Hey any medical doctors here? Have you ever treated any trans patients?

What do you think is important for trans medical care?

Just a Paramedic and I can tell you one thing about health care. Nothing was ever mentioned in two years of Paramedic school about transgender care or meds used in HRT. Considering Spiro itself and it's affects on blood pressure and K+ levels it would have been nice to know. We were not even told how Estradiol could cause CVA or DVT. I have thought about volunteering to teach in the next class all about trans care and meds. Education (at least where I live) is woefully inadequate to pre hospital care providers. It needs to change rapidly.

A similar issue has caused my daughter to attempt medical school. I hope she makes it.

I'm an Registered Nurse and have some fairly strong views FA. Good question

Prior to transition back in huge denial phase and had a trans patient. I was disgusted by the treatment by other nurses at the time. I was the only person who referred to the patient in their clearly preferred name, all other nurses or HCP's were borderline vulgar and completely disrespectful to the patient, statements such as "this is John, he wants to be called Jill. John came to us at ... " etc. even at that time when I was simply scared to look at websites that talked about what trans* people (Like, umm, Susans! ) was terrifying. However I knew that was just "not on" in terms of patient treatment, I wish I had said something to them then but I was new and "knew nothing" so it wouldn't have got through anyway.

The second trans person (maybe 8 months ago) I had as a patient had a significantly large physical and mental health background and tbh I don't think I'm qualified to comment on their medical or psychological treatments. When I was looking after them (I'm trying to be very ambiguous and not necessarily gender specific) I was very aware of their gender dysphoria and asked them which names and pronouns they wished to be called by and also gave them details for the local appropriate clinic for then GID (wow! what a difference 8 months make with DSMV). Unfortunately due to clinical limitations and the type of unit we were unable to consider further options (ie. they wanted to start HRT whilst significantly ill, something the doctors would strongly disagree on), although staff and my colleagues were much more accepting in my new (now) workplace.

Post full time (three and a half months from now) I would like to be much more of an active voice and advocate. Simply, now, me being not out at work I would absolutely correct people on inappropriate terms but may avoid full on confrontational events. Medical treatments and things, HRT and and any birth control etc. is shown to have a higher rate of DVT and clots was taught to us at uni but things like spiro are not common drugs outside renal (kidney), cardiac (heart) or endocrinology (hormones) circles and most nurses within general wards or surgical wards would likely have limited knowledge. I have pointed people in the right direction for information that they may not know however .

Somehow people are to my knowledge oblivious to me transitioning at work though!

Maybe, maybe, I will re-try medical admission tests in the future (barely tried once and didn't get in, surprise), but I kinda like being a nurse and actually having a so called life .

LOL, I totally missed the question!

In my experience, ANY education is a good thing. The difference between gender and biological is an important place to start. They don't get taught that.
Secondly, explaining the difference between clinical "Gender dysphoria" and other mental health disorders is important too. Were not necessarily mad ffs!
This sounds soo mundane to us I'm sure but to people not in "the know", this is really important stuff! If they listen.
I would simply argue that disclosure and confidentiality would be the single most important issue were someone ever a patient or client. If you're in hospital for a lung infection, other that being on medications ie. HRT what does beings trans have anything to do with anything?

I will write more but right now am speaking with someone who will kill me if I don't keep talking and focus on posts (Catherine) .

Quote from: Jessica Merriman on May 10, 2014, 09:53:07 PM
Just a Paramedic and I can tell you one thing about health care. Nothing was ever mentioned in two years of Paramedic school about transgender care or meds used in HRT. Considering Spiro itself and it's affects on blood pressure and K+ levels it would have been nice to know. We were not even told how Estradiol could cause CVA or DVT. I have thought about volunteering to teach in the next class all about trans care and meds. Education (at least where I live) is woefully inadequate to pre hospital care providers. It needs to change rapidly.

What's CVA or DVT? Yeah, I would think training for paramedics on trans stuff would be crucial! I mean, they may come upon a patient who looks female and then have to insert a catheter into a male orifice. That's what happened to me in reverse - there's this fat man with a red beard and when you go to insert the catheter... lol

If there's not already, I think they should be trained for this type of occurrence. Understanding of trans patients would go a long way - overcoming initial shock at someone having opposite anatomy to what they expect, knowledge that they're probably on HRT meds and how that might interact with stuff, etc.

I am not from the medical field, but I had a friend who is a nurse and my Aunt does the typing for doctors. So when I announced it to both (separately), the nurse said "I'm not surprised." and Aunt basically said the same thing. I questioned her and she said, "You have to remember I work in the medical field, and it tends to be a little more accepting..."

My two cents being said, I do think it's a good idea for paramedics and EMTs to learn about trans things. Imagine lifting that skirt and getting a surprise.

And yet there are news articles of trans patients, allowed to die because EMTs did nothing to save the patient because they were too busy laughing. 

Education must begin in 1st year Med school.   

FA, DVT is Deep Vein Thrombosis, also known as blood clots.  CVA.. If I remember, is Cardio Vascular...
Anterior sclerosis (i think).. Something or other.. can't remember the last word, but they are medical complications due to HRT..    Things like... Going off E well prior to any surgery as it significantly changes how blood clots.. Spiro depleting the body of water, leaving behind large amounts of potassium, bad bad.. That's why we have to drink a lot of water, avoid caffeine or any diuretics .. Drinking the 8 glasses of water a day is really a good idea, for everyone.

Quote from: Paula Christine on May 11, 2014, 01:13:17 PM
  CVA..

Cerebral Vascular Accident (stroke).

^ yeah, what Jessie said.

When I was at uni there was not a single mention of what trans* was.
Put simply, trans* issues just don't get taught and it is often down to personal experience in the workplace. That is a large amount of nursing and medical training too.

In my experience I have worked in a few different areas and have picked up things from there that other nurses have no idea about, and I'm sure there is a lot about other areas I don't know the first thing about. From the doctors that I've worked with it's a similar situation, they have rotations as a chance to get as much experience and exposure to as much as possible before they start to specialise.

Unfortunately there just aren't that many of us out there (relative to the rest of the hospital population) and so often we can come across healthcare professionals who have no idea of the concept of what being trans* is because they haven't knowingly had a trans* patient before. Sucks don't it?

I'm a doctor, just not for humans.

My SO is in nursing, and after about 20 years in the field, has had many trans patients. Most of those were while working in Southern California.
She has commented many times on the lack of understanding most doctors have of trans issues, medical or otherwise.

I'm not a doctor but just recently talked to a friend of mine who is in med school. I told her I was trans and she immediately started asking questions about my knowledge of any potential special medical problems trans guys may face. She went on to tell me about the fact that they do have classes that cover gay/transgender sensitivity. Granted, her school is in Miami (and thus, pretty diverse) but I thought it was nice to know that at least some med schools are now covering this in their curriculum.

I'm a medical student, and unfortunately we don't have any lectures that I am aware of in school that gives my colleagues knowledge on how to interact with people with GID.  That being said of course we have covered transgender related topics in Psych or Pharm.  Wish/ hope we have lessons like that in school at some point 

I'm a paramedic in nursing school and I can say that in all of my training thus far there has been nothing about trans issues. I do my best to bring it up on our nursing discussion boards when I can. Also, I found it interesting that virtually all of my coworkers and supervisors at the ambulance service where I work were clueless.

There should definitely be some sort of education. In my rural area it has been an uphill climb first with my therapist, then my primary doctor and now my endocrinologist. I'm their first FtM. Hopefully it will be easier for the next person.

I work in health care, not going to specify which area.

The training environment for HCPs(health care providers) is still very much a testosterone fuelled, homophobic, conservative one.  Old boy networks don't die out easily, and empathy training is placed aside in favour of churning out fresh meat for the system.  (Well, there is lip service).

The reality is, more money is going to be spent on training for dealing with the vast majority of the population, and the most common health issues.  GID is a sideshow issue - there just isn't enough time in a med school programme to cover it adequately, if at all.

As for actually treating trans people - if HCPs can be trained to give gender variant patients the same level of empathy and respect as anyone else, then that would be a great start.  Yes, GRS is specialised, but the vast majority of health issues for trans people will be run of the mill things - blood pressure, cholesterol, arthritis, etc.

7 years as an X-ray tech and going on 4 years as a systems analyst for the x-ray side of our hospitals electronic medical records system.

Up until last year nothing was covered. Not in school, not in hospital policy, not passed on by anyone. If you can in trans you got laughed after your room door closed. In our last policy update and required yearly training they finally covered ->-bleeped-<-. It's covered in the same section as all other forms of discrimination and in its own separate part concerning how those patients might wish to be treated. Nothing on meds though.

Also still no policy on transgender employees. Which is weird to me because we have had them before and in the past the hospital used to perform GRS/SRS for mtf.

I work there and so does my supportive mother.

I just finished an RN program, and yep, no mention of trans issues at all.  Unfortunately, I can see many of my fellow grads being the types of nurses that Rachel talked about....using wrong pronouns/names and being disrespectful because they don't agree with the patient being trans.  I went to a very conservative school though, in my clinicals, the other students did not want to care for HIV+ patients, so I took them all.  It was pretty pathetic. If I were the clinical instructor, I would make sure that anyone who said they did not want an HIV+ got them all until they learned some compassion and sensitivity for them.  Unfortunately, the clinical instructors didn't see a problem with it.