Doctors set out medical guidelines for trans men giving birth - Times

[Igneococcus]

Can't see this shared yet:

www.thetimes.co.uk/article/1471a020-0d2c-11ed-a4af-79eb4b98fc31?shareToken=6ca0e34c47283d9e0ec2cb0554eafa64

A read of Peter Daly's article helps to explain the state the NHS has got itself into. There is a thread here on MN that links to the article. It's long but worth the time.

Thanks for the link. I assume Sajid Javid will be part of the consultation and I hope he will have a lot to say. Have they really specified that 'transwomen should be put on female wards' but evaded stating where transmen should be placed? I suppose that could be the reporting.

What this confirms for me is that we need to watch who gets certain roles in the next cabinet just as closely as who is elected PM.

I have absolutely no issue with them using different language for Transmen - as long as it doesn't change the language for the rest of us.

I have never chest fed. I have breast fed.

As for TW on a female ward - just totally wrong. I would not want to be on a ward with a TW. It would make me feel particularly uncomfortable. It's not just safety. It's about dignity. When a woman is at her most vulnerable, the last thing she needs to be doing is validating a born male.

I don't necessarily think they should be on a male ward. Possibly private room with private facilities. But ultimately my main concern is the safety and dignity of myself or my female loved one.

Thankfully, the document is only guidance so it can be ignored completely, as it should be. The NHS needs to get back to basics instead of trying to force all this ideological rubbish on everyone.

The NHS is imploding at the moment. Ambulances queuing for 12 hours plus outside A&E. waiting lists soaring, but hey they’ve got time to fuck around with this kind of bullshit! 🙄

Surely...Obstetrics and Gynaecology = FEMALE

So what is the relevance to males who choose to identify as women?

Any hormonal or surgical treatments that transwomen may need care for would be responsibility of Endocrine and Plastic Surgery teams?

Calling something a 'Neovagina' does not make it an actual vagina. From what I've read so far, it would appear to be a permanent wound that would require the relevant treatment & care.

Alternative suggestion:

"Our service users are all female, therefore HCPs should use woman-centred language.

Some service users do not identify as women and may be distressed by the use of woman-centred language. In order to support these service users’ engagement with their health care, HCPs should ask whether they prefer to be addressed using gender-neutral terminology.

(List of non-triggering terminology.)

For clarity, all organs and procedures should be called by the medically correct names, and these names should be explained if necessary.”

hysterectomies, when the womb is surgically removed, should be offered to transgender men

I've been on NHS waiting list for 18 months 😡

a womens health physio talks about the effect of testosterone on the foetus, the mother and the potential grandchildren on this video.

why are medics coming out with anti science but a physio is calling out the lack of evidence?

this is so dangerous. We need a Cochran review.

I can totally get on board with mangling the language and erasing women because obviously, the most traumatic thing about this scenario would be if sexed language was used around a transman giving birth.
🙄🙄

I don't know why but I found the section where they're blithely handing out hysterectomies quite chilling. Perhaps because they may be medically unnecessary (depending on how testosterone has ravaged a female body) and likely to be young women who may desist/detrans.

@goodmorningcampers I won't make the obvious crack, that wait is appalling.

I think having specific guidance which can be rolled out for trans men is a really good thing, as long as it’s kept separate from biological women and the terms used specifically for them.

chestfeeding is utter nonsense as are the references to sperm freezing in trans women - what does that have to do with gynaecology?

trans women in wards with female patients is absolutely and utterly terrifying

This.

I have never felt such amazement, awe and pride in the female human body that I have in the days after I’ve given birth. It’s an incredible thing that only a (biological) woman can do, for someone who rejects their female body to embrace that seems very weird to me

There's an article in the Guardian too:

www.theguardian.com/society/2022/jul/27/rcog-advises-greater-support-for-trans-men-chest-feeding-babies

^What did the NHS say about the changes?*
NHS Digital said it followed standards and guidelines set out in the NHS service manual . It says those writing for the NHS website should “only mention sex, gender or sexuality if they’re relevant, for example, to signpost people and help them get the health information and access to treatment they need

When a medical professional reads a manual and is too stupid to connect the dots and signs off on medical texts:

Why is gender-neutral language in healthcare controversial?
Campaigners say “desexing” medical language denies basic biology and risks marginalising women. Earlier this year the NHS was criticised for removing the word “women” from internet pages on ovarian, womb and cervical cancers. It now says: “Anyone with ovaries can get ovarian cancer.” It also removed the word “women” and “woman” from its menopause guidance.

When dealing with sex specific health care the word woman may be a little clue

@GettingMarriedAgain political capture?

Plus I am guessing that male post-op physical examinations etc ended up in the area with the equipment needed to carry them out with the least hassle for the medical staff.

So here is the dilema, the Breeder of Baby doctors guidance says that women go to womens wards and men to the mens.

By that logic the men breeders should be admited to a men's abdominal ward and the doctors should respect the identity and do all their breeder management stuff on that ward.
The nurses in the abdominal may need a little upskilling on breeder stuff and may have to be sent for an extra days or two training on breeder stuff but that should not be a problem. Its not like the nurses, who do the day to day paitent management, gain experience in their area to know when things are not going well. That never happens.

But I am guessing the guidance did not recomend that men breeder's are placed in the men's wards as that would require the doctor to remember to visit an additional ward??

@Iknowitisheresomewhere reminders for sex specific testing etc is generated by using search paramaters on a database, the first is always going to be sex the second is normally age.
If an adult female is sufficiently competent to instruct that her medical record be fabricated to change her sex marker to male, then she needs to be able to take responsibility for the outcomes.

This is particularly infuriating given that we actually do have a group of people in this country where there is such a notable health disparity - the BLACHIR Report is absolutely damning - but while there was a flurry of coverage about the fact black women are four times more likely to die in pregnancy and childbirth than white women there’s been a distinct lack of action.

Of course, when it comes to maternity services specifically, the one issue is a bit harder to unpick & address. It might involve people actually dying rather than hearing words that somehow make them feel more uncomfortable than the actual physical reality of being pregnant. The bigger group of women - the ones doing the dying - are the ones who lack power. They contain a number of women who rely on clear language [that their child can translate for them]. Add a targeted leaflet for trans men. That’s what happens for other minority groups. They get a targeted leaflet, rather than a change to the entire NHS that will render it less accessible to other users.

Do we have any actual studies into health disparities in the trans community? I’d be astonished if there were any, given the general resistance to any kind of accurate data collection (see the last England & Wales Census) & shutting down of research of “the wrong type”. There are lots of groups of people who are hesitant to engage with medical professionals due to bad experiences: people with [a history of] mental health issues & people who are obese are two obvious examples. Both much larger sectors of the population, but again, nobody’s running around to change things for them.

Trans men not being called for cervical screenings is absolutely a huge issue - and one that should have been fixed years ago. Fields for sex + (optional) gender are needed for the NHS; no changing your NHS number; no pretence sex is mutable.

The fact that people are still trying to insist trans women should be treated on female wards enrages me. There is no privacy in a hospital bay & it’s bad enough other women being privy to intimate details about your body. Males, however they may choose to identify, have no place there.

I know the NHS is doing this because it’s thoroughly captured, but given it’s impossible to satisfy TRAs, it really would be nice if this energy and funding could be diverted to groups who’d really benefit from it. You know, ones where people are actually dying; not ones where activists make unfounded claims re: suicide/suicidality of children & young people & utterly misrepresent the nature of some brutal drugs. It’s no wonder there were TM complaining about delays to their mastectomies in 2020 because cancer patients were being prioritised - the NHS has done nothing to quash that kind of entitlement nor the narrative their surgeries are “life saving”. Ugh.

Will someone challenge this legally? Sex Matters?

chestfeeding FFS

The documentary made by the journalist 'Freddie' about pregnancy was interesting in this respect. I cannot agree with his/her stance on many issues but it did give me a lot more sympathy about what it feels like to be a transman.

I agree - there have been some very disturbing stories about the effects on babies of testosterone inadvertently transferred from men using HRT gel. I don't know if any research has looked at the effect in transmen.

Its not a documemt which can be ignored.

If a doctor (or any HCP) is subject to a complaint the best pratice documents and this type of guidance will be used to benchmark.
The benchmark test will be the documents say that the HCP should have done X, but did Y.

The doctors who specialises and becomes a member agrees to follow the rules and agrees to be disiplined accordingly.

These new doctors are being trained to pretend that sex is not relevant in single sex health care provision.
And apparently to provide male reproductive healtcare to males on female wards in clinics etc. when they trained to be specialist in female reproductive healthcare.

There is treating someone with dignity and respect as in seeing the person not the medical problem; and there is political grandstanding.

I'm not calling for the mangling of language, i"m not supporting this guidance @MagpiePi I was just pointing out, to people who wondered why transmen would go through something as female as pregnancy, that pregnancy isn't always a conscious choice.

This bit from the draft guidance is interesting:

"Mode of birth should be discussed with all
trans men who desire pregnancy, ideally
during a pre-pregnancy counselling
appointment, but at minimum before the
third trimester"

How is this different from women giving birth? Shouldn't all women be given the option of planned caesarean if they want it? We all know in practice that they're not, but if not, why not?

i agree it’s a good thing for there to be a specific set of guidelines for trans men and different language etc

however I wish there was this much emphasis on respectful care, dignity, appropriate language choices, discussion over mode of birth for everybody! This is what all women need!

Can you point me to scientific sources for this? I would like to have backup when arguing this point.

I don't feel like "desexed language" or gender neutral should be used in any general health documentation/information where biological sex is relevant. By all means be respectful of a person's chosen pronouns and use gender neutral terms with the person individually but information relating to healthcare should always be in the clearest possible terms. Using more complicated but "inclusive" language can render it completely inaccessible to people with poor literacy skills, people who speak English (or whichever language it is written in) as an additional language or only speak a little of it. Whereas a transgender person knows what their biological sex is in order to identify as trans and therefore must know a document referring to male/female refers to them, so while not "inclusive" they can still access the information.