Case 2 - Remi
Remi is a 27-year-old University student who was assigned female at birth. They identify as non-binary and have changed their name via deed poll, but their social transition has been difficult. Although toilets on campus are gender neutral, navigating elsewhere in a binary world has been tough.
They will soon undergo bilateral mastectomy with reconstruction surgery to create a chest wall more congruent with their gender identity which will additionally relieve them from the discomfort of binding which Remi has been doing to manage their gender dysphoria. They found breast development distressing through puberty, and this has not abated, but they have no interest in testosterone therapy. They are having trouble persuading the surgery reception staff to change their primary care record to display their new name, title, and a neutral gender marker, so they book an appointment to see you about it.
Pertaining to patients with a non-binary gender identity
there is often an underlying intersex condition
Incorrect
he/him or she/her pronouns are used interchangeably
Incorrect
chest or “top” surgery cannot precede testosterone therapy
Incorrect
“unspecified” or “unknown” can be used as a gender marker on the medical record
Correct
‘X’ is a valid gender category in the UK
Incorrect
they can acquire a UK Gender Recognition Certificate (GRC) denoting their non-binary gender
Incorrect