NHS: NOT a Single Biological Male on Female-ONLY NHS Wards

The NHS must not ignore Biological Sex Specifics that Place Female Patients At Risk

Preparation for meeting at House of Lords Noon Tues 22 October 2019:

I'd like to start by saying I am autistic – high functioning.  It means I do think differently &  I am exceptionally numerical. My statistical observations are based on Aerospace Cost Engineering techniques – rocket science in fact! (Being a Quaker may also alter my communication style)

1) Context 2) NHS Experience & 3) HM Govt statistics

In 1979, 5 years before I 'came out' as a lesbian, I saw the BBC TV programme about transwoman Julia Grant. By the end I was absolutely convinced about trans-rights. After 'coming out' in 1984, activism wasn't so much of a choice as a survival mechanism, including as a lesbian teacher through the worst of Section 28. I worked as a volunteer at Stonewall on the Age of Consent campaign c1993/94. 

Since 2007, I engaged with the UK FCO and am pleased that a number of HMG's current LGBT-friendly practices derive from my list of low cost, no cost solution to support LGBT people. Practices such as i) public declarations and ii) the flying of Rainbow flags have spread throughout the foreign Ministries of LGBT-friendly countries. I have known trans-people since about 1992-ish.

2) NHS Experience: In 2008, I was a healthy rape survivor who, working as an engineer developed a hernia, which nobody in the NHS could diagnose because I was… a biological sex: female. Many medical symptoms present differently according to biological sex... hernias and heart attacks BBC 30 Sept 2019 Inequalities in heart attack care 'costing women's lives'

In the decade since this NHS ‘treatment’ for 3 hernias in rapid succession, I have been unable to work due to NHS-induced rape trauma that was totally unnecessary. Not one or two unfortunate incidents but a nightmare-ish sequence in which well intentioned NHS staff subjected me to the worst possible things medical staff can do to a female rape survivor. 

• being placed in all-male wards TWICE & having to refuse surgery & go home
• have an otherwise lovely experienced matron aggressively put me on the spot so I could only reply “I am a rape survivor, I only went to Poland for surgery because I was terrified of mixed NHS wards.” 
• Her shock at this disclosure meant she forgot to consent me for procedures to my nether regions resulting in an indecent assault on the operating table.   
• The good intentions of the individual who carried out the procedure are not in doubt but for 2-3 years, I totally repressed sexual trauma & couldn’t even go to GP’s surgeries, without severe trauma reactions, I didnt understand. [The man who raped me also didn't intend any harm but didnt realise consent was involved. The Friend 15 April 2015 Greenham Common: Teaching a man consent while he was raping me
• I saved health issues for when I was abroad.

The consistency of my experiences suggest that the NHS and individual NHS clinicians are in the same ‘cognitive dissonance’ as the rest of the population and have neither considered the health impact of sexual violence nor hospital arrangements that will mitigate against any patient being subjected to sexual violence. This certainly seems to be true of the current “Delivering same-sex accommodation” which might be more accurate with “How to NOT to” were added to the beginning.   There lurks a suspicion that this was a change in name only to respond to the public outcry about… sexual violence against female patients.

My experiences suggest that very few NHS clinicians are equipped to react appropriately. To protect myself from this ‘cognitive dissonance’ I have developed a little script, which also shows that with very little guidance, medical people can and want to learn. After all we all know it is the role of a patient to put their health-care providers at ease!

     Simple basic training, the training I have to provide every time I encounter NHS staff, which could be in medical training (but isn’t I have checked) & within the ‘Equality & Diversity’ remit.  Basic statistical knowledge that 1 in 5 women have been subjected to sexual violence/abuse, with the compounding damage of the justice deficient which means that fewer than 2% of all rapes result in a conviction Jolyon Maugham QC New Statesman 4 May 2018 Law allows Men to Rape with near Impunity.

My last surgery for gall bladder removal involved my GP going 'above & beyond the call of duty' to locate a female surgeon (with a 1:9 F:M ratio) who organised all female theatre staff with cast iron guarantees that not a single biological male would have access to me at any point. After the surgeon told me, the gall bladder was in a very ropey state and could have gone critical at any time with severe health consequences for me and financial implications for the NHS.

IF “same-biological-sex” wards are not Female ONLY wards, I can never have surgery again. Other female rape survivors have asked me to speak, including those raped on NHS wards.

3) Statistical Basis for Shear Terror that There is Any Discussion

MoJ Annual Prison Population: Sexual Offenders by biological sex

Relevant for H&S Risk Assessment & Safe-Guarding

• 99.1% of all sexual offenders are MALE
• 60 out of 126 “female” sexual offenders may include UPTO 60 transwomen (biological MALES)
• Most transwomen retain fully functional male genitalia (ditto Non-Binary males)
• Transmen represent no threat to female patients (ditto NB females)
• Transmen are at risk in male accomodation (ditto NB females)
• 90% of Trans-people are Hetero- or Bi-sexual wrt (biological) sex (as any other demographic)
• Gender Identity Recognition Certificates do not require removal or decommisioning of 1ary weapon of violence used against females.

Thus, the sexual offending of transwomen AS A DEMOGRAPHIC is of the same order of magnitude as… other biological MALES (using 128 "females")

AND…  that of transmen ISN’T… 

unless you believe there are 14million transwomen in England & Wales!  ;-)

Conclusion

Biological sex specificity of medical symptoms does not change with gender identity.   

Sexual Offending: I have yet to find a single case reported of a sexually offending transman in England & Wales in this or any other time period, which indicates Female-Pattern Sexual Offending ie little/if any.

90% hetero- or bi-sexuality - ie transwomen sexual attraction to females.

Far from being a risk to male patients on male wards, it is transmen who are at risk from male patients. [A transman insisted on a place in a male prison - departed in a body bag after suicide - source MP].

The NHS do not seem to have factored in AGP AutoGynePhilia nor the potential for a male sexual predator to dress AS a woman to be placed on a female-only ward.

Biological Sex specificity applies to transgender population too. MoJ Equalities Bulletin [Nov 2018] records a transwomen 5:1 transmen Male:Female ie Male-Pattern Offending (violent) and Female-Pattern Offending - economic.

With the same Male-Pattern Sexual Offending as other biological males & 90% hetero- or bi- sexuality & trans sources indicating that the majority of transwomen retain fully functional male genitalia, there would seem to me to be zero justification for placing transwomen on what must be FEMALE-ONLY wards. 

A Gender (Identity) Recognition certificate requires a transwoman to be treated AS a woman but does NOT require anyone to impose that transwoman onto female people. 

A Gender Identity recognition certificate for a transwomen, does not require the removal/decommissioning of definitively male genitalia aka 1ary weapon of violence used against female people. It also does not remove the obligation to perform risk assessment and make safe-guarding decisions that is rational and based on the evidence.

By ALL means treat transwomen who gender identify AS women outside MALE wards but that does NOT imply placing biological males, on Female ONLY wards. The high incidence of sexual violence among women most of whom will never disclose even at detriment to themselves means that Female-ONLY wards must remain Female ONLY to prevent adverse mental health consequences which even the survivor may not connect.  Female patients do not exist to provide a female environment for transwomen. No one patient is entitled to health care at the expense of the health of other patients.

Female patients are triply vulnerable when in hospital: by virtue of medical condition, by virtue of the state of undress and by virtue of medication/anaesthesia.

The arrival of the concept "Non-Binary", which seems to have stimulated this update may represent a new challenge for the NHS of it may be hinting at a SOLUTION.  Some training for medical staff about a few basics wrt the impact of sexual violence and strategies for avoiding needless damage of patients - none of them want to do harm if they can avoid it. I am happy to offer my services in developing & delivering survivor/victim awareness.

3 Oct 2018: Video to Welcome Duchess & Duke of Sussex from Female Rape Survivors of Brighton, Hove & Sussex