Quote from: Jenna Marie on November 29, 2013, 11:38:25 PM
DoctorWho : I've mentioned before that I was examined by a gyn and some covering doctors in a hospital (the latter was superficial only) and no one twigged to anything. I suppose I have no way to prove I'm not lying, but I was as shocked as anyone. (As for the lack of cervix, a complete hysterectomy can also account for that.) There is a HUGE variation in cis anatomy, enough that even an expert may not be able to say for absolute certain that a given vulva and vagina were surgically created. Suspect, yes, be utterly sure, no. And I really doubt that the average guy on the street can outperform a gynecologist at that.
I do, however, agree that rejecting people who cannot accept all that you are is brilliant advice.
I think you are missing something very fundamental about the doctor patient relationship, and its something that as a current medical student is being hammered into me and my colleagues again and again. Thing is as a decent doctor your focus has to be on meeting your patient's need first and foremost. This means that sometimes we do hold back on things we know if we feel that to come out with them would be damaging to the patient. If it's not important then, anyone any good would not wish to needlessly upset.
We are trained to be respectful, so we would rather "under perform" and have you leave feeling good than "show off" our knowledge and have you leaving upset. A principle that Ironically I am now breaking - but only because you have asked the direct question, and in this context I see the balance of risk and benefit as being in favour of telling the truth as I see it. In a clinic - even if I was asked directly I might perceive the balance the other way. If I did, and I thought that admitting my suspicion would upset her I would almost certainly deny that I had spotted anything, and she would leave feeling happy that I had not "known". This doesn't mean I didn't suspect, It just means I wanted her to feel good.
If I as a doctor spotted a trans woman I would never tell her and I would certainly feign great surprise if she told me. We have even been taught to take this to the point where even if you know that your patient likely does not menstruate, we should ask her about her periods if the clinical situation warrants it... that's just respect, not making hard assumptions on the basis of what you have observed. So you are taught to be careful about what you do and don't say and how you react. Of course I would be, because I would be utterly respectful of her feelings, and wouldn't want her to think that she is abnormal - because it's not abnormal - just different and that is not the same concept. To be different is not wrong. That is what I and indeed ALL of my classmates have been taught and indeed in relation to this very situation, handling any differences in someone who is trans.
To imply Abnormal would imply pathology - something which needs treatment, this is just human difference. A Trans VJ may not not look out of place to casual inspection, but it's basically made from the wrong tissue - it lacks certain bits that even post hysterectomy would be there - for example the glands I mentioned, and there will be incision marks. I'm sorry but we are trained to look for them in whichever body locations we are examining, because its often a very good clue to possible complications. You can't hide from that. That's just a medical fact.
The point about whether he saw it is moot, but irrelevant because I didn't mention the biggest give away of the lot which is that you still have a prostate - it's not removed in gender surgery, and so if you had one before you still will. In fact we use it as part of the suspensory material for the neovagina. I don't need to see your VJ to feel that.
I have done prostate exams - in a normal male we put two gloved fingers inside the rectum - you can clearly palpate the prostate. Through a trans woman's VJ it would be even easier. I don't know if this guy knew his anatomy? Some men do... Like I say you may get away with it some of the time, but not all.
I'm really sorry that this is evidently a disappointment, but like I say while the results are good but they really aren't anatomically identical.
I've though long and hard about what the balance of risk and benefit here is, since the last thread where I decided to back out because it was getting inflamed and unhelpful. I do NOT want to upset anyone and I would love to apply the normal clinical logic of making people feel good here, and pretend that things are different, so that you all leave the thread feeling good. The only reason that, in the context of this forum, I am not doing so is that I am concerned for your safety. As someone who has lived with a closely related condition all my life, I understand the pressures and risks involved. I've been there, and I don't want to be reading about one of you getting injured by a random partner who you got unlucky with and who reacted badly.
In short I'm trying to keep you safe and be a true friend. Now people can shout at me, and tell me all the reasons why I am wrong, and a fool, and I will just fade away and withdraw again with no argument, because I have no wish to force truth on someone who doesn't want to accept it. Winning or losing this discussion it won't change the facts. I just hope none of you ever get to the point of realising I was right, on the point of a fist or a knife.
Please understand - I agree you will probably get away with it the majority of the time - and if you want to take that slight risk and not adopt my precautions, then that is totally your decision. Just be aware that there is a very slight risk involved... that's all I am saying. I'm NOT saying or implying that you VJ looks abnormal
Tristan - and I never have - I am just saying that there certainly are small differences that can be found if you are looking for them.