Pronouns, DID and the NHS

[Mongoosely]

This may be a bit of a weird question but does the NHS automatically change pronouns with certain diagnoses. I don't think I have ever been asked what pronouns I prefer anywhere within the services I attend, however, I have realised that they are using They/Them in letters and it has really pissed me off.

So I do sometimes identify as "we" but I find identity switches so difficult and confusing that I/we usually go off sex (female) and try to use names when referring to people, and expect people to name us when being referred to.

I'm not sure if I being a bloody idiot though because when I raised the pronoun issue with them I was basically told that everyone with DID should be using they/them pronouns inline with the illness (which is not quite correct as what if all parts are the same sex).

Basically, am I being thick and not realising something here?

@TheClogLady - I know it is horrifying to read, but it's something I am well aware of and that is definitely (and currently) occurring throughout certain NHS bodies.

It took me several years to accept a diagnosis of DID - and when I was first told about it I had never heard of it; I subsequently moved clinics and specialities and the same diagnosis was given again. It is shocking just how many more people are so open about DID on TikTok and Youtube - it's something that I personally don't share (maybe two people outside of the NHS know about it; it's steeped with shame and certainly not something that will ever be given it's on Channel, even in an education sense)

Isn't DID meant to be extremely rare to nonexistent? What are the chances multiple (lol) DIDers would happen to be on this one Mumsnet thread - unless you're all the same person.

Witty.

I know I'm not the OP though!

DID isn't actually as rare as people believe, it's a "hidden" disorder though and so if you knew anyone in real life with it, it would be unlikely you would be told, and it would be unlikely you would realise.

I concur with this, my sister is the only person in real life who knows about my diagnosis. Everyone else just thinks I'm a weird bugger with mood swings and a lousy memory.

@Mongoosely

Of course if by chance you are me, can you feed the cats and take the washing out of the machine. Thanks!

Thanks @Boiledbeetle I’m trying to do this in therapy, it’s very difficult though but it’s good to hear that you are seeing some logic & order, it gives me hope.

The pronouns in the letters may be nothing more than they're using template letters that have that as the default. Our system is like that. I try and change them but, in one of my roles, I'm writing up to 50 letters an hour (yes, really) so it doesn't always happen.

@KurtCobainsColourfulCarpet offline my partner, medical professionals & one other person knows I have DID, I regret telling the other person but I think I can trust them with the information but in telling them it left me feeling very vulnerable & if I’d done the right thing. Going forward I have decided to tell no one else, as from experience, revealing other mental health issues to various people close to me, they have been less than sympathetic & very judgemental. No one would know I have it, most close to me would be shocked to find out that I have DID. There is a lot of ignorance & judgement surrounding it, for me it’s a coping mechanism with it’s roots in childhood trauma.

What does this have to do with sex, gender issues or feminism?

@unwashedanddazed Everything.

Larry, it's telling that the three of us on here that are admitting to a DID have told a handful of people between us. It's not an illness you shout about. It's not helped by the fact that the cases that come to peoples attention are usually for all the wrong reasons and I'd hazard a guess don't bear that much resemblance to most people with DID.

Mine is also a coping mechanism from childhood abuse which I think adds to the keeping it quiet thing. It's all to much to get into with most people.

Treat it like a jigsaw puzzle. You'll see the whole picture eventually, but it will come to you in fragmented pieces. You just need to put all the pieces in the right place.

If you read the opening post you'll see she had been misgendered, and had assumptions made about her that won't help her illness. This was never a part of DID healthcare. Why is it now?

Since when was misgendering an issue for this board?

DID is a very specific illness with a very specific aim in its treatment. That is to get the person with DID to accept that the illness is a maladaptive coping mechanism. And that they are in fact just one single solitary person.

The OP has encountered a healthcare team who have decided that anyone with DID must be they /them or they don't have DID.

That is not on.

Because their disorder is yet another that has been appropriated by the 'self identifying as' brigade.

There is a very large and active health board available on mumsnet.

This has nothing to do with FWR.

@unwashedanddazed it actually does. You may not get why and that's OK.

I disagree completely.

for all the reasons in my long post earlier in the thread.

OP didn’t come here go discuss her health, she came here to discuss the plural pronouns in her NHS letter, and to bring us another angle on how and why gender neutral language (touted as helpful to trans people) can be harmful to people outside of the trans sphere.

posting on health would result in a completely different discussion with a largely different set of mumsnet members.

Yes. The link to topics discussed here is very clear from both TheClogLady's post and what JellySauras said regarding "affirmative care".

Regardless. I found it interesting and am quite happy for the discussion to have landed here. Thank you for honest and thoughtful contribution all round. I feel like self- identitarians are hijacking genuine disorders and warping the treatment of them all out of shape. To the detriment of genuine sufferers.

Also, it’s been discussed here before, albeit by someone making a less sensible argument (that they/them pronouns should belong to people who identify as systems and that trans people using they/them in ‘appropriation’).

www.mumsnet.com/talk/womens_rights/4059301-They-their-them?

(there is a very moving description of living with DID on page 2)

and some more recent threads about the many teens who are self describing as systems with multiple alters across various forms of social media:

www.mumsnet.com/talk/womens_rights/4211120-did-becoming-more-popular

www.mumsnet.com/talk/womens_rights/4451429-Social-contagion-TikTok-trans-alters-multiple-personality-disorder

And one about the Tourette’s-ish social contagion:

www.mumsnet.com/talk/womens_rights/4501248-How-is-the-new-rapid-onset-Tourette-syndrome-any-different-from-ROGD-This-is-an-interesting-read

I'm in a slightly better position to explain why this absolutely belongs here, and why I posted it here. Firstly, it's the safest place on mumsnet to post anything regarding gender - a word that is actually in the title of the board "Feminism: Sex and Gender".

Secondly many feminists (hi to the person who may now recognise me) are already aware of the issues facing people with DID/CPSTD and external influences impacting some of the services that are supposed to care for us. As was mentioned in this thread it is possibly one of those influences or a patient (but only the loud ones or ones linked to external charities or the ones linked to commissioning etc., etc., ) who may have insisted on this wording in letters. For some services, and not all, there are warning signs that they are going down similar routes to GIDS. We are already seeing services remove therapies from traumatised patients because a certain group of patients didn't like the treatment, or had a poor experience - yet these are therapies that many other patients have found incredibly helpful in the past. I'm fed up with one or two groups dictating how I am referred to, what I can access therapeutically (particularly when I've asked several times for a specific therapy to be added to my treatment plan and told no because it's a behavioural therapy, no because I don't have this symptom, no because we don't use it anymore yet my own therapist recommends parts of that therapeutic programme on an almost weekly basis for me to try and we already know it works because half the service are utilising it and improving). At the same time we are being told "everyone has an individualised treatment plan for their specific needs" - those treatment plans are being dictated by people outside of their care teams, and by many who have a personal vendetta against staff in the services, or the services themselves.

These decisions are largely impacting women (who overwhelmingly attend the services for complex trauma presentations).

Very few services recognise any risk from being severely dissociated. Yet again, it's largely women that experience the more extreme forms of dissociation. Traumatised men more typically experience violence and suicide. Guess what services do recognise as risk, and is basically the only risk I have ever been assessed for? Suicide. I don't have the actual figures to hand but women with DID are something like 700 (I think, from memory - I am going to try and find this statistic tomorrow when I am back in the office as I think it's on a paper in there) times more likely to be murdered than a woman without DID. If feminism involves protecting women that it's perfectly fine for us to come on here and talk about the issues we are having with care providers of the disorder.

I personally don't care how other people identify, I do care that I have access to safe single sex spaces when necessary (largely due to that murder statistic), that I have access to appropriate care as necessary that isn't influenced by any external to the NHS factors and that is based on research that has been ethically conducted, that I am given a voice in service user panels (which is not happening anymore even though it may not be inline with what the "Cool Kids" are saying), that I have a choice on whether and when I chose to use medication, that I have choice on whether or not I ask for a referral elsewhere or for a different therapy, and, that I have a choice on how I am referred to because my sex is pretty much the only thing going for me that I can view as stable and scientifically stable as you cannot change chromosomes. At the end of the day my body is female and whatever goes on in my mind I can cope with because I can always come back to that fact. So to get letters where I have been changed to pluralities is really unnerving, particularly on a week like I have just had (actually months, but that's an entire different story).

All of the feminism issues that are related to healthcare - multiply it by several factors for a woman with DID because more often than not we are told it's a fabricated illness, a trauma symptom, or malingering for attention. I thankfully have a fantastic GP surgery and they have all gotten to understand the impacts of DID on physical health care (ie basically if I say something does not hurt they are liable to write that off due to my ability of dissociating from pain rather than there not being any cause for pain), however, not everyone is lucky to have a GP surgery like this. I have lost track of the number of complaints they have made to the ambulance service but they are so on the ball when things go wrong; it's really not just been a case of them getting it right, but also raising merry hell when things go wrong too and finding me physical health services that may be willing to at least learn about DID (few and far between).

So yes, I would say that DID should stay on this board particularly when interlinked with feminism issues because usually the issues are multiplied in their impacts or in their occurrence.

Sorry if that's all a bit jumbled - I didn't have my coffee yet.

I have also really enjoyed (?) the thread and found it helpful - and if people have further questions my PMs are open (please don't ask me where I am having care at the moment though as I have had a few pile ons recently about this and I do genuinely believe they are a good service when they don't have their heads shoved in the sand; well I did, I am not sure if there's anyway they can actually get back to being a good service now - that horse seems to have bolted). Also I am not going to name the external influences because there's ongoing legal and ethical issues with some of them and people impacted are taking their own legal advice etc.

I will also just go back to the disorder (and I am fine with it being called a disorder, nothing about my experiences is normal - again what the activists want people to recognise) being a "secretive disorder"... until recently people with DID diagnoses weren't actually being diagnosed until their 40/50s (ish). It's great this has now changed for those who are in psychiatric / therapeutic services and diagnoses are occurring earlier as the earlier the diagnosis, supposedly the better the outcome.

I was diagnosed with DD-NOS firstly (by a medic, but not a psychiatrist), and then subsequently diagnosed with DID, but I think the entire process took three years of 1:1 assessment, stabilisation, trust building, therapy, me flouncing (a lot, there was a lot of flouncing out because I was absolutely terrified of being found out). I don't really remember the early part at all but apparently I couldn't even sit in a weekly fifty minute session with one clinician.

I think people often think it's a case of people with DID walking into a therapy room and suddenly switching parts/alters and that's how the diagnosis is made (and maybe it is for some), that certainly wasn't my experience of it. And, I refused to accept the diagnosis for years - I argued to be diagnosed with PD for a long time even though I don't fit most of the criteria for it (I know, I know, anyone with PD reading this, I am sorry, I realise you've likely had multiple horrific experiences too and it's also a crap diagnosis). I still don't accept the diagnosis most of the time because of the amnesia that occurs between most switches.

My apologies, I stand corrected. I think I felt a knee-jerk rejection of the subject because it has been adopted so strongly as a 'fashion' by the Tumblr gender types.

Thank you for taking the time to explain. Apologies for the derail.

I totally get that - it feels
like yet more shit that’s being shovelled onto the plates of feminists by the Tumblr crowd.

however, this stuff does affect women directly (as OP has now thoroughly explained) and I personally am of the mindset that we need to be aware of the bigger picture and how it all links together, especially as the teens swept up in the self identity boom (whether that be those who self identify as trans, SEN or having a mental illness) are more or less the same crowd, majority teen girls with pre-existing vulnerabilities (eg dealing with family break down, poor self image, perhaps disordered eating) trying to make sense of themselves in a social media world where unwritten rules can change in the blink of an eye, casting you from ingroup to outgroup in seconds.