I've kind of wondered about this recently. For people who pack, what happens if you're in an emergency situation and have to go to the ER? Hah, I would think things would be a little awkward. Hopefully it never happens.
It's probably awkward anyway if they take you there after a few years on T and then find that nothing's there.
I guess it's a lose-lose type of situation. :-\
Honestly, I don't think the hospital staff would care...
Well, if you have insurance, everything has to be filed under your legal gender and name. Plus any specific concerns that your medications might have.
The nurses will repeatedly wtf at your chart before doing anything.
Nurses..doctors.. they've probably seen some stranger things than what ever we pack with lol.
They could probably write a book about it.
So personally i don't think they'd be bothered, probably even seen it before.
Like alot of things, this stuff is far more common than we think.
That happened to a guy I know. Actually, I don't know if he was packing at the time, but he was unconcious, and the medics were going to have to catheterize him. Fortunately, he was carrying a card that listed a good friend, who was also FtM and who was involved in training medical personnel in how to deal with trans patients, as his emergency contact.
As soon as this friend heard the word "catheter" he called out, "Stop!" He then quickly explained that, although they were expecting to catheterize the patient like a male, they would need to do it like a female. "O.K. Now, GO!"
The story is kind of funny the way he tells it, but I'm sure it was stressful at the time. It also goes to show how important it is to have up-to-date emergency contacts on you at all times, and that you should carefully consider whom you choose as your contact.
I recently ended up in the ER for a kidney infection. The doctors were being disrespectful and making me angry, so when they took me to CT...I left my packer in. I'm not sure if it can be seen on a CT. But I'm almost sure that when the CT lady walked me back to the ER, she looked freaked out. Lmao.
Quote from: Autumn on April 08, 2010, 06:26:11 AM
Well, if you have insurance, everything has to be filed under your legal gender and name. Plus any specific concerns that your medications might have.
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?
Quote from: Autumn on April 08, 2010, 06:26:11 AM
The nurses will repeatedly wtf at your chart before doing anything.
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.)
The medical professionals I know are professional. Even the volunteer EMTs I worked with in the fire department. They might make some crude remarks after delivering you safely to the hospital (crudeness being a coping mechanism for people in professions that deal with trauma - nothing could beat the things said about decapitated motorcycle accident victims, except perhaps for the jokes my friends in the military made about IED victims), but they would deliver you safely first, because they have respect for human life.
The nurses I knew at the hospital were the same way, except a bit more outwardly sensitive, the profession having a more feminine-gendered culture. But they're accustomed to helping patients who have...um...various objects lodged in their rectums. They've treated allergic reactions and chemical burns to the penis. They've seen attempted self-castration much more often than we think. Something harmlessly stuffed down your pants? That may be one of the most mundane things they've seen that day.
The only thing you'd really have to worry about, and the packer might actually help draw attention to this, is that if they have to interact with your genitals they need to do it in the right way. They could injure you, for instance, if you've had enough growth on T to be convincing (perhaps they might assume you're intersex) and they decide to try and cath you like a male.
This is completely relevant to what has happened to me recently.
I was in a car accident on Monday and had to be taken to the ER by ambulance. The police and emergency response team (for whatever reason, be it the fact I was in hysterics or my ID) called me she and ma'am repeatedly. I didn't attempt to correct them because of how out of it I was and I knew I just needed help.
When they boarded and collared me (basically, put me in the ambulance), they came into contact with my packer. I heard them laugh and say "well that's a surprise" but they continued without any other comments. After the door shut and it was just me and the other guy I was able to tell him that I was transgender and identified as male. I was unable to see his nonverbal reaction, but all he asked was if I had surgery yet and whether or not I was legally male because that's what he'd have to go by in the report.
When we got to the ER, he failed to mention that I was transgender in my pertinent medical history so I told the nurse that was attending to me. She was very understanding and even asked how I was handling my transition. After that, I got a mix of male and female pronouns depending on who spoke to me. My name, on paper, is a very recognizably female name but is pronounced in a way so that it is, at the very least, unisex. Not once did it get pronounced the female way.
The second time I was in the ER (the very next day), I was called by the female pronunciation several times and addressed with female pronouns throughout the time I was there. The attending doctor was very abrupt and disrespectful. I guess it all depends on who you get that day.
I am also in the very deep south United States if that makes a difference. Some areas are more tolerant and aware than others. I believe that really impacts how gender variant individuals are treated, especially in emergency situations.
Yeah, when I"m in the ER, when they ask the question, "When was your last...." I answer with "don't know, don't care, cause I'm trans." I know that doesn't help me out much but I really don't keep track and don't care. I guess it's a passive way of saying, "I hate my body".
I usually get she'd by doctors. For what reason, I don't know. I don't look very female. I have sideburns. I have a male voice. And I bind all the time. And pack. I'd hate to see a boy with a name like mine, legally.
Quote from: zombiesarepeaceful on April 08, 2010, 05:44:30 PM
Yeah, when I"m in the ER, when they ask the question, "When was your last...." I answer with "don't know, don't care, cause I'm trans." I know that doesn't help me out much but I really don't keep track and don't care. I guess it's a passive way of saying, "I hate my body".
I usually get she'd by doctors. For what reason, I don't know. I don't look very female. I have sideburns. I have a male voice. And I bind all the time. And pack. I'd hate to see a boy with a name like mine, legally.
When the nurse asked me that she asked "do you still have periods?" and I was able to tell her no. Her follow up question was "Is that because of the testosterone?" I said yes. And that was that. The second ER trip, I was never asked even with all the she's. I believe the triage nurse saw me as male and therefore didn't ask (I was able to correct her about my name pronunciation).
I don't know why guys like us get she'd either. From your pictures, I'd say you pass, but that's just pictures. That's why I don't bother with those "do I pass?" threads. I don't know what your given name is, but mine is a somewhat common male name in parts of Europe and a very common female name in the US. So it works for me as I do pass as male about 90% of the time.
Mine's blatently female. Unless you're from another country. I look different now than in my icon. I have facial hair now, basically. I pass generally all the time. I'm stealth when I don't need to disclose things.
ER personal care about one thing and one thing only - stabilizing your vitals so that you can get the treatment you need to save your live. If you lie in such a situation, perhaps life is not the best choice for you. But as for the rest, they don't care, they more than likely don't even know if you lived or died after you went from the ER to wherever they needed to send you - surgery, burn unit, ICU, whatever. Their job was over, and you future status was not relevant to them, they had other people to deal with who where right in line behind you. But passing when your clothes are all cut off is problematic at best.
Quote from: tekla on April 08, 2010, 06:25:45 PM
ER personal care about one thing and one thing only - stabilizing your vitals so that you can get the treatment you need to save your live. If you lie in such a situation, perhaps life is not the best choice for you. But as for the rest, they don't care, they more than likely don't even know if you lived or died after you went from the ER to wherever they needed to send you - surgery, burn unit, ICU, whatever. Their job was over, and you future status was not relevant to them, they had other people to deal with who where right in line behind you. But passing when your clothes are all cut off is problematic at best.
Can you describe, in your opinion, what would be a lie a transgender individual would tell in an ER situation? As well as what you mean by your last statement "But passing when your clothes are all cut off is problematic at best." What would be problematic?
On a similar note, when I went in for top surgery with Brownstein, you are allowed to keep your underwear and packer. They're used to it.
When I left I was so groggy, barely able to get dressed by myself. When I got home, my tighty whities were missing and in their place those stretchy gauze pseudo-undie thingies.... and my packer, perfectly placed that I didn't even notice it had been touched. LMAO.
Apparently they got ruined (with blood or something) and they threw them out. I can only imagine what they were thinking, but they had probably seen it a gazillion times with Brownstein's patients.
Jay
Quote from: Adio on April 08, 2010, 06:53:09 PM
Can you describe, in your opinion, what would be a lie a transgender individual would tell in an ER situation? As well as what you mean by your last statement "But passing when your clothes are all cut off is problematic at best." What would be problematic?
I'd assume in that you might appear male when your anatomy isn't exactly biologically male. That could be problematic.
Unless you are not covered by health care and are using the emergency room as some sort of general doctor (which is problematic in a different way) just BEING in an ER makes life itself problematic. And the standard way most people come in there - bloody, bleeding, dying... makes it pretty much pro-forma that all the clothing - get that? ALL the clothing - is just cut off and tossed out.
@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).
Quote from: Adio on April 09, 2010, 04:03:48 PM
Trans* awareness in emergency situations is especially important for reasons already stated (namely the need to insert a foley).
I don't get that. The diameter is usually the same Ch14 in males and females according to my information. Why should it be a problem that the tubing is longer if it is only inserted just past the bladder entry? Inconvenient, maybe embarassing, yes. Dangerous, no?
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Tippe
Quote from: Tippe on April 09, 2010, 04:33:18 PM
I don't get that. The diameter is usually the same Ch14 in males and females according to my information. Why should it be a problem that the tubing is longer if it is only inserted just past the bladder entry? Inconvenient, maybe embarassing, yes. Dangerous, no?
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Tippe
No, it shouldn't be dangerous. That doesn't mean health care professionals should be ignorant about trans* issues and anatomy though.
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. I'm not saying that the nurse would attempt to stick the foley in without finding a hole first, but they might poke around or waste time looking for something in a place where they won't find it.
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
Quote from: Adio on April 09, 2010, 06:42:14 PM
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.
Quote from: Adio on April 09, 2010, 06:42:14 PM
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
Quote from: Tippe on April 09, 2010, 09:38:51 PM
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.
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.
Quote from: Adio on April 09, 2010, 10:03:15 PM
Are you a nurse or other HCP?
Nurse to-be :) Pleasure to meet you, too.
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Tippe
Quote from: Arch on April 08, 2010, 02:14:45 PM
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.
Quote
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.
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. :laugh:
Cindy
Quote from: Autumn on April 10, 2010, 02:26:11 AM
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. :D 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.
Quote from: Autumn on April 10, 2010, 02:26:11 AMIt 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.
Quote from: Adio on April 09, 2010, 04:03:48 PM
@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.
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.
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.
Quote from: kyle_lawrence on May 04, 2010, 10:11:51 PM
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
@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. :laugh: