The Jury Talks Back

5/17/2019

AP Headline: “A pregnant man’s tragedy tests gender notions”

Filed under: Uncategorized — Patterico @ 7:21 am

The AP has an article titled Blurred lines: A pregnant man’s tragedy tests gender notions:

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.

The tragic case, described in Wednesday’s New England Journal of Medicine, points to larger issues about assigning labels or making assumptions in a society increasingly confronting gender variations in sports, entertainment and government. In medicine, there’s a similar danger of missing diseases such as sickle cell and cystic fibrosis that largely affect specific racial groups, the authors write.

“The point is not what’s happened to this particular individual but this is an example of what happens to transgender people interacting with the health care system,” said the lead author, Dr. Daphna Stroumsa of the University of Michigan, Ann Arbor.

“He was rightly classified as a man” in the medical records and appears masculine, Stroumsa said. “But that classification threw us off from considering his actual medical needs.”

Does it make sense to say the patient “was rightly classified as a man,” given what happened?

It’s likely that classification of this patient as a woman would have provided a better chance for the baby’s survival:

The 32-year-old patient told the nurse he was transgender when he arrived at the emergency room and his electronic medical record listed him as male. He hadn’t had a period in several years and had been taking testosterone, a hormone that has masculinizing effects and can decrease ovulation and menstruation. But he quit taking the hormone and blood pressure medication after he lost insurance.

A home pregnancy test was positive and he said he had “peed himself” — a possible sign of ruptured membranes and labor. A nurse ordered a pregnancy test but considered him stable and his problems non-urgent.

Several hours later, a doctor evaluated him and the hospital test confirmed pregnancy. An ultrasound showed unclear signs of fetal heart activity, and an exam revealed that part of the umbilical cord had slipped into the birth canal. Doctors prepared to do an emergency cesarean delivery, but in the operating room no fetal heartbeat was heard. Moments later, the man delivered a stillborn baby.

A woman showing up with similar symptoms “would almost surely have been triaged and evaluated more urgently for pregnancy-related problems,” the authors wrote.

But the patient was a woman, at least for purposes of medical professionals trying to assess what to do. It was the “proper” classification of the patient as a man that increased the chance of this tragic outcome.

I’m not here to mock or deride anyone who believes that they were born the wrong gender. I can understand why people like that want to be called by their preferred gender. However, as Ben Shapiro likes to say, facts don’t care about your feelings — and biology doesn’t care what you choose to call yourself. Medical professionals have to have a better way to deal with such situations than shrugging their collective shoulders and doing the same thing.

1 Comment

  1. I think this story is best summed up in the deeply philosophical documentary, Kindergarten Cop:

    Boys have a penis, girls have a vagina.

    Comment by Sean — 5/17/2019 @ 8:43 am

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