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This forum is for Health Care Professionals including student nurses, junior doctors and adult nurses.

Physiotherapy SEEN

327 replies

VenusEnvyXX · 11/04/2024 19:17

I am concerned about the CSP's position statement on transphobia and want to explore whether members think the CSP would benefit from having it's own SEEN.

If you're not familiar with SEENs, they are a balance to the LGBTQIA+ groups, can be formally recognised and eligible for funding on an equal footing as other network groups. They exist in civil service, journalism, police, HR, city, and the NHS one is nearly ready to launch.

I do not agree with Rob Yeldham, and previously, Karen Middleton, when they say that physiotherapy has a transphobia issue. If there is evidence of this I have not seen it.

I have been contacted by a number of CSP staff and members, who share my concerns that this announcement misrepresents the law, defames members and manages to be both unnecessary and unclear.

It seems that people who are diametrically opposed to the view that sex is real and immutable are employed by and in positions of power and influence at our trade union. This is absolutely fine, it is important for a trade union to reflect its membership. I am uncomfortable with the views of activists forming policy without due process and debate. I hope to be wrong, but I suspect that might have happened in the formation of this CSP position statement.

It is difficult to speak up about these issues, people are scared of being accused of transphobia, and rightly so, the personal penalties can be high.

If you would be willing to share your views or insights with me anonymously here then I'd be grateful. Alternatively, (and if you are willing to trust that I am who I say I am!):
email - [email protected]
substack - @venusenvyxx
twitter - @gussiegrips

I am proud to have had a long career in physio and it seems to me that this is little more than a training and communication issue, which, like sex, is not complicated.

bests
Elaine Miller

Position statement on transphobia

We recognise that, like other forms of discrimination, the understanding of the manifestations of transphobia will evolve. We will need to update our position in light of experience and learning, as and when appropriate. This statement will therefore b...

https://www.csp.org.uk/about-csp/equity-diversity-belonging/position-statement-transphobia

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VenusEnvyXX · 11/04/2024 19:18

I meant to say, please spread the word. We'll need a few hundred people to be willing to add voices, which can be done anonymously.

Here's a link to the civil service SEEN

Sex Equality and Equity Network (SEEN)

https://www.gov.uk/government/publications/civil-service-staff-networks/seen-network

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Boiledbeetle · 11/04/2024 19:38

💜 I'm not of any use to you but good luck with it all.

CirrusCumulus · 11/04/2024 19:46

I've just had a look at the guidance. Under 'allyship', the Physio professional body has decided to oppose conversion therapy. This term is seen by transactivists as preventing children from transitioning. In light of the Cass Report, they should look at this again, surely!? (What's it got to do with physiotherapy, anyway?)

SwiftlyseekingSandals · 11/04/2024 19:57

I am a paediatric physiotherapist and like you was shocked by the latest position statement but also by how hard it is to actually work out how they define transphobia.

I work in an environment where we use our compassion and discretion to support children who are exploring their gender identity, whilst recognising that we need it ask questions relating to their biological sex such as questions about puberty to practice as effective clinicians. I would like a professional body that recognises that biological reality is important for many reasons but is integral to clinical effectiveness.

Happy to support where I can be useful.

Anklesprainssuck · 11/04/2024 20:03

OP- Thank you for this thread. To give some clarity, how does one add voices ( email/ letters/ sign up to something) to help take this forward somewhere?

VenusEnvyXX · 11/04/2024 20:30

Boiledbeetle · 11/04/2024 19:38

💜 I'm not of any use to you but good luck with it all.

You are of HUGE use, Boiled! x

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VenusEnvyXX · 11/04/2024 20:39

CirrusCumulus · 11/04/2024 19:46

I've just had a look at the guidance. Under 'allyship', the Physio professional body has decided to oppose conversion therapy. This term is seen by transactivists as preventing children from transitioning. In light of the Cass Report, they should look at this again, surely!? (What's it got to do with physiotherapy, anyway?)

Edited

The paperwork I have been sent says they oppose conversion therapy, which the debate in Westminster showed isn't a thing in the UK, but we don't have a position on trans in sports because we're not experts.

Sports physio isn't a thing, apparently.

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VenusEnvyXX · 11/04/2024 21:15

SwiftlyseekingSandals · 11/04/2024 19:57

I am a paediatric physiotherapist and like you was shocked by the latest position statement but also by how hard it is to actually work out how they define transphobia.

I work in an environment where we use our compassion and discretion to support children who are exploring their gender identity, whilst recognising that we need it ask questions relating to their biological sex such as questions about puberty to practice as effective clinicians. I would like a professional body that recognises that biological reality is important for many reasons but is integral to clinical effectiveness.

Happy to support where I can be useful.

Have you seen the cass review?

I've not read it properly yet, but it seems she is saying that gender issues are a symptom of distress in children rather than the cause.

It's the sort of thing that should be unpicked by HCPs, agree. Someone from the CSP told a member on twitter today that maybe she needed some EDI training so she could ask questions about sex sensitively.

<head shake>

Final Report – Cass Review

https://cass.independent-review.uk/home/publications/final-report/

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VenusEnvyXX · 11/04/2024 21:18

Anklesprainssuck · 11/04/2024 20:03

OP- Thank you for this thread. To give some clarity, how does one add voices ( email/ letters/ sign up to something) to help take this forward somewhere?

Edited

Well, I haven't quite figured that bit out yet...

I need somewhere confidential to collate everything, it needs to be somewhere without phone numbers for the anons and, realistically, incase I am arrested for accidentally committing a hate crime. I am well briefed about not taking a phone but it's best not to have everyone's confidential info in my phone just incase!

Let's hang out here for a bit, I'll use substack, here and twitter. Eventually some clever person with an understanding of tech will happen along and tell me how to do this without using whatsapp.

Thanks for joining in. I think we'll need about 300 of us so please do share with colleagues/friends

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DeepBee · 11/04/2024 21:53

Thank you for setting this up! Trans Actual is also quoted in article and this group is due to give a CPD session at my trust. I wrote a letter via the freedom to speak up guardian, explaining why I didn’t think they were appropriate to give training. I mentioned aspects of their website which is advocating the affirmative model, says that medical transition is safe and that children should be put on a medical pathway. Basically a lot things which the Cass review has now debunked. I was essentially told that gender critical views would not be tolerated.

VivaVivienne123 · 11/04/2024 22:16

Thank you for starting this thread. I am an MSK physio and have read the statement and have significant concerns. The examples of transphobia which include “other forms of discrimination” is extremely vague. Coupled with encouragement to report any perceived transphobic discrimination makes me worry about how those complaints would be dealt with. The Rachel Meade case comes to mind. What can we do next?

TanteRose · 12/04/2024 00:02

Absolutely nothing meaningful to contribute to this but giving you a quick late-night bump (oo-er missus!) Wink

Good luck with this initiative, Elaine Flowers

BoreOfWhabylon · 12/04/2024 00:49

Good luck with this Elaine

Yogiphysio · 12/04/2024 03:07

The CSP statement reads as confused, timing is strange following CASS report.
Definitions ( can it be plural?) vague. Happy to help if I can.
I hope their intent was good but naive?!
who did they discuss/seek advice from?
what’s next Elaine?

Anklesprainssuck · 12/04/2024 10:23

CSP Rob has entered the iCSP space…

GingerCakeWithCustard · 12/04/2024 11:15

I feel the outline of what is considered transphobia isn’t all that helpful. “Other forms of discrimination” is open to interpretation and could have far reaching implications.
The women’s only services that have been set up could be impacted (and may have been already). For example: a women’s only exercise class for women who for cultural or personal reasons don’t feel comfortable or safe exercising in front of men but benefit from being in a group setting, could be impacted if a man who identifies as a woman wishes to join. Surely an individual or a service could get in some very hot water for even questioning whether that person should/could be allowed to join. Is it transphobic to be questioning the impact on the women who the service was geared towards to provide an opportunity for them to participate in exercise and feel safer doing it?
Will it impact chaperoning policy? If a man identifies as a woman, would that person still require a chaperone if treating a woman for certain treatments?
How will it impact a female patient requesting a female therapist?
There is more no doubt, which is why I feel there needs to be much more open discussion in general without fear of being labelled, and particularly about those areas where someone could be considered transphobic when they have not the slightest intention of being so.

BeHangryFox · 12/04/2024 13:19

Thank you for leading this, Elaine.

I've developed a headache from the ferocity of my eye roll on seeing this position statement.

Fascinating to see the key issues - sport and women's spaces - neatly left out, meaning this paper holds as much position as a cloud of steam.

A vacuous piece of bumf that says nothing but could be used to challenge our fitness to practice against whatever is deemed transphobic by the almighty sect.

Anyway, nothing of use to add other than great relief I'm not alone in this. The fact I can't speak a more professional version of the above without potentially threatening my entire career is just devastating.

stealtheatingtunnocks · 12/04/2024 13:26

https://x.com/gussiegrips/status/1778759326951264436?s=46
I think the CSP thought this would go away. It can’t - Paeds physios need guidance about Cass.

https://x.com/gussiegrips/status/1778759326951264436?s=46

VenusEnvyXX · 12/04/2024 14:21

Mr Yeldham does not seem to understand that the time for "conflicting views" about gender in children was before the Cass Review.

In light of her findings I think that if a member applies an affirmative approach in paediatrics then they are doing harm.

There needs to be guidance for members from the CSP. I'm staggered by this response, I really am.

https://x.com/claireOT/status/1778696005724041470

https://x.com/claireOT/status/1778696005724041470

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VenusEnvyXX · 12/04/2024 14:47

I've today made two lists of people - one for people who are "out" and the other for those who are "closeted". If the police come to my door then

I need to work out a way for us to chat confidentially. If you are on twitter, and "out" it would be helpful to comment to the CSP - I have been told they are hoping to frame this as "Elaine is just a Karen, it'll blow over". My impression is they have no idea about the depth of feeling amongst the membership because they have not bothered to engage with us - so if you feel inclined to email in or respond on twitter it might help. Emails are recorded and can be recovered as part of an SAR, twitter puts pressure on because it's frankly, bloody awful press and they wanted to sneak this under the radar.

Mr Yeldham says there is new guidance coming soon on gender health - I have offered to help with this in the past but have been prevented from even observing the EDB committee's work. So much for transparency.

My worry is that we will land up with guidance for a population which is very small and few clinicians have experience of working with. Physio is ideally placed to work with this population:
post double mastectomy shoulder dysfunction
chronic pelvic pain
joint pain
bony injury from osteoporosis
CHD
psychiatric distress
post op complications

The health issues that detransitioners are left with are, frankly, horrific. They are complex in the way that someone who was in an RTA or has radiation burns or widespread excisions are - you've got to pick your way through what you find at the same time as being mindful of their emotional state.

These are the conversations I'd expect a governing body to be having with it's members.

Not "here's what Stonewall and TransActual say"

It's amateurish and embarrassing. I'm very hard to embarrass and I've cringed myself inside out.

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VenusEnvyXX · 12/04/2024 14:49

Sorry! Am chasing my tail - had a call before I finished the message -
if the police come to my door I'll have time to back up the data and delete the lists from the Mac before the police take my tech. I have somewhere safe to hold data that relates to other people.

I've been up to my tits in gender for a long time now, so I want to assure you that I am very good at keeping things to myself. I won't do anything to expose people's information.

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Susiewat · 12/04/2024 15:07

It’s interesting that one of the definitions of transphobia included is attempting to remove trans peoples rights-what rights are they referring to? I want to know exactly what challenging trans exclusionary approaches to service provision actually means. There are some sentences and statements I just don’t understand . As for being on the fence
on sport and single sex spaces outside health care 🤦‍♀️

VenusEnvyXX · 12/04/2024 15:33

The only genderist group which has clinical insights that I know of is GIRES which was set up by physios after their son transitioned.

Here's Bernard, he's very well connected https://www.gires.org.uk/about-us/gires-trustees/

His wife, Terry, sadly died and was, quite rightly, celebrated in Frontline https://www.csp.org.uk/frontline/article/how-my-wife-changed-peoples-lives

When GIRES began 25 years ago we had "transsexuals", males who cross dressed usually for erotic purposes but sometimes because of distress. The latter had genital surgery and I know several trans women in that age group who live happy, productive lives and I sincerely hope that was the outcome for Bernard and Terry's family. There are people for whom transition works - it's just that the landscape of who transitions is no longer middle aged males who have had lots of psychotherapy - it's now tweeny girls who are disproportionately autistic, traumatised, distressed or gay. None of which are things that respond to a double mastectomy.

The festishistic cross dressing was previously conducted at home or in clubs or in secret under standard clothing, not in the workplace. People with distress were few and far between and would be allowed into women's spaces on a favour based system. That lasted til not long after I was a student, there was always some skinny gay lad in the women's loos at the night club, but he was there with a collective permission from us and would be kicked out if anyone was uncomfortable - (I'm sorry if you are new to this, there is some dark stuff, so skip the end of this sentence if you don't want to read about fetishistic behaviours) he wasn't there so he could listen to women pee and steal used sanitary towels for sexual stimulation.

Things are different now, we have males imposing themselves on our spaces and even being confused about why a disabled woman might prefer to have another woman provide her with intimate care.

Sall Grover - Australian woman being sued because she said "no" to a man
Grover, Australian woman being sued by a man she said "no" to M
Henrietta Freeman - a non verbal woman harassed by a trans identifying male because she only wants female carers
https://x.com/mrjamesob/status/1778459506340491340

That's what my issue is about this transphobia guidance and the CSPs position that trans women are women. Well, some might be in law, if they have a gender recognition certificate then it is not legal to treat them as if they are male which all got muddled up and messy and that's why we had male rapists in female prisons and that's why I protested the Scottish Parliament's dreadful Gender Recognition Reform Bill. If not being awfully keen on state sanctioned rape makes me a hateful bigot then, fine, I'll be a hateful bigot. What trans women with a GRC are not, and never can be, is female.

I spoke to somebody senior at Council about this and said that it always comes down to individuals. At the time a woman had had to get to the HOUSE OF LORDS for help after the NHS told her she hadn't been raped on a hospital ward because there were only females on the ward. I said to Alex, this is the issue, inclusion has a cost, if you include a male a female always loses something and it is the female who will pay the price. Her response was to ask me if I was saying that all trans women were rapists. Clearly I wasn't, I was saying that one trans woman who had raped a patient was a rapist. This person encouraged me to consider how upsetting it would be for a trans woman to be placed on a male ward and I'm afraid I became very cross "Just to be clear, you are saying "won't somebody think of the rapist? Are you KIDDING me?" our conversation drew to a natural close at that point.
https://grahamlinehan.substack.com/p/baroness-nicholson-uncovers-a-horrific

So, I started to be very, very scared of what was happening in my governing body and trade union - but it's not just physio, it's ALL Royal Colleges, governing bodies, academia, the police, education, political parties, civil servants, and now, even the bloody transport infrastructure.

We have activists making decisions without speaking to the membership. We are the ones they are supposed to be serving. I do not think it is unreasonable to expect them to get the law correct, to consider unintended consequences and to engage with the membership rather than police us.

I will get into trouble for this, I am aware. I am upsetting people with power and influence who would really, really like me to shut up. However, as I said, I have been up to my tits in this for a long time and I'm confident that if I need help I can get it.

I only really have one skill and that's being noisy. The CSP used to think that was an asset to the profession.

Now, I know this is a LOT and some of you will not be up to speed about the wider issues in gender. If you have questions please do ask. If you have rebuttals please make them. I'm not a fan of hashtag-no-debate and I still, against all logic, hope to find that I am wrong.

I expect my profession to provide excellence in care - that includes those who have a gender issue. I don't think we are anywhere near that, unless we have a proper conversation about the actual health issues linked with transition we are no more than cheerleaders at pride pretending that a glitter rainbow is all you need to fix these people's pain.

We can do better and either we will do better or I'll be struck off for insisting that we try.

Gender Identity Research & Education Society – Improving the Lives of Trans People

https://www.gires.org.uk

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