WHAT’S BEING CLAIMED:
- When a transgender man reported severe abdominal pains, he was apparently pregnant and in labor, but a nurse did not mark his case as an emergency.
- He delivered a stillborn baby shortly after.
- The authors of the case report criticized the flaws of gender classification in medical records and argued that a woman with similar symptoms would have been ‘evaluated more urgently.’
When a man reported severe abdominal pains at a hospital’s emergency room, a nurse only thought he was obese and had stopped taking blood pressure medicine. She did not think his case was an actual emergency.
It was only after a few hours that it became apparent that he was pregnant and in labor.
As stated in the New England Journal of Medicine’s case report, the 32-year-old’s medical record listed him as male. When he arrived at the hospital, he informed the nurse that he was transgender.
He hadn’t had a period in several years, which could be caused by his testosterone intake. However, he had stopped his hormone intake and blood pressure medication after losing his health insurance.
He got a positive result when he used a home pregnancy test earlier that day, but he assumed it was a mistake. He also stated that he “peed himself” that morning, which could likely mean that his water broke, signaling labor. The nurse ordered a pregnancy test but marked his case as non-urgent.
The test confirmed that he was pregnant. When a doctor examined him hours later, she noted that he was obese, had high blood pressure, and a possibly ruptured amniotic sac.
His condition could mean any of the following: labor, preeclampsia (dangerously high blood pressure during pregnancy), or placental abruption (the placenta separates from the uterus before delivery). All these conditions call for urgent treatment, or it could be dangerous for both the mother and baby.
After an exam showed the baby at a risky position, the doctors carried out an emergency cesarean delivery. Part of the umbilical cord had slipped into the vaginal canal and the ultrasound could not detect a clear fetal heartbeat. A stillborn baby was delivered shortly after.
The authors of the case report argued that a woman with similar symptoms “would almost surely have been triaged and evaluated more urgently for pregnancy-related problems.”
The authors continued to point out the flaws of gender classification in medical records. They agreed that transgender people should be able to legally change their sex, but advised that all medical records should state a person’s sex at birth, gender identity, and legal sex – in order to properly help people get the medical care they deserve.