Macmillan Cancer Support leaflet aimed at trans patients: "regressive, unscientific and generally very poor advice" says nurse

[IwantToRetire]

(Some may find this article distressing to read if they or friends or family have suffered from cancer.)

The leaflet, titled “LGBTQ+ people and cancer”, is produced by Macmillan Cancer Support in partnership with a group called “Outpatients”. It is quite possibly one of the most offensive pieces of healthcare literature, amended to include people who “identify as” the opposite sex, that I have seen thus far.

" ... Your team will talk to you about where you will stay. Hospital wards may be single sex or mixed. Where you stay should give you privacy and keep you safe. If the hospital has single-sex wards you will usually be able to stay in a ward which matches the gender you identify with.

" ... Some health conditions are still often treated in clinics that are gendered. For example, if you have a problem affecting the vagina or nearby pelvic areas, you may have an appointment at a women’s health clinic. A problem affecting the prostate, you may be given an appointment at a clinic for men. These clinics can be difficult to cope with if your gender identity does not reflect the sex you were assigned at birth.

" ... If you were assigned male at birth and have had genital reconstructive surgery. If you have had surgery to make a vagina, the risks of cancer in this area are thought to be low. You do not have a cervix and do not need to go for cervical screening (a smear test).

" ... Sometimes surgery to treat cancer is also gender-affirming. Surgery to remove the cancer may remove a body part that you prefer not to have anyway.

Extracts only - full article at https://thecritic.co.uk/gender-identity-ideology-is-undermining-healthcare/

What fresh hell is this?
They want gynecologists to treat problems with artificial vaginas? Why not the cosmetic surgeon who made the fake vag?
Oh, but that would be "difficult to cope with."
They must have the affirmation of being able to see a gyno.
Batshit.

I don’t think there’s anything wrong with the leaflet. It addresses the concerns some transgender people have.
The problem is that the single sex wards are not single sex.

" ... Sometimes surgery to treat cancer is also gender-affirming. Surgery to remove the cancer may remove a body part that you prefer not to have anyway

I believe this comes under the title of reframing your trauma.

That part does seem pretty tasteless, doesn’t it?

I can well imagine a transman with a diagnosis for breast cancer may be feeling a whole load of complex emotions which may be different to a woman who is ok with her breasts, but “you don’t want them anyway🤷‍♀️”, I dunno it’s a bit cold.

Are they suggesting that if you have cancer in one breast, they’ll also remove the other healthy one?

Actually that’s not an uncommon choice. It’s often recommended if at high risk of cancer reoccurring but also some patients choose to have both removed.

evidence.nihr.ac.uk/alert/women-cancer-one-breast-have-both-breasts-removed-satisfaction-with-decision/

Here's a link to the leaflet itself:

https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/transgender

I think it's actually rather good and Jean Hackett is frothing at the mouth about nothing. Yes, it does use the term "assigned at birth" instead of "registered", and "cis-gender" is used a couple of times, but largely it's a well-thought out and plain-speaking leaflet.

The sentence on single sex wards, if accurate, is the responsibility of the hospitals, not the leaflet. Focus is usually on TW in women's wards, but think about it the other way: a TM on a women's ward and the other patients wondering why a man is on their ward (and before anyone starts claiming TM don't pass, yes some do appear to be men). So that would need to be dealt with delicately.

I don't see anything sinister in the comment about how cancer surgery might be gender-affirming, just a recognition that removal of certain body parts might not be as upsetting for a trans person as for a non-trans person.

And Hackett's dismissal of people feeling uneasy in a clinic specialing in healthcare for the "other" sex is just cold-hearted. Of course someone might feel self-conscious being in a setting where they appear to be out of place, and with added discomfort for people with gender dysphoria who usually try to supress or avoid reminders of their true sex. Let's remember that men (natal, not TW) can get breast cancer too but the "pinkification" of breast cancer means that most publicity, and even some of the health-care settings, are designed to appeal to women. I once saw a TV item explaining a man's experience of attending a breast cancer clinic with his adult daughter for support and people assuming that she was the patient and he was supporting her. Is it so difficult to have sympathy for some people's additional discomfort?

Seems a good leaflet to me, it's factual and states clearly that for sex specific cancers you may be treated to with your birth sex rather than chosen gender. Also clearly states if you don't have a cervix you don't need a smear

I think it's a good idea to create specific leaflets rather than erase sex based terms in leaflets for all (e.g. people with a cervix).

It is generally the case that a bilateral mastectomy will be one of the options explored when a unilateral is needed. I think it's sensitive to have separate leaflets for those may be delighted by this, as opposed to most who will be devastated.

My issue is referring to 'gendered' clinics. These clinics are single sex or sex specific. I think it's important for everyone to recognise that their sex plays a fundamental role in healthcare and that they need to follow advance guidance pertaining to their sex, not their gender identity.

When I first received my cancer diagnosis (and for the next couple of years where I received a run of 'not good news' findings) I was deeply grateful to the straight talking manner of doctors. Whilst their tone was gentle, they stated facts, and were direct and to the point. This enabled them to focus previous appointment time on their specialist area. The MacMillan nurses were there to pick up the emotional aspects following each appointment. No one in the team was ever judgmental about the choices I made about treatment. They saw their job as enabling me to make fully informed decisions.

I cannot imagine my team treating trans identifying patients any differently to how I was treated. I am sure they would still use the correct medical language to refer to bodies and offer the same range of treatments. They would not reference 'gender affirming' treatment for cancer treatment. If a patient chose not to have breast reconstruction, they would be no more or less judgmental about this than anyone else who chooses this option (many do for a range of reasons).

Many people have a trans identity and I'm all for them receiving accurate medical advice. The medical advice they get should be the same as that for everyone if the same sex, but the issues and challenges arising for them are likely to be different. Getting a cancer diagnosis is tough enough. Anything that makes this easier is welcome in my book.

It's very clear who it is aimed at. The only reason I can think to object to any of it is if you just don't think trans people should be acknowledged in any setting. Which is an opinion, of course. But don't pretend it springs from any noble motive.

I was feeling ' be kind' till the 'you probably didn't want that anyway' bit.

The cancer sufferers I know were grieving losing parts of themselves piece by piece, feeling shite because of chemo or radio. Worrying about their loved ones and the prospect of metastasis.

I'm all for making the process more emotionally bearable and medically accurate.

I think that most people buying into the trans construct are a bit caveat emptor. If you don't know you don't have a cervix post 'affirmation' surgery I would question how informed your consent was.

I'm also wary of lumping LGB & TQ+ together, but that's just me.

No it's not just you quantumbutterfly, you've put your finger on one of the most damaging aspects of trans ideology.

LGB has been eclipsed by TQ, and in the area of health services, it's really significant - the health needs of trans patients, especially those who have gone down route of life-long meds or surgery, are totally different from the health needs of LGB people.

This leaflet is aimed at trans people, it is of no relevance to LGB people, so I sort-of agree with BobsyaRuncle 'It's very clear who it is aimed at.', but that was undermined by labelling it “LGBTQ+ people and cancer”

The one part of this leaflet that I liked was where it explained to trans-identifying people they may have to bite the bullet and go to a clinic 'gendered' clinic if their medical complaint is specific to their original sex. That was a welcome dose of reality and common sense, and I didn't mind that the leaflet acknowledged that it would be 'difficult' for trans patients to do so.

The Macmillan leaflet linked though is actually labelled Transgender and NB people and cancer.

The LGBTQ+ leaflet is different although cross refers.

The leaflet seems reasonable but this line:

you will usually be able to stay in a ward which matches the gender you identify with.

Made me gawp, feel really uneasy and I'm sure can't be true.

I do feel a bit sick whenever I hear any version of this in various contexts and scenarios.
Because we all know, any man ever could simply utter the magic words don't we.

So if I understand correctly, a transwoman with prostrate cancer could choise to be admitted to a women’s ward. And that would require surgeon, doctors, specialist nurses, to schlep from one area of hospital to another in order to complete rounds, do dressings, etc?

Have I got that right?

". Your team will talk to you about where you will stay. Hospital wards may be single sex or mixed. Where you stay should give you privacy and keep you safe. If the hospital has single-sex wards you will usually be able to stay in a ward which matches the gender you identify with."

And what about the privacy and safe space for women ? To quote Ricky " you know the dinosaurs - the ones with wombs"

Well you know, having a female sex-based cancer is soooo cis-privileged, doncha know?

Apols for using the c-word.

If you don't know you don't have a cervix post 'affirmation' surgery I would question how informed your consent was.

Well M. Willoughby thinks they have one and our Foreign Minister thinks TiMs can grow one.

Pity the Foreign Minister couldn't grow a brain!

I have to say my overall response to the leaflet, its purpose, was just can we stop with the fudge.

This playing along with the lie that you can change sex.

Its just seems madness that for a health issue as serious as this, health professionals are tying themsleves is reality avoidance speech.

Surely we must reach a point where someday, assuming there are still those who want to transition, whether medically or through identity, will no longer be pandered to in the fantasy that they have changed you biology.

Why cant grown up health professionals say, as you know although you have transition to your prefered gender, you body remains the biological sex you are born. You need to accept this to not only be aware of health issues related to the sex of your body, but also so that health professionals can treat you appropriately.

That's all the leaflet is really about.

Forcing highly skilled people to cover up the lie about the reality of biolgoical sex that no amoung of operations, or strong personal identification can change.

Not forgetting the terrible occasion in the US when a transman arrived as a hospital emergency complaining to terrible stomach pains. To cut a long story short, after various suggested prognosis, it turn out these were birth pains. If i remember rightly the baby didn't survive, which is just shocking.

But also, without wanting to dwell on the details, if as a transman you have been having PIV sex wouldn't you just for a moment at some time wondered about getting pregnant.

But to continue the charade at the expense of your own health, and in this instance a baby's, its beyond comprehension.

https://eu.usatoday.com/story/news/health/2019/05/16/pregnant-transgender-man-births-stillborn-baby-hospital-missed-labor-signs/3692201002/

Boy are you right. A GYN is used to treating natural disorders of the female reproductive system. A transwoman is manufactured.

Where does the leaflet actually say that trans women are demanding the opportunity to see a gynaecologist?

Most of the upset on this thread is pure projection of the posters’ own views.

The leaflet is clear that trans people will need to be treated for certain cancers in clinics for people of the sex they were assigned at birth. It acknowledges this might be uncomfortable. However, nowhere does it suggest that trans women are up in arms demanding the right to see a gynaecologist as you seem to think.

With respect, the vast majority of posters on FWR are clearly not the target audience of this leaflet, and you’re just looking for things to get arsey about.

The leaflet is clear that trans people will need to be treated for certain cancers in clinics for people of the sex they were assigned at birth. their sex, which is observed at birth and cannot be changed.

FTFY.