verbnouner:

chickensnack:

happy 15th anniversary final fantasy 8 dog tuesday

[MS Paint drawing of Rinoa flicking Angelo into battle, with a stretched “99999999 points” text underneath.]

verbnouner:

chickensnack:

happy 15th anniversary final fantasy 8 dog tuesday

[MS Paint drawing of Rinoa flicking Angelo into battle, with a stretched “99999999 points” text underneath.]

unceremoniouslykarly:

tin-d0g:

xeansan:

camerongale:

drakensberg:

ttthegingerqueer:

Just filled out my health insurance forms!

yeah!!! fucking around with health insurance forms!!!!

I hate when people complain about “oh health forms are stupid they want my biological sex instead of my gender!!!!” or “they only have male or female!!!”

There’s a reason for that, you dumb fucks, and they’re referring to biological sex

Different health risks are present in different sexes, and whatever gender is in your head does not change the fact that if you were born female, you have a higher risk for certain cancers and osteoporosis, and if you were born male you have a higher risk for heart disease and often a shorter lifespan than a female.

In other words, your biological sex is an important factor in health and health insurance, and your special snowflake status doesn’t change that.

Coulda said it nicer but it’s true; it’s about health.

No. There gets a point where nice doesn’t work. There’s too many stupid ass angsty teens on here that are gonna get themselves seriously hurt or sick because they wanna be a special fucking snowflake. Lemme tell you a thing. Doctors don’t give a flying fuck what you identify as. All they want to know is do you have two X chromosomes or an XY? Because cancer and lupus and certain medicines don’t give a flying fuck what pronouns you use. This is about your fucking LIFE. stop being angsty for TWELVE SECONDS because when you’re in an ambulance or going into cardiac arrest or whatever the situation may be, it’s ESSENTIAL that you get your head out of your ass long enough to tell them your BIOLOGICAL SEX that you were BORN WITH. It literally may save your life.

Firstly, there is some really unnecessary invalidating of identities and name calling in this post that is very uncool.

In my experience, it’s very easy for those of us who study science and medicine to forget that our information is developed within society, and isn’t the end-all, be-all 100% FACT that we often make it out to be. We can’t forget that the process of science is imperfect, as are humans. Medicine and science, like anything else, are created by flawed human beings.

1. Identities and language DO matter when someone is interacting with their doctor.

Many times in medicine, your identity has very little effect on your treatment. If you go to the doctor with allergies, you should have the same medical solution whether you’re a lady, have no nose, don’t speak Czech, or hate the taste of toast. However, some of these things will change the best way for your doctor to interact and communicate with you.

If a lady visits her doctor for allergies and spends the entire visit being called “sir” and “MISTER Fernandez,” not only will this likely bother her, but it may also distract her from hearing important medical information from her doctor or, even worse, make her reluctant to seek out medical treatment again, either from that doctor or any healthcare at all.

If someone who doesn’t have a nose visits a doctor for allergies, prescribing a nasal spray won’t be very helpful for that person. That’s why it’s useful that the doctor not only is aware of that, but accepts the reality of that fact and has alternatives to offer.

A monolingual English speaker won’t reap much benefit from a detailed breakdown of how to treat allergies in Czech, but an interpreter, written English resources, or information from a doctor fluent in English would all be useful to this patient, while a fluent Czech speaker would find these things relatively useless.

There is also something to be said about human decency. I understand if you’re performing CPR on someone that using the right pronouns isn’t your priority in that moment (nor would it be mine), but if I’m putting a bandaid on someone it might behoove me to check in before I start “ma’am” and “sir”-ing them all over the place. Not just in medicine, but in every aspect of human interaction, we as a species need to get better at respecting peoples’ wishes about how they be referred to. If you insisted on calling Bill, your boss, William “since that’s his real name,” even though Bill and all your coworkers asked you to stop, you would be an inconsiderate ass. Same goes for Phillip whose legal name is Kathleen.

2. We need to be more specific when we talk about “sex” (the characteristic, not the act - though that could use some clarification on that in the medical setting as well). The way I understand it, there are four major points that determine how we determine someone’s “sex”:

• Anatomy: so, what genital anatomy someone has (this could include a penis, vulva, vagina, testicles, clitoris, uterus etc.)
• Chromosomes: sex chromosomes can come in many configurations: X0, XX, XXX, XY, XXY, XYY - sex chromosomes are not routinely tested in the US, so a majority of the population is unaware of their chromosomal makeup
• Hormones: this includes both hormones produced during puberty and hormones added in adulthood, which produce secondary sex characteristics including body and facial hair growth, body fat distribution, and voice changes
• Legal sex: simply the letter “F” or “M” on someone’d identification documents (birth certificate, government ID, passport, etc.)

3. Often, even doctors aren’t really sure why they need to know your “sex”

I’d like to provide examples from my above categories, as they impact healthcare in distinct ways.

Anatomy. I’m talking specifically about genital anatomy here. Often, this is irrelevant - an eye doctor could care less what’s in your pants when determining the health of your corneas, for example. But in some ways, this does matter. People need access to the medical care relevant to the body parts they actually have. Regardless of their gender, someone who has had a hysterectomy isn’t going to need access to all the same options to prevent unwanted pregnancy as someone of reproductive age with a functioning uterus and ovaries will. Similarly, someone who doesn’t have testicles probably isn’t really at risk for testicular cancer, and someone probably doesn’t need a pap smear unless they have a cervix. In this regard, someone’s pronouns/identity may not be directly relevant to the medical care they are receiving - but they anatomy certainly is.

In this instance, when a healthcare provider is asking “what is your sex?” what they’re really trying to figure out is what anatomy you have.

Hormones. This comes into play mostly when talking about medications and risk factors for certain diseases. Osteoporosis, for example, is much more common in women. But why? Is there something about wearing dresses that causes bone degeneration? Something about being referred to with feminine pronouns that causes lower bone density? Something inherent in having a vagina that makes bones easier to fracture? Of course not. The difference is hormones.

Healthy people almost always have sufficient levels of estrogen production to generally keep their bone density to healthy levels. The difference is that people who undergo menopause experience a dramatic drop in estrogen, which is one of the key components in keeping bones strong and healthy. Since disease and drug research is conducted almost exclusively on cisgender people, it is easy for these factors to run together. But it is peoples’ relative lack of estrogen later in life - not their inherent female-ness or woman-ness, that increases the risk of osteoporosis.

In this instance, when a healthcare provider is asking “what is your sex?” what they’re really trying to figure out is which levels of certain hormones you have in your body. This can help them determine which drugs might be most effective for you, and also give them a heads up for which diseases to look out for.

Legal sex. Unfortunately this is most often used as a proxy for everything else. Many people who work in healthcare (embarrassingly, myself also included) look for that little “M” or “F” on someone’s records and decide whether to call them sir or ma’am, what anatomy they have (and, therefore, which services they will need accordingly), and a general idea of their hormone levels. While it is important to determine someone’s legal sex for insurance purposes, that’s about the most effectiveness I’ve ever seen it have.

With insurance, for example, sometimes someone’s legal sex determines which procedures and health interventions will be covered. An insurance provider may only cover pap smears or breast exams for people listed as “F,” even though not everyone who is legally female has a cervix and breasts, and not everyone who has a cervix and breasts is legally female.

What I’m trying to tell you is this. Healthcare, medicine, and science, are incredibly complicated, flawed, and evolving disciplines. We all want to help improve peoples’ lives as much as we can, and sometimes what we want to give our patients clashes with what our patients want and need from us. It would make many of us better providers to harness our frustration with words and identities we don’t understand to try and provide as best we can for our patients.

Additionally, science itself can be bettered by deconstructing our current understanding about biological sex. Where we have before found risk factors of “women over 65,” if we are forced to understand more specifically what biological and chemical forces are at work, we will get a clearer picture not only of how diseases function, but of how to treat or even prevent them. If what we know about abdominal aortic aneurysms (AAAs or triple A’s) is that they affect men more, then our solutions are basically limited to “stop being a man,” which is neither likely nor possible for many people. However, if we research further and discover which aspect of what we assume is biological sex (whether it be genetic, hormone related, or linked to social factors), then we’ll know more about AAAs and how to help prevent them.

When our patients react to healthcare provider questions with anger, creativity, or protest, if we respond with genuine inquiry and a desire to improve - both in terms of human interaction and scientifically - we can only make medicine better.

verbnouner:

chickensnack:

happy 15th anniversary final fantasy 8 dog tuesday

[MS Paint drawing of Rinoa flicking Angelo into battle, with a stretched “99999999 points” text underneath.]