Last year, the Insight journal (Edition 1: Autumn 2021) published the article “Caring for the transgender population”, which presented some specific needs and challenges that imaging departments needed to consider.
While I enjoyed the article, there were elements I felt needed further clarity and consideration. I’d like to start my reply by saying I welcome any article that is about making our patients feel comfortable and valued. I also recognise this may be a new topic for some radiographers, so I applaud the authors.
I did find that some of the language in the article was not correct medically and I am concerned that, as professionals, we should not fall on to one side of what is currently a political and very toxic debate concerning women’s rights and transgender rights.
Many large organisations follow the language guidance of Stonewall (a charity focused on LGBTQ+ rights), which advocates “you should allow anyone to access to facilities, spaces and groups which align with their gender identity”.
What seems to be missing with this advice is the recognition that women have fought hard for the rights to single-sex spaces. Indeed, the Human Rights Commission recently issued new guidance stating that transgender people can be excluded from single-sex services
if there is a justifiable reason. For example, for reasons of privacy, decency, to prevent trauma or for other health and safety reasons.
I, personally, have Muslim family members who I know could be discouraged from accessing healthcare if they thought they needed to share unisex spaces – particularly in maternity services.
There is a move to erase the use of the word “woman” from legislation and policies. This is backed by Stonewall (for example), which gave feedback to the Scottish government suggesting “removing gendered items, such as woman, from the maternity
policy”.
I am a mother, not a birthing parent, and I am not a “body with a vagina”, as was put on the front cover of The Lancet medical journal (September 2021). Equally, the use of the phrase “cis women” is offensive to some and unnecessary. I think we need to think about the effect excluding the word woman could have on patients for whom English is not their first language or those unfamiliar with non-gendered vocabulary.
The article also talks about the published guidance for healthcare professionals (by the National Gender Identity Clinical Network for Scotland), which encourages us to ask a person which pronouns they wish to be addressed by. Having tried this in practice, I was met with a lot of confusion and, frankly, due to the time constraints with our work, I don’t think it is practical to do this all the time. Instead, I focus on getting my patient’s name right.
I have and will always defend the rights of gender nonconforming people but wish to clarify that being inclusive is not the same as discrimination. Inclusion is obviously a good thing but it should not be at the expense of any women’s safety, privacy and dignity.
The Equality Act 2010 does actually permit discrimination “on grounds of sex to secure women-only spaces where this is a proportionate means to a legitimate end”.
With this in mind, I do believe there is a third way to bring the different opinions together and for us to move forward. For example, we can add to our collective vocabulary further concepts that represent an adult human with a female gender identity and an adult human with a male identity, this is then not either/or and can also cross-categorise people.
We can focus on using the patient’s name in correspondence (such as letters to GPs) rather than pronouns. Importantly, we can also demand third spaces that can be male, female or unisex – so that there is a choice for all.
The Society has been pioneering in representing the LGBTQIA+ community and trans rights are actually enshrined in the Equality Act. We should be vigorously ensuring that no one of colour, disability, age, sexuality or those transitioning is discriminated against, but please don’t forget women should also be considered and protected too.
