Trans man and cervical screening "confusion"

[SpittinKitten]

Saw this earlier and thought it worth sharing...

www.bbc.co.uk/news/uk-england-humber-58515769

A transgender man has said confusion over his gender caused a delay in receiving a hospital appointment after an abnormal cervical screening result.

Jamie, 29, from Hull, began his medical transition aged 18, but opted to retain his cervix.

When referred to hospital after the screening, it was questioned why a man needed an appointment, he said.

The NHS group responsible for screenings said it was sorry to hear about Jamie's recent experience.

Jamie said the nurse who referred him to hospital following the check in late 2020 wrote an accompanying paragraph explaining he was trans.

"I think the hospital had said 'Why have you sent us this guy?' and she said 'Haven't you read the paragraph that came with it? This is a trans man, he still has a vagina, he needs screening'.

"It had to go through multiple managers to accept and understand it," he said.

Jamie said the confusion over his gender led to a three-month wait for results - not the usual two weeks.

His results came back negative, despite the delay in receiving the appointment.

The Hull Clinical Commissioning Group (CCG), which is responsible for cervical screening, said while it could not comment on individual cases it was sorry to hear about Jamie's experience and thanked him for bringing it to their attention.

"Trans men who still have a cervix should have cervical screening to help prevent cervical cancer," the CCG said.

"They may need to ask their GP practice for an appointment and ask that their preferences are recorded in their notes."

However, NHS guidance says a trans man registered with a GP as male will not usually receive automatic invitations.

Only women aged over 25 are automatically sent reminders to book an appointment.

Jamie said his case highlighted the issue that trans men and non-binary individuals who have a cervix were not routinely called for screening.

"There is no notification to tell me I need a screening, so it's something I need to manage myself," Jamie said.

He said because screening was normally done every three years "it's really easy to forget".

"That's why women are sent letters," he said.

"Everyone that needs a screening needs that reminder and that will prompt more people to go."

Imogen Pinnell, from charity Jo's Cervical Cancer Trust, said there was a need for healthcare professionals to be better educated about the issue "so they are able to better support transgender and non-binary people with a cervix".

"Because so often the experience someone has at an appointment will be what determines if they go back in future", she added.

'Could save your life'
Public Health England said it had worked closely with the LGBT community to produce a guide to help trans people understand what screening is available.

"We have promoted the guide to LGBT groups to help trans people access the most appropriate screening for them," they added.

Jamie said he wanted screening invitations to be sent to everyone who required them.

"No-one is going to say cervical screening is nice, and there is that extra layer of why it is uncomfortable for a trans person.

"But, for a few minutes of being uncomfortable, that could save your life."

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Quite a bit to unpick here- the whole situation is a heck of a mess, isn't it?

I wonder if Jamie will be tripping merrily to the health centre when he gets an invite for a prostrate examination.

I suspect not.

This is not the NHS fault. If I think I'm due a screening test and believe I may have been missed off the list, I ring the surgery and ask. Not sure why result would be delayed - surely once the test is done, the lab just processes in the normal way.

I'm sure this is an old story. If not, then it has certainly happened before. I remember the issue about being registered with a GP as male.

How much is it going to cost the NHS to have to change their computer software to make sure all the right boxes are being offered?

It is kind of the NHS' fault though. They should have had the foresight, clarity and commonsense to never agree to primarily recording patients by gender identity in the first place.

After sex, medical transition is as important for healthcare providers to know as any other medical issues, conditions, medications etc. And only after all that, information about non medical transition (eg pronouns and identities).

Giving precedence to pronouns and identities is at best stretching the remit of the NHS and at worst idiotically dangerous. Both for the individual concerned and for setting the precedence of patients' feelings over their medical needs.

That's what happens when you let outside bodies like Stonewall have sight of your processes and procedures, and critique them solely on the basis of inclusivity.

That's what happens when you let outside bodies like Stonewall have sight of your processes and procedures, and critique themsolelyon the basis of inclusivity

Given same sex marriage is now legal mamny of these lobby have basically done themselves out of a job. I would be surprised if part of the advice given now is purely to create problems so they are still needed in order to solve them , trying to keep themselves relevant/in a job.

If they actually had the welfare of trans people at heart, then alot if this advice would never have been given as it does more harm than good.

Not be surprised

A question I have always wanted to ask:
If you take male hormones or supress female hormones in any other way OR you take female hormones & supress male hormones -can it have long term health implications ie increase in certain cancers, thinning of bones, & increase in heart attacks & strokes
High dose contraceptive pills were linked to these issues & I assume & I may be wrong, that medication for this purpose would be high dosage?

@SheldonesqueTheBstard

I wonder if Jamie will be tripping merrily to the health centre when he gets an invite for a prostrate examination.

I suspect not.

Well no, as he doesn't have one. What is your aim here?

He was attending a health screening programme that is really heavily pushed for and was applicable to his body.

If he gets a letter about a prostate exam, presumably he will ignore it or inform them that it's not required.

So... in short...

Person has NHS records altered, person's sex becomes obfuscated
NHS admin gets a tad befuddled and asks for clarity
Clarification is given
All ends well

Moral of take: save yourself health anxiety and allow a record you will never seet eyes on to have your natal sex clearly recorded and so prevent such a mix up.

@daisyjgrey do you suggest that the confusuon will only work one way and that only women, transmen, will fall foul of such confusion? Yet more organisational misogyny!?!?

@CuriousaboutSamphire

What? I suggested nothing of the sort. I responded to someone being snarky and saying "I wonder if Jamie will be merrily skipping to his prostate exam".

I mentioned nothing about organisational misogyny. I swear that sometimes on these threads there's so much blind rage the ability to read and be logical goes out of the window.

[quote daisyjgrey]@CuriousaboutSamphire

What? I suggested nothing of the sort. I responded to someone being snarky and saying "I wonder if Jamie will be merrily skipping to his prostate exam".

I mentioned nothing about organisational misogyny. I swear that sometimes on these threads there's so much blind rage the ability to read and be logical goes out of the window. [/quote]
Erm... you missed it in the firts post and again in mine.

I'll ask again... do you think that this will ever happen only to women, transmen?

Or do you think it could sometimes happen to men, transwomen, and male focussed medical issues?

If you think it COULD happen to men as well then that's what @SheldonesqueTheBstard was psting about. The fact that pissing around with your medical recordscan cause confusion, waste NHS time and money.

If you think it oculd NOT ever happen to male bodied people then why not? Organisational misogyny is one possibility.

Either way individuals who choose to change their sex markers put themselves at risk of such confusion.

And that confusion costs the NHS time and money.

Is that clear enough for you?

Snarky possibly daisy

But the fact of the matter is that if your biological sex is not first and foremost on your notes then some biological men and women are going to miss important appointments because they have critically important information missing (or hidden away in a tiny additional info box) in their notes.

Similarly some men and women will be getting appointment letters through for checks that do not pertain to them biologically, thus wasting time and resources on no-shows or attending to people who never had a cervix or prostrate in the first instance.

The NHS is on its knees and I feel the resources are just not there to check and double check or scrutinise notes to make sure they aren’t missing anyone for routine or important checks. The most important information should be prominent.

I am being sharp because people could die because they’ve decided that feelings and appearances and words are more important than facts.

But the fact of the matter is that if your biological sex is not first and foremost on your notes then some biological men and women are going to miss important appointments because they have critically important information missing (or hidden away in a tiny additional info box) in their notes.

Cervical screening is a screening process designed to capture all well women between certain ages. You move from one process to the next with maximum efficiency and accuracy in a system that is constantly reviewed to give the biggest gain. It is one-size-fits-all. It is amazingly good, but you have to fit in with the system. That's why they have so many leaflets and information campaigns.

If you individualise it then it becomes too inefficient and expensive to run. The only choice really is to opt in on the NHS terms, or opt out.

@mumwon

A question I have always wanted to ask: If you take male hormones or supress female hormones in any other way OR you take female hormones & supress male hormones -can it have long term health implications ie increase in certain cancers, thinning of bones, & increase in heart attacks & strokes High dose contraceptive pills were linked to these issues & I assume & I may be wrong, that medication for this purpose would be high dosage?

The 'Warhol Superstar' Candy Darling's early death age 29 from cancer is widely believed to have been caused by the hormones Candy used, though that's not mentioned in Candy's current Wikipedia page. This was back in the 1970s, but suppressing details of the risks - who does that actually help?

All my hospital letters and blood forms only have gender on them. This has been the case for the last 5 years. Of course it is going to cause confusion and muck up all research and data collection.
Someone I knew as an aquaintance/ friend of a friend, born male, transitioned early 20s, died aged 40 from massive stroke. Attributed to the hormones they were taking. It was very sad.

Jamie said his case highlighted the issue that trans men and non-binary individuals who have a cervix were not routinely called for screening.

It highlights the issue that the NHS has been so captured by Stonewall and TRA’s they’re no longer able to accurately record sex.

Jamie is an adult human female.

Now, what is the word for that...?

There comes a point where we all have to be accountable for our health and if you choose to opt out of sex based medicine then it's your responsibility to track your health needs.

Yes, but the idea of them taking any responsibility whatsoever for anything is unlikely, the world and everyone in it is there to serve and pander to them don't forget.

The person in the article is not making the point that they think they are.

They think they’re pointing out that each individual person should have which screenings they need recorded against their names, but in a system like the NHS that covers the entire population of 60 million people that would lead to more errors than the current system of using two separate fact based categories of male or female.

Plus the system we currently use it’s really really easy for NHS staff to identify when there’s been a mistake.

I can’t believe this article about confusion about this person’s femaleness actually call it “confusion over his gender” FFS thereby obfuscating the bloody issue

Sex! Confusion over his sex! Because that’s what they actually need to know to give the right treatment! Sex sex sex!

Cervical screening is a screening process designed to capture all well women between certain ages. You move from one process to the next with maximum efficiency and accuracy in a system that is constantly reviewed to give the biggest gain. It is one-size-fits-all. It is amazingly good, but you have to fit in with the system. That's why they have so many leaflets and information campaigns.

If you individualise it then it becomes too inefficient and expensive to run. The only choice really is to opt in on the NHS terms, or opt out.

They don't care, all they care about is themselves and their own special status sod the impact it has on anyone else as is clearly shown by the attacks and changes demanded on Cervical Cancer information and research charities.

I agree that if you choose to opt out of standard systems and sex based medicine, or if you have any particular additional need then you need to take responsibility to track your health needs and go the extra mile in communication. The NHS doesn't have the time and resources to deal with immediate crisis going on like the international pandemic, never mind keep track when a patient intentionally presents them with confusing information on their records that is quite foreseeably going to risk life threatening situations in an emergency.

@BlameItOnTheBlackStar

Yes, the NHS does need to find a way to deal with situations like this; the main way would be to keep sex at birth on file as the patient's sex, though. Paperclipping a note to a referral letter isn't exactly failsafe. Trust me, I worked in an NHS referrals office and we were wading and drowning in bits of paper, something like this could easily have got lost as it was moved between 2/3/4/5/6 locations.

Well maybe a nurse referring someone after an abnormal result for cervical screening would give them a clue that the person (whatever they call themself) has a cervix. The fact that the nurse attached a note explaining the situation should have made it even clearer. Then they spoke to the nurse and still didn't understand.

I think it is quite worrying that the people administering the service can't figure it out after that many clues. As my gran would have said, "Do they need a poke in the eye with a blunt stick."

@TheRebelle

The person in the article is not making the point that they think they are.

They think they’re pointing out that each individual person should have which screenings they need recorded against their names, but in a system like the NHS that covers the entire population of 60 million people that would lead to more errors than the current system of using two separate fact based categories of male or female.

Plus the system we currently use it’s really really easy for NHS staff to identify when there’s been a mistake.

So do you think they doubted the word of the nurse who did the referral. Qualified nurse doesn't understand that you need to have a cervix to have cervical screening? Surely if you are referred it doesn't really need further explanation.