I had a friend of a friend be forced to take (and pay for! Thanks America!) A pregnancy test when she had to go to the ER, despite her telling them she physically couldn't get pregnant because she is trans, I swear in some cases it's like they just don't listen to patients at all 😭
This happens to me all the time. I got sick of paying for it so i started throwing a huge fit every time they start in on that pregnancy test bullshit. If i say "ive had a total hysterectomy" and they still insist that "maybe you just dont quite understand, we HAVE to make sure youre not pregnant" i just start saying "HYSTERECTOMY. HYSTERECTOMY. HYSTERECTOMY." over and over until they give up. I used to be super super nice to medical professionals, but after 10 straight years of them fucking up my meds and insurance both on purpose and on accident, wasting my fucking grocery money, denying me treatment, and (on one occasion) using a medical exam as an in to sexually assault me, i give them exactly ONE chance. Past that, they deal with the mean bitch version of me
Edit: oh my god the well actuallys are so annoying. Yeah, you can have a pregnancy without a uterus. Would it surprise you to learn that ive actually had a total hysto and bilateral salpingooophorectomy and i say that every time and i have proof and they still dont care? It's not about the technicalities, its about valuing liability above human dignity and above the fact that people need money to eat and cant be wasting it on hospital liability that has no bearing on reality
I let them know ONCE and then let them do it anyway and then report them for insurance fraud :)
I havent had to pay for a single one of those tests. I also do not communicate to the medical facility that I am reporting them for insurance fraud. I let my insurance company know that they have done a test they knew they shouldn't do and I also report them to the proper local authority.
I’m curious, does anything ever come of that? Do you hear back about how it’s handled?
This is tangentially how I got a tubal ligation and how I advise others who have struggled to access the same surgery. I called about a dozen doctors and told them what I was looking for. Gave them my demographics. Explained I’d been turned down before after attending initial appointments/exams due to info I’d provided upfront (like my age). Asked that they verify that the doc was willing to perform the surgery with that provided info, because if I was turned down I would report it to the insurance company as fraudulent. Made sure to be super polite while explaining. It took a bunch of calls but I finally found one and got my surgery.
Ironically, getting a hysterectomy was much easier though I chalk that up to getting a genuinely good doctor.
I dont often hear back from the authorities or the insurance company, but I check my online itemized bill with some regularity and I notice that charges suddenly disappear from it. I also do sometimes call my insurance company directly for an update if I am particularly ticked off or if it seems to take too long.
At the point that I am satisfied (fraudulent things removed), the bill is paid. Ive only had a bill go to collections once and I asked the collections agent if they knew that the bill was part of a fraud investigation and havent heard a peep since.
I dont blame you for using the same method, threats of reporting for fraud are surprisingly effective. They do not have a high tolerance for being investigated, especially because it can open them up to having other records looked into.
Doctors will straight up put procedures in their notes that never occured, you get charged, and the doctor makes more money. I'm currently in the middle of fighting upcoding in the hospital that I work at because we keep getting complaints of people being charged for things that never happened.
Due to having a special account to pay for medical care from, I document in detail all payments towards medical care.
I paid, lets say, $1,400 for account at hospital over this year. I got a bill saying that I still owed them $700 and had already paid $700. And the running total of the page documented $1,000 owed.
I called, pissed, rattled off all the info from the receipts I retained and asked them to justify the additional expense. They tried to say "oh its from stuff from before" but they couldn't be specific, and the transaction history did not display that (the transaction history showed 3 different procedures/visits, that had a total of $1,000 in cost). They could not explain why they did not retain the $1,400 or who had it, or why they would be "from another department" (and why that would use the same account number, if different bills/accounts/departments). I told them, listen, y'all, if I took you to court with the bill you sent me and all the receipts, you'd be ordered to refund me that $400 difference. So lets skip it and you send me a check already. They said they'd send me an itemized bill.
That was over a month ago. Silence since then. I've got a lawyer because I recently had to sue an ex-employer, I think I'll throw her $100 to send them a threat over the $400. If they don't pay, I will take them to small claims court for $500 ($400 for bill overpayment, +$100 for legal expenses+filing fees)
Honestly the only way they’ll ever change is if enough people fight back. Most people don’t want to deal with the hassle or be perceived as a “Karen” type. My wife and I routinely go to one another appointments to advocate for one another and it’s drastically improved our outcomes.
While being a polite Karen (insisting, forcing my way up the chain of command, getting shit done when noone wanted me to succeed), a state representative once called me "a significant disruption." while they were being forced to fire 3 prominent public-facing employees over time fraud, documentation fraud regarding who physically had an at-risk nonverbal special needs child in state custody, and racism respectively. Gave me such a rush I almost got it tattood on my chest. It was my job to advocate for the mom of that special needs child at the time. :)
And yes my wife and I go to eachothers appointments. Thankfully we found a doctor who doesn't try to mess with us now.
I still daydream about that tattoo but I'm too worried about autoimmune reactions and pain/fear of needles lol (I hate someone else needling me, I can stick myself for medication and IVs).
I finally have a good doctor and I will sing his praises till the day I die. It's amazing because after the upfront investment of going through my history with me, he rarely needs to see me for more than a few minutes because we have great communication and he has fixed many of my issues. Being a good doctor took effort in the short term but has rewarded him with free time in the long term, as well as a very compliant patient who will be fully honest and who refers literally everyone to him.
My first few visits with my good doctor were quite long, because I had a huge gap in my medical history due to doctors refusing to send me to the correct specialist, so I stopped bothering, because they'd be like "I can't help with that but you're not unwell enough to see a specialist, lose weight fatty."
I got to see the specialists I needed, and I'm losing weight thanks to hormone correction (I literally could not lose weight before, I'm eating more than ever but still losing weight now that the hormones are being managed).
One of my favorite books, Snow Crash, (which yes, is rather pulpy but-in a self-aware way, it's great) contains the following passage:
This is the guy. Raven. This is the guy that Juanita is looking for. The guy Lagos told him not to mess with. And Hiro has seen him before, outside the entrance to The Black Sun. This is the guy who gave the Snow Crash card to Da5id.
The tattoo on his forehead consists of three words, written in block letters: POOR IMPULSE CONTROL.
Hiro startles and actually jumps into the air as Vitaly Chernobyl and the Meltdowns launch into their opening number, "Radiation Burn." It is a tornado of mostly high-pitched noise and distortion, like being flung bodily through a wall of fishhooks.
These days, most states are franchulates or Burbclaves, much too small to have anything like a jail, or even a judicial system. So when someone does something bad, they try to find quick and dirty punishments, like flogging, confiscation of property, public humiliation, or, in the case of people who have a high potential of going onto hurt others, a warning tattoo on a prominent body part.
POOR IMPULSE CONTROL
Apparently, this guy went to such a place and lost his temper real bad.
And your anecdote made me imagine you with a similar tattoo, but worn as a badge of honor.
I’m curious, does anything ever come of that? Do you hear back about how it’s handled?
Health insurance companies take FWA (fraud, waste, and abuse) VERY seriously. Think of all the posts on reddit about denied claims/authorizations...you think they want to pay healthcare providers for fraudulent services?
This is why i specifically notify my insurance company, rather than the facility. They clean things up the fastest. They basically foam at the mouth when it is a repeat offender.
Unfortunately it just doesn't work in my experience.
I got blacklisted from the OBGYN network in my area for insisting on the procedure I wanted despite her opinion that I would want children in the future. I let her know I would be getting the procedure done whether she approved or not because I'm sure what I want done with my own body. She didn't like it and now I am not able to seek care at all in my area. :)
Yes, I did end up driving a couple hours to a Planned Parenthood and getting something else done there for now (due to funding, some of their services have been cut). Thank fuck for PP.
I have a similar issue, im intersex and things are a little funky in the reproductive department, had an obgyn tell me im young and to take Tylenol after she ordered an internal ultrasound, didnt specify to me that I would be getting penatrated for this test, then pressured me into it.
I got super lucky and was able to find a doctor who wasnt connected to her practice who would at the very least sterilize me to lessen the risk.
Probably. But one must have money to play games in the courts, and if we had capital we wouldn't be here on Reddit complaining about access to adequate care.
People have said that that, but I'm not really sure? The reason I'm blacklisted from the whole network is because she works at all of the locations. or... she owns them all? or something? It was hard to find the office she was at on my appointment day because of all the different addresses. I think it's legally within her rights to refuse care to someone? I've got no idea and I've got no money for a lawsuit anyway.
I misread and thought that said "I want 30 crows to like you" and was like, ...I actually like that compliment. I was about to give you commendations until I read it again, and then collapsed the thread and realized it was a username reference.
How much do they usually charge for a pregnancy test? I seem to remember hearing that most care facilities will use the same pregnancy tests sold in dollar stores, so I doubt it's really costing them anything to not get reimbursed.
The irony is it's probably your insurance providers own policy that they run a pregnancy test no matter what. Anything to deny/obstruct treatment as much as possible. Reporting it as fraud just makes them eat the cost (that's maybe 2 bucks wholesale) rather than opening up to potential litigation, because we all know they play dirty fucking pool and don't want legal scrutiny.
As an EMT of over 11 years now, I sincerely apologize for the bullshit you've gone through. There is literally no excuse for medical professionals to treat their patients in such a horrid manner. I wouldn't dare. You, and everyone that goes to a hospital, should be treated with dignity and respect, no matter what is or isn't in your abdomen, or what is or isn't hanging between your legs.
I've had a few transgender patients in my time. One, FtM, was having serious issues with their lower abdomen, and was concerned that they might having a negative reaction to a new medication. Not knowing how far along they were in their transition, I asked if they could be pregnant. They said no, but they haven't had bottom surgery yet, and I stopped pushing in that direction. I then moved on and didn't ask again. It's truthfully that simple.
Once again, as an actual medical professional, I am so sorry that you've had to go through so much trauma caused by a medical system that is systematically failing you and every one of our LGBTQ+ siblings. I hope that, one day soon, you can find a provider that treats you with the dignity, respect, and patience that you deserve.
EDIT: For the one commenter out there saying that I "didn't get permission" to use they/them for the FtM patient: They asked me to use They/Them after I accidentally called them a He. So yeah, no misgendering here.
Thank you, im sorry people are being uncharitable to you in the replies. Ive met a few actually competent and kind medical professionals before. Sometimes i bite their heads off before realizing lol and i feel bad but they usually understand and then we can have a good patient/doctor relationship. Its tough out there. We're all doing what we can to survive
Side note to the conversation, but as someone who has experienced a lot of medical bullshit, I've never had a bad experience with an EMT. Even when I was going through the worst medical malpractice of my life, the EMTs were just being roped into it and were extremely kind and professional. I was being forcibly admitted to the hospital for an allergic reaction that I wasn't having and was denying having (for an allergy that I didn't have) but the EMTs were just told that it was an allergic reaction. The whole way to the hospital they were so kind and I remember one saying that his daughter had an allergic reaction just the other day and that she was healthy now, and that I would be ok too. I knew that I was fine but I was really struck by how comforting that would've been if I was really afraid. Thanks to the EMTs like you for doing important, exhausting work to take care of the rest of us ❤️
I love your approach and want to add as a paramedic: transgender patients can be at high risk for substandard care due to miscommunication and discomfort with asking questions related to their transition. In any patient born with a uterus/ovaries with a complaint of abdominal pain it's best practice to do an 'body organ inventory'. There are multiple other potentially emergent issues beyond ectopic pregnancy like ovarion torsion, ovarian cyst rupture, etc that need to be considered and can be easily overlooked. Please make sure you ask more questions because you may be the only one that does. I usually roll it into my general assessment and include questions about if they still have their gallbladder and appendix as well since both are also relevant to abdominal pain.
There is something to this actually. With a total hysterectomy, your ovaries remain. (A radical hysterectomy is where they take everything). If the surgeon happens to fuck up removing and closing off the cervical area, you could potentially end up with an abdominal pregnancy. Of course the actual likelihood of that is infintesimal and I assume there would be other concerning signs before you end up pregnant.
Yeah the likelihood that the surgeon doing that removal left a piece of the ovary reduces that infintesimal number even further. My only thought is that it's required by the insurance company for anyone who was born with a uterus between 12-55 which is fucking stupid.
Oh, is 55 the cutoff? I went through menopause a few years ago at about 47 and I've been wondering why I keep having to take pregnancy tests, and if 80-year-old AFABs have to deal with this too. (Also haven't had that kind of sex in about 20 years (lesbian)...)
A total hysterectomy is where they remove the cervix as well. Subtotal they leave the cervix. If they’re going to take other organs (tubes, ovaries) they start adding words like salpingectomy (tubes) and oopherectomy (ovaries) (or salpingoopherectomy for both).
Total as opposed to partial, where the cervix is left. The ovaries and tubes aren't technically the same organ, just part of the same system, so their removals get their own names.
I think people in here are thinking the hospital staff are just being dicks, but they are following protocols because not following them gets them fired and can cause them to lose their licenses.
Nobody is coming to the defense of an RN who chose to be kind to a patient and listen to them say they had a hysterectomy, only to later find out they either lied or didn't know what they were talking about (both things very common). Especially if preventable harm then gets done and the hospital gets sued.
And screaming "HYSTERECTOMY!" over and over and acting a toddler to someone on their 10th hour is a GREAT way to discover the utter depths of pettiness at the nursing station. If you find yourself wondering why it takes 2 hours to get a blanket or they talk to you like you're an ignoramus, it's because you're a bitch. And if you get admitted, expect to get the bed straps. (I know this very well because my mom likes to get mouthy and temperamental over stupid things, and I usually have to go play peacemaker.)
well if the surgeon fucks up removing and closing off the cervical area then you have a lot more issues than an abdominal pregnancy like intestines coming out through the vagina and such.
I've heard one case of a woman having a total hysterectomy, and then getting pregnant and giving birth to a healthy baby. Even infinitesimal things can happen occasionally.
If you have ovaries, pregnancy is possible. Yes. Even without a uterus. Yes. It has happened. Yes. It’s very rare. No. We don’t want to miss it. If you’ve had your ovaries removed, it is impossible. If you’re without ovaries, then it’s a great idea not to be pregnancy tested. If you have ovaries, then yeah, we want one done just in case, because a cheap dipstick and a few drops of pee can tell us if we have a five alarm fire happening.
Edit: Jesus, you’d think I’m asking for a pound of flesh.
I’m also a woman and uninsured, for all the lovely people making assumptions.
And to everyone who called me a bitch and/or told me to die in DMs: you are why nurses are perpetually tired and on edge.
Beyond the impacts to the patient's mental well-being which are much better handled by the other comments with that experience, I want to approach this from a different angle.
because a cheap dipstick and a few drops of pee can tell us if we have a five alarm fire happening.
That is also part of the problem too.
I just checked the charge master for the hospital near me. A urine pregnancy test will be billed at almost $300 and the cash uninsured cost is $98.
So, this is not a cheap test for many people (especially since the rest of the visit is likely going to be extremely expensive already).
Yes. It’s very rare. No. We don’t want to miss it.
While on its own this sounds good, there is a reason they don't recommend a lot of tests proactively. There are risks associated with the test including turning off patients from seeking care at all. There is no recommendation for monthly MRIs looking for cancers, no one is suggesting every visit should include a prostate exam, and while colon cancer is a leading cause of death, the current recommendations for colonoscopies is every 10 years after age 45.
Maybe the risk that someone without a uterus may have an abdominal pregnancy with zero symptoms isn't worth the additional stress on the patient to push for testing unprompted.
Elaborating slightly: the pregnancy test requirements absolutely destroy all trust between the patient and the care team. All of it, gone and not coming back.
I came in with an acute issue, you immediately completely ignored that, refused to hear out my symptoms and insisted pivoted to an impossible issue, asked me a bunch of intrusive questions about the issue you made up in your head, and then told me I was probably lying about both the imaginary issue and the real one and you wouldn’t even pretend to care about the real issue until I tested negative for the imaginary one.
The fuck am I supposed to trust someone who is explicitly operating on the assumption that I am lying every single time I open my mouth? The fuck is the point in saying anything? The fuck is the point in not just signing myself out to go suffer at home, since there’s obviously no way for me to convince the doctors that I have symptoms at all?
(Yes. Impossible. I’m a fucking virgin, and I’m not Catholic. Ramble on about whatever infinitesimal odds of an ectopic pregnancy you like, there still needs to have been a dick involved somewhere.)
God damn. I've only been to the emergency room once in my adult life, so I hardly have much experience, but I was treated as a person who's opinions and answers to their questions mattered, and who got at least a perfunctory say in what was going on.
Being a cis man is apparently a golden ticket in the healthcare industry, and everyone else gets to ride in steerage where they amuse themselves by slapping you in the face and calling it medicine.
Specifically a white and reasonably well-groomed cis man.
And it’s not universal, but the likelihood of being treated like shit is going to be at best 30-40%, rising to between 80 and 90% the more urgent you feel about your issue. And knowing that is going to massively impact how you interact with all healthcare, even the areas that are generally good to you. You’re going to do shit like decide not to get swabbed for strep because your throat hurts and you don’t want to spent ten minutes answering the same three useless questions at the local urgent care. That’s why the usual pro-call-all-women-liars argument pisses me off. Treating patients like liars massively increases the likelihood that they will simply stop seeking care altogether. Leave the hospital and not come back no matter what their symptoms are.
But they leave that out of the statistics when they try to justify it. It doesn’t sound like you’re providing me evidence-based healthcare, it sounds like you’re ignoring the vital evidence of my words. It’s nothing but a very, very good way to teach a person that their words don’t mean shit to healthcare workers, so why waste them and your money?
The medical field has had a lot of blatantly moronic ideas that persisted a lot longer than the 3.5 seconds you’d expect it to take to call bullshit. Someday, calling all women liars and demanding pregnancy tests on hysterectomy patients who aren’t even in for abdominal symptoms is going to be looked on as badly as insisting that Black women can’t feel pain.
When people come in with symptoms, especially A+E, the first job is to rule out common serious pathology. This is why there are general questions about bowels, periods, pregnancy, urination, diet ect. It makes certain diagnosis less likely especially the ones which needs immediate attention such as appendicitis or an ectopic pregnancy.
Which then brings us to why pregnancy tests are important. It's not a matter of trust in you as an individual, it's a matter of statistics and likelihoods of a cohort. The truth is, pregnancy possibility is one of the things patients routinely are inaccurate on reporting in A+E when they're stressed or in pain, there are many many cases where patients swear to god they can't be pregnant and it then turns out they are.
This leads to the problem. It's not that they don't specifically believe you as a person, it's just that statistics and past experience show that a patients word isn't infallible. Hence the pregnancy test, because a missed ectopic can kill you, and it's a straightforward low invasiveness test. If it's negative, the diagnostic process can move on with one serious potential cause ruled out.
To contrast this, let's say as part of the history they ask you how often are you opening your bowels, and you say 7 times a day. No doctor in their reasonable mind is going to say "nope don't trust you, best monitor and count the times you go to the bathroom to make sure". People don't lie about things like that (outside of very very niche cases), hence doctors can take everyone at face value.
I hope this helps explain why pregnancy tests aren't people not trusting you.
to my face. You talked over me and called me a liar and refused to touch anything until I had proven you wrong, but you still continue under the assumption that I was lying, it just happened, coincidentally, to be true.
I have heard this line of reasoning before. It has only gotten more idiotic and misogynistic with every tiresome repeat. It’s just wrong.
You are not giving the best care possible, because you are making it more likely that I, and every other woman who doesn’t like being called a liar, will simply give up and seek no care and go experience severe complications at home. That is not the best care. That should be the worst case scenario that you shit your pants over. The patient in front of you is your only patient, and treating that patient as secondary to your imaginary friend is not good care and never will be.
They didn't believed in your ability to correctly assess that, not that they specifically think you're lying nor that specifically YOU are lying.
People lie all the time, people lie to their medical providers, people mistakenly think they cannot get that and so on and so on. It's in their job not to take everything on a word.
Surprise pregnancy is a thing. If doctor would just believe someone because they said something on that, and they would die in result, would it be better than not believing? I doubt so.
Doctors, in the end, are more about not letting you die than about building trust through believing you fully no matter the risks of doing so.
Also, every test has a false negative and false positive rate and doing thousands of unnecessary tests increases the likelihood of false results, which in this case potentially skews diagnoses away from what is really going on. I’m not aware of exact specificity and sensitivity of pregnancy tests (probably varies by brand) but no tests are 100% on both.
“Cheap”, I have watched them stick a 99 cent pregnancy test into my urine then turn around and charge my insurance company $300 for it.
I’ve had a bilateral salpingectomy done, I don’t have fallopian tubes. My eggs get absorbed into my body. They still insist even though last time I checked only 4 pregnancies have ever occurred after that surgery were from left over pieces of fallopian tube. My tubes were fully removed. I’m going to start bringing my glossy hi res photos of my tubes post op that my surgeon gave me (since they had to send them to pathology which meant I couldn’t keep them) with me to procedures so they maybe stop scamming my insurance company into paying hundreds of dollars for an unnecessary and very cheap test.
my vaginal cuff healed extremely well and is completely sealed. no i will not be pissing in a cup for you especially for an outrageous expensive price plus my insurance won’t cover it due to me having had a hysterectomy.
if one day my cuff happens to magically rip itself open so that semen has gotten into to abdomen and met an egg, sure i’ll piss in a cup for you. otherwise, not gonna happen and i’ll laugh in your faces. i’ve had enough experience being a patient as well as a healthcare professional in women’s health specifically, i know how my own body works.
It happens. Very rare but you can get fistula formation from the fallopian tubes which can form a connection to the vagina, which then present as an ectopic pregnancy. I think there's only ever been a handful of cases though.
A bit more common in subtotal hysterectomies though still quite rare.
Essentially impossible in bilateral oophorectomies though, nothing to fertilize.
Basically the blanket rule is, abdominal pain in women of child bearing age? Rule out pregnancy even if the patient swears they can't be pregnant. You'd be surprised the number of times people say they can't be pregnant then it turns out they are.
Though in general I'd agree, it's a bit of a hard sell in the cases of a documented hysterectomy since there are few cases of ectopics in those circumstances. It's such a low impact test though so I don't know why you'd be bothered by it though I suppose if you're charged for it might be different.
YEEEAAAAH. It pisses me the FUCK off when doctors dont understand that TRANS MEDICINE IS A MEDICAL SPECIALTY. Sooo many doctors think treating trans people is just about gendering us correctly and walking around on eggshells so as to not upset our fragile, volatile emotions! /s It's not about EMOTIONS, its about MEDICINE and doing your FUCKING JOB RIGHT
The crazy thing is, as a medical professional, it's super easy to just... chart what's happening.
Let's say it's because a certain medication has birth defect risks. I tell you the risk. You say you understand but don't care (because of the hysterectomy in this case), then I just type that into the box.
This problem is made of meat. Doesn't matter how many boxes they put in there if the doctor doesn't want to put the info in there for whatever personal reason.
If you want to assign "personal reasons" to the equation, I won't argue with you.
I'm just saying the system, as intended, is meant to prevent harm. If the risk of harm is understood by the patient, why should I care beyond that?
If a patient with diabetes doesn't understand the importance of a diabetic diet, it's my job to educate them. If they DO understand and still want to carb load, that's their decision.
As far as I understand it, it's to protect the people that have a poor enough understanding of their anatomy to believe they couldn't possibly be pregnant and insist on going ahead with whatever procedure...only to find out they are in fact pregnant after the fact and the fetus is negatively impacted, and then regret it (and possibly blame the medical providers).
I'm sure you've seen a post or two on reddit about "what's the dumbest thing a patient has done?", right? There's always a story about someone who is flabbergasted that they could be pregnant despite obvious evidence.
Medical providers have no way of knowing the person saying "I've had a hysterectomy" or "I'm a lesbian" even knows what those words mean, no matter how confidently they say it.
You're 100% correct. A lot of people don't even know the names or functions of the medications they take every day
And generally speaking, you'd ask some follow up questions to ascertain they do in fact understand the situation/risks. When it comes to gender though, a lot of people are walking on eggshells
And to be fair, it's new territory for a lot of people. Your lesbian example is perfect, because someone could say they're a lesbian and they have never and will never have sex with a man... but their girlfriend might be a transwoman that's still completely capable of insemination
the attitude that doctors/nurses/ems are just here to help, or know more than you do, or all truly care is such a privileged non-minority take lol. interacting with the medical system as a person of color, a gender diverse person, or often even as a straight cis white woman can often be such a ritual in humiliation and misery.
Someone was over in the adenomyosis sub yelling at us for not ~understanding~ that we needed to be nice and docile to these fucks and I was like HAVE YOU TRIED BLEEDING OUT FOR 30 YEARS AND STILL BE TOLD YOU’RE LYING OR THAT YOU NEED ACUPUNCTURE OR THAT YOU JUST NEED MEANING IN YOYR LIFE OR LITERALLY GOTTEN SMACKED BECAUSE THEY THINK YOU’RE DRUG SEEKING YOU GODAWFUL HARPY but there’s always a pick me somewhere
like tbh these dipshits should be grateful it’s just a snarky mychart message when we’re finally validated
Bilateral salpingo oophorectomy is the term I'd use to get out of a pregnancy test. End of discussion, no eggs to get fertilized. If the uterus came out, but the ovaries remain you can still have an ectopic. I've seen someone get a baby ex lapped off a liver before after a "total" hysterectomy cause sperm made it through the cuff. Obviously that depends on having a remnant vagina, so FtM doesn't really work there.
That being said, I do get the frustration. It's commonly echoed, and if I hadn't seen people get burned like... Semi frequently by "there's no way I'm pregnant" then they end up pregnant? I'd be a lot more willing to forgo the test. Hell, there are some tumors that produce beta HCG so even without the equipment it's still a useful test sometimes. These days the computer systems we use in hospitals will also blare constant alerts recommending a pregnancy test for any woman under 65 which doesn't really help matters.
So there are some good reasons to get it on everyone with ovaries. Some are more for self preservation from lawyers. Still not fun to have like a $35 or (probably) up tax added on to your hospital bill. Idk there's not really a good solution cause we can't just not order it, been lied to too often.
ETA: Sounds like you use the oophorectomy thing so uh... Guess whoever you're dealing with was just dumb.
You have to be rude with many problems. Same happens in other countries with other health issues, pain etc. Try and be nice but sometimes you have to fly off the handle and be a massive cunt so you dont suffer.
I'm FTM and currently on T. I tell them this every time I go into emergency (I get kidney stones semi regularly so unfortunately I'm in a few times a year). I live in Australia here so protocol is if you get a urine from anyone assigned female at birth over the age of 6 or under the age of 60 you do a pregnancy test (I know this for a fact because I worked in that ED in the past), we don't pay for it so it's not the big deal like the bullshit chargers you guys deal with in America for a 50 cent test. I don't even think it's noted in patient files unless relevant, they just do it straight on admission because then they don't have to quiz anyone on sexual history.
Despite telling them that I am assigned female at birth and on T, every single time the stupid person who takes my urine forgets to do the test because they see a man with a beard. I'm pre any surgery so it's fair enough to do one considering my pain could instead be pregnancy related in I was. So every time the doctor has to come in and give me a talk about needing to do a test and acts super weird about asking. I'm like, bro, just do it. I gave you my urine already. Why tf was it not done. I'm someone with a uteras having unprotected sex with a cisgender man. I told you this. Just do the fucking test.
Have you heard about the thing where in multiple states a patient under anesthesia can undergo pelvic exams by medical students? The only reason why that would exist is to assuredly be perverted, but it does.
Im pretty sure that happened to me after my bisalp. I felt sore in a place I really shouldn’t have, given the location of the surgery. I personally just hope nobody took advantage of the fact I was freshly sterilized and went any further than that, bc if you walk by a student doctor with his hand in an unconscious patients snatch that is apparently perfectly allowed here. . .
Yeah cause its "such a good opportunity." And a trans patient is an even better opportunity in their minds because we're rarer. Ive learned what a horrible thing it is to have a body that's seen as a good opportunity. Its why when a doctor sexually assaulted me, she called in her four nurses to watch. "Because its such a good opportunity" she said "we dont get many transgender patients and i want them to be educated." I didnt want to, but i hadnt learned to be mean yet, i didnt know what it looked like when a doctor is intending to hurt you, and i felt the pressure of wanting to help all the trans patients who came here after me. But she didnt want to help trans people. She just wanted a freak show. During the assault they all kept cooing about how "good my transformation was" and "how well i'd turned out." That they'd "never know i was a woman, walking down the street." And after the assault was over the doctor shook my hand and told me it was a "privilege to examine me." I wish this hadnt happened so early on in transition. I wish i had learned how to be a raging bitch by this point. But i hadnt. So i just thanked her and then went to my car and slammed my head into the steering wheel over and over and screamed and cried and for an hour. And now ive just resigned myself to the fact that that kind of shit is probably done and said whenever im unconscious. But at least i dont let it happen when im conscious anymore. And im much more rigorous with screening my surgeons and dentists.
I 100% believe they did that to you. I'm so sorry. Much love to you and solidarity. It's so fucking stupid we have to go through life this way. I wish people would just be kind and professional and treat us like people. <3
Was it hospital policy or something that they gave you the pregnancy test or were they just stupid? Not that it makes it any better and I’m sorry you have to deal with so much bullshit
A combo. Stupid, uninterested in investing extra time and effort in any given patient, and beholden to a hospital policy they dont have any interest in documenting their way around. Either way it didnt really make a difference to me when i was homeless and they were stealing my fucking food money
I don’t understand why people like that are able to keep their job in a field where empathy is a requirement. I hope you have better care teams in the future
I suppose, though when I was getting my CNA certification, empathy and proper bedside care was one of the biggest points preached about.
Paradoxically, my teacher was incredibly callous when it came to her own students. She mocked me when I had been kissed by a dementia patient and dismissed concerns of another student being creeped on by another dementia patient. Obviously she should never come anywhere near a patient again
I just hope that I as well as other future medical professionals can change that, because people deserve to be treated like a human and I hate when I hear shit like because I know we can do better.
Sorry if I come across as preachy or something, that’s not my intent
Yep, I also give once chance due to very similar reasons and if they fail, they then get bitch me as well. It's scary being trans and intersex and if they're not gonna fucking listen the first time, I'll make them listen
Sadly too true, the profession is often about, how can I avoid being sued/found liable for harm rather than what is best for the patient, it frustrates some of us too but policy is unfortunately policy and nobody wants to loose their job over it. I’m sure you’ve tried this already but you should be able to get a pregnancy test waiver. Ask for it in triage, ask at the front desk, ask for extra copies if it’s somewhere you go regularly. Yes it sucks. Also your doctor doesn’t get any extra money for ordering tests. It’s a salaried or hourly position. Take it up with management all day, every day.
This is crazy to me. I'm cisfem in the UK, and everytime I go to our version of ER, regardless of why I'm there, they ask if I might be pregnant. I say no. They accept my answer and move on.
And, I have to stress, our system is really not great at the moment. Yet, the idea of a doctor being like 'Im afraid Im gonna need you to prove that before we move on' would utterly blow my mind.
The difference is that in the UK, if you lied/were wrong about not being pregnant, you'd live with the consequences. In the US, you'd sue everybody for said consequences of your own actions.
In some states it's not just the patient that might sue them, they might face criminal charges or getting sued by literally anybody in texas for violating abortion bans
Yeah to confirm the other comment. In the US if you said "No" and a doctor performed a test or procedure that killed a fetus then they could be massively sued, and there is a solid chance that they would lose their license and never be able to work in medicine again.
Haha, your neighbours in the Emerald Isle here. Our patients are sue happy over here, using American standards when they're funded by the Irish system, not over here they don't. Unless it's in the medical chart that they had an operation to remove a uterus, I'm doing a pregnancy test on a patient. A doctor here asked a patient if they were sexually active, they said no because "I'm too young in my culture to have sex"... BOOM pregnant. There are also reasons why they won't admit their history, such as a parent or guardian being present when being asked those, we do a pregnancy test anyway. We are lied to all the time or it may not be a good time that a patient tells us their medical history, but things like a pregnancy test is a blanket test for child bearing women here, unless it's medically stated you don't do one.
Yeah, not for everything, but if you present as female with symptoms like abdominal pain you are getting a pregnancy test in the UK. Just like in most places in Europe.
Sometimes this is a consequence of the chart being inclusive. If the patient is legally a female and is is coded as F in the EMR, even if they are labeled as trans somewhere else some order sets will automatically include pregnancy rule out. Yes this should be fixed
I think just "i dont have ovaries" rules it out (because if you have ovaries you could still get pregnant even without a uterus, which would be INCREDIBLY dangerous)
I think there are a lot of stupid patients, and a lot of ignorant medical professionals. And the competent ones on both sides are left trying to pick up the pieces.
If patients were always honest then I 110% agree. People lie all the time, and often don't even realize it.
Do you have any metal in your body? "No"
Okay, if you have literally any metal in your body this MRI may kill you, are you absolutely sure you have no metal in your body? "NO!, God you doctors are stupid..."
Okay, one last question. Have you ever been shot? "Yeah a couple years ago..."
Yeah, even as someone who has been forced to become very medically literate, I'm not infallible as a patient. I'm extremely careful with keeping records and preparing for appointments, but I still sometimes don't know things that are relevant. There are underpants that have metal in them. I happen not to own any, but years ago I almost bought some, and I realistically could've worn them to an mri without thinking about it. There are lots of little things like that that require a lot of general awareness and medical knowledge to catch, which makes them easy to miss if you don't know exactly what you're looking for (like, say, a list of questions to ask).
My mom had to ask for a different concoction (I'm sorry, I'm high, I can't think of the right word) to take before her colonoscopy after she got home because she discovered there was something she was allergic to in the ingredients list, and the receptionist or whoever got snippy with her because she didn't list that allergy on the form.
Of course she didn't. They asked for drug allergies. Splenda is not a drug, it is a food.
Yes, and you know that while some people will appreciate that info, others will get rude about you giving food allergies when they asked for drug allergies! Also in that vein, I'm allergic to adhesive, ESPECIALLY medical adhesive. On one hand, nurses generally hate me bringing it up because it's not what they're asking about, but on the other hand I almost always end up with some kind of non-necessary adhesive on me so obviously I want to tell them. Knowing when to share or withhold that information is hard and it's almost inevitable that someone will get mad but if you're allergic you don't have a choice!
I've also gotten odd looks for listing food allergies and it's like, yeah no I'm gonna be thorough as I can be, thanks. Especially with the overlap of banana and latex allergies, and dairy being used in absolutely fucking everything. And medical adhesive is absolutely a pain in the ass, discovering that one via being Internally itchy was Very Not Fun.
This has occasionally been a problem for me in Australia. I'm early on in my transition and so look male, but doctors see F on the chart. They have to guess if I'm early MTF and marked correctly in the system or late FTM and marked incorrectly in the system and well obviously the coin doesn't always land on heads.
As an emergency physician I promise it's not something we do on purpose to harm anyone. It's because people lie to us all. the. time.
I've had patients who were lesbian, with their partner, swear up and down that they only had sex with women who were pregnant not once but twice. I diagnose surprise pregnancies quite frequently. It's not that I don't trust you, it's that I can't fully trust anyone.
Edit:
I appreciate the thougtful comments I'm receiving on this. To help clarify - in the emergency department if I'm ordering a urine hCG I'm probably seeing you in triage, I have 5 to 7 minutes to see you, ask questions, perform an exam, and place orders. No I don't have time to review your prior records, I have 60 patients in my waiting room and 10 people after you to screen, 14 more checking in the next hour.
Respecting your autonomy, your sense of self, and being an ally are very important to me. But I've also had patients believe they had a hysterectomy when they didn't because health literacy is hard. If I'm seeing 60 to 80 patients in triage in a shift my first priority is minimizing mistakes and misses.
As an aroace person who has been sexually inactive my entire life and never goes to bars/parties/etc. where I could potentially have been drugged or blacked out and not remember or something like that:
I understand that people lie and this is why I still have to hand over a pointless piss cup as if I'm potentially the next Virgin Mary, but I should be able to opt out by signing a waiver that says "I accept the potential legal/medical/financial/etc. consequences if I'm lying about it being literally impossible for me to be pregnant right now."
My favorite thing to say, back when I was younger and always under suspect of pregnancy, "I don't want to test for pregnancy. If I am pregnant, abort it while you're up there."
People are incredibly sue happy. In EMS we have people refuse, we tell them something bad could happen, we make them repeat the risk back, we make them sign a paper, the bad thing happens, and then they claim they are owed money because they couldn't have possibly known what those words meant. Or that they didn't think it would actually happen.
Also sometimes it is legitimate that it is difficult for them to understand all the potential consequences or scope we are talking about. I'm guessing you/most people think the only risk is harm to a hypothetical fetus. Which is true, but even that in turn can harm the mother if the unknown fetus is more than just a little cluster of cells and is stuck rotting inside. It can also be an even faster death if you have something called an ectopic pregnancy. Also fun fact, you can take hormonal birth control perfectly but it will not prevent ectopic pregnancy, but everyone taking birth control will adamantly say they are not pregnant. Not only is there always a tiny chance of pregnancy on birth control, they are only designed to stop pregnancy in the uterus. That is not the only place an egg can implant, and it is really bad, like bleeding out internally bad, when it is not caught before it causes something to rupture. I find the concept so terrifying and a lot of people have no idea that is even possible, and those who do often think they are protected by birth control.
Most systems would agree that you are not providing proper medical care if you do not rule out a time sensitive and extremely dangerous diagnosis that is very easy to quickly dispell, or allow a patient to become septic because of carelessness even if they claim they want that.
I actually DO know the risks are not just to a potential fetus, I know no method of birth control is 100% foolproof, etc. I'm just tired of having to deal with shit like this because so much of the rest of the US has zero sex education and ass-backwards values. It's not just about the inconvenience of peeing in a cup, it's about the principle of the thing. I know realistically it won't change, but I'm going to continue to roll my eyes and be annoyed every time.
Well I am sorry I did not mean to offend but it was a careless way to phrase it on my part. I find unknown pregnancy issues interesting (from the medical sense of awful things our bodies can do to us) and as you said most people lack education on health/sex that it's very hard to even find a stafting point for that conversation.
but I should be able to opt out by signing a waiver that says "I accept the potential legal/medical/financial/etc. consequences if I'm lying about it being literally impossible for me to be pregnant right now."
In court, they would argue that the medical professional didn't do their due diligence to make sure that you were properly educated about all the possibilities. Far easier to just get a pee cup.
Remember, a space goes between "trans" and "woman"
Not putting the space implies they're a different type of thing entirely rather than simply a different category of women. Honest mistake, I'm sure. But now you know.
I would be fully willing to take a one-time exam, like the multiple choice part of a driving test, to prove I'm educated enough about the possibilities to be allowed the option to sign such a waiver for all pregnancy tests I encounter in the future. I'm not saying this is a realistic option I think would ever actually be available to me, just illustrating how much it annoys me on principle lmao
As someone who is sexually active but takes not getting pregnant very seriously I'd also like to add an optional clause that says "in the event an unwanted pregnancy is discovered please yeetus the fetus"
Also ace. I'm almost 40 and have never even held hands, little less had sex.
I still pee in the cup.
9 times out of 10, they are running multiple tests on that sample anyway. You're not getting out of doing it. They're going to run blood tests on you, too.
At a certain point, I think fighting over this becomes more about people's personal pride than any sort of practicality or even the cost, and to the hospital, your pride isn't worth the cost of litigation.
I don’t know why the upreg is the thing that gets fought so much more than even tox screens. Babe I just want to make sure this isn’t all being caused by the massive hormonal, metabolic, and anatomical changes of pregnancy I promise I’m not judging if you fuck or not.
(I did once have someone say it’s a privacy concern which would be fair except you’re in the ER, I have your full name, DOB, and blood with me and I’m about to have you strip naked into a gown. Privacy isn’t real here.)
To the person who said I’m calling them a dirty filthy lying whore then blocked me: no, I’m really not. I need to know if you’re pregnant or at least producing hcg. Lots of people don’t think they are when they are. Lots of people lie. Lots of people have other reasons they’re pumping hcg. Lots of people get drugged and raped and don’t remember. Lots of people block out memories. Lots of people lie to THEMSELVES. Lots of people have lots of unprotected sex. None of these people are worth my scorn or judgement. Everyone is doing the best they can with what they have.
It pissed me off because (pre Obama care days) I had to pay for a pregnancy test that I knew 100% I didn’t need to get treated for a yeast infection or whatever
I get it, but I was poor and didn’t have insurance.
Yeah healthcare is way way way too pricey but I’m very tired of hearing people yell about their upreg being expensive (true) but not their on arrival bloodwork (also true, and also probably not giving great info). I agree it’s extremely expensive to get it done and I’m very sympathetic to that because I’m not taking my life extending medication due to cost. It’s ONLY the upreg (out of all the normal tests we run) that gets people THIS lathered, though.
It's probably because they understand what the pregnancy test is for but not what the blood tests are for. The blood tests are vaguely medical to them so they can see those potentially being useful, but since they're certain they aren't pregnant (regardless of the actual chance of pregnancy), that seems like a charge that will be unnecessary. I don't agree with it, but I do get why they're thinking that way.
I guess it is mostly people without insurance taking issue? I've always had insurance and I've never seen the urine test itemized as a separate expense. Typically it's just one charge for the copay or for the labwork (blood and urine).
Yeah, and again, system issue, not an issue with the validity of upreg. I’m also uninsured and also not taking medication because I’m uninsured and likely shortening my lifespan by decades.
Like, sure, there are lots of good reasons (as you said) for a pregnancy test in triage. However, women are proveably systemically ignored in medical settings. Feeling like someone is ignoring you saying that you can't get pregnant when your bullshit meter for being ignored is in the crypt already is probably the cause.
Combine that with the fact that generally, women are the ones being asked about pregnancy tests, and there you go.
In Australia they don’t automatically pregnancy screen you if you’re female.
Why ? Because it’s an entirely legal issue, not a medical one. The only reason that pregnancy screens are carried out automatically in America is because they stop the legal liability from accidentally treating someone who’s pregnant.
In my whole life the only time I have been asked if I’m pregnant is when I’m about to have x-rays or imaging done. And if you say no, they just go ahead and do the x-rays, they certainly don’t do any pregnancy tests first.
It’s really interesting to hear American doctors rattling it off as part of an initial triage work-up. Its just not done here.
You tell me you’re not pregnant. I take your word for it. I order a CT abdomen/pelvis. I irradiate your fetus. You sue me and I lose my license and the ability to do the only thing I’ve ever been good at.
I hope you understand we as patients cannot trust you either. I've had medical professionals outright ignore my concerns and they basically tortured my mom to death during COVID by intubating her repeatedly against her wishes. Never again. I have seen the laziness, massive egos, and downright hostility given to patients, and the lack of genuine give a shit that doctors and nurses seem to have these days.
A lot of medical professionals got traumatized during COVID and if they're still in the field they're so desensitized and shut down. The desensitization from the field was bad before but I think a lot of people really hit their limit during the pandemic and that's partly why it seems like so many more medical professionals are terrible compared to how it used to be. Not excusing though and I'm very sorry that your mom went through that. Just saying you're right, doctors and nurses ARE worse these days. For the US specifically our health system needs to change badly. The only people attracted to the profession do it for money or they just dont have empathy so it doesn't bother them to do what they do.
You don't get what they're saying. A patient saying they've had a hysterectomy doesn't mean they've had a hysterectomy. Think about the absolute stupidest people and remember that they can also go to the hospital.
well, no. but if they had medical documentation in their chart about having had one, they had one.
but more importantly, that other part: people who've never had a uterus to begin with. I DO get what they're saying, but they probably picked the single most goofy place to comment it under (responding to a story of a trans woman being asked to take a pregnancy test)
Yes, even if they've never been to that hospital. Hospitals use a shared network that gets access through your health insurance/medicaid. Its basically on a secured provider-only internet.
No we use something like Alleva which is a protected HIPAA compliant server system that tracks patients care documents. All hospitals participate in it.
Your mind sounds made up on this, but while there are some assholes most of us genuinely care and try to do our best with the limited time and resources we have.
That's all well and good, but any test that you want to run that assumes I'm lying should be free and only charged if I'm actually lying.
I mean, gee, what you're saying sounds reasonable, but also what percentage of the time were you wrong to not trust your patient in the last year? And how much money did your hospital make off of those people who were wrongfully mistrusted?
It sure seems like hospitals have a financial incentive not to trust people no matter what the numbers are. How many women have you treated in the same you've been practicing that you saw those two lesbians who were lying? I'm guessing lots, and that this test catches an absurdly small number of people lying.
I mean, geez, whatever number of women are lying - .001% - so you normally demand medical tests with that small a chance of being necessary?
Havent had a hysto but ive had a bisalp which makes me just as sterile as if I had a hysto (no tubes to grab the egg and put it into the uterus) and I will still be asked to do pregnancy tests even after ive explained I would be a case study if I got pregnant because of how improbable it is and its more likely for me to get struck by lightning on my way to the ER than it is for me to get pregnant.
Technically pregnancy is still possible without tubes. Less than 1% chance, but there is still a chance and it has happened. Like, single digits number of confirmed cases, but still. So it's not as sterile as if you'd had the entire uterus removed, just very close to it. You would likely be a case study, but you wouldn't be the first case study.
Doctors are incredibly prone to confirmation bias, probably more so than any group of people I've ever encountered. Once they've made up an assumption about you, everything you say or do will be interpreted as proof or it will be ignored.
Slightly unrelated: In Germany, if you, as a man, jokingly remark that you are unsure if you are pregnant when going to the hospital, they will make you take a pregnancy test...
I (a cis woman) once reported to a nurse that I had a hormonal IUD. She was confused. She looked at something on the computer and then asked if I had a uterus. I said yeah...hence the IntraUterine Device.
I’m starting to realize that ignorant people hear “I’m trans” and think it means “I am mentally pretending to be the opposite of whatever gender you think I am.” So if they see a female-presenting person who says “I’m trans,” instead of thinking “oh they must be AMAB” they think “this is a woman who wants to be a man.” It’s so stupid.
Question from someone who wants to understand. Is there a chance it's because they HAVE to make sure because 1, the person may be mentally unfit (dementia or another psych issue) or 2, the legal department is paranoid and made it a requirement to avoid a lawsuit?
Not denying the sexism exists, but I can see the second reason being a huge part of the insistence in part because of the first one. Several of the jobs I've worked have had strict policies that I didn't like having to do, but admin and the lawyers insisted on it.
Its absolutely that. People lie or just straight up dont know (thanks US education for not teaching people how pregnancies happen) that they are/could be pregnant and pregnancies introduce alot of risks to using medications.
See without context this is funny(or weird ig) cause when a male individual(assigned male at birth is that the term?) uses a pregnancy test in the standard way and it comes back positive its a sign of cancer so it feels like they brought them back to test for cancer
Yep, happens a lot because they just mindlessly insist on doing pregnancy testing. I don’t know if this happens outside the US but I’ve seen it happen there. Remember that in many states the fetus could make a medical procedure a felony in many states now so even if the physician understands a trans woman can’t get pregnant the hospital will insist they test every woman.
Not defending what they did, but you'd be surprised with how often patients will lie or be mistaken about procedures or treatments they did or did not have. From claiming to have never been pregnant (they miscarried/aborted), to insisting they had a specific disease they didn't have. I once had to explain to a guy that he didn't have migraine, because it is impossible to have it without headaches.
I can imagine the professional simply requiring your friend's friend to undergo it in case they were lying/delusional/mistaken
EDIT: I had forgotten about vestibular and the other rarer manifestations of the disease. My bad. Thanks for those who pointed it out
(technically migraine can occur without headache eg paediatric abdominal migraine and rare forms of focal migraine with aura. But they’re pretty rare and maybe not applicable to the context you were alluding to. ;-) )
Yup. Because they misrepresent surgeries they've had. And also, unless ovaries got yeeted, ectopic is a thing and clincially relevant to certain chief complaints.
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u/mysocksareinsideout MakeshiftEmery Jul 31 '26
I had a friend of a friend be forced to take (and pay for! Thanks America!) A pregnancy test when she had to go to the ER, despite her telling them she physically couldn't get pregnant because she is trans, I swear in some cases it's like they just don't listen to patients at all 😭