If a patient requests same sex care and a doctor lies to them and performs intimate care, that should be a sex crime

Theodore Upton has been vile throughout the tribunal. I cannot believe this has been allowed to happen and that the nhs is funding the man's side.

To me, there is very little difference between a real doctor who is male but pretending to be a woman, and Joe Bloggs off the street pretending to be a doctor. If I am in a position to give consent (hereby excluding emergency situations where I am unconscious, for example) then I expect my rights of autonomy over my body to be respected.

Deception of any kind has no place in practising medicine. We already place a huge amount of trust in healthcare providers- it shouldn't be abused just to fulfil a man's fantasies.

Given that it is a fantasy for this particular doctor to pretend he is a woman, and he has stated that he wouldn't proactively disclose his trans status, one can only assume that the intimate touching of women forms part of his fantasies.

That means it's sex by deception (as that is currently the closest named offence I think). Perhaps 'sexual gratification by deception' would be a closer description.

I don’t find him inspiring. Were the women genuinely happy or just doing what women are socialised to do —be kind, don’t cause a fuss, prioritise others’ feelings?

The NHS have harmed lots of people at the alter of gender ideology. It suits their interests if everyone is forced to continue playing the game

I was diagnosed with breast cancer last year and wasn’t consulted about the sex of the surgeon assigned to me. At that point all l cared about was getting treatment as quickly as possible, so sex wasn’t a factor for me. I can appreciate that it may be for others because of the intimate nature of the exams and treatment, but l don’t think I’m missing the point. Personally l don’t care who is what gender as long as they’re the best person for the job, but l agree that if a patient specifically requests a female HCP then it should be a natal female.

Then they can use a chaperone. Or they can inform the patient that it is against medical advice. The patient has the choice.

But it is unlikely to happen in the NHS.

That was a disgrace.

It isn't always possible to pick and choose your clinician, patients have a right to express a preference and a right to decline care if their preference can't be met. It isn't possible for every healthcare setting to conjure up equal numbers of male and female clinicians to ensure everyone who has a preference gets what they want.

For example in labour we had a male midwife, he was fantastic and I had absolutely no preference either way, but if I'd have said no, I'm not having you, that doesn't mean a female midwife would have magically become available, and I'd have been shooting myself in the foot to decline medical care.

Interestingly patients tend to express preferences for things like GPs and nurses, but when it comes to intimate surgeries or examinations they are suddenly fine with a male consultant.

Lots of people misunderstand and believe patients have a right to their preference being accommodated. They don't as it's not possible for the NHS to promise they can fulfil that preference.

There are also plenty of people that really couldn't care less what's going on in the pants of the professional trying to help them, I'd say that's the norm.

In scenarios where we're considering trans clinicians then I think if someone asks for a woman clinician and the clinician available/assigned is a trans woman then that is something that should be explored with the patient. Is it important to you that they are a woman, or that their sex is female? If it's possible to fulfil their preference that they want a female/cis woman then great, if not, it's just the same as explaining there isn't one available so here are your choices: have the care delivered by a trans woman, or you will need to wait or find another place to carry out the procedure if there isn't anyone on staff that fits that person's preferences.

The NHS has plenty of trans clinicians that navigate this stuff day in day out.

There is also a massive power imbalance. Very difficult to say no when face to face with a medical doctor.

Yes it should be classed as assault by deception.

Who the hell does this Dr think he is? I’m so glad Sandie brought this case, so much sunlight.

Dr U is attempting to ride roughshod over biological women's rights, thoughts and feelings because, in his mind, his feelings, wants and rights trump those of his patients.
I just despair at what this world has become. Literally having to listen to him monologue about how he is a biological woman ...wtaf?!...the reference to Winston's torture scene in 1984 was an absolute cracker.

I digress...in answer to your question, if people like Dr U can't behave morally and with empathy to his patients, then yes a new law probably is required.

My opinion is that if a patient requests a female attendant and a TiM then examines her (presume it's a 'her') that would be sexual assault if it were an intimate examination without a chaperone. But it has not been tested, I think.

Now apply the same logic to men who want to be women.

It's a tricky thing to balance honestly as healthcare professionals are also entitled to privacy around their own medical information. We don't expect clinicians to disclose their sexuality, for example, if a male patient is vocal about not wanting a 'puff' to examine his testicles, or a woman doesn't feel comfortable with a lesbian clinician examining her. Hence why I feel if in a healthcare setting a patient expresses a preference, and the setting has trans clinicians, the person that discusses that with the patient needs to explore further to see what it is they actually are expressing a preference for. This can be done without expressly telling someone 'oh, Dr so and so who was going to see you is actually a trans man, not a cis man, so if you want a male doctor doing your prostate check is that person okay or not?'. I don't see why patients couldn't be asked to express preferences on their intake forms. If someone wants a woman and only a trans woman clinician is available then they can be asked what they're comfortable with and if they only want a cis woman it can be explained that preference can't be fulfilled and these are your options. The patient doesn't know if it's because the entire team is male or the clinician available is trans. Nor do they need to. Consent is important, and privacy is important, hence why it's a sticky topic :)

I should have put informed consent in the question, thats my fault. Possibly explains the 20%. I can't think of any other excuse for those votes.

I imagine the 20% either don't care, or don't think that it's inherently sexual in nature just because it's a trans person is performing the procedure. It's too much of a leap IMO to assume that trans people get sexual gratification out of performing intimate medical procedures.

I don't think that this could ever fall within a sexual offence without additional factors making it so.

It's probably closer to the definition of battery "the intentional or reckless application of unlawful force to another person"

Also... say a patient wants a female doctor. And the person available is a trans man. Are we expecting them to be okay with someone who presents as and looks like a man examining them, because they just said 'female'? All patients need to have their preferences identified so care can be planned and navigated imo.

Deceiving a woman out of her right to same sex care is not a sticky topic.

Patient autonomy underpins health care. The patient's right to make decisions about their own health care is non negotiable. The idea that the rights of a medic who has decided to 'socially transition' to a different identity should trump patient autonomy/rights isn't (shouldn't be!) valid for discussion.

It's very simple, if you can't put a patient's wishes before your own (and this encompasses personal 'beliefs' of all sorts) then a career in health care isn't for you.

No, the NHS may not be able to produce the sex of choice.But if the doctor is a man and it's an intimate examination then a female chaperone should be there. If it's a TiM then that must be made clear i.e. this is a man who thinks he's a woman - and ditto chaperone for an intimate examination.
I think male midwives are a different case - there is no deception.
With a TiM there is the element of deception unless it is clear that this person is not a biological female - and the deception is the main point of the matter, esp of the doctor currently doing this.

I think you've misunderstood. There is no 'right' to same sex care, only to express a preference.

https://www.royalberkshire.nhs.uk/media/gb4pxjda/requesting-same-sex-health-care-professionals_sep23.pdf

"We understand that some patients may prefer to see or be treated by a healthcare professional of a specific gender. There is no statutory requirement for the NHS to provide a healthcare professional of a particular gender in any healthcare setting. Under the NHS Act 1990, we have a duty to provide a proper standard of care to all our patients. The Act does not state that care needs to be deliver care by a particular person of a particular gender. You may make a request to see or be treated by a specific gender of healthcare professional. Our ability to respond to your request will be considered on an individual basis. However, it will be dependent on circumstances such as levels of staffing and the needs of other patients. Our prime aim will always be to provide a high standard of care to you. Please be aware that insisting on care or treatment from a healthcare professional of a specific gender may result in delays to your care. While the Trust endeavours to make alternative arrangements based on your request, it may not be possible to allocate a healthcare professional of the required gender."

It's okay, lots of people get this wrong.

Everyone should be offered a chaperone imo.