Help! FOI request - trans guidance in NHS in South West

[anotherFOIrequester]

Inspired by our Welsh FOI-requesting sister, I have started submitting my own, focusing on guidance on trans issues in the NHS:

www.whatdotheyknow.com/request/guidance_on_supporting_trans_peo

As it turns out, the guidance and the agenda of the meeting at which it was presented are publicly available here:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_5Nov19_item6.4.pdf

Now that I have read the guidance, the second FOI question (has this guidance been formally adopted?) is even more important. If the local NHS CCG (Clinical Commissioning Group) adopts this guidance it will have a negative effect on women, children and young people.

If you're in Bristol, North Somerset or South Gloucestershire please have a look and if you agree, ask them not to adopt it:

[email protected]

From the meeting agenda:

Risk and Assurance:
No specific risk implications

How does this impact on Equality & diversity:
The toolkit has been produced in partnership with a range of
equalities groups and professionals, and aims to reduce inequalities
and challenge the discrimination trans people face.

No mention of women and our needs here or anywhere in the guidance itself. Any disagreement with eg a male on a female ward is framed purely and only as 'transphobia' with no consideration of the needs of female patients or any trauma following male violence they may have:

'Forcing a trans person to use a single-sex ward that does not conform to their gender identity is likely to have a catastrophic effect on their emotional wellbeing. The needs of the patient need to be given priority.'

'Providing education to other service users in a ward to prevent ignorant or transphobic comments is, if succesful, a better solution than having to protect or isolate the trans service user'.

There are many quotes from (of course) Stonewall, and also from the 2016 Parliamentary Inquiry - without any acknowledgement of the way the ground has shifted since then, or of the much more recent PI into the enforcement of EA2010.

It suggests ways to collect data on people's gender identities but does not suggest recording people's sex.

It recommends Mermaids.

There's more but it's been a long day - will post more when I have a chance but please read this and if you're in the area, write to the CCG to explain the problems. Hoping the legal, medical and scientific minds of MN will look at this...

[IWantADifferentName]

Same as always - the emotional needs of the trans community are more important than those of women.

[JellySlice]

How on earth does this make any sense?

Forcing a trans person to use a single-sex ward that does not conform to their gender identity is likely to have a catastrophic effect on their emotional wellbeing. The needs of the patient need to be given priority.'

Forcing any vulnerable patient to use what they understood to be a single-sex ward but is not, is likely to have a catastrophic effect on their emotional wellbeing. The needs of the patient need to be given priority.

'Providing education to other service users in a ward to prevent ignorant or transphobic comments is, if succesful, a better solution than having to protect or isolate the trans service user'.

Lying to other service users in a ward to deny the evidence of reality and force them to lie as well, is, if succesful, likely to have a catastrophic effect on their emotional wellbeing. The needs of the patient need to be given priority. A better solution would be to protect or isolate the trans service user on a ward that serves their sex.

[ItsAllGoingToBeFine]

It's a common theme across all of these decisions. The impact on trans people is carefully considered, but as it is designed to have an impact on transpeople it is not deemed to have any impact on women and their needs are simply not considered.

It's like a massive institutional blind spot

[anotherFOIrequester]

I emailed the following:

I'm writing with regard to the SARI guidance 'Supporting Trans People: best practice guidance for health and care practitioners' presented at the CCG governing body meeting of 5/11/19:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_5Nov19_item6.4.pdf

I hope the CCG does not adopt this guidance in current form as I believe it would have negative effects on women, children and trans-identified people.

At the very least, the CCG should not proceed until it has carried out a real risk assessment and an equalities impact assessment. It is incorrect to state that there are no specific risk implications. The equalities impact assessment only refers to trans people, not to impacts on holders of other protected characteristics. The most significant group to consider are women (adult human females) who hold the protected characteristic in EA2010 of sex.

In the guidance, opposition to trans people being placed on a ward corresponding to their 'gender identity' (this term has no legal meaning), eg a male who identifies as a woman being placed on a female only ward, is framed purely and only as 'transphobia'. The guidance suggests patients should be 'educated' out of this.

I urge you to read this report from a group of female survivors of male sexual violence in order to understand the reasons that women need single sex wards: fovas.wordpress.com/response-to-stonewall-2/

There are many references to 'patients' but this is not a symmetrical situation and the sex of the patients matters - my elderly father spent a night in hospital recently and a female patient on his ward (though of course male patients may well want privacy from the opposite sex) would not cause me to worry in the way that a male patient on a ward with my elderly mother would.

The guidance presents the issues, the science behind them and the legal and political situation as fixed and settled. This is far from the case - indeed, in the weeks since the 5th November meeting there have been court cases in which the judgements may contradict the sections on NHS staff (the Maya Forstater employment tribunal) and Hate Crime (the Harry Miller judicial review). Last week Newsnight covered the plight of detransitioners, and highlighted that, contrary to the SARI guidance, the evidence base for gender treatment in young people is very poor.

The guidance quotes the 2016 Parliamentary Transgender Equality Enquiry without noting the women's groups that have formed specifically to oppose the enquiry's recommendations, and there is no mention of the much more recent Parliamentary Enquiry into enforcing the Equality Act in which women's need for single sex spaces was discussed. Likewise, the guidance quotes Stonewall but does not acknowledge that a new campaign group, the Lesbian, Gay and Bisexual Alliance was formed in opposition to Stonewall and its disregard for women's and LGB people's rights.

[OhHolyJesus]

Should we raise with other local authorities OP? I'm not in those locations listed. Maybe I should do an FOI for my area? It's a concern of mine too.

[anotherFOIrequester]

OhHolyJesus please do - I suspect similar organisations are doing the same thing all over the country.

I didn't actually need to FOI the guidance itself I realised after I sent it out - I suggest going to your CCG website and searching first, unlike me :)

But the part of the FOI that they do need to answer is whether they adopted it or not.

[anotherFOIrequester]

Wow, that was a quick reply:

Dear anotherFOIrequester,

Our customer service team kindly forwarded your email. Although I was not in attendance at the Governing Body Meeting, the document has been shared with me, this document is still in draft and the CCG is awaiting a revised version from the authors. I will of course share your concerns with colleagues. And request that we take into consideration the views of the CCG LGBT+ staff network who play a vital role in informing the organisation.



Thank you again for your email and I will share your concerns today and offer some feedback at the earliest opportunity.



Regards

[anotherFOIrequester]

And request that we take into consideration the views of the CCG LGBT+ staff network who play a vital role in informing the organisation.

If you're in Bristol, North Somerset or South Gloucestershire please conatct the CCG about this - perhaps we can get in there before anti-woman guidance is adopted.

[TobyandLottiesmum]

From FOI requests to Royal Bolton and Salford Royal. Asking different questions but apparent that their are no definitive single sex wards

[anotherFOIrequester]

Bloody hell @TobyandLottiesmum. I spent several days in hospital after routine surgery complications when I was 20, unable to eat or sleep and not really even knowing who I was by the end of it. It was bad enough on a female-only ward, I am horrified imagining what it would have been like to have a male there. There was hardly ever a nurse around, eg I couldn't even get to the toilet.

Here's the latest reponse - NB this is not FOI response but email I sent separately asking the CCG not to adopt the guidance:

''I will aim to come back to you over the next couple of days. I have spoken to one or two staff internally and I have emailed SARI who produced the document around the process of compiling the report for some assurance.



Thank you for your patience.''

[Hollygaggles]

Oh blimey I've only just seen this "toolkit". I'm in North Somerset and will be on the case. Thanks for the heads up.

[babynewt]

Im in this area. are there timescales of when they propose to do this?

[Kit19]

I’m in North Somerset too! Will contact CCG - also healthwatch as the patients voice

[anotherFOIrequester]

Hi Hollygaggles babynewt and Kit19 !

Really glad you are all writing to the CCG.
Great idea to write to the local Healthwatch Kit - looks like they have already been captured: www.diversitytrust.org.uk/2018/05/trans-health-research-report-launched/

That makes it all the more important to contact them imo.

I don't have any information on timescale.
Please ask them!

Thank you all and please keep us updated here.

[Watermonster]

I am in the area too and will contact them. Please all contact your MP as well- it's the perfect time to send a quick email to say you are concerned about this / self ID,/ single sex spaces / GRA as they are adjusting to the the election result.

[agentnully]

I don't get this "trauma" they'd have. If they were born men and lived their earlier lives as boys/men, regardless of how they want to identify now, it doesn't make sense to me as they'd know what to expect and wouldn't be as traumatised by the sight of a penis like a woman who had suffered sexual trauma would.

I've been having ongoing counseling for 15+ years due to abuse. Having a man in the same ward as me would be damaging to my mental health and not just my feelings (as I'd expect would happen to a man wanting to "be a woman").

There's a HUGE difference between having your feelings hurt and being traumatised.

Sorry if this is the wrong place but the thought of being put in this position is freaking me out.

Also, could someone please link the Welsh guidance mentioned by the OP and help me out with what I need to do to help stop this?

Thanks, and sorry I'm a bit dim about all this.

[anotherFOIrequester]

Yes, we should all write to our MPs now we know who they are.

agentnully it really makes me so angry that you and so many other women in a similar position are ignored.

The Welsh reference was about a wonderful poster on here who asked for the equality impact assessment carried out on Welsh government trans guidance (not NHS specifically). They hadn't done one! They then basically said 'the dog ate it'... I'll try and find the thread.

[anotherFOIrequester]

www.mumsnet.com/Talk/womens_rights/3652524-Welsh-Assembly-and-the-lost-equality-impact-assessment

[anotherFOIrequester]

Meant to add - no equality impact assessment or risk assessment has been done on this Bristol/Glos/Som NHS guidance either.

[FOIrequester]

I've finally had a reply to my FOI request to the NHS about their single sex accommodation guidance. I made the request on 2nd October, and after a few gentle reminders they've finally responded.

www.whatdotheyknow.com/request/equality_impact_assessment_for_d_2#incoming-1488421

I've posted about it on this thread.
www.mumsnet.com/Talk/womens_rights/3705528-New-NHS-guidance-on-same-sex-accommodation

[anotherFOIrequester]

FOIrequester Thank you! And thanks for all your hard work. You're an inspiration! Will go to that thread.

This explains an awful lot about what's happening in/around Bristol:

medium.com/@elsaegret/stitch-up-bristol-fashion-f1eb298e28da

[anotherFOIrequester]

Had the FOI reply - yes they have adopted this guidance, they are editing over next few weeks/months. They sent the meeting minutes.

www.whatdotheyknow.com/request/guidance_on_supporting_trans_peo?nocache=incoming-1490631#incoming-1490631

bnssgccg.nhs.uk/library/governing-body-paper-3-december-2019-item-3/

How have you all got on with getting responses from the CCG, MPs, Healthwatch etc?

Will pick this up again after Xmas.

[anotherFOIrequester]

Quickly to add - I really am Xmas-tasks-addled today...

The minutes say that the lead writer of the guidance is Cheryl Morgan, a TW.
CM has called women the four letter t word etc.

So, this isn't just a case of a pro trans org writing guidance, it's an individual with a record of abusive language towards women writing guidance that will affect women.

[Cuntysnark]

I despair.

[anotherFOIrequester]

I despair too.

CM now saying that CM can breastfeed: mobile.twitter.com/CherylMorgan/status/1208712963911245824

Tell me again that AGP doesn't exist.

Fetishisher of women's bodies who abuses women who dare to argue writes NHS policy that will negatively affect women needing healthcare for their women's bodies.

And we're the bad ones 'filled with hate' for seeing what's in front of us.