I’ve been saying, “I was born without a uterus”, which so far seems to answer honestly without directly outing myself as trans.
Any thoughts on how to best navigate this? Ideally without disclosing I’m trans 😅
I’ve been saying, “I was born without a uterus”, which so far seems to answer honestly without directly outing myself as trans.
Any thoughts on how to best navigate this? Ideally without disclosing I’m trans 😅
Nursing student here - probably a solid half of the disease processes we study have “male/female sex” listed as a risk factor. A good chunk of lab values have different ranges for male vs female.
That said, I have no idea if those are intrinsic to the sex, or to the hormone levels, so HRT might completely negate or flip those differences.
I’d run this by your HRT doc. They’d have the best understanding on what your transition is or isn’t doing on a physiological level and which other docs would be able to provide better care if they know you’re trans.
Generally it’s best not to hide things from your doc, but if revealing that info is being treated as “I’m male” then that’s not doing you any favors, since your physiology is not that of a male. And again pointing to the HRT doc, they’d be able to help you articulate that distinction to other docs.
You’ve actually hit on a major reason why disclosing isn’t as simple as you think it is.
Sure, a good chunk of values have different ranges for male vs female, but the normal ranges for cis folk and trans folk are not the same.
Hormones are the obvious example, but there are large parts of the body that respond to the endocrine profile that we have after hormone replacement. Heart attack symptoms, body fat percentages, resting heart rate, blood oxygen levels, iron levels etc, are all shaped by our hormone profile, not the hormone profiles of cis folk.
It entirely depends on the specific medical issue, but in general, it’s the latter more often than the former.
It’s not always that simple. On top of the fact that it’s not realistic to see the HRT doc every time you have an unrelated medical issue, the other aspect is, as you’re probably aware, sometimes, the patient knows more about their health care needs than the treating doctor, because we need to become experts in a way that a GP does not. If your doctor isn’t a specialist in trans care, they’re just as likely to give you conservative, incorrect information that was drafted in a time when trans health care even less understood than it is now.
As you’re a nursing student, I want to give you some advice. When you are dealing with a patient that isn’t “new” to their situation, whether it’s trans health care, or long term illness etc, you need to allow for the fact that the patient likely has a lot of lived expertise in dealing with their situation, and broad, general advice is rarely going to be useful to them.
Not the first time you’ve schooled me - I love seeing your posts!
Thank you, and keep the insight coming. Nursing school doesn’t cover transgender care hardly at all, so a good chunk of my education so far on that topic has come from people like you!
Can I recommend giving this a read? It’s a great resource for getting a decent understanding of some trans stuff. Covers a lot of what we feel and go through, and also the effects of hormones and such. There’s a chapter on intersex conditions also. Lots of good stuff!
Added to my nursing bookmarks. I won’t have time to do a deep dive on anytihng other than coursework for the next few months, but that looks like a great resource! Thank you!
Knowing biology, I’m sure it’s complicated and any generalization will be false. For example, there might be genetic conditions that derive from having two X chromosomes that we could argue are intrinsic to the sex (or more accurately, intrinsic to that karyotype), but for the most part my understanding is that differences relevant to lab ranges are mostly mediated by hormones, so I use female ranges.
Either way, my PCP seemed to indicate I shouldn’t disclose trans status but that the one exception was that I eventually need to find someone for prostate exams once I hit that age (if I hit that age, I guess). The endo that prescribes my HRT has never mentioned whether I should disclose or when to.
I should say, even when my medical chart was shared across hospital systems and my gender dysphoria was listed in my chart, the ER doctors didn’t seem to do uptake or change the way they treated me, even when I walked through my HRT and explained I couldn’t be pregnant. They still thought I was a cis woman and asked if I could be pregnant - I think people mostly just operate based on what they see, and it’s a shock when you say you are trans. It creates an extreme chilling effect sometimes, people stop meeting your eyes, or even interacting (sometimes interacting through a third party instead, like a cis family member). I’ve even talked to a neurologist through the details of my vaginoplasty and he didn’t seem to do uptake that I was trans. Unless I say the words, they just won’t put the dots together. (Meanwhile a trans woman at Sephora’s will clock me from across the store.)
Sounds like you’ve already had the conversation I was encouraging if your PCP said that.
Hormones are pretty wild. The more I study them the more I understand that what I do know is barely a scratch on the tip of the iceberg, so I’d caution against making an assumption one way or another without bouncing it off a doc who specializes in that stuff.
I would guess you’re correct about the ranges, but my confidence in that guess is fairly low due to how insanely powerful hormones are.
Oh 100%. I’ve been a surgical tech for about a decade, and have seen how people get tunnel-visioned. That’s actually one of the reasons I want to switch to nursing, since I’ve caught myself kind of flying on autopilot, and then when some case deviates from the norm, I still do things like open the all the usual supplies, some of which may not be needed this time, so it’s just waste. It’s time to step out of my comfort zone. Anyway, nurses and docs do the same shit after their duties become routinized for too long.
That is fucked up. I don’t know where you’re getting care, but your team absolutely knows better. Even if you’re that rare break from their routine… and in all fairness, you probably are - in that decade I’ve been a tech, I’ve only ever had like three patients I’ve known were trans. But like Ada mentioned, one of the best sources of info in those cases are the patients themselves. They should be treating you the same as any other patient, both medically and socially. Some curiosity is expected - your team should want to get to know you, but standoffish shit like you described is a red flag that merits correction. Don’t be afraid to call that shit out in things like patient surveys if you have the energy to fight in that battle - they need some better training at bare minimum.