"The vaginal cavity is plenty of necrosis... I regret having gone through SRS." • Neovagina Disasters

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[–]MarkTwainiac 14 insightful - 1 fun14 insightful - 0 fun15 insightful - 1 fun -  (1 child)

Good point. I didn't mean to set them up as equivalent or as opposite. Traditionally, there's not really been an equivalent to gynecology for males - at least not on the scale of gynecology.

While you are indeed correct that many urologists do treat both males and females, and most are trained to treat both sexes, as a practical matter there are a fair number of male urologists who specialize only in male urology, male reproductive anatomy and see only male patients. At least in big cities in the US. This has especially become the case over the past 30 years, when a new subspecialty of urology known as "andrology" has emerged.

https://www.caredash.com/articles/your-andrologist-a-mens-health-care-specialist

I've personally gone to urologists who treat both sexes, but when one of my sons had a specifically male issue we were sent to consult with physicians who only treat males for male-specific problems. I was surprised at how many there were to choose from in the city where we lived (NYC). Similarly, even apart from the relatively new speciality of andrology, there are a lot of male physicians who are classified as urologists but who long have specialized in male-only medicine like prostate issues. And even amongst men who go to female physicians for general care, most or many prefer to get their prostates checked by male physicians.

https://www.providencephysicians-sc.com/our-practices/providence-urology-specialists/diseases-of-male-reproductive-organs

Also, I shouldn't have used the term "proctologist" as that's now outmoded apparently. Nowadays they are called colorectal surgeons or lower GI tract specialists.

But all this aside, the same pressure and expectation is not being put on urologists to give transgender patients kinds of care they do not normally provide and are not trained to provide. Urologists are being told they need to provide urology care to trans patients with urology issues, particularly related to genital surgeries. But urologists are not being told they now have to expand their skill sets so they can do prostate exams on TIMs or Pap smears and gynecological exams on TIFs.

From Urology Times, 2016:

Urologists in the United States may see a greater number of transgender or gender-variant patients in their practices due to changing legislation, insurance coverage, and greater social acceptance of transgender individuals. While gender-confirming surgeries should only be attempted by experienced reconstructive surgeons, patients may seek care from general urologists for orchiectomy and management of voiding dysfunction or other concerns that may be complicated by prior reconstructions.

https://www.urologytimes.com/view/management-patient-requesting-transgender-surgery

[–][deleted] 15 insightful - 2 fun15 insightful - 1 fun16 insightful - 2 fun -  (0 children)

Speaking of prostates - urologists, if they don't do urogynecology, are equipped to do rectal ultrasound not neovag ultrasound. Would only be fair to make that in their scope. Ah who am I kidding, the patient would insist on a female urogyne anyway.

It would be interesting (in a world where I could be openly questioning about such things) to talk to the urologists where I work and find out if they actually do orchiectomy on TiMs. Traditionally that's only for cancer.

Gynes and uros are surgeons. They do of course use medications, but from a specialized perspective and a limited repertoire. Asking them to do experimental cross-sex endocrinology is about as opposite as you can get from what interested them in their specialties!

Which is even more true for gynes who again are in their field to deal with women's health. So they include female reproductive endocrinology in some of their practices, though usually everything outside of sex-hormone related stuff is sent back to us or referred to yknow, an endocrinologist if it's outside my scope too. Not male systems!

My male GP colleagues aren't creeped out like I am. I of course don't let on about my real feelings, which makes it even more exhausting, and lonely because for all I know my female colleagues share my discomfort but aren't talking either.