Does The Doctor Need To Know?

[Persephone]

Kinda prompted by Kaitlyn Michelle's thread, "A Short Disclosure Experience", I wondered when does a doctor need to know?

Some medications may react differently on genetic males and females, some, like finasteride, may even be considered potentially hazardous to one sex or another, so are there occassions when it is appropriate to tell a doctor, anyone from a dermatologist to a proctologist, that you were not born into the sex you currently present as?

Hugs,
Persephone.

[noeleena]

Hi,
as one who was with the medic section StJohns yes we need to know because of dose rates or organs and what meds you are on or taking any surgerys and the chats concerning you as a patient i have run into this concerning a woman and her meds so why not your Dr or RN.

why hide you wont the best for you from those who have to for what ever reason help you so is it not worth at least that info being known,

lets put it this way you are aleargic to a type of drug and you die , oh tough ...a... and later at the inquest it was shown you had .......what ever..... had we known your history we would have done different and youd be alive.

I,v been around drugs meds to many years to know what can and does happen , not worth your life or is it.

so your turn ......

...noeleena...

[Angela Campbell]

I would say it depends on what you are going in for. If it is something like having a toenail cut out ...no, if it is a more serious thing then sure they need to know.

Then again they will likely figure it out eventually no matter.

[Frances]

It depends, but a lot of doctors and dentists will ask what medication you take, and will want to know why you take certain medications.

I don't think Finastaride is hazardous to women; it's hazardous to fetuses.

[PretzelGirl]

My first instinct was always, but Angela makes a good point about having a toenail cut out, so I would then go with almost always. I am more in the camp of why hide it? These people are there to help us keep healthy and they can't do that if we are holding back. Also, you can look at it from the perspective that when you go in, it is fairly standard practice to ask what meds you are on. I assume most of us are at least on some synthetic version of estrogen. That should cause a question for anything but the basic of care.

Now if someone says that their doctor doesn't seem to treat them the same because of telling them, then you need a new doctor. My doctor is a DO and he really embraces the aspect of treating the whole body. He has known for a few years and I keep him up on the changes mentally and since the start of HRT, physically. I have seen him twice since starting HRT and both before starting and especially after, I can tell he is asking to learn. I was his first trans patient and he told me that he had someone who self medicated come in and was a physical wreck. What he learned from me helped him in that person's care. I know it wasn't a lot, but the education process is ongoing for anyone.

[Jorja]

As most of you know I have been doing this for 30+ years. In that time I have of course had my fair share of dealings with doctors and the like. Face it ladies, at some point you are going to have to spill the beans. Get over it. It is no big deal. Tell them, get your treatment, and move on.

[BOBBI G.]

I have to completely separate medical systems, one in the private sector and the other the VA. I am using the VA for only my transition, and I felt they needed to know everything I am on. Also I feel my personal doctor needs to know everything the VA is providing for me. This way I have a better chance of not having any adverse reactions from either side. I started this policy the first day I met with my VA prime doctor. I really do want to be able to live for the next 20 years or so. I'm only 71.

Bobbi

[sarahcsc]

As a doctor myself, I will tell you, YES.

We want to know.

Not because we're nosy (maybe I'm nosier than other doctors but that's because I care!), but because hormones interact with other medications, and the body's physiology alters dramatically with HRT hence it affects the way we investigate and treat your symptoms.

Your doctor should know that you're on HRT as part of the transitioning process, but he has no business asking about your personal life and/or the intricacies of being a TS.

Times when you should be especially honest is when you're being worked up for coronary artery disease, deep vein thromboses, strokes, endocrinological abnormalities, or mental illness. Telling your doctor is the safest thing to do for yourself to prevent the delay of appropriate treatment or worse, the administration of inappropriate treatment.

Hope this helps, Persephone.

Love,
Sarah

[Michelle.M]

As most of you know I have been doing this for 30+ years. In that time I have of course had my fair share of dealings with doctors and the like. Face it ladies, at some point you are going to have to spill the beans. Get over it. It is no big deal. Tell them, get your treatment, and move on.

Yup! That’s the right answer. It’s your doctor. Just cowgirl up and get it said.

I know a trans woman who has serious passing anxiety despite everyone’s assurance that she passes very well. Sure, she’s a big girl and no supermodel, but she never gets misgendered. I am serious - never! Her voice is so feminine that when I first met her I thought she was a genetic woman.

She went to the VA clinic for something along the lines of a general checkup, and at one point she was sent to the part of the clinic where they do ultrasounds and other related diagnostic procedures. I don’t know why she thought she was there, but she obediently removed her top and got down on the exam table as she was instructed.

Soon, a tech came in and fired up the machine and began to rub some surgical lube on her tummy, and then she took the ultrasound wand and began to give my friend an ultrasound. When my friend realized what was happening she was too surprised to say anything, so in shock she just watched to see how this was going to play out.

Imagine the look on the tech’s face when she couldn’t find any evidence of a fetus! She was probably thinking she needed to report this to a doctor so they could have a discussion about what might have happened to the baby. And my friend was still flabbergasted that the clinic had sent her for an ultrasound. EVERYONE has gendered her female, and on top of that they thought she was pregnant (like I said, she’s a big girl).

And THAT was how she had this discussion with her doctor.

[Dianne S]

One data point: I have a friend who transitioned. She has a female gender marker on her birth certificate and driver's license, but was advised to keep the gender marker on her health card as "male". Apparently, it can make a difference in some situations if you need emergency treatment.

By the way... Rianna edited my post to remove what she thought was a political slur, but I was just trying to be funny. Sorry if any who read the original post missed my humour and were offended in any way.

[Persephone]

Thank you everyone! Lots of wonderful help!

And an extra-special Thank You to Sarahcsc! Your advice as a physician is really appreciated!

... was advised to keep the gender marker on her health card as "male". Apparently, it can make a difference in some situations if you need emergency treatment.

Ultimate irony! After all, it was the medical doctors who wrote "the letter" that got everyone else to change! I'm not sure that would work as I'm on U.S. Medicare with an "Advantage Plan" and if the medicare and/or insurance company records disagreed with the medical records it could result in bounced prescriptions and delayed payments. So my records, from Social Security, Medicare, Advantage Plan provider, medical facility, and pharmacy are now all "F." And, of course, my primary doctor, my endocrinologist, and any others I see routinely already know.

I was thinking more about mentioning it to any individual physician who might see me for a specialty or in an emergency room or somesuch.

Again, Thank You everyone!

Hugs,
Persephone.

[Sally24]

My GP knows since she is the one I mostly see for medical things. I think your doctor needs to know anything about you that can affect your health.

[Traci Elizabeth]

It depends, but a lot of doctors and dentists will ask what medication you take, and will want to know why you take certain medications.

I don't think Finastaride is hazardous to women; it's hazardous to fetuses.

It's funny this comes up now as the timing of this subject is fresh in my mind. If you look at the Finastaride websites, it shows that women can be prescribed it as well. I went to my endocrinologist last week and we were talking about my current dosage for Finastaride (as well as all the other HRT meds I take) and I specifically asked him if females can take it too and he said yes and that he has prescribed it for some of his female patients. I have a natal girlfriend who wants it to thicken her thinning hair.

From their website I quote. "...studies have shown that Propecia® is effective for many women with follicular sensitivity to androgens. Many doctors do prescribe it for women, but not without either careful birth control measures or assurance that the woman cannot become pregnant."

It can also help with:
→ a weak or interrupted urine flow
→ a feeling that the bladder is not completely empty
→ a need to pass urine more often (especially at night)
→ an urgent feeling that you must pass urine right away
→ a delay or hesitation when you start to urinate

Regardless of the above, ALWAYS consult your doctor BEFORE starting any medications. I know a lot of gals on here get their HRT by self-prescribing and purchasing them overseas. If you are one of those STOP. As others have stated, taking meds without your doctors knowledge can KILL you.

[Aprilrain]

I literally did have some ingrown toenails removed and though the doc did ask about my medications, it didn't seem necessary to go into detail about being trans. Maybe he worked it out maybe not. My GP knows and I told the DR who did my breast augmentation. I don't know if the dentist has worked it out or not, the hygienists always ask me if I'm pregnant before they do x-Rays so I guess not. For me It just depends.

[Nicole Erin]

As most of you know I have been doing this for 30+ years. In that time I have of course had my fair share of dealings with doctors and the like. Face it ladies, at some point you are going to have to spill the beans. Get over it. It is no big deal. Tell them, get your treatment, and move on.

The question here though - HOW to tell them?
I mean like if at the dentist, would you say, "I do have a cavity I wasn't born with"

[Dianne S]

dentist ... "I do have a cavity I wasn't born with"

ROTFL! But would you want it filled? Probably only if the dentist were good-looking. (Apologies in advance if this is too off-color for the forums...)