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 think it is awful they had to go through multiple managers etc to get basic healthcare. That's really bad.

I think that the push to only record gender everywhere/ the fact that the implementation of sex and gender which is what I think happened in NHS and has not been done well. Is really the issue.

So many individuals and orgs have been pushing for only gender to be recorded. Why the hell sex and gender is unacceptable is really worrying. That's not about helping trans people as it obscures them in stats etc. It's simply ideological. To make sex irrelevant.

Are there any trans orgs talking to NHS about making sure the info is captured so sex specific things aren't missed but also transgender people are noted in a way such that the staff don't get confused etc?

I would put money on not. And that is an issue with all of this. It's all about insisting on changes based in ideology and fuck the consequences.

@ancientgran I think they need to stop being deliberately awkward and accept that they ARE female to be honest, cervical screenings are for females so of course staff are going to question it if a man is referred.

It’s such a confusing article. A medical transition but opted to keep their cervix: no clue what that even bloody means! Would have been clearer to say they kept their vagina but I guess that doesn’t fit the narrative as well.

Cervical screening is essentially a very blunt tool, if your sex is recorded as female you get invited for screening. Anyone that falls outside that basic algorithm needs to take a certain amount of personal responsibility to make sure their needs are met.

I used to get invited for cervical screening after I had been diagnosed with cervical cancer and my womb, tubes, cervix and the top of my vagina were removed. I got a nice little letter telling me I would be at risk of cancer if I didn’t attend. I just binned them and yes, did get a bit upset initially but didn’t go to the media about it🤷‍♀️

You must have your correct sex in your medical notes and any medical professional who goes along with saying or doing otherwise is complicit in potential medical negligence.

@CosmicComfort

It’s such a confusing article. A medical transition but opted to keep their cervix: no clue what that even bloody means! Would have been clearer to say they kept their vagina but I guess that doesn’t fit the narrative as well.

Cervical screening is essentially a very blunt tool, if your sex is recorded as female you get invited for screening. Anyone that falls outside that basic algorithm needs to take a certain amount of personal responsibility to make sure their needs are met.

I used to get invited for cervical screening after I had been diagnosed with cervical cancer and my womb, tubes, cervix and the top of my vagina were removed. I got a nice little letter telling me I would be at risk of cancer if I didn’t attend. I just binned them and yes, did get a bit upset initially but didn’t go to the media about it🤷‍♀️

Yes, they must have kept their vagina as otherwise there’s no way of getting to the cervix. So basically they haven’t had surgery though I’d guess they have had hormones.

[quote TheRebelle]@ancientgran I think they need to stop being deliberately awkward and accept that they ARE female to be honest, cervical screenings are for females so of course staff are going to question it if a man is referred.[/quote]
How many times do you think they needed to question a referral from a nurse? What a waste of time, I'm sure they nurse doing cervical screening knows what cervix is.

@CosmicComfort

It’s such a confusing article. A medical transition but opted to keep their cervix: no clue what that even bloody means! Would have been clearer to say they kept their vagina but I guess that doesn’t fit the narrative as well.

Cervical screening is essentially a very blunt tool, if your sex is recorded as female you get invited for screening. Anyone that falls outside that basic algorithm needs to take a certain amount of personal responsibility to make sure their needs are met.

I used to get invited for cervical screening after I had been diagnosed with cervical cancer and my womb, tubes, cervix and the top of my vagina were removed. I got a nice little letter telling me I would be at risk of cancer if I didn’t attend. I just binned them and yes, did get a bit upset initially but didn’t go to the media about it🤷‍♀️

If it is a medical transition then it isn't a surgical transition so presumably they are taking hormones.

Don't you think he took personal responsibility? He got an appointment, we don't know how, he went through the screening and was referred.

I also had a hysterectomy and had womb, tubes and cervix removed. Never got invited for screening again. I assume someone updated my records.

Medical tradition could be breast removal.

Not having full surgery whether male or female is totally understandable.

I want the trans orgs to talk to NHS about recording both sex and gender.. Thing is the aim with everything is to only collect gender and to proceed with everything on that basis.

Even if it puts trans people at risk in some circs.

I can also believe that the hosp people did not understand. From the pic the person looks male. I understand that ftm has much more chance of being read as opposite sex than mtf for a variety of reasons.

This person should not have had to go through a load of managers.

That's why the records need to have both sex and gender and maybe a flag for trans so it's at a glance.

Because I can see that when what seems like a man turns up for a smear plenty of ordinary people would be ???

It may be harsh of me, but I can't help feeling that you can't have it both ways.

Your notes are sealed when you get a grc if you ask for it (same as they are for adopted children) and there is nothing to connect them to the previous notes, they will record you as your new gender with potentially nothing to indicate you are a different sex. A medical professional would have no indication on looking at the notes that the patient has transitioned and had or not had surgery unless there are clues in the current medical history such as medications they are on. Therefore potentially a female recorded patient could tell me they have an issue with their genitalia and I would invite them in for an appointment and be greeted with a totally unexpected set of organs. I would though then be able to record in the notes that they had male genitalia.

This sealing of notes and no reference to the previous gender is the choice of each person when they get a grc if they do this and most do not as they understand it will lead to negative health outcomes but it is their legal right to do so. I am not sure patients are always appropriately counselled on the risks to their health doing so may cause

I mistakenly got invited for a smear after 2 years instead of 3, when I turned up the nurse took me in and explained even if she did the smear the lab wouldn’t look at it because I’d had one too recently, I can well imagine the way it works is very automated for such a large operation as cervical smears to prevent any mistakes so if something out of the ordinary crops up then it’s a “computer says no” situation.

What a wee whiny

Just take some responsibility. Be an adult

And stop whining

@TheWoleb

And this is why, in their medical files, they should be recorded by sex. If the NHS really wants to then they can go ahead and have 2 lines; one for sex and one for made up, chosen gender. But the sex is what matters and needs to come first in all medical stuff.

Exactly!

I've had student nurses rock up to do catheters to find a penis (student nurses are only allowed to catheterise females due to ureter length). In medical settings at the very least, sex matters!

Where’s the bbc on all the smear tests that have been missed cos of Covid

Yet this whiner gets a piece written about them. 🤦‍♀️🤦‍♀️🤦‍♀️🤦‍♀️

Paperclipping a note to a referral letter isn't exactly failsafe.

Its 2021; its mad thats even a sentence when talking about our medical records. SO many reasons not to be a paper system.

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.

Well, no.

All kinds of weird mistakes happen in these kinds of systems, even when there is a referral. For example a record belonging to the wrong person, but with the same name, being sent along, or put together with the kind of note mentioned. Things get lost. The wrong code gets put into the system.

In a big system where you have dozens of these things going through an office every day, administrators see weird errors all the time. Sometimes it's never revealed how they occurred.

Records that are unclear just take away another layer of protection against error.

@CaroleFuckingBaskin

I wonder why he wanted to keep his cervix if he wanted to be male. Perhaps its quite normal but I hadn't heard of it until this thread.

Me either. Why bother genuinely .

Maybe because mistakes happen in the system, and people know that, they see what looks like a man who's been sent for a cervix check or whatever, so they default to "Oh must be a mistake" - which is fair enough as that would be the right thing to do normally, to spot a mistake IYSWIM.

They just need a clear system that gets across the message "presents male (or male "gender" if they must), biologically female" and vice versa, so those cases make sense and can be handled smoothly. But it's not going to go smoothly if the people who need that are potentially going to go off on one if their sex is mentioned - they have to be on board with sex/biology being necessary medical information.

@CaroleFuckingBaskin

I wonder why he wanted to keep his cervix if he wanted to be male. Perhaps its quite normal but I hadn't heard of it until this thread.

Because the rate of complications (ranging from chronic pain to incontinence to life-limiting damage to death) is much higher in female transsexuals undergoing genital surgeries than in male transsexuals. And in male transsexuals the percentage who experience serious complications of the penile inversion or bowel vaginoplasty is already as high as about one in three.

Contrary to those two surgery techniques, the most popular techniques for phalloplasty in female transsexuals also leaves a permanent and very large visible scar on the patient's arm.

So it is far more common for female transsexuals not to have phalloplasty - higher risk of complications, worse outcomes. And of course it means sterility, because the patient first has a hysterectomy, which typically also includes removing the ovaries and fallopian tubes. That is major, life changing surgery in and of itself.

It is far better for the patient's health not to have those surgeries if they can manage their dysphoria without having them.

And what's this practice going to do to future medical research, drugs trials data and the like?

How do they do a cervical smear on Jamie anyway? How do they get to the cervix

This focus on the details of this person's body/ surgery is really unpleasant.

And some of the comments are weird.

@CaroleFuckingBaskin

How do they do a cervical smear on Jamie anyway? How do they get to the cervix

Exactly the same way they get to any cervix.

Which I believe is mentioned in the article...