Screening saves lives

Inclusive language is a favourite topic of right-wingers and bigoted authors: look at what the silly minorities are demanding now! But the reality is that inclusivity can really be a life or death matter.

Writing in the i Paper, Patrick Strudwick talks to deputy House of Lords Speaker Ian Duncan about the death of his brother Sean, a trans man, from ovarian cancer. Duncan is part of a campaign to encourage trans and non-binary people to get screening, and for the system to be more inclusive so trans and non-binary people are not overlooked.

As Strudwick writes:

trans men are automatically removed from GP surgeries’ lists of patients needing smear tests when they register as male, regardless of the extent of their medical transition. Overall, transitioning can reduce the risk of some cancers and increase the risk of others, which in turn can escape detection because no one is looking for them.

The same thing happens with trans women: I get invitations for cervical cancer screening but I won’t for prostate cancer screening; I don’t have a cervix but I do have a prostate.

Anti-trans activists are blaming us for this, claiming that if we didn’t change our gender markers that wouldn’t be a problem. As ever, this is coming from a place of profound ignorance about trans people’s bodies and healthcare. If we don’t change our NHS gender markers then that throws the system into disarray too: our blood tests are returned as abnormal (this happened to me several times) and we are not invited to screenings for things that do affect us, such as breast cancer screening for trans women.

There’s another important issue around this, which is the often appalling way trans and non-binary people are treated by healthcare providers. I know a few trans men who’ve been utterly humiliated by ignorant or openly transphobic healthcare workers, and that humiliation has very understandably made them wary and even avoidant of the NHS.

Screening saves lives, so this is an area where exclusion can kill people. And so can transphobic healthcare providers.

In 2012, former emergency worker Jay Kallio’s doctor didn’t tell him he had breast cancer: he found out by accident when a lab tech asked him how he was coping. As ABC News reported:

Having to find new doctors delayed the start of chemotherapy beyond the so-called “therapeutic window” for his particularly aggressive form of breast cancer.

Kallio was fortunate: despite the late start the treatment was effective. But other people haven’t been so lucky. One of the most horrific things I’ve ever read is the story of Robert Eads, an American trans man who was diagnosed with ovarian cancer in 1996. More than a dozen doctors refused to treat him, fearing damage to their reputation if they were known to have treated a trans person. By the time Eads found a doctor willing to treat him, the cancer had already metastasized to other parts of his body. Despite very aggressive treatment, he died in 1999 aged 53.

I read somewhere that there are two kinds of people in the world: those who think there is too much suffering, and those who think there isn’t enough. The people railing against inclusive language and inclusive services are in the second camp.