By The Associated Press
When a person came to the hospital with severe abdominal pain, the nurse did not think it was urgent, noting that he was obese and stopped to take medicines for blood pressure. In fact, he was pregnant – a transsexual man with a job that soon ended in a dead age.
The tragic case described in Wednesday's New England Journal of Medicine shows larger issues related to the assignment of labels or assumptions in society. are increasingly confronted with gender differences in sports, entertainment and government. In medicine there is a similar risk of lack of diseases such as sickle cell and cystic fibrosis, which mainly affects specific racial groups, writes the authors.
"What matters is not what happened to this particular person, but this is an example of what happens to transsexuals who interact with the health care system," said dr. Daphna Stroumsa from the University of Michigan Ann Arbor.
"He was correctly classified as a man" in medical records and looks masculine, Stroumsa said. "However, this classification rejected us from its real medical needs."
Stroumsa would not say where and when the case occurred and the patient was not identified.
Transsexual men who are considered female at birth but identified as male may or may not use masculinizing hormones or have surgical changes such as uterine removal.
A 32-year-old patient told a nurse that he was transsexual when he came to the emergency service and his electronic medical facility. the record recorded him as a man. He had no time in a few years and used testosterone, a hormone that has a masculinizing effect and can reduce ovulation and menstruation. However, he has lost hormone and blood pressure medication after losing the ban.
The home pregnancy test was positive, and he said he himself was "a possible ruptured membrane and work sign." The nurse ordered a pregnancy test, but considered her stable, and her problems were not urgent
After a few hours, the doctor assessed her and the hospital test confirmed her pregnancy. Ultrasound showed vague signs of fetal heart activity, and the study showed that some navel ropes fell into the birth canal. Doctors were ready to make an emergency cesarean section, but there was no fetal heartbeat in the operating room. Moments later a man introduced a dead baby.
A woman showing similar symptoms "would almost certainly be quickly and quickly evaluated for pregnancy-related problems," the authors wrote
. incident, this is a tragic result, ”said Dr. Tamara Wexler, NYU Langone Medical Center Hormone Specialist.
"Medical training should include the impact of transsexual patients", so health workers better meet their needs, said Wexler. "Many practitioners did not have this in training," but they can still learn from such patients
Nic Rider, a transsexual health specialist and psychologist at the University of Minnesota.
"There are indirect biases that need to be addressed," said Rider
. Health records can use sex male / female templates, but "that doesn't mean we just throw out critical thinking or think about how People are diverse," said Rider.
The case is scary, but "not terrible," said Gillian Branstetter, a lawyer representative at the National Center for Transgender Equality in Washington, DC
. Gender related health care issues such as cervical cancer screening, birth control and prostate cancer screening
More needs to be done to improve medical awareness and acceptance of diversity, as "the consequences may be as terrible as this case suggests" Branstetter.
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