If you have an intimate procedure, you want to be able to trust the person treating you.
If you feel they have lied to you about their sex, could you trust them?
This isn't about being trans. It's a matter of trust.
I actually think some women would be in a position where if they were told the HCP was trans and there would be a chaperone they'd be fine but if they turned up expecting a woman and found someone was trans and felt they'd been misled and they felt unable to ask for a chaperone (as not everyone has the confidence to do this), they'd feel upset about it because of the nature of the procedure.
What you are told matters because it's about walking into a situation you anticipate and feel comfortable with v a situation you have not expected and feel lied to about / disempowered from making informed choices and then struggle to assert yourself due to this fear that you'll be kicked off the patient list for being transphobic.
It's that point again about power dynamics between doctor and patient. The former situation has a different power balance than the latter. This is extremely relevant to survivors of sexual abuse or rape.
I think it's important to acknowledge that women can build up going to a smear / are afraid / in a state of anxiety and feel exceptionally vulnerable.
Given all the initiatives to understand and increase uptake of smears, failure to work out that making your sex ambiguous is probably going to be an issue for a small number of patients is beyond my comprehension. It should be being thought about in any correspondence with a patient.
There are numerous ways in which you can reassure women about this without revealing martial status.
It comes to something when your desire to conceal your martial status / sex comes before considering the known issues of women who are the least likely to turn up to appointment.
Why are we spending money on promoting smears, only to undermine trust by doing this stuff.
HCP should be doing as much as possible to earn the trust of patients. Not putting their politics before other considerations.