MS4 from wake forest in HOT water!!!

[Redpancreas]

it is also further evidence that the pronoun nonsense is a novel wedge (one of many) that insufferable, high-privilege progressives wield to distinguish themselves from the working class. It is not about inclusivity, it is about butchering grammar to signal membership in an in-group. Kychelle is in that in-group, and she is benefiting greatly from that arrangement.

Come on...do you really think that? I agree that sometimes certain people just like to use fancy terminology to show off/distinguish themselves (i.e. virtue signal) but you don't think some people actually believe in these causes? The analogy I like to use is someone supporting a sports team. It always starts with the grass-roots fans but once a team wins the league championship a few times, you get a lot of bandwagoners who ride the coattails of a winning team. I think someone said it earlier but it's best to advocate for these causes by leading by example, not trying to virtue signal. There are people who use these pronouns who lead by example.

In case people don't realize this, people sometimes display pronouns to make transgender people feel included. If someone was born XY, looks male, but is in midst of transition, she may feel like she needs to use "she" as a pronoun so people don't mistake her desired gender. It's kind of awkward for her alone to have to wear that badge so some people who were born the gender they want to be use nametags too so others don't stand out. Maybe they felt discriminated against for something in their lives and want to show empathy for someone else. No one is saying those who chose NOT to do it are not showing empathy (not even Kychelle-she's stating those who chose to make fun of her display of empathy deserved to get poked). Everyone has their own problems and can choose what they decide to show empathy for. I don't know why some many are so angry about what other's choose to show empathy for.

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[Redpancreas]

You have found more problems with the article than with the content of the med student's tweet. I know, you will say that you don't stand for what she said, but your posts certainly feel that you are trying to distract from what this is all about. But hey, it's your opinion.

Yes. It's my opinion that she did not deserve national news coverage for this one time tweet. It's my opinion that she does not need to be automatically expelled for this one time tweet. Punished, yes. To use the logic I anticipate others are using in this thread, if a conservative was expelled for making an inappropriate tweet, imagine the reaction on conservative social media. The memes are already ready.

Not one person here has made a reasonable argument for why she needs to be immediately expelled for this tweet without drawing on inequivalent precedent or taking her tweet out of context.

 

[deleted1100659]

Yes. It's my opinion that she did not deserve national news coverage for this one time tweet. It's my opinion that she does not need to be automatically expelled for this one time tweet. Punished, yes. To use the logic I anticipate others are using in this thread, if a conservative was expelled for making an inappropriate tweet, imagine the reaction on conservative social media. The memes are already ready.

Not one person here has made a reasonable argument for why she needs to be immediately expelled for this tweet without drawing on inequivalent precedent or taking her tweet out of context.

What was the context of her tweet? Its hard to reframe that in a way that sounds less worse than it is, lol. I have no idea if she should be expelled, that decision should be a result of looking at other information as well, but I mean that was a phenomenally stupid tweet.

 

[DarkBluMage]

Not one person here has made a reasonable argument for why she needs to be immediately expelled for this tweet without drawing on inequivalent precedent or taking her tweet out of context.

Numerous people have said why she should be expelled without even mentioning media news/being out of context. You just choose to ignore those comments because you’re so bent on making this into a media/politics issue and making excuses for why she shouldn’t be held to a certain standard that’s higher than the general population as a result of her chosen profession. You’ve chosen to derail this conversation with focusing on the media, other trans issues, and comparisons that quite frankly do NOT matter within the context of the problem that SHE created. The problem is her horrible attitude towards a patient that’s in her care because of a comment, enjoying the idea of harming said patient because she got her feelings hurt and how she chose to brag about it on social media. Perhaps you need to go back through this thread and read what people have actually been saying and not what you think they’re saying.

 

[sloop]

This is not what the girl did. She likely did not stick a patient a second time out of malice. At least there is no evidence of that.

What she said is the literal equivalent of any layperson saying so and so said this hurtful thing to me, they deserve to get hit by a ton of bricks. If you never felt or thought or wished harm onto someone who pissed you off, you’re in a small minority.

The issue though is she’s a future physician who in the moment lacked situational awareness of what her statement implied. Penalties need to be dealt. After rethinking the situation, based on the fact it’s her first offense with no evidence of prior issues in this realm (I imagine if there were Fox News would have made them clear), I think a leave or absence/suspension with some code of conduct training is in order. Her career trajectory was likely to be permanently affected by this assuming the school found out and took the necessary actions. I do not think it warranted national TV news attention which was only done to serve their selfish notion that liberals are crazy sociopaths who care about transgender people but not others (in order to create distrust in people who support transgender people). There was no journalistic or media integrity in any of this.

Perhaps I am being too cynical but I have very little faith that the school’s story is accurate. You could say that the school’s explanation of what actually happened is really the only thing we have to go by in terms of what actually happened, and that’s fair enough. That said, this is the type of situation where there are probably a lot of competing motivations.

Again, the school’s statement seems to imply that there was some sort of medical documentation relating to the incident. This seems fishy to me. Are people really documenting a procedure note whenever they draw blood where they’re writing down how many times they missed a vein and exactly what the med student’s role in this was?

Aside from that, I’m sure you can imagine the medicolegal and reputation consequences if the school was to make a public determination that the student in question actually did deliberately double-stick a patient. As I said, this would be a battery and could open the school/hospital up to a massive lawsuit related to their supervision of the medical student, their process for vetting medical students, etc. The conclusion they came to also happens to be the best possible conclusion for the school, so I think it’s reasonable to be skeptical.

And to be clear, I’m also not saying that the student definitely did deliberately harm a patient. I’m just saying that I’m not necessarily trusting the school to tell us the truth about a situation where it has skin in the game.

 

[Lawpy]

Yes. It's my opinion that she did not deserve national news coverage for this one time tweet. It's my opinion that she does not need to be automatically expelled for this one time tweet. Punished, yes. To use the logic I anticipate others are using in this thread, if a conservative was expelled for making an inappropriate tweet, imagine the reaction on conservative social media. The memes are already ready.

Not one person here has made a reasonable argument for why she needs to be immediately expelled for this tweet without drawing on inequivalent precedent or taking her tweet out of context.

She violated ethical and professional standards and permanently destroyed not only her reputation but severely harmed the credibility of the profession as a whole. Her tweet was intentional, insensitive and inexcusable, and she has no place in medicine.

 

[Lawpy]

People need to realize that it’s very hard if not impossible to resolve deep behavioral and moral problems as this student has demonstrated. Accidents and errors happen and can be worked on. Improving someone from a basic moral and ethical level is practically impossible and someone with deep deficits in these areas WILL be a great danger to patients and the community in the future if spared now. Expulsion is an effective and necessary step to protect the society from immoral doctors.

 

[DD214]

As for the pronouns, which is clearly a debate I cannot convince anyone on

Most people outside of a leftist medical student website agree with you that the pronoun issue is ridiculous

 

[SnowyMoon]

I don't quite understand how using pronouns coherent with one's gender identity "butchers grammar." Singular "they" has existed for a long time in English. Neo-pronouns are an interesting (off-topic) discussion, but if that's all it takes to earn a patient's trust, which is already near rock-bottom in the LGBTQ community, then why is this such a big deal? Is this really the hill to die on?

Many detransitioners wish someone had been brave enough to dissent in the course of their “care.”

Please cite. The most recent comprehensive study I have notes that 13.1% of those who underwent gender affirmation procedures ("transition") have detransitioned, and of those 13.1%, only 15.9% cited "internal factors," and these internal factors included many people expressing gender fluidity rather than wanting to go back specifically to their assigned gender at birth. doi:10.1089/lgbt.2020.0437 if you wish to read it yourself. Please feel free to do research in the field as the more data we have the more informed we can be when helping patients make these huge health decisions.

It's a shame that an important ethical issue is being drowned out by arguments regarding the validity of the trans experience and Fox News. For the record, my opinion is that she should be expelled. I believe these are warning signs of someone who feels they have moral high ground and it gives them the right to use it to belittle or worse, potentially harm patients. I know people like this, and the extremes as with most things are dangerous.

As this seems to be the majority opinion, I feel this thread may have outlived its use.

 

[Redpancreas]

Numerous people have said why she should be expelled without even mentioning media news/being out of context. You just choose to ignore those comments because you’re so bent on making this into a media/politics issue and making excuses for why she shouldn’t be held to a certain standard that’s higher than the general population as a result of her chosen profession. You’ve chosen to derail this conversation with focusing on the media, other trans issues, and comparisons that quite frankly do NOT matter within the context of the problem that SHE created. The problem is her horrible attitude towards a patient that’s in her care because of a comment, enjoying the idea of harming said patient because she got her feelings hurt and how she chose to brag about it on social media. Perhaps you need to go back through this thread and read what people have actually been saying and not what you think they’re saying.

I’m not derailing this thread with trans issues outside the context of her post. She is not posting about how she enjoys the idea of harming a patient. She is posting about how she felt a patient deserved an extra needle stick for making fun of her defense of a minority. There’s a difference.

I agree her attitude towards this patient is horrible and demonstrates a lack of empathy. She made a mistake. There is no evidence she tried to harm a patient nor is there evidence of a repeated pattern of a lack of empathy which if proven I think would prove as grounds for expulsion. Note how I am not saying that there shouldn’t be significant consequences. I think expulsion in this case will set a very grave precedent that is not in anyones interest and it will not in any way gate keep the profession.

 

[anesussy]

She is not posting about how she enjoys the idea of harming a patient. She is posting about how she felt a patient deserved an extra needle stick for making fun of her defense of a minority. There’s a difference.

This is completely disingenuous. Anyone reading the tweet with the least bit of critical reading abilities can tell that Kychelle, at a minimum, viewed the patient being harmed as a favorable outcome.

 

[Redpancreas]

There's no evidence the patient "made fun of her defense of a minority," not that it matters what mortal sin the patient committed. He made fun of her pronoun pin, which given her response in this case, is clearly a way to signal virtue to other lefties. That is why she runs on social media to talk about it. If there's a "pattern" here, it's that cynical medical students like Kychelle have figured out how to leverage identity politics to advance their own careers. That's been going on a very long time. Activists who believe their patients "have it coming" shouldn't be doctors.

Yes there is.

The medical student is telling us the patient asked her something along the lines of why she felt the need to have "she" displayed on her badge which diminishes the whole point of pronouns. I don't see any reason for why she would lie. Nearly everyone understands this is a sensitive issue whether you are a transgender individual or someone who doesn't agree that transgender people should exist and heard about pronouns from news that caters to their opinion.

Regardless, I agree it doesn't matter what the patient said verbally. It doesn't give her an excuse to write that...but we have a pretty good reason to suspect the patient said that.

 

[Lawpy]

I think expulsion in this case will set a very grave precedent that is not in anyones interest and it will not in any way gate keep the profession.

How? If anything the precedent is don’t post insensitive and horrible content on social media

 

[FootballAndSkiing]

How? If anything the precedent is don’t post insensitive and horrible content on social media

I actually think it would be following precedent.

 

[sloop]

I don't quite understand how using pronouns coherent with one's gender identity "butchers grammar." Singular "they" has existed for a long time in English. Neo-pronouns are an interesting (off-topic) discussion, but if that's all it takes to earn a patient's trust, which is already near rock-bottom in the LGBTQ community, then why is this such a big deal? Is this really the hill to die on?


Please cite. The most recent comprehensive study I have notes that 13.1% of those who underwent gender affirmation procedures ("transition") have detransitioned, and of those 13.1%, only 15.9% cited "internal factors," and these internal factors included many people expressing gender fluidity rather than wanting to go back specifically to their assigned gender at birth. doi:10.1089/lgbt.2020.0437 if you wish to read it yourself. Please feel free to do research in the field as the more data we have the more informed we can be when helping patients make these huge health decisions.

It's a shame that an important ethical issue is being drowned out by arguments regarding the validity of the trans experience and Fox News. For the record, my opinion is that she should be expelled. I believe these are warning signs of someone who feels they have moral high ground and it gives them the right to use it to belittle or worse, potentially harm patients. I know people like this, and the extremes as with most things are dangerous.

As this seems to be the majority opinion, I feel this thread may have outlived its use.

So I happen to be a psychiatrist who has had specific training in gender dysphoria and has actually been involved in this work. I have done numerous evaluations for people with gender dysphoria. I have also recommended many people for hormones as well as written letters recommending many people for various kinds of gender affirming surgery.

Detransitioning is relatively uncommon to begin with, though it becomes more common depending on the population you’re looking at. Young kids, in particular, have a relatively high rate of subsequent regret about these types of decisions, which is why most people generally recommend puberty-blocking medications in young kids and checking in when they’re older rather than going forward with irreversible measures. It’s also a similar thing with detransitioning. It really depends on what population you’re looking at. The other thing you need to take into consideration is the degree of suffering that occurs when a person actually makes the wrong decision when it comes to transitioning. There is a spectrum to this, too, but people who wind up regretting bottom surgery in particular can be extremely affected by it.

The reality here doesn’t align perfectly with any mainstream political narrative. Gender dysphoria exists, and some people legitimately do not identify with their biological sex. Surgery and other medical treatments can help some of these people. On the other hand, there are actually people who are pushed toward these measures for reasons other than gender dysphoria. While rare in absolute terms, many people who have specifically worked with these populations have seen examples of people whose gender identity is tied up in some sort of personality pathology or other psychopathology. These people are likely to regret a decision to transition and providers do have to be willing to express their concerns about this.

A problem I have seen with some psychiatrists is that they just take the patient’s expressed identity at face value and recommend hormones, surgery, etc. without actually doing a thorough evaluation. Part of recommending this type of treatment has to involve a willingness to not recommend that treatment. At the end of the day, you’re a doctor and you’re supposed to be looking out for the patient. Your job is primarily to help the patient, not to be a gender advocate.

It’s fine to want to support trans people, but if one’s primary interest and goal in evaluating gender dysphoria is to be some sort of gender advocate, I actually think that’s potentially malpractice.

 

[Lawpy]

So I happen to be a psychiatrist who has had specific training in gender dysphoria and has actually been involved in this work. I have done numerous evaluations for people with gender dysphoria. I have also recommended many people for hormones as well as written letters recommending many people for various kinds of gender affirming surgery.

Detransitioning is relatively uncommon to begin with, though it becomes more common depending on the population you’re looking at. Young kids, in particular, have a relatively high rate of subsequent regret about these types of decisions, which is why most people generally recommend puberty-blocking medications in young kids and checking in when they’re older rather than going forward with irreversible measures. It’s also a similar thing with detransitioning. It really depends on what population you’re looking at. The other thing you need to take into consideration is the degree of suffering that occurs when a person actually makes the wrong decision when it comes to transitioning. There is a spectrum to this, too, but people who wind up regretting bottom surgery in particular can be extremely affected by it.

The reality here doesn’t align perfectly with any mainstream political narrative. Gender dysphoria exists, and some people legitimately do not identify with their biological sex. Surgery and other medical treatments can help some of these people. On the other hand, there are actually people who are pushed toward these measures for reasons other than gender dysphoria. While rare in absolute terms, many people who have specifically worked with these populations have seen examples of people whose gender identity is tied up in some sort of personality pathology or other psychopathology. These people are likely to regret a decision to transition and providers do have to be willing to express their concerns about this.

A problem I have seen with some psychiatrists is that they just take the patient’s expressed identity at face value and recommend hormones, surgery, etc. without actually doing a thorough evaluation. Part of recommending this type of treatment has to involve a willingness to not recommend that treatment. At the end of the day, you’re a doctor and you’re supposed to be looking out for the patient. Your job is primarily to help the patient, not to be a gender advocate.

It’s fine to want to support trans people, but if one’s primary interest and goal in evaluating gender dysphoria is to be some sort of gender advocate, I actually think that’s potentially malpractice.

This is the type of nuance that gender advocates miss and patients suffer.

 

[Redpancreas]

How? If anything the precedent is don’t post insensitive and horrible content on social media

Caving into political pressure and expelling someone for one insensitive/horrible tweet (that if said off social media wouldn't be nearly as scrutinized). I do think schools need to start making student's register social media accounts that represent their name/image, monitor posts, and create rules with well-defined consequences so there's no future confusion. That's all I'll say here.

Edit: Guess I had more to say...

 

[Lawpy]

Caving into political pressure and expelling someone for one insensitive/horrible tweet. I do think schools need to start making student's register social media accounts that represent their name/image, monitor posts, and create rules with well-defined consequences so there's no future confusion.

It’s not political pressure. It’s a serious ethical and professionalism problem. That tweet was first picked up by a liberal group that’s then circulated by Fox News so if anything, the condemnation is actually bipartisan. And for good reasons.

 

[FootballAndSkiing]

It’s not political pressure. It’s a serious ethical and professionalism problem. That tweet was first picked up by a liberal group that’s then circulated by Fox News so if anything, the condemnation is actually bipartisan. And for good reasons.

If your referring to libs of tik tok, they are not liberal lol. scroll through their feed a little. Its entertaining.

 

[Redpancreas]

It’s not political pressure. It’s a serious ethical and professionalism problem. That tweet was first picked up by a liberal group that’s then circulated by Fox News so if anything, the condemnation is actually bipartisan. And for good reasons.

It is, but not one I think warrants immediate expulsion. If you google her name, you find NY Post, Fox News, the usual Reddit groups...all of which are misrepresenting what actually happened.

 

[CantFindMeNowAdcoms]

Me reading this thread: eh... I don't like Twitter that much anyways

 

[SnowyMoon]

Detransitioning is relatively uncommon to begin with, though it becomes more common depending on the population you’re looking at. Young kids, in particular, have a relatively high rate of subsequent regret about these types of decisions, which is why most people generally recommend puberty-blocking medications in young kids and checking in when they’re older rather than going forward with irreversible measures. The other thing you need to take into consideration is the degree of suffering that occurs when a person actually makes the wrong decision when it comes to transitioning. There is a spectrum to this, too, but people who wind up regretting bottom surgery in particular can be extremely affected by it.

This is great to hear. While I don't claim high credentials, my work in the area involves teaching trans and nonbinary students how to sing, and I occasionally had young students who were on blockers. I couldn't in good conscience go through with recommending irreversible measures in someone so young for the reasons you state.

On the other hand, there are actually people who pushed toward these measures for reasons other than gender dysphoria. While rare in absolute terms, many people who have specifically worked with these populations have seen examples of people whose gender identity is tied up in some sort of personality pathology or other sort of psychopathology. These people are likely to regret a decision to transition and providers do have to be willing to express their concerns about this.

I'm not a doctor, just a voice teacher, so my view was never to diagnose those pathologies, only work on healthy singing technique. I don't mean this antagonistically, more just curious - what psychopathologies do you find consistent with this?

I appreciate your input @sloop and agree with your overall post. Gender advocacy is a very different thing from being a physician, and the demarcation is critically important to preventing unnecessary harm. I am in support of the requirements taken to ensure that irreversible measures do not produce extreme suffering, and my only goal in posting that study was to refute the somewhat prevalent claim that "most people who undergo transition regret it." I may have imagined that particular statement from jimbob due to an unfortunate number of prior conversations with vocal teacher colleagues and wanted to preempt that conclusion from being drawn.

 

[Goro]

Can Kychelle identify as a black man? Why or why not?

This type of discussion is only going to land another wise excellent thread into the SPF dumpster fire or get it locked. Stick to the OP and medical ethics and professionalism

 

[DarkBluMage]

She is not posting about how she enjoys the idea of harming a patient. She is posting about how she felt a patient deserved an extra needle stick

This is a literal contradiction to your point. I’m done with the conversation. This kind of professional and ethical violation should not be afforded protection in the medical community.

 

[sloop]

This is great to hear. While I don't claim high credentials, my work in the area involves teaching trans and nonbinary students how to sing, and I occasionally had young students who were on blockers. I couldn't in good conscience go through with recommending irreversible measures in someone so young for the reasons you state.


I'm not a doctor, just a voice teacher, so my view was never to diagnose those pathologies, only work on healthy singing technique. I don't mean this antagonistically, more just curious - what psychopathologies do you find consistent with this?

I appreciate your input @sloop and agree with your overall post. Gender advocacy is a very different thing from being a physician, and the demarcation is critically important to preventing unnecessary harm. I am in support of the requirements taken to ensure that irreversible measures do not produce extreme suffering, and my only goal in posting that study was to refute the somewhat prevalent claim that "most people who undergo transition regret it." I may have imagined that particular statement from jimbob due to an unfortunate number of prior conversations with vocal teacher colleagues and wanted to preempt that conclusion from being drawn.

I can’t pretend to know what he meant, but I can say that the idea that most people regret transition is definitely false.

In terms of pathology that can cause people to seek transition, that can span the gamut. One example that sometimes comes up is that there are some patients with Borderline Personality Disorder who have a very unstable sense of self/identity. These patients often grab onto things that they see as potential sources of identity as a way of avoiding distressing emotions related to poor self-attitude. These patients often also have abandonment issues, so they sometimes join and identify with subcultures as a way of gaining the sort of attention that temporarily assuages their crippling fear that they will be left abandoned and unwanted.

I have seen some people like this who actually seem drawn to the idea of transitioning as a means of gaining a certain degree of positive attention from those around them. Yes, being trans by and large is very difficult but it is also undeniable that transitioning can also gain you a good deal of praise from a subset of people, both in person and on social media, who will comment about how what you’re doing is “brave” and how you’re being true to yourself, etc. This can be attractive to people with Cluster B personality traits because it gives them a sense of belonging and acceptance that can temporarily alleviate concerns that deeply terrify them.

I should also note that, by the above, I don’t mean to suggest that everyone like I described who identifies as trans is lying, necessarily. I think that can happen, but it is probably relatively uncommon. More often one of two things is happening. Either they have both a personality disorder and legitimate gender dysphoria or they have such a severe personality disorder that they don’t really know what their identity is, but they express one gender identity as a behavior that tends to reduce the distress associated with their personality disorder.

Obviously, for the latter people, transition is not the answer. They’re just going to transition and then learn that abandonment is just as possible for a trans person as it is for a cis person.

 

[gyngyn]

The derailment in this thread is bringing it dangerously close to closure.
Name-calling and incivility is not permissible.
Troll posts (and troll) are being removed.

 

[operaman]

I can’t pretend to know what he meant, but I can say that the idea that most people regret transition is definitely false.

In terms of pathology that can cause people to seek transition, that can span the gamut. One example that sometimes comes up is that there are some patients with Borderline Personality Disorder who have a very unstable sense of self/identity. These patients often grab onto things that they see as potential sources of identity as a way of avoiding distressing emotions related to poor self-attitude. These patients often also have abandonment issues, so they sometimes join and identify with subcultures as a way of gaining the sort of attention that temporarily assuages their crippling fear that they will be left abandoned and unwanted.

I have seen some people like this who actually seem drawn to the idea of transitioning as a means of gaining a certain degree of positive attention from those around them. Yes, being trans by and large is very difficult but it is also undeniable that transitioning can also gain you a good deal of praise from a subset of people, both in person and on social media, who will comment about how what you’re doing is “brave” and how you’re being true to yourself, etc. This can be attractive to people with Cluster B personality traits because it gives them a sense of belonging and acceptance that can temporarily alleviate concerns that deeply terrify them.

I should also note that, by the above, I don’t mean to suggest that everyone like I described who identifies as trans is lying, necessarily. I think that can happen, but it is probably relatively uncommon. More often one of two things is happening. Either they have both a personality disorder and legitimate gender dysphoria or they have such a severe personality disorder that they don’t really know what their identity is, but they express one gender identity as a behavior that tends to reduce the distress associated with their personality disorder.

Obviously, for the latter people, transition is not the answer. They’re just going to transition and then learn that abandonment is just as possible for a trans person as it is for a cis person.

This is exactly the kind of discussion I’ve been looking for around these issues and I hope additional solid research is forthcoming. Getting a bit off topic of this thread, but it’s hard to have an adult discussion about these things because the far left seems to allow no room for nuance. Anything less than the full on woke party line is seen as violence and erasing trans people when obviously it’s a more difficult discussion than that.

As a surgeon who has a growing gender affirming practice, I personally find it very difficult to deal with younger patients seeking surgery. I’m lucky that there are therapy options to address vocal issues so surgery is something I can punt on for a long time. I just don’t feel right offering an irreversible surgery to a young person and I worry that the far left woke view of things will make it even harder to discern which patients really need it. It’s either surgery on demand or you’re a bigot and a transphobe, or so it seems.

It’s easy for virtue signalers to wear pronoun pins, but for the rest of us in the tranches trying to provide good care to this population, we need good data and the ability to have nuanced discussions. We don’t need people getting stabbed with needles when they disagree.

 

[sloop]

This is exactly the kind of discussion I’ve been looking for around these issues and I hope additional solid research is forthcoming. Getting a bit off topic of this thread, but it’s hard to have an adult discussion about these things because the far left seems to allow no room for nuance. Anything less than the full on woke party line is seen as violence and erasing trans people when obviously it’s a more difficult discussion than that.

As a surgeon who has a growing gender affirming practice, I personally find it very difficult to deal with younger patients seeking surgery. I’m lucky that there are therapy options to address vocal issues so surgery is something I can punt on for a long time. I just don’t feel right offering an irreversible surgery to a young person and I worry that the far left woke view of things will make it even harder to discern which patients really need it. It’s either surgery on demand or you’re a bigot and a transphobe, or so it seems.

It’s easy for virtue signalers to wear pronoun pins, but for the rest of us in the tranches trying to provide good care to this population, we need good data and the ability to have nuanced discussions. We don’t need people getting stabbed with needles when they disagree.

Trust me, this kind of stuff provokes outrage beyond all reason.

You know, it’s bizarre because I’ve been vilified from both the right and the left when I try to have conversations about issues related to sex and gender.

I’ve been called a transphobe for exactly the position I have described. Which is pretty bizarre to me considering I’ve helped people get gender affirming surgery.

On the flip side, I also hold the position that there should be a narrow exception to mandatory reporting for people voluntarily seeking treatment for paraphilias. That position has gotten me criticism from the right for being some sort of enabler of child sexual abuse. Which again is bizarre to me because my position is that people trying not to abuse children should be able to come to the clinic to get Leupron without worrying that we’re going to get them arrested.

 

[SnowyMoon]

This is exactly the kind of discussion I’ve been looking for around these issues and I hope additional solid research is forthcoming. Getting a bit off topic of this thread, but it’s hard to have an adult discussion about these things because the far left seems to allow no room for nuance. Anything less than the full on woke party line is seen as violence and erasing trans people when obviously it’s a more difficult discussion than that.

As a surgeon who has a growing gender affirming practice, I personally find it very difficult to deal with younger patients seeking surgery. I’m lucky that there are therapy options to address vocal issues so surgery is something I can punt on for a long time. I just don’t feel right offering an irreversible surgery to a young person and I worry that the far left woke view of things will make it even harder to discern which patients really need it. It’s either surgery on demand or you’re a bigot and a transphobe, or so it seems.

It’s easy for virtue signalers to wear pronoun pins, but for the rest of us in the tranches trying to provide good care to this population, we need good data and the ability to have nuanced discussions. We don’t need people getting stabbed with needles when they disagree.

I think it does touch the root issue of the twitter post which is virtue signaling, its downfalls, and where (or if) it belongs at all in medicine. What sticks out to me so far from this thread is that virtue signaling gets in the way of ethical patient care, and also adequate research on topics that require a more nuanced view than the "for/against."

Time will tell, but I think this student may have unwittingly started a domino effect on how medical schools view virtue signaling behaviors on social media in their students. This is going to affect Wake's reputation to some degree, and I'd bet other schools don't want this ire turned on them. Anyone know if wake has a social media policy in their handbook?

 

[operaman]

Trust me, this kind of stuff provokes outrage beyond all reason.

You know, it’s bizarre because I’ve been vilified from both the right and the left when I try to have conversations about issues related to sex and gender.

I’ve been called a transphobe for exactly the position I have described. Which is pretty bizarre to me considering I’ve helped people get gender affirming surgery.

On the flip side, I also hold the position that there should be a narrow exception to mandatory reporting for people voluntarily seeking treatment for paraphilias. That position has gotten me criticism from the right for being some sort of enabler of child sexual abuse. Which again is bizarre to me because my position is that people trying not to abuse children should be able to come to the clinic to get Leupron without worrying that we’re going to get them arrested.

It’s definitely a strange time to be a moderate with independent thinking. Nobody knows where to put us!

Maybe this phenomenon is part of what drives my animosity for the woke left in particular. Not only are they the most vicious toward anyone who wavers from the one true opinion, but they keep pushing the envelope to crazy levels. I’ll be working with my institution and staff to designate gender neutral restrooms and redo some of our intake paperwork and EMR functions to accommodate trans patients, and it’s not always easy to get buy in even for very basic and reasonable measures. And then the woke left comes out saying men have periods, let’s chemically castrate any kid who wants it, and if you so much as joke about a pronoun pin you get stabbed with a needle. Ahhhh!

There has to be some kind intelligent middle ground here.

 

[operaman]

I think it does touch the root issue of the twitter post which is virtue signaling, its downfalls, and where (or if) it belongs at all in medicine. What sticks out to me so far from this thread is that virtue signaling gets in the way of ethical patient care, and also adequate research on topics that require a more nuanced view than the "for/against."

Time will tell, but I think this student may have unwittingly started a domino effect on how medical schools view virtue signaling behaviors on social media in their students. This is going to affect Wake's reputation to some degree, and I'd bet other schools don't want this ire turned on them. Anyone know if wake has a social media policy in their handbook?

I’m sure they must. My school had one ages ago so I’d be shocked if they didn’t. I wouldn’t be surprised if they tighten it up a bit as a result of this though!

It’s probably not legal to bar students from SM entirely, but I could see schools restricting what students can say about their affiliation with their school. All my hospitals have said that if I identify as part of their institution then I must add a line to my bio explicitly saying that my posts do not represent them. It wouldn’t be a stretch to restrict students from publicly claiming affiliation with the school, or subjecting them to additional restrictions if they chose to do so, such as requiring all such accounts to be registered so posts can be monitored.

I think it would be easy and reasonable to forbid students and employees from posting absolutely anything about any patient encounter no matter how deidentified it is. It’s so easy to run afoul of HIPAA - like even the patient in this scenario has likely been identified and may even pursue legal action.

 

[Damson]

I think she can learn from this incident, and still become a good doctor.

 

[Lawpy]

I think she can learn from this incident, and still become a good doctor.

I doubt she’ll learn anything and is only apologizing for being caught. Ethical and professionalism problems are very difficult to resolve and that tweet suggests deeper problems at play

 

[sloop]

It’s definitely a strange time to be a moderate with independent thinking. Nobody knows where to put us!

Maybe this phenomenon is part of what drives my animosity for the woke left in particular. Not only are they the most vicious toward anyone who wavers from the one true opinion, but they keep pushing the envelope to crazy levels. I’ll be working with my institution and staff to designate gender neutral restrooms and redo some of our intake paperwork and EMR functions to accommodate trans patients, and it’s not always easy to get buy in even for very basic and reasonable measures. And then the woke left comes out saying men have periods, let’s chemically castrate any kid who wants it, and if you so much as joke about a pronoun pin you get stabbed with a needle. Ahhhh!

There has to be some kind intelligent middle ground here.

I harbor similar frustrations about the “woke left” as you say. I think part of my frustration is that, while I don’t identify with the left ideologically (nor do I identify with the right for that matter), I sort of do intellectually. That is, I feel like it used to be that the left was the side that encouraged you to interrogate every belief you had and think for yourself. So I think I’m frustrated because I feel like they’ve lost their way. A lot of the left has gotten so extreme now that I feel like it more closely resembles the dogma that used the to come primarily from the authoritarian right.

 

[mrbreakfast]

Anyone know if wake has a social media policy in their handbook?

Almost all medical schools have a copy of their handbook online, including Wake. It's very long, but you can read through it if you like.

It's somewhat moot, however, because medical schools have the power to expel students for almost anything they want (for "not upholding the standards and values of the profession" which has a very broad definition). It doesn't have to be explicitly mentioned in the handbook. This idea has been challenged and upheld in court a number of times (including the "it wasn't in the handbook" part). I'll say that one of the things my school specifically told us not to do was to go out and get completely wasted while wearing apparel that could identify us as a medical student there, like a t-shift.

I think it is well established that we as physicians should put aside our personal beliefs when it comes to treating patients. I've treated multiple patients with swastika tattoos, multiple patients hospitalized for injuries they sustained while murdering someone else, and prisoners serving life sentences for the most horrific crimes you can imagine. We're taught to treat the patient and not just the disease, but sometimes you have separate the two.

 

[Lawpy]

It’s definitely a strange time to be a moderate with independent thinking. Nobody knows where to put us!

Maybe this phenomenon is part of what drives my animosity for the woke left in particular. Not only are they the most vicious toward anyone who wavers from the one true opinion, but they keep pushing the envelope to crazy levels. I’ll be working with my institution and staff to designate gender neutral restrooms and redo some of our intake paperwork and EMR functions to accommodate trans patients, and it’s not always easy to get buy in even for very basic and reasonable measures. And then the woke left comes out saying men have periods, let’s chemically castrate any kid who wants it, and if you so much as joke about a pronoun pin you get stabbed with a needle. Ahhhh!

There has to be some kind intelligent middle ground here.

I harbor similar frustrations about the “woke left” as you say. I think part of my frustration is that, while I don’t identify with the left ideologically (nor do I identify with the right for that matter), I sort of do intellectually. That is, I feel like it used to be that the left was the side that encouraged you to interrogate every belief you had and think for yourself. So I think I’m frustrated because I feel like they’ve lost their way. A lot of the left has gotten so extreme now that I feel like it more closely resembles the dogma that used the to come primarily from the authoritarian right.

There is little to no grasp of nuance in contemporary politics and society. For the same lack of nuance to be observed among this MS4 in question is a serious problem in itself. Medicine should be held at a much higher expectation even if the society is so hyperpolarized

 

[AvsPearTree]

Holy sensationalism. Its like people here are trying to say she's the next Christopher Duntsch.

I doubt she’ll learn anything and is only apologizing for being caught. Ethical and professionalism problems are very difficult to resolve and that tweet suggests deeper problems at play

You seem to talk a lot in absolutes. Can you elaborate what about this tweet clearly depicts "deeper problems at play?" Do you know her personally to also claim she is the type of person who won't learn from this event? I can, on the other hand, see this as someone who is what 25? 26? still learning how to be an adult (sorry to burst some bubbles, but a majority of mid 20 somethings don't have life figured out), who showed a brief lapse in judgement and who made a mistake and said something stupid. If she is shown to have a history of poor judgement, malice, or actual proof without a shadow of doubt that her intent was to harm that patient, then yes throw the book at her. If this is the first time she has done something like this, then she has most likely learned a valuable lesson she will never forget and this does not warrant destroying her entire life over.

 

[Lawpy]

Holy sensationalism. Its like people here are trying to say she's the next Christopher Duntsch.



You seem to talk a lot in absolutes. Can you elaborate what about this tweet clearly depicts "deeper problems at play?" I can, on the other hand, see this as someone who is what 25? 26? still learning how to be an adult (sorry to burst some bubbles, but a majority of mid 20 somethings don't have life figured out), who showed a brief lapse in judgement and who made a mistake and said something stupid. If she is shown to have a history of poor judgement, malice, or actual proof without a shadow of doubt that her intent was to harm that patient, then yes throw the book at her. If this is the first time she has done something like this, then she has most likely learned a valuable lesson she will never forget and this does not warrant destroying her entire life over.

“Brief lapse in judgment”. Oh come on, quit trying to minimize the issue. That tweet was completely intentional and insensitive on her part and she had full control on deciding to post that. A mid-20 something MS4 not being well versed on how to be professional on social media is a major problem in itself and I completely stand by what I said in supporting her expulsion

 

[AvsPearTree]

“Brief lapse in judgment”. Oh come on, quit trying to minimize the issue. That tweet was completely intentional and insensitive on her part and she had full control on deciding to post that. A mid-20 something MS4 not being well versed on how to be professional on social media is a major problem in itself and I completely stand by what I said in supporting her expulsion

one tweet = brief, a string of tweets or some sort of proof of a trend of bad judgement calls = not brief
that tweet is ambiguous so you cannot prove intent based off of it alone, a new graduate from Joe's Crab Shack School of Law would win that case.
You are right she had full control and it was stupid/insensitive to post that. She should know better, but people make mistakes, so admin should ensure she learned a valuable lesson from this, but not expelled for it.
maybe hyperbole; shouldn't all physicians lose their license if they ever make a mistake? Especially if they harm or kill someone, even if unintentionally? If we are going to establish this impeccable standard that all physicians and future physicians must abide by, then we must be consistent!

Or maybe we should acknowledge that physicians are still human and prone to making mistakes, and making a mistake or saying something stupid one time doesn't automatically mean your a bad person or a bad physician.

 

[Lawpy]

one tweet = brief, a string of tweets or some sort of proof of a trend of bad judgement calls = not brief
that tweet is ambiguous so you cannot prove intent based off of it alone
You are right she had full control and it was stupid/insensitive to post that. She should know better, but people make mistakes, so admin should ensure she learned a valuable lesson from this, but not expelled for it.
maybe hyperbole; shouldn't all physicians lose their license if they ever make a mistake? Especially if they harm or kill someone, even if unintentionally? If we are going to establish this impeccable standard that all physicians and future physicians must abide by, then we must be consistent!

Or maybe we should acknowledge that physicians are still human and prone to making mistakes, and making a mistake or saying something stupid one time doesn't automatically mean your a bad person or a bad physician.

That tweet wasn’t really ambiguous. Whether the incident actually happened is unclear but clearly the way that student outlined it showed she had no regard for the patient in question. Proper social media use is important. Following basic ethical and professional standards is important. Putting doctors at a much higher standard than rest of society is important. You can fix accidents and lapses of judgment if remorse and regret are shown. That’s not the case for the student (no the apology isn’t sincere). That’s something indicative of deeper issues that can’t be readily resolved.

 

[DarkHorizon]

It’s definitely a strange time to be a moderate with independent thinking. Nobody knows where to put us!

Maybe this phenomenon is part of what drives my animosity for the woke left in particular. Not only are they the most vicious toward anyone who wavers from the one true opinion, but they keep pushing the envelope to crazy levels. I’ll be working with my institution and staff to designate gender neutral restrooms and redo some of our intake paperwork and EMR functions to accommodate trans patients, and it’s not always easy to get buy in even for very basic and reasonable measures. And then the woke left comes out saying men have periods, let’s chemically castrate any kid who wants it, and if you so much as joke about a pronoun pin you get stabbed with a needle. Ahhhh!

There has to be some kind intelligent middle ground here.

/thread

 

[Lawpy]

/thread

Pretty sure the thread was already done in Page 1 and we’re just going in circles to Page 7 (and counting).

 

[Damson]

I doubt she’ll learn anything and is only apologizing for being caught. Ethical and professionalism problems are very difficult to resolve and that tweet suggests deeper problems at play

True. But for this incident in particular, we can be assured she's learned her lesson.

 

[JP2740]

True. But for this incident in particular, we can be assured she's learned her lesson.

If she gets off with just a few week break, I doubt it

 

[deleted1100659]

one tweet = brief, a string of tweets or some sort of proof of a trend of bad judgement calls = not brief
that tweet is ambiguous so you cannot prove intent based off of it alone, a new graduate from Joe's Crab Shack School of Law would win that case.
You are right she had full control and it was stupid/insensitive to post that. She should know better, but people make mistakes, so admin should ensure she learned a valuable lesson from this, but not expelled for it.
maybe hyperbole; shouldn't all physicians lose their license if they ever make a mistake? Especially if they harm or kill someone, even if unintentionally? If we are going to establish this impeccable standard that all physicians and future physicians must abide by, then we must be consistent!

Or maybe we should acknowledge that physicians are still human and prone to making mistakes, and making a mistake or saying something stupid one time doesn't automatically mean your a bad person or a bad physician.

literally the fundamental rule of being a physician is "do no harm". When you brag about intentionally doing harm, its hard to have empathy for that amount of stupidity. She intentionally made the tweet bragging about intentional harm

What part was a mistake, did she mistakenly spell out those words, then mistakenly hit submit? I mean mistake would imply her actions were accidental, but they clearly were not, lol. They were the result of terrible judgement.

Do physicians lose their license over terrible judgement? Why yes, they do.

 

[VA Hopeful Dr]

literally the fundamental rule of being a physician is "do no harm". When you brag about intentionally doing harm, its hard to have empathy for that amount of stupidity. She intentionally made the tweet bragging about intentional harm

What part was a mistake, did she mistakenly spell out those words, then mistakenly hit submit? I mean mistake would imply her actions were accidental, but they clearly were not, lol. They were the result of terrible judgement.

Do physicians lose their license over terrible judgement? Why yes, they do.

You can't assume that based on the Tweet.

 

[deleted1100659]

You can't assume that based on the Tweet.

they did brag about it. Whether they did it or not, I dunno. But they made a comment bragging about intentionally causing harm. Again, I never said they did it or didnt do it; no idea. Im saying bragging about it is fairly stupid. So that wasn't a mistake, that was poor judgement. Mistake are not intentional, whereas she showed poor judgement.

Not saying she's a bad person, since I dont know her. Im saying she showed terrible judgement, which is far from ideal as a medical student who will soon be a resident. However, I don't think she is beyond redemption either. They should actually investigate if she did it, or just made stupid comments; that is what should determine the severity of consequence

 

[Dral]

Not saying she's a bad person, since I dont know her. Im saying she showed terrible judgement, which is far from ideal as a medical student who will soon be a resident. However, I don't think she is beyond redemption either. They should actually investigate if she did it, or just made stupid comments; that is what should determine the severity of consequence

Without knowing a ton about the situation, things sound to me like the patient really had to undergo two sticks in terms of a successful procedure, and the med student played that up and turned it into a "Haha, but I got revenge on HIM by sticking him twice."

However, as you alluded to, there is no way for us to know that for sure. I agree that maybe someone looking into it a bit further (interviewing the pt, the student, and any other witnesses...past care provides involved in the pt's care (to see if the pt is a 'hard stick' type of patient), etc. would maybe help parse out whether this is just bad judgement or a bigger problem.

 

[deleted1100659]

Without knowing a ton about the situation, things sound to me like the patient really had to undergo two sticks in terms of a successful procedure, and the med student played that up and turned it into a "Haha, but I got revenge on HIM by sticking him twice."

However, as you alluded to, there is no way for us to know that for sure. I agree that maybe someone looking into it a bit further (interviewing the pt, the student, and any other witnesses...past care provides involved in the pt's care (to see if the pt is a 'hard stick' type of patient), etc. would maybe help parse out whether this is just bad judgement or a bigger problem.

the wording was definitely poor and she certainly alluded that it was intentional but the thought process/judgement still makes it bad, lol which I think most people agree on.

But yeah, im most curious what the patient has to say about all this. That would offer an interesting perspective

 

[operaman]

the wording was definitely poor and she certainly alluded that it was intentional but the thought process/judgement still makes it bad, lol which I think most people agree on.

But yeah, im most curious what the patient has to say about all this. That would offer an interesting perspective

I suspect the patient will be making their public statement in the form of a civil legal filing as well as for damages via a formal HIPAA complaint.

You know the attorneys must be lining up to do this pro bono if for no other reason than the free air time on Fox.