“Genuinely” single sex wards are not the best standard of care for all and in particular, trans and non-binary service users - survey

[IwantToRetire]

Through desk-based research and a survey, led by a trans and non-binary researcher, we have asked the question: what are trans and non-binary people’s experiences of single sex spaces in mental health settings in England?

We have asked this question in order to centre the experience of trans and non-binary service users on single sex wards and to better understand what needs to change to make mental health settings safer places for trans and non-binary people experiencing mental distress.

This research found that there is significant variation in trust policies relating to trans and non-binary service users, with gaps between trust policies and peoples’ actual experiences that indicate the urgent need for a better standard of care for trans and non-binary service users. Trans and non-binary service users face serious discrimination and harm within care settings from staff and other service users.

Our key recommendations for services are are:
~ Recognise that single sex wards are not the best standard of care for all service users, in particular, trans and non-binary service users, and take steps to assess and mitigate possible negative impact.
~ Locate the problem in services, not in service users: ask how services and practice can change to support and include trans and non-binary service users.
~ Name the political nature of trans health in policy, education and practice, and the ways in which the needs of trans and non-binary service users may be being neglected or undermined in services.
~ Set out how gender-affirming care and physical health needs of trans patients in mental health inpatient settings will be met with emphasis on not being an obstacle to gender-affirming care.

Extract from www.nsun.org.uk/news/new-nsun-research-report-single-sex-spaces/

NSUN = National Survivor User Network

“Gender-affirming care” is one of those slippery phrases, isn’t it?

in trans healthcare it means giving medically unnecessary hormones and cosmetic surgery treatments, which is bad enough when it’s on the NHS.

But across the rest of the NHS they seem to be expanding the remit of “gender affirming care” to mean “deploy other patients to validate genderhavers, in the role of cannon fodder/human shield if necessary.”

fuck that shit. I hope those responsible will eventually be held accountable for it.

Mental health care is decidedly sketchy for most service users, and it’s as yet unknown whether gender affirming care is (or should be) the gold standard, as any other approach and research tends to be blocked.

To be honest anything led by trans and non binary is not going to take into account the single sex needs of the rest of population.

(Not relevant, but I remember having a conversation with a couple who both worked on the same mixed sex mental health ward - the male of the couple had zero understanding that women tended to thrive better in single sex environments, and felt that mixed sex was better as there tended to be less fighting. The female of the couple pointed out that women’s recovery was quicker and they were less likely to be readmitted when they had man-free time. Any decisions made about any hospital wards should not ignore the needs of the people likely to be impacted by being in a mixed sex ward)

Everybody wants the best possible care for trans patients.

But it’s important to recognise that for many women genuinely single sex spaces ARE the best standard of care, and it is not possible to include trans identifying men in those spaces, as that makes them mixed sex.

Female patients are not a resource to be used to provide ‘gender affirmation’ to males.

What percentage of the users of those services would identify as trans or non-binary? I believe that the percentages matter here, as very large numbers of other users and their concerns will be ignored should they prefer/need single-sex wards if these recommendations are followed.

In any case, all this should be discussed keeping in mind that the rights of all people matter here and not just the rights of some people. Currently too much of this is authoritarian and prioritises very small groups, however suffering the individuals in those might be. But then all who need inpatient mental health care are deeply suffering individuals.

Everything needs to be about supporting Trans and Non Binary people these days right? Nobody is allowed to think of anyone or anything else.

I'm bored shitless with this drivel. It comes as no surprise that 'people that believe in make believe want everyone else to make believe along with them'. They didn't really need a desk study and a survey. We could have told them that.

“Gender-affirming care” is one of those slippery phrases

It's quite concrete really - giving the People of Gender whatever they want regardless of impact on them or anyone else.

There are some words there which need definition surely

What is meant by unsafe
What is meant by discrimination and harm
What is actually being asked for, what changes do they refer to

As others have said MH care or hospital care overall is never great. Hospitals are not places you go to recover they are places generally you go to get urgent or acute treatment. Ive had pretty terrible experiences on general wards personally.

Where is the research (unbiased) which recommends gender affirming care, given we are talking about MH issues in the first place. Perhaps the challenge is rquired about the sense of self in order to recover from dysphoria?

Breaking news: trans and non-binary mental health patients want more, better, faster.

I think the genuinely is is quotes because the trans led survey doesn't want to concede that in this instance the recommendation (if not the practice) is based on biological sex.

But the complete arrogance of saying that the provision of support to others should be subordinate to what they want.

Nor should other patients be part of providing "support" to trans users by making them feel they are the opposite sex to the one they are born.

And (I hope all have read the whole thing not just my extracts) also that they dont want this "genuine" single sex because they dont want any implications that some on them may be an actual threat to other patients, and that the only focus on threat should be that by staff.

Maybe they should have written something about how they are the only "genuine" survivors!!

The research has failed to acknowledge the needs of women who remain vulnerable in mixed-sex spaces and so should not be given the time of day. We cannot choose one very small group of service users and centre the care around them - good services need to cater for all and balance needs.

We also need to:

~ Recognise that mixedsex wards are not the best standard of care for all service users, in particular, women, and take steps to assess and mitigate possible negative impact.
~ Locate the problem in services, not in service users: ask how services and practice can change to support and include women in decision making.
~ Name the political nature of trans health in policy, education and practice, and the ways in which the needs of female service users may be being neglected or undermined in services.
~ Set out how gender-affirming care and physical health needs of trans patients in mental health inpatient settings will be met with emphasis on defining gender affirming in a meaningful way which does not prevent vulnerable and confused people from being space to explore whether they can be comfortable in an identify which recognises that they remain their born sex and which prevents unnecessary surgical procedures.

Within mental health services, there is a growing call for single sex wards, as part of the push for the modernisation of the mental health estate.

This is worrying. I thought it was the law since 2019 that NHS inpatient accommodation had to be single sex. I know it was eviscerated by Annexe B but this is presenting it like it’s a new thing.

Obviously everyone needs safe and appropriate accommodation so this is going to require four groupings.

A male and a female facility, then a male born trans person facility and a female born trans person facility if the trans people are not able to safely able to mix with the general group of patients of their sex (as opposed to gender identity). I hope the MH facilities are feeling well resourced.

Either that or everyone just is grouped by sex (not gender identity) and normal safeguarding for the extra vulnerable persons is implemented.

Is there a reason why trans people should be treated differently to any other extra vulnerable person in the MH facility?

Weird how sex is acknowledged to exist.

A genuinely single sex ward is by definition mixed gender however. Eg a female ward ought to have women, transmen and non binary females on it. Is that not mixed enough? It's almost as if the authors don't actually believe non binary people are non binary and transmen are men!!!

single sex wards are not the best standard of care for all service users, in particular, trans and non-binary service users

Well, it's apparently acknowledging that they are the best standard of care for other service users.

So, presumably they'll suggest an option that provides the best standard for all service users? Third spaces, amirite?

So the needs of the 2%(?) outweigh the needs of the 98% because they is special yes?

I'd love to know what is going on with risk assessments in health care settings.

They used to be holistic and take into account the positions of all service users. Now it's fuck women so long as the men with special identities are get what they want.

“Set our how female patients will be used to validate men’s feelings, regardless of the needs of those female patients”

And this is why research that focuses only on one, very particular demographic group is stupid in evaluating service that by necessarily need to serve the whole population.

There are unavoidable conflicts between the needs of different groups and decisions need to be made. Designing for tiny numbers of trans and non binary people at the expense of millions of people, including many women and girls who would be unable to access services at all because they’re not single sex, is stupid. They are a small group who will need to be accommodated via side rooms if they won’t go on the appropriate single sex wards.

insisting on affirmative care based on these types of research is also ridiculous. Decisions about care like that should be based in proper, medical evidence. Not user research.

I don't actually give a toss what wards trans or non binary people are on - as long as they are nowhere near myself, my daughter and most expecially my mother (and any other female who wants a single sex ward).

When are we going to stop pandering to these idiots?

This is a campaign group and say they are formed by and representative of survivors.:

NSUN is a membership organisation and a network of grassroots community groups and people who have lived experience of mental distress, ill-health and trauma. NSUN connects, supports, and amplifies the voices and work of these individuals and user-led groups. As a user-led organisation, all of our staff members and trustees have lived experience.

So in a way this is even more extraordinary, that one group of survivors seems to think what they want should take precedent over other survivors.

Somehow it seems to boil down to the same old thing.

Entrenched sexism and outright mysogyny that allows men in any group to demand that they be the focus and prime beneficiaries.

I don't care which wards they are on provided they are on wards that correspond to their sex.

Set out how gender-affirming care and physical health needs of trans patients in mental health inpatient settings will be met

It is very far from established that gender-affirming care meets the mental health needs of trans patients. Surely that is the first step? To establish what actually is good mental health care for this population? For example we know that men who transition (and therefore “gender affirmed”) are more than nine times more likely to commit suicide. Why is lying to patients about their sex considered good for their mental health?

Absolutely!

Nope. I wouldn't want a trans man (thinking Buck Angel) on a ward with my mother.

But absolutely no-one male.

I would prefer Buck Angel than Monty though!

Is the percentage of trans and non binary people higher in mental health services than general population? Perhaps not such a tiny minority in these settings.