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Feminism: Sex and gender discussions

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

249 replies

anotherFOIrequester · 02/01/2020 11:41

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]

OP posts:
anotherFOIrequester · 22/11/2020 13:07

yes indeed water - it fits into the overall strategy of opening up the spaces and services of the most vulnerable women and girls to males (see also prisons, refuges, schools), who are also the least likely and least able to complain. And even if they do, to get their complaint heard and taken seriously.

Those pushing this can then announce 'look! there are no bad consequences! no one has complained! everything is great! on to the next one!'

Best wishes to your friend.

OP posts:
anotherFOIrequester · 22/11/2020 13:08

Wow enjoy your birthday garden - reckon you will need that sherry!

OP posts:
anotherFOIrequester · 22/11/2020 13:12

@MissMarplesGlove

This is a huge issue for women needing intimate procedures/ wards or care to be carried out by same sex staff

I read the policy for my trust in the SW. It's all about "inclusion" for those who identify as transgender. Which is important of course - the point that a non-normative identity can often mean familial rejection is a strong one.

But, there's only one point at which the impact on single sex wards & treatment is mentioned. They cite the Equalities Act about "proportionate action for a legitimate aim", but don't give policy guidance to hospital staff - it's very much left as an individual case by case decision, which, as lawyers have shown, is NOT the intention of that phrase which allows biological sex to be considered over the legal "fiction" of gender reassignment.

Most unsatisfactory. If you're ill, in pain, elderly, how are you going to be able to advocate for yourself, apart from flat out refusal of treatment?

If you're ill, in pain, elderly, how are you going to be able to advocate for yourself, apart from flat out refusal of treatment?

Exactly.

OP posts:
BettyDuKeiraBellisMyShero · 23/11/2020 17:36

Wow.
Cracking work.

I’m hundreds of miles away and opened this thread by accident but I’m glad I did because it’s an eye opener.
The absolute bonkers ness of not being able to see the minutes because they were made by a person from org B instead of public body A is a proper aaaaarrrrgh moment.

popehilarious · 23/11/2020 21:56

Bloody hell, some people are really going out of their way to have NONE of this minuted/documented? It reads like a farce!

Watermonster · 26/11/2020 19:27

The EIA is now published, along with a letter from Doctors objecting to the trans guidance, which they state is abusive to women and girls.
The EIA states THERE IS NO EVIDENCE THOSE WITH GENDER DYSPHORIA POSE A RISK TO OTHER PROTECTED GROUPS.'
They were overwhelmed with evidence to the contrary. They knows it's a lie.They know their policy allows any male to self ID as a woman and go on a womans ward depending on clothing choices.
NO reference to womens needs - acknowledges some women with religious beliefs or who have been raped may object/ be excluded.

Watermonster · 26/11/2020 19:44

What else. Oh yes, no mention of women's privacy, dignity or safety. We don't matter. Got a penis? Welcome to the womens ward. Need a single sex ward? Go away, no care for you.
Minor changes to the trans guidance where it clearly breaks the law- eg it will have to state women are protected by sex in the Equality Act, and should not be threatened with 're education' if they object to men in womens wards. But that won't change the guidance. No woman will have any right to a single sex ward.
They will amend the bits that recommended mastectomys and breast binding for teenage girls as the doctors point out this is abusive to lesbian girls who desist.
No mention of the increasing sexual attacks on women in hospital.
No mention of how to provide care for women who can't go in mixed sex wards.
No mention of consent, or the coercive control in telling women they must get undressed and share sleeping accommodation with men to access care.
No mention of the Health Secretary's statement that these trans policies are detrimental to women and girls.
Quotes EHRC guidance without advising the board the guidance to which they refer is facing legal challenge (thanks Ann Sinnot) and the government said a couple of weeks ago it doesn't reflect their view.
No reference to equality Act provision for single sex wards, or that women can object to the presence of males when undressed, under strong medication and vulnerable.

This will have an immense impact on many 1000s of women across Bristol. The CCG is a disgrace. Why is the government allowing such abusive policies to continue? I am so angry. If anyone knows anyone in the press or in government please share.

Here's the link.
bnssgccg.nhs.uk/events/governing-body-meeting-1-december-2020/88/

UppityPuppity · 27/11/2020 08:33

Watermonster

No mention of the Health Secretary's statement that these trans policies are detrimental to women and girls

Where/when was this stated?

gardenbird48 · 27/11/2020 10:23

just reading through it now - thanks for the link - I would never have found that.
this early amendment to the existing trans support toolkit caught my eye, well at least they now acknowledge Sex as a pc [eyeroll emoji]

" Acknowledging sex as a protected characteristic under law in the crisis management section, and making stronger reference to national guidance in this area."

popehilarious · 27/11/2020 10:44

Acknowledging sex as a protected characteristic then deliberately not protecting it...

anotherFOIrequester · 27/11/2020 11:00

Haven't really had time to look properly yet but thank you so much to Dr Lucy Griffin and her colleagues for that excellent letter and for following up in the meeting. Absolutely brilliant job. Actually had a bit of a lump in my throat reading the letter and knowing that there are brave people in the NHS trying to do the right thing.

The table where the impacts on the 9 PCs are summarised says it all. Green for gender reassignment, red or orange for everyone else. I disagree that there's no effect on ppl with sexual orientation PC - as raised above, there's a strong negative impact on young lesbians.

Also note that they rely very heavily on the EHRC guidance which Ann Sinnott is currently challenging - with no mention of the challenge.

Really shows how important the challenge is (please don't mention the way we can all help Ann on this thread as there are rules about that...)

OP posts:
gardenbird48 · 27/11/2020 11:05

Within the report from GIRES, it is estimated that in 2007 the prevalence of people who had sought medical care for gender variance was 20 per 100,000 (i.e. 10,000 people in total). Of this total, it was estimated that 6,000 had undergone transition; 80% were assigned as boys at birth and 20% as girls. GIRES also references more recent data from the individual Gender Identity Clinics to anticipate that the gender balance may eventually become more equal.

Following publication of the draft toolkit in November 2019, the CCG received a number of representations from women’s groups and members of the public to suggest that the toolkit as currently written could have an adverse impact on women and girls.

The toolkit can help to educate health and care staff about the specific challenges this group faces; without undermining the need to respect, safeguard and care for all children. A U.S. study identified that socially transitioned transgender children (children presented and raised as their preferred gender) have better mental health outcomes therefore appropriate support is vital for their overall wellbeing and health. citing the US study before the correction showed that there is no improvement to mh or sometimes a deterioration.

This was supported by legal advice received “reliance on the exemptions under the Equality Act 2010 (EqA) will only be done in exceptional circumstances and does create a status quo going forward”. emphasising exceptional circumstances with the possible implication that single sex wards do not warrant exceptional circumstances (esp. when read in conjunction with NHS Delivering Same Sex Accommodation)

The statement “doing nothing or delaying treatment CAUSES HARM” should be removed. in reponse to clinicians representations that this is not true - a positive move! AND they reference Keira Bell's case directly (although not by name).

The toolkit currently states that “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” – this reference should be removed. at least they are not going to 're-educate' us now...

The EHRC states “In UK law, ‘sex’ is understood as binary, with a person’s legal sex being determined by what is recorded on their birth certificate. A transgender person can change their legal gender by obtaining a GRC. A transgender person who does not have a GRC retains the sex recorded and is protected under the Equality Act as per their legal sex or under the protected characteristic ‘Disabled’ in some circumstances (impaired or limited ability to engage in certain tasks or actions, or to participate in typical daily activities). mixing sex and gender but generally correct re. non GRC sex comparator being birth sex I think? Interesting to consider why they mention the application of pc of Disabled specifically in relation to transgender people? If they were disabled surely the transgender element would be irrelevant - are they trying to argue that transgender creates some element of disability??

It acknowledges the concerns and needs of women (specifically mentioning older women and religious needs) and refers to the Delivering Same Sex Accommodation document which says this:
Providers of NHS-funded care are expected to have a zero-tolerance approach to mixed-sex accommodation, except where it is in the overall best interest of all patients affected. brilliant!!

until you get to this Annexe:
Trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use.
no actual signs of transition need to be demonstrated and: all transgender people whether they live continuously or temporarily in a gender role that does not conform to their natal sex.

in the case of children, the child's preference of 'gender accommodation' takes precedence of that of the parents (aimed at older children) regardless of the child's Gillick competency

It should be borne in mind that many trans adolescents will continue, as adults, to experience a gender identity that is inconsistent with their natal sex appearance, so their current gender identity should be fully supported in terms of their accommodation and use of toilet and bathing facilities. and a final untruth to finish.

the document states that ALL breaches of same sex accommodation in inpatient wards and mental health wards/units MUST be recorded but they don't seem mention whether they view accommodating transgender patients on a single sex ward to be a breach so it may not be recorded.
Pt 18 seems to imply that accommodating transgender people in the ward of their choice will become a negotiation between them and the people on the ward as to whose needs get prioritised - I'm sure the hospital staff have loads of time spare to get into negotiations between patients - and what if a patient is too ill to advocate effectively for themselves? When I was in hospital for being ill I was unconscious for three days - do I get any say?

gardenbird48 · 27/11/2020 11:09

The CCG has asked NHS England to confirm if there are plans to update the national NHS Delivering Same-sex Accommodation Guide. The EIA will be shared with the team. The ‘Delivering Same-sex Accommodation Guide states that it is not a requirement to hold a GRC, however Matt Hancock Secretary of State for Health & Social Care is quoted in a Telegraph article (March 2019) stating that was the case, this view was also taken by other articles in the research. The health secretary also stated both NHS rules and the law needed serious consideration. The guide does not currently express that admitting a patient who does not hold a GRC should be reported as a breach.

well that answers that then - we can't even make a foi request to find out how often this happens.

Watermonster · 27/11/2020 12:04

Yes thank goodness for Dr G and colleagues.

@UppityPuppity
Sorry misquoted - was cross reading the letter from doctors talking about the detrimental effect on women/ girls at the same time. Health secretary raises the need to review trans policies putting male bodied people in womens wards
www.telegraph.co.uk/news/2019/03/04/nhs-review-transgender-policies/

Sorry for my horrified posts up thread. I stupidly believed the NHS CCG would care for all patients, not just males, and address the need to provide care for women who are excluded by mixed sex wards. It would be easy for the Health secretary, NHS England, the CCG and local hospitals to ensure if males can choose single sex or mixed sex wards, then women can do so too- everyone benefits, everyone consents, no abuse or gaslighting of women.

ChickenonaMug · 27/11/2020 12:29

A summary of the issues highlighted in this thread and of the difficult process that some of you have undertaken to try and resolve them would make a great submission for the call to evidence by the WESC regarding the wider question “Are the provisions in the Equality Act for the provision of single-sex and separate-sex spaces and facilities in some circumstances clear and useable for service providers and service users? If not, is reform or further guidance needed?”. Obviously you might be on it already.

I am hurriedly trying to finish my submission on the same question, calling for further and clearer guidance about the same issues, but from my perspective as a ‘service provider’.

Submissions need to be in before 23:58 today. I am finding this thread encouraging and helpful.

www.mumsnet.com/Talk/womens_rights/4089980-URGENT-Call-for-evidence-GRA

UppityPuppity · 27/11/2020 13:22

Watermonster thanks for the clarification.

Fucking hell!!!

Alethiometrical · 27/11/2020 13:42

It would be easy for the Health secretary, NHS England, the CCG and local hospitals to ensure if males can choose single sex or mixed sex wards, then women can do so too

Thing is ... various organisations are totally gaslighted into accepting (and ilegally acting on) the ideology that "Transwomen are women" (with a bit of #NoDebate as an added extra).

So that they see it as not a man choosing a mixed ward, but a transwoman-who-is-a-woman-really choosing a single-sex ward to which they apparently belong.

If you don't hold with TWAW it appears to be gaslighting, but the "institutional capture" is such that the TWAW mantra is getting harder & harder to dislodge.

anotherFOIrequester · 27/11/2020 14:36

Couple of points about the legal advice relied on - from March 2020.
They went to a local large general law firm, Bevan Brittan, rather than a discrimination specialist.
I would love to get Audrey Ludwig's opinion on the legal advice from BB!

It's very heavy on the single sex exemptions being a last resort as is the EHRC guidance - they shouldn't be the norm or set a precedent. As we know that's bollocks.

Instead 'any allocation to single sex services would be made following a thorough case by case analysis' - well this is also bollocks. HOW exactly is that supposed to work? Many of my friends and family are nurses or other NHS workers. I've been a hospital inpatient, I've visited my partner in hospital - there's just no way that's actually possible. You can't run a DBS check at the ward door. Staff are extremely busy and wards are often short-staffed. Yet another example of crap policy on this being dumped on busy, stressed staff who probably fear getting fired or their employer getting sued etc. What a recipe for success.

OP posts:
gardenbird48 · 27/11/2020 15:07

Instead 'any allocation to single sex services would be made following a thorough case by case analysis'

this was the response to a question about hospital wards in the House of Lords recently. I can't remember who made the answer but she basically dumped it onto the frontline staff to deal with. And as you say, the staff may be reluctant to deal with it for fear of their jobs.

In fact, it does mention on this document that privacy of the transgender person is essential except in necessary clinical situations so you would guess that it is like the Lanarkshire NHS Trust instructions to staff that they can't even acknowledge that there is a transgender person present to other patients so how can it be dealt with?
At least they say that they will accept more submissions from the public - I will be writing.

anotherFOIrequester · 27/11/2020 15:20

Cheers Chicken - and glad you are on it from the opposite side of things.

I sent my GRA enquiry submission before the CCG sent all this out, aargh! I did answer that q and mention the Devon policy which allows male sex offenders on female wards and made the point that it's wrong to lie to women and call a mixed-sex service female-only.

OP posts:
anotherFOIrequester · 28/11/2020 10:11

Here's the summary table - says it all.
Though there is also a negative effect on ppl with PC of sexual orientation.

Are you in Devon, Bristol, North Somerset or South Gloucestershire? Tell NHS your view on trans guidelines NOW
OP posts:
gardenbird48 · 08/12/2020 13:17

www.surveymonkey.co.uk/r/H7NYJXR

have you seen this? My answer to the first question is Hell Yeah!!

It is a survey asking if we have any comments on the Equality Impact Assesment. I will be submitting this and I believe we still have a short window to respond on email before the two week deadline?

Watermonster · 08/12/2020 14:22

Because this trans guidance is now being used or considered by many NHS areas, not just Bristol, I have linked to a new thread.

www.mumsnet.com/Talk/womens_rights/4101163-NHS-trans-guidance-URGENT-request-for-help

Angryresister · 09/12/2020 01:21

Watermonster has the other thread gone?

Watermonster · 09/12/2020 09:35

@Angryresister
the other thread is still there - links to all info. Hospitals across the country don't publish their policy , you have to ask the privacy and Dignity manager/ pals team about it. Women don't know they can't access care unless they agree to mixed sex wards in many hospitals.

Swipe left for the next trending thread