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?

@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?

This thread may be of interest.

www.mumsnet.com/Talk/womens_rights/4226475-Effects-of-cross-sex-hormones-on-natal-females-blood-pressure

The more years go by, the more "get off my lawn" I grow about all the varieties of gumballs who want the world to prop up their fantasies but also protect them from the consequences of reality breaking through.

This is no different from anti-vaxxers taking hospital beds from those who are ill through no fault of their own.

If you're a transman and you want useful medicine, be sure "female" is on your NHS card. It's simple.

Of course it’s the nhs fault. The NHS runs the medical system, it’s their duty to provide safe and appropriate care. To do this they need to insist on recording patient sex as well as gender. I don’t care what they call a patient but they need to be able to know and consider their biological sex in providing healthcare. Trans men and everyone of all kinds of queer and non binary who is female should get smear test notifications.
Plus they can’t even read the accompanying note.

If they do insist and have fields in the patients file clearly defined to capture this, and patients withhold the information, THEN it’s the patients fault.
TRAs and the woke madding crowds are the root cause but the NHS’ responsibility is unchanged.

To those saying 'they should have picked up on the clues'. Keep an eye on the numbers here. Given there are tens of millions of men and women with non-fucked up records versus hundreds or thousands of people who have scrambled them, if a sex-specific service sees someone of the wrong sex referred, it is far more likely to be an admin error involving a normal person than someone with falsified records.

Assuming falsified records rather than admin error is not the way it's going to work. Sre, they can check, but the majority of the time it WILL be an error, so the people who've scrambled their data are always going to find themselves being double-checked as a result. Their data IS wrong, so staff need to determine why.

Neither the NHS nor the patient have any basis to complain as they both willingly participated in this farce. But we and the individual staff can be rightly annoyed at their initial and ongoing idiocy.

This was always going to happen. There probably is a ticking time bomb of females who live as men walking about with serious abnormal cell issues.

Will the deaths of females through clerical ambiguity be enough for common sense to prevail - nah.Which is scary as there are actually shit loads more females transitioning than men.

Cases like this were actually discussed at the very start. They said it wouldn't happen...

Sorry I haven't rtft but I have recently received invitations for both cervical screening and a mammogram.

Both state clearly that it's for women.
They also run a clear statement that if you are a trans man you need a cervical screening but and if you are a trans woman you don't.
if you are a trans man with breasts you need a mammogram, and if you are a trans woman you may need a mammogram as some hormones increase the risk of breast cancer.
In every case, trans or not, you are invited to make your own appointment.
I'm sure if you are a trans person you don't have any confusion about whether your a transman or a transwoman.
I can see why medical staff get in a pickle if a trans person has erased all evidence of their gender at birth.

Record sex instead of gender. NHS doesn't ask for musical taste, why ask for gender? Be careful what you wish for.

I wondered about the phrasing of “keeping the cervix”, too- to me that suggests a hysterectomy has happened.

That’s really, really young to have had one

The system doesn’t cope well with anomalies. I don’t have a cervix after a total hyst, and have the devils own job getting myself off the system- I’ve moved a few times and every time, I get added back on to the list to be called. And it is upsetting to have text messages and letters plop onto my phone or doormat fairly regularly, prompting me to have a good old think about the desperately unhappy series of events that led to my not having a cervix.

Maybe I should do my best sad face and run to the media too? Rather than being an adult, picking up the phone again, and correcting my record…

All of this is an entirely foreseeable series of events. Your doctor needs to know your sex- they can’t treat you, prescribe for you, refer you, operate on you, or proactively manage your health without that knowledge.

Sophocles, Mumsnet hugs for you and

‘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"

Same organisation issued this note (on the wall of my doctors surgery). Let’s make this simple - sex. Keep it sex

Obviously the NHS computer needs to send out letters to everyone and then hope that only women and transmen turn up - I'm sure that will be a straightforward and non expensive way to be sure of capturing everyone

Just need to keep to sex.

I know I'm preaching to the choir here, but the way to fix this - fix all of this - without making trans people feel invalidated or unseen is to strip sex right back to a fact of your body, and acknowledge gender identity (including no gender identity) as a separate and unrelated thing. The first being how your body is, the second being who you are and how you want to live.

In that model, "not feeling" like a woman would be as meaningless as "not feeling" like your height.

Then we can all get on with prioritising sex when it's relevant and gender identity the rest of the time.

@PotholeHellhole

Sophocles, Mumsnet hugs for you and

Thank you breakfast cake, yum!

This

And this is why, in their medical files, they should be recorded by sex.

Cut the crap and pop the sex on the medical notes and then no problems like this occur. It's quite easy really.

Of course transmen that chose to keep their cervix when they change their gender to male could remember they have one and so ensure they have regular check ups relating to female body parts.

@Cbtb

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

Maybe the fact that a nurse had referred her was a clue, maybe the note from the nurse explaining the situation was a clue, maybe the telephone conversation with the nurse was a clue. They didn't need to be the second coming of Sherlock Holmes to work it out.

This is why you can't ignore sex and justify that gender is the same thing. It isn't. If they want their gender recorded as male, and treated as one, then it is their responsibility to ensure that at the times that then doesn't biologically suit, they get what tests are necessary organised. You can't have it both ways, deny the female (or male) and have basic biological information covered up so it doesn't offend you, then com0ain when that same cover up has consequences

I wonder what they say when they get a prostate check letter?

The nhs has got a lot wrong when it comes to trans. I don’t think the recording of people with a grc with their new gender is the nhs fault tho, that’s legislation. Trans People who have not got a grc usually have the name on the notes changed and a explanation of which gender is preferred when addressing them. With grc it’s different - like adoption - and we don’t have a choice - they get a new nhs number so a whole new set of records (it’s the same process as for adopted kids, which I also think is stupid as well,- have a shit start in life and then maybe have a medical issue because you are adopted and we don’t know your medical hx). It’s a legal fiction creating a whole new person so there is nothing the nhs can do

In essence, Stonewall and its ideology should NEVER have been allowed to set foot inside any NHS premises. With regard to capturing data on patients, the information should ALWAYS be factual and accurate.

What’s the point on having a box to tick about how you “present” to the rest of the world?? I told my teenage DCs this “story” over breakfast today. They were appalled. They totally “get it”, thank Christ.

@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.

I wondered this too, though I guess it's not really the point.

.. Biological sex should be the predominant factor on a medical record, AND it should also include birth name, to help clear up any confusion.

What’s the point on having a box to tick about how you “present” to the rest of the world??

It's daft when you look at it in isolation, but it could help with the problem of having a patient who looks and sounds like a man who wants to be treated as and called a man, who also needs female biology checks/treatment. Because otherwise, thanks to the rate of error, people will see the "male" and think the female biology treatment is a mix-up, leading to situations like the one in the article.

After all, cervix for example means neck, there are "cervical" ie neck treatments and body parts. You might reasonably think is a man came along needing a "cervical" treatment that there was some confusion and it meant a neck issue.

If you are aware of the category "XX biology but wants to be treated like the opposite sex except for the XX medical issues" then that makes it straightforward.

Obviously shouldn't be necessary in my book because people would be OK with medics having a clear record of their sex and being open about that, but many aren't.

It's daft when you look at it in isolation, but it could help with the problem of having a patient who looks and sounds like a man who wants to be treated as and called a man, who also needs female biology checks/treatment.

Agree - it's relevant to the care of the patient.