Transgender patients can choose to be treated on male or female wards, new NHS guidance says The Telegraph 01.10.19

The original article is here.

“Transgender patients can choose whether they want to be treated on male or female wards, new NHS guidance stipulates.

NHS England says patients should be accommodated “according to their presentation”, noting the “way they dress, and the name and pronouns they currently use”.

The announcement follows a Telegraph investigation which revealed that despite official guidance from the Department of Health designed to eliminate mixed sex wards, hospitals were routinely allowing male patients to share female wards if they self-identify as women and without them having to transition.

Matt Hancock, the health secretary, ordered a review following this newspaper’s findings, which came from more than 100 Freedom of Information requests.

The data found that none of the NHS England trusts required patients to have begun transitioning for them to be treated in accordance with how they identified.

However the latest NHS guidance, entitled Delivering Same-Sex Accommodation, says that having “different genital or breast sex appearance” is not a reason for denying patients a space on a single sex ward.

It also added that “trans men and non-binary individuals can become pregnant and should be treated with dignity while using maternity services”.

Last night trans rights charities and human rights lawyers hailed the policy as “sensible and encouraging”. However some academics and women’s groups have criticised it, with one MP claiming that it “drives a wrecking ball” through women’s rights.

The document says that “trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use”.

It adds that: “Those who have undergone transition should be accommodated according to their gender presentation” and that “different genital or breast sex appearance is not a bar to this”.

This means that patients would share toilet and bathing facilities – although it is advised that “pre-operative trans people should not share open shower facilities”.

Non-binary patients should also be “asked discreetly about their preferences” and allowed to choose whether they are allocated to a male or female ward.

The guidance concludes: “Good practice requires that clinical responses be patient-centred, respectful and flexible towards all transgender people whether they live continuously or temporarily in a gender role that does not conform to their natal sex.”

In March the Health Secretary Matt Hancock confirmed that transgender patients are currently treated “as they present” – regardless of whether they have undergone a medical procedure to transition.

He then announced that the government would review the NHS rules which allowed men to share women’s wards if they identify as female.

The Department of Health and Social Care said yesterday that the latest NHS guidance is not the response to this, but instead is a separate, routine review of current guidance.

Dr Jane Hamlin, president of The Beaumont Society, the UK’s largest transgender support group, welcomed the move saying it has “clearly been thought through very carefully and is sensible and encouraging”.

She added that the Equality Act 2010 protects trans people from discrimination and recognises “that the best person to consult over a patient’s gender identity is the patient themself”.

“Just as in any other situation, if a patient behaves in a way that is inappropriate and puts other patients at risk, then special arrangements may need to be made.”

The latest NHS guidance, entitled Delivering Same-Sex Accomodation, says that having “different genital or breast sex appearance” is not a reason for denying patients a space on a single sex ward.

Jonathan Cooper QC, a human rights barrister at Doughty Street chambers, said that the guidance looks “sensitively devised”.

“Trans identity is an integral part of being human,” he said. “The provision of healthcare for trans people is premised on equality not tolerance. This policy respects that and is in keeping with the spirit of the Equality Act.”

However, David Davies, Conservative MP for Monmouth, described the policy as “entirely incoherent”.

“This newly defined guidance drives a wrecking ball through those hard fought for rules/rights,” he said. “It means people who are physically male will be placed in women’s hospital wards.

“Nobody wants to see transgender patients discriminated against or treated badly in any way. But placing people who are physically male in close proximity to vulnerable women who may be facing intimate medical procedures is not fair.”

Dr Nicola Williams of Fair Play For Women campaign group added that the guidance means that “the privacy and dignity of women goes out the window”. “There has been no consideration for the needs of women in this guidance at all,” she said. “It’s shocking.”

A spokesperson from the Equality and Human Rights Commission said: “Service providers can allow transgender people to use single-sex facilities, including hospital wards, toilets and changing rooms that match the gender that they identify with. Under the Equality Act 2010, providers may exclude transgender people from single-sex facilities, provided this can be justified as being a proportionate way to achieve a legitimate objective.”

An NHS spokesman said: “The NHS is here to provide all patients with the excellent physical and mental health treatment they need and to support them while they are in our care.

“The revised document on ‘delivering same-sex accommodation’ provides clear and considerate guidance for NHS staff so they can prioritise the safety, privacy and dignity of all patients.”

A Department of Health and Social spokesperson said: “We’re working closely with the NHS to consider the findings of the review.”

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