What are the medical rules regarding gender-variant patients?

[Nicole Erin]

If this sounds hateful or rude or whatever, that is not the intention. I know some of this are arguments the bigots might use. I am just trying to gather facts. And, I am TG. I am not some man or woman who is so insecure about my gender that I look to bash others. Anyways...

Today I went to donate plasma. A couple months ago I was in the hospital getting cellulitis treated. I have no clue HOW I caught that but whatever. A few weeks later i had a follow-up appt for the cellulitis.

Anyways, on my D.L. it has an "M" for sex. I had my name years ago changed to something distinctly female. However, I haven't had any surgeries, therapy, fancy papers, or any of that stuff that some TS do, specifically the gender marker on the I.D. I do not even know what the rule is for that in Indiana, nor do I care much. I present as a woman best I can, I am sure most people figure it out pretty quick, and having some piece of ID saying I am one or the other isn't going to help me "pass" anyways.

With the plasma donation, doctor visit, and the hospital though - on their paperwork I am listed as female. That is great of course, but with my semi-obvious trannyness and gender marker saying M, do doctors and medical professionals just list me as female based on my presentation and trying to avoid a discrimination suit? I tell you the most awkward part is being asked questions about pregnancy and when my last menstrual cycle was. In none of these three cases was i asked about gender.

Alright so in society, work, whatever - yeah if someone is presenting as a certain gender, the polite thing to do is treat them as such. But in a medical setting, wouldn't it be better for the patient, from a medical standpoint to recognize a patient as their birth gender? What if something serious came up where the patient HAD to be medically treated as birth gender?

Or, does it all go back to recognizing their preferred gender and trying to avoid a discrimination suit?

[pamela7]

I suspect it is variable depending upon local law and admin practices. I also don't believe "the system" has yet learned due sensitivity.

I'll give my own example. With my legal name change and my referral acceptance by the NHS (UK), I received a letter from the central register with a new NHS number and me listed as female- wonderful. But the next day I receive a letter telling that I "will no longer be receiving invitations for cervical screenings because I do not have a cervix". As i'd never received an invite before, obviously, and as they must have known I was therefore transgender, i felt assaulted by the tone of the letter. There was no need for them to send me such a letter. I realise this is mostly people just doing their jobs, and trying to avoid causing offense, and so I'd say there are only the rules we get the system to adopt by our own local pressure through letters and awareness presentations.

xxx Pam

[Pat]

In the US, medical records are supposed to be based on the information you fill out on your form when you visit the office. You don't mention filling out forms, but I rarely see a doctor for the first time without having the receptionist hand me one to fill in. If you're dealing with a larger bureaucracy like the VA or Medicare they have centralized records, but again, those records are supposed to be based on the forms you filled in. If you have private insurance, then you get the forms to fill in and they must match the insurance company's records for payment to be issued.


What if something serious came up where the patient HAD to be medically treated as birth gender?

Again, I can only speak for the US, but the standard is that you are treated for whatever is wrong with you and the details are worked out later. Savvy places are starting to understand that there are some women out there who need prostate exams and some men who need mammograms. ;)

[grace7777]

Now that my drivers license has an "F" for sex I have been filling medical paper work identifying myself as a female. At the place I am currently getting treated medically I did ask the trans coordinator how I should list myself and she said to put down female since I am legally female.

The physicians and nurse practitioners who have treated me know that I am a trans woman and not a natal woman. For people who need to know this fact I do let them know.

As to questions on last menstrual cycle I just leave it blank and answer no on pregnancy.

[Mirya]

As Pat mentioned, when you filled out your forms and paperwork at the doctors office, plasma donation location, and hospital, did you check the box for female or male? If you checked female, it would make sense that you're listed as female, right?

[Nicole Erin]

In all those cases I do not even remember having the M or F question come up. If so, I would not remember what I even checked.

[Leanne2]

Several years ago my GP doctor referred me to a dermatologist to check out a spot on my back. I went to the appointment enfem and was given a clipboard and form in the waiting room to fill out. I left the male/female question blank. Soon I was called into the examination room where the nurse asked me more questions and took my picture. She told me that they take everyone's picture on their first visit. After looking at my spot I was asked to schedule a biopsy appointment. On checkout the secretary explained how I could access my records online. Later, back home I pulled up the report of my visit and smiled when I saw that I was listed as female.....................Leanne