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8 months agoI hear people put down trots a lot but I don’t really understand why this is. I don’t remember them mentioning anything that was specifically trotskyist either. Not defending them at all but my take is that it was more of an organizational culture thing vs a trot thing, but I had pretty limited experience with them
Not justifying this whatsoever but I do see that they offered a potential resolution: “If a female is not considered to be at risk of pregnancy, the reason for this should be recorded in step 1 of this form and the patient is not required to use contraception.” Assuming the Ace in your name means that you are Asexual so it seems like this would fit this criteria?
Edit: I see in another comment you’re saying they told you that this really means women who are sterilized. It is unclear to me if this is truly correct as I’m seeing this guidance in a PDF about valproate which is a lot worse to take during pregnancy (https://www.rcog.org.uk/media/uqofkclk/valproate-guidance-march-2019.pdf)
“This includes women who are not currently sexually active unless the prescriber considers that there are compelling reasons to indicate that there is no risk of pregnancy. Individual circumstances should be evaluated in each case, involving the patient in the discussion, to guarantee her engagement, discuss therapeutic options and ensure her understanding of the risks and the measures needed to minimise the risks.”
“In addition, there may be women who wish to avoid bleeding problems or side effects associated with some hormonal methods. The GMC consent process (currently under consultation) (41), states that: You should do your best to make sure that such patients have considered the available options and reached their own decision (clause 42). You must respect a patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational (clause 43). It is essential that the discussion is fully documented, so that it is clear how it has been made, and following best practice all parties involved should be included in correspondence. Even if a woman is non-compliant with a PPP, it is unsafe to withhold the prescription of valproate.”
Another document on isotretinoin, which is even more risk for the fetus than valproate: https://assets.publishing.service.gov.uk/media/653f8b3de6c9680014aa9cee/Pharmacist_Checklist.pdf "A person with childbearing potential requires contraception 4 weeks before treatment, during treatment and 1 month after, UNLESS the prescriber and patient agree that, during treatment and for 1 month after treatment, there is no expected risk of pregnancy due to: a) Only having sex/sexual intercourse with a person who has no potential to make them pregnant. This must be for the duration of isotretinoin treatment and for 1 month after stopping isotretinoin treatment. Examples include sex with a:
This document is on an official gov.uk website so thus should hold a good deal of weight. Even though they are not the same medications, these are medications which have a lot more risk to the fetus than topiramate and the law should apply equally.
It sounds like they are not actually following the spirit of the program due to fear of liability or something like that, which unfortunately is not surprising. I would fight back by producing documentation such as this and other things you can find.
I know the UK is very different than the US and seems to be getting really unhinged medically, but what I do in the US in situations like this is make use of organizations that provide free case management service. I either include them in emails or have them come with me in person. Sometimes I won’t be listened to on my own but if the third party case manager comes in they will start taking you seriously. I have no idea if the UK has something like this and it was somewhat hard to find the organizations in my area that would do it, but this technique has worked for me pretty well.