The tragic case, described in Wednesday's New England Journal of Medicine, points to larger issues about assigning labels or making assumptions in a society increasingly confronting gender variations in sports, entertainment and government.
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In medicine, there's a similar danger of missing diseases such as sickle cell and cystic fibrosis that largely affect specific racial groups, the authors write. More: Iowa Senate Republicans propose banning the use of Medicaid dollars on transgender surgery. More: Armenian transgender activist says she's faced death threats since historic speech.
Transgender men, who are considered female at birth but who identify as male, may or may not be using masculinizing hormones or have had surgical alterations, such as womb removal. The year-old patient told the nurse he was transgender when he arrived at the emergency room and his electronic medical record listed him as male.
He hadn't had a period in several years and had been taking testosterone, a hormone that has masculinizing effects and can decrease ovulation and menstruation. But he quit taking the hormone and blood pressure medication after he lost insurance.
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A home pregnancy test was positive and he said he had "peed himself" — a possible sign of ruptured membranes and labor. A nurse ordered a pregnancy test but considered him stable and his problems non-urgent. Several hours later, a doctor evaluated him and the hospital test confirmed pregnancy.
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Nurse mistakes pregnant transgender man as obese. Then, the man births a stillborn baby
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