Transgender man has stillbirth

Nurses General Nursing

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https://apnews.com/b5e7bb73c6134d58a0df9e1cee2fb8ad

This article denotes something that the nurses in my area have wondered about since early 2015.

To summarize;

"When the man arrived at the hospital with severe abdominal pains, a nurse didn’t consider it an emergency, noting that he was obese and had stopped taking blood pressure medicines. In reality, he was pregnant — a transgender man in labor that was about to end in a stillbirth."

In school we were informed by our nursing instructor that the typical S/S of a heart attack were taken from male patient complaints. She went on the explain that the female patient has a diverse and varied complaints when it comes to heart attacks. We should use caution and critical thinking to allow us to come to a conclusion on pt condition during a possible heart attack.

Enter now the necessary doublethink that must occur when dealing with the trans-gendered community. You look, talk, reports as, and have legal documents stating your are a man, but I as a healthcare professional need to treat you as a woman.

This, as the article has shown, is going to increase the number of inappropriate treatments and misdiagnosed issues, especially in trauma and emergent situations. This is something that we as healthcare providers need to begin to have conversations about to ensure own own safety in our professional lives.

On 5/16/2019 at 9:32 PM, Emergent said:

So, this is a woman who is becoming a man? But, still has a lady parts? And is engaging in sexual intercourse with men? So, is this person becoming a homosexual man? A bisexual man?

I'm confused...

Right

On 5/18/2019 at 11:00 PM, sarolarn said:

Simply put, sexual orientation and gender identity might not have anything to do with one another. This person is a man who was born biologically female and never had gender assignment surgery. Because this person is a man who has sex with men, we don't know what his sexual orientation is but we can ask this. As sensitive as it is, we need to ask about gender identity and biological gender as it relates to health status. Many may not wish to identify with their biological sex, and it is our responsibility to create a safe environment for our patients to tell us about their histories.

LGBTQ+ issues need further emphasis in our education, training, and in continuing ed. How can we obtain this information from patients if we don't think to ask, if we were never taught to, if it never came up before? Lots of organizations are forming groups and offering classes, conferences, and workshops on LGBTQ+ health issues and how we as clinicians can improve care delivery. Check with your HR dept, there are plenty of forums in person and online that welcome honest questions because this community and especially the trans community are woefully underserved in healthcare.

I can see a time where people born one ethnicity and could identify with another ethnicity. That may lead to healthcare issues as well. I have seen programs on television where people identify themselves as animals, a cat, a lizard, etc. I wonder if these people insist that they be treated as a cat or lizard. It is a strange world.

1 Votes
Specializes in CTICU.
27 minutes ago, Forest2 said:

I can see a time where people born one ethnicity and could identify with another ethnicity. That may lead to healthcare issues as well. I have seen programs on television where people identify themselves as animals, a cat, a lizard, etc. I wonder if these people insist that they be treated as a cat or lizard. It is a strange world.

Have a look at this: https://www.theguardian.com/commentisfree/2015/jun/16/transracial-definition-destructive-rachel-dolezal-spokane-naacp

2 Votes
Specializes in ICU/community health/school nursing.

So regardless of appearance....

What organs does the person have? Usually testosterone suppresses the estrogen in a female-to-male transgender person (which is how this likely got missed). If there's a uterus, there can be a pregnancy. It would be better for our patients if we focused on that and not the who/how/what and why.

2 Votes

I know this topic has died off a bit, but I want to add that as a transgender man, myself, I see other transmen in groups on facebook who have not had it explained that while someone taking testosterone often ceases to have a period, that does not mean one cannot get pregnant. While whenever this is brought up it is always very quickly explained to the *often* young man. I definitely agree with the fact that more education needs to occur so that people in health care are more aware of issues related to the transgender population. I don't know that it was clear from the original article this thread was based on if that was the case in this situation and it did seem to be that the man had explained that he was transgender and pregnant, so in an ideal world it shouldn't require extra work to determine what biological organs a patient has. Keep in mind that when a trans patient is withholding information about their transition or reluctant to answer questions, it is not out of spite or trying to be a nuisance, but because it can be very hard for some to discuss this part of their lives. I am very open about my transition, as needed, so I can only view what should happen in terms of disclosing from my viewpoint, but just wanted to shed a little light on the issue. I also want to thank whomever it was who shared the genderbread man image, that is one of the best tools out there to explain that one's gender identity, gender expression, biological sex, and sexual orientation can all be vastly different. Just because one is a transgender man, doesn't mean they might not still dress more feminine, just as there are cisgender men who sometimes dress more feminine.

6 Votes
Specializes in Nurse Scientist-Research.

@CamMc I believe I shared the genderbread graphic. The only reason I know about it was it was shared with me by others who didn’t fit neatly on the binary. I was raised very conservative so my understanding of gender was very limited. I try to share what has helped me understand.

2 Votes

This is why everyone that treats transgender patients needs additional training. This is NOT a primary care issue and so many APRNs (and physicians) are jumping on the "we want to help the transgender community" bandwagon and they are attending a couple of conferences and crowning themselves competent to provide healthcare for this patient population.

Well, here is your reality check: You are not.

Writing for hormones is only part of the picture. EVERY transgender person that presents for healthcare needs to identify themselves by....

1. The gender in which they identify

2. Their anatomical gender at birth.

This isn't about "not respecting choice". You can't change someone's chromosomes and no matter how many hormones you take, there are STILL going to be healthcare issues that will follow you by your anatomical sex at birth. It is about educating the transgender community.

Right now, transgender care is a free-for-all and I feel very passionately about this community and they sure as heck deserve better..

2 Votes
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