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Do you have to let other doctors know when post-op?

Started by makipu, February 11, 2015, 09:24:39 AM

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makipu

After you have any gender reassignment surgery, do you have to actually tell other doctors (non gender related) saying you did? They usually ask in some forms.  Even though it may be confidential, it's basically outing you to someone else new isn't it?  I was wondering if there are those who doen't mention to the doctors. I personally wouldn't want to because I don't want anyone knowing my underlying condition.
I am male because I say so and nothing more.
I don't have to look or act like one therefore.
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Zumbagirl

My endo and my primary care doctor both know of my surgery. My regular doctor freely admitted that he lacks understanding of people  such as myself. I only go to my regular DR for specific medical needs. I'm not exactly a sexual tyrannosaur so I don't feel that I need to see a gynecologist just to get a rise out of saying I had a sex change.
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suzifrommd

They usually have a form that asks me my sex and has only two possible answers, male and female, so I get stuck right there, since I have characteristics of both males and females. I don't presume to know what will or won't be important to a doctor and I want accurate care, so I generally let them know.

It is a violation of federal law, in the U.S. at least, to disclose medical records, so I'm not too worried about being outed.
Have you read my short story The Eve of Triumph?
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Muffinheart

I'm the first post op my family physician has ever had, and she knows very little, but eager to learn.
Two months after surgery, I went to see her. I was nervous as I hadn't shown the new vag to anyone.
She looked at it, and one word summed it up: remarkable.
She was impressed with the look.
Now I don't know if a doc can tell immediately, but any doctor will ask female patients at some point to do a Pap smear. Well, you need a cervix for that.
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makipu

I meant it more like on some forms they ask "Have you had any type of surgery?" and they have a list of common surgeries as well as an "Other" selection or the doctors ask themselves.  I am talking about any doctors/ specialists/etc.     For example, I wouldn't want to say 'I had a mastectomy' or 'hysterectomy' because they will surely ask more about it which will out my condition...  About pap smears, can't the patient refuse it?
I am male because I say so and nothing more.
I don't have to look or act like one therefore.
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Jenna Marie

I prefer to personally, because I think the ideal situation is to let your medical providers have all the facts.

That said, even I didn't go into it when I wound up in an ER with a stomach bug... so I'll give you the trick I used there. :) I said I was "in surgical menopause," meaning my gonads had been removed and I needed HRT. Which is 100% true, it just evades the question of which gonads I had before the surgeon took them out! Physically, I'm more or less indistinguishable from a cis woman who had a hysterectomy (no cervix and therefore no need for a Pap smear, surgically manipulated vaginal canal, the body fat/breasts/hormone balance expected of a woman) in most instances, though an X-ray might (or might not) show some apparent differences.
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sam1234


It is a violation of federal law, in the U.S. at least, to disclose medical records, so I'm not too worried about being outed.
[/quote]

Medical records are confidential. Staff aren't always and gossip does occur.

I'll tell a Dr. if I think it will be needed information or they are going to be doing a full exam. I always tell the Dr. if I wind up in the ER. Kind of a "need to know" basis.

Sam1234
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ThePhoenix

Quote from: makipu on February 11, 2015, 09:24:39 AM
After you have any gender reassignment surgery, do you have to actually tell other doctors (non gender related) saying you did? They usually ask in some forms.  Even though it may be confidential, it's basically outing you to someone else new isn't it?  I was wondering if there are those who doen't mention to the doctors. I personally wouldn't want to because I don't want anyone knowing my underlying condition.

The short answer is, "it depends."

The last time I went and saw a doctor (aside from routine follow up with my HRT doctor), it was because I had a piece of glass stuck in my foot that I couldn't get out and it was painful to walk on it.  I didn't say anything about anything of any kind related to being trans* because  it's pretty obvious that "can you get this glass shard out of my foot?" has nothing to do with anything related to being trans*. 

But unless it is that obviously irrelevant, I usually mention it.  Complete information can only help them provide better care.
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ImagineKate

I tell my doctors everything about my body. They need to know everything. They are not going to disclose. They would be breaking the law.
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kelly_aus

Just be aware, that if you don't disclose and have some kind serious medical issue, you may find that the doctors you never told are given a free pass on liability.. Which means no compensation..

And no, it doesn't have to be a related issue - the lack of disclosure is enough...
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Jessica Merriman

For proper medical care, yes you do. Like Kelly mentioned if you do not disclose and something goes wrong YOU will have to deal with it with no financial compensation.
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ThePhoenix

Quote from: kelly_aus on February 11, 2015, 04:32:06 PM
Just be aware, that if you don't disclose and have some kind serious medical issue, you may find that the doctors you never told are given a free pass on liability.. Which means no compensation..

And no, it doesn't have to be a related issue - the lack of disclosure is enough...

Quote from: Jessica Merriman on February 11, 2015, 04:39:29 PM
For proper medical care, yes you do. Like Kelly mentioned if you do not disclose and something goes wrong YOU will have to deal with it with no financial compensation.

With respect, this would appear to be an incorrect understanding of law.  It's like saying that you are at fault for a car wreck because you forgot to turn off the oven at home.  Yes, it's bad to leave the oven on.  But it's irrelevant to the car wreck.  Now if the issue was your house burning down, then you might indeed be at fault for that because you forgot to turn off the oven.  And you might have a hard time recovering from your insurance carrier.  That's because the oven being left on may have been related to your house burning down, but it has nothing to do with the car wreck.

Kelly and Jessica appear to be discussing tort liability for medical malpractice.  Basically malpractice is negligence in providing professional services.  An overly simplistic, non-legalistic explanation of legal malpractice is that the doctor messed up, you were harmed as a result, and the doctor (or the doctor's liability insurance carrier) must compensate you.  But if you helped make the mistake happen, then you would be partly or wholly to blame and you would not be allowed to recover as a result.

So if you wholly or partly caused your injury by failing to disclose something, AND YOUR FAILURE TO DISCLOSE CONTRIBUTED TO YOUR INJURY, then you may be barred in whole or in part from recovering.  The specifics of how that would shake out will vary from state to state depending on concepts of comparative or contributory fault that we really don't need to discuss here.

For example, lets say that I have an infected ingrown toenail.  If I failed to disclose that I had previously had ingrown toenails surgically operated on, the doctor chose a treatment he would not have chosen if he had known about the past surgery, and I lost a toe as a result then my failure to disclose the information might bar me from recovering for malpractice in whole or in part.  That might be true even if the doctor asked me about something, I failed to disclose because I thought it was irrelevant, and it turned out to affect the doctor's treatment decisions because the doctor thought it was relevant.  For example, being on HRT might not seem relevant, but it actually might be relevant because some of the treatments for ingrown toenails do involve, for example, surgery.  Being on estrogen can affect blood clotting, so knowing about HRT might affect the doctor's decision on whether to perform surgery or do anything else that would involve bleeding.

Now let's say that I'm there for the situation I actually was: removing a foreign object that was stuck in my foot.  The configuration of my genitals and having had or not had SRS (or anything else having to do with my private parts) is absolutely irrelevant to the fact that there was a glass shard in my foot.  If, for example, the doctor was making an incision to remove the glass and he slipped with the knife and cut my toe off, then my failure to disclose information related to the status of my genitals did absolutely nothing to cause my injury.  I would have no fault for it.  The fault would lie solely with the doctor for slipping with the scalpel and cutting off my toes, and so would the liability. 

Now, medical malpractice law is not my specialty.  So if Kelly or Jessica has a contrary legal citation, I'd be very interested in knowing about it.  I do note that Kelly is in Australia, so things might be different there.  But this is a basic, law school level analysis of the tort issues here and, barring a few details, it should be basically correct in any legal system descended from the UK's common law system.

So, as a practical matter, what does this mean?  Answering questions truthfully is always the safest course of action.  But if you ignore a completely irrelevant question, you should be fine as far as ability to recover if your doctor commits malpractice.  Provided, of course, that it truly is irrelevant.  You may not be qualified to decide if it is irrelevant, which brings us back to the fact that truthful answers to questions are always best.  But always consult with an attorney licensed in your jurisdiction to get a definitive answer to your specific circumstances.
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mac1

Quote from: suzifrommd on February 11, 2015, 09:55:59 AM
.........................

It is a violation of federal law, in the U.S. at least, to disclose medical records, so I'm not too worried about being outed.
Believe that all you want. However, medical records are rapidly being computerized and combined in national medical records databases.
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AnonyMs

Quote from: suzifrommd on February 11, 2015, 09:55:59 AM
It is a violation of federal law, in the U.S. at least, to disclose medical records, so I'm not too worried about being outed.
I'm not quite so trusting and make every effort not to get anything about being transgender on computers. I try to balance privacy against safety, and tell some doctors but not others. I'll be tending more towards not telling them in the future.

Suit Alleges IRS Improperly Seized 60 Million Personal Medical Records
http://www.forbes.com/sites/scottgottlieb/2013/05/15/the-irs-raids-60-million-personal-medical-records/

Your medical record is worth more to hackers than your credit card
http://www.reuters.com/article/2014/09/24/us-cybersecurity-hospitals-idUSKCN0HJ21I20140924

Anthem hacked, millions of records likely stolen
http://www.cnbc.com/id/102398852
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Cindy

In Australia my medical records have been changed to female. I don't disclose to anyone and there is no legal reason for me to do so.

I am a medical professional and I have verified this. In Australia there is no legal reason to disclose my previous gender identification and there is no physiological reason either. I am a woman born without female sex organs, end of story.

As part of my job I work with the genetic counselling service, I am fully aware of the confidentiality that is in place. It is extremely strict.

I cannot talk for other countries.


Addendum.

I have accessed my medical records from prior to my legal gender change (not many people can do this). The gender marker is female.
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AnonyMs

Quote from: Cindy on February 12, 2015, 02:37:23 AM
In Australia there is no legal reason to disclose my previous gender identification and there is no physiological reason either.
I'm very interested in this statement as I really don't like disclosing it. Not the legal, but there's no physiological at all? There's got to be  something. This is post-op presumably, as pre-op M2F there's testicular cancer and no doubt other things. I always worry that by not disclosing I might be making a mistake, so I'd like to know the boundaries of the decision.

Quote from: Cindy on February 12, 2015, 02:37:23 AM
I have accessed my medical records from prior to my legal gender change (not many people can do this). The gender marker is female.
What is a medical record? I recently got copies of all my hospital records just by asking, and I'm not privileged in any way. I always get test results when I visit doctors, although I've never asked for their notes on me. I'm wondering what I'm missing out on.

Quote from: Cindy on February 12, 2015, 02:37:23 AM
As part of my job I work with the genetic counselling service, I am fully aware of the confidentiality that is in place. It is extremely strict.
I don't think hackers and criminals respect that viewpoint. There's vast numbers of computer records leaked every year.
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lilredneckgirl

IMO,  to  get  the  best  care,  you  MUST  tell.  like  it  or  not,  our  body  started  out  in life  one  way,  and  we  changed  it. 
  there  are  huge  differences  in  the  male  and female  body.    changing  it  at  some  point,  only  complicates  a  doctors  task. 
  give  him/her  the  best  information  and  you  can  expect  the  best  result  in  the  care  you  receive. 
  withhold  information,  and  you  assume  the  risk. 
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Northern Jane

I am 40+ years post and only disclose my  past when it is relevant to the current procedure/complaint - basically on a "need to know" basis.

Medical records are NOT secure and never will be! 20 years ago I was outed by a clerk at a medical facility, rumours  that spread through my community. Due to the breach of confidentiality, new rules were adopted in my province that required medical records to be purged of non-relevant information every 10 years. Since old medical records have turned up in the dumpster behind doctors' offices and other insecure locations, DON'T TRUST ANYBODY!
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MCMCyn

I almost always share with the doctor, especially my primary care physician. If I end up with a nurse practitioner or substitute doctor for sinus infections or something that won't effect 'that region' I don't share. But if asked if I've had any sugeries, I am honest and upfront.

It can be very important that you fully disclose to your pcp, because as an example, if you are MtF, just because your testicles are gone, and your prostrate has shrunk, you are still a candidate for prostrate cancer.

AnonyMs

Quote from: lilredneckgirl on February 12, 2015, 07:11:45 AM
IMO,  to  get  the  best  care,  you  MUST  tell.  like  it  or  not,  our  body  started  out  in life  one  way,  and  we  changed  it. 
  there  are  huge  differences  in  the  male  and female  body.    changing  it  at  some  point,  only  complicates  a  doctors  task. 
  give  him/her  the  best  information  and  you  can  expect  the  best  result  in  the  care  you  receive. 
  withhold  information,  and  you  assume  the  risk.
While I understand your viewpoint, it causes me a lot of stress knowing that there's yet more chance of being outed, and I'm worried about the harm if I am. I need to balance that against the risk of not telling the doctor. I need to make the best decision I can. And you're absolutely right, I assume the risk - its not like I can ask anyone else to in this situation.

Quote from: Northern Jane on February 12, 2015, 08:31:50 AM
I am 40+ years post and only disclose my  past when it is relevant to the current procedure/complaint - basically on a "need to know" basis.

Medical records are NOT secure and never will be! 20 years ago I was outed by a clerk at a medical facility, rumours  that spread through my community. Due to the breach of confidentiality, new rules were adopted in my province that required medical records to be purged of non-relevant information every 10 years. Since old medical records have turned up in the dumpster behind doctors' offices and other insecure locations, DON'T TRUST ANYBODY!
I'm totally with you on this, but my concern is in knowing what's relevant and what's not. How do you know?

Regarding the don't trust anybody, I don't. I sometimes wonder if I'm a bit paranoid. I'm not, apparently.
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