He paced the floor. It was clear he was angry. He muttered to himself.
‘How could he betray me like this? After all I have done for him over these years. He is an ungrateful, selfish SOB’
I tried to avoid his gaze, but he noticed me as I walked by.
‘Doctor, please doctor, can you tell me what is the diagnosis? Is my boyfriend pregnant?’
I took a step back. It is wonderful that we have the HIPPA laws that prohibit me from sharing confidential information. I resorted to what is legal.
“No sir, I am sorry, I can’t divulge that information. Your boyfriend will have to do that if he so chooses.”
Having no obligation to explain further, I hurriedly stepped away and went to the lab to find the results of the pregnancy test. I knew the results would not be in yet, as I had only ordered them five minutes ago. However, it gave me time and space to regroup, rethink and calm down so that I could try to understand the complexities of this patient encounter.
I was born and trained in an era where boys were boys and girls were girls. I still have problems finding a place in my brain to store this new data. How do I do so in a way that recognizes the accepted science (things like X and Y chromosomes) and the accepted social norms (things like LGBTQ)? And how to do this in a way that is not judgmental yet accurate and compassionate. I stood in the break room for a minute, gathering my thoughts before heading back to see the possibly pregnant man.
My patient looked every bit like a man. His face, chest, back, arms and legs were full of hair. His stature was slim and his voice sounded tenor. If it were not for the name, Leslie, but then again, I have seen that name with men and women, so, who am I to judge.
I wondered if I did a pelvic exam, would would I likely find a prostate. (XX XY LGBTQ). This is confusing.
Leslie explained to me; “Dr. Johnson, I am transitioning from female to male, but I had an intimate relationship with man and I don’t want my boyfriend to know. He did not use a condom and I don’t know if I have a sexually transmitted disease. I also need to know if I am pregnant I would like to get an abortion. Can you help me please?”
This is what some philosophers would describe as an enigma, in a puzzle inside of a riddle. King Solomon’s head would swoon.
“Well Leslie, I went on to explain, let us deal with the issue at hand of how to provide for your health care and I will have to refer you on to someone else who can manage the other questions. For now, lets make sure your blood count is okay and your blood pressure is managed well.”
With those distinct parameters I was able to escape this room with my professional integrity intact and without moralizing or sermonizing about what I perceived as the evils of this present generation.
It turns out, he is pregnant. Try cutting that baby in half King Solomon.