The media erupted in a flurry this week as Health Secretary Steve Barclay announced his intention for the NHS to exclude trans women from female wards. Understandably, this has shocked and concerned the trans community.
Its the Conservative party conference 2023; transphobic mithering edition. Their conference last year featured some transphobia, sure – this year however it appears to be the headline event. With anti-trans organisations in attendance and even a nice cameo from that one lady who lied about a trans woman saying penis in a bathroom.
Stealing the transphobic limelight from Suella Braverman, who gave it her best shot by overseeing the speech where Andrew Boff was removed for heckling against Tory queerphobia, is Steve Barclay. Barclay, who is the Health Secretary, announced his intention for ther NHS to exclude trans women from female wards.
Between stories like the above and the amount of times we’ve heard anti-trans stories about cisgender women being denied care for being transphobic. Healthcare settings have been firmly established as a battlefield for anti-trans campaigners.
As noted by some legally and politically minded people from around Trans Twitter, it is unlikely that the government would be able to allow the NHS to exclude trans women. The short story is that they almost definitely don’t have the time before the next election to put this in place, nor would it likely get passed their own lawyers.
I also don’t think frontline NHS staff are, on the whole, willing to mistreat trans people. I think should this materialise as a potential we would see strikes across the NHS in solidarity with queer NHS workers.
But in my view actual policy is not necessarily the point of transphobia like this. Sure, anti-trans activists would love to see real anti-trans legislation and policies put in place, it’s just not necessary for what they want to achieve. Trans exclusion.
Trans exclusion can be just as easily achieved by creating an environment that feels unsafe for trans people. The constant attacks on trans people from politics and the media serve to create this environment, normalising the mistreatment of trans people.
The options for trans people then become tolerate being mistreated or self-exclude from spaces that mistreat you. This is a horrible enough thing to contend with when its just a local pub you experienced transphobia and an unsupportive bar staff in; now imagine it happening at the NHS.
Trans people already have to contend with an unsupportive NHS; it has been decades of us desperately begging to be treated as human beings with little to no movement from the NHS on that front. This has already led to many trans people self-excluding from the NHS’s trans specific medicine and engaging in self-medication.
Self-medication is recognised by the NHS in the Good Practice Guidelines for Gender Dysphoria (2013) as an unsafe practice, in the same document they recommend that GPs consider prescribing treatments and monitoring bloodwork as part of a harm reduction strategy. The NHS is fully aware of the problems and has guidance on how to solve some of them; it simply does not enforce it.
Furthering anti-trans narratives around healthcare settings will only exacerbate these issues, push more trans people into self-medication practices and result in more of a burden on the NHS should any one of a myriad of problems that can* occur through improper hormone management and monitoring happen.
*Note: these issues are very rare but are made more likely without proper monitoring or management of care.
“Gender medicine” in the UK has already proven how trans people will only tolerate so much crap before simply self-excluding and taking a crack at it ourselves. The pursual of anti-trans narratives in all other healthcare settings too won’t result in policy for the NHS to exclude trans women from female wards because they won’t need to; you don’t keep corpses on the wards.
The issue is now ultimately in the hands of frontline NHS staff who I hope organise and threaten action should they be asked to enforce this obviously inhumane and dangerous bigotry. Though I really do hope my friends are right and this will never get that far.