Distortions of treating through a trans lens

3 minute read

GPs should take care not to treat trans people like curiosities

GPs should take care not to treat trans people like curiosities

I learned a new expression last week – “trans broken arm syndrome” – the phenomenon where healthcare providers assume a trans person’s medical issues are all a result of their being trans, whether it’s a sprained ankle, otitis media or anything in between.

In one online account, a patient with a broken arm says the first five minutes of their 20-minute consult with an orthopod was spent being “grilled on gender stuff’’, which seemed a disproportionate amount of attention when they had a fractured limb.

As doctors we’re trained to be thorough, and to take a comprehensive history. And, of course, being trans can bring with it unique medical issues. For example, it may sometimes be that parts of the trans-related history, such as hormonal agents, are relevant to the presenting problem.

But can you imagine the frustration, especially if it’s a regular occurrence, of being seen only through a trans lens when you’re seeking medical help? Like that’s the main thing the GP is interested in, relevant or not.

It’s far from a patient-centred way of practicing, and you could go as far as saying it’s hijacking the consultation.

In another online post, a person said it took several years for their headaches to be diagnosed as migraine, and receive appropriate advice. Several doctors had assumed the headaches were due to their hormonal treatment.

They said mentioning hormones when asked what medications they were taking felt like a coin toss. It might be relevant and guide therapeutic options, or it might end up that their symptoms were automatically put down to hormones, and their real diagnosis missed.

“It’s a calculated risk on our part. The 1% chance that it is relevant and you make it worse by hiding, versus the 99% chance that it’ll be used to push you out of the clinic with no diagnosis.

“I take that 1% risk every time, it’s safer. But if I didn’t have to take that risk then I wouldn’t,” they wrote.

Whether the facts are correct on all this isn’t the point. The point is that trans people say they frequently feel uncomfortable, sometimes to the point of knowingly putting their health at risk, by the seemingly disproportionate focus on their gender.

They often don’t trust us. This will change only when we are fully informed on trans issues, and don’t treat trans people like curiosities.

Dr Kerri Parnell is the Editor-in-Chief at The Medical Republic.

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