Gender Issues in Medicine: 1984 or 2021

In 1984 (the year- not the book), I was a second-year resident at Queens General Hospital in New York City. One night I was called to the ER to admit a transgender patient with secondary syphilis. Back then, we used the word transsexual, but the idea was the same. The patient was a biological male, complete with a penis. He/she (that was the commonly used pronoun before people started using pleural pronouns for individual people) dressed up and spoke like a woman, though not too convincingly. 

The burning question, besides figuring the dose of penicillin, was to decide on which ward to put the patient. You see, Queens General had 36-bed open wards. These were the sort of wards you may see in old movies- a large room with beds perpendicular to the walls. Around each bed was a railing on the ceiling holding a flimsy curtain that could be pulled closed to provide the illusion of privacy. There were male wards and female wards since each person was on full display to their neighbors. 

We decided, with the patient, to send the patient to a female ward. Surprisingly, thirty-seven years ago, we naturally did what would be considered politically correct today. But, that’s not the end of the story. The patient’s wardmates objected. Yet, the patient didn’t want to go to the male ward for fear of harassment. What to do? Not sure who came up with the solution, but we put the patient in an isolation room. This really amounted to a luxury for the patient who got to have a private room. Case closed. We simplified a complicated issue.

In 2021, on the other hand, we complicate simple issues. Take for instance the New York State covid vaccine intake form pictured above. In order to get a covid shot, do we need to have people declare if they are binary, tertiary, or quaternary? If they are conforming or non-conformists? No. They are just getting a shot, not comprehensive care. The inclusion of this extraneous information does not serve a medical purpose. It is there for a different reason. Furthermore, the “gender ID” is not even uploaded to the New York State Immunization Information System (NYSIIS) registry. If you search the NYSIS registry, there are only 3 options: male, female, and unknown. 

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