More on *the* Institution of Transgender Discrimination Within Healthcare

I opened my inbox this morning and was surprised to find that a friend had sent me a link to the Equality and Diversity page on The University of Warwick pertaining to their policy on Gender Reassignment. The policy document linked to on that page, which hasn’t been – it seems – updated since 2008 [so, prior to the passing of the Equality Act] states the following:

15.0 SICKNESS AND ABSENCE FROM THE UNIVERSITY

15.1 In putting together the transition action plan the time the student or employee will need in order to undergo gender reassignment treatment should be discussed. When the individual is absent for treatment or surgery then normal sick pay arrangements or absence arrangements should apply. The normal policy for medical appointments should also apply, flexibility should be offered in taking holiday or rearranging working hours or academic commitments in order to attend medical appointments. A sick note will be required, but the sick note does not need to state the procedures performed.

I have highlighted the aspect which I found most interesting in bold, since it seems to be clear that – with regard to story I commented on late last week – that the Warwick Medical School have not only breached the Equality Act 2010 but also policies laid down by the University. Interesting, no?

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On *the* Institution of Transgender Discrimination Within Healthcare

Anyone who’s read some of my earlier blog posts will know that I’ve a keen advocate of education of LGBT issues with in Medical Schools, as I feel early education – and thus the removal of ignorance – is an important and effective tool in the prevention of LGBT discrimination at the hands of doctors. I feel that the example that is set in the early years of medical education – as is the case in life – has a heavy hand in shaping the sort of doctors which are produced and, as such, it is hugely important not only that medical students are taught the skills and knowledge that allows them to be effective healers, but that it is done so in an environment free from prejudice and discrimination. In many ways, whether the attitudes held by staff – and especially senior staff – are explicit or more implicit is completely irrelevant as it still eventually sets the same negative example for young doctors, and nowhere is this issue currently more pressing than at Warwick Medical School.

In a story broken in tandem by TransActivist and NoMoreLost (both of whom have very different, but equally interesting takes on this story) it seems that Warwick Medical School have shown a pattern of transgender discrimination towards a student who has been consistently doing their best to assist the school in improving their record in terms of LGBT issues. Given the article which the school were so proud to have printed in a prominent medical journal earlier this year –  in which it is stated that they were discussing rectifying the lack of education given to their students on LGBT issues  – the irony that arises from is practically caustic. It seems that Warwick Medical School are keen to present themselves as LGBT friendly, progressive and anything other than transphobic to the public eye, whilst fostering an atmosphere which – according to students I’ve been in touch with – is hugely homophobic, ablest and generally unsupportive toward anyone less-advantaged or in need of assistance. This is, according to friends and colleagues, an attitude which they have held – and have failed students with – for a number of years, and one which doesn’t look likely to change any time soon.

So, what does this say for the Warwick Doctor? If a child were raised – or in this case educated – in an environment where discrimination is tolerated and support is, effectively, neglectful at best then what sort of adult would you expect them to become? Would they be emotionally healthy or stunted? Would the environment really get the best out of them? And, particularly important in the context of this article, would they know that discrimination – whether to an LBGT patient, disabled parent or (in the case of one colleague) a carer – is simply not acceptable?  At the very least, I feel it is fair to say that these adults would lack empathy, sympathy and as such not be the sort of person you would like to be shaking hands with on the way into the consultation room. Luckily for their students – and even more fortunately for NHS patients – they are not raising children, as else I fear social services would have a field day. It is probably important to point out that even in spite of this adversity the so-called “Warwick doctors” I have met are competent and hugely caring, but very few of them have anything positive to say about how their Medical School treats their students, and even fewer of them would say that the School sets an example which should be followed.

Whilst I am certain that Warwick Medical School are not alone in their failure in this area, I find this particular case of discrimination to be especially troubling since it appears to be the case that any other Transgender student who passes through their doors will find themselves subject to exactly the same heinous treatment. According to Elusia over at NoMoreLost, WMS are currently refusing to make changes to prevent further violation of the Equality Act 2010. This is particularly surprising at a time when, according to the most recent quality assurance visit conducted by the GMC, the school is currently undergoing a curriculum review; and so one would hope that they would be particularly open to positive change. Especially when Tomorrows’ Doctors – the document which governs the curricula of british medical schools – effectively states that a medical school must be able to provide evidence of addressing equality and diversity matters within  assessment covering (amongst other characteristics) gender identity [article 62]. As such, if this situation is as clear-cut as it appears to be, it is not only seems that Warwick Medical School are not only guilty of Indirect Discrimination under the Equality Act 2010, but that they are also failing to meet the requirements laid down by the GMC.

It is interesting to consider what the response of the Medical School might have been in the case wherein she had been required to undergo excision of a tumour as opposed to Sexual Reassignment Surgery [SRS]. If they had indeed agreed that in the case of an excision a reasonable adjustment could and should be made (i.e. in the form of an individual examination) then it would indeed be the case that Warwick Medical School are discriminating against transgendered individuals in their totality, but what of the opposite? Were no reasonable adjustment made here either (bearing in mind that transgender also counts as a disability under the definition of the Equality Act 2010) then it would be the case that Warwick Medical School are discriminating against injured, sick and disabled people in their totality. Not what you would expect – or hope to see – from an institution that hopes to train people to care for those very people it appears to be showing prejudice against.

Perhaps even more interesting to this is the current stance being taken by Coventry and Warwickshire Friend who are currently refusing to take sides in this dispute, stating as their reason that this has happened before with Warwick Medical School and as such they feel it would be unwise to get involved. Their trustees cite specific examples of  “a student who was diagnosed with cancer and had to take a temporary withdrawal but tragically died”, “another student being given the choice of either 2 weeks or a year to recover from depression” and numerous “students who make the choice to become pregnant have to also take a temporary withdrawal for a year”. I guess, Warwick Medical School are nothing if not consistent in their appalling treatment of students (not to mention the example they’re setting!).

Further to this is what appears to be a flagrant disregard for the student’s right to confidentiality on not one, but two occasions – especially given her status as transgender and the additional protection this grants to her under the Gender Recognition Act 2004. It goes without saying that confidentiality is hugely important within medicine since doctors are essentially strangers that we allow to be privy to the type of information usually reserved for those closest to us so that they might assist us with whatever our ailment may be. Confidentiality, and the importance thereof, is drummed into trainee doctors from day one, as is the fact that the breaching of that confidentiality – that inherent trust that is given to us based solely upon our position – is completely unacceptable (and, quite rightly, a disciplinary matter). The fact that a Medical School could set such a poor example to its students – even if we completely disregard the additional protection bestowed by the Gender Recognition Act – is completely deplorable and, quite frankly, the school should be ashamed.

Warwick Medical School have been asked for comment by numerous people at this point, but as of yet have refused to comment. Meanwhile, the GMC have responded, saying: “We encourage med students to contact us if they have evidence that their school isn’t meeting our standards”. Personally, I feel that it will also be interesting to hear what the GMC have to say about this matter is the student does indeed choose to get in touch with them; especially at a time when both they and the department of health need to be being seen as acting – and improving – on issues relating to LGBT discrimination.

 

Update 03/09/2012 = More on this topic here

 

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I intend to keep a list of articles on this subject below. Please contact me if you would like yours to be added:

Trans? Disabled? In need of surgery? Best to avoid Warwick Medical School – Writings of a Trans Activist

Discrimination? You Bet! What might you expect from Warwick Medical School – No More Lost

LGBTQ Summer 2012 Newsletter Supplement – National Campaign Against Fees and Cuts