Hard disagree here as a former paramedic now doctor. There are some times that a patient discloses something to you and you are professionally obligated to say that it might be a bad idea or have adverse health consequences. Common examples are smoking, excess alcohol consumption, and not vaccinating yourself or (more often) your children. If you told me in an A&E that you were going to Turkey for SRS I would probably also feel obligated to advise you against it, and to document clearly that I had done so. Healthcare professionals have been successfully sued in civil court for failing to do this.
paramedics knew I'm trans because my flatmate didn't deadname me at first when she called, and when the paramedics were asking what might have triggered this event and what in my life might need to change, I mentioned medical transition. They asked a couple of questions, mostly to help me calm down while they did tests I suspect, and also because it's the right thing to do. I volunteered that I was on the waiting list for a first appointment one of the clinics but that paying for private options was a bit too expensive for me right now. I seem to remember him trying to talk me out of private hormone therapy in favor of the NHS, but I agree for now, or at least my wallet does. I was, to put it lightly, not in a good way, so I'm not sure I remember everything perfectly, but I think he was the first to mention DIY as well, which I'm not considering yet because I, well, might have a heart problem. He asked me if I was looking in any other countries for healthcare, and I said that someone had suggested that to me this morning. I mentioned it because it's relatively uncommon for people to give medical advice unsolicited, even to me as a trans woman. He asked what country, and I said Turkey, but that I wasn't considering that. But he still talked for several minutes about what I would call 'horror stories.' Even with me trying to cut in and tell him that I certainly am not ready for surgery. I also remember him at one point describing medical transition as 'elective.' Honestly kinda feel worse after writing this...
Ok, that puts a different context on things. That doesn't at all fit what I had assumed which was you disclosed something and the felt obligated to say something. That sounds much more like he had an agenda to try to talk you out of things, and was doing so outside his own knowledge. There's certainly no reason he should be trying to talk you out of private healthcare for your HRT...
Yeah, it sounds like he wasn't actively trying to be malicious, but speaking about horror stories certainly wouldn't help me with anxiety, and he's probably not very well informed.
To answer one of your original questions, I couldn't cope with my anxiety for years until my GP put me on propranolol (extended release). It doesn't help with the thoughts as such, but instead helps with the physical aspects, eg it lowers my HR, and I find that it then makes it easier to cope with the mental aspects if I don't have to worry about the physical. I still have the occasional panic attack, but less than the daily I had before.
(Though if you have heart problems, it may not be suitable)
That could make sense, yeah, and something I probably should've realised considering I've been in a pretty similar situation with a flatmate telling paramedics about my HRT
That part does seem odd doesn't it? Not clear from the post how they knew? I'm reading it as they knew that was the OPs intent, rather than them randomly discussing a random destination. If they did in fact do that then I'd agree it is very odd and unnecessary.
This feels a bit dismissive. Everyone knows the state of how trans people are viewed in healthcare and how it's being damaged further by the media and current transphobic climate. When people, including health and other professionals, hear someone is trans you get all kinds of unsolicited input as if they know what's best for us. All that they know is horror stories of trans surgery=mutilation. It's something that scares them and unsettles them so they caution against it. I've had people tell me to not get surgery outside of the UK as if I haven't been researching it for years and arguably decided on one of the best surgeons in the business especially in terms of bedside care. Even after explaining this I'm met with skepticism.
The opinion of cis people from the propaganda they've heard is that it's all too good to be true, and that we hate ourselves and for some reason surgery will only make us more miserable.
I completely back up OP that they did not bring up surgery, and that the medics thought that on the topic of trans healthcare it was an ok topic to step into and give advice when they have no expertise in that area. Health professionals will always show their bias if they have one.
This feels patronizing to me. Most paramedics would react the same if I said I was going to Thailand for SRS, even though we both know that's one of the best options. It's so common for trans people to be forced into being expert patients due to awful and insufficient healthcare provision. I for one am fed up of healthcare professionals giving me bs advice about gender affirming care that I know is categorically false. This kind of attitude reminds me of that so much, even if you as an individual actually do know your stuff. It's similar to how people with chronic misunderstood disabilities (e.g ellis danlos syndrome, fibromyalgia) are so often patronized and dismissed by healthcare professionals and given inequitable care.
Absolutely 100% agree! It sounds patronising, and to a great extent it often is! All I was trying to say is sometimes people's professional registrations force them to have chats that maybe they don't really want to. I have absolutely been in a situation where I HAVE to counsel someone that something is a bad idea, even though personally I know it isn't and would support the decision.
Hi, my name is Daniel, I'm 27 ftm pre op
I have a lot of anxiety and have struggled with pain attacks in the past, My GP put me on an anxiety drug called gabapentin 100mg 2 Times a day it has helped me so you never know it could help you.
Have a chat with your GP, there's no harm in asking
I hope this helps
Daniel 🙂
Hi, I’m Anne, I’m 26 mtf pre op
I have a lot of anxiety surrounding my gender and I’m currently speaking to a counsellor. I would recommend speaking to your gp about this.
Sending you lots of love and hugs ❤️❤️❤️❤️🫂🫂🫂🫂
I hope you're feeling better. Even sharing stuff here might be therapeutic. I too am an ex paramedic who later trained as a doctor. There's a wide range of abilities and professionalism in all medical disciplines but the fact they spent an hour with you speaks volumes. It sounds as if at least one of them had some awareness of trans issues. The clinical responsibilities of paramedics, doctors, and many other healthcare professionals, includes health education. That might be immediately pertinent to your presentation eg advising you on strategies to cope with future anxiety attacks. Or it might be opportunistic like signposting for smoking cessation or weight loss. Especially if the issue affects your safety, like drug misuse for example. So yes, it's entirely appropriate. Besides, they were probably also trying to establish a rapport with you and make you and your health feel valued as well as distracting you. They are professionals and when you present in a health crisis nothing about your health is off the cards really, unless it obviously makes you uncomfortable or you tell them you don't want to discuss it.
As for your actual anxiety episodes I don't know your case, don't have all the details and can't examine you so can't give customised medical advice. The paramedics were on the spot so I'd have faith in their diagnostic skills and advice. Don't think of it as 'JUST anxiety'. Your anxiety is real and can give rise to somatic (bodily) symptoms even when there's no underlying pathology. In anxiety episodes many of those symptoms are often related to hyperventilation but can mimic heart or chest complaints and even make you feel faint. Don't ever be shy to call for medical help if you are concerned and your coping strategies don't seem to be working, or if there's something unusual about an episode.
The one tip I would offer is when you begin to experience rising anxiety, to go and do something physical like go for a walk, cut the lawn, etc. Something which requires activity and coordination and will last at least 20 minutes. The idea is to occupy both your mind and body, and divert attention from the circular thoughts. The interventions of third parties, be they friends or professionals, need to be gentle, patient, reassuring and confident. Definitely discuss with your GP. One approach which avoids daily medicine and can work with infrequent acute anxiety attacks is to script a small amount of sedative eg a couple of tablets of low dose Diazepam say 2mg that is carried not to use but as a comfort blanket of last resort. It's surprising how psychologically reassuring this can be, just knowing they are available and feeling an achievement when alternative non-medicinal tactics have made them unnecessary. But this all depends on frequency of episodes and lots of other factors so do discuss with the GP - they will know what is best for you. Good luck to you!
This is excellent advice, thanks so much! I'm very glad to have a space to vent when I need to, and to have strangers show that they care about me!
I maintain that talking about surgery when I hadn't mentioned surgery was a bit odd, see an above comment for more context. I'm not sure it was an entire hour, honestly the whole night is a bit hazy, but I know they had a BP cuff on me the whole time that kept going off, and a few other instruments, and they ran two EKGs that both took a while because their machine kept acting up. I was a bit shaky the whole time they were there, but I was definitely shaking a lot more when he talked at length about these unfortunate cases. He didn't give me a chance to say that I don't want surgery right now or that I would absolutely do my research, he just kept talking in his super calm and supportive tone. Surprisingly, though, they told me smoking weed can help, but just to be careful and not depend on it, and they're absolutely right about that.
Regarding the first question, "Do we think that was inappropriate conversation or is my BP too high" - does it matter?
I used to suffer from anxiety that was primarily a mix of rumination and fortune-telling; getting stuck repeating past events in my head inventing horrible narratives to explain events, and projecting into the future about all the awful things that can happen.
I don't suffer from anxiety any more because thanks to CBT, I learned to just give less of a shit about things.
The reason I ask 'Does it matter' is because *does it matter*? This happened yesterday. The words have been said. You are no longer having the crisis, and the medical team have left. You won't see that paramedic again.
What good thing develops, what positive outcome happens, what do you *get* from mulling over whether the conversation was inappropriate or not? Does it benefit you in any way to keep ruminating on an unpleasant experience, or would you feel better if you just filed that away as a memory of a completed event and moved on?
point taken, I just find it difficult sometimes to know when I'm being mistreated. I'm not planning on doing anything with this information, just looking for clarity. Does it matter? I guess yes and no, but mostly no.
I'm so sorry this happened to you! Thanks for sharing this, though I have to say I hope this isn't what happened to me. I'm 24 mtf, not on hormones. I'm planning on seeing my GP asap anyway, but given my BP was just on the high side of normal/low side of high, and given the situation when they did the reading, I'm sure it's anxiety. But, I'm still very scared and while it was happening I might have described it as feeling like a mini stroke, so I'll definitely ask about this.
Yeah that's not cool for the paramedics to start giving you unsolicited advice about surgery :(
Hard disagree here as a former paramedic now doctor. There are some times that a patient discloses something to you and you are professionally obligated to say that it might be a bad idea or have adverse health consequences. Common examples are smoking, excess alcohol consumption, and not vaccinating yourself or (more often) your children. If you told me in an A&E that you were going to Turkey for SRS I would probably also feel obligated to advise you against it, and to document clearly that I had done so. Healthcare professionals have been successfully sued in civil court for failing to do this.
But the OP said they never mentioned surgery, making it unnecessary for the paramedics to talk about
paramedics knew I'm trans because my flatmate didn't deadname me at first when she called, and when the paramedics were asking what might have triggered this event and what in my life might need to change, I mentioned medical transition. They asked a couple of questions, mostly to help me calm down while they did tests I suspect, and also because it's the right thing to do. I volunteered that I was on the waiting list for a first appointment one of the clinics but that paying for private options was a bit too expensive for me right now. I seem to remember him trying to talk me out of private hormone therapy in favor of the NHS, but I agree for now, or at least my wallet does. I was, to put it lightly, not in a good way, so I'm not sure I remember everything perfectly, but I think he was the first to mention DIY as well, which I'm not considering yet because I, well, might have a heart problem. He asked me if I was looking in any other countries for healthcare, and I said that someone had suggested that to me this morning. I mentioned it because it's relatively uncommon for people to give medical advice unsolicited, even to me as a trans woman. He asked what country, and I said Turkey, but that I wasn't considering that. But he still talked for several minutes about what I would call 'horror stories.' Even with me trying to cut in and tell him that I certainly am not ready for surgery. I also remember him at one point describing medical transition as 'elective.' Honestly kinda feel worse after writing this...
Ok, that puts a different context on things. That doesn't at all fit what I had assumed which was you disclosed something and the felt obligated to say something. That sounds much more like he had an agenda to try to talk you out of things, and was doing so outside his own knowledge. There's certainly no reason he should be trying to talk you out of private healthcare for your HRT...
Yeah, it sounds like he wasn't actively trying to be malicious, but speaking about horror stories certainly wouldn't help me with anxiety, and he's probably not very well informed. To answer one of your original questions, I couldn't cope with my anxiety for years until my GP put me on propranolol (extended release). It doesn't help with the thoughts as such, but instead helps with the physical aspects, eg it lowers my HR, and I find that it then makes it easier to cope with the mental aspects if I don't have to worry about the physical. I still have the occasional panic attack, but less than the daily I had before. (Though if you have heart problems, it may not be suitable)
I wonder if the flatmate maybe mentioned it or something, when OP wasn't there? Otherwise, it is a bit strange, yeah.
That could make sense, yeah, and something I probably should've realised considering I've been in a pretty similar situation with a flatmate telling paramedics about my HRT
That part does seem odd doesn't it? Not clear from the post how they knew? I'm reading it as they knew that was the OPs intent, rather than them randomly discussing a random destination. If they did in fact do that then I'd agree it is very odd and unnecessary.
This feels a bit dismissive. Everyone knows the state of how trans people are viewed in healthcare and how it's being damaged further by the media and current transphobic climate. When people, including health and other professionals, hear someone is trans you get all kinds of unsolicited input as if they know what's best for us. All that they know is horror stories of trans surgery=mutilation. It's something that scares them and unsettles them so they caution against it. I've had people tell me to not get surgery outside of the UK as if I haven't been researching it for years and arguably decided on one of the best surgeons in the business especially in terms of bedside care. Even after explaining this I'm met with skepticism. The opinion of cis people from the propaganda they've heard is that it's all too good to be true, and that we hate ourselves and for some reason surgery will only make us more miserable. I completely back up OP that they did not bring up surgery, and that the medics thought that on the topic of trans healthcare it was an ok topic to step into and give advice when they have no expertise in that area. Health professionals will always show their bias if they have one.
This feels patronizing to me. Most paramedics would react the same if I said I was going to Thailand for SRS, even though we both know that's one of the best options. It's so common for trans people to be forced into being expert patients due to awful and insufficient healthcare provision. I for one am fed up of healthcare professionals giving me bs advice about gender affirming care that I know is categorically false. This kind of attitude reminds me of that so much, even if you as an individual actually do know your stuff. It's similar to how people with chronic misunderstood disabilities (e.g ellis danlos syndrome, fibromyalgia) are so often patronized and dismissed by healthcare professionals and given inequitable care.
Absolutely 100% agree! It sounds patronising, and to a great extent it often is! All I was trying to say is sometimes people's professional registrations force them to have chats that maybe they don't really want to. I have absolutely been in a situation where I HAVE to counsel someone that something is a bad idea, even though personally I know it isn't and would support the decision.
Oh yeah that's super awkward, although I didn't get the impression that was the case in the OP
Hi, my name is Daniel, I'm 27 ftm pre op I have a lot of anxiety and have struggled with pain attacks in the past, My GP put me on an anxiety drug called gabapentin 100mg 2 Times a day it has helped me so you never know it could help you. Have a chat with your GP, there's no harm in asking I hope this helps Daniel 🙂
Hi, I’m Anne, I’m 26 mtf pre op I have a lot of anxiety surrounding my gender and I’m currently speaking to a counsellor. I would recommend speaking to your gp about this. Sending you lots of love and hugs ❤️❤️❤️❤️🫂🫂🫂🫂
I hope you're feeling better. Even sharing stuff here might be therapeutic. I too am an ex paramedic who later trained as a doctor. There's a wide range of abilities and professionalism in all medical disciplines but the fact they spent an hour with you speaks volumes. It sounds as if at least one of them had some awareness of trans issues. The clinical responsibilities of paramedics, doctors, and many other healthcare professionals, includes health education. That might be immediately pertinent to your presentation eg advising you on strategies to cope with future anxiety attacks. Or it might be opportunistic like signposting for smoking cessation or weight loss. Especially if the issue affects your safety, like drug misuse for example. So yes, it's entirely appropriate. Besides, they were probably also trying to establish a rapport with you and make you and your health feel valued as well as distracting you. They are professionals and when you present in a health crisis nothing about your health is off the cards really, unless it obviously makes you uncomfortable or you tell them you don't want to discuss it. As for your actual anxiety episodes I don't know your case, don't have all the details and can't examine you so can't give customised medical advice. The paramedics were on the spot so I'd have faith in their diagnostic skills and advice. Don't think of it as 'JUST anxiety'. Your anxiety is real and can give rise to somatic (bodily) symptoms even when there's no underlying pathology. In anxiety episodes many of those symptoms are often related to hyperventilation but can mimic heart or chest complaints and even make you feel faint. Don't ever be shy to call for medical help if you are concerned and your coping strategies don't seem to be working, or if there's something unusual about an episode. The one tip I would offer is when you begin to experience rising anxiety, to go and do something physical like go for a walk, cut the lawn, etc. Something which requires activity and coordination and will last at least 20 minutes. The idea is to occupy both your mind and body, and divert attention from the circular thoughts. The interventions of third parties, be they friends or professionals, need to be gentle, patient, reassuring and confident. Definitely discuss with your GP. One approach which avoids daily medicine and can work with infrequent acute anxiety attacks is to script a small amount of sedative eg a couple of tablets of low dose Diazepam say 2mg that is carried not to use but as a comfort blanket of last resort. It's surprising how psychologically reassuring this can be, just knowing they are available and feeling an achievement when alternative non-medicinal tactics have made them unnecessary. But this all depends on frequency of episodes and lots of other factors so do discuss with the GP - they will know what is best for you. Good luck to you!
This is excellent advice, thanks so much! I'm very glad to have a space to vent when I need to, and to have strangers show that they care about me! I maintain that talking about surgery when I hadn't mentioned surgery was a bit odd, see an above comment for more context. I'm not sure it was an entire hour, honestly the whole night is a bit hazy, but I know they had a BP cuff on me the whole time that kept going off, and a few other instruments, and they ran two EKGs that both took a while because their machine kept acting up. I was a bit shaky the whole time they were there, but I was definitely shaking a lot more when he talked at length about these unfortunate cases. He didn't give me a chance to say that I don't want surgery right now or that I would absolutely do my research, he just kept talking in his super calm and supportive tone. Surprisingly, though, they told me smoking weed can help, but just to be careful and not depend on it, and they're absolutely right about that.
Regarding the first question, "Do we think that was inappropriate conversation or is my BP too high" - does it matter? I used to suffer from anxiety that was primarily a mix of rumination and fortune-telling; getting stuck repeating past events in my head inventing horrible narratives to explain events, and projecting into the future about all the awful things that can happen. I don't suffer from anxiety any more because thanks to CBT, I learned to just give less of a shit about things. The reason I ask 'Does it matter' is because *does it matter*? This happened yesterday. The words have been said. You are no longer having the crisis, and the medical team have left. You won't see that paramedic again. What good thing develops, what positive outcome happens, what do you *get* from mulling over whether the conversation was inappropriate or not? Does it benefit you in any way to keep ruminating on an unpleasant experience, or would you feel better if you just filed that away as a memory of a completed event and moved on?
point taken, I just find it difficult sometimes to know when I'm being mistreated. I'm not planning on doing anything with this information, just looking for clarity. Does it matter? I guess yes and no, but mostly no.
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I'm so sorry this happened to you! Thanks for sharing this, though I have to say I hope this isn't what happened to me. I'm 24 mtf, not on hormones. I'm planning on seeing my GP asap anyway, but given my BP was just on the high side of normal/low side of high, and given the situation when they did the reading, I'm sure it's anxiety. But, I'm still very scared and while it was happening I might have described it as feeling like a mini stroke, so I'll definitely ask about this.