Trying to follow the doctor's orders
March 21, 2024 4:33 PM Subscribe
From February, two pieces on learning and adhering to medical instructions. Zareen Choudhury's short comic "Fasting or No Fasting?" starts: "Last year, I had to take a blood test for Lupus during Ramadan." (Image descriptions are available for each cartoon panel.) And "Doctor's Orders: Making the most of the best care you can get", by an anonymous trans woman, is about the necessity and difficulty of following one's care plan after gender-affirming surgery.
A lot of the problem, as I understand it, is that fasting is determined by whether the observant feels that they should fast, not by some objective standard. There are various schools of thought even within a given branch of Islam, one should not be surprised that a lot of people tend to trend conservatively about whether they should be fasting or not, even or especially against medical advice.
posted by ivan ivanych samovar at 6:44 PM on March 21
posted by ivan ivanych samovar at 6:44 PM on March 21
Hi, I'm wondering if either of the previous commenters is Muslim.
I would counsel non-Muslims not to weigh in with their opinions of what the ruling in this case might or should be, simply out of respect.
Muslimah here. It's incumbent on a Muslim to learn about their religion, and Muslims are counseled to read basic texts of shari'a law with the guidance of a qualified scholar. These texts can be as simple as those learned by heart in grade school in places like Morocco, but it's still recommended to study them with a scholar.
I'm blessed to belong to such a community. We have a very active WhatsApp group, where questions like this get lobbed at qualified scholars at the rate of 10+ a day. This type of issue is exactly the kind of thing that would get asked, and answered, quickly and completely.
And the answers, grounded firmly in shari'a law, are wise and compassionate.
posted by rabia.elizabeth at 4:59 AM on March 22 [12 favorites]
I would counsel non-Muslims not to weigh in with their opinions of what the ruling in this case might or should be, simply out of respect.
Muslimah here. It's incumbent on a Muslim to learn about their religion, and Muslims are counseled to read basic texts of shari'a law with the guidance of a qualified scholar. These texts can be as simple as those learned by heart in grade school in places like Morocco, but it's still recommended to study them with a scholar.
I'm blessed to belong to such a community. We have a very active WhatsApp group, where questions like this get lobbed at qualified scholars at the rate of 10+ a day. This type of issue is exactly the kind of thing that would get asked, and answered, quickly and completely.
And the answers, grounded firmly in shari'a law, are wise and compassionate.
posted by rabia.elizabeth at 4:59 AM on March 22 [12 favorites]
Rabia, can you give us some insight, some examples out of that whatsapp group?
posted by DreamerFi at 5:25 AM on March 22
posted by DreamerFi at 5:25 AM on March 22
The pharmacy dean at my university has contributed to the creation of a tool that helps health professionals gain a better understanding of religiously fasting patients. (He's not the main guy the article focuses on, but one of the co-creators.)
posted by dlugoczaj at 6:30 AM on March 22 [2 favorites]
posted by dlugoczaj at 6:30 AM on March 22 [2 favorites]
I found the anonymous piece really problematic on various levels. I mean, it's great that it offers a post-op trans perspective. Precious few people in this world can write that. And the author is trying hard to save other trans women from dangerous health outcomes.
That said, she paints an awfully rosy picture of the patient-surgeon relationship. In my experience - two surgeries later - I have to say I had a very different situation. Kathy Rumer, my bottom surgeon, was I think almost criminally negligent in her patient relationships (and I've read a harrowing essay in Jezebel where another patient had a very similar experience with Rumer). My top surgeon has some serious transphobia going (I remember him asking why I was getting augmentation if I was only into women!), and also discharged me with a similar lack of post-op care (the pain I had when getting home was far worse than bottom surgery, the worst I've had in my life).
So no, listening to and following surgeon's advice is far from sufficient. Trans women's healthcare is bad enough without victim-shaming.
It is true that the issue of dilation post-op is a real one, and we're finally starting to see signs of a recognition of that by trans healthcare providers. Pelvic floor therapists are starting to get training on how to help trans women recover from problems with dilation, even years later. I found pelvic floor therapy really helpful, and more recently, I've had a gynecologist handle my exam in a compassionate, thoughtful manner.
There's hope. But like with all women's healthcare, it's going to take resources and awareness to get better, not blaming women for poor treatment by providers and the system as a whole.
posted by Flight Hardware, do not touch at 8:27 AM on March 23 [2 favorites]
That said, she paints an awfully rosy picture of the patient-surgeon relationship. In my experience - two surgeries later - I have to say I had a very different situation. Kathy Rumer, my bottom surgeon, was I think almost criminally negligent in her patient relationships (and I've read a harrowing essay in Jezebel where another patient had a very similar experience with Rumer). My top surgeon has some serious transphobia going (I remember him asking why I was getting augmentation if I was only into women!), and also discharged me with a similar lack of post-op care (the pain I had when getting home was far worse than bottom surgery, the worst I've had in my life).
So no, listening to and following surgeon's advice is far from sufficient. Trans women's healthcare is bad enough without victim-shaming.
It is true that the issue of dilation post-op is a real one, and we're finally starting to see signs of a recognition of that by trans healthcare providers. Pelvic floor therapists are starting to get training on how to help trans women recover from problems with dilation, even years later. I found pelvic floor therapy really helpful, and more recently, I've had a gynecologist handle my exam in a compassionate, thoughtful manner.
There's hope. But like with all women's healthcare, it's going to take resources and awareness to get better, not blaming women for poor treatment by providers and the system as a whole.
posted by Flight Hardware, do not touch at 8:27 AM on March 23 [2 favorites]
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My cursory search on this subject turned up a few articles that were very full of very precise readings of the Quran, and also this medical journal article on how to handle giving medical advice to patients with cardiovascular problems that could potentially be made life-threatening by fasting. Which also contained a summary of the various fasts of seven major religions.
posted by egypturnash at 6:27 PM on March 21