One of the little joys of technology is that whenever I need to re-order my prescriptions, I can use the Patient Access app. It lists all my prescriptions and I simply tap the ones I need, and a few days later the pharmacy texts me to let me know they’re ready.

If I weren’t trans, I’d be able to use the same app to renew my seven-years-running prescription for HRT patches. But I can’t, because my GP refuses to prescribe trans women’s healthcare. Signing off on the same patches, and the same strength of patches, that my GP routinely prescribes and monitors for women who are not trans is suddenly too complicated and risky and beyond their competence.

So instead of tapping two or three buttons in Patient Access, every four months or so I have to get up, walk past my GP surgery, get on a train to the city, walk through the city centre, meet a pharmacist, walk back, get the train, walk past my GP surgery, wait a few days for the prescription to come through, walk down to the pharmacy just round the corner from my GP and get my perfectly ordinary medication.

This is a pain in the arse, and discriminatory, and degrading. But at least it’s not a potentially fatal problem.

A trans woman posted this on Bluesky while I was travelling back from my pharmacist meeting.

Just got a call from a lovely but very nervous Dr, who advised I wouldn’t be routinely screened for breast cancer because I’m not indicated as being “biologically female” on the central NHS database and my biology wouldn’t indicate I’m at risk. My records have been altered, which is upsetting.

Apparently they had discussions in the NHS recently and now I’m classified as biologically male. She didn’t even understand that I have been on HRT for 20 years and am biologically female in all important ways – I had to explain that to her.

She’s based in England, so it’s a different part of the NHS. But it’s the same issue: parts of the NHS treating trans women differently from women who aren’t trans. And in this case, that’s very dangerous.

I don’t want to dazzle you with my incredible in-depth medical knowledge here, but the thing that most increases your risk of breast cancer is… having breasts.

Men can get breast cancer too, of course – hence why it’s sometimes referred to as chest cancer, so men won’t be too embarrassed to check themselves and seek help if they find anything concerning – but it’s comparatively very rare. Whereas if you have breasts rather than just a chest, your risk is much higher. Trans women’s risk isn’t as high as the risk for women who aren’t trans. But it’s still much higher than for men.

And this is the problem when anti-trans rhetoric meets medical reality. “Biologically male” is a bullshit term pushed by anti-trans weirdos to yet again separate trans women, a term rejected by doctors because they know that what matters medically is the biology you have now, not the biology you were born with.

But thanks to anti-trans activists’ billionaire-backed insistence that butterflies must always be classified as caterpillars, we’ve got this ludicrous situation where women with the two most important risk factors for breast cancer – breasts and estrogen – are being excluded from screening.

Trans women’s bodies are not identical to the bodies of women who aren’t trans (which is why I opted out of cervical cancer screening invitations, as I don’t have a cervix). But they’re not identical to men’s bodies either, so in the case of my body I have zero risk of testicular cancer and an elevated risk of breast cancer. So by insisting that we ignore people’s bodily reality, the anti-trans idiocy genuinely puts trans women in danger – danger we had already addressed, danger that is clearly understood, danger that we have (or had) systems in place to minimise.

Removing trans women from important health screening won’t do anything to improve a single woman or girl’s healthcare. But what it will do is put trans women’s lives at risk. For many in the anti-trans movement, I think that’s considered a bonus.