by Joan Smith
Monday, 2
January 2023
Debate
16:00

The NHS is betraying women over same-sex care

A new report shines light on a health service in thrall to gender ideology
by Joan Smith
Credit: Getty.

The NHS exists to look after patients. Some of them will be scared or embarrassed about having intimate procedures performed by a stranger, which is why women often ask for a female doctor or nurse. So how did any section of the NHS ever come to the conclusion that it is acceptable in some instances to override such requests? Even more astonishingly, evidence has emerged that an NHS trust in the west of England believes that patients are not always entitled to know the ‘gender identity’ of the person proposing to treat them.

‘Gender identity’ didn’t exist until about a decade ago. What matters is biological sex, which is one of the first things we notice about another human being. If a woman asks to have a cervical smear carried out by a female nurse, she doesn’t want to be treated by a man who ‘identifies’ as a woman and uses female pronouns. And she doesn’t want to be denied treatment for insisting that the person in front of her, speculum in hand, is male.


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Many people will be astonished to discover that this is happening in a service where so much is based on trust. But the practice is confirmed in a report from the think tank Policy Exchange, which suggests that trans NHS staff are being permitted to treat patients who have asked for same-sex care for intimate procedures. It has obtained a letter, written in 2021 on behalf of the North Bristol NHS Trust, which even argues that there is ‘no requirement for clinicians to disclose their gender identity’.

At first sight, it is hard to know what this means, although it appears to suggest an element of deception. If a woman who has asked for same-sex care suspects that the person proposing to treat her is male, surely she is entitled to be told. Only in exceptional cases, according to the letter, which cites the example of a transgender person who is providing intimate care to vulnerable people. If the staff member has a gender recognition certificate and is ‘fully transitioned’, however, the exception will not apply.

Let’s be blunt about what this means: sick and worried people are being expected to put aside their right to informed consent to spare the feelings of a clinician or carer who believes human beings can change sex. In a development few, if any, patients have ever been consulted about, screening programmes for life-threatening conditions, such as cancer, are at risk of being turned into a process for affirming someone’s ‘gender identity’. 

So is hospital care, according to guidance from NHS England, published in 2019, which says trans patients should be accommodated according to the way they dress and the pronouns they use. It is currently carrying out a review into same-sex guidance, although some of us would say that the answer — putting the privacy and wishes of female patients first — is blindingly obvious.

In a blistering foreword to the Policy Exchange report, the government’s former advisor on violence against women, Nimco Ali, writes that the North Bristol NHS trust letter ‘reveals the NHS to be seriously compromised by an ideology that is diminishing the rights of women and girls’. 

It is hard to know how far this ideology has spread within the NHS, but it raises an urgent question for managers. If a woman who asked for same-sex treatment discovers later that it was carried out by a man, it undermines the entire concept of informed consent. And without consent, some intimate procedures might begin to look and feel like a serious breach of trust.

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Steve Murray
Steve Murray
1 month ago

“And without consent, some intimate procedures might begin to look and feel like a serious breach of trust.”
Actually, without consent, some intimate procedures might begin to look and feel like sexual assault. We await the first case.

Last edited 1 month ago by Steve Murray
Steve Murray
Steve Murray
1 month ago
Reply to  Steve Murray

Comment deleted, edit button working now.

Last edited 1 month ago by Steve Murray
Doug Pingel
Doug Pingel
1 month ago
Reply to  Steve Murray

ISTR that this has already happened before all the recent hoo-har. I’m having trouble thinking, let alone thinking stright due to a change in my meds.

AL Crowe
AL Crowe
1 month ago
Reply to  Steve Murray

This has been happening for a long time, and those of us who will not just go along with it are treated as if we are unreasonable and hysterical.
I was sent to have an ultrasound several years ago for an ongoing medical issue, and it was not until I arrived in the room that I discovered that I was expected to have an internal ultrasound conducted by a man. This in spite of documentation in my medical record indicating a history of significant trauma that made those kinds of invasive medical procedures very challenging for me.
I left in tears, without having the ultrasound, and afterwards in spite of the seriousness of the problem, I have not attempted to get it investigated further, as not only was I informed that it was impossible for them to guarantee me a female ultrasound technician, but that I would have to have the ultrasound done before other investigations could be done.
The response to my complaints about this was to be frank rudely dismissive, and I have no doubt I am one of many thousands of women (as well as men) who have had been treated with such contempt by the NHS for the crime of being traumatised.

Last edited 1 month ago by AL Crowe
julianne kenny
julianne kenny
1 month ago
Reply to  AL Crowe

You could request a rescheduling and bring an advocate or companion or partner -a friend so that you don’t miss an important scan because of your difficulty w being alone in an appointment with a male professional. Don’t put it off for this reason- bring a friend. Not all men are predators or insensitive to female vulnerability in hospital settings. You will feel miserable wondering about results -far more important for you to get your health matters dealt with .

Ian Stewart
Ian Stewart
1 month ago

Is this any worse than rape victims being counselled at the Edinburgh Rape Crisis Centre by men who say they are women?
And the head of the rape crisis centre (who is, amazingly, a man who says he is a woman) stated that raped women using their service who don’t wish to be counselled by such men, need to have their trans ‘bigotry’ dealt with as part of their rape recovery trauma.
https://www.heraldscotland.com/politics/19509343.outcry-plan-educate-bigoted-rape-survivors-trans-rights/

Last edited 1 month ago by Ian Stewart
Lindsay S
Lindsay S
1 month ago
Reply to  Ian Stewart

Wow! That’s some messed up priorities

Alphonse Pfarti
Alphonse Pfarti
1 month ago
Reply to  Lindsay S

Jaw dropping. At least JK Rowling did something about it!

Jonas Moze
Jonas Moze
1 month ago
Reply to  Ian Stewart

The comedian JP Sears doing a skit on an ‘identifying woman’ swimmer. https://www.youtube.com/watch?v=_sgjc29QCGo

The Best Female Swimmer in the World!’
Best line from it

‘And woman can get other woman pregnant…….I know, I’ve done it.’

Ian Stewart
Ian Stewart
1 month ago
Reply to  Jonas Moze

Very funny. I don’t know why more comedians aren’t exploiting this woke lunacy for laughs – nah I do know – they can’t betray their brethren on the left.

Lindsay S
Lindsay S
1 month ago

it is deeply disturbing that in institution that is supposed to be based on biology (if they’re not experts then who is?) doesn’t know the difference between sex and gender!
There have been a number of occasions in these discussions where I have pointed out that surgeons are humans and not gods, therefore they cannot change someone’s sex, only give them facsimiles (on the rare occasions where the trans patient actually takes the full surgical route). Perhaps this is an example of the medical practitioners ego, they think they are gods, capable of godlike abilities!

John Solomon
John Solomon
1 month ago
Reply to  Lindsay S

“surgeons are humans not gods”
I don’t think surgeons would agree with that!

Aphrodite Rises
Aphrodite Rises
1 month ago
Reply to  Lindsay S

I once read, many many years ago, that god complexes are extremely rare except amongst the medical profession.

Last edited 1 month ago by Aphrodite Rises
michael stanwick
michael stanwick
1 month ago
Reply to  Lindsay S

I agree with the sense of your point and was thinking about the term ‘facsimile’. I find it doesn’t really do it for me because it has the sense of an exact copy, and I would argue the surgical outcomes are anything but exact copies.
I would propose they are cosmetic objectifying constructs of femininity, as Genevieve Gluck puts it in a Spiked, Brendan O’Neill YouTube interview. COCF for short.
She says that what gender identity proposes is that a man, by performing these constructs (essentially surgical castration etc), can achieve womanhood and hence, according to gender identity, a woman is therefore a castrated man, because women are not thought to have an independent existence entirely separate from men women are not seen as full autonomous human beings women are still perceived as an extension of men …

Last edited 1 month ago by michael stanwick
Miriam Peck
Miriam Peck
1 month ago

Displaying contempt, ill-will, and unfriendliness – all part of the definition of “hostility” used by the Crown Prosecution Service for the purposes of hate crime – towards women seeking single-sex services, many of whom have the protected characteristic of religion, whether their level of observance and the obligations placed on them are a matter of choice or not, isn’t what you would expect from a “service” which wants to encourage people to seek timely help with physical & mental health challenges. When was personalisation shelved as a goal in health and social care? Who was consulted on, or voted for, that change?

Linda Hutchinson
Linda Hutchinson
1 month ago
Reply to  Miriam Peck

No-one was consulted; no-one is ever consulted on these things. They are a bunch of egotistical, arrogant, high-handed, self-appointed experts who believe that they know what is best, and the rest of us ignorant peasants should just do what our betters tell us to do.

Ian Stewart
Ian Stewart
1 month ago

It’s worse than that – women’s groups that support safe services for women that have tried to provide input to changes have been deliberately excluded (blacklisted) from consultations on the basis that they are bigoted transphobes.

Jonas Moze
Jonas Moze
1 month ago

NHS, a political organization which does health care.

R Wright
R Wright
1 month ago

It’s going to be fascinating watching the trans activism train hit the Muslim women bumpers down the line in a few years.

Jeremy Bray
Jeremy Bray
1 month ago

I asked the AI ChatGPT ,that is often criticised for its woke ideology, whether it would be wrong for a woman on religious grounds to ask not to receive an intimate examination from a doctor of a different sex to her even if the doctor was of the same gender.

The answer received was as follows: “It is important for patients to feel comfortable and respected during medical procedures, and it is generally appropriate for a woman to request a female healthcare provider for an intimate examination if that is what she prefers. However, there may be situations in which a female healthcare provider is not available, and in those cases, the patient may need to consider whether the potential benefits of the examination outweigh any discomfort or concerns she may have about being examined by a healthcare provider of a different gender. Ultimately, the decision about whether to proceed with the examination should be made by the patient in consultation with her healthcare provider, taking into account her personal preferences and the specific circumstances of the situation.”

Slightly surprisingly that seems to be an eminently sensible approach and one that the NHS should in fact adopt. It is certainly arguable that a woman who asks to be examined by someone of her own sex would be entitled to claim she had been sexually assaulted if the person who examined her was merely a man who was the same gender as her as a result of possessing a gender recognition certificate although the same might not apply if she merely asked to be examined by a woman as the man with a gender recognition certificate who had chosen to be a woman would qualify as a woman by the legal definition. It would seem women should be with careful semantics.

Jacky Holyoake
Jacky Holyoake
1 month ago

Perhaps a proportion of staff leaving the NHS might be because of the domination of all this “gender identity” nonsense?

Alphonse Pfarti
Alphonse Pfarti
1 month ago

May I just note that many men, while probably unconcerned about female nurses or clinicians examining their privates, might be absolutely horrified by such a situation occurring to them also.

Last edited 1 month ago by Al M
Ethniciodo Rodenydo
Ethniciodo Rodenydo
1 month ago

I do not think we are given the option

Heidi M
Heidi M
1 month ago

This is certainly a can of worms waiting to happen. I have had one exam by a male doctor (checking cervical dilation during pregnancy) as I didn’t want to put anyone out by requesting a female (that, I suppose, is another problem altogether). It was certainly a little more uncomfortable than facing a midwife. And also I would suggest just a bit more physically uncomfortable since the women typically have more slender fingers. Of further interest, another female nurse had to attend during the examination (which never occurred with the midwife) which I expect is to do with ensuring there is no misconduct. Not sure if a similar set up is in place in the UK (Oz here), but it would be interesting what the ramifications would be for such a policy.

E Wyatt
E Wyatt
1 month ago
Reply to  Heidi M

So you could end up with two trans women, one conducting the exam and the other acting as chaperone?

Ian Ryder
Ian Ryder
1 month ago

This issue ultimately reflects social manipulation through the control of language.
“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean—neither more nor less.”
“The question is,” said Alice, “whether you can make words mean so many different things.”
“The question is,” said Humpty Dumpty, “which is to be master—that’s all.” (Lewis Carroll)
The trans propagandists have become masters. Perceived gender has been deliberately conflated with biological sex to such an extent they have now become interchangeable in the media and even scientific journals. Hence the utterly absurd idea that one can change sex at will because it is merely ‘assigned’ at birth, as if doctors and midwives randomly guess biological sex. They do not. Sound anatomical criteria correctly denotes male or female 99.8% of the time. For the 0.2%, there’s a biological fault (https://www.realityslaststand.com/p/intersex-is-not-as-common-as-red) This has got nothing to do with how anyone feels, or dresses or wishes they were different.
I understand that zealots care nothing for evidence or the consequences of their actions so long as they get what they want. What I don’t get is why so many otherwise sensible people running everything from rape centres to jails, to international sports to the NHS have not only fallen for this biologically ridiculous idea, but have become such ardent disciples that they are willing to risk harm to women in the pursuance of it.

William Cameron
William Cameron
1 month ago

This is largely a one way street . Males claiming to be women to get at vulnerable women.
We dont hear much the other way round do we ?

Jamie Smith
Jamie Smith
1 month ago

Hospital staff told police their patient was not raped as alleged attacker was transgender, despite CCTV showing assault in ward
https://www.gbnews.uk/news/hospital-staff-told-police-their-patient-was-not-raped-as-alleged-attacker-was-transgender-despite-cctv-showing-assault-in-ward/250941

Tom Scott
Tom Scott
1 month ago

So who recruits these people? Converts and/or cowards.

Melissa Martin
Melissa Martin
1 month ago

I can’t get past the stupidity of trying to impose a reality denying ideology on us ALL.. Yes, it’s dystopian, totalitarian etc but above all its ‘losing the will to live’ stupid. What a way to start the third millennium, recategorising sexed bodies by preferred sex as defined by regressive stereotypes. And that’s everyone’s documents issued post 2004;the general public just haven’t realised it yet. Sunaks daughters’ birth certificates don’t record their biological sex. Coincidentally, it’s the same but it’s not what’s being legally recorded.

Kate Heusser
Kate Heusser
1 month ago

Professional healthcare staff are just that: professional.
Until very recently, there WERE no female specialist doctors. All surgical and medical examinations and procedures serious enough to require senior staff were carried out by – men! At the other end of the scale, vanishingly few nursing staff were female, so pretty well all the nursing was done by females.
Hospitals don’t have enough staff to guarantee safe levels of care when occupancy is high, so why on earth would people assume they have the right to be treated and cared for only by those of their own sex, whether ‘identifying’ as men or women?
On the other hand, patients are NOT professionals. It isn’t unreasonable for patients to be certain they’re spending their time in wards where the other patients are the same sex as themselves. Mixed-sex wards cause unnecessary anxiety, and allowing patients to self-identify can’t help that anxiety.

j watson
j watson
1 month ago

Of all the things to worry about regarding our health service at the moment…
Just getting to the point of treatment is a minor miracle after the car-wreck policies of the last 12yrs.
This scenario is so rare I suspect hardly any NHS organisation have given it much thought, and if/when they need to the clinical teams at the coal-face will just use some common-sense and intelligence. If a woman asks for a female practitioner they won’t assign the trans colleague to the procedure.
A bigger issue can occasionally be the availability of a woman practitioner at all, but that won’t be the case in the instance highlighted in this article as that field has a much higher rate of female practitioner.
I can tell you having a trans-clinical colleague remain a rarity, despite what Unherd’s commentariat might suggest. Treating a Trans-patient is a rarity too but not in any way new. Been dealing with such occasions for years and using good common sense as and when needed. Wards do have side-rooms with en-suite you know and increasingly so. The ethos of the service is to treat everyone with dignity. (A proper struggle right now but for other reasons)
Now any chance of an article about how the heck we got into such a staffing crisis in the NHS and how we get out of it?

Steve Murray
Steve Murray
1 month ago
Reply to  j watson

I can assure you NHS organisations most certainly will have “given it some thought”. For instance, male midwives have been practising in the NHS for some time now – and nothing wrong with that whatsoever. However, women in labour have the right to choose not to have them providing care (although the vast majority don’t object – it’s no different from having a male Obstetrician attending if complications occur.) There are policies on these matters.
In the case of a gynaecological examination outside the maternity sphere, any Trust which didn’t have a policy in place would be leaving itself at risk of criminal negligence. The key here, is what would be included and/or excluded from that policy. Clarification is required, hopefully before a test case comes before a court.
There are plenty of articles available for you to peruse on NHS staffing issues. That issue doesn’t require the exclusion from publication of other relevant issues.

j watson
j watson
1 month ago
Reply to  Steve Murray

You missed the point in your indignation. There are always policies about the request to be treated/examined by someone of your own sex. That is not the same as a Policy that digs into the difference between sex and self declared gender and how that then plays out as to whether the practitioner is deemed male or female. That is not something that Trusts have got into in these Policies because it’s such a rarity. Things may change, but in the meantime good common sense will be being applied.

Zak Orn
Zak Orn
1 month ago
Reply to  j watson

“Now any chance of an article about how the heck we got into such a staffing crisis in the NHS and how we get out of it?”
A combination of a spineless government, absolute hysteria about ‘privatisation’ every time any reform is suggested, and the BMA voting down the plans to train more medical students / build more medical universities because they didn’t want to devalue their pay.
To get out it now we’d have to stop seeing the NHS as the sacred cow, the “envy of the world” (it absolutely isn’t) and admit it needs massive reform before throwing any more money at it. Cut out the dead wood and use the money saved to recruit/incentivise the good staff… unfortunately the NHS works in the opposite way, it’s impossible to fire anyone so you promote the useless people just to get them out of your department. The higher the band the more likely you are to encounter incompetence

Last edited 1 month ago by Zak Orn
j watson
j watson
1 month ago
Reply to  Zak Orn

I think you’ve sort of underlined my point with some half baked simplistic nonsense and invective that shows no real grip or appreciation of the issue.
Forget the NHS for the moment, and ask yourself why we don’t have national workforce plan and why that’s been repeatedly blocked by the Treasury over many years. No calculation of how many doctors and nurses we need for the future, Crackers isn’t it. Yet France does. Germany does. So that both join-up health and education planning. Ask yourself also if you’d be keen to wean us off a reliance on foreign workers needing to prop up our health services and how one might do that? Ask yourself why can’t hospitals discharge thousands of patients because of inadequate social care? If you remember there was an ‘oven ready’ solution to social care a little while back. What happened?
By the way the BMA is a union and it doesn’t have a veto on medical school training places. If you can send me the link to where they have voted against an expansion and had executive authority to then implement that I’ll stand corrected, but good luck with your fact checking.
On ‘deadwood’ – actually I do agree we could get rid of the remnants of the internal market and the additional bureaucracy that required – was a free marketeer invention that has failed of course. That saving should be reinvested in frontline staff, but we have to have a training plan for that or the money just goes on v expensive agency cover.

William Cameron
William Cameron
1 month ago
Reply to  j watson

The answer is easy . The Nhs has been self governing since 2012. Why hasnt it drawn up such a plan?

j watson
j watson
1 month ago

That wasn’t an answer was it WC? It was a question.
The reason is the Treasury blocked it because it didn’t like the projections and what that might commit it to funding longer term. So the NHS was prevented from further developing and publishing a plan. Thus ‘self-governing’ had limits and the control for this crucial element remained with the relevant Sec of States. Education places remained capped. Subsequent to Brexit they have allowed some expansion as the reality of not being able to pull on eastern european workers as much dawned, but it’s not based on a proper forward plan with population and demographic modelling. Social care has nothing, and it’s social care bottlenecks that are really adversely impacting the NHS. Things are going to get much worse yet as there is a demographic timebomb in the age of employees meeting the aging population.
Now whether somehow the idealogues thought the ‘market’ would somehow provide one isn’t sure. Hopefully the national Pandemic enquiry will further cover some of what was going on regarding workforce planning from the perspective of resilience.

Last edited 1 month ago by j watson
Linda Hutchinson
Linda Hutchinson
1 month ago
Reply to  Zak Orn

It’s often forgotten that the BMA actively opposed the legislation that created the NHS, and said that only about 10% of doctors wanted the NHS. So, it appears that the BMA have history in opposing any changes.