Medical professionals in the United Kingdom are concerned about speaking out on issues related to gender identity for fear of bullying, harassment, and disciplinary action. The experts who spoke to Al Jazeera requested anonymity due to concerns about reprisals both personally and professionally. While human beings are biologically male or female, gender identities have become more prominent in recent years, posing challenges for sectors such as education and health. Gender is seen as an identity that is not qualified by biological markers and is often fluid but always self-declared. However, some medical professionals are worried that an affirmative approach to gender identity could lead to the erosion of sex-based medical terminology and practices, ultimately harming patients and society as a whole.
In February 2020, Edith, a forensic psychiatrist, became increasingly concerned about the conflation of sex with gender after the Association for LGBTQ+ Doctors and Dentists (GLADD) announced that the UK’s General Medical Council (GMC) would remove sex markers from its online public register. GLADD called these markers “gender,” and the move meant that doctors could remove their sex from the register. This issue is divisive, with some arguing that patients, such as sexual violence victims whose abusers were of the opposite sex, should have the right to know the biological sex of their doctors. Others say doctors should have the right to identify how they wish.
The British Medical Association (BMA) published a report in November 2022 titled “LGBTQ+ equality in medicine,” which stated that discrimination on the basis of sexual orientation and/or gender identity has no place in the medical profession. However, Edith believes that there is pressure to push an affirmative approach to all matters of gender identity over evidence-based methods. She submitted questions to a panel regarding trans women in mental-health institutions who change gender while awaiting criminal trials and was accused of being “transphobic,” “discriminatory,” and “biased.” Edith believes that it is not a psychiatrist’s job to promote positive stories but to be neutral and objective.
Ashley, who has years of experience in medical teaching in colleges and hospitals education, said that a culture of fear is brewing, and people are afraid to speak out. Even doctors are hesitant to do so because it is not worth the risk. Ashley shared screenshots of a presentation given by a GLADD-aligned diversity director in November last year, which stated that hospitals should accommodate trans women in female wards. Ashley worries about the elderly being put in mixed-sex wards and believes that it is a failure of the government to protect the population from this.
As the gender rows continue, the UK’s Health Secretary, Steve Barclay, has asked leaders of NHS bodies to review memberships of LGBTQ+ charities and assess the necessity of having diversity officers. The Office for National Statistics stated this year that 262,000, or 0.5 percent of the population aged 16 and over in the UK identify as having a different gender identity than their birth sex. While British law does not require medical treatment to change from female to male on documents such as passports and driving licenses, a Gender Recognition Certificate is necessary to adapt birth, marriage, and death certificates. This certificate requires a medical diagnosis of gender dysphoria and at least two years of living in the “affirmed gender.”
Isadora Sanger, a retired psychiatrist who is still registered as a medical practitioner, believes that some clinicians have had men who identify as women and have had their records completely scrubbed of any information about their biological sex. This can lead to strained interactions between doctors and trans patients who present with complaints that could be related to hormone treatment, but doctors are not able to discuss this openly with them. Sanger believes that doctors are being muzzled from doing their job responsibly.