[orand]

Race and sex should be inputs. Giving any medical prominence to gender identity will result in people receiving wrong and potentially harmful treatment, or lack of treatment.

[lalaithion]

Most trans people have undergone gender affirming medical care. A trans man who has had a hysterectomy and is on testosterone will have a very different medical baseline than a cis woman. A trans woman who has had an orchiectomy and is on estrogen will have a very different medical baseline than a cis man. It is literally throwing out relevant medical information to attempt to ignore this.

[nonethewiser]

How is that in any way in conflict with what he said? You're just making an argument for more inputs.

Biological sex, hormone levels, etc.

[root_axis]

Seems like adding in gender only makes things less clear. The relevant information is sex and a medical history of specific surgeries and medications - the type of thing your doctor should already be aware of. Adding in gender only creates ambiguity because there's no way to measure gender from a biological perspective.

[LadyCailin]

That’s mostly correct, that “gender identity” doesn’t matter for physical medicine. But hormone levels and actual internal organ sets matter a huge amount, more than genes or original genitalia, in general. There are of course genetically linked diseases, but there are people with XX chromosomes that are born with a penis, and XY people that are born with a vulva, and genetically linked diseases don’t care about external genitalia either way.

You simply can’t reduce it to birth sex assignment and that’s it, if you do, you will, as you say, end up with wrong and potentially harmful treatment, or lack of treatment.

[nonethewiser]

>But hormone levels and actual internal organ sets matter a huge amount, more than genes or original genitalia

Or current genitalia for that matter. It's just a matter of the genitalia signifying other biological realities for 99.9% of people. For sure more info like average hormone levels or ranges over time would be more helpful.

[connicpu]

Actually both are important inputs, especially when someone has been taking hormones for a very long time. The human body changes greatly. Growing breast tissue increases the likelyhood of breast cancer, for example, compared to if you had never taken it (but about the same as if estradiol had been present during your initial puberty).