True Stories from the ER: Do You Have a Uterus?

By J. L. Thurston

Do you have a uterus?

It’s an easy question. Straightforward, not offensive, at least it shouldn’t be. Lots of people don’t have uteruses. Women get hysterectomies and no man is born with a uterus, and they don’t implant them as far as I’ve ever heard.

Do you have a uterus? It is a question we should be allowed to ask in a hospital. Especially those who work in radiology, a field that could potentially end a pregnancy with X-rays. Because that’s what it’s all about. The sole purpose of a uterus is to house a developing fetus. And — no matter what you identify as — if you have a uterus, we in the hospital need to know whether there’s a chance for pregnancy. Drugs, radiation, and certain procedures can harm or kill a fetus.

Most of the time, when I’ve come across a transitioning person, I’m met with the same polite respect I give my patients. Usually, the conversation works like this:

“Hi, I’m Jenni from CT, and I’d like to take you for a quick scan. I understand you are transitioning, but I need to know if there is any possibility of pregnancy?” It’s easy, and I acknowledge that I respect their position and am only trying to help get them moving forward in their care.

The responses I get are usually very easy to work with. Males transitioning to females tend to grin at me and let me know that they cannot physically get pregnant. We exchange smiles, they sign the pregnancy waiver, and we’re on our way. Females transitioning to males usually let me know when their last period was, if they’re on birth control, if they are even sexually active with a male. Females, whether they identify as one or not, have dealt with their own reproductive functions for a while and know what I’m after with my question. They sign the waiver or pee in a cup. Bing, bang, boom, they’re scanned and on their way.

Because, in a hospital, there is only one registration. And they don’t care what you identify as, they just ask if you are male or female. And in my experience, all transitioning people mark down what they identify as, not what organs they actually possess. I feel like registration should change that question. It should not be Circle F or M. It should be Do you have a uterus?

Because that is all we care about. Because of babies.

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In the first fourteen weeks of pregnancy, a CT scan can cause a spontaneous abortion. That’s what they teach us in radiography school. Any X-ray radiation can alter the developing cells and cause malformations and cancer. The risk is higher in the stage where most uteruses haven’t been suspected of housing life, yet.

The worsening damage of Thomas Edison’s assistant’s hands from X-ray radiation. For more reading on this highly interesting topic, feel free to check out a prior article here on The Ape, Lives that Science Claimed: A Piece of Radiological History.

I bring this up because a coworker of mine, let’s call her Caty (for CAT scan), gets an order to shoot an X-ray on a transitioning person. This person, let’s call her Nit (for nitwit) has been in the ER for the tenth time this month. She complains of chest pains, age thirty, no diagnosis yet.

Caty approaches Nit. Caty is young, bubbly, and one of those people who tend to be instantly likable. She has the pregnancy waiver in hand and asks Nit, “Is there any possibility of pregnancy?”

“No.”

“Great, would you be willing to sign a form stating that there is no possibility of pregnancy?”

Nit takes the clipboard and with hardly a glance, throws it back to Caty. “No.”

Caty knows Nit could be scared or nervous to be in the ER again, receiving judgmental glances from the nurses convinced she’s a drug seeker. So, Caty remains patient.

“Do you,” she stammers. “Do you want the X-ray?”

“Yes, I want it.” Her tone makes the situation difficult to access. Her eyes are cold, staring into Caty with what could only be interpreted as anger.

Caty, not one to be deterred, smiles patiently. Perhaps this topic embarrassed Nit, even though she has gone through this nine times already this month in this ER. “Okay, but I can’t take the X-ray until you sign the form.”

Nit refuses to look at the form, just continues to glare at Caty. “No, I eat pussy.”

The vulgarity makes Caty blush scarlet, and it sparks up the fighter inside her. She’s not a chick to be intimidated or pushed around. “That is irrelevant. I just need the form signed so I can shoot the X-ray and be on my way.”

Nit glares, practically snarling. “Do you speak English? I fuck bitches.”

Caty sighs, feigning boredom. “Do you want the X-ray?”

If Nit says no, Caty is free to tell the physician the patient is refusing to cooperate and the whole thing can get cancelled.

“Yes,” is Nit’s unfortunate answer. “Just do it.”

Caty, still holding her sickly-sweet smile just because she hopes it’ll irritate Nit, holds out the clipboard for the third time. Nit snatches the pen, assaults the paper and grumbles, “There, you bitch. Done.”

Technically, Caty could have security take it from there. Also, Nit could be removed from the ER because no hospital employee has to put up with verbal abuse. But Caty is a lot tougher than she looks, and the tension between them is far too interesting to pass up now.

Caty checks out the pregnancy waiver. For Last menstrual period Nit wrote “years.” Interesting response, considering Nit had been born male and never had to suffer a period. And for Is there a possibility of pregnancy? Nit wrote “PENIS.”

But it’s passable. Caty lines up the X-ray and gets ready to shoot when she notices a motherfucking necklace. Her reaction is anything but positive because she has to, has to, remove the necklace.

She assumes her polite voice. “Can we take off your necklace for this?”

“Fuck no.” Classy as ever, Nit.

“It will ruin the shot, we have to take it off.” Caty takes initiative, reaching over the patient and undoing the clasp. Nit doesn’t think much of this. “You’re treating me like you’re my mother, which you’re not.” Nice argument, Nit. “I didn’t give you permission to take my stuff. That’s illegal.”

Caty makes sure to wad the necklace up, praying to knot the chain or something, and leaves it in Nit’s lap. She preps the X-ray machine, “Take a deep breath in and hold it.”

“Fucking bitch.”

Caty shoots the X-ray. It’s not pretty because Nit decided to swear instead of cooperate.

“Put my necklace back on.”

Caty continues to smile, collects her X-ray board and goes on her way without indicating she’d even heard Nit.

And that is why hospitals have to check, my friends.

Caty, knowing I write for The Ape and that I’ve been wanting to write about transitioning patients, promptly came to me to share her experience as close to verbatim as she could.

Nit’s exact situation is one of a kind at our hospital in that she treated us terribly and as disrespectfully as she could muster.

✶

I’ve assisted women becoming men and men becoming women and even more patients who aren’t sure yet how they feel. We’re all human, we’re all lost in our own way, and most of us are just trying to get along and get by.

Most of us techs never have a problem with any patient besides drunk ones until dear old Nit. Her manner was uncalled for and it had nothing to do with her identity. She’s just a shitty person.

A defensive person may argue she could have been in a lot of pain, or possibly she was severely embarrassed. But I’d like to argue that no one could find a single thing physically wrong with her after ten ER visits, and an embarrassed person probably wouldn’t brazenly proclaim that they “eat pussy” and “fuck bitches” in response to basic personal health information questions.

If she took offense by our policy, perhaps she should have registered as a male simply because she had a penis, even though she identified as a female. But that could eventually be offensive, even when at a hospital. Bottom line, we shouldn’t care about male, female, or somewhere in between. It’s just uterus or no uterus.