What Trans People Want Healthcare Professionals To Know feat.
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- Опубліковано 1 чер 2022
- You asked, they answered. I posed trans, nonbinary, and gender nonconforming people's questions to Dr. Alok Patel, MD and Registered Nurse Sheena Williams from @pbsvitals . Actually, for most of the video I just shared what we all WISH healthcare professionals like them understood about trans/nb/gnc people. It's less of a Q&A and more of an... A&A 😉
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→ 5 Years Later | FTM Transition Video Timeline
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Jackson Bird
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👋 I'm Jackson Bird and I make (hopefully) funny, (sometimes) educational videos for LGBTQ+ nerds like me - and the people in our lives that want to understand us better.
Here on JACKISNOTABIRD, you can find new videos (roughly) once a month sharing my experiences as a bisexual trans guy, answering questions about LGBTQ+ issues, exploring trans history, and sometimes showing what happens when you put weird stuff on a waffle iron.
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I totally get what they were saying about doctors admitting when they don't know stuff. I (ftm, 18) had a great experience with a doc when I went to the ER for stomach pain. I told the doc I was 3 weeks on T and he straight up went "yeah I don't think T would be related but honestly I don't know. I'm going to go research it." He went away, researched what he needed, and gave me the best advice he could. So respectful and honest
Exactly, seems no one knows as nothing like this has ever been done before in history. But there's def been cases of cross-sex hormones causing health issues. Hope you feel better
When I went to my pcp last year they had just added a question that asked about gender identity vs assigned gender in the system and when I said transmasc nonbinary the nurse said "im gunna level with you, I don't know what that means in relation to all the check boxes I have so I will read them off and you just stop me when I need to check it off" and i felt like that was a good way to handle the situation.
Theres a twitch streamer called Boba who worked in a clinic that dealt with a lot of trans healthcare before she became a full time streamer. And one of the things shes talked about is how she noticed that when new trans patients would come in, how obviously uncomfortable they would often be when she had to ask them for details like legal sex and pronouns. So she made up some laminated sheets that asked the questions they needed for their system, and they could be put on the reception desk and people could just point to the answers on the sheets, or write down their answers on a note pad so the questions didn't even have to be asked out loud and they didn't have to out themselves in the waiting room. That made me cry when I heard her describe it.
This is where she talks about it, but the whole clip is worth watching for some feels
ua-cam.com/video/Y6UEKO4SVFM/v-deo.html
I wanna do that 🥺
why would they ask personal questions out in the open waiting room? Code of ethics of most professionals states we have to maintain confidentiality. Where did that go?
One of the things I was hoping to be brought up in the conversation is how the _categories of_ biological sex is still a social construct that we used to reduce something that is on a spectrum to a binary (shout out to all of the intersex people).
It is an undeniable fact that the entire system of physiological characteristics has an impact on health risks and the efficacy of treatments, but I think we as a society could do better by describing more accurately _which specific physiological characteristics_ determine what risks and/or what effective treatment options a patient has. So rather than asking "what is your assigned sex at birth" they could ask "what kind of reproductive organs do you have?", or "do you have breasts?" or "what is your average testosterone level?". the value of that rephrasing of the question is obvious for trans people, but it doesn't just end there.
My last example also demonstrates the pandoras box that is "biological sex". Most people can't answer that question, because nobody ever checks. At best, they can make an educated guess, based solely on the category of biological sex the doctor assigned to them, which in turn is based on nothing but the shape of their genitals at birth. Who says they aren't intersex, who can have all kinds of permutations of physiological characteristics that aren't visible on the outside?
And what is intersex anyway? If I am correct, some "biological females" have higher testosterone levels than some "biological males". If being "of a sex" means you have either higher or lower levels of testosterone than "the other sex", does that make both of these categories of people "intersex"? But more pressingly: how does their statistically abnormal testosterone levels impact diagnosis in our hypothetical case?
And even people who perfectly fit the binary at birth can bump into issues: what if they - through whatever environmental factor - have had any of the characteristics typically associated to their assigned sex, changed? If a person used to have testicles, but lost one or both of them due to cancer, how does that impact our hypothetical case?
I would have loved to hear their take on this subject, and how/when medical research uses or discards the - in my humble opinion hopelessly outdated - binary in biological sex, and why.
Aaaaaaaaaaaaaall of this!
I doubt most people would be able to honestly answer the proposed questions. Unless an individual has done imaging studies, reproductive organs would be determined from assumptions dictated by the external genitalia. All females and males and intersex individuals have breast tissue. It is also unlikely for patients to know their average testosterone levels.
Freshly graduated med student here, I can indeed corroborate that modern medical education is starting to catch up when it comes to LGBTQ+ healthcare. We not only got a number of special lectures specifically pertaining to LGBTQ+ patients, as Dr. Patel mentioned, such as on sensitivity training with patient interactions, but we also touched upon special cases to consider in, say, a trans patient on HRT with regards to endocrine-related problems (like for instance, when learning about breast cancer screening, we also discussed the risks in AFAB trans males and AMAB trans females).
That said, I think there's still more improvement that could be made, since the majority of the time it felt more like a crash course on "LGBTQ+ 101" -- stuff that I already knew from my own online experience/research -- but that's not to say they were useless: there were plenty of classmates who gained a lot from the lessons when they hardly knew much to begin with, and I still learned quite a bit myself.
Thanks for the video! The takeaway I've gotten from this and from what others have told me is definitely to be open and transparent with patients about what you know and don't know, and to just try to be more mindful. Here's hoping the healthcare field as a whole continues to improve in this aspect. :)
Jackson, we enjoyed chatting with you! Thank you for sharing your personal experience, some of the barriers faced by the trans community, and how we can all lend our support. Also, thanks to your audience for all the great questions!
I am non binary. My partner of 30 years is cis and has a nickname. The doctor's office asked my partner's preferred name and has never used. I am so grateful that they don't know my dead name.
Great conversation to have! ☀️ I have a fantastic doctor I go to but I went to the ER once and quickly remembered that most of these hospital workers who went to school decades ago didn't get trans training from school or often from the hospital. I remember being in the ambulance with the paramedic who was asking me questions about my name and identity (he wasn't writing them down or anything, just asking and looking at the photo on my ID) and I couldn't help but think how, in a situation where I'm in distress in an ambulance, the curiosity of this paramedic is maybe just a bit inappropriate, but I also felt the urge to explain things to him while I was in the middle of aforementioned distress because I thought, if I don't do this, he might never learn about this at all.
As for prefered names bing different from legal names. My granddad's legal first name was Moses, but he was only ever known by his middle name Edwal, or more commonly Eddy. Sometimes when he was in a waiting room at the hospital a doctor or nurse would come in and ask if Moses was there and even grandad wouldn't respond because it just wasn't a name he was used to hearing. And one of my aunt's is known universally as May, but her legal name is June. She doesn't have the name May on any of her legal documents and no one can remember why she's called May. It's just what everyone has always called her since she was a baby. Neither of them are trans, they're just Welsh. And the welsh often have an idiosyncratic relationship with names :p
Yeah, whenever my deadname is called, someone has to remind me “oh, they might be calling for you” because I genuinely don’t register the connection with it being my name, since it’s not my name. It’s honestly created problems at airports and things when they’re trying to call me up to the desk if there’s a seat change. My last name is pronounced so horribly wrong by most people that it doesn’t even trigger the “oh someone is calling for me” response.
Thanks for the talk! We are a trans HRT specialty clinic in Mississippi (the only one in the state, actually). And we get calls allllll the time from other healthcare professionals seeking help on learning about trans care. We also get crazy people, too, but it's encouraging how many do reach out to us with an open mind and heart.
Note: I’m using the term “real name” to mean “preferred” name.
I wish all medical forms had pronouns and real name sections. But sometimes, I’ve put my real name (along with my deadname, as it’s my legal name for the moment) on forms, and some people have called my deadname at doctors’ offices and I’ve corrected them, saying my real name. Then, they’ve said “oh yeah, I saw that in there but ignored it.” It’s so strange.
Yikes, a lot of the medical industry don’t really care about trans people in general it sucks
This is great! Really interesting to hear from all sides. My doctor’s office recently had me fill out my forms again and there were new sections allowing me to elaborate on gender-related information that hadn’t been there last time and the front desk encouraged me to write things in if the multiple choice didn’t cover it. It felt like a relief to not have to initiate that coming out conversation or alternately have them continue to assume things like everyone else does.
I am a 63 year old nonbinary retired nurse.
We are lost if even people your age fall for that gender-ideology-cult.... 🙈🙉🙈🙉
@@eat.food.not.friends you realize that most cultures throughout time have recognized that more than 2 genders exist, right? That white colonial culture isn't the be all end all?
White colonial culture is a small and frankly bigoted part of the overall history of humanity that has historically enforced it's bigotry with violence.
Epic is awesome for an electronic health record. Our version used to have heavily gendered scripts, but now I am able to order gynecological tests for a man without some firewall going up. And their gender list is M, F, FTM, MTF, and OTH and autoscripts will correct the documentation where appropriate("adult" for "man"). Not perfect, it only enables caregivers who know what they are supposed to say and do to care for this person, it does not help ignorance or stupidity. Still...a start.
FTM and MTF aren’t separate genders
Fantastic conversation!! I learned so mcuh also got me thinking about trans/non binary/non confirming elders as I know a couple of those people and they shoudl be mentioned more in the trans topics
Very interesting video as someone who's interested in healthcare and is also trans :)
Edit: I'm also from the UK and I think things are quite bad here with trans healthcare to be honest, I remember when I first called my GP to ask to be referred to a gender clinic 2 years ago at 18 years old and my GP straight up told me to 'fix my autism' first, like how a GP can be that ignorant is quite disturbing to me lol but yeah I'm much happier now and I ended up getting a different GP after that cos I asked to see a different one
I'm sorry that GP said that to you. It was very dismissive and ignorant and just plain awful. I'm glad you were able to see a different GP who was able to help you instead, and that things are better for you now!
@@chrimar456 Aw thank you so much, I hope you are well too :)
The uk is indeed atrocious for trans people in the NHS. I got surgery for endo and terfs have been busy removing all gender neutral language they can, the NHS Digital lot themselves replied to our complaint that the sites refer only to women with a "we'll get to it" response. Mental healthcare is trash and a cpn's triage results drove a sui attempt, changing name and gender marker is a massive hassle and we're fiiiiiinally going to get the letter for changing passport a year after first trying to get it.
4:46 As a scribe using Epic, it seems super easy to change that.
Two weeks ago, one of our patients was coming up as a trans woman. It showed a little exclamation point, easy to see so you have medically relevant info. I told the doctor "oh hey, she's trans". The doctor had known her for years and was pretty certain she wasn't, especially considering one of the first lines in her note said she had a hysterectomy...
So I went into her demographics and just changed that (with permission, of course). She was not assigned male at birth, and is not a trans woman. I'm not sure who made that mistake, but it was a quick fix.
I believe names are just as simple. They'll come up with a "xyz" for a preferred name. And sometimes we'll get things like
*Jackson "Jackson Bird" Bird* . So I think someone went in by accident and put the full name as the preferred name
Edit: I recently tried to change a patient's name because the first letter was lower case. And I couldn't figure out how to do that. So yeah, doesn't seem as easy and gender...
Love this! Just a plug for PTWC's pro track- there is a medical track for Philly Trans Wellness Conference. While not all of the presenters are trans, many of us are (I'll be presenting on Gen Track this year and am both a therapist and trans person). So, if you're wanting to learn from your trans colleagues, come to PTWC!! It's in late July this year and 100% virtual. CEs are provided for several professions and it's very affordable for the Pro Track and completely free for the Gen Track!
My sister does psycho-biology (which is more of a research thing rather than specifically medical, though some people can go into medical masters afterwards), and as recent as two years ago she still had professors full on going 'yeah so being transgender is a mental illness, these people are delusional'. And this was in Amsterdam's progressive university (UvA). So I'm going to say we have a long way to go.
There's two universities in Amsterdam, and the other one, the more conservative Christian one (VU), has the Netherlands' main gender clinic, which is currently my only option for accessing transition related healthcare. They're very big on gatekeeping. They didn't believe in nonbinary people until a few years ago, which is why I didn't apply sooner. I have my first appointment in two weeks, after over three years on the waiting list. I'm scared. Wish me luck :)
Turns out I was right to be scared. Was conversion therapy. Am traumatized. Survived though.
@@ryn2844oh no!!😢 I'm so sorry to read that. I hope you find care somewhere else soon. Stay strong.
And that's why I am going to go to 'de vaart', recommended to me by my speech therapist. I first went to the youth 'clinic' in Groningen, but the only thing they would provide was gaslighting. Constantly hammering on the fact I am physically disabled therefore I wouldn't be able to do certain things, nevermind them never actually *helping* me. They were apparently infamous to my speech therapist for gaslighting autistic and otherwise disabled patients. Jokes on them I am both.
'Exercise more and more intensely'
Yes, because exercising is so fun and healthy with a binder. Then do it without a binder you say. Yeah absolutely not, that's detrimental to my mental health. And I *do* exercise near daily. I bike to school every single day, I go on long walks, I never use the car, etc. But *heavy* exercise is something I have always struggled with even before the tit dysphoria. And after a schoolday I am often glad to have gotten home due to just exhaustion. Yeah turns out I'm also hypermobile. So exercising more heavily can be damaging.
That's not even all. I mentioned to them I had an eating disorder. They really focused in on that. I told them I was eating healthy, lots of vegetables. Just no fruit, sensory issues and trauma caused by school make it really difficult for me to even try eating fruit. I told them, at this moment I am stable enough to deal with it. I am not recovered, I will never be, I am always recovering. Even now, after a stressful week of midterms I relapsed into some of the patterns. It is not something inherent to my dysphoria. They begged to differ. Telling me i needed to eat healthy (already was and am), exercise more (at the height of my ed I was constantly exhausting myself with exercise), try and 'watch my weight' (for over 6 years I have not known my weight since it's one of ny biggest triggers), oh and of course they didn't give any tips on how I should make those improvements to my life, only told me what I was doing badly and that I needed to change it.
Anyway, long rant about my experience with the Groningen youth 'clinic'
The speech therapist btw being 'logopedie beetsterzwaag'
She specialises in transgender voice therapy, both for lowering the voice (without T) and for highering(?) the voice. She can be a bit much sometimes but she's incredibly accepting and accommodating.
@@theokooistra5856 Thanks for sharing your story. I can't say I'm surprised to hear they focused in on your autism and eating disorder, because I know what they're like, but yeah no that's sh!t and I wish you didn't have to go through that.
For me it was definitely also my autism that got them to treat me the way they did. They did not seem to believe I was capable of independent intelligent thought, or that I was 'developed' enough to count as an adult, despite the fact that I was 28.
I'd heard from friends that it would be bad, but I did not in a million years expect it to be THIS bad. I guess I just didn't expect a so-called expert to laugh in my face when I told him that I thought I was born trans, and then tell me that something must have happened to me to make me this way, because being born trans was impossible. He said that if he found out what the cause for my trans-ness was, then he would use it to 'challenge' my transgender identity, he would solve my 'confusion' about my gender identity, and he would help me reach an 'alternative outcome' (=no transition), because obviously that would be better than 'damaging a healthy body', because I would surely regret that, because of course, as an aut!stic person, I was more easily influenced, less cognitively developed, and less capable of distinguishing reality from my supposed 'obsession' with gender.
He had a long list of 'hypotheses' for what could've caused me to 'struggle with dysphoria' (because he'd never call people 'transgender', no no, people just 'struggled with dysphoria', and he could help them overcome it if he helped them understand the cause.) Autism was involved in most of his hypotheses for me, but not all of them. It's kind of pointless to list them all here, because you can just look up Terf/Gensect leaflets that train therapists to perform 'Gender exploratory therapy' (=reparative conversion therapy for trans people), or read Abigail Shrier's 'Irreversible Damage' and you'll find most of his 'hypotheses' in there. I went through nine months of this type of interrogation/me attempting (and failing) to prove that nothing had made me this way and that I didn't need to be fixed.
I've been a straight A student my whole life, I mask well, and I'm late diagnosed, so yeah, if I wasn't safe from this ableism, then no aut!stic person is. I shouldn't have made the choice to get diagnosed. I should've lied to them. I'm terrible at lying, but I still think the result wouldn't have been as disastrous as telling the truth was.
His name is Roy van Vlerken. Avoid at all costs.
Anyways, I got green light to transition in the end and I'm doing EMDR therapy soon to hopefully lessen the PTSD they gave me (though my new therapists don't really seem to believe yet that what I went through at the VUmc was conversion therapy, and therapists not believing me about my own experiences is obviously pretty f*cking triggering right now, so I'm a lil scared but oh well we'll see how it goes.) So yeah I guess on the grand scale, all's well that ends well :)
Just power on through. They can stall you, but they can't stop you indefinitely, always keep that in mind. You'll get there. Just keep going.
I just graduated as a medical assistant this year (in america, this is generally the person who calls you back, asks you questions, and gets your vitals before the doctor comes in) and they taught me LITERALLY NOTHING outside of the fact that trans people exist. Even when we were taught about hormones and the reasons people may need to take them, trans people werent mentioned a single time.
1000% train reception and desk staff! Its always a nightmare
I'm an English med student who will graduate in a year's time, and I think generally it's pretty different over here compared to what's been said about the US, unfortunately. I have had zero training about trans healthcare- in fact, I've had zero training on LGBTQ+ healthcare in general in medical school! I imagine the only way you'd learn about LGBTQ+ healthcare in med school would be if your university has medical societies (created and led by the students) that were formed specifically to disseminate that knowledge. Otherwise, the onus is on the students to find out that information from external sources (eg social media)- but most don't, I think, because they don't even realise that's something they should do. It's a disgrace and a massive disservice to patients. I hope things change and such training becomes mandated within the medical school curriculum.
People don't realise the NHS actually had to be sued by trans people to open gender clinics, and ever since those clinics have been areas of abuse and defunding. The US doesn't have the exact same history there and despite healthcare being inaccessible due to expense, its more decentralised nature allows things like informed consent and huge variety in standards. Which of course were still atrocious in the past but right now, insurance companies are the big concern for trans people I think. And that's the case for some European countries as well - in Germany, waiting lists aren't such a problem but insurance companies require people go through therapy with the purpose of making sure they want to transition before starting anything. And that may sound neutral, but this is a sort of conversion therapy as the therapist by definition will be challenging your gender identity.
First thing I mention when an LGBT person walks into my office, before any questions or explanations happen; I tell them that this is a safe place. I immediately see them relax a bit and make eye contact. That, in my opinion, is the first move to make.
Here in Australia they put Miss / Mrs /Ms / Mr on hospital admission bracelets. Even if the patient puts Mx on their admin form.
I'm a medical professional as well and had no training whatsoever about LGBT. Luckily, I'm gay so I'm aware compared to some of my straight colleagues. However, I'm closeted at work as there is a lot of judgemental thinking and prejudice. It's not just about having a course on learning about pronouns, it's about breaking down the myths and judgements. That takes much longer then simply learning to be respectful because it's your job. I'm still hearing negative comments from colleagues about anything LGBT. We do have to review past medical files so we can do proper health follow-up. It's about support, it starts with the type of person who's supporting you. There is sometimes a discomfort treating someone who makes us uncomfortable. So the more knowledge we have about LGBT, the easier it is to treat them. Certain diseases are relevant to gender and related to DNA so it is important to address birth gender. We're treating the potential issues according to the body's response, not necessarily the gender you've become as the transition doesn't change every aspect of your anatomy. Misgendering is not meant to insult but rather to understand your symptoms and potential remedies. 😉
This is wonderful and wholesome! I think we need a LOT more conversations and "getting to know us" type of interviews.
Haha when I had to get my gp to refer me to a gender clinic (3 years ago) she was also like 'Well, I know nothing. I googled it. But sure, I'll refer you to that place you sent me a link to.'
Honestly to me it's just as well. That's all I needed from her anyways.
Oh and she updated my name in the system when I told her my new name and I didn't even have to ask her to do that. No pronoun changes though. So all in all decent score lol.
Yeah, I just got a new pcp, and she's super excited to help me with all my trans stuff, shes printed me out a ton of information on doctors in yhe area who do gender-affirming care- and she still calls uses feminine pronouns for me. I wish I wasnt too scared to correct her, lol.
Great video! Thank you so much to Jackson for asking our questions and to the lovely guests for listening and educating!
I love this, thank you so much for posting this and educating us so frequently!
God bless you all! 😁 Thanks especially to the guests!
I think it‘s a good thing to add a field of preferred name. But I hope it could get further to actually have the fields be „name (use to adress the patient)“ and „legal name“.
It is kind of frustrating how even the people who want to learn and want to say they are good with trans people will still talk over us and assume things. Like, you really don't need to know what gender someone was assigned at birth if you just need to know if they have or have had a uterus you can ask that.
yea the dental thing was overkill as well lol.
I really like the nurse in this question period, however the vitamin D thing IDK, working in a hospital that barely cares if half the patients are dying, I doubt people give a damn about vitamin levels in a hospital setting. The food in our hospital is crap and the area I live in most people are low in vitamin D as it's an area with long winters.
That said like Jackson said if you're on T your body would operate the same as a male's in term of vitamin D/ bone health thats why they say you are advised not to come off T post hysto as your bone health would suffer.
I guess in the states hospitals care more? lol.
Sorry I’ve got a question? Do you believe trans people should be able to choose their gendered care setting(either the female or male wards) please
I'm in nursing school and we've definitely had some Transgender patients in our modules! I'm watching this actually because I'm doing a cultural presentation ion transgender.
Great show
Accountability is key; if more health care professionals call in and challenge their co-workers when things get unsafe and or transphobic, call them in. Support like that moves the needle forward. At the end of the day Cis people will listen best to other Cis people.
what a great conversation!
Was interesting to hear about older ppl and pronouns as I had just run into it. Since I am in my 50s decided to go on a zoom call for an older lgbt group. As opposed to what I am used to elsewhere nobody other than me listed pronouns and am guessing I was the only trans person there. One person mentioned someone else used they pronouns and actually heard the same stuff about they from that group as other cisses. Then later they had no idea what to do when I said I use any pronouns.
First comment!!!
Okey.... You looked like a hobbit between them two.... 🧙♂️🧚♂️🧝🧚♀️
Luke 13:1-5
New Living Translation
A Call to Repentance
13 About this time Jesus was informed that Pilate had murdered some people from Galilee as they were offering sacrifices at the Temple. 2 “Do you think those Galileans were worse sinners than all the other people from Galilee?” Jesus asked. “Is that why they suffered? 3 Not at all! And you will perish, too, unless you repent of your sins and turn to God. 4 And what about the eighteen people who died when the tower in Siloam fell on them? Were they the worst sinners in Jerusalem? 5 No, and I tell you again that unless you repent, you will perish, too.”
The only thing Healthcare Professionals do need to know, is their scientific field, and not to respect people's delusions and fake pronouns that so openly contradict their science.
I disagree with the new Healthcare that they are signing!!! My wife has been a diabetic for years and needs a surgery done on her stomach to help her lose weight but since she isn't that big of a woman they will not give it to her unfortunately. Now the new insurance that they offer them to get sex charges and shit that's totally BULLSHIT!!!! I don't know what makes them any different then my wife and her needing the surgery or not only her kids and grown ups that need stuff and these doctors will nor do it due to the insurance coverage they have!!! Girl guy I don't care what they want to make themselves but I know if they want to change their style they too should have to pay out of pocket for those things they aren't any special then anyone else bottom line!!!!
there is only two genders you can identify to be with male or female enough of these childish games.