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Original poster

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

30 replies

anotherFOIrequester · 28/11/2019 21:36

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...

OP posts:
OhHolyJesus · 29/11/2019 14:45

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.

Original poster
anotherFOIrequester · 29/11/2019 14:39

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.

OP posts:
ItsAllGoingToBeFine · 29/11/2019 08:46

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

JellySlice · 28/11/2019 23:37

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.

IWantADifferentName · 28/11/2019 22:00

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