Well this was totally predictable

[OverlyFragrant]

Woman identifying as a man is 'raped in all-male psychiatric ward' https://www.dailymail.co.uk/news/article-15461027/Transgender-man-raped-male-psychiatric-hospital-ward-court-hears.html?ito=native_share_article-bottom

Shame on these men and shame on the NHS for placing this poor women directly in the hands of predators.

https://www.cqc.org.uk/provider/RV5/reports

I'm sure this is a difficult area to work in, to say the least. There appear to have been ongoing and long standing issues wrt safety and safeguarding, specifically short staffing, and many serious incidents including suicides and violence. So, quite a lot of inspections in recent years. This is from 2023, there has been another inspection since, in 2024, which showed some improvements, but still some failings in safety etc:

'The trust did not always meet its targets for compliance with mandatory training in basic and immediate life support, safeguarding training at level 3, the National Early Warning Score, Seni Lewis, and fire warden training.
There was varied quality and consistency of risk assessments and care plans on Virginia Woolf, Leo and ES1 wards, making records hard to follow for staff not familiar with the wards. For some patients there were no care plans about key areas rated as high risk such as neglect and self-harm. Triggers and protective factors identified in risk assessments, were not always included in patients’ care plans.* *
On ES1 ward we had concerns about levels of patient violence and aggression towards other patients and staff, and this was impacting on staff and patients’ morale.
The trust did not always complete serious incident reviews promptly, leading to delays in implementing learning from serious incidents. A small number of actions from serious incident reviews had not been completed within the timescales set including providing training to staff on breaking bad news, and regular emergency scenario training on some wards.'

Unfortunately, I think 'be kind' now has to be heard with scare quotes around it. They've repurposed the word 'kind' to mean 'obedient'.

A woman was allegedly raped by two men on a men's locked psych ward and you don't want to sully yourself by looking at the DM? Just stop with the purity politics already.

From 2024 report:

' Where relevant staff worked with patients’ offender managers, and specialist teams responsible for managing Registered Sex Offenders and ensuring public protection.'

I think that's mainly about getting in and out of the ward, rather than internal arrangements.

I must say

"I'm not touching the filthy, right-wing Daily Mail, I'll stick with the respectable and morally-upright Daily Express."

is not a take I was expecting.

This FOI on the Trust's Trans policy is qjite astonishing. It's 40 odd pages and there's a lot to raise eyebrows, but I'll focus on the single sex relevant parts:

The 'Policy for the Care and Support of Transgender and Non-
Binary People' is from 2023, so was put in place AFTER this rape, if I've got the date correct?

I'll put links at bottom, but I want to lay out the history of the policy, which is also recorded. From around 2019:

'Discussion of adult trans guidance at Southwark Service User & Carer
Advisory Meeting 20/05/19

Changes Made as a Result of Consultation

The group acknowledged the complexity of the issue, recognising that the introduction of single sex wards (whilst improving privacy & dignity) has increased problems in this area.
• They encouraged forward thinking in terms of gender-neutral provision, especially given an increase in the number of non-binary/trans young people using CAMHS service.
• They discussed the need for tolerance and understanding around all “difference” suggesting that routine opportunities for discussions about being inclusive would be helpful for staff and service users alike. The group understood and supported the approach of dealing with inpatient admission of trans service users on a case-by-case basis.
• They suggested that giving clear information to all service users before admission to an inpatient unit about the approach to gender identity might help avoid difficult situations between patients

Discussion of adult trans guidance at
Lambeth Service User & Carer
Advisory Meeting 30/05/19

A group member stated that a LGBTQ+ friend had experienced prejudice in the Trust.
• The group highlighted the need for greater awareness of gender identity issues among staff and service users
• They identified the value of bringing in external expertise to better understand the needs of trans people and the need to encourage more trans service users to get involved in mechanisms such as the Involvement Register.

Circulated to external LGBTQ+ organisations/stakeholders/individuals
on The Trust’s confidential LGBTQ+ MH circulation list 06/10/19

Focus group of 5 trans and non-binary service users and emailed
feedback on Trust Adult Clinical policy facilitated by CliniQ
March 2021:
Changes to definitions, terminology and section on clinical records, staff awareness, behaviour and communication, concerns, complaints.

Feedback on policy from NHS Rainbow Badge Assessment August
2021
Edits to terminology and clarification of protection against unlawful discrimination of non-binary people by HRA in section 5.

'Legal advice on questions raised by TNBCPWG on current clinical policy
received from Trust solicitor.

19/04/21

Response included:
• The way in which the policy deals with single sex exemptions in 13.2 is appropriate.
• The policy EIA meets legal obligations under the public sector equality duty.
• If the policy is applied fairly by staff who are sensitive to the issues, the chance of any successful litigation is minimised.
• The Trust is currently balancing the need for single-sex spaces (e.g. female only wards, toilets, etc) with giving transgender patients a say in how they wish to receive services.
• The Trust should make sure that it does not unlawfully discriminated against anyone making complaints.
• The Trust should support staff who feel uncomfortable performing searches of people of the opposite sex if staff believe this is requested for a malicious reason.'

'13.2 Admission to adult inpatient wards
All decisions to admit trans and non-binary service users should be made on a case-by-case basis in accordance with the legal requirements detailed in section 5 and guidance from NHS England and NHS Improvement and the Royal College of Nursing.
13.2.1 The staring place for making a decision on which ward to admit a trans or non-binary service users should be the individual’s preference. Staff should remain mindful that an individual may not want to be admitted to a ward that matches their gender identity (e.g. a trans man may not want to be admitted to a male ward because of safety concerns)'

'13.2.3 There may be some circumstances where it is lawful to exclude a trans or non-binary service user from single sex ward of their preferred gender but only if this is a proportionate means of achieving a legitimate aim. Establishing these two criteria requires staff to do the following:
• Involve the trans or non-binary service user in discussions about their admission and be explicit about how their rights are being considered.
• Undertake an objective and evidence-based assessment of all relevant aspects of an individual trans or non-binary service user's circumstances, needs and care requirements in addition to their gender identity to justify any decision.
• Completing a comprehensive risk assessment to determine any known risks to other service users or to the trans or non-binary person.
• Balancing the needs of the trans or non-binary 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 trans or non-binary person is admitted.
• Take steps to minimise any discrimination against a trans or non-binary service user if access to their preferred ward is justifiably denied.
• Keep a written record to demonstrate why a decision is justified and what steps have been taken to minimise any potential discrimination.
• It may also be useful to consider a theoretical comparator of how a cisgender or male/female service user with exactly the same circumstances would be treated.'

3.3.3 If accommodating a young person’s preferred gender within the ward environment poses significant safeguarding issue which cannot be managed with other interventions, then consideration should be given to moving the young person to another unit without gender demarcation. This should only be considered when all other options have been explored and ruled out. The young person and family /carers should be included in this decision as
much as possible and steps should be taken to minimise any discrimination against the trans or non-binary service user in that unit.
13.4 Risk assessment
All risk assessments for trans and non-binary service users should be undertaken on case-by-case basis in accordance with the Clinical Risk Assessment and Management of Harm policy.
Staff should ensure that they take an objective and evidence-based approach to assessing any potential risks and vulnerabilities that could arise because of a trans or non-binary person being admitted to a ward in accordance with their gender identity. This should consider all relevant factors and not just be based on someone's gender identity alone.'

My bold.

So, looks like activists were actively involved in writign the Trust's policy on housing trans patients according to preference. Who were those 'external organsiations/stakeholders'?

Consulted:

• Equality, Diversity and Inclusion Group
• Psychological Therapies Diversity Forum
• LGBTQ+ Staff Network
• Trust Rainbow Champions

www.whatdotheyknow.com/request/policies_and_protocols_regarding#incoming-2684531

https://www.whatdotheyknow.com/request/policies_and_protocols_regarding/response/2684531/attach/html/4/Care%20and%20Support%20of%20Transgender%20and%20Non%20Binary%20People%20v2%20May%2023.pdf.html

I should add that it's quite possible that policy has been updated since 2023. But it's there to see that despite a rape, the Trust was still pushing the idea that patients should be allocated to single sex services according to their preference.

I work in this type of hospital and have only come across one transgender patient - FTM and had a prosthesis - they were housed on a ward with other biological females, although there are mixed sex facilities. I guess it depends on the type of ward as to whether female-only areas were available for this individual

They won’t be single sex services in that case.

• They discussed the need for tolerance and understanding around all “difference” suggesting that routine opportunities for discussions about being inclusive would be helpful for staff and service users alike.

Which sounds lovely, but in fact all the 'tolerance and understanding' only ever goes one way, to support men and heavy political bias at the expense of women who need single sex spaces. Which isn't 'tolerant' or 'understanding' in the slightest.

So in fact, is just absolute bollocks, and active deceit to achieve a desired political aim. Which is to get dicks in spaces where women are undressed, vulnerable and permitted no right of informed consent or anything else that would inconvenience said dick.

More from that policy ...

'There may be times when staff will need to determine if their presentation is due to the current mental health needs, or otherwise. Each case should be assessed objectively in collaboration with the individual. Some people prefer to occasionally wear clothing not usually worn by their assigned gender for reasons of comfort. This should be respected as long as it not overly sexualised or revealing'

'Ward staff would need to be aware that restraining a service user wearing a tight chest binder can further impact on breathing in the prone position. In addition, any potential ligature risk would need to be assessed and a care plan put in place for the individual. Wearing chest bindings for long periods of time, or in warm environments, can impact on oxygen saturation levels and staff need to consider this in their care planning.'

'Searching
....
If a trans person is in the early stages of transition, this could include a preference for a member of staff of one gender to search the top half of their person and a staff member from the other gender to search the lower half of their person''

'Using toilets and showers

Trans and non-binary service users should be able to use the facility appropriate to their gender. There may be some circumstances where it is lawful to exclude a trans or non- binary person from single sex toilets or showers appropriate to their gender but only if this is a proportionate means of achieving a legitimate aim, for example if it compromised the safety or dignity of other service users. Any decision to do this must be made on a case- by-case basis following an objective and evidence-based assessment of the circumstances and relevant information. Staff should not direct a trans or non-binary person to an accessible toilet unless they have access needs'

The Daily Express is also a right-leaning tabloid.

Frankly, I don't care who is reporting this case, as long as they are reporting it.

I'm getting a picture of people who wear 'overly sexualised or revealing' clothing, may risk suffocating themselves, make requests for certain staff to search their 'lower half', and/or demanding to use certain facilities with the opposite sex.

In all of these scenarios. other patients and staff are apparently given less consideration. Every time, staff are told they have to second guess the usual response and check it against an opaque, incomprehensible inner sense we are told some people have - is this person wearing inappropriate clothing because of 'gender'? Is this person suffocating herself because of 'gender'? Is this person asking for women to search his penis because of his 'gender'? Is this person asking to use the women's showers because of his 'gender'?

Every time, safety and safeguarding are compromised on the basis of this thing called 'gender', that only special people have, and we only know about when the special people tell us.

In every instance, 'gender' negatively impacts on safeguarding, of the patient and others.

Psychiatric provision in Nottingham is especially vulnerable to forgetting safeguarding in favour of genderwoo. Michael "Yogyarta Principles" O'Flaherty was a Professor of Human Rights [sic] at the university & strongly infuenced the direction of travel on rights & ethics. Sadly, it's a university with a medical school, so you can imagine the havoc that wrought.

Nottingham's gender clinic is entirely WPATH-staffed & flatly refused to release patient data for the linkage study proposed by Cass. One of its consultant psychiatrists, Walter Bouman, is a former WPATH President, & is the guy who launched that highly unprofessional & abusive attack on Hilary Cass when her report was published. Also on staff is Jon Arcelus, the first person to hold a UK Chair in Transgender Health (at Nottingham, of course) who was a lead developer of WPATH's mis-named "Standards of Care 8", the one with no lower age lmits for medical transition & a chapter on "eunuch gender" for the delight of extreme BDSM fetisists like the now incarcerated "Eunuch Maker", Maricus Gustavson. Arcelus' chief concern when WPATH discussed demand for surgeries like "penis-preserving vaginoplasty" was that they should not be called "non standard". 🙄

No doubt poor, puddled Nadia Whittome has been influenced by the University & NHS gender "experts" in Nottingham.

More from their policy:

'19.1 Legal references

• Equality Act 2010
• Equality Act 2010 Statutory Code of Practice: Services, public functions and
associations (Equality and Human Rights Commission, 2011)
• Gender Recognition Act 2004
Care and Support of Transgender & Non-Binary People Page 24 of 42
• Providing services for transgender customers: A guide (GEO and Gendered
Intelligence, 2015)
• Separate and single-sex service providers: a guide on the Equality Act sex and gender
reassignment provisions (Equality and Human Rights Commission, 2022)'

Gires 2015 for a legal reference?! And this trust is now involved in an ongoing, relevant court case. Eek.

'The law offers protection against discrimination to a person who “cross-dresses” as part of the process of reassigning their gender but not where someone chooses to cross-dress for some other reason.'

Some other reason, eh? Geez, Maud!

I had been wondering where they got their legal advice. It looks very much as though they had an Isla Bumba on the case & skipped seeking actual legal opinion in favour of the effusions of crank activists.

I've said this so many times before.

Nottingham STILL signposts to WPATH's SoC V 8 - the one with 'eunuch' gender, and the one with links to the Eunuch Archive.

NHS Scotland had to report themselves to the police when it was found they'd hosted the SoC v8, because of the CSA therein.

https://www.scotsman.com/health/investigation-launched-after-documents-published-by-scottish-nhs-in-error-stated-that-eunuch-should-be-recognised-as-formal-identity-3734369

A good many of the NHS policies reference the likes of Stonewall, Mermaids, Gires and others as sources of advice and consultees in the development and approval process.

the notes on the trans policy says the Trust solicitor signed off on the policy:

'Legal advice on questions raised by TNBCPWG on current clinical policy
received from Trust solicitor.'

[sighs] The SRA really are pants, eh? Time was, a solicitor wouldn't put their name to such self-evident legal batshittery but now the threat of sanction is all but theoretical.

Wow those policy documents are so much worse than I imagined ...

Awful as they are, I've seen worse. They do at least occasionally acknowledge that other people may also have rights, and - however reluctantly - that it's sometimes necessary to keep people out of opposite-sex services.

Chill a bit.

I'm not enforcing anything. I merely said, its put to everyone as a 'be kind' type of thing, where I work, which implies if you dont follow the pronouns eg refer to them as their chosen gender you aren't being kind. That's all. Enough aggression.