Privacy, dignity and safety

“Privacy, dignity and safety” is the new code for driving trans women out of women’s wards, and “same-sex care” means treating trans clinicians as of their assigned sex at birth. The NHS consultation is about all sorts of things, but the press release headline only refers to trans people.

My privacy, dignity and safety matter, just as much as cis people’s. The 2019 NHS guidance provides for that. Trans people should be accommodated according to how we present, as the EHRC Code of practice says.

Trans people would often be in a single room. If I needed to be in hospital, I doubt I would be able to keep my wig looking respectable all the time, and you can’t sleep in a wig. I would not want my bald head on show. Some patients will not have had genital surgery. My aureoles are much smaller than most women’s, and I would be self-conscious showering with others. Trans people I have visited have had a single room.

Privacy and dignity are held out as objective values, but are not. They are subjective.

Subjectivity is the subject or person’s view of themself and the world. There may be an objective truth, a truth not dependent on the perception of minds, but it is extremely hard for minds to know it. We can attempt to understand the biases our minds create, and to eliminate them as far as possible, but not attain true objectivity.

It is not Objective Truth to say “trans women are men”. It involves the value judgment that genes, gonads and genitals matter more than the person’s sense of themself. A woman with a Y chromosome and androgen insensitivity syndrome, AIS, is a woman, according to her assignation at birth: the idea that she is more like a woman, so should be brought up and treated as a female, is subjective not objective. She has no cervix, no female reproductive system, and she will not grow breasts without hormonal intervention. The belief that AIS makes her a woman but the intransigent, incomprehensible belief that they are female does not stop trans women being men, is also entirely subjective.

When Kemi Badenoch opines that I am a man, even if the AIS woman is not, that is merely linguistic. Trans allies say I am a woman. If cis women see me in their ward and feel this is a threat to their dignity and privacy greater than being in hospital, sick, perhaps asleep when male hospital staff and visitors are a few feet from their bed, that I am a threat equally repugnant to being in a bed next to a man, that too is subjective.

Privacy and dignity are subjective. It is as if my privacy and dignity do not matter to the Ministers driving such a change to the NHS Constitution. The Ministers privilege their subjective feelings and ride roughshod over mine.

The current guidance suggests a curtain may be sufficient privacy, for trans women in women’s wards. It would not be, for a trans woman, in a men’s ward. Taking hormones, trans women develop breasts. Those of us who don’t need wigs have our hair in women’s styles. Moving from a single room to the stairs would be humiliating. It might even put pressure on trans women who might pass as men to conceal their trans status while in hospital: it might make us false to ourselves. Whether presenting female or male, being in a men’s ward would place additional stress on me, which I would not want while dealing with the actual health issue.

Safety is more objective. You can count how many assaults there are. Freedom of Information requests found no complaints about trans women in women’s wards.

Excluding trans women does not improve cis women’s “safety”. Saying that it does, is a slander on trans women. There have been abusive NHS staff: projecting threat onto harmless trans people makes patients less safe, as scrutiny is diverted from where it should be.

Trans exclusion has been bolted on to an NHS consultation which deals with real issues, and might even make small improvements. It is a non-issue, put in to grub for votes from hate and gain publicity for the Ministers.