Transpeople being denied NHS treatments

[Oliver_W]

Women who identify as men are not being routinely offered potentially life saving NHS screening for breast and cervical cancer, amid fears it might offend them it is claimed. (http://www.telegraph.co.uk/news/2018/01/14/women-identify-men-not-offered-routine-nhs-breast-cancer-screening/)

However men living as women are being invited for cervical smear tests even though they do not have a cervix, an official guidebook states.

A 24-page Public Health England booklet giving information on NHS screening programmes for trans people explains who is routinely invited for tests.

The booklet explains that trans people who register with their GP as being their birth sex will be invited to screenings appropriate to that.

But if they register with their doctor as their new gender, they will not be. For example if a trans man, who was born a woman, registers with a GP as male, they will not be sent an invitation for breast or cervical screening. Studies have reported most trans men have not had their wombs removed.

Cervical cancer claims the lives of 900 women each year in Britain, but the NHS screening programme is estimated to prevent thousands of cases.

A video accompanying the guidance explains that smear tests can be “uncomfortable” for trans men, as “it is often a procedure designed for women”.

Public Heath England said the invites were generated using GP’s data on sex and age. The advice says trans men not invited for a smear test “should still consider having cervical screening”.

Anne Mackie, director of screening, said: “Where people feel they are not being referred correctly, they can speak to their GP or the screening service to ensure they are offered the right services.

“Following engagement with the LGBT community, we produced a guide to help trans people understand what screening is available in England. We have promoted the guide to LGBT groups to help trans people access the most appropriate screening for them.”

Thoughts?

[Maru]

It would probably be a good idea to give the patient an education post-surgery on how they should register/get advised on care from a GP/PCP since their situation is likely to be pretty unique wherever they go... at least until the overall system is better equipped. And even if the system is improved, they probably should receive specific guidance...

[Oliver_W]

It would probably be a good idea to give the patient an education post-surgery on how they should register/get advised on care from a GP/PCP since their situation is likely to be pretty unique wherever they go... at least until the overall system is better equipped. And even if the system is improved, they probably should receive specific guidance...

Agreed, there should be some kind of talk, possibly early in the transition process, where someone says "you will always biologically be your birth sex, nothing can change that. Mildred, when you reach forty we'll still need to still our fingers up your pooper to check your prostrate, but we'll also check your breasts as they develop. That's the way it is, suck it up buttercup"

[Tom4784]

Seems stupid not to offer people tests that could save their lives in case it offends them to think of their previous gender. I think when faced with the prospect of cancer, most trans people would rather have the tests regardless.

[Niamh.]

Well that is just plain stupidity, pretending science and biology aren't things anymore.

[Jamie89]

I heard about this recently and I thought it was largely put down to being an administrative error thing? Rather than anything to do with doctors being worried of causing offense or anything (as far as I can tell that's just an assumption that's been made, there's nothing to back it up?) But yeah isn't it just because of how people register themselves with their doctors, and some transsexuals may either in error or on purpose register their birth sex as the gender they transitioned to, and therefore when invitations to cervical screenings are sent out automatically, those people whose birth sex is registered incorrectly will of course experience the error. Some transmen will by the way register their birth sex as male intentionally whilst being aware of the risks involved in not attending screenings which although it's worrying I suppose it's up to them as long as they're informed.

[smudgie]

Whatever tests they need should be provided.
I have no idea how a trans man could have a cervical smear though, could prove difficult maybe.

[Niamh.]

Whatever tests they need should be provided.
I have no idea how a trans man could have a cervical smear though, could prove difficult maybe.

I was just thinking that actually

[Jamie89]

Whatever tests they need should be provided.
I have no idea how a trans man could have a cervical smear though, could prove difficult maybe.

I was just thinking that actually

(I don't really know what a cervical smear involves but a lot of transmen still have female genitals for various reasons... if that answers the question?)

[Niamh.]

(I don't really know what a cervical smear involves but a lot of transmen still have female genitals for various reasons... if that answers the question?)

It does if they've not had surgery otherwise it doesn't :laugh:

[Jamie89]

It does if they've not had surgery otherwise it doesn't :laugh:

Yeah the reason would be because they've not had the surgery :laugh: (or some might have partial surgery) But they may still consider themselves transitioned and want to change how their sex is registered because of that, despite still having female genitals... which is what causes the issue in the article.

[Jamie89]

Should be pointed out though that the NHS isn't 'denying' anyone any treatments, this is really all just down to how people register their birth sex with their doctors and automatic invites going out accordingly. A transman wouldn't be denied a cervical smear and a transwoman wouldn't be given one.

[Niamh.]

Yeah the reason would be because they've not had the surgery :laugh: (or some might have partial surgery) But they may still consider themselves transitioned and want to change how their sex is registered because of that, despite still having female genitals... which is what causes the issue in the article.

I wonder what happens if they have had full surgery though? I wonder is there another way to test them for cervical cancer than a cervical smear or do they just hope they don't get it? women are supposed to have this done every two years after the age of 25

[DemolitionRed]

I wonder what happens if they have had full surgery though? I wonder is there another way to test them for cervical cancer than a cervical smear or do they just hope they don't get it? women are supposed to have this done every two years after the age of 25

Its every 3 years in the UK

[bots]

this is where the I identify as falls completely on its head.

[Niamh.]

Its every 3 years in the UK

Definitely two here, i just double checked :laugh:

[user104658]

I wonder what happens if they have had full surgery though? I wonder is there another way to test them for cervical cancer than a cervical smear or do they just hope they don't get it? women are supposed to have this done every two years after the age of 25If they've had full gender reassignment surgery I'd have thought, most likely, they will have had a full hysterectomy and so be at zero risk of cervical or ovarian cancers...

[Niamh.]

If they've had full gender reassignment surgery I'd have thought, most likely, they will have had a full hysterectomy and so be at zero risk of cervical or ovarian cancers...

Oh do they have a hysterectomy? I suppose they'd have to really now you mention it, if they had the full op otherwise what would happen with periods etc, I never thought of that before

[Ammi]

...I think for female to male transexuals, a hysterectomy does greatly lower the risk of ovarian and cervical cancers ...but I don’t believe it completely removes the risk so it’s still important for them to have the 3 year check...I’m not sure if it’s a glitch in the system of not being invited for the check or whether it’s something that some themselves feel uncomfortable about though...hopefully it’s something their surgeon discusses with them in depth../..the risks if they weren’t to have the checks...

[DemolitionRed]

Definitely two here, i just double checked :laugh:

I think it should be two here as well because whilst CIN is normally slow growing, that's not always the case.

[Vicky.]

Its absolutely ridiculous that transpeople are registered under the opposite sex. Really really stupid. Transwomen are not female, and transmen are not male. They should be registered under their correct sex and whoever came up with the idea of this is just absolutely stupid. Biology matters. And sex specific illnesses not give a **** what you 'identify' as.

[Vicky.]

I heard about this recently and I thought it was largely put down to being an administrative error thing? Rather than anything to do with doctors being worried of causing offense or anything (as far as I can tell that's just an assumption that's been made, there's nothing to back it up?) But yeah isn't it just because of how people register themselves with their doctors, and some transsexuals may either in error or on purpose register their birth sex as the gender they transitioned to, and therefore when invitations to cervical screenings are sent out automatically, those people whose birth sex is registered incorrectly will of course experience the error. Some transmen will by the way register their birth sex as male intentionally whilst being aware of the risks involved in not attending screenings which although it's worrying I suppose it's up to them as long as they're informed.

I wouldn't say it was an administrative error, more stupidity in the 'rules'. No transwoman should be registered as female, and no transman as male in a medical setting. I would put money on it being that ridiculous extremist transactivist group 'action for transhealth' pressuring the NHS to register people as the opposite sex. I would also put money on doctors thinking this is all bat**** but having to go along with it for fear of being sacked for 'transphobia' if they speak up.

Identify as whatever the hell you want, but biology does matter in a few areas of life (especially health) and sex cannot be changed and this is risking peoples health for very silly reasons.

[Brillopad]

I wouldn't say it was an administrative error, more stupidity in the 'rules'. No transwoman should be registered as female, and no transman as male in a medical setting. I would put money on it being that ridiculous extremist transactivist group 'action for transhealth' pressuring the NHS to register people as the opposite sex. I would also put money on doctors thinking this is all bat**** but having to go along with it for fear of being sacked for 'transphobia' if they speak up.

Identify as whatever the hell you want, but biology does matter in a few areas of life (especially health) and sex cannot be changed and this is risking peoples health for very silly reasons.

Agreed Vicky.

[Vicky.]

Even without sex specific diseases..male and female bodies react differently to illness. For example the symptoms of a heart attack are very different in male people to female people. So if a male is registered as a female (or vice versa) or like..if they call 111 and say they are female when they are not, it could potentially cost them their lives. Its just so stupid and these groups that say they are trying to help trans people are doing the exact opposite IMO.

I get that people with sex dysphoria do not like to be reminded they are not the sex they want to be. But sometimes, its necessary.

[Jamie89]

I wouldn't say it was an administrative error, more stupidity in the 'rules'. No transwoman should be registered as female, and no transman as male in a medical setting. I would put money on it being that ridiculous extremist transactivist group 'action for transhealth' pressuring the NHS to register people as the opposite sex. I would also put money on doctors thinking this is all bat**** but having to go along with it for fear of being sacked for 'transphobia' if they speak up.

Identify as whatever the hell you want, but biology does matter in a few areas of life (especially health) and sex cannot be changed and this is risking peoples health for very silly reasons.I meant it's administration rather than doctors choosing to not invite patients as to why the invites are being sent to the wrong people and not to other people. Yes there are a lot of other factors within all of this too but the way it's being reported is very misleading in suggesting that doctors are making a decision that's harmful to their patients which is what I was clarifying, and that it's administrative from their point of view. Of course the reasons as to why a trans person might select the wrong 'birth sex' takes it out of administration and there's a whole load of other issues there but I wasn't really commenting on that.
I can only assume that their reasons would be to do with discomfort... I'm not sure if this is a recent trend, or if something changed recently which meant people were able to register their birth sex incorrectly whereas previously they weren't. I suppose if it is a new trend then transactivists could have played a part, I really don't know tbh. But my understanding is that the decision of how a transsexuals birth sex is registered comes down to them and not the doctor. I do agree though that the priority should just be the individuals health and that birth sex should be registered correctly, unfortunately some people don't look after their health, and don't go to screenings, for a variety of reasons across all walks of life. I'd guess that most trans men do put their health first with stuff like this (I'd hope anyway), but what can really be done about the ones that don't?

[user104658]

...I think for female to male transexuals, a hysterectomy does greatly lower the risk of ovarian and cervical cancers ...but I don’t believe it completely removes the risk so it’s still important for them to have the 3 year check...

If you don't have ovaries or a cervix, you can't get ovarian or cervical cancer :think:. It would be cancer of something that doesn't exist. There is still a small risk of peritoneal cancer which is similar to ovarian cancer. However, the screenings are not for ovarian cancer... they're specifically for cell abnormalities on the cervix, and if you don't have a cervix, you obviously can't get it ... smeared.

All that said; I'm actually not all for across-the-board screening, and personally won't be having regular prostate examinations.

[Marsh.]

and personally won't be having regular prostate examinations.

There's nothing like one of those at the end of a long hard... working week.

[Vicky.]

But my understanding is that the decision of how a transsexuals birth sex is registered comes down to them and not the doctor. I do agree though that the priority should just be the individuals health and that birth sex should be registered correctly, unfortunately some people don't look after their health, and don't go to screenings, for a variety of reasons across all walks of life. I'd guess that most trans men do put their health first with stuff like this (I'd hope anyway), but what can really be done about the ones that don't?

Yeah, this should not be an option IMO. Your sex is your sex, whether you want it to be or not. Its ridiculous that people can 'change sex' when you actually cannot change sex. Birth certificates is another one thats daft. A birth certificate is a historical document. Its wrong that you can change it to say that you were actually born the opposite sex :S

[DemolitionRed]

If you don't have ovaries or a cervix, you can't get ovarian or cervical cancer :think:. It would be cancer of something that doesn't exist. There is still a small risk of peritoneal cancer which is similar to ovarian cancer. However, the screenings are not for ovarian cancer... they're specifically for cell abnormalities on the cervix, and if you don't have a cervix, you obviously can't get it ... smeared.

All that said; I'm actually not all for across-the-board screening, and personally won't be having regular prostate examinations.

You can get cancer in the cavity where the ovaries were once situated. primary peritoneal cancer, is still often classed as ovarian cancer because there's a direct link in tissue structure and cell migration.

[Vicky.]

This thread has actually reminded me actually that I am due a ****ing smear. Great. Had the letter a month or so ago but keep putting it off as its just awful but going to have to bite the bullet :(

[Marsh.]

Yeah, this should not be an option IMO. Your sex is your sex, whether you want it to be or not. Its ridiculous that people can 'change sex' when you actually cannot change sex. Birth certificates is another one thats daft. A birth certificate is a historical document. Its wrong that you can change it to say that you were actually born the opposite sex :S

Yeah, I agree with this. Change whatever you want, but the facts are the facts and should be kept on record.

[Maru]

This thread has actually reminded me actually that I am due a ****ing smear. Great. Had the letter a month or so ago but keep putting it off as its just awful but going to have to bite the bullet :(

Same. It's such a bother

Yeah, I agree with this. Change whatever you want, but the facts are the facts and should be kept on record.

I didn't use to mind the change sex change on ID as long as it was for legal purposes (such as bathrooms), but after reading how far the left has gone towards wanting to force people's hands to allow people the ability to self-identify as pretty much whatever they want (trans-age, trans-racial, trans-species, etc)... it's gone a little bit too far for me at this point.

[Marsh.]

Same. It's such a bother



I didn't use to mind the change sex change on ID as long as it was for legal purposes (such as bathrooms), but after reading how far the left has gone towards wanting to force people's hands to allow people the ability to self-identify as pretty much whatever they want (trans-age, trans-racial, trans-species, etc)... it's gone a little bit too far for me at this point.

Oh, don't get me wrong. If people change sex or their name or whatever, then I feel they should be able to legally. What shouldn't happen is them changing factual history by changing/erasing records of their birth etc. If you were born a particular gender/sex then that's the way it stays IMO. If it changes later, fine, but that's what it is, a change.

[smudgie]

This thread has actually reminded me actually that I am due a ****ing smear. Great. Had the letter a month or so ago but keep putting it off as its just awful but going to have to bite the bullet :(

Haha, me too.
Couple of painkillers an hour before and you are floating on air.:blush:

[Ammi]

If you don't have ovaries or a cervix, you can't get ovarian or cervical cancer :think:. It would be cancer of something that doesn't exist. There is still a small risk of peritoneal cancer which is similar to ovarian cancer. However, the screenings are not for ovarian cancer... they're specifically for cell abnormalities on the cervix, and if you don't have a cervix, you obviously can't get it ... smeared.

All that said; I'm actually not all for across-the-board screening, and personally won't be having regular prostate examinations.

..it’s something I’ve only read recently through watching CBB and being interested in India Willoughby but I was more researching male to female...so I have to say I didn’t read up much about that aspect...as DR has said, the cancer could still form in the cavity...but the article did mention other factors as well such as family history of cervical or ovarian cancer, if particularly prominent etc...maybe also the trans surgery may be more common as a partial hysterectomy...?...It did also mention breast cancer and I do know that breast cancer is still a possibility after a full mastectomy, so that made it make sense to me more...

...just looking at your word ‘can’t’...I think that’s a word that’s hardly used in the medical profession for obvious reasons...so I think it would be more ‘unlikely’, type thing...but where there is any risk at all with something so serious, screening would have to be offered as it is to any born female ...obviously that screening is something the person themselves would have to be willing to do as well...I hope it’s something a surgeon discusses in depth, the importance of screening...