Emergency medication isn’t dosed by gender, it’s dosed by weight. It really would only matter with certain drugs in pregnancy.
It is helpful to know the original gender for some things because certain illnesses present differently in men V women and not all of that changes post transition so if you are treating a man it would be helpful to know that he was born a woman so you don’t brush off certain symptoms as minor if in fact in a women they would be very alarming. For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
But in an unconscious trauma patient, it doesn’t really matter. If a trans man still has a uterus then that’s an additional organ to be damaged that might not be expected, but that’s not something that’s going to be caught in the ambulance either way because we don’t have a CT scanner hanging out in the cabinets.
For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
This is why we need more medical research focused on trans and intersex bodies. It’s honestly a travesty that it hasn’t been studied much, largely due to the pushback from oppressive governments and transphobes. The problem extends beyond trans people, so much medical research is modeled on white cis male bodies, but I’m sure you’re already aware of that issue.
Transition affects nearly every part of the body. It’s already known that trans brains more closely resemble their cis counterparts rather than their sex assigned at birth (citations: NIH.gov, Scientific American). It wouldn’t make sense to treat a trans woman as a cis man for brain imaging. In trans men, testosterone deepens the vocal chords and can even slow down or stop periods. In trans women, estrogen shrinks the prostate and can even reverse male pattern baldness. Surely there are other effects on internal medicine, both positive and negative
Part of trans liberation involves sponsoring more research in this topic. In your heart attack example, has it been scientifically proven that the symptoms are immutable with transition? Does the amount of time someone’s been transitioning affect it? These are genuine questions, I don’t know the answers to them
I agree that more research needs to be done. I don’t know the answers to those questions either. I’m sure there’s lots more knowledge out there that is known that I just don’t know, but there’s also tons of knowledge that’s lacking, the same way that there’s tons of knowledge that’s lacking about women’s bodies. Humans are fascinating and there’s so many different factors that can affect medical presentations or risk factors.
Unfortunately in the current climate that research is considered too “woke” to “waste” money on, so people will continue to suffer from insufficient medical care even when their providers are genuinely trying their best.
Weight isn’t the only consideration for emergency medicine dosing, though… There are lipophilic drugs in emergency medicine. CT scanners aren’t the only thing used in emergency medicine, point-of-care ultrasound is used by physicians too.
It’s not like biological sex is irrelevant in emergency medicine.
Sure, but none of the drugs that would be used in the situation you describe would matter enough to kill or seriously harm anyone. At worst it would just have a longer half life and then you just don’t give as many or as high doses later on. And that also applies to many different demographics including old people and people with other medical issues that causes them to clear drugs slower, which is why patients are monitored and dosed accordingly and the dosage schedule is a guideline not a rule.
If some random distribution of body fat could kill a person then you’d have people dropping dead left and right based off differences in everyone’s muscle mass to body fat ratio and it just doesn’t work that way.
I never said it was irrelevant, I literally wrote that it can be very very relevant in some cases, but it’s not so relevant that it’s vital to know if you’re unconscious and bleeding out.
I mostly agree with you, but it’s not like overdoses caused by medical errors don’t ever happen either. Because it has a longer half-life (due to biological women commonly having a higher percentage of body fat compared to biological men, for example), medication levels can build up (as you mentioned) and result in adverse effects if you make a mistake with dosing. Pharmacokinetics and pharmacodynamics do matter too.
Just because it’s not common (because physicians are trained to handle it appropriately) doesn’t mean it’s not possible.
Like you said, demographics (including age, biological sex, etc) do matter.
Emergency medication isn’t dosed by gender, it’s dosed by weight. It really would only matter with certain drugs in pregnancy.
It is helpful to know the original gender for some things because certain illnesses present differently in men V women and not all of that changes post transition so if you are treating a man it would be helpful to know that he was born a woman so you don’t brush off certain symptoms as minor if in fact in a women they would be very alarming. For example, men having heart attacks are more likely to present with the classic chest pain radiating to their arm. Women can have chest pain, but often present as sudden onset of nausea and vomiting with no pain. That’s a rare presentation of a heart attack in a man, so a man complaining of severe nausea is more likely to be thought of as GI in nature, but if you know he’s trans then alarm bells start screaming that this might be cardiac and you need to do an EKG now.
But in an unconscious trauma patient, it doesn’t really matter. If a trans man still has a uterus then that’s an additional organ to be damaged that might not be expected, but that’s not something that’s going to be caught in the ambulance either way because we don’t have a CT scanner hanging out in the cabinets.
This is why we need more medical research focused on trans and intersex bodies. It’s honestly a travesty that it hasn’t been studied much, largely due to the pushback from oppressive governments and transphobes. The problem extends beyond trans people, so much medical research is modeled on white cis male bodies, but I’m sure you’re already aware of that issue.
Transition affects nearly every part of the body. It’s already known that trans brains more closely resemble their cis counterparts rather than their sex assigned at birth (citations: NIH.gov, Scientific American). It wouldn’t make sense to treat a trans woman as a cis man for brain imaging. In trans men, testosterone deepens the vocal chords and can even slow down or stop periods. In trans women, estrogen shrinks the prostate and can even reverse male pattern baldness. Surely there are other effects on internal medicine, both positive and negative
Part of trans liberation involves sponsoring more research in this topic. In your heart attack example, has it been scientifically proven that the symptoms are immutable with transition? Does the amount of time someone’s been transitioning affect it? These are genuine questions, I don’t know the answers to them
I agree that more research needs to be done. I don’t know the answers to those questions either. I’m sure there’s lots more knowledge out there that is known that I just don’t know, but there’s also tons of knowledge that’s lacking, the same way that there’s tons of knowledge that’s lacking about women’s bodies. Humans are fascinating and there’s so many different factors that can affect medical presentations or risk factors.
Unfortunately in the current climate that research is considered too “woke” to “waste” money on, so people will continue to suffer from insufficient medical care even when their providers are genuinely trying their best.
Weight isn’t the only consideration for emergency medicine dosing, though… There are lipophilic drugs in emergency medicine. CT scanners aren’t the only thing used in emergency medicine, point-of-care ultrasound is used by physicians too.
It’s not like biological sex is irrelevant in emergency medicine.
Sure, but none of the drugs that would be used in the situation you describe would matter enough to kill or seriously harm anyone. At worst it would just have a longer half life and then you just don’t give as many or as high doses later on. And that also applies to many different demographics including old people and people with other medical issues that causes them to clear drugs slower, which is why patients are monitored and dosed accordingly and the dosage schedule is a guideline not a rule.
If some random distribution of body fat could kill a person then you’d have people dropping dead left and right based off differences in everyone’s muscle mass to body fat ratio and it just doesn’t work that way.
I never said it was irrelevant, I literally wrote that it can be very very relevant in some cases, but it’s not so relevant that it’s vital to know if you’re unconscious and bleeding out.
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I mostly agree with you, but it’s not like overdoses caused by medical errors don’t ever happen either. Because it has a longer half-life (due to biological women commonly having a higher percentage of body fat compared to biological men, for example), medication levels can build up (as you mentioned) and result in adverse effects if you make a mistake with dosing. Pharmacokinetics and pharmacodynamics do matter too.
Just because it’s not common (because physicians are trained to handle it appropriately) doesn’t mean it’s not possible.
Like you said, demographics (including age, biological sex, etc) do matter.