The case of the transgender man who arrived at the hospital with a pain in the stomach and no one suspected the cause: a few hours later he lost his son

When a man arrived at the hospital with intense abdominal pain, a nurse did not consider that it was an emergency, considering that he was obese and had stopped taking any medication for blood pressure. In fact I was pregnant: It was a transgender giving birth that resulted in a loss.

"The heart of the problem is not what happened with this particular individual, but rather is an example of what is happening with transgender people who interact with the health system"said the main author of the report published Wednesday in the magazine New England Journal of MedicineDr. Daphna Stroumsa, from the University of Michigan at Ann Arbor.

"He was correctly clbadified as a man"in the medical record and has a masculine appearance," commented Stroumsa.But this clbadification prevented us from considering their true medical needs"The author did not specify where and when the case occurred and the patient's identity was not provided.

Transgender men, who are considered women at birth but who identify as men, may or may not use male hormones or have undergone surgical changes, such as removal of the uterus. .

The patient, 32 years old, he told the nurse that he was transgender when he arrived at the emergency room next to his boyfriend, and his electronic medical record clbadified him as a man. I did not have my period for several years and I had taken testosterone, a hormone that has masculinizing effects and can decrease ovulation and menstruation. However, the man stopped taking the hormone and a drug for blood pressure after he was without health insurance.

Nail Positive home pregnancy test and said that he had "urinated", a possible signal of membrane rupture and labor. A nurse ordered a more reliable pregnancy test, but considered that he was stable and that his problems were not urgent.

A few hours later, a doctor examined him and the hospital pregnancy test confirmed him. An ultrasound showed uncertain signs of fetal heart activity and an examination revealed that part of the umbilical cord had entered the uterine cbad. Doctors have prepared for an emergency cesarean section, but no fetal heartbeat has been heard in the operating room.. A few moments later the man gave birth to a dead baby.

If a woman had arrived with similar symptoms, "she would surely have been treated and evaluated more urgently for pregnancy-related problems," the authors wrote.

The tragic case notes that there are more significant issues with labeling or the presumption of things in a society with more and more gender-specific variants in the fields of sport, entertainment and government. In medicine, there is a similar risk that diseases such as sickle cell disease or cystic fibrosis will not be diagnosed and will greatly affect specific racial groupsadded the report.

"This is a very sad incident and a tragic outcome," said Dr. Tamara Wexler, hormone specialist at Langone Medical Center at New York University.

"Medical training should include situations with transgender patients"so that health workers are better prepared to better meet their needs," said Wexler.Many practicing doctors do not have this in their training", but they can still learn from this type of patients.

Nic Rider, a transgender health specialist and psychologist at the University of Minnesota, said the training was not enough. "There are implicit biases that need to be solved," he said.

Medical history could use male and female models for bad, but that "does not mean that we simply reject critical thinking or think about the diversity of humans," Rider said.

The case is horrible, but "not really surprising," said Gillian Branstetter, spokeswoman for the National Center for Gender Equality in Washington.

Transgender people often struggle to obtain gender-sensitive medical care, such as cervical cancer screening, birth control, and prostate cancer screening.

Much remains to be done to improve the medical culture and the recognition of diversity because "the consequences can be very serious, as this case shows", Stressed Branstetter.

(With information from AP / Marilynn Marchione)