Give trans staff extra breaks to adjust underwear, NHS trust suggested

Telegraph

5 days ago

An NHS hospital trust drew up plans to give trans staff extra breaks if they wore chest binders or had to tuck their genitals away.
In draft guidance seen by The Telegraph, University Hospitals Sussex NHS Trust (UH Sussex) said trans colleagues 'may require extra scheduled breaks in their shift in order to have breaks from binding and tucking'.
However, the trust said the new proposals, which also said women-only spaces should include trans women, had been put on hold in February and would not be pursued following the Supreme Court ruling last month.
Judges ruled that the Equality Act referred to biological women and biological sex, rather than those choosing to identify as a woman.
But critics said the draft guidance raised concerns about the time spent by NHS staff on working up and consulting on these types of policies. The NHS has no specific advice for trans people who wear chest binders or tuck their genitals, but the actions are considered controversial by some because of the harm they can cause.
Chest binding is when a woman wears an item of clothing to compress their breasts to look more like a man, while the 'tuck' involves pushing the testes and penis back between the legs to appear more female.
Both can cause infections, inflammation and other health problems, doctors have warned, which in some cases can be irreversible or lead to infertility in biological males.
The proposed guidance said:
It is understood that employees in the UH Sussex LGBTQ+ staff network had written the 15-page document last year and sent it to other groups for consultation.
One former employee at the trust said: 'If we're going to make allowances for people who have to use the toilets to change and do this, that and the other, should we not be making allowances for women with heavy periods, or people who have to pray three times a day? Why are we making allowances for one group of staff over everyone else?'
Dr Alice Hodkinson, a co-founder of Biology in Medicine, a doctors' campaign group, said people binding or tucking were 'risking medical and psychological harm'.
She said tucking male genitals 'between the buttocks can cause pain, inflammation, fertility problems and testicular torsion', while 'binding can cause chest and spine deformities, cysts, infections and difficulties breathing'.
Dr Hodkinson added that testicular torsion 'is a surgical emergency requiring an immediate operation to preserve fertility and sexual function', saying: 'The UK National FGM Centre considers breast flattening to be a form of child abuse.'
'Disgraceful coming from a healthcare body'
Helen Joyce, the director of advocacy at Sex Matters, a human rights charity, said the proposals for 'employees who are self-harming in pursuit of the impossible goal of sex change should never have made it onto paper, even as a draft'.
She added: 'Tucking genitals and binding breasts are culturally motivated actions that cause permanent physical damage, just like breast ironing and the use of neck coils. The only difference is that self-harm in the name of trans identity is high status and fashionable.
'This blatant attempt to normalise such a harmful practice is particularly disgraceful coming from a healthcare body. It is a relief to know that NHS Sussex won't be taking it forward.'
The draft guidance also told staff they should try and understand the impact of cross-sex hormones on any trans colleagues and their mood.
'It is also helpful to gain an understanding of if there are certain times that are better or worse for their mood and wellbeing e.g. when someone is prescribed testosterone, energy levels and mood can be lower towards the end of a medication cycle, and can vary greatly on the type of preparation,' it said.
'Feminising hormones can require a lot more consultation to achieve an appropriate dosage, and may similarly impact mood and energy levels.'
UH Sussex said it had never had a policy on this and that this draft had been put on hold in February, after being reviewed by senior leaders and had now been dropped altogether.
A spokesman for the trust said: 'This draft paper is not trust policy or guidance, it never has been, and never will be.
'A colleague submitted it to a manager in February, for consideration, but it was not accepted.'