Who cares if only women have a cervix?

“Do only women have a cervix?” has become a front in the culture war. Both the Prime Minister and the Leader of the Opposition have been asked and, after a fashion, answered. Prognostications about what Keir Starmer’s answer means for Labour’s electoral chances have been made. The best answer so far from a sitting politician has been from Emily Thornberry; “My cousin has a cervix and he is a man.” What has received relatively little attention is why any of this matters.

How did we get here?

In August last year, TV talking head, person without a cervix and inveterate arsehole Piers Morgan waded into the conversation about the cervix. He took exception to a Tweet summarising a statement by the American Cancer Society on cervical cancer screening, one assumes because as a failed newspaper editor he is eminently qualified to speak on matters oncological and gynaecological.

I’ve written on my old Wordpress blog about the bigotry underlying this incident and I won’t be revisiting those arguments here. Enter Rosie Duffield, Labour MP, who liked Morgan’s bigoted and nonsensical Tweet and, when challenged on this, responded “I’m a ‘transphobe’ for knowing that only women have a cervix?!” From here, Duffield continued to claim to be unfairly persecuted for the criticism she faced, insisting that the trans people of various genders who objected to her scorn for efforts to include trans men and nonbinary people in cancer screening programs were really picking on her for being a woman.

This row continued over the following year or so, culminating with Duffield claiming that the “abuse” she had received caused her to choose not to attend the 2021 Labour Conference shortly before appearing at an unofficial fringe meeting at the 2021 Labour Conference. This furore led to the question of cervixes and gender becoming a key question of the party conference season.

Who cares?

The question “Do only women have a cervix?” is very carefully phrased, strikes at the heart of a great deal of cis people’s discomfort with trans identity and is amazingly boring. You could simply reword it as “are trans men men and nonbinary people nonbinary?” To which the answer is, clearly yes, but why are we talking about the cervix?

For trans people of all types of bodies, accessing traditionally gendered healthcare, like pregnancy care, many types of cancer screening and sexual health services can be a minefield. We often face unnecessary delays, faulty assumptions about our needs and wants and unequal treatment, as well as outright hostility and transphobia. Trans men and nonbinary people who need cervical cancer screening are simply not receiving the same quality of healthcare that cis women seeking the same services are.

I think the hospital had said ‘Why have you sent us this guy?’ and she said ‘Haven’t you read the paragraph that came with it? This is a trans man, he still has a vagina, he needs screening’ — Jamie, a transgender man from Hull

NHS systems are often simply not designed with trans people in mind. Automated reminders for cervical screening, for instance, are not sent to trans men unless they are registered as female. Being registered as our assigned at birth sex carries its own risks; this outs us by default, no matter the relevance of our transness to any particular appointment, often leads to discriminatory treatment when our presentation doesn’t match what is written in our files and often simply fails to account for the different needs trans people may have (a trans woman, for instance, might need both breast cancer and prostate cancer screening). This situation that could be avoided simply by designing databases that can easily record which men have cervixes (or which women have prostates, for that matter) instead becomes a danger to trans lives. We are presumed not to exist and our existence is put at risk because of this.

Last month, the trans rights organisation TransActual released the results of their Trans Lives survey. 1 in 7 (14%) trans people reported being outright refused GP care because they were trans. 3 in 10 (29%) reported that they were refused care for gender/sex specific health issues. The reduction of trans access to appropriate healthcare to another culture war talking point distracts from this disturbing inequality.

What is framed as a question about biology serves to stop us from talking about what we really need as transgender people, the biological realities of being us. Powerful politicians sit in television studios alongside pundits pontificating about the validity of trans identity while trans people die of preventable cancer.

Do only women have cervixes? Why are you asking me that when trans men and nonbinary people are dying of cervical cancer?