identity politics open letter

Why is the NHS Confederation ignoring the Cass review in pursuit of trans allyship?

The NHS confederation is launching a tender to create a practical guide to “model meaningful trans and non-binary allyship”. The confederation is a membership organisation that brings together various healthcare systems throughout the UK. It represents its members’ interests, and exerts considerable influence on government.

This invitation takes a very particular position with regards to “trans allyship”, and fails to acknowledge the current controversies around issues, such as the most appropriate care pathways for gender questioning patients, and access to single sex spaces within healthcare settings. 

The successful bidder will be invited to carry out a review to update the toolkit, Trans: A practical guide for the NHS. Organisations involved in the original creation of this guide include Mermaids, GIRES and Press for Change. These are transactivist organisations and take a very particular position in debates around sex and gender, for example, by advocating for gender identity to take primacy over sex in society and law.  Where there is potential for conflict between groups with various protected characteristics, partisan pressure groups should not be involved in policy decision making. Any updated policy should be mindful of the Public sector equality duty  to foster good relations between the various groups. 

Confusion as to single sex provision with respect to hospital wards has arisen secondary to NHS England’s updated document Delivering same sex accommodation. Annex B advises providers that they accommodate trans patients according to their gender presentation (clothes and pronouns), even if this is a temporary ‘gender role’ and the patient is not planning any medical transition.   

A group of clinicians have analysed a number of policies  as part of a request that the Nursing and Midwifery Council leave the Stonewall Champion scheme. These are trans policies that have been implemented in various NHS trusts throughout the country. Some are quite shocking in their disregard of the rights and dignity of female patients. Examples include likening women who complain about having male patients on their wards to ‘racists’ and using seclusion for women who object to males on female psychiatric wards. None of the organisations listed in this document had carried out meaningful equality impact assessments. 

The NHS toolkit should be abandoned, and any position the NHS Confederation takes must be informed by current discourse. This includes acknowledgement of the Interim report of the current Cass Review  which highlights lack of evidence of best treatment options for gender dysphoria in children and young people,  the closure of the GIDS service at the Tavistock, and the current review of single sex wards in NHS hospitals being undertaken by NHS England.