it’s dosed by weight. It really would only matter with certain drugs in pregnancy.
It is helpful to know the original gender for some things because certain illnesses present differently in men V women and not all of that changes post transition so if you are treating a man it would be helpful to know that he was born a woman so you don’t brush off certain symptoms as minor if in fact in a women they would be very alarming. For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
But in an unconscious trauma patient, it doesn’t really matter. If a trans man still has a uterus then that’s an additional organ to be damaged that might not be expected, but that’s not something that’s going to be caught in the ambulance either way because we don’t have a CT scanner hanging out in the cabinets.
For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
This is why we need more medical research focused on trans and intersex bodies. It’s honestly a travesty that it hasn’t been studied much, largely due to the pushback from oppressive governments and transphobes. The problem extends beyond trans people, so much medical research is modeled on white cis male bodies, but I’m sure you’re already aware of that issue.
Transition affects nearly every part of the body. It’s already known that trans brains more closely resemble their cis counterparts rather than their sex assigned at birth (citations: NIH.gov, Scientific American). It wouldn’t make sense to treat a trans woman as a cis man for brain imaging. In trans men, testosterone deepens the vocal chords and can even slow down or stop periods. In trans women, estrogen shrinks the prostate and can even reverse male pattern baldness. Surely there are other effects on internal medicine, both positive and negative
Part of trans liberation involves sponsoring more research in this topic. In your heart attack example, has it been scientifically proven that the symptoms are immutable with transition? Does the amount of time someone’s been transitioning affect it? These are genuine questions, I don’t know the answers to them
I agree that more research needs to be done. I don’t know the answers to those questions either. I’m sure there’s lots more knowledge out there that is known that I just don’t know, but there’s also tons of knowledge that’s lacking, the same way that there’s tons of knowledge that’s lacking about women’s bodies. Humans are fascinating and there’s so many different factors that can affect medical presentations or risk factors.
Unfortunately in the current climate that research is considered too “woke” to “waste” money on, so people will continue to suffer from insufficient medical care even when their providers are genuinely trying their best.
Weight isn’t the only consideration for emergency medicine dosing, though… There are lipophilic drugs in emergency medicine. CT scanners aren’t the only thing used in emergency medicine, point-of-care ultrasound is used by physicians too.
It’s not like biological sex is irrelevant in emergency medicine.
Sure, but none of the drugs that would be used in the situation you describe would matter enough to kill or seriously harm anyone. At worst it would just have a longer half life and then you just don’t give as many or as high doses later on. And that also applies to many different demographics including old people and people with other medical issues that causes them to clear drugs slower, which is why patients are monitored and dosed accordingly and the dosage schedule is a guideline not a rule.
If some random distribution of body fat could kill a person then you’d have people dropping dead left and right based off differences in everyone’s muscle mass to body fat ratio and it just doesn’t work that way.
I never said it was irrelevant, I literally wrote that it can be very very relevant in some cases, but it’s not so relevant that it’s vital to know if you’re unconscious and bleeding out.
I mostly agree with you, but it’s not like overdoses caused by medical errors don’t ever happen either. Because it has a longer half-life (due to biological women commonly having a higher percentage of body fat compared to biological men, for example), medication levels can build up (as you mentioned) and result in adverse effects if you make a mistake with dosing. Pharmacokinetics and pharmacodynamics do matter too.
Just because it’s not common (because physicians are trained to handle it appropriately) doesn’t mean it’s not possible.
Like you said, demographics (including age, biological sex, etc) do matter.
Only in-so-far as medical regulation would require. Like if the hospital failed to check this crucial information and made a mistake because of it they should be held liable. Having it on your ID might also be important if you list yourself as an organ donor; not sure if that would matter but it might.
I can think of a handful of ways of confirming someone’s biology without checking official documentation. After all, hospitals still check blood types and tissue types
That takes time. You don’t want to get the wrong dose of fentanyl, but you’ll definitely want fentanyl if you’ve been hit by a car and broke some ribs.
Okay but that argument kind of falls apart when you know that emergency medicine won’t, for example, give a patient a dose of fentanyl without having naloxone immediately on hand. I am not a paramedic but I have known a few and a few ER nurses and they are almost always working with more unknowns than knowns.
I mean it’s not, what I’m saying is that the only time a patient’s gender being unknown is a risk is in emergency situations. Otherwise the doctor and the patient are going to have a conversation before the doctor does anything and it should come up then. Although I should hope that it’s not a doorknob comment.
With the only situation when a person’s gender is undermined is when the doctor and/nurses are already working with less than ideal information. Having a person’s sex/gender on their identification isn’t really answering the questions that need answering then. The only reason it’s so important is because the protocols are built with the assumption that the person is one of two genders. Which lets not even begin to get into the atypical sex’s (XXX, XXy, Xyy, ect). It’s an outdated standard but it’s so engrained into everything.
Crime investigation purposes. The information on state ID was used s as a resource for crime fighting. Once DNA analysis became a thing, knowing male vs female was even more important.
Everyone has a different anatomy/needs. You know how many random foramen and bones people can have? Random extra shit that the body spontaneously develops on it’s own for no reason? Most of them are fine, some are not, but to say we need to know if you fit into the “male” or “female” box to treat you is incorrect. We need to know so much more. In fact, I think the mere presence of a vagina seems to tell a lot of doctors “Don’t take this persons pain seriously,” so I think if we just assume everyone is a male or a testosterone/testes-deficient male at the clinic, we might get better results.
Tbh most of the medical history men’s anatomy was treated as the default, not much far off from what you’re suggesting. Therefore now medical doctors still have no idea wtf is going on during perimenopause despite half the population going through it and as someone in the thick of it I can tell you that no, we abso-fucking-lutely need a more specialized women’s healthcare.
This also I think could be fixed by taking a more human-centric holistic approach. Don’t need to know you’re a woman, just that you’re experiencing drastic hormone changes. BAM, we gotta help regulate those hormones. Men love finding out they’re low on testosterone, so they can start taking a bunch. Women should be able to get their hormones just as easily.
Trans people should go to the doctor and be like, I appear to be missing a bunch of estrogen and progesterone! and the doctor should be like “no shit, that sucks, here’s a prescription for them.”
This assumes that men and women have the same medical needs. They don’t. Our average hormonal balances are completely different so for a doctor to be able asses doses, they need to know what the average hormonal balance is for women.
Except women’s hormonal balances change during different phases of each month, but not for men. Thus the need to study women’s health since women and men have different phisiologies. Oh look, we’ve come full circle.
I mean, yes, we need to study women’s health more. It’s a big glaring hole in a ton of medical research. I’m just trying to stay with the vibe of the thread. I think that just like with cutting edge cancer research being done that focuses on tailoring the specific drug/method of action to that persons specific cancer, so too should most of our medical treatments be tailored not just to what’s between your legs, but to you, specifically. More research into everyone, but especially the largely ignored demographic of women, is needed to accomplish this. So… you’re right, but I think I’m right too.
Medical issues.
Men and women have different anatomy and needs. Knowing your biological sex for medical reasons is kinda important.
Everywhere else, it’s a social construct and does not matter in the slightest.
Weird as fuck how heavily this gets downvoted.
Yes, it does matter in a medical context. Anyone who thinks otherwise is fucking ridiculous and not understanding the nature of reality.
I agree that it doesn’t matter in too many other places. But pretending it doesn’t matter in a medical context is quite frankly ridiculous.
It’s important for people with breast tissue to get screened for breast cancer.
It’s important for people with prostates to get screened for prostate cancer.
People who bleed each month often have lower hemoglobin levels that are not as immediately alarming as in people who don’t bleed every month.
It’s not rocket science. Enjoy not being treated for potentially deadly issues because you think biological sex is irrelevant to medical issues.
Look…express yourself however best suits you. I absolutely advocate people expressing themselves in whatever manner of gender that is truly them. But biology is incredibly important in a medical context.
“Biological sex” says jack shit about a trans person’s biological characteristics, especially deep into transition. It’s more often than not a dogwhistle that transphobes use to imply that trans women have the same violent sexual tendencies as many cis men, and to imply that those characteristics are somehow immutable.
The state does not need to get involved in a medical discussion between a trans patient and their doctor.
I get your point, but it’s important to have your gender somewhere on a trustworthy source that everybody has.
As someone who’s been transitioning for 12+ years, I guarantee my body fat and hormones are literally nowhere near “genetic male”. Medically confirmed in fact, repeatedly. You’re making big assumptions about trans bodies that aren’t necessarily true.
I’d love to see what emergency meds you’re talking about that are more dependent on body fat composition rather than something like BMI, allergies, medical conditions, or age. But even then- soft tissues are the most affected by medical transition and are more closely aligned to their cis targets. That’s kinda the whole point. Not to mention the medical expertise behind whoever is administering said drugs.
Edit: oh you’re from lemmy.ml, that explains a lot
Cisgender women have a naturally higher percentage of body fat than cisgender men, so lipophilic drugs have a larger volume of distribution in women. They sink into the fat tissue, stay in the body longer, and can take much more time to clear out. Overlooking sex-based variations in volume of distribution can be dangerous in an emergency situation, it absolutely can result in adverse drug reactions.
That kind of information can be a factor in an emergency medicine situation, it’s not worth pretending that it’s not the case.
Medicine is one of the areas where biological sex is actually relevant.
This sounds convincing, but then, is there actually any medication an EMT would administer based on sex? I honestly dont know.
Maybe we should all have blood types written down somewhere, because that surely is the same situation right? (I mean, we should all know it, I don’t)
If you donate blood, depending on the org, you might get a card that has your blood info on it. Seems like a good thing to keep in your wallet :)
Emergency medication isn’t dosed by gender, it’s dosed by weight. It really would only matter with certain drugs in pregnancy.
It is helpful to know the original gender for some things because certain illnesses present differently in men V women and not all of that changes post transition so if you are treating a man it would be helpful to know that he was born a woman so you don’t brush off certain symptoms as minor if in fact in a women they would be very alarming. For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
But in an unconscious trauma patient, it doesn’t really matter. If a trans man still has a uterus then that’s an additional organ to be damaged that might not be expected, but that’s not something that’s going to be caught in the ambulance either way because we don’t have a CT scanner hanging out in the cabinets.
This is why we need more medical research focused on trans and intersex bodies. It’s honestly a travesty that it hasn’t been studied much, largely due to the pushback from oppressive governments and transphobes. The problem extends beyond trans people, so much medical research is modeled on white cis male bodies, but I’m sure you’re already aware of that issue.
Transition affects nearly every part of the body. It’s already known that trans brains more closely resemble their cis counterparts rather than their sex assigned at birth (citations: NIH.gov, Scientific American). It wouldn’t make sense to treat a trans woman as a cis man for brain imaging. In trans men, testosterone deepens the vocal chords and can even slow down or stop periods. In trans women, estrogen shrinks the prostate and can even reverse male pattern baldness. Surely there are other effects on internal medicine, both positive and negative
Part of trans liberation involves sponsoring more research in this topic. In your heart attack example, has it been scientifically proven that the symptoms are immutable with transition? Does the amount of time someone’s been transitioning affect it? These are genuine questions, I don’t know the answers to them
I agree that more research needs to be done. I don’t know the answers to those questions either. I’m sure there’s lots more knowledge out there that is known that I just don’t know, but there’s also tons of knowledge that’s lacking, the same way that there’s tons of knowledge that’s lacking about women’s bodies. Humans are fascinating and there’s so many different factors that can affect medical presentations or risk factors.
Unfortunately in the current climate that research is considered too “woke” to “waste” money on, so people will continue to suffer from insufficient medical care even when their providers are genuinely trying their best.
Weight isn’t the only consideration for emergency medicine dosing, though… There are lipophilic drugs in emergency medicine. CT scanners aren’t the only thing used in emergency medicine, point-of-care ultrasound is used by physicians too.
It’s not like biological sex is irrelevant in emergency medicine.
Sure, but none of the drugs that would be used in the situation you describe would matter enough to kill or seriously harm anyone. At worst it would just have a longer half life and then you just don’t give as many or as high doses later on. And that also applies to many different demographics including old people and people with other medical issues that causes them to clear drugs slower, which is why patients are monitored and dosed accordingly and the dosage schedule is a guideline not a rule.
If some random distribution of body fat could kill a person then you’d have people dropping dead left and right based off differences in everyone’s muscle mass to body fat ratio and it just doesn’t work that way.
I never said it was irrelevant, I literally wrote that it can be very very relevant in some cases, but it’s not so relevant that it’s vital to know if you’re unconscious and bleeding out.
deleted by creator
I mostly agree with you, but it’s not like overdoses caused by medical errors don’t ever happen either. Because it has a longer half-life (due to biological women commonly having a higher percentage of body fat compared to biological men, for example), medication levels can build up (as you mentioned) and result in adverse effects if you make a mistake with dosing. Pharmacokinetics and pharmacodynamics do matter too.
Just because it’s not common (because physicians are trained to handle it appropriately) doesn’t mean it’s not possible.
Like you said, demographics (including age, biological sex, etc) do matter.
Lol imagine going to a doctor and they can’t figure out your gender if it’s not on you legal documents.
Get another Dr. I think this one got his license from Trump university
The blood group is very important too, for medical issues, but I don’t think it is common to make it a legal marker (such as on passport).
Also, some people are born not matching exactly the classical genders, and labeling them legaly male or female can be misleading for medical things…
Does it need to be tied to the legal system, though?
Only in-so-far as medical regulation would require. Like if the hospital failed to check this crucial information and made a mistake because of it they should be held liable. Having it on your ID might also be important if you list yourself as an organ donor; not sure if that would matter but it might.
I can think of a handful of ways of confirming someone’s biology without checking official documentation. After all, hospitals still check blood types and tissue types
That takes time. You don’t want to get the wrong dose of fentanyl, but you’ll definitely want fentanyl if you’ve been hit by a car and broke some ribs.
need to know weight for dosing, not genitals
Okay but that argument kind of falls apart when you know that emergency medicine won’t, for example, give a patient a dose of fentanyl without having naloxone immediately on hand. I am not a paramedic but I have known a few and a few ER nurses and they are almost always working with more unknowns than knowns.
And why would you want to add an additional unknown factor again? Because that’s what you’d be doing by removing sex from the basic information card.
Don’t see how increasing the amount of times naloxone is given is beneficial here.
I mean it’s not, what I’m saying is that the only time a patient’s gender being unknown is a risk is in emergency situations. Otherwise the doctor and the patient are going to have a conversation before the doctor does anything and it should come up then. Although I should hope that it’s not a doorknob comment.
With the only situation when a person’s gender is undermined is when the doctor and/nurses are already working with less than ideal information. Having a person’s sex/gender on their identification isn’t really answering the questions that need answering then. The only reason it’s so important is because the protocols are built with the assumption that the person is one of two genders. Which lets not even begin to get into the atypical sex’s (XXX, XXy, Xyy, ect). It’s an outdated standard but it’s so engrained into everything.
I can count your ribs faster than I can look up government documentation, and even that’s assuming you’ve already been identified.
My apologies, I didn’t know you were such a slow reader.
I think the same for the donor marker in general. Can’t the hospital system keep that info? Why does it need to be on my ID?
Yup, that’s my point. I don’t think a government (should) need this.
On that note, I learned from another commenter that in Germany you can have your gender deleted from their database.
Crime investigation purposes. The information on state ID was used s as a resource for crime fighting. Once DNA analysis became a thing, knowing male vs female was even more important.
Everyone has a different anatomy/needs. You know how many random foramen and bones people can have? Random extra shit that the body spontaneously develops on it’s own for no reason? Most of them are fine, some are not, but to say we need to know if you fit into the “male” or “female” box to treat you is incorrect. We need to know so much more. In fact, I think the mere presence of a vagina seems to tell a lot of doctors “Don’t take this persons pain seriously,” so I think if we just assume everyone is a male or a testosterone/testes-deficient male at the clinic, we might get better results.
Tbh most of the medical history men’s anatomy was treated as the default, not much far off from what you’re suggesting. Therefore now medical doctors still have no idea wtf is going on during perimenopause despite half the population going through it and as someone in the thick of it I can tell you that no, we abso-fucking-lutely need a more specialized women’s healthcare.
This also I think could be fixed by taking a more human-centric holistic approach. Don’t need to know you’re a woman, just that you’re experiencing drastic hormone changes. BAM, we gotta help regulate those hormones. Men love finding out they’re low on testosterone, so they can start taking a bunch. Women should be able to get their hormones just as easily.
Trans people should go to the doctor and be like, I appear to be missing a bunch of estrogen and progesterone! and the doctor should be like “no shit, that sucks, here’s a prescription for them.”
This assumes that men and women have the same medical needs. They don’t. Our average hormonal balances are completely different so for a doctor to be able asses doses, they need to know what the average hormonal balance is for women.
but what they really need to know is the average hormonal balance for that specific person, before they started going out of whack.
Except women’s hormonal balances change during different phases of each month, but not for men. Thus the need to study women’s health since women and men have different phisiologies. Oh look, we’ve come full circle.
I mean, yes, we need to study women’s health more. It’s a big glaring hole in a ton of medical research. I’m just trying to stay with the vibe of the thread. I think that just like with cutting edge cancer research being done that focuses on tailoring the specific drug/method of action to that persons specific cancer, so too should most of our medical treatments be tailored not just to what’s between your legs, but to you, specifically. More research into everyone, but especially the largely ignored demographic of women, is needed to accomplish this. So… you’re right, but I think I’m right too.