Doctors set out medical guidelines for trans men giving birth - Times

Thank you @Justme56, that had completely slipped my notice! Admittedly reading that whole awful document felt mind melting in its thoughtlessness and lack of scientific rigour.

@Whatwouldscullydo I agree. Some may think that scenario is too dystopian but I think that we are already through the looking glass (eg assault of women in only recently mixed sex private spaces) and the posts on the long thread of “it will never happen.” The Venn diagram of trans rights activists and mens rights activists is not yet a perfect circle but it’s getting closer every week.

I found this interesting. I am sure I read that the The Scottish NHS has recently told GPs to prescribe 'bridging hormones' to patients who have not yet been seen at a gender identity clinic.

"Prescribing endocrine treatment with the intention of changing sex-specific characteristics may have profound social and psychological consequences. Clinicians must recognise and work within the limits of their competence. Prescribers who do not have specific expertise/experience in the prescribing and monitoring of endocrine treatment for gender dysphoria should work with clinical supervision from an experienced gender specialist (described by the GMC as having, “evidence of relevant training and at least two years' experience working in a specialised gender dysphoria practice such as a National Health Service Gender Identity Clinic”)."

I don't get the specific problem here. I absolutely don't agree with removing the word "women" from standard guidance/literature, but surely it makes sense to have separate guidance for this very small minority group?

As for all the "I just don't understand WHHYYYY" comments- people do all kinds of stuff I don't understand all the time. Individual decisions that don't affect anyone else are not really not an issue for society as a whole are they?

And if it became official men could give birth then surely companies could hire all men and then use that to prove they dont discriminate on the basis of maternity. And where would that leave maternity leave? Could it be argued that as men can give birth and none of the men employed have taken maternity leave then clearly its not something that's needed.

Turkeys voting fir Xmas

I share every one of your concerns and thoughts (maybe not those where the medical terminology is beyond me as a lay person!).
I would be very interested, if you'd be willing to share it, to see what the College says when (if?) they respond to you.

Oh, and I love your username 😄

"The paper does not mention inclusion of trans identifying males (transwomen) on women’s wards thankfully"

It does on the page 7 table.

"Gender diverse people should be allocated in-patient accommodation in line with their gender presentation, unless there is a significant reason (e.g. the individual care needs that cannot safely be provided in other settings). If there is a reason to depart from this, this should be discussed and agreed with the individual."

Why would a Transman want to give birth?

Surely they would not want to being a man in their eyes?!

It makes no sense.

@fannycann, and all this money wasted on woke wording is making an the NHS not have an enough funding for essential treatments, or doctors and nurses. Can't help feeling the world has gone mad to accommodate what is less than 1 percent of population.

I find the chest feeding thing so sinister. There’s a million words you could call it that don’t make it male centered.

Whats wrong with nursing ffs. Thats already a used word and actually the standard term in lots of countries.

Makes me think it’s not really about making it more inclusive. It seems to be about taking words away from women and making them male.

And I am VERY keen to see the response to this excellent FOI which is now overdue.

https://www.whatdotheyknow.com/request/definitionoffwomangenderrsex#incoming-2065542

To understand the full extent of policy capture in the NHS take a look at this FOI.
The Rainbow Badge scheme is funded by NHS England (£220k this financial year, £70k last fy) and administered by the LGBT Foundation.
40 NHS trusts are signed up this year, 10 in the pilot scheme last year.

Senior management need to demonstrate their rainbow credentials at interview.
Patient information needs to be gender neutral. There is much more that has been dug out by someone.

https://www.whatdotheyknow.com/request/rainbowbadgeeaccreditation25

I agree

what absolute nonsense

This is incorrect.

I can see why a female person might embrace the intensely and uniquely female experience of pregnancy, childbirth and breastfeeding, while at the same time rejecting society's stereotypes of femininity.

Words like 'she' and 'breastfeeding' do not reflect societal stereotypes, but if avoiding such words when addressing these individuals will improve their outcomes, then it is an appropriate way of achieving a legitimate objective.

But only when addressing these individuals.

It's such extreme male supremacy, it's difficult to believe.

Using the term cis woman in the context of pregnancy, childbirth and breastfeeding? It's unhinged.

They're talking about a woman doing the most female thing she can possibly do, in terms of 'not being a man who identifies as a woman'.

All because a tiny minority of sexist males have demanded it.

Final point for MN before I attempt to write to the college -

The document states, of the Equality Act (2010):
The definition of ‘gender reassignment’ in the Act includes people who have not yet undergone any medical interventions and those who are making a social gender transition without any intention to undergo medical interventions. Protection under the Equality Act does not require a gender recognition certificate.

If this is indeed true then should it have a caveat? The paper does not mention inclusion of trans identifying males (transwomen) on women’s wards thankfully, but I know first hand that transwomen have been placed on womens gynaecology wards without the consent of those women.

I have read the document and I will be writing to the college shortly. I have a few thoughts so far but I am still in too much disbelief to write a coherent response to the college. They tend to ignore their own members and fellows anyway (who pay millions in membership fees) but evidently they listen to Stonewall (which is where those membership fees appear to be going):

1. Why is the pseudoscientific term “assigned [sex] at birth” used throughout this document? Sex is not assigned at birth, it is observed. Sex is determined at conception.
2. Why is the term “cis” used at all when it comes from a belief system that many (or indeed most) women do not subscribe to and therefore do not identify with and may find hateful?
3. Why does this document detail surgical and medical treatment for transgender identifying males? Certainly the issue of surgery is a urological one and would therefore be better addressed by the royal college of surgeons.
4. The term “cis-sexism” is defined in the document to mean “prejudice in favour of ‘cis gender’ people.” Why is there no defined term to mean “prejudice in favour or transgender people at the expense of ‘cis gender’ women”? There are already numerous examples of this occurring in the NHS with regards to sexual assault of women by trans identifying males and the difficulties that these vulnerable have had in accessing support.
5. Hysterectomy and bilateral salpingo-oopherectomy: the document details the risk of prolapse of neovagina in trans identifying males (an operation which would not be done by a gynaecologist anyway) but in its recommendation for hysterectomy and bilateral salpingo-oooherectomy in female patients there is no mention of the much much higher risk of pelvic organ prolapse (40% vs 2.8% for males), osteoporosis, menopausal symptoms, heart disease, depression, anxiety and memory problems to name a view. Naming the complications for male patients who the college members don’t even treat but not naming the complications for female patients is sexist, negligent and patriarchal. I see women almost every month in my own clinical practice who have life changing symptoms of pelvic organ prolapse following hysterectomy and were not appropriately consented prior to their operation.
6. Why is the term “chest-feeding” used as a default term throughout the document, with no mention whatsoever of “breast feeding” in the context of “cis women”? Have “cis women”, who make up over 99% of OBGYN patients, been consulted on this change in language? Language appropriate to patient preferences is essential. Do not change to “chest feeding” as the default when many women prefer “breast feeding.” Use “chest feeding” when it is appropriate to the patient and what they prefer. I am a doctor and a mother. I have never and will never “chest feed” and am horrified at its increasingly common usage. I breastfed my babies and would have struggled to engage with any “chest feeding” support meaningfully, and I have no doubt that use of the term “chest feeding” (or indeed “cis woman”) would have left me feeling alienated and alone as a new mother.

The reason why this sort of mind blowingly simple advice is not provided? Wholesale capture by TRAs

The sooner trans people realise that actually these tras are not their friends nor do they have their best interests at heart the better. If they cared at all about trans people then they'd stop asking for things where the only possible outcome is that care cannot be properly provided. Either because their sex markers have been changed on records or because they cannot have anything explained to them in appropriate Language.

Its a power play masked as inclusion where trans people are merely the tools to achieve it.

Most of this is ridiculous, and some is dangerous nonsense.

As far as pregnancy, I would say that people who have body issues of other kinds will still want to become pregnant, so I don't see that it would be different with transmen. I've known women who had anorexia for example who desperately wanted to become mothers but struggled with the weight gain of pregnancy.

I don't think helping people disassociate in thee kinds of circumstances is particularly kind of helpful, mind you.

It's also true that many pregnancies are accidental and many people don't consider abortion to be a neutral option for dealing with that, so the idea that any transman in that situation would have an abortion if possible seems like a tremendous assumption.

Wow that sounds really awful for the child’s development.

This! A thousand times.

Covers all the bases. In two bloody paragraphs.

The reason why this sort of mind blowingly simple advice is not provided? Wholesale capture by TRAs.

I wonder how the staff feel about this. They are their to deliver babies and provide care. Were they asked if they were happy to indulge untruths and be responsible for affirming identities irrelevant to anyone besides the one person involved.

Haven't staff got enough to do. And how do you get informed consent when you cabt use medically relevant language? Surely its a law suit waiting to happen.

Future litigation by a woman who suffered the consequences of substandard care caused by the language being mangled so badly in the name of inclusivity that neither she nor her HCPs understood each other?

Out of interest (as the times article refers to cancers and cervical screening etc as well) I went on NHS page for testicular cancer. All about men and boys….what about trans-women who might get this?
will they address these pages next, or will they leave them as be as it’s nothing to do with women?