Can we be honest about the need for affirmation?

You would be forcing otherwise passing transwomen to go to a mens shelter

If TIM don't want to use men's shelters, the alternative isn't to use women's.

Really interesting thread. Trying to formulate my views on very little sleep!

You are all so reasoned, passionate and with logical, well thought out points, and I can't understand how people don't get it.

Agreed terfing. It should be acknowledged that these things are either a conflict of interest or a perceived conflict of interest and they should seek other roles.

Sorry haven't read the whole thread, but absolutely agree with the OP that there are serious ethical issues around transwomen who are HCPs seeking validation from patients. To avoid this, I think transwomen who are HCPs should avoid roles where patients are likely to request care from women , for example taking smear tests.

They should also avoid other roles that could give them positive affirmation (or distress if not given), such as bra fitters or rape counsellors.

There are plenty of other jobs they can do.

Baroquehavoc - Must, IMO. But like Poppyred85 said, asking the patient appears to be common place, though in the examples that FortuneCookie and boatyardblues have provided, this does not always appear to be the case.

FortuneCookie - If I am reading your post correctly, by reviving health case do you mean the likes of CPR and other emergency situations? In this instance, I feel that patients comfort is to be waived in favour of patient survival.

With respect to crisis shelters.. I think that the individual situations should be taken in to consideration. But I also understand why someone who having to use these services would feel uneasy about voicing their discomfort to someone they perceive as trans.. I also disagree with the single sex blanket ban. You would be forcing otherwise passing transwomen to go to a mens shelter (which would likely be traumatic for them). And you would still end up in situations whereby transmen would then have to go to the women's shelter which would be equally traumatic for the transman but also potentially add to the trauma of non trans individuals at the women's shelter by being confronted by someone who appears male.

Frankly, any excuse to get out of having a smear test

That's so relevant. So many woman avoid smear tests. We have to make woman feel as safe and comfortable as possible because smear tests save lives. Feeling that you might have to be forced to be examined by a transwomen will discourage women from getting the test done.

We need the right to ask for biological females. If transwomen want to work as midwives and nurses fine, that's their right. But females need to be able to request actual females without fear of being labeled as transphobic. In these sorts of circumstances gender should not be relevant, only sex.

Do you believe Muslim women should be excluded from cervical screening?

I recently had a smear test. It was incredibly painful despite hormone treatment beforehand to try to encourage the cervix to open up a little more.

As some here may know, the smear test post menopause can be very painful.

No I would not want a transwoman to perform the test and I would refuse. Frankly, any excuse to get out of having a smear test would be fine by me! I had a very intimate discussion with the nurse doing the test. She of course has had to go through them too. And that matters to me. Empathy can only go so far. There is no equivalent for men you can compare a painful smear test to.

I don't want a man doing a smear test and I don't want a woman who used to be a man doing it. My needs as a patient should come before the healthcare professional or where does this end?

Whilst slightly at tangent, in that the transwomen was a patient, the idea that someone in a healthcare setting is labelled transphobic for objecting to effectively mixed wards is horrifying but seems to be the approach now when it comes to healthcare policy metro.co.uk/2018/01/14/woman-who-feared-men-accused-of-transphobia-after-objecting-to-hospital-room-with-trans-woman-7227597/

Whether that’s using a sheet to cover their lower half while you examine their abdomen right down to the basics of not laughing at something you hear or see. If you can’t put your own feelings aside when doing the job, and always put the needs of your patient first then you need to a new job.

I had an EMCS with ds1 and I still vividly remember 2 young female theatre nurses/assistants pointing and giggling at something the other side of the sheet across my abdomen. I have zero idea what was so funny, whether it was my badly dry shaved pubes (thanks midwife!), my stretch marks or whether I’d crapped myself, as I had been given an epidural block and was numb, naked and prone, but DS1 is 12 and that scene regularly pops into my head when I think about the night he was born. I rarely think about the lovely obstetrician or anaesthetist, but I do think about how vulnerable I felt and how humiliating that experience was. I have zero respect for any HCP that doesn’t show the utmost respect for their patient’s needs and wellbeing.

Must. Absolutely must. And it must be enshrined in good clinical practice.

In the case of the OPs post though, the patients comfort should come before the ego of a trans HCP.

Should or must? Because the way some TRA are talking, they want to remove women's ability to refuse treatment from a TIM. We instead have to rely on TIM doing the right thing.

I’m still on page 3 so sorry if things have moved on.
I’m a doctor. I always ask all of my patients if they are comfortable for me to examine them before doing any intimate examination and always offer a chaperone, whether the patient is male or female. As far as I am concerned if a patient does not want me to examine them then I don’t. That’s it. It is their right to choose. It makes no difference whether it’s because I’m a woman, wear glasses, have long hair or whatever. It is their right to choose who does what to intimate parts of their body. Yes, in an emergency situation it may not be posssible, but for routine care it is. As a student I remember one of the hardest things to get over was asking patients to take their clothes off. It’s such an intimate thing to do and puts the examiner in such a position of power. We are at out most vulnerable in these situations. Another element of examination drummed into us was about maintaining a patient’s dignity at all times. Whether that’s using a sheet to cover their lower half while you examine their abdomen right down to the basics of not laughing at something you hear or see. If you can’t put your own feelings aside when doing the job, and always put the needs of your patient first then you need to a new job.

I am sure someone will argue against it Fortunate, the very idea that women can ask and receive anything is anathema to some.

The analogies we have been treated to from the TWAW side to support their cause have become more and more ridiculous and, frankly, desperate. I thought we'd hit the bottom of the barrel with the 'styles of canine urination' but then along came the absurd 'obese woman at Pilates' and I heard a distinct scraping sound.

The analogies referencing black women are just downright offensive.

I know this post was quite a few pages ago, but I kind of liked it:

MrsTerryPratchett - And on the issue of gay HCPs. Mine is a lesbian. I know because she very very unsubtly dropped it into the conversation before she booked my smear. I assume she does this so homophobes can opt out. Because patient comfort is more important to her than affirmation.

I don't think it is unreasonable for a woman to specifically request a HCP that is not a transwoman for something as intimate as a smear test.

In the same way that if I was having a breast exam, I would very much prefer a woman (or trans woman) to perform the breast exam on me. It is not about validation (for me) to be seen by a woman, it is about not having a man touching my breasts. I would prefer that someone who understands having breasts does the exam (if that makes sense?). Before anyone picks apart my usage of the word 'man', I am distinguishing between man and male.

In the case of the OPs post though, the patients comfort should come before the ego of a trans HCP. I would hope that any trans woman or trans man working in a healthcare setting would have the humility to accept this. It is called professionalism. There is no harm in being trained to perform the test, but accept that not everyone will want you to perform it and equally, IMO, in this instance and others relating to it, trans status should be disclosed.

Side note... Is this possibly my most concise post ever??

To take pressure off the woman, this should be something that’s asked of her well in advance, or perhaps even added to her file? When booking a smear for example, the person should ask ‘do you require a woman to perform this?’ Or when you register as a patient someone asks you - when we call your for smears, do you require a female HCP? It should also be made clear that even if a woman ticks no, she still has the right to refuse at any point

I have been asked this previously at a practice which had a male nurse, and I think it’s a good option - it also allows the surgery to plan and allocate time.

Perfect Fortune.

Hotdog I agree with you about transmen/non bianary, provided you can see they are actually female. But I would imagine they wouldn't want to do it as they would then not get their affirmation. Unless you objected in which case they shouldn't be doing it.... if they are good nurses they won't make a big thing about presenting as male - I wouldn't want anyone swaggering round as a stereotypical male as I want very small careful movements down there!

Babel I believe the reference to transmen was as they were born female.

Lazy I know you didn't ask me but as far as I'm concerned men have the right to ask for a male to do an exam and should absolutely get one. I would imagine they would be more likely to object to a trans woman doing it than women would to a trans man though.

Yy