Women who believe they are men are not being offered routine NHS screening for breast and cervical cancer amid fears that it might offend them.

But astonishingly, an official guidebook states that men living as women are being invited for cervical smear tests – even though they do not have a cervix.

The advice, spelt out in a 24-page booklet published by Public Health England, was last night described as politically correct ‘lunacy’ which was putting lives at risk.

Women who believe they are men are not being offered routine NHS screening for breast and cervical cancer amid fears that it might offend them but men living as women are being invited for cervical smear tests – even though they do not have a cervix

Cervical cancer claims the lives of 900 women a year in Britain.

But without the NHS screening programme, the number would be four times higher.

Meanwhile, breast cancer screening is thought to save 1,300 lives annually, according to an independent review of the NHS mammogram programme.

Screening saves lives by spotting cancer early, when it is possible to treat the disease successfully.

Those not screened are more likely to go on to develop advanced cancer, which is almost always fatal.

The PHE booklet, NHS Screening Programmes – Information For Trans People, ‘explains who we invite for screening’.

Trans people who register with their GP as being their birth sex will automatically be invited to screening appropriate to that.

But if they register as their ‘new’ gender, they will not be.

So if a trans man – who was born female – registers as male, he ‘won’t be invited for breast screening’ at 50.

Likewise, it tells those born as girls: ‘If you are registered with a GP as male, you won’t be invited for cervical screening.’

Most trans men do not have their wombs removed – only a small number have full sex-change surgery.

However, if a trans woman – born male – ‘registers as female, you will be routinely invited for cervical screening’.

Trans health adviser Aedan Wolton, who features in a related NHS Choices video, said smear tests could be uncomfortable for ‘trans masculine people’ – born female – as it challenged how they perceived themselves.

‘This is unsurprising as the experience is often a very gendered one; from the waiting room, to the words used during the smear, it is often a procedure designed for women,’ he writes in an accompanying blog.

Conservative MP David Davies, who has campaigned against Government plans to let people legally ‘self-identify’ their own gender, said: ‘This NHS effort to be politically correct is putting the lives of women who claim to be men at risk.’

It was also ‘wasting the time of men who claim to be women by offering them tests for organs they do not have’.

Women’s campaigner Laura Perrins said: ‘We’ve now got to the point where state collusion with this transgender agenda is endangering the health of women.

'It’s a ludicrous use of NHS resources to invite men for a cervical smear test, while it’s immoral and dangerous not to invite women.’

The advice, spelt out in a 24-page booklet published by Public Health England, was last night described as politically correct ‘lunacy’ which was putting lives at risk

The PHE booklet is the latest in a series of official documents that cast aside normal biological definitions apparently to avoid offending transgender individuals.

Last year, The Mail on Sunday told how the British Medical Association had advised its 160,000 members not to call pregnant women ‘expectant mothers’, but ‘pregnant people’ instead.

It is not just trans men who could miss out under the screening protocol.

Men living as women will not be invited to a vital screening test, too.

When they reach 65, all men should be asked to attend an ultrasound scan to check if they are developing a blood vessel defect called an abdominal aortic aneurysm (AAA).

AAAs are six times as common in older men than older women.

If left untreated the artery can rupture, with fatal consequences.

PHE’s booklet warns: ‘Any trans woman [born male] will have the same risk as a man and should consider accessing screening.’

But it goes on to say: ‘If you are a trans woman aged 65 who is registered with a GP as female, you won’t be invited for screening.’

By contrast, trans men – born female – who identify as male will be invited, even though they do not have a raised risk of AAA.

What is biologically suitable, in terms of screening, is not always straightforward.

Trans men who have had their uterus and cervix removed do not need smear tests; while trans women who have grown breast tissue after taking hormone therapy will need mammograms.

Public Health England last night said that screening invitations were automatically sent by computer, based on patients’ registered age and sex.

Director of screening Anne Mackie added: ‘Following engagement with the LGBT community, we produced a guide to help trans people understand what screening is available in England.’

Bernard Reed, of support group Gender Identity Research and Education Society (GIRES), praised PHE, saying that its booklet ‘provides valuable guidance’.