A transgender man was treated for abdominal pain but was pregnant

When a man arrived at the hospital with severe abdominal pain, the nurse did not consider that it was an emergency, considering that he was obese and had stopped take a medicine for blood pressure. In fact, I was pregnant: it was a transgender about to give birth. All resulted in a stillbirth.

The tragic case, described in the Wednesday issue of the New England Journal of Medicine, highlights the greater difficulties of labeling or decision-making in a society characterized by more and more gender variant areas of sport, entertainment and entertainment. the government.

"The important thing is not what happened with this person, but it is an example of what is happening with transgender people who interact with the health system," said lead author of the report. Dr. Daphna Stroumsa, University of Michigan, Ann Arbor.

"He was properly clbadified as a man" in the medical record and appears as a man, Stroumsa said. "But this clbadification has prevented us from taking into account its current medical needs".

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. .

How events happened

The patient, aged 32, told the nurse that he was transgender when he arrived at the emergency and that his medical file 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 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 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. 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.

"Medical education should include situations with transgender patients" so that health workers are better prepared to better meet their needs, said Dr. Tamara Wexler, hormone specialist at Langone Medical Center at the University of Toronto. New York.

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.

Gillian Branstetter, a spokesperson for the National Center for Gender Equality in Washington, said that transgender people often have problems getting gender-specific health care, such as cervical cancer screening, birth control and cancer screening. Prostate

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.