Macmillan Cancer Support leaflet aimed at trans patients: "regressive, unscientific and generally very poor advice" says nurse

I think it's a good idea to create specific leaflets rather than erase sex based terms in leaflets for all (e.g. people with a cervix).

It is generally the case that a bilateral mastectomy will be one of the options explored when a unilateral is needed. I think it's sensitive to have separate leaflets for those may be delighted by this, as opposed to most who will be devastated.

My issue is referring to 'gendered' clinics. These clinics are single sex or sex specific. I think it's important for everyone to recognise that their sex plays a fundamental role in healthcare and that they need to follow advance guidance pertaining to their sex, not their gender identity.

When I first received my cancer diagnosis (and for the next couple of years where I received a run of 'not good news' findings) I was deeply grateful to the straight talking manner of doctors. Whilst their tone was gentle, they stated facts, and were direct and to the point. This enabled them to focus previous appointment time on their specialist area. The MacMillan nurses were there to pick up the emotional aspects following each appointment. No one in the team was ever judgmental about the choices I made about treatment. They saw their job as enabling me to make fully informed decisions.

I cannot imagine my team treating trans identifying patients any differently to how I was treated. I am sure they would still use the correct medical language to refer to bodies and offer the same range of treatments. They would not reference 'gender affirming' treatment for cancer treatment. If a patient chose not to have breast reconstruction, they would be no more or less judgmental about this than anyone else who chooses this option (many do for a range of reasons).

Many people have a trans identity and I'm all for them receiving accurate medical advice. The medical advice they get should be the same as that for everyone if the same sex, but the issues and challenges arising for them are likely to be different. Getting a cancer diagnosis is tough enough. Anything that makes this easier is welcome in my book.

Seems a good leaflet to me, it's factual and states clearly that for sex specific cancers you may be treated to with your birth sex rather than chosen gender. Also clearly states if you don't have a cervix you don't need a smear

Here's a link to the leaflet itself:

https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/transgender

I think it's actually rather good and Jean Hackett is frothing at the mouth about nothing. Yes, it does use the term "assigned at birth" instead of "registered", and "cis-gender" is used a couple of times, but largely it's a well-thought out and plain-speaking leaflet.

The sentence on single sex wards, if accurate, is the responsibility of the hospitals, not the leaflet. Focus is usually on TW in women's wards, but think about it the other way: a TM on a women's ward and the other patients wondering why a man is on their ward (and before anyone starts claiming TM don't pass, yes some do appear to be men). So that would need to be dealt with delicately.

I don't see anything sinister in the comment about how cancer surgery might be gender-affirming, just a recognition that removal of certain body parts might not be as upsetting for a trans person as for a non-trans person.

And Hackett's dismissal of people feeling uneasy in a clinic specialing in healthcare for the "other" sex is just cold-hearted. Of course someone might feel self-conscious being in a setting where they appear to be out of place, and with added discomfort for people with gender dysphoria who usually try to supress or avoid reminders of their true sex. Let's remember that men (natal, not TW) can get breast cancer too but the "pinkification" of breast cancer means that most publicity, and even some of the health-care settings, are designed to appeal to women. I once saw a TV item explaining a man's experience of attending a breast cancer clinic with his adult daughter for support and people assuming that she was the patient and he was supporting her. Is it so difficult to have sympathy for some people's additional discomfort?

Actually that’s not an uncommon choice. It’s often recommended if at high risk of cancer reoccurring but also some patients choose to have both removed.

evidence.nihr.ac.uk/alert/women-cancer-one-breast-have-both-breasts-removed-satisfaction-with-decision/

Are they suggesting that if you have cancer in one breast, they’ll also remove the other healthy one?

That part does seem pretty tasteless, doesn’t it?

I can well imagine a transman with a diagnosis for breast cancer may be feeling a whole load of complex emotions which may be different to a woman who is ok with her breasts, but “you don’t want them anyway🤷‍♀️”, I dunno it’s a bit cold.

" ... Sometimes surgery to treat cancer is also gender-affirming. Surgery to remove the cancer may remove a body part that you prefer not to have anyway

I believe this comes under the title of reframing your trauma.

I don’t think there’s anything wrong with the leaflet. It addresses the concerns some transgender people have.
The problem is that the single sex wards are not single sex.

What fresh hell is this?
They want gynecologists to treat problems with artificial vaginas? Why not the cosmetic surgeon who made the fake vag?
Oh, but that would be "difficult to cope with."
They must have the affirmation of being able to see a gyno.
Batshit.