Are you in Devon, Bristol, North Somerset or South Gloucestershire? Tell NHS your view on trans guidelines NOW

[anotherFOIrequester]

Happy New Year!

Starting a new thread with the aim of putting all the information in one place as I now have a clearer picture.

Old thread here: www.mumsnet.com/Talk/womens_rights/3755711-Help-FOI-request-trans-guidance-in-NHS-in-South-West?pg=1

The NHS CCG for Bristol, North Somerset and South Gloucestershire are adopting 'best practice' guidance for trans patients that you can read here:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_5Nov19_item6.4.pdf

There is no consideration of women or anyone else with protected characteristics, eg 'Providing education to other service users in a ward to prevent ignorant or transphobic comments is, if successful, a better solution than having to protect or isolate the trans service user'.
There has been no equality impact assessment, no risk assessment and no consultation with patients who don't identify as transgender.

The guidance is produced by Bristol charity SARI (Stand Against Racism and Inequality) but the meeting minutes below reveal that the lead writer is Cheryl Morgan, director of the Diversity Trust:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_3Dec19_item3.pdf

Morgan is a transwoman who attended a menopause event and claims the ability to breastfeed:

medium.com/@elsaegret/abusive-misogynist-activist-writes-nhs-policy-in-bristol-21dd02cc4c9c

Morgan has also used abusive language to women for many years:

www.thetimes.co.uk/article/police-used-violent-transgender-activist-for-equality-training-x0mktgclw

SARI and the Diversity Trust have form:

medium.com/@elsaegret/stitch-up-bristol-fashion-f1eb298e28da

The guidance also features the logos of North Bristol NHS Trust and Devon Partnership NHS Trust. I have FOIs pending with both of them to establish what's happening there.

In response to women contacting the BNSSG CCG, they are now conducting an EIA, for what that's worth.

The good thing is we are disrupting the usual 'under-the-radar' proceedings before this is signed off - this is the time to contact them if you're in those areas, or if you're in Devon, or if you live elsewhere but use those NHS services.

Bristol/South Glos/North Som: [email protected]

North Bristol NHS Trust: [email protected]

Devon Partnership NHS Trust: [email protected]

[popehilarious]

Not meaning this nastily kit19 but that's a bit of an assumption and perhaps not appropriate if she isn't publicly out?

[Kit19]

True - I’ll ask fir my list to be removed

[Kit19]

I’ve reported it & asked it to be removed

[Jux]

I'm in Devon - I'm writing to Paul Johnson ^^; I still can't find anything else on it that's local. Sorry, I'm being a bit useless atm as I've been ill for over a month (not COVID!).

[Watermonster]

@anotherFOIrequester
I share your anger- but take heart- it's not all bad news re Bristol. Every woman on here who has written to them, or got someone else to if she is too scared, makes a difference.

The CCG know they are at risk of legal action for religious/ sex discrimination if they proceed with the trans guidance and ignore the rights of other Protected groups, and that it is a safeguarding breach.

Following complaints, the CCG have now removed all mention of gender on the 'Equality and Inclusion ' page online and instead now link to the Equality Act. New wording-
'We aim to provideequality and fairness for all, andnot to discriminate on any basis'
bnssgccg.nhs.uk/about-us/equality-diversity-and-inclusion

We need to keep reminding them policies and guidance must consider women and children, not just males, be legally compliant, evidence based and free of political ideology. Every time. Every part of every sentence in the trans guidance must pass this standard. And if not, do a formal complaint. And repeat.

[anotherFOIrequester]

That's interesting Water. What was it before - all Gender McGenderface I assume?

You're right - but that's what makes me so angry, that we have to do this. It's in law already FFS! And doing it takes time and energy that we really don't have to spare.

[Watermonster]

Yes- all trace of sex and religion as protected characteristics had been removed in favour of 'gender' , now changed to the Equality Act link following complaints.

Every time I meet a woman now self excluding from abuse support locally because Bristol CC has made everything mixed sex/ self ID it makes me even angrier, and the fact that NHS organisations are prioritising the demands of males over the needs of vulnerable women and children/ safeguarding beggars belief.

[anotherFOIrequester]

And the women running the services women 100x more vulnerable than them are now self-excluding from say 'we're nice and inclusive and there are no problems'.

[Watermonster]

Bristol and North Somerset CCG has now further delayed the results of the Trans guidance EIA and next steps- new date 'by Oct 2020'.
This will be after Liz truss announcement.

[anotherFOIrequester]

Where did you see that Water?

Well God forbid that they write guidance based on what is right and what's best for women and girls, in the knowledge that it's perfectly possible and legal to maintain single sex wards and services even when someone has a legal fiction certificate. How much better just to go with whichever way the political wind blows...

[Watermonster]

@anotherFOIrequester have PM'd you

[nothingcomestonothing]

Hello GC feminists in the South West, I am loving your work! I found this thread while googling for info - I work for an NHS trust in another part of the country.

I had made an appointment to meet with the Trust's whistleblowing support person (don't want to give the actual job title in case it's specific to my employer) re the mile-wide safeguarding holes in the Trust's transgender care policy. Then I cancelled it, once I realised the Trust's policy is lifted wholesale from the nonsensical NHS single sex guidance annex b, so there is no point.

I went searching for other documents on our intranet, and found the equality impact toolkit, which the Trust helpfully provides so individual services can ensure their policies are compliant with the EA. There is a handy chart of the protected characteristics to tick off against - sex does not feature. It doesn't have a column. Neither does gender reassignment - there's just a column for gender. I actually felt a bit sick seeing it, and realising that my employer has decided to pick and choose which bits of the EA to check they are compliant with, and sex wasn't important enough to be on their helpful chart.

The reason I'm posting this here is to say, maybe don't set too many hopes on the equality impact assessment you're waiting for. If they use the same toolkit my employer does, sex won't even feature in their assessment.

And also to say, thank you for your hard work in pursuing this - I would like to do the same in my local area, except I'm scared that it'd cost me my job. I'm already on thin ice having failed to attend the transcheerleading diversity training, and having declined to put my preferred pronouns in my email signature. So thanks for being braver than me.

[anotherFOIrequester]

Hi nothingcomes nice to hear from you as a current NHS employee. You're right that it all comes from national level, but the way I see it is we've got no way to get national executive people to listen. CCGs at local level do have to listen to patients and service users though, and if enough of us make a fuss it may make a difference.
I see EIAs as a tool and a record really - if it's crap we can then loudly object to the crapness and cite the actual law. I went to a brilliant workshop with Audrey Ludwig and Julian Norman about EIAs - there is a write up somewhere which I'll post below when I find it.
I don't work in the NHS so it's not a question of bravery - it's much harder for you. My sister does though and so did our mum - in fact we wouldn't exist if she hadn't come to this country to do so :) So I'm aware a little bit of how things work - my sister said she's braced for this to come in and is thinking about how to respond when it does.
If you don't feel you can speak at work you can always send FOIs!

[anotherFOIrequester]

womansplaceuk.org/2020/07/20/making-policies-equality-act-compliant/

[ThinEndoftheWedge]

Nothing

sex does not feature. It doesn't have a column. Neither does gender reassignment - there's just a column for gender.

On the back of your post I checked the trust policy at my work.

There is a more formal policy which states all the EA characteristics correctly, and another document that just states race, disability, gender, sexual orientation and age. They do go on about gender elsewhere.

My trust isn't woke so I think that for gender, they do actually mean ‘sex’. I am prepared to write to them to correct them on this document, however as it also doesn’t state gender identity/gender reassignment etc, I don’t want to suddenly inspire them to go off looking for input from Stonewall et al.

So I have decided to keep abreast of at changes and will write formally if it is changed to gender +gender reassignment or gender identity.

[gardenbird48]

I have now written to my local Trust. This is a summary of their policy:

Regarding the provision for Transgender Patients - self-declaration is allowed with no apparent gate-keeping. They will be asked for their preferred ward and allocated accordingly. A side room may be offered but they will not be placed in one without their consent.

1. Discrimination from staff, other patents (sic) or the public will not be tolerated. this is obviously fine but discrimination is a very broad term and could almost cover any situation
   
   
2. If patients or the public are discriminatory, they should be reminded that this behaviour will not be tolerated by the Trust. Continued failure to comply with the required standard of behaviour will result in the Security Staff or Police being called and the removal of the offending individual form the Trust Premises.
   
   That reads to me that if a female objects to a trans woman choosing to be on the female ward, they could get removed from the hospital -which seems a bit harsh, especially as they are pretty likely to be in for essential medical treatment.
   What if the female patient suspects that the intentions of the trans woman (or possibly person pretending to be a trans woman) are less than genuine? What are her rights to raise concerns?
   Does the trans woman's choice of wards extend to the maternity ward? This sounds like a silly suggestion but it is not specified that there is any limit to the trans woman's choice of ward so presumably this could be an option? Why write a policy that creates grey areas?
   
   It could cause a difficult situation for the nursing staff if the trans woman (or person pretending to be a trans woman to access women) has an expectation of a free choice of ward - how will this be dealt with? Part of the policy suggests consequences for staff raising issues so are they going to be willing to react to a woman's request?
   As with so many of these policies there seems to be no mention of any safe-guarding precautions so I'm guessing there are none.

[gardenbird48]

A quick update - I’ve had a response and all is fine apparently (unless you’re a women who doesn’t want to share a ward with a male bodied person). They are misusing the Gender Reassignment pc to allow self id into wards and ignoring the exemptions.
If anyone has the clarification on why this is not correct to hand can you chuck a link my way please - I want to get my response correct and apparently they are currently reviewing the relevant policies.

[ThinEndoftheWedge]

garden

This might be useful - by feminist lawyers:

www.mumsnet.com/Talk/womens_rights/3961169-LegalFeminist-Twitter

The blogs posted on the 17/7 - are TW women for all purposes and 25/7 about personal care should be helpful.

[334bu]

Below is an extract from the Equality Act2010. Note what is said about hospitals.




paragraph contains exceptions to the general prohibition of sex discrimination to allow the provision of single-sex services.

734.Single sex services are permitted where:

only people of that sex require it;

there is joint provision for both sexes but that is not sufficient on its own;

if the service were provided for men and women jointly, it would not be as effective and it is not reasonably practicable to provide separate services for each sex;

they are provided in a hospital or other place where users need special attention (or in parts of such an establishment);

they may be used by more than one person and a woman might object to the presence of a man (or vice versa); or

they may involve physical contact between a user and someone else and that other person may reasonably object if the user is of the opposite sex.

735.In each case, the separate provision has to be objectively justified.

736.These exceptions also cover public functions in respect of the “back-room” managerial, administrative and finance decisions which allow such single-sex services to be provided.

Background
737.This paragraph replaces some similar provisions that only covered public functions and some that applied to services in the Sex Discrimination Act 1975. These exceptions have been extended to cover both services and public functions.

Examples
738.These exceptions would allow:

a cervical cancer screening service to be provided to women only, as only women need the service;

a fathers’ support group to be set up by a private nursery as there is insufficient attendance by men at the parents’ group;

a domestic violence support unit to be set up by a local authority for women only but there is no men-only unit because of insufficient demand;

separate male and female wards to be provided in a hospital;

separate male and female changing rooms to be provided in a department store;

a massage service to be provided to women only by a female massage therapist with her own business operating in her clients’ homes because she would feel uncomfortable massaging men in that environment.

[gardenbird48]

that's brilliant thank you both - I will check out that feminist lawyer thread and work out how to go back to them.
Am I also right in thinking that the law hasn't defined 'trans' or 'transgender' yet either so I'm guessing that they are not yet a legally recognised replacement for the term transsexual?

[anotherFOIrequester]

This is so excellent from Maya Forstater: a-question-of-consent.net/2020/09/16/doctors/

Still can't believe that no one has ever gone 'hang on a second...' about any of this... well it's only women after all.

[anotherFOIrequester]

I've now received the notes from meeting in July - women raised similar points it looks like. No one can claim ignorance. IDK what's happening with the EIA.

Introduction



Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG) arranged a listening event with members of the public to hear the concerns they have about the Supporting Trans People Toolkit.



Julia Ross, Chief Executive for BNSSG began by thanking members of the public for the information they had provided prior to this event and for taking the time to meet today. Julia apologised that wider input was not obtained in the development of this Toolkit and acknowledged that this is a sensitive issue.



Julia assured the group that BNSSG is committed to reviewing and taking into account all the documentation that has been submitted by members of the public as part of the Equality Impact Assessment process. Julia updated on progress to date and then opened the session to public feedback and input.



Themes from the public – what we heard



A concern was expressed about the need for transgender support guidance specifically and members of the pubic questioned the broader approach to guidance for other protected groups.

Concerns were raised about the original authorship of the Toolkit and who will be involved going forward.

Members of the public stated that a conflict exists between the legal position (sex as protected characteristic) and the toolkit contents which imply gender identity as a protected area.

Members of the public further raised concerns that biological sex and gender identity have been unhelpfully conflated in the document, and expressed that this would ultimately be harmful to women and girls.

Members of the public were concerned about the section on same-sex wards. Concerns were raised that women could effectively be placed on mixed-sex wards without knowing it and that this compromises dignity and safety.

It was stated that women have the right to know if they are on a mixed-ward without having to disclose discomfort or that they have been victims of abuse. It was also raised that









women may be scared to speak up, and the onus should not be on women to protect their dignity in single-sex spaces.





Concerns were raised that NHS staff are being ‘forced to accept that men are women’ and concede to gender identity as a belief. A comparison was made here with religious belief and freedom of expression.

Members of the public raised the potential disproportionate impact on young lesbians, and referenced a 4, 400% increase in young women seeking help for dysphoria over the last decade.

Members of the public raised concerns that Bristol does not have a Lesbian Alliance Group and that schools are referring young people to LGBT+ organisations if they are gender dysphoric.

Members of the public raised concerns about the current references to suicidality in the toolkit as irresponsible.

Members of the public raised BNSSG’s status as Stonewall Diversity Champions as potentially problematic given the organisation’s recent stance on gender issues. Members of the public also questioned female staff within the CCG would feel comfortable with this position.



Conclusion



Julia thanked everyone for their time and assured the group that the submissions received and the views given at this event will be built into the EIA.



Julia confirmed that BNSSG are committed to maintaining communication with members of the public about this subject.



Further written representations can continue to be made by email: [email protected]

[anotherFOIrequester]

garden It comes down to the illegal guidance that Ann Sinnott is challenging and its influence on national NHS policy I think... Check out Ann's crowdfunder (can't link on MN but google hername)

[gardenbird48]

thanks for that information anotherFOI - that is most helpful - I have sent my letter now and made that the crux of it along with my specific questions re. how they will meet the needs of women patients and filter out any potential abuses of the self-id.

It sounds like the person I am in contact with is at a more local level but she said that my letter came as they are reviewing their policies so we shall see.
I might write to the bnssg email you gave to request progress updates as they work through this.
btw, not sure how local you are but did you hear about public toilets in parts of Devon being made mixed sex?

[nothingcomestonothing]

another that piece from Maya Forestater is fantastic.

I'm still working up the courage to make a FOI to the Trust who pay my wages re their Transgender Care Policy.

I have a tiny amount of belief that the sands might be shifting - my manager, who earlier in the year tried pretty forcefully to get me to attend what my team now call the Woke Training, laughed when I suggested she solve our pressing lack of nurses by just employing people who identify as nurses. Some previously unquestioning people seem to be starting to see the wood for the trees a bit.