ER situations

[myles]

Only been to the ER once since being on t and had to tell them, even though my insurance/ID and everythign else has male. There was a chacne that why I was there was a side affect of the T they were fine with it. There were no isssues with anything but I did not have any reason to take my pants down.
Myles

[Tippe]

That doesn't mean health care professionals should be ignorant about trans* issues and anatomy though.

I agree. I've usually been the first transgender patient, whereever I've been, but fortunately haven't had any major communication problems. Pronouns have been confused due to a gendered SSN, though, but since my name change that's not bad either.

Like kyril said, they might think that an ftm who has been on T for a while is intersex and attempt to insert the catheter through a hole that doesn't exist.

Oh, now I see, yes, given that your natal anatomy is itself pretty varied I've sometimes seen collegues calling in an extra nurse to help find the urethra. An outwardly male appearance might add to the confusion. I'll remember that if I ever encounter an FTM. Thanks.

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Tippe

[Adio]

I agree. I've usually been the first transgender patient, whereever I've been, but fortunately haven't had any major communication problems. Pronouns have been confused due to a gendered SSN, though, but since my name change that's not bad either.

Oh, now I see, yes, given that your natal anatomy is itself pretty varied I've sometimes seen collegues calling in an extra nurse to help find the urethra. An outwardly male appearance might add to the confusion. I'll remember that if I ever encounter an FTM. Thanks.

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Tippe

I'm usually (from self reports from staff) the first trans patient where I go as well.  Sometimes I have problems and sometimes I don't.  I'm glad that things have been mostly smooth for you.

Are you a nurse or other HCP?  I'm currently a nursing student.  It's always nice meeting other trans people in the health care profession.

[tekla]

What about a MedicAlert bracelet - or, at the very least, someone at the other end of your ICE number on your cell phone who knows, and who cares.

[Tippe]

Are you a nurse or other HCP?

Nurse to-be Pleasure to meet you, too.

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Tippe

[Autumn]

I'm not sure I get your drift. Do you mean that the guys who pack are not legally male and will show up as female on their insurance? If so, some of my friends are legally male across the board but haven't had bottom surgery...in fact, I know or have met a few dozen FTMs in my city, but I only know a couple of guys who have had any kind of bottom surgery. Can you clarify what you're getting at?

If you have not had your gender legally changed, then you must use that with all medical information. If you have changed it, then you are legally (on paper) that gender. However we are talking about the ER so generally speaking it's probably a good idea for them to know about a major medical history.

But if it's an ER situation, will the ER staff even have access to my chart? I guess they can call up my insurance info, but my actual chart? Is all of that computerized these days? 'Cause if it is, think of the potential for abuse...yikes.

Anyway, medical staff are not immune to bigotry. If you're pre-T, look androgynous, and pack, they might or might not bat an eyelash. If you present convincingly as male and turn out to have an innie and a pantstuffer, I think there's more room for prejudice and lousy treatment. But seriously, it all depends on the staff. (FWIW, I think pre-SRS women get more crap than pre-SRS men in the ER, but that's just an impression I get.)

It soon enough will be all computerized, actually, yes. If you have been within the hospital district before, they will have you on file. I've been to both of my local hospitals, only once for an emergency.

I had a conversation with one EMT about whether or not I'd get breast implants (she did.) In the hospital, the triage nurses would walk in, read my chart, and basically go  wtfh and I'd have to say "Yes, that's my name, ts" or "Yes, it's the right chart, ts." I forget how many times I had to explain the situation, but since I had nearly died and was pretty out of it I really didn't give a ->-bleeped-<-. I did update my facebook from the ER, which resulted in a panicked call from my ex and beatings later for scaring her.

Proper pronouns were used and I was treated great, especially in aftercare. Once I was out of triage there was never any confusion. You can imagine how someone being "obviously" mistagged could cause major problems and possibly delay critical care.

[Cindy]

I think there are a couple of points I would make. One is human nature, if you are the first trans person the staff have seen well you are a curiosity, ER staff are usually curious people, it's their job. But they should also be professional, so a written polite complaint after the issue can be very helpful in education. They are acted upon, at least where I work. The size of the hospital and city is also an issue. Staff in  large hospitals in busy big cities see lots, staff in smaller place don't.

I still recall the incident that got the most (embarrassing)  attention in ER, was a non-TG guy who had inserted a rolled up news paper in his groin and leg area, that gave a very obvious (and biologically impossible) bulge. Sadly he ruptured his knee at the night club and was taken to ER where his rather tight pants were cut off. No one laughed, lots of people walked in and out of the cubicle to help. Walked out again and disappeared. The car park sounded like comedy company central.

Cindy

[Arch]

If you have not had your gender legally changed, then you must use that with all medical information. If you have changed it, then you are legally (on paper) that gender. However we are talking about the ER so generally speaking it's probably a good idea for them to know about a major medical history.

I think I'm still confused, but I'm not sure I remember why I was confused originally. Anyway, I'm in a rather delicate position at the moment because I'm male with the state and fed but female with my insurance company. Practically everyone I talked to told me to stay female with my insurance, in case I have "female" problems and can get a hysto covered.

I hate it, but I guess I'll keep it the way it is for a little while longer.

It soon enough will be all computerized, actually, yes. If you have been within the hospital district before, they will have you on file.

Sorry, I meant my existing chart with my GP. The way I understand it, they are not authorized to make that info available outside of the system.

[AceCream]

     

@Tekla:  I understand how the ER works as I've been there several times, and I do clinicals as a nursing student at hospitals.  Still didn't answer the questions I asked though.  But thanks anyway.

Also, thanks for weighing in, Lachlann.  I understand that transgender individuals often appears to be one gender/sex but are often genetically another.  Does that mean if we are in an accident and for whatever reason are unable to alert health care personnel, we should all wear medical alert bracelets or have our trans status printed somewhere like our DL?

Honestly, I don't think so.  I think it is up to health care to catch up to us, not for us to catch up to or accommodate for them.  Trans* awareness in emergency situations is especially important for reasons already stated (namely the need to insert a foley). 

I know that you are worrying when the patient is under emergency for example and no one are there to help. I think the best suggestion is to put a medical alert system in every room in order to monitor the condition of the patients. This is mostly what I've seen to the hospital.

[Hurtfulsplash]

If I was in a situation where ER "professionals" used female pronouns or names to address me I'd use pronouns on them that are opposite to their gender. As for finding a packer on me and having anything rude to say about it, well they can shove it.

[kyle_lawrence]

I ended up in the ER last November, and since I'm not on T and havn't changed my name, I didn't even bother with trying to correct my name or pronouns.  Mostly because It was 3am when I got there, and I was too tired to care much.  (I was drunk, and trying to hit a light switch while kneeling on the end of my bed. ended up falling off the bed and dislocating my shoulder.)  I also had to give my female name for insurance and everything, and didn't want to cause any confusion.

I was wearing a binder though, which was pretty obvious since they were dealing with my shoulder. From what I remember through all the drugs, most of the doctors and nurses avoided using pronouns in front of me, and I never got called sweetie or hun or anything like that.

If it had been during the day or something I may have told them I preferred male pronouns, and asked to be called Kyle, but at the time all I cared about was having my shoulder put back in place so I could go home and sleep.

[Tippe]

From what I remember through all the drugs, most of the doctors and nurses avoided using pronouns in front of me, and I never got called sweetie or hun or anything like that.

I'd say that is the professional way to treat a patient regardless of them being transgender or not. We generally learn not to use pronouns around patients, because they tend to make the communication less personal and make patients feel more like objects being talked about. The best would be to communicate to the patient rather than about the patient. For instance a nurse can tell her coworker to assist by saying "Peter, we are going to give you an injection now". This way the patient is involved a little. This should be the case even when the patient is unconscious.
In general it would be preferable to use the name of the patient more than 3. person pronouns. That could obviously be a problem if you're still stuck with an unwanted name, but that would be the general advice.

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Tippe

[Adio]

@Tippe:  Sadly not all HCPs do that.  I can't count how many times I've seen nurses talk over their patient like they didn't exist.  Conscious or unconscious.  I admit I've been guilty of it myself (mainly when asking someone something the patient wouldn't know).  I think the only thing that makes me angrier than seeing a patient with pressure ulcers is hearing someone talk about a patient in third person while that patient is right there.  Long sentence is long.