”Trans women also have a lot of important issues with medical autonomy and safety…”
I have personal experience with this. After my vaginoplasty, my surgeon was quite insistent that I needed a good gynecologist. No problem, there are lists in the phone book and on line, but almost all had no interest in treating “men”. Ultimately I found a large practice associated with the Medical School of the local University. After some uncertain hemming and hawing, they gave me an appointment with a local practitioner—a male midwife!? At least I had found someone to provide some kind of care, though I was unsure how his specialty applied to my needs. It was unlikely i would ever need his particular area of expertise.
After I set up the appointment I asked my local transgender support group if anyone knew of a trans friendly gynecologist who migh accept me as a new patient. One of the trans MEN in the group suggested a female gynecologist with superior credentials and a good reputation in the trans community who had done his hysterectomy and continued to provide follow up care. I called the doctor for an appointment and was surprised to discover that she was part of the same group that had assigned me the midwife. I asked for an appointment with her instead. Reluctantly I was given one when I insisted, though I felt like they thought they were wasting their resources on a MAN. And this is allegedly a trans friendly practice.
What the scheduling staff did not understand, or just didn’t care about, is that I have the same potential health issues as any woman who has had a hysterectomy—UTI’s, vaginal dryness, infections, vaginal cancer, and other potential problems. I have the additional challenge of needing treatment for granulation, should it occur (It has though is being treated by my surgeon for the present until she can hand me off to the gynecologist). I also have potential issues not faced by cis women, including vaginal stenosis and loss of depth requiring possible revision surgery. My needs are just as complex as any older cis woman, in some ways even more so.
Given the hurdles I have had to overcome to access standard female medical care by a group supposedly sympathetic to, and trained to understand and deal with, the issues presented by the trans feminine community, I shudder to think what I would have to go through if the politicians were to get involved as well. A scary thought.
