Telegraph: Patients may be guilty of discrimination if they refuse care of transgender medic, NHS bosses told

[ResisterRex]

A report by the NHS confederation is in today's Telegraph. A good example of how a hierarchy of EDI seems to have been cultivated, with disabled people right at the bottom. Anyone who's had a parent or grandparent with dementia will be upset to read that parts of the NHS want to be able to refuse to provide care to their loved one because their comfort comes last.

www.telegraph.co.uk/news/2023/06/09/nhs-patients-discrimination-transgender-staff/

"Patients may be found guilty of discrimination if they refuse the care of a transgender medicc_, according to new NHS guidance.
Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth.
However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says.
The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff memberr_ in limited circumstances, such as if they are having an intimate examination.
It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”.
Patients with dementia ‘should be challenged’

The report goes on to say that “the patient has no right to be told that the person treating them is trans or non-binary,” adding: “It would likely be discriminatory for the patient to refuse to be treated or cared for by a trans person, unless clear and evidenced clinical harm may result to the patient.”
Patients with dementia “should still be challenged” if they express discriminatory views about transgender staff, the 97-page guide states, while their relatives “may be removed from the premises” if they do the same.
But a non-binary medic can refuse to treat a patient, with the advice stating they “should not be forced to deliver care if this would cause undue distress or invalidate their lived experience of gender”.
It comes as the NHS published its first equality, diversion and inclusion (EDI) plan, which outlines that organisations are to include “diversity training on gender reassignment and sexual orientation” within mandatory training for healthcare workers."

Accessible link in this tweet

twitter.com/braddockbessie/status/1667081739871690753?s=46&t=WHoOZ_3Kv5G6-FyQuvE0LQ

That report is incredibly biased and I'm unclear if it has any real weight or if it's 'advisory' only.

Lawyers on twitter are saying the advice is illegal and a patient's consent needs to be gained, and that the Equality Act does not apply to individuals. Individual patients cannot be guilty of discrimination.

If you think it through, if the EA applied to individual people, could people sue someone for not having sex with them because of a protected characteristic? I would argue that anything involving intimate medical care is very much along the same lines. It is completely reasonable to need a single sex medic in some situations.

It's just completely bonkers. Let's hope it gets wide, wide sunlight. And I hope that patients start to sue for sexual assault if they're forced against their will to have opposite sex care.

The patient's needs are meant to come first - I think if care is denied as a result of a request for single sex HCPs if it could have been reasonably provided that would be ground for a legal action too.

Women who've got PTSD from being raped, are they to be completely denied medical care then because of the wants of a few transwomen? Even when there's plenty of female nurses who could care for them?

It also seems to be a way that nonbinary or trans staff can get out of doing any work whatsoever - they seem to have the choice whether or not to work or treat a patient. It almost seems to be saying if they think someone's gender critical they can just not do their job.

If this is the way the NHS is going, bring on private healthcare.

Absolutely fucking appalling.

Mail report: https://www.dailymail.co.uk/news/article-12174641/Patients-dont-right-know-medics-transgender-NHS-warns.html

I’m so pleased the newspapers have picked up on this. I hope they will force a rethink.

There's another thread about the NHS confederation guidance.

https://www.mumsnet.com/talk/womens_rights/4823255-guidance-for-nhs-completely-misrepresents-the-law-again

I agree it's unclear if it has any weight...but neither does "gender" or "gender identity" or "non-binary" and look where we are with all those terms.

Also the power against the patient lies with the NHS. They're going to have to deal with their "offended" employee on a day to day basis, which likely leads to a situation whereby the patient is more likely to lose out.

I mean, patients might not know if a HCP is transgender (it being all about inner identity and there being 400 genders), but it's obvious what sex they are. And that's the issue. They're trying to legislate so we're not allowed to speak about and act on the evidence of our eyes and ears about which of the two sexes someone is.

My sister has recently been through some very traumatic gynae problems that have involved a whole series of examinations and tests. She has been really traumatised and on one occasion hurt very badly by a male doctor.
The thought of her being confronted with a policy/attitude like this is horrific.
Knowing what we know about men who identify as women, they are the very last people I would want near me if I was sick/vulnerable.
It is insane.

https://twitter.com/legalfeminist/status/1666199916153036816?cxt=HHwWoICz8d3_w58uAAAA

This is legal feminist's take 'this is a legally illiterate document'

I'm up for a few quid if we can sue the NHS over this.

I do consider this more sunlight. Let it stream in. I would hope that the future brings more balanced EDI advice. Because the way EDI is going, it is risking being viewed as nonsense and biased on its focus.

Final tweet from legal feminist

'his is a dismaying document: legally illiterate, and dripping with contempt for women and their article 3 and 8 rights. End (for now).'

So if it's breaching article 3 and 8 rights, can we sue?

There is so much wrong with the document this is just one of the pages

Bathroom and shower facilities page 59 of pdf

Examples A non-binary staff member working in a residential care facility does not feel comfortable using the female or male staff toilets. They share this with their manager, who suggests that they use the disabled toilet instead. The nonbinary employee accepts this as an adjustment and continues to the disabled toilet following this conversation.

A patient staying at the residential facility questions why the non-binary staff member uses the disabled toilet, and as their manager does not know if they have consent to share their gender identity with patients, explains to them that their employee feels more comfortable using this toilet, and that they have the right to do so.

A female member of staff who has medically transitioned needs to shower at the end of her shift. She feels unsafe using the women’s showers because other women know her trans status and have made belittling comments in the past. As using the men’s showers would be unsafe and inappropriate, she requests use of a private cubicle in which to shower. Her manager, recognising the nuance of the situation, allows this.

If there are no private shower facilities available, the manager may consider other accommodations that could be made, such as negotiating a time in which the trans employee can shower during which other staff agree not to enter.

never mind all the other bollocks: who suggests that they use the disabled toilet instead. How fucking dare they!

Oops, sorry I missed that

That thread is excellent and explains clearly why this guidance is legal nonsense. I am not sure who you would sue, however, unless and until it’s adopted by any NHS trust or the department of health. At the moment it’s just words on paper from an NGO.

The whole document seems to work on the presumption that there is only one protected characteristic and screw everyone else

It also totally fails the reality test. In what magical NHS land will there be private showers on demand or will the staff have time to negotiate separate times for showering. What if someone's shift runs over?

Do they know the NHS is on its knees and patients are dying from lack of timely care?

Like the bit about the only situation in which a patient can be assured of same sex care is where there's a 'documented clinical need' - so are HCPs supposed to spend time form filling for all the vast numbers of women and men who simply want same sex care for intimate procedures? Maybe we all need to go in with a document outlining all the clinical reasons we need single sex care at the start, present it to them so there is documented evidence that they're refusing a reasonable clinical demand in the best interests of the patient.

This distresses me on a number of levels.

First of all it's a matter of trust and power imbalances. I have a documented long history of distrusting doctors and fear of medical settings on my medical history. This combined with my family situation, means I am even more likely to seek medical help should I need it.

Never mind the fear of being vulnerable in hospital full stop.

This will kill some women.

Yes, very much this. Screw anyone with a disability.

Incapacitated patients will be at even greater risk of sexual assault if this comes into force. It's actually creating an environment where sexual predators will seek out NHS jobs more than they do now. Did they not read the report about sexual assault in the NHS?

This seems to be the way with all EDI stuff - trans is literally the only thing that matters. How do people get or keep these jobs? They're rubbish at it. My 6 year old (and her entire class) could do better at balancing different protected characteristics.

very much this. I was reading Hannah Barnes excellent book about the Tavistock and it really struck me how much money and resource comparatively speaking got chucked at that shower when funding for kids with ASD, for example, was slashed to the bone (my son has ASD). Which god decreed these are the only people who matter? It’s so odd.

It's actually creating an environment where sexual predators will seek out NHS jobs more than they do now.

Sorry to quote myself but it just hit me that this may very much be the point. Sigh.

We should NOT have to fight this in the courts. NHS EDI staff should have a passing fucking acquaintance with the law and given how much they're paid should be marginally competent. It should not be for busy doctors and nurses to have to push back on something so clearly illegal in so many ways.

NHS Confederation is not the NHS as such. It is a stakeholder members' group - NHS trusts, among others, sign up to membership. However, it is extremely influential - it would not have put out this guidance without informal consultation with NHS England, I'm sure.

So no one in the NHS is obliged to follow this guidance but the likelihood is that they will. Many will assume that it is legally correct, because Confed is regarded as a reliable source.

"A female member of staff who has medically transitioned needs to shower at the end of her shift. She feels unsafe using the women’s showers because other women know her trans status and have made belittling comments in the past. As using the men’s showers would be unsafe and inappropriate, she requests use of a private cubicle in which to shower. Her manager, recognising the nuance of the situation, allows this."

Why would a medically transitioned transman using the men’s showers "be unsafe and inappropriate"? Are they acknowledging that men are a potential threat to women (medically transitioned or not)? Do they therefore reach the logical conclusion that it would be "unsafe and inappropriate" for male staff (whether natal, transwomen or non-binary males) to use the women's showers?

Which god decreed these are the only people who matter? It’s so odd.

If you view it through the lens of enabling a certain group of XY type people to have unfettered access to and abuse women and children then it makes a lot more sense.

I don't think it's really about caring about marginalised groups at all.