Is my job transphobic?

[vivariumvivariumsvivaria]

I am a health care professional. I work in sexual health. Most of my patients are female, an increasing number of whom also have a gender difference, which is why they land up in my clinic.

Is it transphobic to say to a person who has a condition which only affects female people that this is because of their sex? I have re-written patient information leaflets so that trans men and NB identified females have the correct language in the info, but the fact remains that it is a condition linked to their sex.

I'm a little worried because the Lib Dems and Greens have said that it is transphobic to refer too someone's biological sex if they have transitioned. I think their definitions leave me vulnerable to being accused of bigotry because sex is immutable.

I want to talk to HR about this, but, can't quite think about how to frame it without sounding like I'm, well, a bigot.

Do you need to use the word female when talking to them? Can you not just talk about the body parts affected? Or chromosomes if that's what's relevent.

Or you could acknowledge the reality that their sex never changes and that they need to be aware of sex-linked conditions in order to maintain their health. Including the impact of any cross sex hormones they are taking.

Can you not simply use a fairly neutral phrase such as 'this condition affects those recorded female at birth'?

Is this condition's link to sex key information for the management of this condition - i.e. is it needed on the leaflet at all?

We need to stop being coy about the word "sex" being used in a clear scientific context. It's not teenage or smutty, it's simply factual.

I re-read Paradise Lost recently. Even in the 1680s Milton was able to use the word "sex" when describing the creation of Adam and Eve.

Can you not simply use a fairly neutral phrase such as 'this condition affects those recorded female at birth'?

Head bang. How does the recording affect anything? It's not going to affect someone male who was incorrectly recorded as female, and it's not going to avoid someone female who was incorrectly recorded as male, was it?

We're not talking quantum effects here where the outcome depends on whether you looked at it or not.

And if being "female" is so bad, why haven't we stopped that recording from happening?

Female is a neutral term describing sex. Do not give a millimetre on this, or you will never be able to hold onto a term.

Is it transphobic to say to a person who has a condition which only affects female people that this is because of their sex?

If it is transphobia the word has lost all meaning and society has lost the plot. Without biological sex there would be no "gender", or "transgender".

Or you could acknowledge the reality that their sex never changes and that they need to be aware of sex-linked conditions in order to maintain their health. Including the impact of any cross sex hormones they are taking.

This. Don't pander to fashionable dogma.

I’m no expert but neither the Lib Dems nor the Greens are in power, so I wouldn’t think that they’re policies are things you need to abide by? Didn’t a High Court judge, in the Census case recently say that it’s not legal to redefine sex? I’d say that has more weight

*their policies

You need to get proper guidance from HR about this and not be coy about it. I'm surprised you haven't been given this guidance already.

But equally, if a transman is asking why they have to have a cervical smear if they're a man now, or a transwoman is asking why they need to be screened for prostate cancer, they are either being deliberately obtuse or have some significant misunderstandings about their body and the process of transitioning.

And to be honest, I'm not sure you would ever need to say the sentence "this only happens to females" really.

Have you ever actually had a situation where a patient didn't understand something and saying "this only happens to males/females" was the best way of explaining it? Surely "Prostate cancer is a risk for people over the age of whatever so we ask you to check XYZ when you ABC".

I understand that you're keen to be sensitive around a certain group of patients, but is it that complex, really?

But Prostate cancer is a risk for people over the age of whatever isn't true. It's a risk to male people only. Female people don't have a prostate.

Just speak about the relevant body parts. "Anyone with a cervix is at risk of cervical cancer".

I'm GC, but if a transman is in your clinic and is distressed about having to have a mammogram or a smear, saying "IT'S BECAUSE YOU'RE REALLY A FEMALE" just seems needlessly pedantic. They KNOW that, but they're still upset and that's okay. We can be upset about all sorts of things.

@wusbanker

Just speak about the relevant body parts. "Anyone with a cervix is at risk of cervical cancer".

That will be dangerously unclear to anyone with LDs, English as a second language or just low levels of anatomical understanding.

Women and people with a cervix, maybe.

Do you have to have one size fits all leaflets? I really hate the complex language that inevitably has to be resorted to when talking about sex related conditions without alluding to the persons sex. Medical information for the public should be written in simple accessible language.

No it's not, it's stating a damn fact and I am fed of of this pussy footing around people as facts suposedly offend. You can't get cervical cancer if you were born a man, it's a disease exclusive to women and testicular cancer is exclusive to men. What plastic surgery you have had or even what styles of clothes you wear doesn't change biology.

And to be honest, I'm not sure you would ever need to say the sentence "this only happens to females" really.

Maybe, but the words male and female are quite useful in general.

I remember that ridiculous photo of two anatomical diagrams up on the wall in a Planned Parenthood (I think) in the US.

The titles were "Female reproductive system" and "Male reproductive system", but little pieces of paper had been stuck over the dirty words "female" and "male", like Victorians covering up piano legs. (Apocryphal?)

Bizarre euphemisms to try to pretend the two sexes don't exist by not giving them names is ridiculous.

And I fail to see the logic of using "people with XXX" when apparently naming any body parts is also a problem. We're told "breastfeeding" being bad, but "people with vulvas" or whatever is fine.

Given that any individual could find any random thing "triggering", there's no possible way you can satisfy every person's demand to "not use the word X, I don't like" it simultaneously.

It's a risk to male people only. I agree, but a) if a man had his prostrate removed for some other reason earlier in life, then it's not a risk to him any more, even though he is obviously still male and b) there is literally no harm having a leaflet that says "If you have a prostate you are at risk" because it's more important that prostate cancer is identified early, than to risk alienating a vulnerable patient (because trans people are often vulnerable anyway) to make a point.

I am highly gender critical, but medical professionals routinely make allowances for people's beliefs, even when they are demonstrably wrong, because when you have someone actually sitting in your clinic, needing your help, helping them is the most important thing at that moment.

Anyone with a cervix is at risk of cervical cancer

You cannot be serious. That is one of the lowest information sentences I have ever read.

That will be dangerously unclear to anyone with LDs, English as a second language or just low levels of anatomical understanding.

That is true. One size fits all messaging is definitely unhelpful.

You cannot be serious. That is one of the lowest information sentences I have ever read.

Can you explain?

And on top of that, all these "dysphoric" people are apparently dysphoric because of whatever baggage they've mentally attached in their heads to "woman" or "female".

What do we do when people start getting dysphoric about being a "cervix haver"? Move on to the next thing on the euphemism treadmill?

(I think a lot of people here are already pissed off about that one, but presumably at some point more important people will decide they don't like it and there will be a flip like with "womxn" last week.)

@DaisyWaldron

Do you need to use the word female when talking to them? Can you not just talk about the body parts affected? Or chromosomes if that's what's relevent.

Sure so you could use "vagina havers" if you were specifically dealing with the patient's vagina.

The problem with this is that of course our bodies aren't disconnected organs stuck together and good healthcare should work holistically. "Vagina havers" are also "menstruators", "cervix wielders", "womb keepers", "female hormone system operators", "impregnatable voids" etc.

Referring to discrete parts would seem to disadvantage a potentially already vulnerable female. And that's before we consider female bodies are already disadvantaged by medicine and health care. (Personal example - my mother was not a "cervix haver" when she developed an hpv cancer, so she was not on any lists for screening.)

OP it's a valid and pertinent question. Would your insurers have any info?

Crosspelican, the more complex the language, the fewer people will get the right message, surely.

As a slight derail, my child was asked at a medical appointment whether they had 'any diarrhoea or constipation'. Now this was a bright-ish primary-age kid, who said 'No.'

None of us, parents or doctor, thought to check whether the child understood. He didn't. Thought the two words meant the same thing, it turned out. It sent us off down the wrong medical track for quite a while.

A biology-teacher friend says under 50% of GCSE students remember what a cervix is, to judge from answers on their test papers, and that's straight after being told all about it.

Can you explain?

Okay, it's not as bad as "anyone who identifies as a woman is a woman" - how do I know what a woman is and whether I should identify as one or note, but it's close.

How would I know what a cervix is and whether I have one? Especially in a foreign language. I am living abroad, and I have reasonable comprehension skills, but I am rubbish at anatomy words, and do not believe I would recognise the local word for "cervix". I definitely know the word for "woman" though.

You could have said that very clearly as "any woman is at risk of cervical cancer" and immediately alerted all woman that they should be checking this, and stopped men from paying attention to something they don't need to pay attention to. But phrased like that, a woman can happily skip past it, assuming that if they were trying to attract attention they wouldn't have phrased it so oddly specifically.

Is the aim to get all women in for screening, or try to make it sound like a niche thing? It sounds like people suffering from some particular condition.