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?

But Bowlofbabelfish, if the patient has requested a female HCP but is presented with a tranwoman, and knows that refusal to affirm can lead to mental health problems and even suicide, as well as to themselves being thought of as a bigot (as shown by GibbertyFlibbert on this thread), then how could this ever NOT get in the way of patient care. The pressure on the patient to affirm the tranwoman as female, despite their own feelings (from discomfort to distress), is immense.

That reply was to your previous post

I don’t think I’m disagreeing with that fortunate? That’s pretty much what I’m saying. That it shouldn’t ever get in the way of patient care, and any person who tries to push it in a ‘you must affirm me or I’ll kill myself’ way is not fit to practice.

A patient has the right to ask for a same sex HCP. Whoever is supervising would be wrong to then send that person a trans HCP when a single sex one was specifically requested.

Tbh I am uncomfortable with the entitlement to pretend you are the opposite sex and knowingly attempt to deceive everyone you interact with, which underpins the fear of being 'outed'.

How about you stop lying, pretending and deceiving eh?

Other people have the right to form boundaries and recalibrate them according to each other person's sex.

'Enjoying', feeling more 'comfortable', more 'yourself' and more 'authentic' is a very selfish justification for denying others their right to treat you according to their appropriate boundary.

You should be open and honest about who you are not over step the mark with others because you will be 'outed' for being the deceiving liar that you are.

Yes I know, but your point seemed to suggest that there are individual trans HCPs who would use this for validation, whereas I’m trying to say that what the individual trans HCP thinks is irrelevant, as far as the patient is concerned they are ALL seeking validation and this is what compromises the patients care.

I don’t think I’ve explained that very well, I hope you get what I mean.

It’s the dynamic that’s the problem, not he individual HCPs is what I think I’m trying to say.

No that’s a very good point - and I agree. I think both scenarios could be valid actually and it does show the power imbalance.

The patient has no idea if the HCP is acting in good faith and thus is under pressure regardless? Yes I think so.

It’s the dynamic that’s the problem, not he individual HCPs is what I think I’m trying to say.

Yes I agree the dynamic is the issue. And resolving it at that level removes the need to single out individuals- blanket policy on same sex providers is probably easier and fairer than case by case

You should be open and honest about who you are not over step the mark with others because you will be 'outed' for being the deceiving liar that you are.

The law that has encouraged this behaviour, and made it possible to legally obscure your true identity, is part of the problem. It helps no one. It doesn't help the person who is in constant fear of being 'outed'. It doesn't help the wider public who are deceived and /or forced to go along with the lie. It doesn't help the young people struggling with gender identity issues who are being coerced into a lifetime of deceit in the quest to be their 'true selves'.

blanket policy on same sex providers is probably easier and fairer than case by case

Definitely. This has been such an interesting thread. I would love to get views from inside the health service on this.

Great points OldCrone

I asked for a certain female doctor a few weeks ago. I was told that the other female doctor in the practise was on long term leave and so Dr A was incredibly busy. If I had to have a female doctor it was roughly a month waiting list. I could see a male doctor the next week.

There are times women want a female to examine them. This is not unreasonable and should be provided. Likewise if a man wants a make HCP.

I've pinched this quote from another thread.
it is men who designed the hierarchy with themselves at the top, and it is men who are trying to create a new class of people who cannot be told no, and have been given the right to take priority over all others on the basis of how they identify.

This sums it up for me. We have created a situation were a group of people are allowed to dictate how people behave around them, even to lie to keep them happy. It makes no difference that individual TIM wouldn't put themselves into certain position, because a culture has been formed where it's impossible to say no anyway.

It seems off to me that TIMs would head straight for a job where women are vulnerable. Why? There's plenty other careers.

They already breached two boundaries 1 womanhood 2 heading straight for work where women are at most vulnerable. These are huge red flags.

Pratchet because if non-validation is so awful that it can lead to suicide the it follows that positive validation would be extremely rewarding and fulfilling.

When women are vulnerable they often want other women to care for them (as in smear test example). To be validated as a woman in that environment must be quite a high. And that’s without bringing AGP into it. Even so, I would not want my smear test to be someone’s ‘fix’.

Same.

if non-validation is so awful that it can lead to suicide the it follows that positive validation would be extremely rewarding and fulfilling.

And we're supposed to believe that this isn't a mental illness.

Placemarking

There are also a small minority of people who push boundaries to force women into participation in a sexual fetish.

Since no one can reliably determine the difference between hurt feelings, AGP, or it being someone’s paraphilia, a blanket policy of ‘ask for a same sex provider, get one’ would seem to be wisest.

Babel: re searching, I agree. The trans person will say it's assault to be searched by a male. I'm just envisaging the situation. Also I've heard about female officers who have been in the situation and had to do it. Will seek link.

Notts police have to accept self ID because it's illegal to ask for GRC

Checking whatvghey say about searches

Although they are asking for some extra checks actually

Yes I agree the dynamic is the issue. And resolving it at that level removes the need to single out individuals- blanket policy on same sex providers is probably easier and fairer than case by case

Exactly. This dynamic is what the single sex exemptions in EqA are for.

You couldn't have a blanket ban on men doing cervical exams or gynocology because there are loads of very good male gynecologists. The solution we have is that women bothered can ask for a woman or can ask for a third party to be present.

The current system works fine. Transwomen being real women unquestionably and then entering nursing or gynocology (or transitioning after) is disrupting the exsiting system.

So there are two options, stop transpeople working in women's health or stop treating woman as bigots for saying transwomen are not real women and give them the right to ask for an actual biological female.

On a side note, if you asked for a woman to do your smear and a transman or none binary biologic female attended, I think it would be transphobic to refuse that person.