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Mixed sex wards and trans women.

(633 Posts)
sarsleypage Thu 24-Nov-16 17:46:29

I've opened a new account as the old one was too full of personal bits and someone could've connected the dots.

I am a medical student and we have a diversity lecture coming up, so I had a look at the LGBT slides. A lot of this seems to focus on trans.

I got curious about the requirements for sex-segregated wards, as I know this has been an issue for a while. Women want single-sex wards, both on wards for physical illness and those for mental illness, because they see themselves as vulnerable to abuse from men, especially whilst ill.

Fine. Nobody seems to oppose this, and it's become a requirement in pretty much all hospitals.

And then you see this:

"• Trans people should be accommodated according to
their presentation: the way they dress, and the name
and pronouns that they currently use.
• This may not always accord with the physical sex
appearance of the chest or genitalia;
• It does not depend upon their having a gender
recognition certificate (GRC) or legal name change;
• It applies to toilet and bathing facilities (except, for
instance, that pre-operative trans people should not
share open shower facilities); "

There's an example in the leaflet of a young female nurse refusing to wash a trans person because it was against her religion. This is held up as an example of trans discrimination.

I am struggling to square this away with feminism. In fact, I don't think it does square. Women have fought for this segregated space, based on female sexual characteristics (not a preference for make-up, long hair, but XY/vaginas/generally smaller in stature and weaker). But now, apparently, if you decide you feel like a woman, you're entitled to be on a woman's ward when women are at their most vulnerable.

It means if you're sectioned under the mental health act and a trans woman with a penis is on the ward, you have no legal argument to get them removed to make you feel safer.

How is this right?

sarsleypage Thu 24-Nov-16 17:47:20


WellErrr Thu 24-Nov-16 17:48:09

Well, it's not.

sarsleypage Thu 24-Nov-16 17:50:02

Another example:

"When I was admitted to hospital to have my hysterectomy
the doctor said I would be put in a side room near the
gynaecology ward. She asked me to shave my beard so I
would not embarrass female patients.

On arrival I was given a side room but in the main
women’s’ ward. Nurses would not care for me after my
operation and left me haemorrhaging. When I tried to
leave my room to get help I was corralled in my room alone
and unaided.

I felt stripped of my dignity and humanity by such
insensitive and unprofessional treatment"

What about their dignity? Why has identity politics reduced any argument over rights to who has the rarest characteristic?

sarsleypage Thu 24-Nov-16 17:57:49

"A trans woman, who is a part-time cross dresser, dies in a
road traffic accident while dressed in female role. The police
at the scene establish that none of the documentation on her
reflects the gender in which she was presenting. At the
hospital mortuary, it is decided that as the documents of the
deceased state that they are male, they will be referred to
with male pronouns. This is a sensible assumption to make
as members of her family may not know that she was a cross
dresser. When the wife of the deceased comes to view the
body, all evidence of the gender in which the deceased was
found is removed (for example a wig, make-up, female
clothing). When asked about what happened to the clothes
the deceased was wearing, the wife is told that the clothing
was badly damaged in the incident"

And this - I just don't understand. How is it the job of a HCP to cover up someone's cross-dressing after death?

fakenamefornow Thu 24-Nov-16 18:10:35

I don't know, it seems identifying people by preferred gender and not the inarguably biological fact of sex is creating loads more problems than it could ever solve.

Why do people feel they are the opposite sex in the first place? The trans people I've know have all been MtF and they've all been an almost caricature of a women with overly feminine mannerisms, very glam clothes, hair, makeup and nails always done. I don't know any women who dresses or behaves like that. I guess if they didn't dress like this, with loads of makeup they'd just look like men though. I think it's all quite sad really.

lougle Thu 24-Nov-16 18:13:14

"There's an example in the leaflet of a young female nurse refusing to wash a trans person because it was against her religion. This is held up as an example of trans discrimination."

As a nurse she doesn't have the right to refuse to treat people because of her religion. The only legal right she has (all health professionals have) is limited right to conscientious objection to take part in termination of pregnancy except where that termination is lifesaving, and the absolute right to conscientious objection to taking part in the technological procedures to achieve conception and pregnancy.

There is no right to refuse to care for someone because they have a reproductive organ that doesn't match their chosen pronoun hmm and she's in the wrong job.

Having said that, there is a requirement for single sex wards and we get fined if we have mixed sex breaches, even in intensive care once the patient is ward ready, even if we simply can't discharge a patient to the ward because they don't have a bed.

However, I have always understood it to be a 'mixed sex breach' not a 'mixed gender breach' so until this thread I'd never considered how a trans individual would fit with that system....I'll try to find out.

M0stlyHet Thu 24-Nov-16 18:16:11

Yes, I'm a bit hmm about the washing example - a nurse couldn't refuse to wash a male patient because of her own religious beliefs - giving bed baths is part of the job - so would have no grounds for refusing to wash a MTT patient either. That strikes me as the sort of made-up example designed to get the Daily Mail frothers out in force, which doesn't really help people to have a sensible, reasoned discussion of the issues.

lougle Thu 24-Nov-16 18:19:13 This is from Department of Health 2009 policy. Gender comes above sex.

ErrolTheDragon Thu 24-Nov-16 18:27:22

yes - in that example, if the nurse would wash any other male-bodied person (as her contract presumably requires) then refusing to wash the trans person would (for once) be a genuine case of trans discrimination.

But apart from that - single sex wards should be single-sex wards. Trans people should be treated with sensitivity, maybe using side rooms on the correct sex ward but treated properly, the example of the FtM having a hysterectomy sounds bad.

sarsleypage Thu 24-Nov-16 18:27:59

I don't know, it seems identifying people by preferred gender and not the inarguably biological fact of sex is creating loads more problems than it could ever solve.

Exactly, at what point as a society do we admit that this has gone too far? All the extra stuff in place to avoid hurt feelings is denying basic biology.

First there was the theory that "gender is different to sex" but now it's all become blurred again, and apparently declaring male/female sex at birth is "doctors assigning a gender" and is a form of oppression.

I'm young, I went through a right-on phase of going along with it all, but I can't any more. It makes no damn sense.

Apologies for the thing about nurses - I had no idea you had to wash male/females. I know that doctors can get another doctor to examine a patient if they feel uncomfortable about it, and assumed it was the same across the board.

lionheart Thu 24-Nov-16 18:29:25

'A person who is Transgender is someone who expresses
themselves in a different gender to the gender they were
assigned at birth.' Gets off to a bad start.

TheMortificadosDragon Thu 24-Nov-16 18:29:29

If you're in the health service, suggest you write to your MP about this before the upcoming debate.

sarsleypage Thu 24-Nov-16 18:31:17

If you're in the health service, suggest you write to your MP about this before the upcoming debate.

I'd feel uncomfortable attaching my name to anything that could be seen as "transphobic", which is apparently any criticism of trans. I think it could damage my career.

I don't even feel able to challenge the rhetoric in class.

Seachangeshell Thu 24-Nov-16 18:37:13

Hi OP - I understand your first post but I'm not sure your examples are very good to be honest. The one about the patient having a hysterectomy sounds terrible. If the patient was really refused care because they are a Trans man then that is awful. Being left to haemorrhage is obviously completely unacceptable. The patient was also on the correct ward because they are biologically female. Where else could they go if they've had a hysterectomy?

M0stlyHet Thu 24-Nov-16 18:39:34

Though there is probably a grey area here re. examinations from the view of the HCP - if a male doctor has to give a female patient an internal exam, they will get a female nurse in to chaperone them (and presumably vv for a male patient and female doctor). What would be the rules for pre-op trans people?

sarsleypage Thu 24-Nov-16 18:41:23

I wasn't really talking about the haemorrhaging (which is obviously awful, if true).

It's more the idea that a bearded person on a female ward, full of women undergoing gynae, should just be accepted without question. The lack of empathy as to why someone might tell that person to shave their beard for the dignity of the women there.

If the person is presenting as male, being on a female ward is really not appropriate and I can see why a side room was used. But it seems that wasn't enough either and somehow the use of a side room is being blamed for a post-op complication?

M0stlyHet Thu 24-Nov-16 18:42:53

Should say that would be "with the patient's consent" - I've had urgent gynae problems in the past where I just wanted it looked at and didn't care what the sex of the doctor doing the exam was - but the doctor, understandably, went to fetch a chaperone. Though again, that opens up a whole range of issues - what are my rights as a patient if confronted by a female-identifying doctor with five o'clock shadow and an adam's apple? (Weirdly, I realised when having a mamogram recently that my own feelings about this are all over the place - I have had vaginal exams from male doctors in the past and not been in the slightest bit bothered, but it struck me I would feel strangely vulnerable having a breast exam from a male doctor - I have no idea why I feel this way.)

OrangeSquashTallGlass Thu 24-Nov-16 18:44:16

I'm a bit confused as to your point of view to be honest and I'm unsure what you want to prove with the example of the patient left to haemorrhage. It's a terrible story and should never have been allowed to happen.

sarsleypage Thu 24-Nov-16 18:46:04

Sorry if it's not clear to you. I guess my PoV is that if you segregate wards by sex, they should be segregated by sex and not gender. Whereas the trans literature insists on segregation by gender. I don't see how this is fair to women.

OlennasWimple Thu 24-Nov-16 18:46:24

Those examples raise lots of interesting questions.

FWIW, I agree that a nurse should not be allowed to cite religious reasons for not washing a transperson. If her religion prevents her from doing her job properly, she shouldn't be in that job. The FTM appears to have received appalling treatment.

I'm not sure how police and others could establish that someone was a "part time cross dresser" from such limited information, but I don't have a problem as such with them behaving in this way: I suspect that they might do similar if the individual had been in an accident with someone with whom they were clearly romantically involved but not their wife. Ie use some discretion with what they share with next-of-kin. It's not their job to keep secrets, but neither is it their job to share personal information without agreement to do so when it can easily be avoided.

The guidance says that open showers should not be used by pre-operative transpeople - a telling recognition that there is a tension inherent in their policy...

sarsleypage Thu 24-Nov-16 18:47:34

The guidance says that open showers should not be used by pre-operative transpeople - a telling recognition that there is a tension inherent in their policy...

This also stood out to me because I thought that the position was generally "you have no right to know about my genitalia" and that pre/post op terminology is now unacceptable?

Seachangeshell Thu 24-Nov-16 18:51:13

I'm afraid you are confused sarsley. The Trans Man having a hysterectomy was born a woman. They are biologically female. That's why they had a womb so that's why they had to go on a women's ward. They were on the correct ward according to their biological sex.

OrangeSquashTallGlass Thu 24-Nov-16 18:51:18

As a medical student what do you think - In the case of the patient who was left to haemorrhage for example, what set up do you think would have been best? A bed on a male ward or female ward?

sarsleypage Thu 24-Nov-16 18:53:33

I think the side room was the right decision, and without further information I wouldn't have any idea whether it led to side effects. Often very sick people (contagious illnesses) are in side rooms and there is no evidence that this leads to further complications..

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