There should be more gender categories in the NHS, the chairman of the national clinical network of sexual assault and abuse services at NHS England has suggested.
Dr Binta Sultan made the comments in an online panel discussion this month hosted by UCL, titled Intersectionality in Inclusion Health: Why Does Gender Matter? where she introduced herself as “a brown cisgender Muslim woman”.
Working at UCL’s Collaborative Centre for Inclusion Health (CCIH), Dr Sultan is “a consultant physician in inclusion health at Uclh, the first in the NHS”. CCIH’s website describes “inclusion health” as a “social justice movement to prevent and address the harms of extreme inequality through research, service and policy”.
Panellists included Kate Luxion, a “non-binary” researcher at UCL who recently told the BBC that trans milk is just as good as breast milk.
During the event panellists advocated the idea of gender identity being recorded in public services as well as sex. Event chairman Serena Luchenski, a founding member of CCIH, asked Dr Sultan: “As a clinician recording people’s gender in the data, do you think that’s a problem in your day job? Do you think there’s an excuse for the NHS not to be doing this?”
Dr Sultan replies: “I have very strong views on this and I think it’s not a problem. I think the problem is the lack of comfort with nuance and complexity, and the need to have binaries within our systems.
“I don’t think it’s a problem to have more [gender] categories and ask people how they want to be identified, right? It’s not difficult. As a clinician it’s not a difficult thing and if someone chooses not to answer that’s fine as well, right? It’s giving people the opportunity to share what they want. And I don’t think it’s a problem. I think the problem is our systems just want ‘yes’ or ‘no’ answers. We can do a lot more to get comfortable with complexity and nuance.”
Concerns over safeguarding
NHS England guidance says it’s “important to ask [patients] about” gender identity, which “should not be confused with registered sex at birth”. NHS trusts and hospitals offer a diverse range of guidance on the matter, with Brighton and Sussex University Hospitals explaining genders such as “woman, man, non-binary, gender queer, gender fluid, transgender” and Lincolnshire Partnership exploring numerous transgender identities, including “crossdresser” and “agender”.
Last year Dr Sultan responded to a report that found a widespread pattern of female trainees being abused by senior male colleagues, in what was called a “MeToo moment” for surgery.
Dr Sultan told one publication: “We know inequality and sexual misconduct exists and is experienced disproportionately by our female colleagues across the NHS” and that the National Clinical Network of Sexual Assault and Abuse Services at NHS England would “provide more support and clear reporting mechanisms to those who have suffered harassment or inappropriate behaviour”.
But her more recent comments have raised concerns over how gender categories might impact safeguarding in public services.
Helen Joyce, director of advocacy at human rights charity Sex Matters, said: “Everyone needs to feel welcome in the healthcare system but it is imperative for all patients, trans identifying or not, that everyone involved in their care is clear about their actual sex.
“Doctors don’t need lists of self declared identities to treat everyone with courtesy and respect.”