Male criminals can self-identify as women in mental health hospitals
NHS mental health hospitals are allowing male criminals to self-identify as women, NHS documents have revealed.
Trusts in London are permitting transgender women to use female-only spaces despite acknowledging their presence as a 'risk to a particular gender' and potentially 'very distressing for other patients on a single-sex ward'.
Campaigners have accused the NHS of endangering the welfare of the 'most vulnerable women' by allowing transgender women, who were born male, on female wards.
A women's rights group used Freedom of Information (FoI) requests to obtain sex and gender policies at NHS mental health trusts in London.
The recently disclosed documents found mental health trusts raising concerns over the guidance that forensic patients should use single-sex female spaces if they identified as women.
Forensic patients are those referred to the NHS from court or prison for committing offences, or considered a potential risk to themselves or others because of a mental health disorder.
Under the current NHS guidelines published in 2019, transgender people should be accommodated according to the way they dress, their name and pronouns, which 'may not always accord with the physical sex appearance of the chest or genitalia'.
This also 'applies to toilet and bathing facilities', with the exception of pre-operative transgender people sharing open shower facilities.
Policy at West London NHS Trust, which runs the high-security Broadmoor Hospital, abides by these guidelines, stating: 'A trans man or a trans woman must be admitted on to a ward in accordance with their presenting gender, if this is their preference.'
It added: 'Patients should be addressed respectfully, using the pronouns of their acquired gender.'
The trust cited an example of a transgender patient in a manic state getting undressed in front of women and revealing their genitals.
It said: 'A patient with bipolar (who happens also to be trans) who is in a manic state and who does not have capacity may be disinhibited and at risk of disrobing in public.
'Depending on where they are in their transition, it may be more appropriate for them to be admitted to a ward that is in line with their birth gender … while they are acutely unwell and at risk of 'outing' themselves.'
The policy document added: 'Once they have recovered and have regained capacity it would be essential to have a conversation with the patient around where they would be most comfortably accommodated, and to arrange a move to a ward in accordance with their correct gender.'
Both trusts note that there may be circumstances where it is lawful to exclude a patient, transgender or otherwise, from a single-sex ward if it constitutes 'proportionate means of achieving a legitimate aim' such as harm reduction.
At Central and North Western London, a policy document said that 'further consideration may be needed as to how best to manage a trans individual' in some cases, such as when 'a sexually disinhibited pre-operative transsexual individual may be very distressing for other patients on a single-sex ward'.
In such a 'rare occasion', the policy recommends the individual 'be transferred to a single room and consideration made to their temporary use of a disabled toilet should individual toilets not be available'.
The trust said it 'respects an individual's right to self-identify as male or female', and made clear that transgender women could access women's lavatories.
The Equality and Human Rights Commission, the equalities watchdog, has issued interim guidance advising it should be 'compulsory' for workplaces to provide single-sex lavatories, though trans women should not be left with no facilities to use.
The NHS is currently reviewing its guidelines on same-sex accommodation in the wake of the Supreme Court ruling on biological sex.
Helen Joyce, director of advocacy at the human rights charity Sex Matters, said: 'It's deeply disturbing that the safety and welfare of some of the most vulnerable women in London – those in the care of state mental health services – are being so seriously compromised by NHS trusts.
'The Supreme Court judgment was crystal-clear that single-sex services must be run on the basis of biological sex.
'There is no excuse for a dangerous 'case-by-case' approach that deems some men safe to be housed in women's accommodation.
'These NHS trusts are missing the point: no male patient should ever be allowed in female accommodation under any circumstances. His claimed identity, history of sexual behaviour and whether he has had surgery to remove body parts are all irrelevant. So is the state of his mental and physical health.
'If health care managers cannot understand why this matters so much in mental health services, then they are not fit to run NHS trusts or to have female patients in their care.'
A campaigner involved in the audit told The Times that it was 'scary to think' that the gender identity of violent criminals could 'override the safety and dignity of women'.
They added: 'NHS trusts are playing Russian roulette with women's safety. The Supreme Court ruling clarified that single-sex spaces must be single sex, and it is vital that this is now enforced nationally across all hospitals.'
An NHS spokesman said: 'The NHS is working through the implications of the Supreme Court ruling, and we absolutely recognise the need for revised guidance. It's important that we wait for the Equality and Human Rights Commission to publish its statutory guidance before final decisions about future policy are taken.
'In the meantime, we are working closely with Government to ensure we can provide updated guidance for the health service as soon as possible.'
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