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Feminism: Sex and gender discussions

Should access to mental health services depend on you saying pronouns?

130 replies

wanttoworkbut · 23/07/2026 08:34

I think not...

I have been having a rough time of it lately and wanted to self refer to CBT. A chat bot greets me - fair enough, saves staff time taking down vital details.

But quite quickly you are asked for your gender, and not sex. Femail includes trans women, it says. OK, I could probably see why, if ones mental health difficulties related to have dysmorphia etc. But then you have to state pronouns, no option to say no or 'other' or skip question.

I've not continued, I can't face it. Therpay requires authenticity surely.

vitahealthgroup.co.uk/nhs-talking-therapies/newcastle/

OP posts:
GrumpyPanda · 23/07/2026 19:26

Imdunfer · 23/07/2026 11:39

I'm not trying to stop you feeling however you want.

But let's be honest, this is not about being asked to say what pronouns you want the therapist to refer to you by.

This is about NOT wanting other people to be able to specify that they want to be called "she" when they are male.

So much for you ostensibly advocating for the POV of "ordinary women" 🤣🤣🤣. But nice try.

WrongKindOfFeminist · 23/07/2026 19:29

TiredShadows · 23/07/2026 19:09

It is frustrating, particularly having it pretty much right away.

When I used it recently on recommendation from another to access local services, it was off-putting to jump into all of this. I can see why some might from the AI bot just too much of a slog to get through the innaneness and obvious data collection before getting to anything of value.

No-one is asking you to call anyone else by their preferred pronouns, they're asking you want to be called. Why are you allowing this to prevent you from getting access to mental health support?

Except it doesn't really ask what anyone wants to be called, not really. The closest it gets it asking: Is [name] your preferred first name?

This is the starting sequence after being asked if the referral is being made for 'myself' or someone else, and selecting 'myself':

What's your full name?
Is [name] your preferred first name?
Which gender do you identify as?
Is your gender the same as the gender you were assigned at birth?
What's your title?
And what are your preferred pronouns?
It then goes on to collect several other data points including date of birth, post code and so on. It doesn't get into actually asking questions related to mental health until after the dozens of data point questions.

It never asks if you prefer to go by your first name or title + surname or something else.
It doesn't give the option to have no title or use any other title other than the options it gives.
It doesn't give the option to say any pronouns or give any set of pronouns other than the pre-set options

If those behind it cared and wanted to ask 'what do you want to be called', they would have programmed it in. They didn't. They asked a series of data questions, asked in a way that presumes everyone has a certain, firm answer that can fit into the presets (going against many theraputic practices) and is okay with going through all that before getting to apparently less significant questions like "have you had thoughts that you would be better off dead, or thoughts of hurting yourself in some way?"

This isn't 'what do you want to be called?', it's 'What data can we get on you?'." This isn't a mistake - the function shows its purpose. The mental health support is visibly secondary (or tertiary) to data collection. In many locations, these types of bots are the only way to access NHS mental services -- those who can afford to can get support without being asked anything on this data list.

If don't see how it raises questions about quality of support to be asked how you want others to refer to you.

I mean, on mine (which I saved a copy), it says "Alright, I'm just going to search you in the NHS database with the details you've given me
Found you!" and still went on to ask serveral more data questions before getting that what I think are far more essential to the core of the service. There were multiple times throughout I was tempted to close because it felt like it was doing nothing but trying to gather more data on me that I didn't need to do with any other related service.

Also this is a private company getting paid public funds to do all this - one that is partially owned by a US asset management company, which means the data collected by the sections they own likely come under US laws.

Can you guess why it raises questions about quality of support to know why a private company with that ownership that is focused on asking those kinds of data questions before asking mental health questions?

Geezo, that raises a shed load of other questions!

DierdreDaphne · 24/07/2026 08:31

Amazing post @TiredShadows . I have opted out of the NHS data research thingy because I m pretty sure the NHS are buying cheap software off Palantir who set a low price, because they are really in it to suck up our data. I hate it.

WrongKindOfFeminist · 24/07/2026 09:43

That seems to go against Data Protection principles (my bold).

'Article 5(1) requires that personal data shall be: * *
“(a) processed lawfully, fairly and in a transparent manner in relation to individuals (‘lawfulness, fairness and transparency’);
(b) collected for specified, explicit and legitimate purposes and not further processed in a manner that is incompatible with those purposes; further processing for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes shall not be considered to be incompatible with the initial purposes (‘purpose limitation’);
(c) adequate, relevant and limited to what is necessary in relation to the purposes for which they are processed (‘data minimisation’);
(d) accurate and, where necessary, kept up to date; every reasonable step must be taken to ensure that personal data that are inaccurate, having regard to the purposes for which they are processed, are erased or rectified without delay (‘accuracy’);'

https://ico.org.uk/for-organisations/uk-gdpr-guidance-and-resources/data-protection-principles/a-guide-to-the-data-protection-principles/

https://ico.org.uk/for-organisations/uk-gdpr-guidance-and-resources/data-protection-principles/transparency-in-health-and-social-care/

Transparency in health and social care

https://ico.org.uk/for-organisations/uk-gdpr-guidance-and-resources/data-protection-principles/transparency-in-health-and-social-care

WrongKindOfFeminist · 24/07/2026 09:55

I don't really want to go down this rabbit hole. From my layperson's eye, the NHS is fucked partly because it expends so much damn time, effort and money on employing unnecessary people to do unnecessary things in an unnecessarily complicated way.

The chatbot linked to seems to involve these two organisations:

Vita Health Group and Limbic.

the DPP from Vita:

https://vitahealthgroup.co.uk/about-us/policies/data-protection-policy/

'Confidential data must be treated with an enhanced level of diligence. For clarity, confidential data includes any data (or information) which is shared under a reasonable expectation of confidentiality, but specifically includes all Special Categories of Data as defined in the GDPR:

  1. Race or ethnic origin;
  2. Political opinions;
  3. Religious or philosophical beliefs;
  4. Trade union membership;
  5. Genetic data;
  6. Biometric data;
  7. Health data;
  8. Sexual history and/or sexual orientation;
  9. Criminal data.'
... 'Vita Health Group collects and stores personal data on behalf of private customers, the NHS, employers, Occupational Health providers, or insurance companies who pay for our services, and website users who visit our webpages and resources. Generally, the data we collect may consist of (where required for treatment or the provision of services):
  1. name;
  2. address and post code;
  3. telephone number;
  4. employee number or employment details;
  5. email address;
  6. payment card details;
  7. medical history;
  8. medical conditions;
  9. age or date of birth;
  10. gender;
  11. ethnic group or race;
  12. sexual orientation;
  13. criminal offences;
  14. political, religious or philosophical beliefs;
  15. other details about a patient as required for legitimate treatment purposes;
  16. Relevant interests or activities;
  17. Some data is collected automatically by our websites. See relevant website Privacy Policy for more details.'

And limbic, the AI used:

'Depending on how you use our chatbot, we might collect:

  • Identity info: Name, date of birth, NHS number
  • Contact info: Email, phone number
  • Messages: Anything you tell us in the chatbot or by email, which may include information about other people in your life, such as your children or family members, where that context is relevant to your referral.
  • Usage info: For example, how long you use the chatbot, where you click in the chatbot
  • Health info: Info about your mental health, symptoms, medication, and sensitive things like ethnicity or sexuality if needed by your care provider
Our chatbot is for individuals over the age of 13 referring themselves for care. If you choose to share information about your children or other family members as part of your own referral, we'll handle that information with the same care as your own. Please only share what is relevant. We don't collect information about criminal records - Please don’t share that.

https://limbic.ai/uk-policies/privacy-intake

'Limbic has delivered clinical assessments for over 650,000 patients and has served 45% of NHS Talking Therapies.'

So rather than paying medics to help people, the NHS is sinking presumably lots of money into paying tech bros to create bullshit AI programmes that harvest people's data unnecessarily?

Maybe the bigger problem is this technification of what should be human interactions. If you could actually see a human person nobody would need your fecking pronouns.

Data Protection Policy - Vita Health Group

https://vitahealthgroup.co.uk/about-us/policies/data-protection-policy/

womendeserveequalhumanrights · 24/07/2026 12:29

Chatbots / inflexible AI gatekeeping preventing actual mental health help like this is what MAKES me depressed. And I suspect it would worsen the mental health of anyone forced to use it and that many people who are suffering the most will just give up, which I suspect is the point.

I hope some academic somewhere studies this, as I'm pretty sure this will be a universal experience.

It definitely breaches GDPR / Data Protection law as is collecting data it doesn't need. If there were massive neon letters at the start of the process flashing 'WE DON'T REALLY GIVE A CRAP ABOUT YOUR MENTAL HEALTH' it couldn't be clearer. Deeds not words and all that.

womendeserveequalhumanrights · 24/07/2026 12:33

I definitely feel that my mental health has worsened through having to use AI chatbots or apps to do what used to be basic tasks rather than talking to humans (as in the good old days) in a general sense.

If you're elderly and alone these days presumably you can go weeks without talking to another human being if everything is done via app/ automatic check out etc. My elderly parents get so frustrated they can't pop to the post office to do things like they used to (their local post office has shut anyway, and their local bank branch). It's not natural for humans and I suspect very very bad for all of our mental health except the 1% profiting and squeezing every last drop of money out of us via this route.

RedToothBrush · 24/07/2026 12:50

womendeserveequalhumanrights · 24/07/2026 12:29

Chatbots / inflexible AI gatekeeping preventing actual mental health help like this is what MAKES me depressed. And I suspect it would worsen the mental health of anyone forced to use it and that many people who are suffering the most will just give up, which I suspect is the point.

I hope some academic somewhere studies this, as I'm pretty sure this will be a universal experience.

It definitely breaches GDPR / Data Protection law as is collecting data it doesn't need. If there were massive neon letters at the start of the process flashing 'WE DON'T REALLY GIVE A CRAP ABOUT YOUR MENTAL HEALTH' it couldn't be clearer. Deeds not words and all that.

I won't engage with it.

What's the point?

Mental health issues are so frequently about loss of human interaction, communication and connection.

One of my things has always been about not being processed like a sausage factory and being seen as a human individual.

I may as well just go online and do self help shit than engage with a bloody chat bot.

womendeserveequalhumanrights · 24/07/2026 13:25

RedToothBrush · 24/07/2026 12:50

I won't engage with it.

What's the point?

Mental health issues are so frequently about loss of human interaction, communication and connection.

One of my things has always been about not being processed like a sausage factory and being seen as a human individual.

I may as well just go online and do self help shit than engage with a bloody chat bot.

Quite but then the service will be less and less used and they'll say 'oh there's no need for mental health services' - having baked in inaccessibility at the start - and dump the lot, meanwhile the number of people harmed in ways big and small rises exponentially.

You'd almost think those designing these 'services' which do the opposite of what they purport to had a vested interest in the failure of the NHS.

WrongKindOfFeminist · 24/07/2026 13:30

It'd be interesting to see a bit of research into the effects of being met with a fucking bot when you're at a low ebb and seeking help.

I wonder whether accessing this type of shitty, low-rent 'service' actually has worse outcomes than not accessing it. A new kind of iatrogenic harm!

That said, OP, I hope you are able to seek and access some support from somewhere. Happy to try and help - PM me if you want to chat. Bear in mind I'm just a nobody on the internet with no qualifications, but I am at least human.

RedToothBrush · 24/07/2026 14:48

womendeserveequalhumanrights · 24/07/2026 13:25

Quite but then the service will be less and less used and they'll say 'oh there's no need for mental health services' - having baked in inaccessibility at the start - and dump the lot, meanwhile the number of people harmed in ways big and small rises exponentially.

You'd almost think those designing these 'services' which do the opposite of what they purport to had a vested interest in the failure of the NHS.

That won't happen.

There will be more people hitting crisis before they end up with contact with the system.

Hawksie · 24/07/2026 16:36

It's rubbish OP and I feel the same as you.

I don't write my pronouns, I don't have gender dysphoria but another illness that complicates pronoun use.

I filled in a form and ignored the gender question and they put me down as trans - it was a community organisation. They have now sent said form to my GP and so it's on my medical records and is one of the lies my GP is refusing to remove as they deem it part of my medical records

I now longer feel I can access GP care

Lovelyview · 24/07/2026 18:20

If you want to complain op this is a link to Prof. Alice Sullivan's report on sex and gender data collection. Short version sex data should always be collected separately from gender identity. https://www.gov.uk/government/publications/independent-review-of-data-statistics-and-research-on-sex-and-gender/review-of-data-statistics-and-research-on-sex-and-gender-executive-summary

Obviously if you're feeling fragile then complaining is probably not high on your list of things you want to be doing right now. If you want to link to the form I'd be happy to complain on your behalf.

Review of data, statistics and research on sex and gender: executive summary

https://www.gov.uk/government/publications/independent-review-of-data-statistics-and-research-on-sex-and-gender/review-of-data-statistics-and-research-on-sex-and-gender-executive-summary

WrongKindOfFeminist · 24/07/2026 18:23

Hawksie · 24/07/2026 16:36

It's rubbish OP and I feel the same as you.

I don't write my pronouns, I don't have gender dysphoria but another illness that complicates pronoun use.

I filled in a form and ignored the gender question and they put me down as trans - it was a community organisation. They have now sent said form to my GP and so it's on my medical records and is one of the lies my GP is refusing to remove as they deem it part of my medical records

I now longer feel I can access GP care

That is just not on. What is the GP equivalent of PALS?

Hawksie · 24/07/2026 18:41

WrongKindOfFeminist · 24/07/2026 18:23

That is just not on. What is the GP equivalent of PALS?

There isn't one, I've worked out the ICB may be an option. I am meeting a solicitor on Monday as there's significantly more that has been shared which is inaccurate.

Hawksie · 24/07/2026 18:42

WrongKindOfFeminist · 24/07/2026 18:23

That is just not on. What is the GP equivalent of PALS?

There isn't one, I've worked out the ICB may be an option. I am meeting a solicitor on Monday as there's significantly more that has been shared which is inaccurate.

WrongKindOfFeminist · 24/07/2026 23:06

Gosh. I hope you get things sorted.

BunfightBetty · 25/07/2026 00:18

Hawksie · 24/07/2026 18:42

There isn't one, I've worked out the ICB may be an option. I am meeting a solicitor on Monday as there's significantly more that has been shared which is inaccurate.

Definitely worth getting in touch with the ICB. I've recently got in touch with two separate ICBs to enquire about/moan about lack of timely appointments given by a GP and a hospital department, and in both cases a quick phone call/short email prompted them to contact the GP/hospital department to find out what was going on.

In both cases, suddenly it was discovered that an appointment could, in fact, be found in short order, despite us previously being told that was a sheer impossibility. The GP practice manager was highly pissed off, but so what.

icingonmycupcake · 25/07/2026 00:29

Imdunfer · 23/07/2026 08:48

No-one is asking you to call anyone else by their preferred pronouns, they're asking you want to be called. Why are you allowing this to prevent you from getting access to mental health support?

Because therapy shouldn't be politicised by ideological bullshit.

No one should 'have' to categorically state their pronouns. In fact it could be completely counterproductive for someone who is in a state of flux about their identity. Which may be the very reason why they're attempting to access therapy.

MiraculousLadybug · 25/07/2026 04:56

It’s just too inyerface and when I’m having a MH episode I can’t “just click through and pretend this isn’t batshit” this sort of thing absolutely would prevent me from accessing MH support. I am a detransitioner. People can piss off with their “what pronouns are you?” I don’t fucking know anymore just call me anything while you help me stop wanting to off myself. Mindless bureaucracy and rightthink when someone is vulnerable and needs help and is potentially having an identity crisis is not on at all. How does this cater for people with EUPD who have an unstable sense of self and could spiral if they can’t skip the question and are pushed into a concrete answer? How does it help EAL people access support? It shuts more people out than it helps.

MiraculousLadybug · 25/07/2026 04:58

Also being a detransitioner is part of my trauma that I won’t feel able to talk about in a MH service clearly designed by and for TRAs. How could I trust them?!

SodThisHeadache · 25/07/2026 05:43

I have had mental health support, in large part because of my reactions to losing my much-loved job as result of refusing to go along with gender ideology (transing a child).

Seeing NHS MH services signal their adherence to something so sinister and damaging presented me with an additional emotional barrier. This was not fair on me. I did see a therapist and luckily she was great. But it's pot-luck in the NHS.

Subsequently I sought private longer-term treatment and at assessment I had to request that the allocated psychotherapist was open-minded - and additionally (based on possibly false assumption, I know) I did not want someone young to work with me. I know how ideologically captured the therapy professions are, in their training and via their professional bodies. Look at what is happening to Dr P (Clinical Psychologist).

Discussing my experiences and reactions to them has formed a large part of the work we are doing. I needed to trust the person because I have all-but lost trust in so many institutions and individuals I used to believe to be thoughtful, ethical and professional.

I believe that is someone wants their therapist to use wrong-sex pronouns it is their responsibility to ask that at their assessment. It should not be thrust in the faces of the vast majority who don't know about this stuff, or who are actively against it.

SodThisHeadache · 25/07/2026 06:17

... or like me and @MiraculousLadybug have been traumatised by it

RedToothBrush · 25/07/2026 07:44

One of the things that really sent me over the edge was stuff associated with my brother.

From what I know, mental health issues in family members of someone trans are not uncommon and are often directly related to the trauma on the family.

I'm not remotely surprised by the above two posters but it highlights a real issue.

There's lots of people for whom restricted access methods are really problematic. Autistic people are known to have real issues with telephones. They have a higher rate of mental health problems than the rest of the population. So naturally, our health authority makes all assessments phonecall only... There are absolutely no exceptions for a face to face assessment unless you are hospitalised then and there. It's appalling and not fit for purpose.

Not that the services are worth much anyway. But that's an entire topic of it's own.

SodThisHeadache · 25/07/2026 07:51

Thank you @Redtoothbrush, and I am sorry for the angst you have suffered. This is all so destabilising.
I am knowledgeable, of a mature ish age, reasonably assertive and used to work in the NHS. Still I felt so vulnerable in the face of seeking help from them and not fully trusting them. God knows how others without the advantages I've had are expected to cope.

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