Mixed sex wards and trans women.

[sarsleypage]

I've opened a new account as the old one was too full of personal bits and someone could've connected the dots.

I am a medical student and we have a diversity lecture coming up, so I had a look at the LGBT slides. A lot of this seems to focus on trans.

I got curious about the requirements for sex-segregated wards, as I know this has been an issue for a while. Women want single-sex wards, both on wards for physical illness and those for mental illness, because they see themselves as vulnerable to abuse from men, especially whilst ill.

Fine. Nobody seems to oppose this, and it's become a requirement in pretty much all hospitals.

And then you see this: uktrans.info/attachments/article/5/trasngender_booklet_low%20res.pdf

"• Trans people should be accommodated according to
their presentation: the way they dress, and the name
and pronouns that they currently use.
• This may not always accord with the physical sex
appearance of the chest or genitalia;
• It does not depend upon their having a gender
recognition certificate (GRC) or legal name change;
• It applies to toilet and bathing facilities (except, for
instance, that pre-operative trans people should not
share open shower facilities); "

There's an example in the leaflet of a young female nurse refusing to wash a trans person because it was against her religion. This is held up as an example of trans discrimination.

I am struggling to square this away with feminism. In fact, I don't think it does square. Women have fought for this segregated space, based on female sexual characteristics (not a preference for make-up, long hair, but XY/vaginas/generally smaller in stature and weaker). But now, apparently, if you decide you feel like a woman, you're entitled to be on a woman's ward when women are at their most vulnerable.

It means if you're sectioned under the mental health act and a trans woman with a penis is on the ward, you have no legal argument to get them removed to make you feel safer.

How is this right?

YY to that. Everyone deserves decent healthcare, and it would seem obvious to me that careful statistics be kept on trans individuals taking prescribed hormones or postoperatively. We need to know the long-term risks.

But from what I've read, a lot of trans people, impatient with gate keeping, are obtaining meds online without prescription. This is either instead of official prescriptions or as well as. Elsa told us about other parents encouraging her to get online blockers for her child during her time with Mermaids.

If there are enough trans people taking meds that haven't been prescribed it will be difficult to measure long term outcomes of them as a patient group. You don't even know who you're measuring. It'll be more like research into the use of street opiates, which can never be accurate.

Still, I guess that the patients who only take what they've been prescribed can be followed up. I find the fact that children are being given medication off-label very concerning.

Surely it is illegal to purchase medicines off the internet and to administer them to a child without a prescription, or worse still off-license when there is ZERO safety data? I think I read that the puberty blockers that are used on children are actually chemotherapeutic drugs that were developed to suppress the pituitary gland's production of hormones fuelling a tumour. Would any parent feel comfortable "free-styling" their own chemo regimen for their child without medical guidance or regular monitoring? For parents found to be administering puberty blockers outside of medical supervision, I think care proceedings would be entirely appropriate. I also have a view on doing so under medical supervision, but hey ho...

I suspect the only illegality is if there is regarded as damage to the child. I tend to favour parental freedom until children are more like 13 - 15 when they should have a lot more say in making their own decisions.

I would imagine that if it came to light that parents were obtaining illicit supplies of puberty blockers or cross sex hormones that this would be perceived as a safeguarding issue, though these days who can tell, we've gone so far down the rabbit hole. If parents have the money they can get them legally. The CEO of Mermaids obtained medication for her gay son by flying him to the US for prescriptions at 12 and flew him to Thailand for SRS at 16. People at Mermaids assure us the kid is very happy but is suspect many such individuals will experience profound regret as they mature.

While I agree that teenagers should have the right to obtain some forms of medical treatment, contraception for example, I don't think their wishes should extend to action that will sterilize them or cause lifelong physical changes. Girls on testosterone aren't always affected permanently but some find themselves stuck after only a few years with a bass voice, male pattern baldness and heavy male facial and body hair. A high price to pay for some serious teenage angst, and the fact that many lesbians don't recognize their sexuality until they reach their 20s.

We don't permit teenagers to opt for sterilization in any other context, and rightly so. I would have told you I was never going to have children right through until my 30s. Much of the medical treatment available to trans teenagers is, imo, far too risky to offer to immature brains.

Prawn and indeed many adult women are denied permanent sterilisation by their GPs, even when they are adamant that their family is complete, until they are in the 30s "in case they change their minds".

if transgendered men on hormone therapy are at risk of developing breast cancer in an attempt to become something they are not (female) the doctor prescribing the hormones should stop doing so. It is a truly a crazy society where someone can receive damaging hormones and surgery from a doctor to treat correct the mental illness of gender dysmorphia.

Well, pretty much everything that is prescribed carries the risk of side effects but the doctor and patient weigh up the risks of taking the medicine or not taking it and decide whether to proceed. Taking the pill increases the risk of certain cancers (but appears to reduce the risk of others), for example, but for most low risk people that increased risk is better than an unwanted pregnancy. So I don't think it's a simple as not prescribing at all, I think there needs to be a better understanding of the different risk factors, which can only be achieved if proper data is collected that distinguishes between women and transwomen / men and transmen