Mental health nurse almost died when trans hospital patient tried to strangle her using a drawstring from his hoodie - as attacker is jailed for life for attempted murder

@PriOn1

I think there’s been discussion of an incel-to-trans pipeline, which would account for lots of insecure & aggressive TW even without any potential impact of testosterone suppression. Should there be a parallel impact to that seen in dogs, it would indeed explain a lot - plus of course “trans” now includes the sort of aggressive men who are used to holding positions of power & used to just cross-dress in private but now bring their whole late-transitioning selves to their high-powered jobs in banking/politics etc.

Male trans people retain male levels and patterns of offending. Is that maybe because it's hard for testosterone to leave the body?

The question of testosterone in MtF transitioners is complex.

In the first instance, the drugs they use to reduce testosterone have very varied effects. There are a large percentage of MtF transitioners who retain M levels of testosterone, despite the drugs.

In addition, the effects of removing testosterone are complicated. In addition to masculinisation, testosterone is thought to have a more general effect on confidence and well-being.

I’m a vet, not a doctor, but it is well established that before castrating male dogs for aggression, they should be tested using chemical drugs that reduce testosterone before committing to surgery.

That is because male dogs that are aggressive due to fear can become more aggressive, rather than less, following castration. I have often wondered whether a similar effect can occur in insecure men. There are certainly some very aggressive MtF transitioners and I had wondered if it was a factor.

In response to the trans ‘theory’ comments. The risks were known, this person had previous, regardless of their transition. Male and female patients ask all the time for specific gendered staff, regardless of being trans. People working in psychiatric wards and in the community face daily risk from patients, that’s why there are individual risk assessments. Nothing predicts risk like the past. Sadly in this case, the risks were there but not shared, not care planned for, no contingency and if there was a plan, it wasn’t adhered to. There could be a number of reasons why all the above happened, and I’m sure as shit it wasn’t to do with the person being trans. In an high risk environment and profession, it’s about risk management…. Not gender identity.

Exactly what I thought, @NitroNine. It does seem clear that this person used their trans status to get their victim alone in the bathroom, but this could have been easily avoided if the nurse she attacked had known about the previous violence, and if two nurses had been present.

It is interesting that the attacker knew the gender of the male nurse, and was allowed to discriminate against them in such a bigoted fashion, when an actual female woman would not be allowed to request that intimate care be provided only by other biological females. Such a person would be excoriated for assuming the gender of their nurses!

They have fixed male ideas of what it is like to be a woman and they want to live that fantasy. They tend not to want to blend in and live the life of an real unremarkable woman.

Yes that's definitely true, but a sexist male idea of what women are like tends to include women being weaker and "girlier", less aggressive, more easily upset etc. Hence the TW you see performing being unable to open jars, being scared of spiders etc. and saying it's because of the estrogen. So you would think that they would want to try to emulate less aggressive behaviour, even if that was motivated by misogyny and fetish.

I know that's not what generally happens, just pondering the differences.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0016885&type=printable

I would diffentiate between long-term transmen and young females who have been caught up in the Rapid Onset Gender Dysphoria phenomenon. The latter group is a relatively recent phenomenon and we are still learning about them.

It does raise an interesting question. I’ve always thought transmen should be recognised as female sex. However, if testosterone increases their strength and violence to male levels, then clearly dangerous transmen can’t be safely managed using female protocols. Not sure how this is best addressed.

In any case, all risk assessments should include staff and other ‘service users’ and members of the public, as well as the individual subject. This change should be applied immediately

Do you have a link for this? Thanks

MrsWhattery
If that's true, it's even more interesting how it doesn't seem to be the same the other way round. Male trans people retain male levels and patterns of offending. Is that maybe because it's hard for testosterone to leave the body? But if the other factor is true (trying to seem hyper-masculine by being aggressive) then you would expect transwomen to also show at least some of a similar effect, but they don't.

In general males who transition have different motivations from females. There is a small cohort of males with gender dysphoria from childhood who are similar to the females but the vast majority of males have tended to transition from middle age.

This group are mostly sexually motivated. They have fixed male ideas of what it is like to be a woman and they want to live that fantasy. They tend not to want to blend in and live the life of an real unremarkable woman.

I think that due to the widespread availability of niche internet porn younger males are being drawn into this world and the lower stigma now attached to being trans means more males coming out as trans as teenagers and young adults but with similar motivations.

i agree, if we were going by biological sex they would have provided 2 female staff from the off ( so actually staff safety was improved by allowing 1 male, 1 female to be present)…. the very moment the care plan was changed to allow only 1 staff member to be present was the breach of the risk assessment . The fact that the member of staff only heard about the long history of assaults on staff when she attended court also indicates the trusts failings. Certain individuals with certain diagnoses who are long term within the mental system are well known to be highly manipulative and try to swing situations in their favour so the managers should have been fully aware of the need to brief their staff and maintain staff safety .

*I think many people are not aware that the Dhejne long-term follow-up study of transsexuals found that female to male transsexuals showed higher criminal offending rates than females. Offending rates corresponded to male offending patterns actually.

To me, this is not completely unexpected. We know testosterone increases aggression. Also, just observing the physical appearance of committed transmen (not the recent ROGD cohort), they sometimes cultivate a hyper-masculine appearance. It’s like they are trying (too hard IMO) to convince the world that they really are men. So I wouldn’t be surprised to see the same kind of attitude reflected in their behaviour.*

If that's true, it's even more interesting how it doesn't seem to be the same the other way round. Male trans people retain male levels and patterns of offending. Is that maybe because it's hard for testosterone to leave the body? But if the other factor is true (trying to seem hyper-masculine by being aggressive) then you would expect transwomen to also show at least some of a similar effect, but they don't.

I think many people are not aware that the Dhejne long-term follow-up study of transsexuals found that female to male transsexuals showed higher criminal offending rates than females. Offending rates corresponded to male offending patterns actually.

To me, this is not completely unexpected. We know testosterone increases aggression. Also, just observing the physical appearance of committed transmen (not the recent ROGD cohort), they sometimes cultivate a hyper-masculine appearance. It’s like they are trying (too hard IMO) to convince the world that they really are men. So I wouldn’t be surprised to see the same kind of attitude reflected in their behaviour.

It never seems to be a 'trans' issue when it is a 'trans' person being violent, but it is always a 'trans' issue when women say no to violent people who call themselves 'trans'.

Weird.

"...In Sutton's case, because he was born female but identified as a male and because he posed a risk of self-harm, she said his care plan originally stated that observations would be carried out by one male and one female nurse."

for those who are keen for it "not to be a trans issue" that is fair enough. But the fact is that the status as transman lead first to the two in attendance being one male and one female, then that transman deciding that the presence of a male nurse when changing was a problem.

AT THAT POINT the male nurse should have been swapped out for another female, and at no time a nurse of either sex should have been left alone with this person. So yes, there are issues that are unrelated to this person's gender issues, but yes there are issues that are directly related to this person's gender issues.

Either the male nurse should have said "suck it up, i'm here at your request and we have to work in pairs" or called - without leaving the room - and had himself replaced by a woman.

It's a difficult one. But. A transman requesting only a woman be present while they are changing? that is a very different proposition to a transwoman insisting that they only have female attendants. Which leads me to believe that the motivations of transmen and transwomen is very different on at least some occasions.

It is completely outrageous that given this patient/prisoner's history that ANYONE (male or female) should ever have been in a position where they were alone with them, and kept in ignorance of their past (highly relevant) actions.

Not sure about the side effects of Testosterone, but seems as though that is an issue, tool.

This isn’t a trans issue it’s a risk assessment and lack of communication issue by the trust. There have always been failures of trusts to protect their staff and other patients from patient violence, google the death of Georgina Robinson ,an OT ,in ‘93 who was used as a case study when I started work in mental health in the 90’s. If you wish to highlight risks particularly associated with trans issues then look at single sex spaces and the issue of rape and sexual assault within nhs mental health facilities…see rape crisis report attached.https://rapecrisis.org.uk/news/alarming-scale-of-sexual-violence-and-abuse-on-mental-health-wards/

That was what was reported. You just have no bloody idea these days because of all the lies they have published to ‘be kind’.

I work in mental health and the dangers are starting to outweigh the job satisfaction.

unwell patients that have a history of violence will most likely go to PICU or secure services. However the low staffing and bad communication on wards causes these incidents. I have been abused by a patient with a long jail background of sexual assault. I have been spat at by a patient who has hep b and c, and we were not made aware until the patient had left. I have been punched by a patient on a local ward whose previous admission was low secure.

all off these incidents could have been prevented should we have been told historic events, we could have put things in place to minimise the risk. However we only get told of the patients presentation and section when they are being admitted to a ward.

some people will say as a professional I should read the notes back years and see, we are that understaffed we do not have time to read back, as this would take away care from vulnerable patients who need us especially with the like of patients on a ward in the news above.

mental health in this country is on its knees and I cannot see it getting better.

The trans identity is important because if the disturbed woman hadn't insisted on the basis of her 'trans' identity', on having a man and a woman nurse, and then did a 180 and decided she didn't want the man in the room, Mrs Afzal would not have been left alone with her.

Yes again, bending the rules to 'VALIDATE SOMEONE'S GENDER IDENTITY' has led to a woman being put at grave physical risk.

Not sure why the focus is on the woman's trans identity, except that this was a partial cause of the hospital's fuck-up in only having one nurse present. Not by any means a significant cause: they could have had two female nurses present, but failed to.

This case is about the failure of a hospital trust to manage safety and keep its employees and patients safe.

Please don';t drag it into the whole trans debate. It is about the failure to provide safe mental health care. That failure is massive, and is actually part of the wider context of the fuck-ups identified in the Cass Report.

I don’t see how this has anything to do with gender, male and female nurses work across male and female wards. Both male and female patients can pose risks to male and female staff, nothing to do with being trans.

It has everything to do with the state of our psychiatric care. Over subscribed wards, lack of staffing, poor information sharing. Why didn’t this nurse know the potential risks and why wasn’t there a robust risk management plan in place. Mental health services are in a sorry state and this is what happens, people get hurt.

Not the first case of a violent trans man and for me, that brings into question the wisdom of housing this violent creature in female prison given her proclivity to attack females. Solitary confinement is the only option and I hope to god that the bloody prison is not as incompetent as the hospital.

Very interesting that, despite the 'maleness' of their stated identity the patients wish for privacy and intimate care was not to have opposite sex care - eg they wished for privacy from the actual male carers while going to the bathroom despite their gender identity.

Or maybe in this case it was that the patient wanted to attack someone and attacking the male wouldn’t have been a safe bet. It says “pretended to need the toilet” so it seems like there was a conscious plan. It seems this person had a perfectly normal and reasonable awareness of the realities of sex, one way or another.

it’s so confusing when you don’t know what someone’s sex is in a report - reading the info in the OP I thought it was a man because they were using “he” including the victim, and it came across like they were abandoning the gender identity in view of the crime.

Also it makes me think it’s yet another situation where the policy/culture of instant affirmation is just so irresponsible. Severely mentally ill people are known for being prone to thinking they’re something they’re not and that wouldn’t be affirmed if it was anything else. They’re also likely to be on medication and be unstable and adding powerful hormones to that is not in anyone’s interests.

The trust should be sued, disgraceful.

Heads should role 🤔 with that hospital trust as ultimately that's where the blame lies squarely and firmly and robustly...!