Yesterday, NHS England released their updated guidelines on how to uphold patients’ privacy, safety and dignity when hospitalised. The guidance states that NHS accommodation in hospitals should be provided on the basis of sex assigned at birth, ensuring people are put in “same sex” wards – putting trans people at risk.
At Spectra, we are disappointed at the news of this updated guidance, and the message it sends to trans and non-binary people. This will have real world consequences: trans people and non-binary people will be reluctant to seek care out of fear of being discriminated against when they do. Many trans and non-binary people have already reported increased anxiety and uncertainty following this year’s EHRC guidance around access to public spaces and facilities, including not knowing what public restrooms to use.
Yesterday’s guidance just reinforces the idea that trans people are a problem to be solved, and are not welcome in single sex public spaces, unless they are willing to be told that they are someone who they are not. We are concerned about the negative message this guidance sends. For trans or non-binary person, to be reduced to their sex assigned at birth can be dehumanising, harassing and undignified. Trans people need to be supported and loved, not vilified and told who they are by others and where they should go. The impact of these guidelines on trans and non-binary people’s mental health, wellbeing and willingness to seek healthcare has not been considered.
The updated guidance says:
When making these decisions, NHS staff should consider 3 core questions:
1. What are the patient’s clinical needs?
2. What is safe and fair?
3. How can the patient’s privacy and dignity be respected?
At Spectra we ask, how will safety and fairness be implemented for trans and non-binary people? How will trans and non-binary people be kept safe from being outed, potential harassment and assault? How will trans and non-binary people’s privacy and dignity be taken into consideration when making these decisions?
The NHS is also under enormous economic strain already. The guidelines are based on unrealistic expectations of the current realities of the NHS waiting lists and will put even more pressure on NHS staff to police their patients’ gender, while at the same time trying to support their clinical needs. The guidelines seem impractical and difficult to implement in real-life NHS contexts. Making the reporting pathways of the breaches more official is bound to create a culture of fear amongst NHS staff, fear of being reported for not following this guidance.
Spectra’s CEO, Joel Robinson, says:
The NHS says these guidelines are about privacy, dignity and safety. The question is: whose privacy, dignity and safety? For many trans people, this guidance risks creating fear and uncertainty at a time when we are already at our most vulnerable. Nobody should be made to feel that who they are is a problem to be managed in order to receive healthcare.
Our advice to trans and non-binary people is to continue to seek the healthcare that you need and, although it’s difficult in this current climate, to try to speak up for your needs, remembering that many people support you, including many healthcare staff themselves who are affected by this guidance.
To our allies our advice is to be there for your loved ones, attend hospital with them if you can, helping to speak up for their needs.
*Spectra offers support services specifically for trans and non-binary people, with online and in person group social spaces, for both young people and adults, as well as advocacy support and counselling.