Sharing the trans* label (e.g. Casper Smart news)

[Carolyn Marie]

If someone wants to start a thread on sexual dimorphism, please go right ahead. In the meantime, lets let this thread go back to the OP's original intent and theme. Thank you.

Carolyn Marie

[Guest Leah1026]

The truth here is that you were born male and therefore are male. It doesn't matter if you, and I, have removed the penis, you are still physiologically male. It is very important for your medical records to be accurate and up to date. Any radiologist worth his degree would know right away you didn't just have a hysterectomy, the anatomy is completely different. Plus, a neo vag is a huge difference on an X-ray and a CT

I am a medical imaging professional and I'm telling you that you're wrong. There have even been studies on this. Radiologists are trained to look for certain things and that's all they look for. They are waaaayyyy too busy to be wasting they're time to decide somebody's biological sex. And it's just as I said before, if they don't know you're history and don't see a uterus or ovaries, they're usually just going to assume hysterectomy.

Second, once you are on estrogen the differences between male and female physically blurs. We become much more like our identified gender than not. So, NO, I don't consider myself male in any respect except for having a vestigial prostate (because after 10 years on estrogen it's barely detectable).

[~Nova~]

The truth here is that you were born male and therefore are male. It doesn't matter if you, and I, have removed the penis, you are still physiologically male. It is very important for your medical records to be accurate and up to date. Any radiologist worth his degree would know right away you didn't just have a hysterectomy, the anatomy is completely different. Plus, a neo vag is a huge difference on an X-ray and a CT

I am a medical imaging professional and I'm telling you that you're wrong. There have even been studies on this. Radiologists are trained to look for certain things and that's all they look for. They are waaaayyyy too busy to be wasting they're time to decide somebody's biological sex. And it's just as I said before, if they don't know you're history and don't see a uterus or ovaries, they're usually just going to assume hysterectomy.

Second, once you are on estrogen the differences between male and female physically blurs. We become much more like our identified gender than not. So, NO, I don't consider myself male in any respect except for having a vestigial prostate (because after 10 years on estrogen it's barely detectable).

Well, I have been doing it for 25 years with hundreds of thousands of xrays and I'm telling you I'm right. I really do think you're overthinking the power of E, but whatever. Go ahead and don't tell the person whom you are entrusting your life with the truth about your past, they'll never know.

"except for having a vestigial prostate"

Nope, not pathological at all...

Let me ask you this... If a MTF post op trans person were to die and went for autopsy, the ID unknown, how would the pathlogist list gender?

[Guest KimberlyF]

Let me ask you this... If a MTF post op trans person were to die and went for autopsy, the ID unknown, how would the pathlogist list gender?

This is the heart of the issue right here. Laws can change and depending on where the body is, the pathologist may be legally required to fill in 'M' or 'F' based on the laws or procedures. That will not change one bit how the dead MtF viewed herself or lived her life. Only she held the ultimate validation for herself.

In science, one false disproves a theory. We know there are women with XYs that have given birth. We know there are intersex people born with both genitalia, and therefore a penis doesn't always equal male and a vagina doesn't always equal female. So what is the biological proof of sex? It depends on who you ask, I'd guess.

Definitions and understandings of words are in a constant state of change. For some of us, a prostate, which will never be gone does not suddenly make us men. You are welcome to your own definition. It won't change mine. I accept myself, and I try to move forward every day.

[~Nova~]

Let me ask you this... If a MTF post op trans person were to die and went for autopsy, the ID unknown, how would the pathlogist list gender?

This is the heart of the issue right here. Laws can change and depending on where the body is, the pathologist may be legally required to fill in 'M' or 'F' based on the laws or procedures. That will not change one bit how the dead MtF viewed herself or lived her life. Only she held the ultimate validation for herself.

In science, one false disproves a theory. We know there are women with XYs that have given birth. We know there are intersex people born with both genitalia, and therefore a penis doesn't always equal male and a vagina doesn't always equal female. So what is the biological proof of sex? It depends on who you ask, I'd guess.

Definitions and understandings of words are in a constant state of change. For some of us, a prostate, which will never be gone does not suddenly make us men. You are welcome to your own definition. It won't change mine. I accept myself, and I try to move forward every day.

Please do not misconstrue what I'm saying. I see myself as female, period. What I won't do is confuse physiological differences between make and female. The OPs question was about medical records and the need for truth to be stated in them. I cannot in good faith tell a Dr that I am female when biology says different

No amount of how ones will change the male body to female. The E and progesterone can fools one of the body, but in reality, our bodies will not change completely. I have grown breasts, my skin has softened. My face has morphed into a more female shape, and I have a neo vag, but none of that makes my body female.

Interesting thread

[Guest Leah1026]

Well, I have been doing it for 25 years with hundreds of thousands of x-rays and I'm telling you I'm right. I really do think you're overthinking the power of E, but whatever. Go ahead and don't tell the person whom you are entrusting your life with the truth about your past, they'll never know.

"except for having a vestigial prostate"

Nope, not pathological at all...

Let me ask you this... If a MTF post op trans person were to die and went for autopsy, the ID unknown, how would the pathlogist list gender?

First, I'm not overstating anything. I know how radiologists are trained and have seen them in action. They are looking for PATHOLOGY. If a person is post-op female and the radiologist doesn't know their medical history, they will read the study as if it was a non-trans female. You are also passing negative judgement on my looks; thanks.

Second, I didn't say I never say anything. I said I give out that information on a need to know basis. And quite often the fact that I transitioned is totally irrelevant.

Third, you laugh at my "vestigial prostate", but it's not a joke. It's shrunk so much that a radiologist isn't even going to notice it on a CT. They would have to know my medical history to know any different.

Last, if I'm dead I frankly don't care how they categorize me. That said, the medical establishment is in a state of flux right now on this issue. They are learning to respect our identities like everyone else. Laws like this will become standard:

http://www.advocate.com/politics/transgender/2014/06/02/calif-assembly-passes-bill-respect-trans-people’s-gender-death

Further, given that, they are not going to list me as male. Why should they? My body appears female. My ID says female. Friends and acquaintances will say the same. I know you said "no ID", but that's a clever ploy on your part to undercut my points. Not to mention the conversation was about a radiologists reading diagnostic imaging studies, not about coroners!

I'm frankly upset, insulted and saddened by the shortsightedness by some in this thread.

I'm taking another vacation from this place.

[Guest DesiB]

The truth here is that you were born male and therefore are male..

While this is a scientifically accurate statement, it still smarts when said in that manner.

Carolyn Marie

I am not bothered by how it was stated as much as by what it means and just as much by the concurrence it was given. You do not have enough of the pieces of data that would go into the determination of my sex to make it a scientifically accurate statement. And you should realize that some of those elements are susceptible to change from the time of birth to negate the "therefore" statement. Secondary sex characteristics always change after the time of birth and we know that social and legal sex certainly can too. But even at the time of birth, we know many are born with intersex conditions as well and it is not a simple binary system. I can't believe I have to even go back and restate this here. But there it is. I am honest to a fault myself, and I will not go around expecting people to pretend I am female while secretly telling people on a forum that I'm really male. Since my original question was about terminology, and maybe you don't want to say I fall completely on the female end of the spectrum, I do accept that and I am open to better terminology that would distinguish me from what is in the tabloids. But if I am only given the choice between male or female, I know I fall closer to the female end of the spectrum, and always have, so that is the best term I currently have to identify myself--truthfully!

No matter what organ you now have between your legs, no matter what your brain, our brain says, we cannot change physiologically who and what we are. You can believe you are female, I do, but I also know that I was born with a male body.

I'm sure Rene Descarte would sound convincing to some on this forum as he would mask his dualist philosophy in scientific rhetoric. But I do not subscribe to the mind/body dualism from medieval times. Why are we so obsessed on giving priority to the organ between the legs while disregarding the reality of the equally physiological organ in the head. By the way, we are capable of viewing the live workings of the brain now in ways Descarte never saw. And as so many have been asking, if they did an autopsy of the brain, research has shown that M2Fs have brains that are closer on the spectrum to those of females. My brain is my body too and it was female when I was born. Unfortunately, all my body parts did not fit the simple binary.

Other parts were mixed up too. For example, when I went to get my FFS to remove some bone from forehead, I had to get a skull x-ray. Yes, the bony protrusions, caused by the excess testosterone, were male features. But even through at that point I went in identified as male and the tech had no idea what the scan was for, the results said my sinus cavities were smaller than normal and were more like that of a female. Did that one factor make anyone jump to the conclusion that I must be declared female at that instant? Of course not--it's always the preponderance of all the elements, and not just the bone structures that determine our sex. But this is just one more piece of evidence that I have always been somewhere on the spectrum that was not strictly male, not even physiologically.

How will we ever get the public to see us the right way if we can't even see ourselves or each other the right way?

[Guest DesiB]

To get this back on the original topic, accepting that we do have a spectrum and need more identifiers than just male or female when it comes to certain medical treatments, my issue was with the use of "transgender" or even "transsexual"--based on the way these are used in the tabloids and are generally misunderstood by the public. (e.g. Casper Smart Cheats on JLo with 2nd Transexual [sic])

Since even most medical staff are not trained on our issues, they too can be influenced by what they read in the tabloids. And as I said initially, I completely support and empathize with all those who are encompassed under the transgender umbrella, but I do not want people to look at me and think that I am one of those people who have "the best of both worlds" and have them wondering about what's under my clothes that way! Even when I go for a new medical procedure and that all the staff knows about me is a little notation with the word transgender, it makes me uncomfortable because I don't know what kind of false assumptions are being made about my body! Maybe that is petty, but that is something that matters to me. I think there ought to be a more precise medical term than something that is used/misused in the tabloids. We are not all the same, except that we all do deserve to be treated with respect and even compassion as patients.

[Guest Melissa~]

My copy of Mosby's sectional anatomy really doesn't dwell on gender...

[Charlize]

While i was in the hospital recently for heart problems i noticed that my chart said nothing about being trans. Instead it used the same diagnosis that medicare uses GD. Thats enough for me.

Hugs,

Charlize

[KathrynJulia]

There are four reference ranges of normal lab values. There are the normal male and female ranges used by labs and medical practitioners. But after a limited study of just over 500 trans healthy adults. Our normal values are neither that of either genetic males and genetic females. We have our own normal trans-male and trans-female range. Some doctors especially those that treat and are familiar with trans patients, some of these practitioners are familiar with the reference normal range for transsexual patients.

If you see one of these practitioners, it might be a good practice to tip off your primary doctor, otherwise your lab values may be viewed as abnormal, yet be in the normal range for a trans woman on estrogen or a trans man on testosterone. Kathy

[Guest DesiB]

There are four reference ranges of normal lab values. There are the normal male and female ranges used by labs and medical practitioners. But after a limited study of just over 500 trans healthy adults. Our normal values are neither that of either genetic males and genetic females. We have our own normal trans-male and trans-female range. Some doctors especially those that treat and are familiar with trans patients, some of these practitioners are familiar with the reference normal range for transsexual patients.

If you see one of these practitioners, it might be a good practice to tip off your primary doctor, otherwise your lab values may be viewed as abnormal, yet be in the normal range for a trans woman on estrogen or a trans man on testosterone. Kathy

After first noting that not all lab ranges are (or need to be) sex segregated, I think it is great that someday we may have a valid database with more precise sex-based ranges for times when such distinctions may need to be made. But before we can even collect such data correctly, we need to have the correct categories by which to gather the information.

Let me go back to the example I gave of meeting a new medical technician who took my DEXA scans. She saw me as a woman with matching state and federal legal identification as female, but with a confusing notation about me being a 'transgender' patient. She did not know if that meant I was born female and wanted to transition to male or if I was born male and had already transitioned to female. Those were the only two options she thought possible, even though I tried to explain to her that I was born with a female brain and other male birth defects that caused me to be misidentified as male up until recent years. Her main concern actually seemed to be whether or not I could get pregnant, and I assured her I could not. Unfortunately, in her mind, the led to the conclusion that I deserved my DEXA scans to be labeled as male, which infuriated me. I would not have been so upset if they had been labeled 'trans-female,' since these types of scan do have different scales based on sex. For any other medical services I receive, I would prefer to have them simply marked as 'female' the way everything else in my life is identified.

But what does the notation, "transgender" really tell a medical practitioner? I can see different transgender patients fitting into any of those four reference ranges--male, female, trans-male, or trans-female. What is the patient is a M2F crossdresser? That person is transgender, but all labs would still be unchanged from the normal male ranges. What if the patient is a M2F transsexual, but for medical reasons cannot take hormones and cannot have any surgical procedures? Again, this person's labs would need to be read in the normal male ranges. You can simply reverse both of these for F2M situations. What about intersex individuals? And what about changes that may develop over several years after being on hormone therapy and after gonadectomy? The normal lab ranges may change in the same person according to the years that have passed since these major steps in transition.

Now I hope it is more clear why I am so dissatisfied with the umbrella term "transgender" and would not even be satisfied with the term "transsexual" since it does not indicated anything about medical status. Both of these terms are also most commonly represented in popular media as representing men who only appear as women only they still have fully functional parts that women do not have, which seems to be the main attraction.

[Guest Ms Giggles]

I feel i must respond to Nova's comments regarding differences in lab tests for male and female. I know something about this since I have been a practicing veterinarian for the last 35 years. As a result ALL the doctors I see consider me an equal and treat me as a fellow medical professional. I also should note that on ALL my medical records I am now identified as simply "Female". Yes, there are male and female ranges for blood tests. The values are altered by the levels of estrogen circulating in your blood stream. Those of us on appropriate HRT have FEMALE hormone levels and as a result have the SAME changes in blood test normals. If you do not, it is because your HRT is either not in balance or you have not been on it long enough. This is not just my opinion, i have been told this specifically by my endocrinologist. To whit - he has in no uncertain terms told me that my blood tests MUST be compared to female normal ranges because my biochemistry is specifically that of a post-menopausal woman. To compare them to male normals would result in AN INACCURATE diagnosis of anemia for instance, because my red blood cell count and HCT (percentage of red blood cells per volume) SHOULD be in the FEMALE normal range.

As to changes on radiographs (x-rays) between genders, I don't know what "huge" differences Nova is talking about, but the simple fact is that the ONLY difference is the presence of the sex organs (breasts, ovaries, uterus and vagina for females and penis, testis, and prostate for males) and overall body size. The rest of the body's organs (thoracic, abdominal, cerebral, skeletal ...) are identical other than scale. I have seen many male and female organs up close and personal on my surgery table and can assure you that all of the organs with the above mentioned exceptions are IDENTICAL. Perhaps Nova is confusing the scale of male and female radiographs since the typical male in our society is roughly twice the mass of the average female. However there are very large females and small males. I myself am only 5' 5" and am little larger than an average female of my age.

To summarize, what I am saying is that in my medical experience including what my own doctors tell me, the changes our bodies go through in transition when relatively completed make us closer if not exactly female as far as most medical tests go. We have to watch bone density because we are at risk for osteoporosis just like a cisfemale and NOT like a male. Our prostates likely will shrink to the point that they are difficult to detect and tests like the PSA are NOT accurate for those of us on HRT. The atrophy of our prostates does not prevent the possibility of prostatic cancer and so there are times that it is important for our medical professionals to know that we are in fact trans*, but those same professionals who need to know are usually our endocrinologists who ALREADY know since they are prescribing the very hormones causing this prostatic conundrum. As far as any of our NON-gender specific organs as well as most medical tests are pretty much indistinguishable from a cisfemales.

[Guest LizMarie]

I've had a similar conversation with my endo as Ms. Giggles has had with hers. My blood work is now female normal, according to him. I respect his opinion.

[KathrynJulia]

I to agree with the lab values changing. I keep a copy of all my labs for about 5 years and I've been taking estrogen for half thar time. My lab values have shifted over to the female range. This has necessitated changes in my med dosages. One area was blood pressure. 20 years ago, I developed into Nephrotic Syndrome where I was spilling large amounts of protein into my urine with a future prognosis of dialysis. My kidneys healed, my blood pressure return to normal and now I spill only trace amounts of protein.

I'm off blood pressure meds entirely and this mornings reading 117/75. Cholesterol and triglyceride levels are lower. My CBC has changed dramatically into the female range. My doctor compares me to other woman when he treats me. Kathy