He is transgender, he arrived at the hospital with a stomach pain and no one suspected what was happening to him.

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 ended in the baby's loss.

The tragic case described in the last issue of the magazine
New England Journal of Medicine, shows the wider difficulties around badigning labels or baduming established things in a society that has more and more gender variants in sports, entertainment and the government.

In medicine, for example, there is a similar danger, which is to not diagnose diseases such as sickle cell disease or cystic fibrosis that significantly affect specific racial groups, wrote the article's authors in the medical journal .

"The heart of the problem is not what happened with this individual, but it's an example of what's happening with transgender people who interact with the health system," he said. said Dr. Daphna Stroumsa, the main author of the report. from the University of Michigan to Ann Arbor.

"He has been properly clbadified in medical records and has a masculine appearance," Stroumsa said, "but this clbadification has prevented us from taking into account his true medical needs."

Stroumsa 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 case

The patient, aged 32, told the nurse that he was transgender when he arrived at the emergency and that his electronic medical record clbadified him as a man. He had not had his period for several years and had taken testosterone, a hormone that has masculinizing effects and can decrease ovulation and menstruation. However, the man stopped taking the hormone and medication for his blood pressure after exhausting his health insurance.

A home pregnancy test that was done was found to be positive and revealed that she had "urinated", a possible sign of a ruptured membrane and labor. A nurse ordered a pregnancy test, but she felt that she was stable and that her problems were not urgent.

A few hours later, a doctor examined him and the hospital pregnancy test confirmed that he was in this state. 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. 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.

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

Include transgender patients in training

"Medical training should include situations with transgender patients" so that health workers are better prepared to better meet their needs, Wexler said. "Many doctors who practiced did not have it 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.

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

AP Agency