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Feminism: Sex and gender discussions

NHS Policy Audit - working party -Thread #3

732 replies

KnottyAuty · 12/06/2025 20:57

NHS Policy Audit - working party -Thread #3

Original thread #1 here:
https://www.mumsnet.com/talk/womens_rights/5291237-nhs-policy-audit-working-party?page=1
Thread #2:
https://www.mumsnet.com/talk/womens_rights/5322494-nhs-policy-audit-working-party-thread-2

This is a thread about “keeping the receipts” on NHS Policies prior to the Supreme Court ruling on 16th April 2025.

Our working theory is that there were no single sex spaces for NHS Staff or Patients in the entire country before that date, having all been removed by stealth.

We are aiming to prove this by auditing websites and policies for all the UK trusts and using the results to raise public awareness.

As well as recording what has happened historically, the information will form a baseline so we can check which Trusts comply or defy the judgement in due course...

We are working around the country region by region. If you fancy getting involved in a bit of grassroots feminism then please do join in to help!?

Each trust takes about an hour to research and you can upload online without giving any personal details away. Comment below and we can give you the link to an online survey - it changes for each region.

Thanks soooo much to all the vipers who have helped so far and @twoloons for doing a great job with the thread wrangling!

NHS Policy Audit - working party | Mumsnet

Following on from Thread #23 of the Peggie v NHS Employment Tribunal. Anyone who wants to help with survey/audit of paperwork against the Equality Act...

https://www.mumsnet.com/talk/womens_rights/5291237-nhs-policy-audit-working-party?page=1

OP posts:
Thread gallery
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KnottyAuty · 12/06/2025 20:57

Here are the press articles we’ve managed to generate so far:

Scotland:
25th March: The Telegraph: Bearded trans women can be treated on female wards, says Scottish NHS
https://archive.is/dTUhY
26th March: Scottish Daily Express: Research from group of Scottish Mumsnet users claim that NO NHS Scotland health boards offer single sex facilities
https://archive.is/kaLCB
26th March: The Telegraph: Trans policy will 'raise awareness of menstruation in men's toilets' says NHS trust
https://archive.is/iSD9m
12th May: audit referenced in Telegraph: scottish NHS trusts refuse to ditch trans policies
https://archive.is/ja6mT

London:
21st April: The Telegraph: Trans NHS patients can access every women-only space in London
https://archive.is/awGuz
23rd April: The Telegraph: NHS hospitals 'trying to defy' trans ruling (in conjunction with another thread by NHS mumsnetters)
https://archive.is/1DO8d
25th April: The Telegraph: Teenage boys allowed on girls' hospital wards under NHS gender rules
https://archive.ph/Iyblu
25th April: BBC Antisocial Podcast - Sex, Gender & The NHS (about 26mins)
https://www.bbc.co.uk/sounds/play/m002b76x
3rd May: The Telegraph: NHS uses derogatory 'terf' slur in official guidance
https://archive.ph/uLsfi 
4th May: The Daily Mail: NHS Trust uses offensive TERF slang
https://archive.is/Wlve8
6th May: audit referenced in Telegraph: NHS must ‘use plain English’ for transgender people, says Streeting
https://archive.is/oivI5
13th May: audit referenced in Daily Sceptic: The NHS no longer recognises the reality of biological sex/
https://archive.is/MXl9A
4th June: The Times: NHS mental health hospitals allow criminals to self-identify as women
https://archive.is/uMbDb
4th June: Daily Mail: Mental health hospitals in charge of violent criminals allowing biologically male patients who self ID as women on female wards
https://archive.ph/ExvU1
4th June: Telegraph: Male criminals can self-identify as women in mental health hospitals
https://archive.ph/t23JQ
5th June: UnHerd: NHS mental health hospitals should not let criminals self-ID
https://archive.ph/G7ecJ
5th June TalkTV WRN: Mentally ill men permitted to self ID as women by the NHS
https://www.youtube.com/watch?app=desktop&v=h5syQoT1Y2M&abchannel=Women%27sRightsNetwork
5th June TalkTV JHB: NHS Trans Crisis
https://x.com/TalkTV/status/1930567996667232744

OP posts:
Bannedontherun · 12/06/2025 21:50

Ta

Bluebootsgreenboots · 12/06/2025 22:06

Hello! Thanks for all your amazing work - if there’s still lots to do I’d like to help, but despite having watched your threads in fascination, I haven’t worked out how you actually do it. But if you’re happy to brief me, I’d love to pitch in.

KnottyAuty · 12/06/2025 22:17

Brilliant thanks! If you pop a note on the end of Thread #2 and tage Farriersgirl then she will allocate you a trust. I will DM you a link to the online form now and you can have a look at the instructions. Fire away with questions - you will probably have a lot! (but do please fill up the old thread first - thanks)

OP posts:
FarriersGirl · 13/06/2025 07:27

Bluebootsgreenboots · 12/06/2025 22:06

Hello! Thanks for all your amazing work - if there’s still lots to do I’d like to help, but despite having watched your threads in fascination, I haven’t worked out how you actually do it. But if you’re happy to brief me, I’d love to pitch in.

Welcome - there is plenty to do. Could you take Portsmouth Hospitals University NHS Trust? Thanks

YellowRoom · 13/06/2025 14:08

Sorry this is long... I've submitted SE Coast Ambulance which covers Brighton. Trans Policy drafted with GIRES.
Very open - all policies etc available on Trust website. Pages dedicated to trans including their commitment to the trans community, guidance for call-takers and clinical staff.

Apols if the form is confusing. Wouldn't usually have a patient single-sex accommodation policy being an ambulance trust - but they do refer to hospital transfers so I've included.

Trans paramedic poetry
Transgender Day of Remembrance Poem by Steph Meech, 18 November 2019
When I meet my maker, And go up to the skies, I will sit right down beside them, And look them in their eyes. Oh, why did you do this, Oh, why will I cry, My life has been a struggle, Right up until I died. I was not like the others, I just did not fit in, I had so many issues, Just where would I begin. I was born a boy, But even I could see, As I grew up, There was no male in me. I tried to be a good son, A father and a dad, But deep inside I am hurting, And I’m feeling bad. For I am a lady, And I have always been, I have just hidden her, Didn’t want her to be seen. But now I am a female, I just want you to see, That girl that’s there in front of you, That girl is really me. Please do not judge me, I do that by myself, I want to be me know, Not anybody else. I may not be a beauty, That I must confess, With my dyed red hair, And my long coloured dress, But I am at peace now, For who you now see, Yep that lady, Well that lady is really me. So don’t be afraid, Don’t be shy, Please don’t ignore me, Please don’t walk on by.

The staff policy is remarkable:
It is crucial to use the correct pronouns, names and titles when speaking to trans people. Nothing is more distressing than being regarded as a man when you identify as a woman, or vice versa.

Employees caring for trans patients must ensure that trans people have access to appropriate facilities whilst in their care, which accord with their full-time presentation.

Not seen this before in a trans policy - this is the government positive action guidance:
https://www.gov.uk/government/publications/positive-action-in-the-workplace-guidance-for-employers/positive-action-in-the-workplace
Positive action is a range of measures allowed under the Equality Act 2010 which can be taken to encourage and train people from under-represented groups to help them overcome disadvantages in competing with other applicants. Positive action can be used to encourage particular groups to apply, or to help people with particular protected characteristics to perform to the best of their ability. In circumstances where the candidates are "as qualified as" each other, two applicants could be equally appointable following interview with the same qualifications and experience, and under the Equality Act it would be appropriate to select the individual from the minority group in order to enhance diversity within that team.

The Trust will not count absences related to the gender reassignment process in stages for absence management.
It should be noted that absences from work in order to have treatments linked to gender reassignment, are protected under the Equality Act 2010, and may not be used to disadvantage a person in terms of, for instance, promotion.

Where required potential users of the facilities should have trans awareness training to help them to be properly prepared, to welcome any trans person who is starting to use the facilities. It is not appropriate to request that a trans person use accessible toilet facilities. If others do not wish to share facilities with a trans person, then they, rather than the trans person should be directed to accessible facilities.
Where locker or shower facilities are open plan, then the Trust will review this and, at the least, will provide some provision (e.g. curtained spaces) where employees need not be in a state of undress in the presence of others. If it is genuinely impossible to adapt locker or shower facilities in order to accommodate an employee in a state of undress, then the Trust will make reasonable adjustments for the employee concerned. If planning alteration work or commissioning a new building, consideration should be given to providing more gender-neutral facilities, and/or changing the labelling on some facilities so that they are gender neutral. Greater privacy may be provided by having more cubicles, and by having partitions that extend from floor to ceiling, and doors that extend to the floor.

Positive action in the workplace

https://www.gov.uk/government/publications/positive-action-in-the-workplace-guidance-for-employers/positive-action-in-the-workplace

Cantunseeit · 13/06/2025 14:08

Thanks for the new thread!

Popping on to share a couple of (heartening) clauses that I haven't come across before. These are from Queen Victoria Hospital NHS Foundation Trust's Supporting Gender Identity Policy [2022]. It would be interesting to know if either of these has ever been used to protect single sex wards/bays:

"There may be some circumstances where it is lawful to provide a different service or exclude a TNB person from the single sex ward of their identified gender but only if this a proportionate means of achieving a legitimate aim. Any decision to do this must therefore be based on:
- an objective and evidence-based assessment of the circumstances and relevant information
- Balancing the need of the TNB person and the detriment to them if they are denied access, against the needs of other service users and any detriment to them if the TNB is admitted."

"12.2 Risk assessment
Staff may be concerned about the possible risks & vulnerabilities that could arise as a consequence of a TNB person being admitted to a ward in accordance with their identified gender. These should be assessed objectively in light of the cause of that concern."

Before anyone gets too excited, the very next paragraph reads:
"12.3 Using toilets & showers TNB people have equal rights to access single gender toilets or showers as any other person. Consequently TNB people should be able to use the facility appropriate to their identified gender."

KnottyAuty · 13/06/2025 14:15

Cantunseeit · 13/06/2025 14:08

Thanks for the new thread!

Popping on to share a couple of (heartening) clauses that I haven't come across before. These are from Queen Victoria Hospital NHS Foundation Trust's Supporting Gender Identity Policy [2022]. It would be interesting to know if either of these has ever been used to protect single sex wards/bays:

"There may be some circumstances where it is lawful to provide a different service or exclude a TNB person from the single sex ward of their identified gender but only if this a proportionate means of achieving a legitimate aim. Any decision to do this must therefore be based on:
- an objective and evidence-based assessment of the circumstances and relevant information
- Balancing the need of the TNB person and the detriment to them if they are denied access, against the needs of other service users and any detriment to them if the TNB is admitted."

"12.2 Risk assessment
Staff may be concerned about the possible risks & vulnerabilities that could arise as a consequence of a TNB person being admitted to a ward in accordance with their identified gender. These should be assessed objectively in light of the cause of that concern."

Before anyone gets too excited, the very next paragraph reads:
"12.3 Using toilets & showers TNB people have equal rights to access single gender toilets or showers as any other person. Consequently TNB people should be able to use the facility appropriate to their identified gender."

Gosh I have definitely seen all that word for word somewhere else - I just have no idea where... I had the same reaction = "aaah common sense" quickly followed by "oh maybe not"!

OP posts:
TwoLoonsAndASprout · 13/06/2025 14:21

@YellowRoom, the “we won’t count absences related to gender reassignment procedures as actual absences” comes up in a lot of trusts, and it makes me grind my teeth. I have a whole list of “perks” if you will, that are extended to trans members of staff that would never be considered for any other member of staff, at least not without begging and much hoop jumping, and statements that it must not be taken as setting any sort of a precedent (imagine a mother of a child going through major surgery, for example).

Also thank you for the…delightful poetry. I now need to go and listen to some angry thrash metal
or something to reset my brain.

TwoLoonsAndASprout · 13/06/2025 14:25

@YellowRoom, and this:

Greater privacy may be provided by having more cubicles, and by having partitions that extend from floor to ceiling, and doors that extend to the floor.

of course means less safety for all users in case of collapse, as @Keeptoiletssafe would definitely remind us.

KnottyAuty · 13/06/2025 14:29

@YellowRoom very interesting.

So if you go for a job as a trans or NB person then if all else is equal you will be offered the job? And you can self-ID into that without making any other changes to your physical appearance and maybe tick a box on the monitoring form or produce a gas bill with Ms/Mr?

I can't lie. My immediate thought was that I could qualify for that. I could easily evidence 30+ years of gender non conformity to justify NB status.

OP posts:
YellowRoom · 13/06/2025 14:49

@TwoLoonsAndASprout you're more than welcome for the poetry, it understandably moved you greatly. And thanks for including Keeptoiletssafe - I had in mind when reading about the floor to ceiling cubicles.

I wonder if any, presumably women, did receive training in how to welcome trans identified men into their toilets.

@KnottyAuty Interested in how the under-representation of trans paramedics would be quantified - particularly as you'd not possibly ever know they'd transitioned/couldn't ask them anyway. The gov guidance said to be aware of potential legal challenges.

Bunpea · 13/06/2025 16:09

TwoLoonsAndASprout · 13/06/2025 14:25

@YellowRoom, and this:

Greater privacy may be provided by having more cubicles, and by having partitions that extend from floor to ceiling, and doors that extend to the floor.

of course means less safety for all users in case of collapse, as @Keeptoiletssafe would definitely remind us.

Yes. Whoever wrote this is an unqualified ignoramus, giving out downright dangerous instructions.

FarriersGirl · 13/06/2025 16:24

Afternoon All

Below is the latest update on progress with the SE Region - a strike though a name means the allocated jot form is submitted.

Acute trusts in the South East region

Ashford and St Peter’s Hospitals NHS Foundation Trust - Cantunseeit
Buckinghamshire Healthcare NHS Trust -Cantunseeit
Dartford and Gravesham NHS Trust - Theeyeballsinthesky
East Kent Hospitals NHS Foundation Trust - Needmoretinfoil
East Sussex Healthcare NHS Trust - Yellowroom
Frimley Health NHS Foundation Trust - Cantunseeit
Hampshire Hospitals NHS Foundation Trust - Yellowroom
Isle of Wight NHS Trust - Cantunseeit
Maidstone and Tunbridge Wells NHS Trust - socialdilemma
Medway NHS Foundation Trust - Yellowroom
Oxford University Hospitals NHS Trust - thenoisiestteramgant
Portsmouth Hospitals University NHS Trust - bluebootsgreenboots
Queen Victoria Hospital NHS Foundation Trust - cantunseeit
Royal Berkshire Hospital NHS Foundation Trust
Royal Surrey County Hospital NHS Foundation Trust
Surrey and Sussex Healthcare NHS Trust
University Hospital Southampton NHS Foundation Trust
University Hospitals Sussex NHS Foundation Trust

Community and mental health trusts in the South East region

Berkshire Healthcare NHS Foundation Trust - withsilverbells
Central Surrey Health - FarriersGirl
First Community Health and Care - FarriersGirl
Kent Community Health NHS Foundation Trust - Cantunseeit
Kent and Medway NHS and Social Care Partnership Trust - Blackmetallic
Medway Community Healthcare - FarriersGirl
Oxford Health NHS Foundation Trust
Solent NHS Trust
Southern Health NHS Foundation Trust
Surrey and Borders Partnership NHS Foundation Trust - teawamutu
Sussex Community NHS Foundation Trust - teawamutu
Sussex Partnership NHS Foundation Trust - teawamutu

Ambulance trusts in the South East region

South East Coast Ambulance Service NHS Foundation Trust - Yellowroom
South Central Ambulance Service NHS Foundation Trust

Keeptoiletssafe · 13/06/2025 17:31

TwoLoonsAndASprout · 13/06/2025 14:25

@YellowRoom, and this:

Greater privacy may be provided by having more cubicles, and by having partitions that extend from floor to ceiling, and doors that extend to the floor.

of course means less safety for all users in case of collapse, as @Keeptoiletssafe would definitely remind us.

Hello!!

From EHRC: To rely on the objective justification defence, the employer, service provider or other organisation must show that its policy or age-based rule was for a good reason – that is 'a proportionate means of achieving a legitimate aim'.
To prove objective justification:

  • the aim must be a real, objective consideration, and not in itself discriminatory (for example, ensuring the health and safety of others would be a legitimate aim)

I believe providing single sex toilets and changing rooms, with a door gap in individual cubicles into a single sex area, will be a proportionate means of keeping everyone as safe as possible in medical emergencies and to prevent assaults in a confined space.

I believe ‘Greater privacy may be provided by having more cubicles, and by having partitions that extend from floor to ceiling, and doors that extend to the floor.’
is harmful and discriminatory to everyone at their most vulnerable. 11% of cardiac arrests happen on the loo for example.

However, transactivists like a mixed sex area with individual private cubicles within the area. It’s a design called ‘inclusive’ by certain academics. Inclusively dangerous but least unsafe for healthy men.

TwoLoonsAndASprout · 13/06/2025 17:38

@Keeptoiletssafe, I like your judicious use of “certain academics” 😆

Keeptoiletssafe · 13/06/2025 18:20

TwoLoonsAndASprout · 13/06/2025 17:38

@Keeptoiletssafe, I like your judicious use of “certain academics” 😆

Hmm. I actually reported my own post last time I linked to some of their views on toilet design because I wasn’t sure if it crossed into being too offensive or pornographic!

KnottyAuty · 13/06/2025 20:23

Good evening wims!
Could we maybe talk tactics please?

I had hoped we could have completed all the audit by the time Peggie Part 2 is back. The Tribunal is scheduled to run until 30th July and presumably the press interest will mean our chance for stories will step up around then.

So I was wondering if we could collate a list of possible "specific interest" stories from the audits so far?

For example - have you have seen trusts specifically say in their policy that they will refuse treatment to anyone who is transphobic or discriminates against a trans person (staff or patient)? If you have any names can you please DM me?!

What other stories spring to mind from your surveys so far? And/or are there other local issues or Trust announcements which make results more newsworthy?

OP posts:
FarriersGirl · 14/06/2025 07:57

KnottyAuty · 13/06/2025 20:23

Good evening wims!
Could we maybe talk tactics please?

I had hoped we could have completed all the audit by the time Peggie Part 2 is back. The Tribunal is scheduled to run until 30th July and presumably the press interest will mean our chance for stories will step up around then.

So I was wondering if we could collate a list of possible "specific interest" stories from the audits so far?

For example - have you have seen trusts specifically say in their policy that they will refuse treatment to anyone who is transphobic or discriminates against a trans person (staff or patient)? If you have any names can you please DM me?!

What other stories spring to mind from your surveys so far? And/or are there other local issues or Trust announcements which make results more newsworthy?

There are a couple of things from 1 or 2 early trusts that might be useful. I will have a look back when I get a few mins.

Cantunseeit · 14/06/2025 08:27

I’ve seen a few that use “hate crime” to describe behaviour that doesn’t fully comply with the trans person’s wishes. Possibly linked with using the wrong pronouns. I think this is a difficult angle though as obviously trans people should not be discriminated against or harassed. I’m not sure how overt the threat is to people who won’t comply and how much only implied (but clarified by cases like Sandie’s)

Likewise, similar challenges with highlighting all the time off and kid gloves treatment for staff transitioning. I remember thinking “I bet they don’t have a check list like this for mothers returning after maternity leave” but then of course perhaps they do and the NHS is just a great employer…

I think the deception angle could be a story in its own right- how many policies we’ve only seen thanks to Ermine and how many claim single sex accommodation on websites but have hidden policies that make this a lie.

One other, that I think might be difficult to pursue sensitivity, is the inclusion of definitions for “intersex” in the policies. Some are really out there and even the less obscene don’t fit with a 21 century health service. Raises the question (for me) of who is actually writing / responsible for these policies? Surely no medically trained people would be including the term Intersex (and certainly not the definitions I’ve seen). Also saying intersex people don’t have the pc of sex. It’s truly batshit

and on who’s writing them / is there a story of the origin of the whole thing which explains why so much of them are the same- points to a centralised solution as almost all Trusts are using the same stem with a variety of embellishments (which are also repeated by other Trusts)

sorry - that turned out longer and more rambling than expected! I’ll have a proper think and come back with any other thoughts (hopefully in concise bulletpoints).

KnottyAuty · 14/06/2025 09:10

Cantunseeit · 14/06/2025 08:27

I’ve seen a few that use “hate crime” to describe behaviour that doesn’t fully comply with the trans person’s wishes. Possibly linked with using the wrong pronouns. I think this is a difficult angle though as obviously trans people should not be discriminated against or harassed. I’m not sure how overt the threat is to people who won’t comply and how much only implied (but clarified by cases like Sandie’s)

Likewise, similar challenges with highlighting all the time off and kid gloves treatment for staff transitioning. I remember thinking “I bet they don’t have a check list like this for mothers returning after maternity leave” but then of course perhaps they do and the NHS is just a great employer…

I think the deception angle could be a story in its own right- how many policies we’ve only seen thanks to Ermine and how many claim single sex accommodation on websites but have hidden policies that make this a lie.

One other, that I think might be difficult to pursue sensitivity, is the inclusion of definitions for “intersex” in the policies. Some are really out there and even the less obscene don’t fit with a 21 century health service. Raises the question (for me) of who is actually writing / responsible for these policies? Surely no medically trained people would be including the term Intersex (and certainly not the definitions I’ve seen). Also saying intersex people don’t have the pc of sex. It’s truly batshit

and on who’s writing them / is there a story of the origin of the whole thing which explains why so much of them are the same- points to a centralised solution as almost all Trusts are using the same stem with a variety of embellishments (which are also repeated by other Trusts)

sorry - that turned out longer and more rambling than expected! I’ll have a proper think and come back with any other thoughts (hopefully in concise bulletpoints).

Thanks - interesting points.

On the deception - regarding advertising/promising single sex and then in policy (not public facing) deciding that this isn’t the case, is THE story… But probably only at the end once we can evidence this and that politicians promises to protect SSS were false.

The hate crime is an interesting angle because that does impact on others - DBS checks would fail impacting on someone’s ability to make a living. Now obviously “true” harassment of a trans person is different to someone else’s (article 8 human right) to assert their own boundaries and state basic facts in an appropriate context and a respectful way. But I suppose we would actually need some examples of people who had suffered a detriment due to this NHS policy to make this newsworthy… anyone seen stories about that?

Thanks for those pointers - does this spark any ideas for others here?

OP posts:
TwoLoonsAndASprout · 14/06/2025 09:28

@KnottyAuty, you already know about this, but just for everyone on here, I am looking at the dementia angle.

There are two issues - non-trans dementia patients who want same-sex care being given trans-identified carers and being told that these are same-sex.

And the second came from one of the policy documents which stated that trans patients with dementia often “detransition” (that is, forget that they were trans). The policy document instructed staff to discourage contact with any family who went along with (the document used the words “took advantage of”) this dementia-induced detransition, which is (as far as I understand) completely contrary to all best care instructions for dementia sufferers.

TwoLoonsAndASprout · 14/06/2025 09:34

TwoLoonsAndASprout · 14/06/2025 09:28

@KnottyAuty, you already know about this, but just for everyone on here, I am looking at the dementia angle.

There are two issues - non-trans dementia patients who want same-sex care being given trans-identified carers and being told that these are same-sex.

And the second came from one of the policy documents which stated that trans patients with dementia often “detransition” (that is, forget that they were trans). The policy document instructed staff to discourage contact with any family who went along with (the document used the words “took advantage of”) this dementia-induced detransition, which is (as far as I understand) completely contrary to all best care instructions for dementia sufferers.

I should say - if anyone comes across anything related to this - including personal experience or news articles or anything, do share on here.

Cantunseeit · 14/06/2025 09:39

Actually, that policy- led push to sideline and disregard relatives that don’t agree with the trans identity runs right through more generally. I nearly included an example yesterday but didn’t because it is in all of them. The views of the relatives of non-trans people should be sought and taken into consideration but the families of trans people who don’t agree with the patient should be ignored.

same for children with the “even when not Gillick competent” line

TwoLoonsAndASprout · 14/06/2025 09:43

Cantunseeit · 14/06/2025 09:39

Actually, that policy- led push to sideline and disregard relatives that don’t agree with the trans identity runs right through more generally. I nearly included an example yesterday but didn’t because it is in all of them. The views of the relatives of non-trans people should be sought and taken into consideration but the families of trans people who don’t agree with the patient should be ignored.

same for children with the “even when not Gillick competent” line

Indeed! And thank you - I should find a few of those, because I think that there are also strong recommendations that familial support is vital for patient recovery, and discouraging this is really anti-good-health, if nothing else (and it’s so much else).

The dementia one I mentioned went further and said that family was to be sidelined in favour of the “trans community.”