The disgraceful RCN and Nurse Jennifer Melle

[ArabellaScott]

The Darlington Nurses Union has now formally intervened to ask the RCN to step up and do its actual job:

'Suspended nurse Jennifer Melle says her gender row with the NHS has left her abandoned, vulnerable and alone.
The medic claims she has been cast into the wilderness and feeling like a pariah over her unshakable and religiously-held beliefs on biological sex.
She has been suspended from work for four months for breaching patient confidentiality after “misgendering” a convicted sex offender.
Single mum Ms Melle, 40, now faces being struck off but says the silence from those with a duty of care towards her has left her broken. '
...
'Ms Melle was hauled before a disciplinary hearing after an incident in May last year during which she refused to use female pronouns for a patient under her care.
She remains unable to work after Patient X, who was born male but identifies as a woman, was taken to St Helier Hospital in Carshalton, Surrey, from a male prison for treatment for a urinary condition.
Ms Melle was called a n*** multiple times after the inmate overheard her using biologically accurate pronouns during a phone call with a senior doctor.
She was suspended by the trust on April 2 for breaching patient confidentiality after speaking about the racial abuse and referred to the Nursing and Midwifery Council.'

https://www.express.co.uk/news/uk/2090368/gender-biological-sex-trans-NHS-nurse

'A paying RCN member for 12 years, Jennifer says that when the incident happened the union dismissed her case as not “meritorious” and told her to complete a “reflection” exercise to avoid future ‘misgendering’. She received no support despite the RCN recognising the abuse she experienced.
The Darlington Nursing Union (DNU), which represents Jennifer, has now formally appealed to the RCN to intervene.'

https://christianconcern.com/ccpressreleases/christian-nurse-in-trans-paedophile-misgendering-case-says-royal-college-of-nursing-abandoned-her/

@FlirtsWithRhinos Thanks for questions. Apologies for slow response.

If this so-called “doctor” appeared in a real medical setting, they’d likely be seen as delusional and this "belief" neither confirmed or denied as that's usual practice.

On the “white to Korean” Q— biological ethnic background matters for medical reasons: some conditions are more common in certain groups. This info may not be the same as how someone identifies or appears.

And so it is reasonable for a healthcare provider to ask and record that info — in this case, “white” — but regardless they should not routinely refer to patients by any ethnicity, often that would be viewed as demeaning.

I have a question for you r.e. my mention of being asked by NHS how to address deceased relative and choosing "Dr." as they had a PhD.

Some doctors argue this wide usage muddles the waters and is harmful. It can lead to health advice being taken from someone with an irrelevant PhD. Some even use it deliberately to mislead i.e. sell self help books.

May a medical doctor decline PhD "Dr." use and say i.e. "I'm sorry it goes against my deeply held values to prioritise patient welfare."?

Thank you for the reply.

I'm not clear on why you diffentiate between the not-doctor who can be "neither confirmed nor denied" and the trans person who has to be confirmed to minimise their/their family's distress. Can you clarify on what basis you treat them differently?

May a medical doctor decline PhD "Dr." use and say i.e. "I'm sorry it goes against my deeply held values to prioritise patient welfare."?

Yes. The patient or their family might complain of course, in which case whatever the procedure for non-medical complaints is would kick in. But of course, this scenario of a genuine doctor by way of PhD is not the scenario I posted and is not analogous to your "trans people are people distressed by their actual sex and compelled to present as the opposite sex" definition.

But @BeLemonNow you are falling into the trap of missing the wood for the trees.

Take a step back and the very fact that you are tying yourself in knots trying to find ways through all these thought experiments should be a good indication that the model is fundamentally wrong.

It's like pre-Coppernican astronomy where they kept having to add more complexity to their models of celestial motion because they were trying to predict the motion of the planets based on the centre of their orbits being the earth rather than the sun. Their fundamental assumptions were wrong so reality kept popping through and breaking their "rules".

Don't feel bad about that BTW, it's a hallmark of the ideology to distract well meaning people with ever-more-specific scenarios to keep attention away from the fact that the framing of reality is wrong.

R.e. the "Dr." relevance I suppose I was asking about the grounds in which it is legitimate for a medical professional not to call someone a particular way based on their values, which has a strong analogy to the case.

You could make an argument for indirect sex discrimination if this was widely refused. Women would be far more disadvantaged as men defaults to "Mr." whereas a woman has to choose between "Miss/Mrs or Ms" with detrimental assumptions likely whatever they choose.

One concern I have about this GC case, unlike others, is I don't want HCP's personal values entering medical care except in exceptional, ideally prior agreed circumstances (abortion, end of life etc.) Am I correct in understanding from your answer "yes" you don't mind?

But in your example the ‘PhD Dr’ is deceased so won’t be muddying any waters with their advice.

I have never heard of this being an issue in a similar way to the scenario you are attempting to compare.

@FlirtsWithRhinos makes an excellent point above. Maybe now is the time to reflect and reconsider why you are going round in ever decreasing circles trying to make your argument work.

In someone else's example on this thread the transgender person was also deceased so what's the reasoning for not using transgender's preferred form of address i.e. preferred pronouns then? It's very relevant as Coroner's Reports, formal complaints and investigations into death are part of medicine. If dead, what's the harm?

We don't have many issues regarding HCP bringing their personal values into conflict with patients in medicine is they are required not to and are taken to internal disciplinary as with Melle. In a personal capacity they may and do act differently.

There's a lot about this in the NMC Code of Conduct and explanatory notes. One quote:

We don’t expect professionals to conceal their personal beliefs at work. Yet, we may find their practice impaired, if they express a personal belief in a way that:

- constitutes discrimination, harassment, bullying or victimisation of others,
- means that they are not delivering the fundamentals of care effectively, or are not listening to people and responding to their preferences and concerns, or conflicts with the Code’s requirement to treat patients and people who use services with ‘kindness, respect and compassion’.

We don't have the full report obs, Melle has complained that one reason she received a final written warning after the incident was that she was bringing her person beliefs into practice and not responding to patient's preferences.

I assure you I appreciate and read @FlirtsWithRhinos other points, and hope to reach them in response, there's been a few questions asked of me and so I've been prioritising.

Ps. The "Dr.' is deceased, it was a personal anecdote primarily responding to a Q about when are patients referred to in third person.

It wasn't a thought experiment. Then it struck me that there was a broader relevance so that's why I asked FlirtwithRhinos about that.

I don't want HCPs' personal values entering medical care when those personal values hide sex, which has some importance in medicine, behind gender identity, which doesn't. And I don't want gender identity theory used as justification for physically harmful treatments; my personal concern for my son makes this particularly important to me.

Also, I think you exaggerate the religious component in people's views of abortion and end of life issues. It is perfectly possible to have concerns about abortion based on valuing foetuses as potential (or even actual) humans without a religious understanding of conception as the start of life, and there are Christians who take a pragmatic "least harm" or "lesser of two evils" approach to the subject, or who entirely agree with "women's right to choose". Likewise with end of life, there are people who take the view that we shouldn't "play God", and people who don't use that framing but have concerns about risks of coercion.

These issues are controversial not just from a clash between theistic and atheistic worldviews. Look at Dawkins, in agreement over sex and gender with some of the people he has been battling against over religion.

The deceased isn't going to care whether you use 'preferred pronouns' or normal language (where I mean language as used for the vast majority of most people's lifetime). The people who may mind are the relatives and friends of the deceased. There is a very significant chance that you won't even be able to take your lead from the relatives and friends, as they may profoundly disagree with each other.

For example (though no deceased person is involved) I have let my close family know that I am not telling them what language to use, but I want them to understand that use of my son's new name and demanded pronouns is painful for me. They are, as far as I'm concerned, free to use gender identity language, but I am not going to pretend that I don't mind. So many parents, children, spouses and siblings of trans people have been unable to tell their stories because of the coercive control exerted by their loved trans identifying relative. Fear of estrangement is a powerful silencing factor, and many parents, particularly of non-adult children, go along with preferred pronouns and trans name because they are desperate to keep the relationship alive, both for their own sake and for the sake of their children. For many, they start out assuming that what society is telling them, to "be kind" or their children may be suicidal, is the right and only option. By the time they realise that they are being coerced, it is very difficult to backtrack.

The assumption by medical and associated groups that it's right to go along with trans language is damaging. A parent in great distress and worry being told, either directly or by implication, to accept their new daughter or son, is being abused by the agencies that should be supporting and listening.

No ‘bring your whole self to work’ for nurses then!

It's not outing, when it cones to talking with other medical professionals biological sex does matter. Gossiping to another staff member/patient " oh we've got a trannie on our ward" would be a different scenario.

It comes back to whether I think it’s a human right to be considered as a member of the opposite sex. I don’t, so all this talk of “outing” is meaningless.

'Outing' implies 'passing'. How is it outing to refer to an obviously male person using masculine pronouns?

'Outing' in these cases = not living your life according to his rules.

'Outing' means failing to pretend.

Indeed.

Time to extend MB's I'd rather be rude than a fucking liar - it's fucking rude to be a liar.

I enjoyed your Copernican analogy @FlirtsWithRhinos. I'm sure, like many people I'm guilty of holding onto a view too long...but I'm not sure that applies here yet.

You asked me to explain the rationale for the NHS accommodating transpatient's desire to be treated in their preferred gender. As opposed to the "not at all a doctor and distressed" scenario.

I agree it isn't sufficient to argue someone's distressed about themselves so we should accommodate how they wish to be seen.

(It's more complicated in a medical setting as directly denying a psychiatric delusion tends to reinforce it. I'm going to move beyond that and assume they aren't psychiatrically delusional but distressed by something they know to be true.. )

As far as I'm aware cases like the white man identifying as Korean are extremely rare and varied. Generally they seem to have been plausible to "treat" beyond that. I.e. Oli London has now "detransitioned". Denying yourself has a psychiatric cost. Even those who "pass" and hold TRA ideologies will nevertheless be reminded they are not, let's say "born women". Sex matters.

Transgender identities, on the other hand, so far have not shown amenable to psychological treatment, present across nationalities, both sexes and can be prevalent from a young age. We don't understand them yet scientifically but we do know children identity different sex from a very young age. So it's plausible they will be harder to resolve, possibly partly or in whole to do with underlying neurology.

The ECHR decided in Goodwin v UK that under Article 8 (respect for private life) that the UK needed to respect the acquired "gender" of transexuals. The Gender Recognition Act followed, which allows those with underlying distress r.e. biological sex to change their legal gender after a certain process.

(I appreciate that self ID policies don't require a GRC and there's an argument that maybe they should. I don't know if the patient has one.)

Anyway, though I respect people's private right to "misgender" and hold GC views they do, equally the NHS has a responsibility to respect the patients' private life and create appropriate policies for certain groups especially those under Equality Act i.e. transgender, different religions and yes actual biological women!

And additionally - although we disagree here - HCPs have a duty not to bring their values into medicine, except in rare circumstances like conscientious objection to abortion (which can be any rel

The law works in general terms and there are a large variety of beliefs that could be protected under the Granger criteria. I have concerns in this case that the nurse declined to use preferred pronouns on religious grounds, and if successful what other cases may be made.

I.e. CLC has brought and failed cases such as a B&B owner refusing a gay couple for religious reasons.

I hope that answers your question, rather long windedly sorry

R.e. "NHS Pronoun Policy" I don't view preferred pronouns as lying, contributing to sexism and so on. But I can see where others are coming from. We should try to accommodate them. It's a balance of rights issues.

But having thought about this and discussed, I'm not sure it's feasible for the NHS to avoid a "NHS Preferred Pronoun" policy. See below.

1. Privacy. The grounding for Goodwin was privacy r.e. transgender status. HCPs need to know biological sex. Others they speak to about patients do not: relatives, hospital transport staff etc. Using "they" for someone with a feminine name will be very obvious.

2. Respect Day to day, I find third party pronouns respectful although some trans will disagree. However, I used the example of an extensive NHS report into my diseased.relative, where they prior asked me how to refer to him. I don't see how third party pronouns could be respectful here and in other formal situations.

(NB acknowledging posters' example that all concerned may not agree how to refer to someone, I don't know how that gets resolved generally as it must happen, but in some cases all will want preferred pronouns used).

3. Not all agree with third party even. There are religious and linguistic (changing language) objections to using third party pronouns. Even in some cases to someone using a feminine name.

4. Hiding status/avoiding care I have seen examples of transgender patients "hiding" their status for medical professionals already. If they are not referred to in their preferred fashion they are more likely to hide it or avoid medical care as many find it very distressing to be "misgendering.

Thanks for all responses it has been interesting to think about. I'm going to drop off and let you get back to it. But any final arguments or questions (especially if I missed them) are welcome.