Hm, yeah, sorry. I'm more familiar with the medical issues of transwomen then transmen. But you're right, the transman I know used an IUD for protection until he had a hysterectomy.

So for the possible pregnancy complications, transmen being well educated and EMTs considering it as a possibility is important.

As a pharmacy student I asked my teacher about the Cockcroft-Gault equation in regards to transpeople. Since it isn't quite certain where the difference comes from, it isn't known which equation should be used for trans patients. The equation is only able to give an estimate based on averages and if you really need to know the renal function, doing the full work up that needs the urine collected over 24 hours is the only accurate method anyway. Since sex hormones change a lot and could alter renal function by themselves, I'd imagine a trans woman could be close to the male average at the beginning, but closer to the female average after a decade or so of taking hormones. But we just don't have scientific data to actually tell when which modifier should be used.

As for UTIs, that would also depend on whether the transgender person is operated or not. So pre-OP transmen could do with the "easier" treatment, post-OP they would probably fall into the complicated category. And that's not considering that it might be an OP-related infection if the OP wasn't too long ago.

It's definitely certain that medical professionals need to know the medical history to choose the best treatment. But whether the birth certificate contains the AGAB or the right gender, it may lead to the wrong treatment for trans people anyway. So using that as a reason to not be allowed to change it just seems like an excuse to me.

Those aren't emergencies and it would come up in any prior appointment or while making the appointment. It may be a bureaucratic issue if insurance doesn't want to pay for a (diagnostic) procedure that's not in accordance with the gender on record. But that's something fixable with insurance policies becoming more inclusive and not something that would lead to worse health outcomes for the patient.

Yeah. Neither is the birth certificate or ID card always available (like when you get into an accident while jogging). So for emergencies, the gender on those documents rarely plays a role. And in cases the patient is still able to talk (or has someone with them who knows them) and they answer honestly to "Are there any prior medical issues or infos we should know about?", it can be taken into consideration anyway.

So, two of these only are a problem if a transguy is pregnant. That's extremely rare since they usually take hormones that make that impossible.

For the urinary catheter: they might prepare the wrong one, but they'd realise they'll need the other after one second of looking, so I doubt that would actually be much of a problem.

Abdominal pain can have multiple causes, so their origin are often only found after imaging and a full work-up anyway.

So, imo, giving EMTs a one or two hour "awareness lesson" during training would be enough to avoid all of this. That's not enough of a reason to not allow people to correct their gender on their birth certificate.