What does IL26-638 have to do with pelvic exams?
The pelvic exam proposal is especially perverse. All major organizations (ACOG, AAFP, USPSTF, AMSSM) advise against routine pelvic exams for asymptomatic adolescent females. The USPSTF goes as far as to say that harms caused by these unnecessary exams include “the psychological harms, pain and discomfort from the examination, and the potential for these to serve as a barrier for women to receive medical care.”
With the recent Supreme Court decision to allow states to legislate trans girls’ participation in sports, Brian Heywood’s recent ballot initiative (IL26-638) is getting more attention. The initiative could require some girls to undergo invasive genital examinations if their eligibility is questioned, something no teen should be forced into.
Heywood suggests that, before they could play sports, girls undergo an invasive genital exam to determine their anatomy, expensive genetic testing to make sure there are two X chromosomes or have their testosterone checked.
Some will find these ideas unhinged, while others will find them offensive and dangerous. The biochemical analysis he recommends is flawed for plenty of reasons, not least the expense of genetic karyotyping (is that going to be popular in our rural counties?) or the huge variability in natural testosterone levels for girls throughout puberty and even throughout the day.
The pelvic exam proposal is especially perverse. All major organizations (ACOG, AAFP, USPSTF, AMSSM) advise against routine pelvic exams for asymptomatic adolescent females. The USPSTF goes as far as to say that harms caused by these unnecessary exams include “the psychological harms, pain and discomfort from the examination, and the potential for these to serve as a barrier for women to receive medical care.”
Washingtonians have a track record of rejecting Heywood’s outlandish but well-funded proposals. I think this will get similar treatment in November. Heywood’s dangerous idea risks direct harm to Washington’s girls; let them play without expensive tests or invasive exams.
Kevin Glover, M.D.
