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."

I would say to all posters please read @Naunet 's quote above before you post wildly provocative comments without having read the document. The danger is you could cause such baseless fear in someone with a history of traumatise they don't attend for necessary medical care and then come to harm as a result! Please be responsible!

I am not paying tax, being pimped out by the NHS and looking after the gigantic ego of Emperor Henry IX when I am sick, so I have to die as punishment?

If same sex means I might get a transwomen, it's not necessarily helpful.

Same sex requests MUST mean same sex. Not gender.

I've read the document. The document IS the problem.

I'm terrified.

How dare you tell me not to express my fears and concerns.

Perhaps the NHS should have considered the impact of their guidance on anxious and vulnerable patients WHILST writing it - and considered the unintended consequences of making women disengage from NHS or the emotional stress of being told they might be treated as a witch.

@RedToothBrush again none of this is true! All you have to do is when you book your appointment say that you would prefer a biological female. The guidance then sports you getting that if you feel having a non biological female will cause you any psychological upset.

For the first time you now have guidance which supports this choice explicitly.

I agree don't do it face to face -for 2 reasons

1. It sounds unnecessarily awkward for both of you.
2. There won't be a spare member of staff sitting round s o your appointment will be rescheduled which wastes both your time.

Tell the receptionist or booking line.

With regards to inpatient care - speak to the ward manager, nurse in charge, sister or duty manager.

It’s not the women talking about their concerns here that scares me, it’s the cases I’ve read about where women in a similar position to me have requested same sex care and been given a transwoman and then told they’re bigots if they object.

Didn’t the NHS use one woman’s experience of requesting a female to do her breast screening and then rejecting the transwoman who was sent to do it, as an example of bigotry in their guidance?

What makes you think intimate examinations are excluded? That's not what it says. I'm going to quote a few paragraphs here and perhaps you can explain why you believe this.

This provision allows for patients to request a
healthcare, community mental health or care worker to
have a particular protected characteristic in situations
wherein this is necessary to deliver reasonable
standards of care. Examples of this could be genital
examinations or provision of intimate care, where a
patient may request a staff member of the same sex.

A patient can also request a staff member with
or without a particular protected characteristic to
mitigate potential psychological impact. An example
of this could be a woman requesting a female
therapist as she has been the target of sexual violence
from a man.

A patient cannot request a different member of staff
where there is no clear clinical benefit.

For employment purposes, guidance from the British
Medical Association supports the view that a trans
person’s assigned sex at birth is irrelevant to their
working life. For this reason, they conclude that a
patient has no right to be told a healthcare worker’s
assigned sex at birth.

When a patient requests an employee to be a woman
or a man, the needs and safety of both staff and
patient should be considered. If a trans woman or
trans man is assigned to provide care, they should be
made aware of the patient’s request, and given the
choice of whether they feel comfortable treating or
caring for the patient.

So a patient can only request a same sex doctor or nurse if it is for 'intimate care', which I think we have established is any situation where the HCP may come into physical contact with the patient (so most hospital situations). But they can't request a different HCP "where there is no clear clinical benefit". (This seems to contradict what others have said on this thread.)

But at the same time, the BMA says that "a patient has no right to be told a healthcare worker’s assigned sex at birth." How can they have the right to request a same sex HCP if they don't have the right to be told their sex?

And then, if a female patient has requested care from a woman (in a situation in which they are allowed to request someone of the same sex), they may be assigned a transwoman, who will be given the choice of whether they will be 'comfortable' with this, but the patient will be given no such choice (and is not even allowed to be told the sex of the person treating them).

Have you bothered to read this @User613? Because it makes no sense, and it certainly doesn't say what you say it does.

Healthcare is one of the few areas where the priority should be on employing people who are gender critical, or at least who agree that sex is more important than playing along with someone else's gender identity fantasy. Ideally this would be a condition of employment.

I do not trust the dead eyes sharks in the NHS, they already offered me mental health care to accept men are women because I was the problem not them.

yes of course women can decide what is intimate! Again the definition allows great flexibility - see this quote from GMC guidance on the topic intimate examinations "include examinations of breasts, genitalia and rectum, but could include any examination where it is necessary to touch or even be close to the patient"

So why threaten women with not being allowed to refuse to be treated in ANY situation?

It's incoherent. And unenforceable. And will not be applied in this way in practice. It WILL be restricted to boobs and below when it comes to the crunch. We know this. We aren't fucking stupid.

It's forcing women to justify and disclose. Often in situations they feel most vulnerable. At risk of being labelled transphobic if they don't. To the very people that are giving them concern.

That's not fucking ok. It smacks of coercive nonsense.

No same sex doesn't mean transwomen. I've said it several times, included the relevant quotes and you claim to have read the guidance! You must know this. You can choose any relevant "protected characteristic" as defined by the equality act.

Sex is listed as one such characteristic. The equality act defines sex as being "binary being a man or a woman. For the purposes of the act a person's legal sex is their biological sex recorded on their birth certificate"

Maybe this is a good news story?? The guidance seems to support exactly what you say you want!

A good news story, get to fuck!

I HAVE ANXIETY SO BAD EVEN SPEAKING IS DISTRESSING AROUND HCPs.

It's on my medical records that I go mute.

How the fuck do you expect me explain this further shit and justify it?

All it does is ADD to my stresses.

This is why there shouldn't be a sword of fucking Damocles written into the guidance with the threat of being accused of transphobia.

It's fucked in the head.

You just don't get the trauma aspect to vulnerable patients.

@OldCrone it does make sense - you've got hung up onthe asking bit.

Let me use an example to hopefully clarify. When you ring your surgery at present you can ask for a female doctor. You can still do this - just explicitly state biologically female and the organisation now has a clear duty to provide you one. The guidance is saying you don't have the right to ask in situations where there is no benefit - for example - if the receptionist was a transwoman and just needed to take your address and phone number down - you don't have a right to ask them their sex or ask them to be replaced by a biological woman.

Yes to all the other posters - I agree its possible areas ot the nhs will mess up implementing bits of the guidance but that's not the fault ot the guidance and you now have clear written grounds to complain.

@Naunet the new guidance would have given that woman grounds to complain from the brief description you have given

User613, you are assuming that your average patient is articulate and understands procedures. Many, often from socially conservative backgrounds, don't understand English well and may be unused to asserting themselves, either in their own community or within a hospital environment.

Again the policy is centred around the needs of one group. Why?

What about transwomen with a GRC?

That's clear as mud as it stands.

Sorry but you are talking out your arse and not listening to the concerns about when does single sex mean single sex.

No one trusts the NHS on this. We don't have single sex wards we legally are supposed to. The number of assaults, particularly on women is astronomical. And that's particularly bad in relation to mental health wards.

So the NHS think the priority is to do this shit.

And further undermine trust.

Get to fuck. It's woman hating bullshit. The NHS don't care about the well being of female patients.

They want to further traumatise by making women justify their right to single sex. It's another way to insist we put up and shut up.

If same sex doesn't mean transwomen, what does this paragraph mean?

When a patient requests an employee to be a woman
or a man, the needs and safety of both staff and
patient should be considered. If a trans woman or
trans man is assigned to provide care, they should be
made aware of the patient’s request, and given the
choice of whether they feel comfortable treating or
caring for the patient.

I interpret that to mean that if a female patient requests a woman, they might get a transwoman. Is there another possible interpretation?

The equality act defines sex as being "binary being a man or a woman. For the purposes of the act a person's legal sex is their biological sex recorded on their birth certificate"

And if a man gets a GRC to say he is a woman, he can get a new birth certificate which says 'female'. So even this doesn't protect women who want to be treated by someone of the same sex.

And if a man gets a GRC to say he is a woman, he can get a new birth certificate which says 'female'. So even this doesn't protect women who want to be treated by someone of the same sex.

Quite.

I want single sex provision to be crystal clear in ALL situations. The equality act updated to reflect biological sex. Easy preemptive opt out of being treated by opposite sex if requested (with third party explanation and no judgement if this isn't available). Single sex wards to be single sex. No mixed wards for mental health issues.

I don't think this is unreasonable.

It is the lack of transparency and the threat of withholding treatment for 'incorrectly phrasing a desire for single sex without a strong enough justification' that is the issue and is actively CREATING anxiety for patients who feel disrespected and not cared about. They feel staff are able to freely abuse the system because it's captured by activists and people in need of validation at their expense.

This is not ok.

This highlights the power dynamics and vulnerability of patients explicitly.

100% this , well well so they do think there is a risk from men but not towards us real women , funny that eh 🤔

This is yet another reason why the GRA needs to be repealed.

just explicitly state biologically female and the organisation now has a clear duty to provide you one.

The guidance says the opposite. It says that "a patient has no right to be told a healthcare worker’s assigned sex at birth."

And also, if I ask for a woman, this woman might be a male 'woman':

When a patient requests an employee to be a woman
or a man, the needs and safety of both staff and
patient should be considered. If a trans woman or
trans man is assigned to provide care, they should be
made aware of the patient’s request

If you think this means something else, it just shows how appallingly badly written this document is that two people can interpret it in such different ways. I still don't see how it allows me to ask for a biological woman when I'm not to be told the actual sex of the person treating me.

The document only mentions 'biological sex' once, and not in this context, but in the context of being offensive to people who are gender critical.

Gender critical
The philosophical belief or opinion that
that biological sex is ‘real, important and
immutable’ and should not be conflated with
gender identity; even in cases in which a
trans person has legally changed their sex
for all purposes (see ‘Gender Recognition
Certificate’ for more information). This belief
is acceptable under the Equality Act on the
grounds of the protected characteristic of
‘Religion or Belief’, and remains acceptable,
even if such a belief of opinion may be
considered ‘profoundly offensive and even
distressing to many others’.

It may indeed be profoundly distressing to a man that I continue to perceive him as a man regardless of his internal sense of self and any bits of paper and cosmetic changes involved. That is not my problem.

If that man is being sent to provide me with intimate care when I have asked for female only care in this situation, he has forced me to the discourtesy of having to point out that no, he is not female and I will not be accepting him as female, and why does he expect me to nurture his feelings and care about HIS offense when he has no fucks to give about mine? I am not his mum. I am not his service human.

There's an easy answer. Don't put him or me in that situation and we can all crack on without a problem.

I am not his mum. I am not his service human.

There's an easy answer. Don't put him or me in that situation and we can all crack on without a problem.

If he is too sick to do the job them like anyone else he should not be working with vulnerable people.

When you ring your surgery at present you can ask for a female doctor. You can still do this - just explicitly state biologically female and the organisation now has a clear duty to provide you one

So how do you intend to get this message out to all the women who need to know this? For example, elderly women who haven't come across this idea that men are women if they say they are? What about women with dementia, women who speak English as a second or third language, women with a learning disability, or just women who think that 'transwomen' are like that bloke down the road who likes to wear dresses occasionally, and have no idea that someone like that would be trying to pass himself off as an actual woman in a healthcare situation?

Why should we have to ask for a 'biologically female doctor' when everyone knows what a woman means when she asks for a female doctor?

"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."

Hi user613
Any thoughts on the meaning of 'female' in this quote from the document?

A couple of pp are going with a biological female with a trans identity but I reckon it only makes sense if they are talking about a man who calls himself a woman who wants to use the female showers.

If I'd needed to ask specifically for a female hcp for my demented mother, and this member of staff turns up, a) what sex would you think they are likely to be? And b) if, as I suspect, the NHS confederation are using both the word 'female' and 'woman' in the above paragraph to refer to what my very distressed mum would see as a man, then what is the phrase I'd need to use to get an actual woman to see her?