Can we be honest about the need for affirmation?

[FortunateCookie]

I posted some of this on the misgendering thread but it was lost in amongst everything.

I asked on that thread whether refusing to affirm someone’s gender identity was a big deal or not, and many people thought it was, and that it could lead to mental health problems and possibly suicide.

If non- affirmation is so damaging then it also follows that positive affirmation would be extremely rewarding and fulfilling.

It seems obvious that this could lead to serious conflicts of interests. For example, in the case of the woman who asked for a female nurse to carry out her smear test, and was faced with a trans nurse.

Here, when the patients needs should be paramount, she instead becomes either a cause of huge distress, or a vehicle to experience the reward of validation. Either way, it is difficult to see how her needs could be centred against the pull of such a powerful motivation. Do eg hospitals, rape crisis centres recognise this dynamic?

Either it is a big deal that a trans person has their identity affirmed, in which case it should also be recognised that this can cause conflicts of interest in situations where affirmation or not is a factor (ie performing smear tests, working in a women’s refuge)

Or it’s not that big of a deal if a trans person has their identity affirmed and therefore they won’t be offended when a patient asks for a female nurse to carry out their smear.

Which is it?

Totally agree and this is exactly. What happens now. No one as a issue with this and in reality it happens very infrequently. I have a firend who is a trans gynaecologist and you know how many issues she as had none. We face these sort of issues all the time younger nurses routinely get asked by older people to get someone more qualified and if they are insistent then we do that. No one wishes to cause anyone distress as it's not helpful to positive health outcomes and makes the job harder

Bespin
It really isn't in the spirit of MN talk guidelines to lie about what women on this thread have said about requesting females for intimate care like smears.

I think the guidelines still apply to you even though you get special consideration from the mods.

Posts at question our understanding or sexualisation of female genitals are poeple who have no idea of how caring for someone works. We don't know how people with cancer or other conditions feel but we can still care for them and emperthise with them. We are professionals and personal issues do not come into this and if they do we deal with them in the appropriate way.

If you do not feel that my. Post is in the spirit of MN then by all means report it to the mods you have that right.

Bespin
So everything the other MN members said about their experiences as patients are all lies and none of that ever happened because you say so?
Not buying it.

No, I can't do that. I risk being banned for reporting something that violates the guidelines but the mods find acceptable because of who said it. You get the special consideration that the women do not.

Didn't say it does not happen poor nursing happens all the time unfortunately and people act in ways that are not appropriate. I can not infulance that I mearly want to give a perspective that is missing. On this thread as no one else appears to be or as worked with a trans nurse I thought you might want to have that point of view in your debate my mistake

Well if you have nothing constructive to say about what I put then I suppose that's ok then I must have special privileges that other woman don't have as you said.

Right patent interaction you know how many times people have asked if I'm trans none, I tend to put this down to people having more. Pressing matters when they are in hospital and wanting someone who knows what they are doing looking after them.

I would ask you to at least consider an alternative possibility- that the British generally are a polite and conflict averse nation. That patients are vulnerable in many healthcare situations and do not feel comfortable saying no. This is a theme I’ve seen again and again in the childbirth threads - women feeling uncomfortable but too vulnerable to speak up.

This may not apply to you personally - as you’ve said, the EA was used and you do not do smears. Also I dont think anyone on here has said a blanket no to trans nurses in general. Just as they have no problem with Male nurses in general - they just want a female nurse to do a smear.

I have no issue with a trans nurse in general ward situations just as I have no issue with a male nurse in a general ward situation. None whatsoever. But if I was to have an intimate exam Or needed personal care like a bed bath I would request a female nurse or HCP.

The cancer analogy misses the point. Cancer has nothing whatsoever to do with the fact that someone is trans. The state of ‘being female’ does. While you suffer from dysphoria, the patient has no way of knowing that you do. They have no way of knowing whether the person who is treating them is a transwoman with a GRC and gender dysphoria or an individual with AGP.

Again, absolutely none of this is in any way personal to you, or your own professionalism. But women’s right to have a veto on anyone touching their bodies in an intimate way is so important. Women from various faith groups for example could be deterred from accessing healthcare.

Again totally agree with this, though the. Britiah public are becoming. Far less polite and are far more able to. Express there views than they ever. We're and that on the whole is a good thing as health care should be a collaborative process. The organisation acts as the patents advocate in relation to the checks that it does on staff and will endeavour to provide the right staff for the roles.

While personal issues can and do effect how we care for someone I would. Hope that any staff would have enough insight and reflective practice to see the issues and act appropriately either removing themselves from the situation or. Putting the issues to one side.

The smear issue which I have never done and would not choose to do as its not my area of nursing. If I was in that area I would not do them as the potential for issues would be high and I no one comes to work to cause people issues.

Well then. You agree with what's been said here. Why do you think there is a difference?

Totally agree and this is exactly. What happens now.

Well it may be largely what has happened until now.

But there has already been one high profile case of a woman requesting a female HCP for a smear and a trans nurse attending. When the patient said "I requested a woman" was told the HCP was a woman because they are trans. The patient left without having had the procedure.

Now that is only one example, but it's the one example that means it can happen.

Not only that, but until now it has been generally accepted that transwomen are male and, therefore, not women. The current rhetoric has changed to mean that we are being told trans women are women.

All women are trying to do is ensure that the current safeguards are protected. No one is trying to take anyone's job or profession away from them.

Male nurses routinely still get the stereotyped responce that they must be gay all the time and there are some people who don't want gay man do in there care, and they too have the right not to have that person touch them. We all have the right to refuse personal. Interactions with people and.we do not need to state out reasons for doing so.

The case that as been quoted as a few issues and there is a. Conflation between a health care assistant and a nurse in this one as it appears that they might have been a health care assistant. In this case it is poor healthcare not the fact the person is trans though that was the reason. What should have happened is that an alternative person should have been found, or if not possible the appointment rebooked as I have said this is a collaborative process.

I would be very surprised if this was infact a trana nurse who is routinely. Doing smears but probably a care assistant who was covering the clinic due to shortages. But there are few. Details around this so it is hard. To say what happened

If I was in that area I would not do them as the potential for issues would be high and I no one comes to work to cause people issues.

My interpretation of your post is that you agree with what many posters have said, but you don't want us to say it.

Bespin
I suggest you read the title of the post again.
You have taken us far afield with your adamant assertions that this never happens.

It is very easy to say what happened. They apologized to the patient and explained that they had been deceived.

Bespin thank you very much for taking the time to give your insight.

The smear issue which I have never done and would not choose to do as its not my area of nursing. If I was in that area I would not do them as the potential for issues would be high and I no one comes to work to cause people issues.

It is reassuring to hear that you know that to carry out a smear would not be appropriate for the patient. You sound very professional and I’m sure most HCPs are, however we can see in the article I linked that unfortunately not all are.

But I am most heartnened to read this:

it was the organisation who highlighted it and used the positive discrimination in the equality act to limit areas of my practice

It should never be down to individuals. The trans HCP should not be put in the position of giving a smear in the first place as refusal may either cause distress, offence, or as in the example I linked, an inability to put the patients needs first.

I’m relieved to see that as far as the NHS is concerned, trans women are not women.

What I have issue with and why I posted is when people start to go off on generalisations of why or how trans nurses think or that this is in any way sexualised as people were starting to comment on I do not wish to stop anyone saying anything you can say what you like what I want to do is give you a real face to this as this is not theoretical there are actual people doing these jobs every day. You are all entitled to your views on this.

I will never make an excuse for poor nursing and it did look like that was the case. The person should have a GRC or the ccg would be within there rights to ask the person not to work in that area. So without knowing things like that it is hard. To comment on that case and the issues around it

What about if the nurse had a GRC and the patient still didn't want them to do her smear? What about a nurse with a GRC doing smears in general if their birth sex is still obvious to patients?

What is the relevance of a GRC? The patient doesn’t care about a piece of paper?

As I have stated all patents have the right to decide who undertakes there care and accommodations should be made that is either getting another nurse or rebooking the appointment and as. I have said this happens all the time for a number of reasons. The biggest being race at this moment in time.

As smears are a specific procedure and you need to be trained in them I would be suprised if there are a lot of trans nurses again different to care assistants who might be covering and who take people in and support. That work in this area the teams that do this are usually experianced in what they do due to the nature of it. But with shortages at the moment maybe someone covered. Again details for this case are vague

What does a GRC have to do with anything though? From the patient's perspective it makes no difference at all.

You are correct the GRC as not relivent to this in practical terms as the enthasis is on the nurse not to distress the patent and respect there wishes even if they do not agree with them. They are to. Act in a professional manner and seek an alternative. This includes when people are adusive towards usz though at that point we also have the right not to treat them. If I had a nurse who had these issues I would. Seek to address this through supervision and clinical. Supervision and I would. Hope. That they could. Reflect how they impact. On parents and a just. There practice accordingly this is done all the time. For a number of issues if a nurse is unable to see the potential issues they can cause then this is a issue in relation to awareness of others again we can get this with people who are religious who are unable. To put there beliefs to. One side to work with people

Bewilderness - yes to pointing out the special treatment for transactivists here

My interpretation of your post is that you agree with what many posters have said, but you don't want us to say it

I bet this is true. So well observed.

It's just men saying 'no you're wrong, it's like this...' and then repeating what you've said and everyone applauding their point.