Woman loses tribunal over transgender tweets (and defended by JK Rowling)

[MigL]

So now R Gervais is under fire for allegedly transphobic tweets.

https://www.msn.com/en-ca/entertainment/celebrity/ricky-gervais-under-fire-for-transphobic-tweets-he-claims-are-jokes/ar-BBYeR7O?ocid=spartandhp

When did it become a thing, that people can be offended for OTHERS ?

[iNow]

1 hour ago, MigL said:

When did it become a thing, that people can be offended for OTHERS ?

Long enough about that Obama is commenting on it, too

https://www.bbc.com/news/world-us-canada-50239261

Quote

Mr Obama told the audience: "I get a sense among certain young people on social media that the way of making change is to be as judgemental as possible about other people.

"If I tweet or hashtag about how you didn't do something right or used the wrong verb, then I can sit back and feel pretty good about myself because 'Man did you see how woke I was? I called you out!'"

That's enough," he said. "If all you're doing is casting stones, you are probably not going to get that far."

Mr Obama added that "people who do really good stuff have flaws".

 

[John Cuthber]

5 hours ago, Prometheus said:

How?

I never came across that in 6 years of A&E nursing. There's a difference in the presentation of abdominal and associated pains, but for the ones you have listed i can't remember any instances where knowing the sex made any difference to the patient's outcome. 

I'm  fifty-something man and , if I turn up in A&E with chest pains I expect to jump the queue in a way that my hypothetical twin sister wouldn't.

I'm not saying that's good or right; I'm saying it's what happens.

[Carrock]

26 minutes ago, John Cuthber said:

I'm  fifty-something man and , if I turn up in A&E with chest pains I expect to jump the queue in a way that my hypothetical twin sister wouldn't.

I'm not saying that's good or right; I'm saying it's what happens.

Not in my one-off experience.

I took a neighbour in her 20s complaining of chest pains to A&E and she jumped the queue as soon as the triage nurse heard the magic words 'chest pain.' (It was 'just' asthma + panic attack.)

As unexplained chest pain is always(?) treated as time critical and I'd be surprised if any A&E would normally spend time triaging such patients.

 

[Prometheus]

Chest pain is one of the most common presenting complaints in A&E (~5%). You'll get assessed by a triage nurse or doctor ASAP, get an ECG, and your pathway determined based on those.

Most UK departments still rely on The Manchester Triage system. It's old, but has been well validated. Not a single presenting complaint includes sex as a factor.

[StringJunky]

7 hours ago, MigL said:

So now R Gervais is under fire for allegedly transphobic tweets.

https://www.msn.com/en-ca/entertainment/celebrity/ricky-gervais-under-fire-for-transphobic-tweets-he-claims-are-jokes/ar-BBYeR7O?ocid=spartandhp

When did it become a thing, that people can be offended for OTHERS ?

Defending an oppressed group that one may have an affinity with is a bad thing? If only the slighted group took umbrage then there would be no change because they are invariably the minority. If Gervais is going to be ambiguous and "edgy" in his humour then he should shut up and suck it up because it goes with the territory.  

[iNow]

14 minutes ago, StringJunky said:

 If Gervais is going to be ambiguous and "edgy" in his humour then he should shut up and suck it up because it goes with the territory.  

I suspect he’s on this same page with you

[Raider5678]

15 hours ago, Prometheus said:

I never came across that in 6 years of A&E nursing. There's a difference in the presentation of abdominal and associated pains, but for the ones you have listed i can't remember any instances where knowing the sex made any difference to the patient's outcome. 

Stroke: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637395/

Asthma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629917/

There was a study for cardiac arrest/heart failure I remember reading, but I can't seem to find it. You can take my word for it or discard that example.

Whether or not this is actively practiced/put in use in a hospital, I can't prove. I had a friend of mine who told me things like this are used at her hospital, but anecdotal evidence doesn't count for much. 

[Prometheus]

5 hours ago, Raider5678 said:

Stroke: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637395/

Asthma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629917/

There was a study for cardiac arrest/heart failure I remember reading, but I can't seem to find it. You can take my word for it or discard that example.

Whether or not this is actively practiced/put in use in a hospital, I can't prove. I had a friend of mine who told me things like this are used at her hospital, but anecdotal evidence doesn't count for much. 

Thanks for the articles. 

I can only speak about UK practices. Here are the NICE guidelines for stroke, one type heart attack, a more dangerous type of heart attack, asthma and the Resuscitation Council's guidelines on cardiac arrest. The only explicit mention of sex in any of these documents was is in the MI document: 'Immediately assess eligibility (irrespective of age, ethnicity or sex) for coronary reperfusion therapy...'

Which is not to say that there aren't differences in the sexes in how these present, only that at present they are not considered relevant: any differences are far too small to be relevant to emergency situations (emergency medicine is a blunt tool compared to the precision medicine in some other fields). That could change in the future, but i doubt it for one particular reason.

The holy grail for medicine for some time now is personalised medicine, where treatments are tailored to the individual, as opposed to the one size fits all approach still prevalent. You might think using sex to guide assessments and treatments would be a step to this end, but the opposite is true. For instance, the asthma article you provided talks about the impact of sex hormones on asthma. One day emergency medicine may be good enough to take these into account when making treatment plans. However, human variability being what it is, if we just assume women and men will have a certain levels of relevant sex hormones we could be doing more harm than good - the fact is that men and women as populations exist on a distribution, and without more information we do not know where on this distribution they exist. We can only treat based on averages, which is the antithesis of personalised medicine. If emergency medicine is good enough to be able to take into account sex hormones in asthma treatment it should be good enough to directly measure these sex hormone levels, via a blood test for instance. In this case, sex would still be irrelevant as we have the direct measure of the pertinent factor - circulating oestrogen and  progesterone levels in this instance.

If you know of different practices outside the UK let me know, i find this interesting, although perhaps off-topic here.

[CharonY]

On 12/23/2019 at 5:28 AM, Prometheus said:

The holy grail for medicine for some time now is personalised medicine, where treatments are tailored to the individual, as opposed to the one size fits all approach still prevalent. You might think using sex to guide assessments and treatments would be a step to this end, but the opposite is true. For instance, the asthma article you provided talks about the impact of sex hormones on asthma. One day emergency medicine may be good enough to take these into account when making treatment plans. However, human variability being what it is, if we just assume women and men will have a certain levels of relevant sex hormones we could be doing more harm than good - the fact is that men and women as populations exist on a distribution, and without more information we do not know where on this distribution they exist.

This is an excellent point. Some of the work in this area indicates that some some differences we associated with male/female or white/black are probably not that medically useful, especially as we lack information for certain groups. Many trials were historically conducted exclusively with men, for example. My work is mostly focused on molecular mechanisms of disease and similar to what you said, we see quit significant variation in the molecular response on the molecular level, and while we probably could stratify our data on gender lines the diagnostic value is incredibly poor. There are of course massive barrier one has to overcome (including price) before personalized medicine (folks like to call it precision medicine now, since it appears that it is time to rebrand it once more) could become implemented in earnest.