‘Be the change that you wish to see in the world.’
– Mahatma Gandhi
[Trigger warning for a brief mention of a suicide attempt mid-post]
Considering how cutting edge medical interventions have become, it makes me really sad how slowly attitudes within medicine change. I’ve certainly written about my difficulties persuading colleagues that masturbating isn’t a joke and how doctors, myself included, rarely consider their patients’ sexual needs when thinking about their health, and there are too many stories about people clashing with their doctor because of their sexuality.
Which is why this week’s BMJ has made me so, so happy.
This is an educational journal that is sent to every BMJ member every week and it has prioritised transgender health. Although this journal is sent so frequently that it usually ends up in a pile in the corner, this is such a brilliant and bold cover that it couldn’t easily be ignored. And among the usual articles about new drugs and opinions on millennial’s working habits (*eye roll forever*) is an article about gender dysphoria for non-specialists and another from transgender people about how doctors can talk to them and manage their medical problems.
Yes! Fucking yes!!
Inexperience begets fear and blundering behaviour that can so easily be disrespectful, and medics of my generation and above just aren’t taught the right language to prevent this. There are also no structures in place or protocols to accommodate trans needs in hospital.
A few months ago, I was called by a GP about a patient that she was sending into hospital who had taken an overdose. They were in the middle of a mental health crisis and could see no other way out. The GP told me their name and then said that they had recently transitioned and their medical records may be in their previous name. I asked about what pronouns they used to make them feel comfortable when they arrived, but the GP didn’t know. Fail. I put their current name on our expected patients list, but when they arrived they had to be recorded as their old name for continuity. Fail. They then had to be nursed in a side room because no one could decide if they should be in a male or female ward. Fail. We managed this patient’s medical needs but I know that we did not help with their mental health needs at all.
So I have absolutely no doubt that this guidance is both necessary and timely. It is clearly and confidently written, with simple enough instructions and recommendations that anyone could understand them and, hopefully, change their practice. There’s even an infographic! (Damn, I love infographics!!)
But I found the quotes from article providing the opinions of the transgender authors in the above tweet much more affecting. I could see my own bad practice in their advice and, more importantly, see obvious ways that I could improve.
Put simply, you can’t tell my medical needs by looking at me.
Please don’t bring up my trans status if it’s not relevant to the consultation.
You probably aren’t an expert in trans issues—that’s OK. You don’t need to be an expert to treat me with kindness and compassion: something as simple as the name you call me makes a huge difference.
You’ll need to think outside the tick-box about what’s relevant for my body.
Please follow my lead with how I talk about and relate to the gendered parts of my body. Just as a disability isn’t caused by the wheelchair, but by the stairs—sometimes my dysphoria isn’t caused by my body, but by how the rest of the world regards what and who I am.
Maybe this article is the start. Maybe the wider medical community has realised that we’re not doing enough; that we’re not nearly good enough.
But maybe we can change… (Yes!!)
This is post #2 of a planned 6 for Smutathon 2017.