Visit to the doctors

[Breeze]

My Husband went to see a doctor today to discuss how he was feeling in regard to some gender issues that he is having.


He phoned up the surgery and requested that he see a female doctor as he was sure that talking to a male doctor would be almost impossible for him.
Well his request was granted and off he went to the doctors. ( I was at work) When he got there he said it was obvious that she was a trainee and very young. He told her about his cross dressing and that he was having a hard time with gender issues and her face looked puzzled and he even thought he saw her smirk at him.

He said that it was obvious that she had not been trained or even had a patient in front of her with this type of complaint. She asked him a few questions which he thought were totally irrelevant and hurried him out the door saying she would arrange some counselling for him and that was that.

I believe that it is now 2013 and doctors should have more understanding of gender issues regardless of their age.

[Rogina B]

There is a saying used in Trinidad and it goes like this.."You don't go looking for a gold nugget at the blacksmith's shop and you don't go to the jeweler for a piece of black iron"...Not sure where you are and where you went...

[Ressie]

Makes sense as I don't see this as a medical issue. Is there more to the story that would make me see this differently?

[Rachel Morley]

I'm mean no malice toward your husband, but IMHO going to a general practice medical doctor (GP) to talk about gender issues and how you are feeling about them is almost a waste of time. For these folks it's about giving you a prescription to keep you happy not actually fix something like this. At least she gave you a referral to a counselor .. although don't assume that a "standard counselor" will be trained in understanding gender issues, CDing or GID, as often they aren't or only have had limited experience. Try to find you own counselor that you know already works with TG people. Your local LGBT support group might be able to recommend one.

[Leona]

Hmmm, interesting. On the one hand, ANY doctor needs to be familiar with gender issues to some extent. A surgeon presented with a man who needs a bellybutton hernia dealt with that sees a vagina, fallopian tubes, and a uterus in the ultrasound needs to know that there are issues, like the threat of blood clots during surgery from taking hormones (dunno if that's something FTM's deal with, to be honest).

On the other hand, picking a random female surgeon probably isn't the best way to go about finding someone to talk to about what I assume are procedures related to transitioning. Those procedures are performed by specialists, and I believe you have to go through a gender oriented counselor before you even get to talk to the surgeon.

Your GP should know enough to be able to make a quick and easy referral just as easily as s/he would be able to do so for cancer screening, depression, and any of myriads of situations GPs encounter every day. Why would a GP be able to watch for a rare medical condition and have no training in gender issues?

This is a known problem, to be honest. There was a trans man here in Austin that was injured somehow (I don't remember the whole story), and when the EMT's came, they refused to help him, claiming they knew nothing of his anatomy. What's so hard to understand? Keep that man alive! That man has a vagina and is taking hormones, why do you not know how to deal with this? He wasn't even in a life-threatening situation. I believe he ended up suing for a ton of money, but the injuries suffered from the wait to find someone who could deal with his anatomy are now lifelong, but if the EMT's had dealt with it properly, those injuries would be fully recovered by now.

So, yes, there's a severe lack of knowledge amongst the very people who should have it. No doubt about it. Also, your husband went picking the wrong person to talk to anyway, but the person he did talk to should have known enough to receive him professionally and refer him to an appropriate specialist, and she clearly did not have that knowledge.

[PaulaQ]

A surgeon presented with a man who needs a bellybutton hernia dealt with that sees a vagina, fallopian tubes, and a uterus in the ultrasound needs to know that there are issues, like the threat of blood clots during surgery from taking hormones (dunno if that's something FTM's deal with, to be honest).

This is absolutely a risk for FtM's, and often quite a serious one. I have a friend who's been hospitalized because of collapsing from hyper tension / blood clots from taking testosterone. He's doing better with blood thinners & meds for his BP, but he's been told he risks his life to do HRT.


Your GP should know enough to be able to make a quick and easy referral just as easily as s/he would be able to do so for cancer screening, depression, and any of myriads of situations GPs encounter every day. Why would a GP be able to watch for a rare medical condition and have no training in gender issues?

I'll answer this question really bluntly. I know you are trying to make the same point I'm about to make, but it really needs to be said much more strongly:

The AMA doesn't give a shit about transgender people. Indeed, it abrogates it's oath sworn obligation to help the sick in a grotesque and inexcusable manner when it comes to us, in my experience and in my opinion. Individual doctors are very much the exception to this rule.

And understand this very clearly - if you think that by and large docs don't care about TS people even though they have products they can sell us, then how much less, in general do they care about CDs? They got nothin to sell you, and most of you aren't in danger, despite the discomfort you might feel. So they REALLY don't care about CDs.

My GP is exceptional, and does care, and has a small amount of experience, mostly by accident, and because he cares about his patients and dumped his personal prejudices on entering med school. He is sympathetic, honest, helpful - and was completely unable to find specialists who wanted to help me. He tried - he just doesn't know the secret handshake to find specialists in transgender.

Believe me - you will have no trouble finding horror stories about physicians - basically good, competent ones, who DO NOT WANT to treat trans patients.

Sorry this is so negative, but as best I can tell, it is the reality, so finding a doc who cares about you is MUCH more important than their gender.

[ImAlexis]

I believe that it is now 2013 and doctors should have more understanding of gender issues regardless of their age.


Shrug.

At my school we do get some training and we have a LGBT panel come in that we can bombard with questions during second year (rotations are 3rd and 4th year). It's not much and a good chunk aren't really paying attention for a variety of reasons.

Additionally, remember, some people are inconsiderate regardless of their profession and specialty. Furthermore (assuming by "trainee" you mean medical student and not a resident physician), it might have been the first time she has worked with someone with gender issues (as a 4th year, I haven't had any patients that I've known to be LGBT, but I've had limited outpatient experience and it's really not a concern for inpatients), and moving from theory to practice can present problems from time to time. This is also assuming that the student wasn't 'phoning in' (so to say) a rotation in a field that she had no interest in. Personally, I hated surgery clinic during my month on surgery. I'm more of an inpatient person anyways.

[Laura912]

Based on the OP's wording, the situation sounds like the British medical system and most likely the physician was a resident. If a resident, it may have been her first time encounter with gender issues. As a resident, one is a little insecure but trying hard to learn. Couple the insecurity with lack of knowledge about an uncommon problem, and the awkwardness is understandable. In the frequency distribution of illnesses in the world, gender issues are lower frequency...not saying they should be ignored for that reason but trying to put a young trainee's viewpoint into perspective. Medical schools are making am increased effort to train awareness of gender issues but it will take time to catch up to the seasoned practitioner. As with any other thing in life, pick the person, whether it be carpenter, mechanic, dentist, or doctor, carefully because you know all are not equally experienced.

[arbon]

I don't understand why he would go to a surgeon instead of his primary doctor? or better yet a mental health professional.
What was the purpose of the visit? what did he want from it? medication for anxiety or depression caused be the gender issues? hormones? start plans for transition?

No, most doctors really don't know much about it. And a lot of doctors are still prejudice against the ts community - in the state where I live good luck finding an endocrinologist , their moto is "we don't help people like you!"

I just got a new doctor that is local, a family health doctor, as I have been trying to get a local doctor to treat me. But I went prepared knowing what I need and documentation about treating transsexuals for him to look over. He agreed despite not having any experience with transsexuals. So he gets to learn with me.
However I'm sure if I had shown up as a guy saying he had gender issues with no clear idea what he needed, the doctor would have reacted like other doctors I had approached a few years ago looking for help, he would not have had a clue how to help me beyond telling me to see a mental health professional and maybe giving me some antidepressants.

[Beverley Sims]

Doctors are like everyone else, they have to start somewhere.
She did the right thing by arranging counseling for you.

Just reading what Arbon has said, reinforces what I have said.
To treat you doctors need input, they are not mind readers.