Sticky Hands: Were you titty farking yourself or something?

Ah no, it was a muscle, most likely from using an arm in a repetitive motion too much.

/thanks for making me spell that out.

we were covered by Aetna when i snapped and was finally diagnosed. ran up huge bills from mental health facility stays and lots of therapy and meds.

instead of just covering the bills they chose to play ping-pong between different divisions of their own company, each insisting it was the responsibility of the other to pay.

my poor wife damn near had a breakdown herself trying to deal with those arseholes. burn in hell Aetna. burn in hell.

/the food in most psychiatric wards is really quite good

KrispyKritter:

/the food in most psychiatric wards is really quite good

but you'd have to be crazy to go there for the food...wait....

Sorry, I just had to. Glad you're better.

JPINFV:
/Why do I play with the trolls?
Ya love us!

//Being transgendered must be terrifying, confusing, and depressing.
I can 't think of any mental illness that would be fun & games.

GrymRpr: JPINFV:
/Why do I play with the trolls?
Ya love us!

//Being transgendered must be terrifying, confusing, and depressing.
I can 't think of any mental illness that would be fun & games.

Well, yes, but you don't get identity conflicts in people with bipolar or depression. Also people can emphasize easier with the more common mental disorders (e.g. depression, bipolar, or even schizophrenia) because we all have periods of depression, mania, or even thinking we heard something. On the other hand, most people don't wake up in the morning and think, "Wait... I'm in the wrong body."

/Difficulty is responding: Gender dysphoria/incongruity is in the DSM IV and V respectively, and thus a psychatric disorder.
//Prefers the term "neuropsych" over just plain "psych."

I'm intersex. I live as a guy. Have a girlfriend even. Had to get a mammogram and see a gynecologist. BCBS of FL covered it all. Even an MRI and a pelvic ultrasound and a bunch of other crap. they didn't even biatch about a "guy" getting prescribed birth control ( farmed up uteri run in the family. Mom and sis both had theirs out in their 30's)

This is presently a problem with most medical systems, which where designed with "M" and "F" in the "Sex" field, and have hundreds of thousands of medical coding rules written with that assumption.

Someday, CMS will update the NCCI guidelines to perhaps include a "B", but until then, you can only mark a patient as one or the other, and you're going to hit these snags. This is new territory for everyone, really, and adding a new gender to a system as large as healthcare payment has the potential to cause unexpected side effects in totally unrelated aspects of the system (computer-geek wise).

They'll get there; maybe ICD-10 has diagnoses specific enough to make it easy? "Routine Prostate exam; blood screen, of a female; post-gender-reassignment-surgery"?

Winktologist: This is presently a problem with most medical systems, which where designed with "M" and "F" in the "Sex" field, and have hundreds of thousands of medical coding rules written with that assumption.

I use arguments like that a lot in these threads against changing birth records and ID's. There is a certain potential related to each gender/sex, and people arbitrarily assigning their own can shortchange many systems.

My common example of everyday life is how a construction company would tend to hire a scrawny male before a very similar female, because of their potential to grow into the strength needed. I don't see that as discrimination, but I do see where being less than upfront about it as one applying can cause problems and even be viewed as an outright "lie". Even women under hormone therapy would find it more challenging to keep up in some jobs.

Women are supposedly better at clerical work.(that's not purely anecdotal, women on average score higher in those areas and get those jobs in the military, but in the civilian world normal circumstances tests aren't necessarily available*ie the ASVAB).

We really need an "other" or _tM and _tF, in my opinion.
_____________________________________ ____________________
And less relevant to that specific topic but still pertinent to the general topic:
In healthcare. IMO, a patient, for whatever reason of discomfort, deserves some leeway in choosing what other genders are present when they're ...being anatomically candid... Men and women both, can find certain staff to be unsettling/embarrassing to an extreme when bent over, or spread eagled on, a cold table in an exam room. A large proportion of both the norms can find "mixes" to be just as, if not more, unsettling.

It's not just bigoted intolerance(though it often goes that far), there are studies that place a lot of that uncomfortableness into the area of instinct. It can't be helped. It's known as the "ick" factor. People tend to show it to disfigured, retarded, and all other manners of physically different.(simple means of race to extreme genetic problems).

In some it's a strong tendency, and in a way, it's no less of a biological problem than are people who are transgendered(in whatever variety or label you want to use).

If one gets to use "born that way" as an excuse, so do others. It's not so much of a choice or lifestyle, as something you have to live with every day.

omeganuepsilon:
I use arguments like that a lot in these threads against changing birth records and ID's...

wow, grow up

Voiceofreason01: omeganuepsilon:
I use arguments like that a lot in these threads against changing birth records and ID's...

wow, grow up

Your username does not suit you.

rudemix: [t1.gstatic.com image 168x300]

Ah, Bailey Jay.

Whatever. The last time I was in prison the state provided me all the free prostate exams I wanted!

/Something something obamacare

omeganuepsilon: We really need an "other" or tM and tF, in my opinion.

I think I'll use that for the box if (when...) I get a transexual patient. I think T_F and T_M (using gender, not sex to designate male or female) works better though. However that's just a stylistic difference.

/medical student.

JPINFV: omeganuepsilon: We really need an "other" or tM and tF, in my opinion.

I think I'll use that for the box if (when...) I get a transexual patient. I think TF and TM (using gender, not sex to designate male or female) works better though. However that's just a stylistic difference.

/medical student.

A more "kind" approach would be to re-organize. Keep M and F to not confuse the norms(maybe add a "born as" or "genetic" to aid the process). Add a tick box with some note as to "Important See Notes in Section 7(or Attachement 3, whatever) if you need to/have changed genders"(again, vague statment, could say whatever, just conveying a meaning)

Because in reality, a TM may have this done, or that awaiting, something snipped, tucked or added. A simple tickbox for TF or TM wouldn't hold all the same assumed rules as M/F do because there is a quite large variety of status that's available, and doesn't necessarily cover all "mixes".(actual hermaphrodites, or whatever other categories that are out of the norm)

"Other" TM and TF can be taken offense to as much as tranny or even flesh-golem. "Other" is a bit de-humanizing.

In Section 7, do a Q&A based on transgender status to codify some more common procedures among that branch of medicine.
Include for kindness, maybe, "social gender" so staff and doc don't go around calling a Missus wanna be "Mr. Jones."
And a text box for details.

I think that'd be easier, tacking on a side sheet and just a tickbox on the main to ensure that sheet is viewed.
I'm not in the field at all, but I've filled out entirely too many forms when I was in the service.(it got to where I didn't have to read the forms for the whole yes/no section, just memorized the sequence by repetition. (had a string of cavities, on top of all the other mandatory periodic visits and the occasional illness)

omeganuepsilon: Long discussion on paperwork

Well, there's two different issues at play. There's the "What do I put in the small box marked "Sex?" Then there's the "What do I put in the documentation (SOAP note)? It's trivially easy to say, "A 54 y/o pre-op male to female transexual presented with a chief complaint as _____" because the HPI in most notes will start off with the same "[age] [sex] [complaint]" (i.e. A 54 y/o male presented with a chief complaint of ___"). Also, anything as serious as gender dysphoria should find it's way into the past medical history. Similarly, any of the myriad of intersex conditions/ambiguous genitalia conditions are going to be a part of the patient's past medical history.

In regards to the box, it's an important box if just as an identifier, especially when dealing with androgynous names. Also, we can't have a bajillion boxes to cover any issues that may occur, especially when you can just as easily write a proper SOAP note.

Next time you see your primary care doctor, ask to see your chart. While the actual documentation is often called into a dictating service, it isn't just a string of check boxes on our end.

Also, a lot of the interaction issues can simply be worked out by calling a patient by what ever gender they look like (effort over outcome). That's a problem more with a-hole health care providers than a survey.

JPINFV: Next time you see your primary care doctor, ask to see your chart.

I was thinking more along the lines of what patients fill out, either fresh move, vacation, or if I've been in one location for a while, there's always the same pages to be filled out every time. Also, a thorough review of medical history isn't always performed by regular or new doctors(especially if on a vacation or something). A cursory glance at the cover, maybe the last visit.

Whatever goes in one's medical record should of course be made to maximum efficiency and amount of information for the health care industry.

It looks like it got what it wanted and it made the news so I am sure it is happy now.

Jesus farking christ on a cracker.

JPINFV: GrymRpr: JPINFV:
/Why do I play with the trolls?
Ya love us!

//Being transgendered must be terrifying, confusing, and depressing.
I can 't think of any mental illness that would be fun & games.

Well, yes, but you don't get identity conflicts in people with bipolar or depression. Also people can emphasize easier with the more common mental disorders (e.g. depression, bipolar, or even schizophrenia) because we all have periods of depression, mania, or even thinking we heard something. On the other hand, most people don't wake up in the morning and think, "Wait... I'm in the wrong body."

/Difficulty is responding: Gender dysphoria/incongruity is in the DSM IV and V respectively, and thus a psychatric disorder.
//Prefers the term "neuropsych" over just plain "psych."

/medical student.

Spent over 12 years as a Grade 13 supervisor for New Your State's Dept. of Mental Health with most of that time running 2 secure units back in the early 80's... Ya know.. Back when Aid's/Crack hit it big time in NYC.

I bring that up for only one reason.... As I see, you are a Med student and if the path you are taking is "psych." I just wanted to wish you luck!
lol