As a Tory cabinet minister said, the NHS under the Tories is “wanting and inadequate”. But its rules on admitting trans women to women’s wards is good. Its guidance adopted in 2019 (pdf) says trans people should be accommodated according to how we present. We do not need a GRC or legal name change. If our breasts or genitals appear of the opposite gender, we should be given sufficient privacy with curtains or a single side room.
A trans person who has not had a genital operation should not share open shower facilities. Where the treatment is sex-specific, such as a trans man having a hysterectomy, staff should discuss options with the patient. If a patient is unconscious, staff should draw inferences from mode of dress and only consider genitals if this is specifically necessary for treatment (I am sad that needs to be said). A trans woman without her wig should have extra care to ensure her privacy and dignity. Nonbinary patients should be asked discreetly about their preferences.
A child’s preference should prevail even if the parents disagree and the child is not Gillick competent.
Unfortunately, anti-trans hate campaigner Emma Nicholson has become aware of this guidance, and wasted House of Lords time at 1am on 17 March to amend the Health and Care Bill to exclude all trans women from women’s wards. The usual hate campaigners- Claire Fox, David “Blencathra” Maclean- came out to bore everyone with their usual disinformation. The government whip, JoJo Penn, thanked Emma for “all her work advocating for women’s rights”, and I hope that is just the usual oily courtesy shown by “noble Lords” to each other. She said the NHS is currently reviewing its guidance and seeks “privacy, safety and dignity” for all its patients. Guidance should be based on “evidence, compassion, empathy and respect”, but she could not give a date for the review being published beyond some time this year.
Fox put her extreme case emotively. She spoke of vulnerable cis women patients losing their right to single-sex wards. She said women (anti-trans campaigners) were effectively being told “Don’t you worry your pretty little heads”. The hate campaigners in the House of Lords have been whinging about this extensively, and the Evening Standard reported their words uncritically. Then Fox refers to the newspapers. It is all circular. However she gave the good news that Dr Michael Brady, NHS LGBT adviser, is involved in the review, has consulted Stonewall and Mermaids, and stated there are “no plans to reduce the existing rights of transgender people”.
Nicholson told the story of a trans woman constituent when she was an MP. The woman was a police officer, who after transition was given a lower rank. Nicholson claimed that she helped “persuade the police that [transition] was a fully acceptable thing to have done”. Then she claimed a trans woman on a women’s ward raped another patient a year ago. That is explosive.
Ralph “Baron Lucas” Palmer (Con) claimed “trans women are men” under the Equality Act. Michael Farmer, former treasurer of the Tory Party, recited some legal interpretation from anti-trans campaigners, claiming that excluding trans women from women’s wards would be a “legitimate aim”. Timothy Clement-Jones, LibDem, spoke for the amendment despite his party’s definition of transphobia. As nonbinary people are not explicitly protected under the Act, he wanted them assessed for objective sex.
Terence Etherton, former Master of the Rolls (President of the civil Court of Appeal) explained that putting trans women on men’s wards would be unlawful harassment under the Equality Act, as it would violate our dignity. He said changing your name is changing an “attribute of sex” sufficient to clearly fit the protected characteristic of gender reassignment. “It is not a legitimate aim that some people feel uncomfortable sharing accommodation and facilities with trans people of the opposite birth sex. That would make a nonsense of having the statutory protected characteristic in the first place.”
Sal Brinton, LibDem, said Nicholson’s amendment “seeks to create a false understanding” of the Equality Act.
Michael Cashman talked of evidence: freedom of information requests around the country have shown there is no need to change Annexe B, the part of the policy specifically about trans people. He pointed out how Maclean, as a Home Office minister, had blocked an equal age of consent for gay sex with straight sex. That had to wait for a Labour government, despite a win in the European Court. He drew parallels between the hate against trans women now, and against gay men in the 1990s, and “against minorities across the centuries”. Ruth Hunt said “many lesbians” support trans inclusion. To detoxify the debate, she said, we should stick to the facts. Elizabeth Barker, LibDem, said the amendment was not about single-sex wards at all, but Nicholson’s continuing campaign against trans women, and “we should simply not pay attention”. She says trans women “are women with a different experience”.
Trans women are probably safe from this review. We will continue being treated on the appropriate wards, and given dignity and privacy. And the hate campaign will continue.