Trans Broken Arm Syndrome: Understanding Medical Neglect and Misattribution
Samantha is a 35 year old transgender woman who has been having chest pain that comes and goes since last year. This last month she started to experience dizziness that accompanies the pain. When she seeks help, her family doctor tells her that her issue is likely caused by the hormone replacement therapy she has been on since the last twelve years and tells her to stop taking estrogen. Samantha declines this advice. The doctor tells her that he can not help her if she is not willing to comply with his advice and sends her home without ordering any tests. The doctor takes a note on her file that Samantha is non-compliant with medical guidance.
Trans broken arm syndrome refers to medical professional’s tendency to blame gender affirming care and sometimes the person’s gender identity for each medical issue experienced by the patient.
The name of the phenomenon itself makes a cheeky reference to some physicians’ tendency to view any health issue experienced by the patient as a direct consequence of being trans/transitioning, regardless of how unreasonable. According to Wall, Patev & Benotsch (2023), medical professionals who pathologize or stigmatize gender affirming care such as hormone replacement therapy sometimes end up neglecting trans patients health concerns due to the assumption of gender affirming care being the root cause of medical issues. This attitude may end up with neglecting legitimate health issues and simply blaming affirming healthcare for medical problems.
Invasive questioning
Samantha decides to visit the urgent care after her visit to the family doctor goes bad. The doctor who examines her asks her if she started to feel more emotional ever since she started to use hormone replacement therapy. The doctor later asks her if her family has been sad when she decided to transition.
Besides medical misattribution, Trans Broken Arm Syndrome is regularly accompanied by invasive questioning and expecting disordered thinking from the trans patient, as explained by the authors. Invasive questioning of trans patients may include asking to perform unnecessary physical examinations, spending the majority of medical appointments talking about medical transition while the reason for visit is different or asking questions about a person's life that is unrelated to the medical issue at hand. In this case, the doctor engages in invasive questioning by asking about the patient's family life while also expecting the patient to have unreasonable thinking patterns due to the hormone therapy she is on.
Medical misattribution, neglect and invasive questioning can decrease the quality of care received by transgender patients and may further decrease trans patient’s willingness to seek healthcare services. To improve the quality of care for everyone, we should focus on how to combat transphobic attitudes in medical settings, and in ourselves.
By: İlhan Yalçın | Blog Comittee Member
References
Wall, C. S. J., Patev, A. J., & Benotsch, E. G. (2023). Trans broken arm syndrome: A mixed-methods exploration of gender-related medical misattribution and invasive questioning. Social Science & Medicine (1982), 320, 115748. https://doi.org/10.1016/j.socscimed.2023.115748
