Sorry to take an age to post - it's been quite a lot to unpick. Conference was great, met lots of very interesting people doing really good things, as you'd expect.
There were a couple of issues which surprised me - firstly, there was a small note on the ticket email saying that by turning up they assume your consent to being photographed and videoed...and that the CSP could digitally alter your image and use it for any purpose. Naturally, Ruth, the lead author of the paper, and I objected. Given the issues there are with men using AI in pornography this was a staggeringly naive thing to assume. It would be fine if we had confidence in what the CSP would do with our image and how this data would be stored - but as that was unclear we refused permission. Despite this, we were photographed and had to insist the images were deleted.
We attended the workshop run by the LGBTQIA+ network, which over ran into the break. There were five people on the panel plus Paul Rees, the chair - he did not introduce the panel so I don't know who they were. I was disappointed with the talks - there were three accounts of lived experience, one of which was very good and raised issues beyond the ubiquitious "list of the speaker's diagnoses, account of discomfort prior to gender interventions and then catechisms about how much better life is after gender interventions". I am grateful for anyone who is willing to talk about their personal history at a scientific conference but patient experts usually have relevance to the field - so I was surprised to not hear about the speakers experience of physiotherapy, especially as one of the panel later mentioned having had pelvic health physio and scapular pain post-double-mastectomy.
What was disappointing was that the questions from the floor generated lots of words from the panel and chair but not actual answers. One was "how do I approach a patient presenting with back pain who is binding?" There was shuffling from the panel, eyes down, an actual shrug and "yes, that's difficult". Then Paul Rees gave detail of his (entirely unrelated) MSc thesis and they moved on to another question. This is not adequate. Binding is known to be harmful (binding BMJ) and we should, as clinicians, be able and willing to discuss these issues - even if people in the room are using binders.
Our own paper was fine, though the chair told us we had to cut it because the CSP had some tech issues - which was very odd. She also limited our allocated 5 minutes of Q+A to one question - but that meant there was time left at the end of the session so all presenters did a quick panel which was very good. Here's Ruth's thread on the findings of the paper:
We said in our presentation that these are contentious issues and that we hoped people would come and talk to us afterwards. A member who is a trans man did, and was very generous in what they shared with us. The conversation was productive and I think we managed to communicate that our aim is to provide excellence in care - which requires talking about and managing unwanted effects. There were points of disagreement, as you'd expect, this member felts strongly tht women should be kind and let males into our single sex spaces because women's right to privacy is not enough to make a male person sad by excluding him. However, it was a positive chat, so much so the group invited us to go clubbing with them in Cardiff. We declined, obviously, one of my protective characteristics makes me too old for that!
The next day none of the group were willing to look at us, never mind talk to us. They were trans flags on clothing and disapproval on display, I assume they had googled us.
The AGM was awful, though most people in the room looked very pleased with the whole thing. The reports of the CSP's work lacked much in the way of mention of actual patients. There was lots of praise for commenting on global issues - none of which should be, in my mind, the business of a trade union or governing body as we do not have a foreign office. John Cowman said they had made a statement condemning islamaphobic and racist unrest in Dublin - which is interesting as that statement has been removed from their website and was made while the crime scene being investigated which is, at best, premature, and at worst, cloth eared as we could have members in Dublin who were directly impacted. Comment was made so quickly it would have been before the forensic examiner would have even seen the child (terrible story about the sexual assault of a child) I do not think this is the role of my governing body or trade union - they are not journalists, it would be good if they focussed on issues in physiotherapy and health.
Then it was time to vote on various motions - you had to pre-register on civica to do that (is that legal? Surely being a member entitles you to vote?) and many people in the room could not get the tech to work, including me. About 20 people asked for help and three others told me they gave up. All motions passed, much applause. We were told 500 people voted, much applause. I was appalled - 500 votes out of 60k+ members? This union does not have membership engagement.
I was talking to some members at the back of the room and John Cowman asked if I was coming to the Q+A session.
Now, that was interesting - there was a panel of 4 of the exec plus John Cowman, and 20 people in the room - including all of the council and Baroness Ilora. I counted four others, including Ruth and I, and she is no longer a member. I don't know how many delegates there were, I'd guess about 1500 - and 4 turned up to the Q+A. So, I'm judging - are you? Either this organisation is not engaging with it's members or its members are not engaging with it.
Questions were about why physio is badly represented in a plan - I think it was the NHS workforce plan. This was well explored, all the panel, the CEO and the Baroness commented and a plan seemed to be agreed to push things forward.
I asked how they felt about 0.8% of the membership voting in the AGM. The answer was "quite good, actually, usually there are about 100 votes". Goodness.
Then I asked about the last motion - which I thought was adding "woman, intersex, non binary and working class" to the list of "minorities" - and asked what their definition of "minority" was, and given that women are 71% of the membership and 52% of the population then how can we be a minority? There was a long silence and I got tetchy and asked "Is this silence saying that none of you know what the last motion that you asked us to vote on, and I voted against, was?"
The answer was that I had muddled the words, the motion acutally said "minoritised". I said that my point stood.
Claire Sullivan said that they were getting ahead of the trend, that women used to be 90+% of the membership but that is changing - so they added "woman" so that if they ever needed to make a special group then they could. Which sounded like nonsense to me.
"I'd be very happy to organise that. Your position is that TWAW, though?" Claire nodded "So that is fine, as long it is not set up as a single sex resource that is legal - but if I included males with a gender issue in a women's group then I'd have to also allow males who don't have a gender issue or I'd be discriminating against them on the basis of their sex under the Equality Act"
That got a lot of blank looks in response.
At some point Claire said that the position statement on transphobia would not be changing - which is odd, because anything can change if members want it. I thanked them, said it was very helpful.
A woman asked a question about occupational health not being adequately championed and that she was meeting with someone in Westminster herself. Rob Yeldham's phone rang for his taxi so he left - I've heard there's a rumour that he left in the huff while I was talking, but that is not the case.
Ruth and I then had a chat with some of the council who were very positive and seemed to understand that there is an issue that some of what is on the website is not actually legal. The new chair, Sylvia, said she has a meeting with the CEO today and would raise this with him. Ruth sent her some briefing notes.
My thinking is that we could have a woman's group with men in it, regardless of how they identify. Male physios work with women, so it is important they understand the impacts of our biology and physiology, and what our legal rights are.
I wonder, though, if there's a need for a professional group supporting members by interpreting the research, evidence and law (R.E.A.L) pertaining to sex and gender - which meets the criteria as a professional group needs to address a clinical need and I think that would. We'd need 100 members to set that up - which is a challenge as I keep hearing from people who agree, are unhappy but afraid of putting their name out there because of fear of consequences. I think people don't realise how protected they are, the law is supportive, sex factual views are legal and you are allowed to say that sex is real and sometimes matters. The way to help address that is to give members confidence in the law and guidance - and the CSP is clearly not in a hurry to do that.
We have written a "critical friend" letter which we are hoping will be a joint letter - if you are interested please get in touch. It shows the lacks of the "position statement on transphobia" which, we think, makes the CSP vulnerable as it is not legally literate, not based on reliable statistics and does not include the references we found in our state-of-the-art literature review. Here's Ruth's tweet about it.
Please do have a chat about this with anyone you know, give them my details. DM here, twitter is open (@gussiegrips), email is [email protected]. My feeling is there are a significant number of members who want to support patients who have gender related issues but the evangelical approach the CSP has adopted to this population is possibly not optimally serving them - or the membership.
Here's the leaflet we took to conference - share it with anyone interested, including people who would disagree. We really do want to talk to everyone and oppposing views are welcome. Nothing is solved without debate.
I'll put a substack up shortly with links to the resources we think might be helpful for members. I'll link that here.