New NHS Policy Excludes Women Who Identify as Men from Breast and Cervical Exam Reminders

A new pamphlet released by England’s NHS is causing quite a stir. The 24-page booklet is called “Information for trans people — NHS Screening Programmes” and it explains which preventative screenings people will be invited to receive, and when. The pamphlet covers four different screenings, but the controversy surrounds the first two: breast screenings and cervical screenings. More specifically, the issue is around who is invited to receive them — and who isn’t.

The problem boils down to this: the NHS will invite you to receive screenings — or won’t invite you — depending on which gender you are registered as, and not which body parts you actually have. What this means is that, for example, someone who is biologically female but has registered as male won’t be invited to receive potentially life-saving screenings on her breasts and cervix, even though she has them. And someone who is biologically male, but is registered as female, will be invited to have these screenings, even though he doesn’t actually have female breasts or a cervix.

Now, to be fair, the pamphlet does also express that people should still come in to receive the appropriate tests for their body parts. It is by no means saying that “women” without cervixes should come in for cervical exams, or that “men” with breasts should skip their mammograms. What it is saying, though, is basically that the NHS won’t remind people to come in for screenings if they’ve changed their official gender to one that doesn’t need those screenings. And it will remind people to come in for screenings they don’t need if they’ve changed their official gender to one that does need them.

Personally, I don’t care one way or the other how a person chooses to present himself to the world. It’s not my place to judge him. But I am troubled that the world of medicine, which ought only to deal with biology, is entering the world of psychology.

Whatever a person feels about himself in relation to his gender is his own business. I certainly don’t proclaim to know better than he what’s inside his own head. But what body parts he actually has (even if he wishes he didn’t have them) ought to be the only concern of his doctors. Not for any political or ideological reason. Simply because these tests save people’s lives. And, to me, a person’s life is more valuable than his feelings.

Politicians in England are criticizing the pamphlet. Conservative MP David Davies told The Daily Mail, “This NHS effort to be politically correct is putting the lives of women who claim to be men at risk,” and it’s “wasting the time of men who claim to be women by offering them tests for organs they do not have.” Women’s campaigner Laura Perrins said: “It’s a ludicrous use of NHS resources to invite men for a cervical smear test, while it’s immoral and dangerous not to invite women.”

Whether or not this policy will actually stop people from getting the tests they need remains to be seen. But it does seem to me that it’s an example that gets at the heart of the issue around transgenderism. Because there’s a difference between saying, “I was born a woman but I wish I was a man,” and “I was born a woman but I am a man.” The first statement, it seems to me, could be absolutely true without any harm coming to anyone — except, perhaps, the person in question who, regrettably, feels she was born in the wrong body. The second statement, though, isn’t technically true (particularly if she still has female body parts) and could harm her if her doctors don’t offer her necessary screenings, and she chooses not to seek them out herself.

There is a difference between what you wish, and what is so. And, while I have sympathy for those who wish they were born into a different body, I cannot, in good faith, say that they have that body when they don’t. More importantly (much more importantly) a doctor shouldn’t either. It isn’t about hatred, or bigotry, or fear. It’s about truth. Because, in seeking to understand one another, the truth is usually a good place to start.

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