The HSE has released a new update to their literature regarding Cervical Cancer screenings stating “Anyone with a cervix between the age of 25 and 65 should go for regular cervical screening when it’s due.” This inclusive language has started a firestorm of debate that questions the movement to erase women, and the rights of transgender people. As this new literature has been released TENI feels it is important to discuss the topics at hand and how this debate has helped and harmed the transgender community across Ireland. 

First and foremost, TENI was not involved in the wording released by the HSE. TENI has chosen to speak because the debate has a direct impact on the transgender community’s access to affirming healthcare. As TENI has reviewed the statement we believe that healthcare should be accessible to everyone. TENI also welcome’s the HSE’s explicit inclusion of transgender men and the phrasing “anyone with a cervix” as that further includes non-binary and intersex people across Ireland. In general, this update is a statement of inclusion, and will help many transgender people get the care they need without fear. Trans men will not face discrimination when they need to go for a screening, and they will hopefully be met and cared for by affirming doctors, nurses and staff. 

As it has been stated by many that the HSE has erased women from the website and literature and stated by a guest on Liveline that it has been removed we must also highlight how that is not the case.

https://twitter.com/Salwicklow/status/1305967737563422720

As TENI stated on Liveline we also believe that the HSE should be inclusive in all of its healthcare literature, not just cervical cancer. Furthermore, TENI believes and stated the HSE would do well include “women, transgender men, intersex and non-binary people with a cervix.” This explicitly inclusive language could be then be carried forth across the range of services that intersect with the transgender community. However it is important to note at this stage, the debate is not about the erasure of women at all, but seems to be questioning why transgender people are being included.

In particular, the HSE continues to explicitly include the word women in much of their literature such as the Women’s Charter on the Cervical Check site. This charter document states “Cervical Check offers free cervical screening to all women aged 25 to 65 years”  and therefore shows that the HSE has a commitment to include women in their need for cervical screening. When searching for cancer care on the HSE website the HSE again lists  “BreastCheck- free breast x-ray for women aged 50-64 years every two years” and “Cervical Check smear tests for women aged 25-60 years” both of these services are services that would be accessed by cisgender, transgender, non-binary and intersex people. So the HSE is not erasing women as we see many places on the website continue to centre these conversations around women’s healthcare. Therefore the new statement includes many more people and should help more individuals understand their treatment. 

As the debates have continued into this week much of the HSE website was not the focus. Debates centered around the rights of transgender people to affirming services and even to deny the reality of transgender identities. Statements were made that one’s body parts are what dictates their gender, and to include anything other than men or women is harmful. One Twitter user tweeted TENI stating:

“Well you certainly don’t stand for women do you, we all know that. Trans people are either men or women, people with a cervix are women. Woman/women, that’s all you need say, women who identify as men are still women and they know it. You have no problem saying men or trans though”

https://twitter.com/DigsyOtrb20/status/1307432516970786822

Again, these harmful statements are being directed at those that did not change the wording. Worse yet, these statements are being sent to members of the transgender community online forcing many to worry about their safety as some have even received violent threats. As the debate began about the proper inclusion of a word it has morphed into a debate about transgender lives. These beliefs and statements by those upset at the HSE show a deep misunderstanding of transgender lives and the state of transgender healthcare worldwide.

Transgender people have had to advocate for access to healthcare for years, and now as services become more inclusive we are seeing an unfortunate backlash against transgender people. What the HSE is doing is showing that it seeks to be more inclusive. They are making a determined step to better care for all people. By using inclusive language the HSE is making sure its facilities, and care providers are educated and affirming. They are also committing to care for the health of all. What is disheartening to see is a debate about the erasure of women really become a platform for hate against transgender, non-binary, and intersex people.

The HSE website still includes the word women in much of its literature in print and online. Using online platforms to target harassment toward transgender people in an effort to support the word women does not show concern for better healthcare, or for affirming care for all, it shows a platform to denigrate transgender people. 

The debate has moved from including all to stating that the HSE and the transgender community are lobbying for a healthcare system that restricts the access of women to healthcare. That is not the case. The HSE using the phrase “anyone with a cervix” is truly inclusive of the range of gender identities that have a cervix and shows a commitment to care. Furthermore, the HSE specifically has sections of the website that mention women with a cervix and care for trans men. Moving toward “anyone” is a move toward the gender diversity present in Ireland. 

TENI understands the challenges of healthcare. It is a key foundation of TENI’s work to educate and train members and health care providers for the HSE and TENI has highlighted how beneficial affirming and inclusive care can be. TENI has been devoted to helping remove those barriers to care. The organisation hosts fifty health training seminars per year, and hosts the Gender Identity Skills Training Conference for national and international healthcare providers. Working for a more affirming and inclusive healthcare system is a value we hold dear. Within this very debate TENI would support the right to affirming and timely healthcare for all, and the removal of barriers that could hinder service. We support as we did publicly the inclusion of the wording women, trans men, intersex and non-binary people with a cervix to be explicitly inclusive.

As the week has progressed this debate, unfortunately, has descended into providing a platform for transphobic beliefs and statements to be made. It has moved beyond making an inclusive statement to questioning who has the right to healthcare. TENI stated publicly it is our goal for any wording to be inclusive. However this weekend an attempt was made to align TENI with beliefs that are harmful to our community and TENI can not stand silent in the face of that. We would again recommend explicitly inclusive wording for literature across the board by the HSE highlighting that women, men, trans women, trans men, intersex and non-binary people all have many of the same healthcare concerns and all need to be given a safe and affirming place to receive that care. 

TENI believes transgender people have a right to affirming healthcare, and the HSE’s recent policy update moves toward affirming and informed care for all. Additionally, the HSE still highlights the healthcare needs of women across its platforms as cited. We are disappointed much of the debate has centred around transgender people’s identity and lives. We are disappointed that those who call for inclusion are also attempting to inspire others to target transgender people and threaten their safety and health. Transgender people simply want to receive affirming care and to live freely. Our lives are not to be used to further a political agenda, or for Twitter tantrums. The HSE is working toward inclusive policies, and TENI believes that the inclusion of transgender and gender-expansive people in literature and websites on healthcare is a step toward better healthcare.