How do trans people deal with medical symptoms that are related to biological sexes? I know this sounds kinda confusing but a simple example is if a AFAB trans man was having symptoms of a heart attack (we all know males and females have different symptoms) like how does one who doesn’t know the sex they were assigned with suss it out? Idk I’m just worrying about people who might get really sick and stuff bc of biological sex thingies.
Sorry if this triggered anyone I really tried my hardest to express what I mean in a non offensive way. Please call me out if anything is wrong and answer my question bc I’m super confused tbh.
So, hey. You just started following me today, and when I went to peruse your profile this is the first thing I saw.
Assuming good faith here: you need to realize that this is a very, very common form of concern trolling. You might not mean it that way, but that’s how it gets used so… stand advised?
The actual answer to your question isn’t simple, because the question itself is a little disconnected from the reality of the situation. Again: I’m assuming good faith here, don’t take my saying that personally — just kinda how it is.
Gonna walk you through this.
First thing: "biological sex" isn’t "biological", it’s as socially constructed as anything else. It’s assigned at birth based on nothing more than genitalia, and not only are those not inherently binary, they’re also tell you very little about the health and biology of any trans person with a particular type (and are changeable in any case).
That might seem like a tangent, but it’s actually important. You’re assuming that a CAFAB man will have health problems similar to those of a cis woman, except for hormone levels. That is not at all a safe assumption. We have far too little research on trans people’s health, but what we do know indicates that a *lot* changes on HRT alone. Hormones are the drivers of your metabolism, and they control all kinds of things both large and small scale in the body, many of which are still poorly explored (and even moreso for trans folks). The younger you are when you start, the more true that is — your body will grow and develop differently as your hormones change.
Meanwhile, there are actually very few aspects of human medical biology *directly* mediated by genes, chromosomes or anatomy. Hormones are the big driver on a cellular level, and that’s handled by your endocrine system. What that means is you really can’t tell from a trans person’s CASAB (coercively assigned sex at birth) what their body is actually doing.
You’re also assuming, re: the heart attack example, that the distinction between cis men and women’s heart attacks is clear and obvious. It’s not — most cis men *and* cis women report chest pain; more cis women than cis men don’t, but isn’t at all clear why. And even then, the difference isn’t as big as you might think — to the point that the difference may well not be clinically significant, and is certainly not sufficient to explain why more cis women *die* from their heart attacks.
Basically, for anything that’s not clearly specific to anatomy (you can’t get testicular cancer without testes, you can’t need a hysterectomy if you have no uterus, etc), your sex assignment matters a good deal less than you might think. And if you’re intersex, that’s even more the case.
Meanwhile, doctors very often don’t know how to serve us, or what our needs and issues even are, and they frequently abuse us (PDF). Many of us have to walk our own providers through this information because even the research that has been done and verified as best practice is still very poorly known within the medical community. It’s not at all uncommon for us to simply be denied medical coverage, as doctors assume that we’re weird, unnatural, unknowable and probably just a source of liability.
So the answer to your question, “How does one who doesn’t know the sex they were assigned with suss it out?” is “Often really poorly, because cis folks and doctors especially make way too much outta birth assignment, and trans people pay the price for their ignorance and misinformation.”
The other thing is… you won’t find too many trans folks with actual regular access to health care who *don’t* disclose when it’s salient. It’s just that cis people’s idea of “when it’s salient” isn’t terribly well calibrated; me and some other folks I know have been turned away by *dentists*. Because we were on HRT.
…because estrogen is obviously this weird foreign alien chemical and who KNOWS what THAT does to a body.