In reply to @Helen8220 about healthcare settings... You might have felt a bit embarrassed visiting the doctor, but not minded which sex they are or whether the toilets were single sex. That’s fine, many people will feel the same. Forget about toilets for a second or whether you wake up in a ward with men after a heart op.
To reduce health inequalities - one of the most important things we must do is to know which groups are at the most risk of ill health. Who is suffering barriers to healthcare?
So the ‘WHO’ is important. Recording accurate data on WHO is critical, without it we have no idea who to target and which inequalities or health needs in particular groups to address.
For this reason I am strongly against anyone being able to put down in a form that they are biologically female or to fudge the issue by just asking do you identify as... It is useful to put both down e.g. born as a male, identify as a female, identify as gay etc. It is very useful to know if being gay or transgender for example is having any effect on accessing healthcare. So my first point:
Data must be factual and accurate - for collection in statistics, crime stats, healthcare stats...
I think you’d probably agree that many groups do suffer more from ill health, of various forms?
For example menopause symptoms, or sickle cell.
And many have more barriers than most to accessing healthcare? For example those who do not speak English (more women than men). Health Visitors would tell me that it was women in domestic violence situations would avoid appointments and be hardest to reach.
You would agree that it is important that we make sure that healthcare is accessed by those that need it? Which is my second point, that once we have identified groups who have ‘access’ issues, such as women in DV situations, we need to tailor our healthcare provisions to enable access.
No one is going to argue with a ramp for a wheelchair user into a hospital. Even though lobbying groups fought hard to get these. However the more ‘invisible’ access issues are still important to address, and one of these is women and men. Both sexes have access issues. Men, particularly young / deprived areas will avoid the GP more than women for example, and present late in illness.
Women particularly older, or who have suffered abuse, mental ill health or because of their religion, need some single sex provision in order to access healthcare. In addition, in hospitals or at the GPs are when women are at their most vulnerable.
Single sex wards are there because more sexual assaults occur in mixed wards, and patients report feeling that they have a lack of privacy and dignity. Recovery from illness is a critical time and mental wellbeing does have an effect on this, so it’s not just a question of preference.
Many single sex wards are now saying that trans people can use the ward that ‘they identify with’.
The difficulty with this is that single sex wards arose because of what I have described - the real historical problems that males and females sharing resulted in: increase sexual assaults, increased lack of privacy and dignity, increased vulnerability. This happened every time they tried to make wards more mixed so they had to go back to single sex wards.
I understand that there is now a quandary for trans people and hospital wards. Where do you go? However that debate needs to be discussed over time. And crucially it cannot just be a back door to mixed wards again - because the problems with them are not going to go away. Instead anyone now feeling a lack of privacy or dignity, or leered at (as was reported increasingly when mixed wards were introduced more and more) are going to be met with accusations of hate crimes / discrimination towards trans people too.
This is a bit of a mess from hastily introduced policies that are ignoring the problem of access, and inequalities, which in this case are the increased vulnerability in terms of body privacy, dignity and sexual assault of women ill in hospital. For example an elderly Muslim woman recovering from a heart operation does not need the additional stress of having to be in a state of undress next to a bed with a man who identifies as a woman. A young woman fleeing domestic violence, recovering from her injuries should have discharge herself early because she realise that there are men in her toilets and in the adjacent bed. A woman experiencing debilitating depression on a long term mental health ward should be able to do that with some privacy and dignity with her own sex.