Question 5 - Georgina
You see 53-year old Georgina as an urgent presentation with chest pain.
She has recently begun the process of medically transitioning to a female gender identity and although she gave up smoking before starting HRT, she has risk factors for cardiovascular disease.
You decide that she needs to go to hospital for further investigation of chest pain as you suspect ACS (acute coronary syndrome). She has changed her medical record and works full time as a coach driver. The troponin reference range is sex-specific.
You are composing a handover letter for the A&E Registrar, and in doing so will need to:
revert to birth sex as relevant for hospital blood testing
assume the patient’s pronoun will be ‘she/her’ given that she presents in a feminine way
ask permission to include reference to their trans status explaining why this is relevant in this scenario
confidentially mention their trans status to the paramedic but not put this into the written handover
B, and D