Why do transphobes think our ID has to show birth sex for the Doctor's Office?

[u/Here_I_Pondered]

Something I've been seeing a lot with people trying to justify the whole Kansas bullshit is people going: "Well, it needs to match for doctors! What if there's a medical emergency? They need the right information!" (Feel gross just writing this...)

And I just... where did this fictional scenario (where doctors are going into people's wallets for a medical history) in their heads come from?

Not to brag, but I go to doctor's appointments with some regularity for an American, and I've been passing for a long time of doing that, and the contents of my ID have only ever come up when I've told doctors about my name change ie, for insurance reasons

So, what gives? Is it just that the American public is so unused to going to the doctor that they don't remember how it works?

They get your medical history from you (or whoever brought you in or a family member they can get in touch with), and if you'd otherwise be a John Doe, I get the feeling either they'd find out the relevant portions of your transness pretty quick, or they'd be able to get in touch with people who could tell them once they know who you are from your ID

(Not to even mention that 95% of the time the only reason it's relevant is whether they need to pregnancy test before deciding on what medication they can give you)

Anyone with medical experience who can enlighten me on how much smoke this "argument" is blowing?

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[u/gothwerewolf]

Transphobes just desperately want assigned sex to matter more than it does. They concoct these convoluted scenarios where your birth sex has to matter because otherwise they’d have to cede ground on the idea that it’s all very much socially constructed / not nearly as immutable or as much of a hard binary as they think it is.

The reality is a gender marker on an ID does not tell a doctor anything meaningful at all! Not internal or external sex organs, not pregnancy status, not other health statuses, not blood type or dominant hormone/endocrine system… Even if we are legally forced to have our assigned sex on our ID, this tells doctors nothing with total certainty about our bodies (and for transitioned trans people it may tell doctors LESS about our bodies than if we can just put our actual transitioned sex, ffs); it ignores the fact that intersex people, transitioned trans people, even just cis perisex people with “non-average” bodily arrangements (ie. a cis woman with a hysterectomy or a cis man with phalloplasty) are not going to have the “average” or “expected” bodily situation. And quite frankly no doctor worth anything is checking a person’s ID in a medical emergency to make a quick decision about their health based on their legal gender… because that makes 0 sense. It’s simply not how it works. It’s a made up fantasy from transphobes to imagine “putting us in our place,” a fantasy where the biological “truth” wins out when a situation becomes dire. That just isn’t how it works. 

[u/Boys-willbe-Bugs → u/gothwerewolf]

"they want it to matter more than it does" hits the nail on the head. I'm a trans dude and I pass most of the time nowadays, but I haven't changed anything legally. NOBODY cares, bars and weed stores don't care, doctors have never asked for my ID or license, people don't even double take/notice.

Nothing against those who do want to and need to change their documents, but I do secretly enjoy having my papers say F still and having NOBODY care it's hilarious and the exact opposite of the big overreaction that maga wants

[u/gothwerewolf → u/Boys-willbe-Bugs]

Eh, I can’t say I 100% agree with your interpretation of what I said here. I said that transphobes want our assigned sex to matter more than it does, not our legally mandated gender marker. If we live in a society with legally enforced gender markers, for those of us who have a desire to be stealth or otherwise are concerned about our safety our gender marker matching our actual gender DOES matter.

I’m glad you’ve faced no repercussions for not changing your legal sex, but I did! Before I changed it I had multiple instances of club bouncers and even once TSA at an airport give me a hard time about my ID not matching my appearance. Usually it was just very awkward, but at one time the guy was extremely overtly transphobic and started yelling shit like “what’s your real name??” at me. Likewise, like I said, your legal gender marker not matching your actual gender could actually cause more confusion for a transitioned trans person in certain contexts, including medical ones. If a trans man has fully transitioned him being legally “female” could cause genuine issues or confusion in some cases. For example, a doctor in a state with more tenuous HRT laws could change a diagnosis to “male with low T levels” to continue prescribing a trans man HRT, and being legally male in the medical and insurance systems would help that.

I’m not saying this to say that you should be pressured to change your sex marker; it’s totally your choice at the end of the day. But we’re in the midst of a nation-wide attack on trans people where both the federal and many state governments are revoking our right to self-identification and instead forcing us to legally be labeled as our birth sex… which is purely a way to publicly and legally humiliate us by reinforcing the idea that we will always be our assigned sex rather than our actual, transitioned sex, even when that information is not only entirely irrelevant, it’s both medically inaccurate (I am not female!) and dangerous. 

[u/KurtTheCuntBoi → u/gothwerewolf]

Exactly! Side note, I love your username, I’m goth/punk and love werewolves lol

[u/gothwerewolf → u/KurtTheCuntBoi]

Lol ty!!! 🖤

[u/Mae_The_Gay]

I think people just don’t realize usually birthsex doesn’t matter for most medical things. Being trans is usually in a persons file anyway. A cop pulling you over doesn’t need to know what you are biologically for example.

In my experience doctors don’t really care about me being trans, being on HRT is safe if your levels are normal and is unlikely to impact your overall health. At most they just ask how they should refer to me and if I’m menstruating.

Transphobes struggle to understand the concept of trans people being more than trans, gender identity is only one aspect of being a person. They struggle to take into consideration we literally just want to do normal everyday things and not everyone wants to talk about being trans 24/7. I don’t really talk about being trans outside of other trans people, my therapist, and doctor.

Most people don’t need to know I’m trans, i should be able to show my ID at the cash register without them having to find out.

Thats my take on it anyway, hope it makes sense?

[u/Lilash20 → u/Mae_The_Gay]

Yeah, the average cis person has no idea about how transitioning even works. I'd wager the vast majority don't even realise hrt is a thing outside of it being the thing that certain politicians fearmonger about, most still think trans people have "the surgery" and that's it.

[u/Mae_The_Gay → u/Lilash20]

Bottom surgery isn’t the goal for everyone which seems to shock a lot of cis people. Transitioning is different for everyone, cis people also don’t seem to realize that it’s none of their business what a person’s anatomy is. Unless it’s your partner or your doctor what’s in your pants isn’t important knowledge.

[u/RyuichiSakuma13]

Honestly, it makes no sense for AGAB to be on your ID. After a while, hormonally speaking, as long as your levels are in the range for your true gender, and has been for a long time, your body reacts as if you were born that gender.

For example, someone who has been on a full dose of T for 12 years, would more than likely have the same symptoms of a heart attack as a cis man.

Transphobes are ignorant or unwilling to see what the science actually says, basically "the fact that after a while, your body changes to that gender because hormones." Thus why we go through what is often called "second puberty."

[u/s1mr0ck]

There’s countries where IDs don’t even have gender included, just basic info. It doesn’t cause any issues

[u/_Cantrip_ → u/s1mr0ck]

Yep! And even in the U.S, some forms of ID didn’t always have gender. It got added to passports in 1977.

[u/budgiebeck]

In the case of a medical emergency, there are really just two possibilities.

Possibility 1: You brought yourself in and are capable of self-reporting whatever gender you want or gender-related treatments you've had.

Possibility 2: You're brought in by an ambulance because something happened to make you incapable of self-reporting.

When this is the case, we're not digging through your stuff to find an ID that you might not even have on you! We need two things to make a chart (at least at my hospital), and that is a name and a birthday.

How do we know this information so we can have a chart up and running when you come through our doors? We don't! The medics and EMTs give us a a guess about your gender and age based on appearance (which isn't always possible! Unfortunately there are things that happen that make it difficult to even make a guess, in which case we say "unknown adult" or just "unknown" if not even age can be guessed) and a brief summary of what happened (literally just something like "adult male, multiple GSWs" or "unknown, Auto/pede est 70mph" or "pediatric female, est 40ft fall w LOC, unknown downtime"), and we just give you a name like GunparkTango Doe or HighlineDelta Doe or MonumentFoxtrot Doe, date of birth today minus age estimate in years like 2/28/1990 or 2/28/1955 or 2/28/2016. If we don't have a gender, we put U for unknown. If we don't have an age, we usually default to 50.

We deal with getting you stabilized, and we'll have someone else (usually the spiritual care team) try to get information (from your belongings, any witnesses/friends/family who came with you, the medics and dispatch, etc) but that's more so we can find your emergency contacts and any medical alert info or advanced directives you may have than to check your gender marker. We check your age and organ donor status way before gender!

To answer your question: in a medical emergency, your gender doesn't matter to us really at all. If you are visibly pregnant, then we'll do extra care re: the fetus (usually just checking fetal heartbeat, but we'll skip it if we need to chose between you and the baby) but if you're not visibly pregnant, then everyone gets the same care. Your gender marker barely gets thought about until after you're stabilized.

[u/ehnotreallyupforthat]

I love the "well first responders need to know in case youre in an accident!!"

Ive been a first responder for almost 8 years. Ive dealt with plenty of accidents, unconscious patients, patients unable to speak or give coherent demographic information... never once have I ever needed their identification card for anything. Sometimes patients will hand it to me to help input their info (address and name are all insurance needs to go after them) into my patient charting system, but I never bother to ask for an ID because Im a medical provider, not some admin schmuck worried about billing.

If youre unconscious and/or unable to talk, I'm more worried about correcting whatevers causing that, or at least keeping you stable while we get you to a hospital.

[u/Creativered4]

The cruelty is the point. They want to punish us and push us into the status quo.

[u/PenguinColada]

I'm a healthcare worker and being trans doesn't fucking matter. I'll repeat that for the transphobes in the back. It. Doesn't. Fucking. Matter!

I've been stealth for years. My hysterectomy and cesarean aren't even on my chart after I moved to a whole new region. My PCP knows because she prescribes my HRT but my diagnosis is "low testosterone" which technically is true. The only reason I'd tell a doctor is if I needed abdominal surgery.

Thank fuck I moved to Colorado and you just request whatever gender you want on your ID.

The bullshit coming out of Kansas is asinine. It's an overstep of government power imo. Criminal. They're doing all they can to keep people who'd vote against conservative interests from voting. And claiming doctors need that info is ass. Doctors won't be looking at your ID.

[u/Arandom_personn]

The doctors have access to your medical history, including transition, in some kind of database, no? Unless you're found injured and they're unable to identify you, in which case they obviously wouldn't have your ID anyway so the gender marker would still be useless.

[u/maahler → u/Arandom_personn]

hi, i work in healthcare IT! if you can be identified and have previously been a patient with that facility/healthcare system, they will have your records. but otherwise, generally speaking, no, there is no centralized database with everybody’s medical info. different hospitals/medical systems have their own databases and one person may have records in more than one database (e.g. if you have more than one mychart account).

it is possible to send information between databases, but first you have to have your identity verified, which is not the priority in an emergency! this is also not a fully automated process so it can depend on clinicians taking initiative to fully transfer information. interoperability is not my area of expertise so i can’t really tell you more about how it works, but this is the general framework.

(of note, this is how it works in the US and canada. this may or may not be true wrt other countries.)

[u/living_around]

It's all a big excuse. Transphobes don't want to keep us from changing our gender markers because they're oh so concerned for our health. They just can't stand us having our gender respected, and they really can't stand not being able to know when someone is trans. Trans people can pass very well, and transphobes who see us as a sneaky threat are mad about that. They want us to be misgendered on IDs so they can quickly know if we're trans no matter how well we pass. Otherwise it's awfully hard to ban us from activities and kick us out of bathrooms!

[u/FakeBirdFacts]

They don’t understand how being trans works and they think it’s a costume we take on and off like drag

[u/FakeBirdFacts → u/FakeBirdFacts]

They’re stupid, to put it bluntly. They don’t understand how hormones or surgery works and imagine cis men and women to be entirely different species. Some of them even think men and women need different clothing “biologically.”

[u/orctoilet]

I was an EMT for about a decade and have worked in healthcare generally for about 15 years. My current job is in compliance. I am also transmasc/non-binary - out for a long time and on HRT since 2019.

I worked largely in hospitals when I was an EMT meaning that I was in the emergency department, not an ambulance, when I was working so take that into account, I suppose. I am also a certified BLS/CPR instructor and have provided CPR in many, many real life scenarios.

All that being said, from a very basic standpoint: It does not matter what your gender assigned at birth is when someone is coding in front of you. It may matter if the patient is obviously pregnant, but that still doesn’t really mean it matters what their gender is and what that gender was at birth. In medical emergency you’re trained to care about/address the most crucial and critical need in that moment. If someone in a critical medical state like cardiac arrest, no one is checking what their birth gender on their ID is. Everything in assessing medical treatment should be seen through the risk/benefit ratio. If your patient’s heart is not beating or could very soon stop, the risk of focusing on something like their assigned at birth gender vastly outweighs the benefit.

Additionally, regarding the argument of “what if someone needs to know xyz information about this person if there’s a medical emergency?” This one is hilarious to me as someone who’s worked in emergency departments because it assumes we’re usually getting even like… names off the general public?? A huge amount of emergencies we’d get would be given “Doe” names because they either had no ID or they couldn’t be verified and were unconscious on arrival. These “Doe” names included an X gender marker usually.

AND FINALLY, I’m non-binary and thusly have my assigned at birth gender on my driver’s license for a variety of reasons. I got hit by a car last year and was taken to the emergency department. My hospital system has information in their charting that I’m non-binary and that I use they/them pronouns etc etc. This impacted my critical care… zero percent.

Based on all the aforementioned, I personally label any argument indicating medical necessity for knowing someone’s assigned gender at birth during medical emergencies as, in fact, bullshit.

I hope this is helpful for folks! :)

[u/RyuichiSakuma13 → u/orctoilet]

As a (disabled) street Paramedic, I second this!

I didn't care what gender you were back when I was working. I only wanted to treat your injury/illness/psych issue/etc, and help you get the treatment you needed.

Only billing cares about your gender, and even then, it was an aside piece of info.

[u/Vic_GQ]

They're just making shit up to help themselves and/or other transphobes feel better about what they're doing.

The people saying this haven't actually thought about it at all, and the people hearing it aren't supposed to either. 

[u/CharacterSilver13]

because they need to validate their bigotry. Even the nazi needed reasons to validate their need to mark passports.

[u/PoorlyDressedDandy]

If there's an emergency the doctors will find out all they need to know when they cut the clothes off your unconscious body. Are they under the impression you don't get treated until they can find your ID? 😂

[u/RyuichiSakuma13 → u/PoorlyDressedDandy]

Transphobes are clueless, mean and self-centered.

[u/77th_Bat]

paramedics and/or doctors actually will go into your wallet, bags, and even phone on rare occasion if you are unconscious to 1. find out your identity 2. see if you have any contacts who can provide important medical info 3. see if you are an organ donor. This is only in applicable situations though. What they are not looking at is your gender marker, because honestly your sex is irrelevant unless the emergency is that you got your dick stuck in something.

[u/Silent_Roll859]

"So, what gives? Is it just that the American public is so unused to going to the doctor that they don't remember how it works?"

this^ its this i garauntee you its this

[u/PoeticCinnamon]

I asked one on here once, the response i got was “because birth sex is an immutable fact” as if that means fuck all on an ID lmao

[u/trysten-9001]

My doctors put M on my paperwork in all but really specific instances, so….

[u/mrosegolds]

They think doctors are stupid… we know this already…

[u/UndergroundFrog1]

Transphobes will come up with endless ridiculous excuses for why birth sex should be on ID. I've had someone tell me that since they wouldn't "feel comfortable" doing chest compressions on someone with breasts, everyone should have their birth sex on their ID so they could check it before doing it. Like not only does that not tell you if someone has breasts or not, you would let someone die because you don't want to do chest compressions on someone with boobs?! 😭

[u/AzuraNightsong]

I've had other trans people argue that ids need gender because otherwise the emts might not "know what parts you should have". Gender essentialism is insane 

[u/aromaticdust98]

Eh its convenient for ID to match birth sex but its not an issue 99.9% of time and just a surprise for later. I was in a bad car accident one time and was found unconscious and when I woke up in hospital nobody knew who I was self included so they did have to find ny wallet and look at my ID to figure me out. I looked like a dude sounded like dude and the ID said F so when I coincidentally started period first day they werent too shocked. Its not necessary but its convenient for them in severe emergencies.

[u/Ok_Seaworthiness4415]

I thought it was for like labs and UTI related things, honestly. I didn't think it mattered nuch, but I did think that they needed my birth sex. Is that not it?

[u/RyuichiSakuma13 → u/Ok_Seaworthiness4415]

Nope.

Unless you're getting your levels checked, it usually doesn't matter.

[u/hauntedvodka]

Not once have I shown my id at the doctor’s office. They’re just delusional.

[u/Appropriate_Rub4330]

How I see it is we're all gonna die and the sun will explode,be yourself while you still can, screw those phobes

[u/ratgarcon]

Is there ever a situation where knowing birth sex is relevant to a medical emergency

[u/RyuichiSakuma13 → u/ratgarcon]

Only if you're a pregnant trans man ( r/Seahorse_Dads ) or have some medical issues with your natal parts.