"I can be whatever I choose to be", we were told. This is the result
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In Los Angeles the other week, I heard about the experience of physicians with patients identifying as transgender.
Under California’s Gender Non-Discrimination Act, a transgender patient has “the right to nondiscriminatory treatment on the basis of gender identity or gender expression”. All patients, it states, will be addressed and referred to
based on their self-identified gender, using their pronouns and name in use, regardless of the patient’s appearance, surgical history, legal name, name registered in the EMR [Electronic Medical Records], or sex assigned at birth. The correct gender and pronouns should be reflected in the documentation whenever possible. If the patient’s family members suggest that the patient is of a gender different from that with which the patient self-identifies, the patient’s view should be honoured.
In other words, any Californian physician who thinks such treatment is wrong, or that it may lead to harming the patient’s mental or physical health and thus contravenes medical ethics, must shut up and get on with it. Not to do so would expose the physician to disciplinary action.
One physician told me about a patient of his who had identified as a transgender woman. Mindful of the risks involved to his professional standing, the doctor said he was extremely careful not to transgress any of the rules. He used the patient’s preferred pronouns of she/her, addressed the patient as a woman and in no way questioned the patient’s professed female identity. He played it by the book.
The patient, however, launched a complaint against him. His offence, said the patient, was to have referred to her as “a person”. She was, she said, “a dragon”.
The patient, said the physician, was of course mentally ill. But to say so would have cost the doctor his job. Instead he sent the patient back the thousands of dollars she had paid him in fees and told her the professional relationship was now void.
