The importance of disclosure in gender specific screening
A new information video, issued on behalf of Cancer Research UK, has been criticised for its use of trans inclusive language. The key issue revolves around the video’s reference to the importance of screening for ‘people with a cervix’, rather than ‘women’.
However, in spite of protestations by some, the video is in fact accurate and raises an important point.
The numbers of transgender people living openly in the UK is on the increase. As more people successfully change their gender marker on their NHS records, there is a risk that their right to life-saving anatomy specific screening will fall between the cracks.
This is because if you are labelled as female on your NHS records you will automatically be called for cervical screening. If you are labelled as male you won’t.
It is true that some may wish to leave the gender they were assigned at birth behind them, while others may find the process of accessing gender-appropriate healthcare excruciating because of ignorance and uncertainty in the GP surgery. However, failure to access these vital tests can have devastating consequences.
According to statistics, published by Cancer Research UK, there are nine new cases of cervical cancer diagnosed every day and half of these diagnoses are in people under the age of 45.
Cervical cancer can grow, symptom free, until it is too late to treat. The cancer cells form in the neck of the womb, develop and then spread. Cervical screening, which takes a sample of the cells from the cervix can identify early cell growth. Early treatment prevents the cells from multiplying and developing into full blown cancer. This is why considering screening is so important for anyone with a womb.
I say ‘those with a womb’ because, like Cancer Research UK, I believe it is vital that we acknowledge the fact that not all those assigned female at birth continue to identify as women. Trans men will have a womb unless they have had a hysterectomy, and they too will need to be offered screening. Nonbinary people may or may not have a womb, and each case should be taken individually.
Cervical screening is just one example of anatomy specific screening. Other key tests include:
- Mammograms for those with breast tissue
- AAA screening for those assigned male at birth
Cancer Research UK is not being anti woman in its reference to ‘people with a cervix’ but rather acknowledging the fact that whether you are cisgender, transgender or nonbinary is irrelevant, if you were born with a womb then screening can save your life.
As GPs it is our job to ensure that patients are aware of the importance of such tests and that they feel comfortable enough to communicate their history without fear of prejudice. If your NHS records accurately reflect your gender then that may mean you do not get invited for appropriate NHS screening.