Stock photo of a gynaecological exam. (Envato)
Trans men and non-binary people face “unique barriers and stigma” to getting gynaecological healthcare like smear tests and are less likely to be up to date with them, two doctors have confirmed.
Dr Crissman and Dr Stroumsa both work – as clinical lecturers and fellows – at the University of Michigan, and have written for Contemporary Ob/Gyn, a news site for those working in pregnancy and reproductive healthcare, about “gynecologic care considerations for trans masculine people”.
Their article comes amid a heated public row about using inclusive language like “people with cervixes” has reignited, following Labour MP Rosie Duffield’s comments that “only women have cervixes”.
When people online pointed out that trans men and some non-binary people also have cervixes, Duffield called this “a tedious Communist pile on” and later shared an article calling those accusing her of holding transphobic views “petulant youngsters“.
Several other senior Labour figures, and the Archbishop of Canterbury, have since defended Duffield.
Crissman and Stroumsa, who are US based, are likely unaware of the row in the UK.
But their article is not based on Twitter arguments; it is based on their medical expertise.
“Transgender and non-binary people face disproportionate rates of stigma and discrimination in seeking healthcare — and may encounter additional unique barriers in attaining gynecologic and reproductive care,” they say.
Crissman and Stroumsa continue: “Even in the absence of overt discrimination, transgender and non-binary people face challenges related to structural discrimination, or cis-normativity – the assumption that all individuals are cisgender and the ways in which the social world is constructed to address the needs of cisgender people and to encourage conformity with such norms.”
Clinics can create a “structurally affirming environment” for trans and non-binary people, they say, which helps negate these things – like training staff on using the right name and pronouns for people, having gender-neutral bathrooms available, avoiding cisgender assumptions on forms and posting LGBT+ friendly signs.
The doctors also report that many trans and non-binary people avoid having pelvic exams “due to fear, secondary to personal or collective trauma in healthcare settings”.
“Nearly one-quarter of transgender and non-binary individuals report avoiding seeking healthcare due to fear of being mistreated due to their gender,” they say. “Many trans masculine individuals find pelvic exams triggering of their dysphoria.”
And when it comes to smear tests – the thing that transphobes most hotly contest only women need to have – they add that “trans men are less likely to be up to date on cervical cancer screening than cisgender women, in part due to anxiety about exams”.
“Gender minority people who have a cervix should receive the same cervical cancer screening as cisgender women,” they continue.
“Many transgender and non-binary people assigned female sex at birth feel dysphoria related to their uterus, fallopian tubes, ovaries, and/or vaginas,” they conclude. “Approximately 50 per cent of individuals [will] need of a hysterectomy in the future.
“There is broad consensus in the medical community that gender-affirming surgeries, like hormones, are a medical necessity rather than elective.”