BY Sam Harris
01 Jun 2022

Healthcare As It Happens - Pride Month

Smear Tests for Trans Men

Within the NHS, invitations for cervical screening tests, designed to prevent cervical cancer, are sent out every 3 years between the ages of 25 and 49, and then every 5 years from ages 50 to 64. These automatic invitations are sent on the basis that you are registered with the GP as female. This means that if you are a trans man, and are registered as male at the GP, then you will not receive these invitations. The NHS have responded to this exclusive practise by inviting trans men to book smear test appointments with their GP. However, this may not be as easy as it sounds.

Dr Laurie Hodierne described the process as “exhausting”, despite having an expert understanding of the language and the systems, he explained that others may find it more difficult to navigate the cervical screening system. He described the system to BBC news as “healthcare inequality”, in the sense that anybody with a cervix can get cervical cancer, but not everybody has access to the tests in the same way, or with the same ease. Visit the BBC article “My exhausting smear test battle” for the full story.

In a 2019 study, Dr Alison Berner interviewed 137 transgender and non-binary people at her practise, discovering that half of which were eligible for a smear test. The study then revealed that 40% of that half had never been to a screening.

The “brick wall” that Dr Hodierne describes facing is not uncommon, as transgender and non-binary people continue to face stigma and discrimination within the healthcare service. Clinical lecturers Dr Crissman and Dr Stroumsa explain that many non-cis people avoid cervical tests due to fear or due to a previous trauma within healthcare, and many others report that cervical tests trigger their gender dysphoria, whilst others worry about how their gender identity will be received within the GP, along with fears of being mistreated, mis-gendered, and dead named. Reception staff and the sample taker especially play a pivotal role in creating a welcoming and educated environment, that can calm these widespread fears and decrease stigma around smear tests, especially for trans men.

For more information on the regulations, visit the NHS page on screening for trans and non-binary people here.

Conversion Therapy Ban not to Include Trans People

For England and Wales, conversion therapy, the practise that attempts to alter somebody’s sexual or gender orientation, was deemed an “abhorrent” practise, and has remained in our society having rooted itself in generational homophobia and widespread ignorance. Frequently referred to as the ‘gay cure therapy’, more than 15% of trans Londoners have either been offered or have experienced the abusive practise of conversion therapy, and a further 2017 study suggested that 5% of the LGBT+ community had undergone the conversion therapy in the UK.

The Government’s pledge to ban conversion therapy was first introduced in 2018 under Theresa May, and in March 2022, it was revealed that Boris Johnson had dropped the plans completely. After facing immediate backlash from the general public, Johnson reinstated the pledge but introduced a shocking U-turn – that the legislation would not cover trans people, effectively only banning gay conversion therapy. For more information, visit the BBC article on “what is conversion therapy and when will it be banned?”.

Now, the government plans to outlaw conversion therapy for sexual orientation, whilst allowing the practise for gender orientation to continue. The plans have been criticized by charities such as The Rainbow Project, and MP Nadia Whittome said the legislation was “not good enough”, adding that “LGB comes with the T".

In some religious households, conversion therapy can be a very real threat to LGBTQ+ youth – who are often subjected to the practise without them even knowing, resulting in feelings of isolation, confusion, trauma, and can ruin the lives of those who have survived it.

Watch this clip as popular and talented drag queen Mo Heart offers some heartfelt reassurance to the trans youth of today.

Asexual Inclusivity

When it comes to sexual orientation, and LGBTQ+ discourse, asexuality is something that we don’t hear mentioned very often. Although not exclusive to the ace community, sexual and romantic orientation often become two separate things. Asexual is a term used to describe those who experience a lack of sexual attraction towards others, but may or may not experience romantic attraction as well. It is suggested that about 1-3% of the population are asexual.

Firstly, it’s important to note that asexuality is not the same as celibacy. Celibacy, unlike a sexual orientation, is a choice, whereas asexuality is not. Another key component to understanding asexuality is that not all asexual people are celibate, and vice versa. Asexuality speaks more to drive and desire, rather than behaviour or action.

In terms of the LGBTQ+ community, it is often debated whether the asexual orientation is a part of the community or not. The main argument in favour of excluding the orientation falls largely on the fact that historically, asexual people haven’t appeared to have had faced the same systematic oppression that gay, bi, lesbian, and trans people have. With that said, it is important to remember that asexual people also face the same abusive conversion therapy that bi, lesbian, gay, and trans people have historically been (and still are) subjected to. In the UK’s 2019 national LGBTQ+ survey, it was revealed that 10% of asexual respondents had either been offered or had undergone conversion therapy. More information on the ace community can be found on the Stonewall website.

There is also the case that an asexual person with a heteroromantic preference would still fall under the heterosexual category. Interestingly, up until 2013 the Diagnostic and Statistical Manual of Mental Disorders (DSM) had stated that “low sexual desire” was a symptom of either Male Hypoactive Sexual Desire Disorder or Female Sexual Interest/ Arousal Disorder. Essentially, asexuality was classed as a mental disorder, which naturally faced backlash from the ace community.

The DSM then revised these entries to include that self-identification as asexual would exclude you from any mental disorder diagnosis, finally recognising that asexuality is not something to be cured, and that the asexual community are valid and real. Michael Doré of the Asexual Visibility and Education Network (AVEN) encouraged those who feel isolated to join an asexual community, either via AVEN or other LGBTQ+ organisations such as My Umbrella.

A Brief History on HIV and PrEP(Pre-Exposure Prophylaxis)

In the September of 1982, the CDC, centre for disease control and prevention, used the term AIDS in reference to Pneumocystis pneumonia, for the first time. This would also be later referred to as the HIV virus. By the end of the year, AIDS cases had been reported all over Europe and America. By 1983, AIDS was widely recognised as the ‘gay plague’ for the way in which it largely only effected gay men. This almost immediate classification of the disease was the beginning of an age of public stigma, homophobia, and fearmongering, and continues to this day. 

In the UK, Terrence Higgins was the first named person to die of the HIV virus, in 1982. Now 40 years since his death, attitudes towards HIV have remained largely the same – according to research carried out by the Terrence Higgins Trust. More information on Terrence Higgins can be found here. This research claimed that only 30% of British people said they would be comfortable dating somebody with HIV, with only 21% of those saying that they would be comfortable having sex with somebody living with HIV that was actively treated. You can find more on Terrence Higgins and HIV treatment here. For more details on the history of the virus, the History of HIV website can be found here.

HIV is treated with antiretroviral medicines, that stop the virus replicating and allows the immune system to repair itself. Often times people need to take different medications due to the way that HIV can quickly adapt, with up to 4 different medications needed to be taken each day. Treatments continue until your viral load (the amount of HIV in your blood) becomes undetectable, ultimately preventing you from transmitting the disease. The NHS provides more information on HIV treatment here,

Trans Community Barred from Sport

Last month, swimming as an international sport became the third to exclude transgender people from competing. The International Swimming Federation (FINA) has revealed that new guidance will allow trans women to compete on the condition that they have not experienced male puberty before the age of 12.

Athletes such as Chris Mosier have spoken out against the exclusionary trans rule in sport, describing it as outrageous, unscientific and discriminatory. There are several factors that can impact sport on a performance level, but the case remains that transgender sport research is still young, and remains under scrutiny by many. Dr Joanna Harper estimates that we may not have definitive answers for at least 20 years. You can find more on this on BBC article “Transgender athletes: What do the scientists say?”.

The decision to require puberty blockers and other treatments before the age of 12 not only excludes a huge majority of trans women already, but also puts unethical pressure on children who are still exploring their gender identity.

In terms of mental wellbeing, a UK study looking at LGBTQ+ people in sport, carried out by Outsport in 2018, revealed that 82% of their respondents (5,524) had witnessed homophobic/ transphobic language in sport, with only 8% of the respondents reporting these incidents. For many in the community, the fear of harassment, abuse or exclusion is enough for them to remain silent. Furthermore, many aren’t aware of the resources available in these situations.

For a huge number of people, sport and staying active are key components to maintaining both physical and mental wellbeing, and for those whose very existence is constantly under debate, more needs to be done within the sporting world to be more inclusive, accessible, and safe.

You can find more information on the latest FINA guidelines on the Mermaid’s website.