This FOI on the Trust's Trans policy is qjite astonishing. It's 40 odd pages and there's a lot to raise eyebrows, but I'll focus on the single sex relevant parts:
The 'Policy for the Care and Support of Transgender and Non-
Binary People' is from 2023, so was put in place AFTER this rape, if I've got the date correct?
I'll put links at bottom, but I want to lay out the history of the policy, which is also recorded. From around 2019:
'Discussion of adult trans guidance at Southwark Service User & Carer
Advisory Meeting 20/05/19
Changes Made as a Result of Consultation
The group acknowledged the complexity of the issue, recognising that the introduction of single sex wards (whilst improving privacy & dignity) has increased problems in this area.
• They encouraged forward thinking in terms of gender-neutral provision, especially given an increase in the number of non-binary/trans young people using CAMHS service.
• They discussed the need for tolerance and understanding around all “difference” suggesting that routine opportunities for discussions about being inclusive would be helpful for staff and service users alike. The group understood and supported the approach of dealing with inpatient admission of trans service users on a case-by-case basis.
• They suggested that giving clear information to all service users before admission to an inpatient unit about the approach to gender identity might help avoid difficult situations between patients
Discussion of adult trans guidance at
Lambeth Service User & Carer
Advisory Meeting 30/05/19
A group member stated that a LGBTQ+ friend had experienced prejudice in the Trust.
• The group highlighted the need for greater awareness of gender identity issues among staff and service users
• They identified the value of bringing in external expertise to better understand the needs of trans people and the need to encourage more trans service users to get involved in mechanisms such as the Involvement Register.
Circulated to external LGBTQ+ organisations/stakeholders/individuals
on The Trust’s confidential LGBTQ+ MH circulation list 06/10/19
Focus group of 5 trans and non-binary service users and emailed
feedback on Trust Adult Clinical policy facilitated by CliniQ
March 2021:
Changes to definitions, terminology and section on clinical records, staff awareness, behaviour and communication, concerns, complaints.
Feedback on policy from NHS Rainbow Badge Assessment August
2021
Edits to terminology and clarification of protection against unlawful discrimination of non-binary people by HRA in section 5.
'Legal advice on questions raised by TNBCPWG on current clinical policy
received from Trust solicitor.
19/04/21
Response included:
• The way in which the policy deals with single sex exemptions in 13.2 is appropriate.
• The policy EIA meets legal obligations under the public sector equality duty.
• If the policy is applied fairly by staff who are sensitive to the issues, the chance of any successful litigation is minimised.
• The Trust is currently balancing the need for single-sex spaces (e.g. female only wards, toilets, etc) with giving transgender patients a say in how they wish to receive services.
• The Trust should make sure that it does not unlawfully discriminated against anyone making complaints.
• The Trust should support staff who feel uncomfortable performing searches of people of the opposite sex if staff believe this is requested for a malicious reason.'
'13.2 Admission to adult inpatient wards
All decisions to admit trans and non-binary service users should be made on a case-by-case basis in accordance with the legal requirements detailed in section 5 and guidance from NHS England and NHS Improvement and the Royal College of Nursing.
13.2.1 The staring place for making a decision on which ward to admit a trans or non-binary service users should be the individual’s preference. Staff should remain mindful that an individual may not want to be admitted to a ward that matches their gender identity (e.g. a trans man may not want to be admitted to a male ward because of safety concerns)'
'13.2.3 There may be some circumstances where it is lawful to exclude a trans or non-binary service user from single sex ward of their preferred gender but only if this is a proportionate means of achieving a legitimate aim. Establishing these two criteria requires staff to do the following:
• Involve the trans or non-binary service user in discussions about their admission and be explicit about how their rights are being considered.
• Undertake an objective and evidence-based assessment of all relevant aspects of an individual trans or non-binary service user's circumstances, needs and care requirements in addition to their gender identity to justify any decision.
• Completing a comprehensive risk assessment to determine any known risks to other service users or to the trans or non-binary person.
• Balancing the needs of the trans or non-binary person and the detriment to them if they are denied access, against the needs of other service users and any detriment to them if the trans or non-binary person is admitted.
• Take steps to minimise any discrimination against a trans or non-binary service user if access to their preferred ward is justifiably denied.
• Keep a written record to demonstrate why a decision is justified and what steps have been taken to minimise any potential discrimination.
• It may also be useful to consider a theoretical comparator of how a cisgender or male/female service user with exactly the same circumstances would be treated.'
3.3.3 If accommodating a young person’s preferred gender within the ward environment poses significant safeguarding issue which cannot be managed with other interventions, then consideration should be given to moving the young person to another unit without gender demarcation. This should only be considered when all other options have been explored and ruled out. The young person and family /carers should be included in this decision as
much as possible and steps should be taken to minimise any discrimination against the trans or non-binary service user in that unit.
13.4 Risk assessment
All risk assessments for trans and non-binary service users should be undertaken on case-by-case basis in accordance with the Clinical Risk Assessment and Management of Harm policy.
Staff should ensure that they take an objective and evidence-based approach to assessing any potential risks and vulnerabilities that could arise because of a trans or non-binary person being admitted to a ward in accordance with their gender identity. This should consider all relevant factors and not just be based on someone's gender identity alone.'
My bold.
So, looks like activists were actively involved in writign the Trust's policy on housing trans patients according to preference. Who were those 'external organsiations/stakeholders'?
Consulted:
- Equality, Diversity and Inclusion Group
- Psychological Therapies Diversity Forum
- LGBTQ+ Staff Network
- Trust Rainbow Champions
www.whatdotheyknow.com/request/policies_and_protocols_regarding#incoming-2684531
https://www.whatdotheyknow.com/request/policies_and_protocols_regarding/response/2684531/attach/html/4/Care%20and%20Support%20of%20Transgender%20and%20Non%20Binary%20People%20v2%20May%2023.pdf.html