'Trans healthcare professionals and patient consent'
By Maya Forstater
September 16, 2020
(extract)
"Dr Kamaruddin is one of four GP partners at the East One Practice. GP Partners invest financial capital as co-owners and have large degree of control. They make hiring decisions and decide how things are organised and run. The practice’s patients are amongst the most deprived fifth of the population of England, with a large Bangladeshi muslim population, many speaking English as a second language.
At the age of 53, after being a partner at the practice for 15 years Dr Kamil Kamruddin decided to transition to live as a woman. Dr Kamaruddin recounts announcing the decision to the other three partners and their joint employees during a regular monthly practice meeting,
My colleagues and staff welcomed the news without much surprise. They voiced their support and even gave a round of applause.
When the other partners and staff raised the question of how to explain this to patients Kamruddin said:
I told them that I would tell them myself, I wanted to carry that burden.
In the Newsweek article: Kamaruddin describes the first day coming to work in the new identity of Kamilla “with a big smile and a bright dress”, having had facial surgery, a hair transplant and other non-specified surgery.
Kamaruddin called it “a satisfying experience”. The GP recounts compliments and congratulations and fantastical cases of mistaken identity “One of my colleagues did not recognise me at first, thinking I was a female locum GP. But it was my patients who took me by surprise the most. No one was hostile towards me. Some thought I was the wife of Dr Kamaruddin, me, their doctor, and a lot of them thought that I was a new GP. “
In the end, my staff did not have to field any awkward questions or hand out any leaflets. (continues)
Again and again, across different platforms Dr Kamaruddin discusses female patients, mainly Muslim women, allowing intimate examinations without a chaperone, as a positive experience validating the doctor’s new identity.
After my transition, they even allowed me to perform more intimate examinations that they did not let me to do when I was a male GP.
“Every single one of them refused my offer of a chaperone even when they knew that I am transgender. “
In a feature in Malysian Medics International Kamruddin says “I had a fear that my patients would treat me differently as they might not agree with my new identity due to prejudice and ignorance. … Surprisingly, my patients were adorable; some thought I was a new female locum GP, few male patients were flirting with me, and almost all were happy for me when they got to know I was the same person”.
Again this raises questions:
Is it appropriate for a medical practice to see the role of staff and patients as being to validate a doctor’s gender identity with complements, unquestioning acceptance and a letting down of personal sexual and religious boundaries?
Were these patients really empowered to say ‘no’ if they did not wish to be seen by intimately examined by the doctor — if this view is seen as hostile, prejudiced and ignorant ?
Were these patients really empowered to say they wanted to have chaperone, when the person offering the choice sees it as highly personal to the healthcare worker, and celebrates if the patient decline a chaperone, as a sign of positive affirmation?
Did the surgery consider the fact that “every single one”, amongst a population described as conservative muslim women turned down the offer of a chaperone for intimate examinations as a sign that the measures they have in place free and informed consent might not have been effective? Was this monitored? (continues)
a-question-of-consent.net/2020/09/16/doctors/