Shocking guidance from NHS Education for Scotland around transgender provision

NHS Scotland has told its employees, in shocking guidance, that they have a legal duty to treat transgender women (biological males) as female, even if they have facial hair.

The ‘Cultural Humility’ training module, which is available to all Scottish NHS staff and which was developed by NHS Education for Scotland, posits a number of hypothetical scenarios, such as the case of ‘Lucy’, a 29-year-old transgender nurse who has not yet formally changed their name from Lee.

The scenario suggests that Lucy “is still producing facial hair which is exposed” and warns that “discrimination against Lucy will not be tolerated and that they have a duty (under equality law) to use the correct name and pronouns for Lucy”.

A different scenario surrounded the introduction of gender-neutral toilets in care homes, and how to deal with a potential backlash; it suggests that managers should tell their staff that “there is no evidence safety risk increases” with gender-neutral toilets and that if they are unhappy they should “reflect” on whether their objections are “informed”.

However, it seems that the law has been misinterpreted. Michael Foran, a legal academic, said that the law states that when there are toilets with cubicles and a communal sink area, separate facilities for men and women should be provided. He also said that there was not a specific legal duty to use preferred pronouns, as the guidance erroneously claimed.

The Conservative MSP Stephen Kerr said in response: “It is absolutely nonsensical to demand that staff and patients ignore biological reality and participate in an enforced illusion.

“This kind of thought control has no place in a rational, professional healthcare setting, where clear communication, trust and biological facts are critical to patient care and workplace cohesion.”

Another fictional scenario declares that people can decide for themselves “whether they identify as disabled”.

This situation has emerged shortly after a landmark case hit headlines, in which the nurse Sandie Peggie was threatened with being sacked after challenging Dr Beth Upton over using the women’s bathrooms (despite Dr Upton being biologically male). The tribunal will resume in July.

When approached about the training materials, NHS Education for Scotland deleted the section about gender neutral bathrooms from the module, and the claim staff had a legal obligation to “to use the correct name and pronouns for Lucy”.