A trans woman (referred to here as A for her privacy and dignity) has come forward to discuss the transphobic discrimination she experienced while attempting to access emergency healthcare on the NHS that left her with “zero trust with hospital emergency care” and “scared to go back” in future. A was admitted to an NHS Wales hospital in June of this year with a spontaneous haemotoma on her leg which left her in severe pain and unable to walk. Throughout most of her 12 day stay at the hospital, A remained in a bed in a corridor in A&E, before eventually being admitted to a side room on the final night. A’s account of her stay describes a disturbing lack of regard for her dignity and well-being and repeated misgendering by a member of nursing staff.
Inappropriate placement
Despite a lengthy hospital stay, at no point was A ever admitted to a ward for treatment, instead being treated in a hospital corridor. While this is an increasingly common issue in NHS hospitals due to capacity issues, it is noteworthy that this state of affairs continued for over a week in A’s case. While A described the hospital as extremely busy, she noted that “other people needing to stay were taken to wards within a few days.” It seems possible in the context of increasingly hostile public discourse and proposed policy on trans women’s treatment in hospitals that A’s status as a trans woman played a role in the decision to keep her in A&E while other patients were moved to wards.
Neglect and lack of dignity
For the first 9 days of her hospital stay during examinations, A was not provided with a privacy screen or any other means of maintaining her privacy from other patients and visitors to the hospital, instead having to be examined by doctors in a state of partial undress in full view in the corridor. One member of the hospital nursing staff repeatedly misgendered A within her earshot while speaking to other staff, despite staff having been made aware that this would cause A distress while already in significant pain and discomfort. A reported that while in severe pain, the same member of staff left her without pain relief for an hour and a half after being asked.
This treatment left A feeling that she did not receive the same quality of care that a cisgender patient would have.
“Scared to go back”
A was eventually discharged from hospital with a referral to secondary services, but was left still struggling to manage at home and has been unable to carry out basic self-care due to the inaccessibility of her home and the effects of her impaired mobility. A has expressed reluctance to seek help from the NHS in future, saying “I'm scared to go back, and I know I won't get cis patient levels of service.”
In TransActual’s 2021 Trans Lives survey, 70% of trans people responding reported being impacted by transphobia while accessing general healthcare, with 57% of trans people reporting that they avoid seeking healthcare when ill. Transphobia in healthcare not only harms trans people through direct experience of mistreatment, but harms our ability to trust health services and drives a lack of engagement with services that may endanger our health.
Earlier this year, then Shadow Health Secretary and current Health Secretary Wes Streeting expressed a view that trans people should not be admitted to single sex hospital wards but instead admitted to “suitable, safe accommodation,” effectively advocating for segregation of trans patients within NHS hospitals despite a total lack of evidence of any serious issues arising from treatment of trans patients in appropriate single sex wards. Many in the trans community have expressed concern that segregation of the sort proposed by Streeting could result in harm to trans people, both in terms of our stigmatisation and in terms of the quality of care that we receive. A’s case, alongside other cases such as an alleged incident described by Translucent where a trans woman in a side room died due to the staff’s inability to get a cardiac arrest trolley into her room suggest that these fears are well founded and if segregation were made official policy, serious harm or even deaths could result.
In a statement, a health board executive said that they are unable to comment on individual cases, but that they are “sorry to hear if a patient has not had a positive experience” and claim to have provided relevant diversity and inclusion training to staff. The health board claimed that staff are expected to be “non-judgemental” and “sensitive to the individual needs of all patients and service users and provide dignified care and treatment to all,” however it is clear that in A’s case this did not take place in practice.