Women ‘risk health over trans NHS workers fear’ The Times 18.12.18

The original article is here.

Campaigners have raised concerns that a new policy which allows male doctors to self-identify as female is deterring vulnerable women from visiting gynaecologists.

A handful of women claim that they have cancelled, delayed or felt uncomfortable during cervical cancer screenings because they were anxious about being presented with a healthcare worker who had transitioned to female.

A survey of 2,000 women by the campaign group Women and Girls in Scotland invited respondents to say whether they had ever excluded themselves from a service because of gender concerns.

One woman wrote: “I’ve already missed three smear tests because I am so scared of being presented with a male nurse.” Another said: “The NHS currently try whenever possible to provide me with female healthcare providers due to my traumatic history. If their definition of female and mine changes, it means that I’m unlikely to access medical care.”

One health board, NHS Lothian, said that it was unable to guarantee that female-only care would not be undertaken by a transgender doctor. It said in response to a freedom of information request: “Unless the practitioner consented, to exclude them from carrying out female-only care would be a breach of section 22 of the Gender Recognition Act 2004, and a criminal offence. There are also restrictions under the Equality Act 2010 around requiring staff to disclose their gender identity and staff selection on this basis.

“For these reasons, NHS Lothian does not have any policy to guarantee that a legally female member of staff carrying out female-only care as requested by a patient, will be biologically female.”

A spokeswoman for Women and Girls in Scotland, which is campaigning for transgender women to be excluded from carrying out female-only healthcare, said that the policy “could prevent women from accessing potentially life-saving healthcare”.

James Morton, manager of Scottish Trans Alliance, said he recognised that trauma from sexual abuse could mean some individuals required intimate examinations to be carried out by women who were not transgender.

He added: “We would seek to reassure such individuals that, while trans people have the right to privacy about their gender reassignment history, all patients have the right to choose the particular healthcare professional that provides their smear test. This could be done by booking their smear test with a named nurse or GP they know and trust. Alternatively, they could inform the NHS that they require the person not to be transgender and the NHS could then discreetly arrange for a healthcare professional who is known not to be trans to do the smear test.”

Attendance at cervical screening appointments is at a ten-year low in Scotland. Across Britain, three quarters of women who had experienced sexual violence did not attend or delayed screening, according to research published by Jo’s Cervical Cancer Trust, a charity. There is no evidence to suggest that concerns about the gender of medical staff is responsible for significant numbers failing to attend smear testing.

A 38-year-old charity worker from Aberdeenshire, who wished to be identified as Jessie, had experienced sexual violence and had missed a smear test as a result. She is autistic and has post-traumatic stress disorder. “I talked to friends who go to sexual health clinics and are able to use the speculum and this seemed like it would work,” she said. “However, there is no way I could do this in the presence of somebody I perceived as male. I prefer women’s healthcare to be delivered by women who have experience of the issues that can arise from genital contact in a healthcare setting.”

“Charlie”, a 47-year-old writer from Fife, was sexually assaulted as a teenager and suffers flashbacks when put in a vulnerable position with a man. “To be told that I can’t be guaranteed female-only care and I won’t be told when that might not be achievable — those are both real violations of my trust in the health service,” she said. “If someone is telling me they’re female, when I can see that they’re male, I’m already thinking the worst. They’re already lying to me. I would leave.”