As a trans man who is both disabled and very active within the trans community, I was thrilled to find out the NHS had updated its advice on Cervical Screening to be more inclusive. This included advertising a trans man for booking the tests! Finally, the opportunity for healthcare to become more accommodating and to help dispel some of the stigmas.
Society’s barriers, assumptions, and negative attitudes towards trans people continue to persist greatly in the UK. This spiked especially in 2018 after the Gender Recognition Act consultation in the UK. Fueled especially by the increase of anti-trans groups and gender-critical “feminists” such as Women’s Place, LGB alliance, JK Rowling and Julie Bindel.
Through my activist involvement since 2011, I became painfully aware of the exclusive healthcare for trans people. Many medical and disabled support groups use very gendered language; for example, Endometriosis UK – the leading charity for endometriosis – still frequently states that “it is a condition that affects “1.5 million women” and talks about women’s experiences.
No mention of trans men, non-binary people, or gender-neutral language. This is something that is very common across lots of support groups and charities, as well as within the NHS presently and historically.
I have EDS, a connective tissue condition that does primarily affect more women than men, so I often see comments in EDS support groups that will say something such as “a question for the women in the group…” when discussing the impact of puberty and menstruation.
As a trans man reading these posts I see exclusion and feel I don’t belong there. As a result, many trans EDS and disability groups have been created out of necessity so that we can discuss the same issues in a space where we aren’t judged.
This has also been very clear in healthcare for a long time too. For instance, when I was in the middle of legally changing my name, I had my name flashed across the screens of my local GP centre and had to deal with the stares and scowls of the public who gendered me based on a name on a PA announcement and my physical appearance mismatching.
This is something many trans people experience and will often mean you have to manage the emotional and dysphoric feelings of having to see your birth name up on screens for everyone to see. It adds to the anxiety of how the public gender us based on knowing our name.
GP reports often include wrong names and pronouns which are then used as medical evidence, and it is a very long, stressful process to get things altered so you don’t need to out yourself to employers or for disability benefits.
Additionally, if being investigated for a condition such as endometriosis you are referred to what is called a “women’s health centre/hospital”. This is followed by a very invasive examination of the cervix and vagina. Patients are reassured they can have a chaperone and request a female doctor, but as a trans person, that does not always make it an easier experience if we do not know where they stand on trans rights.
Additionally, when your name and gender are changed on your medical record, you stop receiving reminder alerts about tests for your birth gender (unless you have an extremely trans-aware receptionist). This means that many trans men do not receive any alerts to have cervical testing in the first place.
Instead, we receive alerts for things that are not usually relevant to us, such as testing for testicular cancer. This is why the NHS updating their cervical screenings shows great promise for increased trans inclusion across the NHS and healthcare generally for services.
There have, however, been some great advances to trans inclusion in healthcare. For example, the pilot program from RM Partners, 56 Dean Street, and the Gender Identity Clinic in London highlight the importance of providing trans men and nonbinary people with cervical cancer screening.
Additionally, the NICE guidelines for the first time will include trans and non-binary people with menopause aged 40 and older on guidance on the diagnosis and treatment of menopause, including the effects of Hormone Replacement Therapy (HRT) will have.
For me as a trans man with a cervix, this really makes me feel that booking an appointment will be a lot less stressful and that this is something that the NHS has become more respectful and aware of, especially as historically the cervix screening service has been especially difficult for us to access.
Of course, I am not saying that based on this act that the NHS and healthcare are no longer an issue or barrier for trans people. Advice and information for pregnant trans and nonbinary people have been “blocked” from publication on the NHS website by senior figures in the health service.
As well as a 2022 study by the LGBT Foundation that found 30% of responders didn’t access any perinatal care during pregnancy out of fear of the treatment they might receive as a trans person.
However, I do strongly believe this inclusive screening is a massive step forward.
Not only is this simple act showing the world how easy it can be by amending words to be more gender-neutral (e.g. ‘people’ instead of ‘women’) – but by using trans-inclusive adverts, it shows other trans people that the service is in fact for them.
This is especially important for trans people who are too often denied appropriate healthcare and can lead to serious health issues if left unresolved. This gives hope of what can be possible for universal, trans-inclusive healthcare.
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