Can we be honest about the need for affirmation?

[FortunateCookie]

I posted some of this on the misgendering thread but it was lost in amongst everything.

I asked on that thread whether refusing to affirm someone’s gender identity was a big deal or not, and many people thought it was, and that it could lead to mental health problems and possibly suicide.

If non- affirmation is so damaging then it also follows that positive affirmation would be extremely rewarding and fulfilling.

It seems obvious that this could lead to serious conflicts of interests. For example, in the case of the woman who asked for a female nurse to carry out her smear test, and was faced with a trans nurse.

Here, when the patients needs should be paramount, she instead becomes either a cause of huge distress, or a vehicle to experience the reward of validation. Either way, it is difficult to see how her needs could be centred against the pull of such a powerful motivation. Do eg hospitals, rape crisis centres recognise this dynamic?

Either it is a big deal that a trans person has their identity affirmed, in which case it should also be recognised that this can cause conflicts of interest in situations where affirmation or not is a factor (ie performing smear tests, working in a women’s refuge)

Or it’s not that big of a deal if a trans person has their identity affirmed and therefore they won’t be offended when a patient asks for a female nurse to carry out their smear.

Which is it?

Incidence of smears have dropped dramatically.
Some think it is because instead of saying women the advice to get smears now say people with a cervix. Many women will not know they have a cervix so they won't know it means them. But NHS has done their part to be gender inclusive and that is all that matters.

Really?

I would think that a more. Important factor in the reduction in smears. Is the lack do health education in schools and the wider general public. This is true for a number of routine tests that are declining in uptake.

Also this appears to be linked to general issues with gp services.

Actions to be taken include

supporting local services to encourage more women to attend screening by providing clearer information
encouraging GPs to consider offering a variety of appointments earlier in the morning and evening, making it easier for women to attend at a time that suits them
developing an interactive database which informs individual practices about the numbers of women they are screening and how they compare with neighbouring practices

Incidence of smears have dropped dramatically.
Some think it is because instead of saying women the advice to get smears now say people with a cervix. Many women will not know they have a cervix so they won't know it means them. But NHS has done their part to be gender inclusive and that is all that matters.

Do you have a source for this claim?

Just catching up here and noticed:

Bespin
"As I have stated all patents have the right to decide who undertakes there care and accommodations should be made that is either getting another nurse or rebooking the appointment and as. I have said this happens all the time for a number of reasons. The biggest being race at this moment in time."

As people seem to be conducting this debate based on personal experience and anecdotes, I wanted to say that my black mum has worked as a nurse her whole adult life and is still going, part retired, in her late 60s. No one has ever refused her care based on her race in all those decades. I don't know why people keep referring to race when talking about trans issues.

I'm glad your mum as had a positive experiance in her career and like me I have had little or no issue. But there are people that do and I have worked with a number to African nurses who have not been able to assist people with bed baths dolue to there race. Also a Indian nurse who was called offensive things. But as you say this is just. My experiance and is not representive of all people and I do not speak for them

That's cool. Its just that I don't know if there are any figures and without statistics it just seems like an assumption that race is a big issue when it may not be at all. I feel kind of queasy when people start using race as an analogy here.

Many women will not know they have a cervix
Sorry, I think you're wrong here. Thats basic knowledge which nearly everyone knows (barring people with learning disabilities, who should be getting support with health care anyway).

Sadly I think there will be women who are not aware they have a cervix. Or who dont understand the text.

I had to explain to someone what a parsnip was a couple of years ago. They’d never even heard of one, and my mum, before she retired, used to have a session where she brought veg into the school she worked at to teach the kids what it looked like.

There are a LOT of very vulnerable people out there who have poor literacy and understanding/cognitive problems. We should be making all medical communication as clear and simple as we can for the level that’s needed.

Sadly I think there will be women who are not aware they have a cervix.

I have seen posts on here where grown women admit they thought they peed out of their vagina.

I imagine there are lots of women who are unsure what exactly a cervix is, even if they have heard the word before.

And here we have a tweet from Cancer Research yesterday...

Cervical screening (or the smear test) is relevant for everyone aged 25-64 with a cervix. Watch our animation to find out what to expect when you go for screening

mobile.twitter.com/CR_UK/status/1006857678767951872

Bespin, you write "All patents have the right to decide who undertakes there care and accommodations should be made that is either getting another nurse or rebooking the appointment and as. I have said this happens all the time for a number of reasons. The biggest being race at this moment in time."

But we're not talking about race. Refusing care because of the HCP's race is unreasonable. In a non emergency situation, refusing to be intimately examined by a male bodied person, however they may identify, is perfectly reasonable, given so many women's experience of men and even of male HCP. Some women will not be able to access care at all if they aren't secure that their request for another woman to do their smear will be honoured.

When you say: ...accommodations should be made that is either getting another nurse or rebooking the appointment, I would point out that if a patient has specified that they want a female HCP to carry out the smear, a MTT does not qualify and should not tip up.

This thread is not about a theoretical situation. It actually happened. Women have a right to expect a HCP of the same sex if that's what they request. They should not be put in the position of having potentially to rebook or to have to point out that the HCP is not female. Most British women are very reluctant to make a fuss.

Exemptions still apply to someone with a GRC.

The law does not state that there is a change of sex. This issue is one of change of gender and of rights relating to people who have had/going through gender reassignment.

"Cervical screening (or the smear test) is relevant for everyone aged 25-64 with a cervix. Watch our animation to find out what to expect when you go for screening"

It should say 'is relevant for all women aged 25-64'

It's clearer and is going to include all relevant women.

When they advertise that older people can access chiropodist, they don't say 'relevant to people with feet' do they?

Cancer Research think they are being inclusive in order to target more women, but I wonder if they have even stopped to consider if changing the language from “women” to “people with a cervix” is going to reduce the reach of this ad.

I don’t feel up to asking them today but I would like to email them to see if they have assessed the impact of this change in language.

A fairly recent thread on here made it clear that a number of articulate and apparently well educated women were unsure about the location and function of the cervix. Happily they were quickly informed by other posters, clearly and without being patronising.

I think that advert is silly, I am sure some women are pretty hazy about what the cervix is.

But women know they were born female. Even trans men know they were born female so why not say 'If you were born female you need cervical screening for cancer.' Nice and straight forward. They could even flash up the words Non-binary and Trans man. That way it would be very inclusive.

@Bespin

Thank you for being so open and sharing your perspective.

I don't think anyone has said trans women should not be nursing. And you yourself agreed that you would not be doing smear tests even if this was your area, because of potential issues.

May I ask a question, please? You do not need to answer. You said about your friend who is a trans gynaecologist. By this do you mean a trans woman or a trans man? I'm assuming you mean a trans woman as you said 'she'.

Do new patients know that the gynecologist they will be seeing is trans or is male?

It should say 'is relevant for all women aged 25-64'

I'd like to think they are saying that to exclude any transwomen who might take up the invitation and exercise their right to access Women's Health, thus wasting time, money and resources rather than because they think some transmen would stubbornly say "nope, I don't identify as a woman ergo I won't get cervical cancer so I won't have a smear test".

And I can't see how 'non binary' is such a strongly held belief that anyone would be upset by it other than to make a political point.

According to the current trans definitions, I am agender (and, as such, also fall under the trans umbrella). But I still recognise I have a female body and that smear test invitations relate to me.

I didn't learn the word vulva until I was in my late-twenties. Prior to that, that part of my body had no formal name and had been referred to by my grandmother as "down-below" and "unmentionables", a terminology that possibly contributed towards my failure to report childhood sexual assault.

Given that, I can genuinely foresee women being unaware that "person with cervix" means them, especially if they are from a socially-conservative family where "women's parts" aren't openly spoken of or are not native English speakers.

@bd67th yes 'down below' my mum used to call it that!

Sorry, should have read on "... a terminology that possibly contributed towards my failure to report childhood sexual assault."

I am so sorry to hear that.

I think a lot of women will 've unfamiliar with correct terminology.

Rather than making the language inclusive, I think it would do the opposite and exclude some women, including the ones bd67th mentioned. I'd expect the writer of the tweet to know that. Unless they target the advertising and have some that do mention women?

Our private bits were called 'under your pinny'

Rather than making the language inclusive, I think it would do the opposite and exclude some women

Yes. I don’t think CR have thought about that though.

Bd67th