NHS staff network representing the protected characteristic of sex. We are committed to promoting sex equality and equity in all NHS settings. Join us.
Welcome to SEEN in Health, the Sex Equality and Equity Network for NHS staff. We focus on the protected characteristic of sex. We're open to anyone who works in the NHS who shares our aims and values. Find out more or sign up for updates here
SEEN in Health is disappointed that
@theBMA
is undertaking a Review of the independent
#CassReview
. As the leading representative body for doctors in the UK, the BMA has a special responsibility in upholding the ethics, standards and professionalism in the medical profession. 1/5
SEEN in Health's mission is to create an environment in the NHS where staff feel safe and encouraged to discuss issues related to the protected characteristic of sex, so that they can speak up for themselves as employees and on behalf of patients
Let’s talk about ovaries
These are the female gonad which produces large human gametes: ova and female hormones. Only women have ovarian diseases such as polycystic ovarian syndrome (PCOS) and ovarian cancer. Only women go through the menopause when the ovaries stop releasing ova
NHS communications must be, at a minimum, factually accurate.
This poster is misleading for 2 of the 9 legally protected characteristics
Sex is protected, not ‘gender’
Gender reassignment is protected, not ‘trans’
These errors undermine public & staff confidence in the
#NHS
Sex-based rights are protected under the Equality Act 2010, staff who raise concerns about safety, privacy and dignity should not be ignored, belittled or advised to “broaden your mindset”.
We are growing! As the NHS staff network we can do so much to help our employers understand and respect the protected characteristic of sex.
Capturing the right information on IT systems is vital. We would love more colleagues working in IT to join us:
Let’s talk about sex.
Sex is a protected characteristic. It is a characteristic shared by 100% of the population. NHS data collection, EDI training, policy and patient pathways should all refer to sex.
The 2024 NHS staff survey findings indicate a concerning trend that female healthcare staff are experiencing unwarranted sexual approaches at a disproportionate rate
1 in every 26 NHS workers report sexual harassment from their work colleagues /1
SEEN in Health is seeing some disappointing examples of discriminatory policies in various trusts around the country, highlighted by the experiences of the nurses in Darlington.
We at
@SEENinHealth
wrote to the Chair of
@TheBMA
, the doctor’s union, today to express our concern about its decision to publicly critique the Cass Review.
Read the full text of our letter
Let’s talk about abdominal pain
There are many causes of abdominal pain that a doctor must consider when seeing someone as an emergency, with the diagnositic complexities that require a good deal of thought and concentration. 1/
It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record in every setting.
Join us here at 8/8
It’s clear from the Adams V ERCC case that women have an explicit right to same-sex intimate care.
This is applicable in healthcare too.
Staff & all patients who believe in same-sex care must not be punished for this belief.
It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record, with recording of gender separately as appropriate.
Join us here at
Thank you to those of you who have engaged positively with our tweets.
We have noted your comments, either on here or on the "Join us" form on our website, and your views are helping shape our next steps as a staff network.
To join us, go to
Nearly 900 doctors express "dismay" at BMA's decision to challenge puberty blockers ban and criticise Cass Review. Doctors can sign here . Signatures are being verified
We at
@SEENinHealth
wrote to the Chair of
@TheBMA
, the doctor’s union, today to express our concern about its decision to publicly critique the Cass Review.
Read the full text of our letter
We are concerned this is an attempt to undermine the findings of the
#CassReview
- an independent, 4 year review by a leading Paediatrician. We expect the BMA to take contributions from the experience and expertise of its members, including those in SEEN in Health 2/5
Many of our members are also members of the BMA and we have expertise in Psychiatry, General Practice, Emergency Medicine, Ethics and Law, and in systematic review which would be invaluable in recognising the conflicting rights within the Equality Act 2010, 4/5
Given the clinical, research and policy expertise of Dr Cass, we would wish to ensure that any such review can be objectively held to the highest standards and does not bring the Union or the profession into disrepute in seeking to critique a 4 year expert review. 3/5
What are the consequences of desexed / ambiguous language in healthcare?
@DrKarleenG
details her findings in this peer reviewed paper (free access)
We’ve summarised them in this thread:
while also considering the rights and responsibilities of children and young people, parents and clinicians alike. We would like to contribute our experience and expertise to aid the BMA to reach an evidence based child centred conclusion. 5/5
As NHS staff we are disappointed when the word ‘woman’ is removed as only women are at risk of ovarian cancer. It is crucial that we use clear language so that women from all parts of society are aware of their risks, and to avoid confusion among men and women.
It is vital that we know the sex of a patient to be able to consider these causes when doctors are already working hard to reach the right diagnosis. Obscured vital information can be the difference between life and death. 6/
Today is World Blood Donor Day
Donors rightly take pride in being able to help others in this way. Without regular blood donations, thousands of people every day would not be able to receive vital emergency or ongoing medical treatment.
It’s deeply concerning that one of the leading medical journals has chosen to express these untruths whilst encouraging prospective authors to follow suit
The accuracy and clarity of future medical publications involving sex-based findings are at risk. In healthcare, sex matters
It was a pleasure to talk with
@WomensRightsNet
this evening to explain why we felt the need to set up SEEN in Health.
We exist because sex inequality exists in NHS workplaces across the four nations. Once we have achieved our mission we will gladly disband.
(1) The guide claims that 'Sex and gender are often incorrectly portrayed as binary, concordant and static'.
There are only two sexes and they are immutable. 'Gender' is the socially constructed stereotypical behaviours applied to people based on sex.
It is vital to know the sex of an individual when they present to a health care setting with abdominal or genitourinary symptoms and we encourage the NHS to ensure accurate recording of sex in the electronic record.
The NHS is a key election battleground. NHS staff alone account for nearly 2M votes.
All parties must understand the importance of the protected characteristic of sex, sex equality & equity in healthcare; not least for patient and staff safety
SEEN & voters are watching
#GE24
It was a pleasure to meet with the Rt Hon.
@EstherMcVey1
& other Sex Equality and Equity Network (SEEN) representatives from across the country, in Parliament yesterday. We are grateful for the opportunity and it is encouraging to know we are not alone and are being heard.1/3
Women who have been pregnant can have antibodies in their blood that could cause harm to a recipient when receiving platelets and plasma, so men’s donations are easier to use than blood from women:
It is incredulous that an NHS Trust denied the rape of a patient for a year because the trust reprehensibly prioritised the gender-identity of the alleged attacker over the female victim
These are just a few examples that have allegedly occurred in NHS Hospitals /7
(2) “…these constructs exist along a spectrum that includes additional sex characterisations and gender identities, such as people who are intersex/ have differences of sex development”
Sex is not a spectrum. People with differences of sex development are still male or female:
🧵
@SEENinHealth
welcomes the legislation passed before government dissolves for the election, which is prohibiting the private UK or overseas prescribing of puberty blockers for under 18s (subject to consultation to make permanent)
(3)“In any given person, sex and gender might not align, and both can change”
As we have said, gender is socially constructed. Sex, however, is immutable and absolutely cannot change.
We have just published our response to the consultation on the NHS Constitution. We encourage everyone who works in the NHS or uses its services to submit a response.
See our submission here:
Sex-specific causes in women include ovarian torsion, pelvic inflammatory disease, ectopic pregnancy, other complications of pregnancy and, of course, going into labour.
In men, testicular conditions such as torsion or infection can present with abdominal pain. 4/
REMINDER
If you've got any examples of public bodies with policies or guidance that wrongly suggest that people can access single sex spaces based on self-identified gender, you can still submit them, despite the election.
The requirements for donating blood are different to ensure that women are not put as health risks. Women with a shorter stature under 65kg might not be able to donate, and women can only donate every 16 weeks minimum while men can donate every 12 weeks as they recover faster.
Women of childbearing potential requiring blood components need to be matched for Rhesus factor and Kell factors, to help prevent haemolytic disease of the newborn in future pregnancies. Men, however, can receive a wider range of blood types.
Additionally,
@TheLancet
advises authors to use the phrase “sex assigned at birth” rather than “biological sex” or “natal sex”; claiming this is more “accurate”.
However, there is no single, universally agreed-upon set of guidelines reporting sex-based findings.
Michelle Russell, an experienced, specialist nurse was one such female sexually harassed by a male work colleague. Her own Trust’s investigation into these allegations were deemed ‘catastrophically flawed’ by NHS England: /2
Abdominal pain can also be caused by conditions outside the abdomen such as pneumonia, a heart attack or even a skin condition such as shingles (I saw one of these last week). 3/
@SEENinHealth
are aware of many more.
These incidents depict the sobering reality facing UK healthcare staff and patients, these are the real life consequences of failing to safeguard the protected characteristic of sex in health
#BeSEEN
/8
Ovarian Cancer Action website has lots of great information on the condition and we support their clear sex based language. Ovarian cancer can present with persistent symptoms of bloating, stomach pain, feeling full more quickly and needing to wee more frequently.
Welcome to the SEEN community
@LocalAuthSEEN
👏🏼 👏🏼 🚹🚺
We’re a growing network of staff groups committed to sex equality and equity in all areas of society.
Again, the concerns raised by a group of female nurses were repeatedly ‘brushed aside’ by
@CDDFTNHS
when they were forced to share their changing room with a male colleague /3
There’s obvious ones: appendicitis, constipation, GI infections which make up the bulk of what is seen. Then there's hernias, torsion (twisting) of the bowel, pancreatitis, or gall bladder disease, and more subtle conditions such as abscess, bowel ischaemia or aortic aneurysm. 2/
It is vital to know the sex of an individual when they present to a health care setting and we encourage the NHS to ensure accurate recording of sex in the electronic record.
Join us here at
#MentalHealthWeek
In 2022
@ONS
reported that males continued to account for 3/4 of suicide deaths.
Accurate sex recording in healthcare is crucial to ensure services are supporting the appropriate demographic
@SEENinHealth
is committed to achieving sex equality in healthcare 🚻
It is important that all NHS bodies are aware of their legal responsibilities to review their policies in light of legislation which balances the rights of different groups.
Sex matters and is protected under the Equality Act 2010 yet this is not universally recognised, nor supported in practice, across our NHS employers, professional bodies or public sector unions.3/3
#SEEN
#strongertogether
#SexMatters
#NHS
We believe the misguided attempts of inclusivity at the expense of women must end. Sex is a protected characteristic and mustn’t be erased or replaced with the term ‘gender’
@SEENinHealth
is committed to sex equality in healthcare and we support the use of accurate sexed language
“I support
@SEENinHealth
because sex matters” 🧵
The NHS needs to be more sex considerate, and so do our patients. I am relieved Constitutional changes are proposed to support this but more needs to be done at operational, strategic and policy level 1/9
#BeSEEN
#NHS
The cervix is the neck of the uterus, an extraordinary structure is unique to females with no similar male structure, as it develops from the Mullerian structures which are suppressed in male development.
The cervix of the uterus is not synonymous with front hole: anatomically a front hole, a ventral orifice, is the urethral meatus, very different from the unique structure of the cervix, being the internal structure sitting at the top of the vagina that forms part of the uterus.
@SEENinHealth
looks forward to the newly elected Labour Govt ensuring the protected characteristic of sex is upheld in healthcare.
Patients and staff both have sexed based rights which must be respected./1
After years of progress in which the public in general and women specifically have become more knowledgeable about their own anatomy we are disappointed that there is now a regression to using inaccurate terms.
@seeninhealth
are committed to protecting the sex-based rights of all healthcare staff - we encourage all staff involved and those who are concerned to join our network for support:
The goal of Men’s Health Week is to raise awareness around the health challenges faced by men and reducing stigma around those challenges.
Men are less likely to discuss or seek help for their physical or mental health and many men find it difficult to open up and reach out.
We discussed the negative impact of poorly implemented EDI policies and practices, the current culture of fear in our professional and personal communities and the importance of impartiality in the NHS.2/3
@SEENinHealth
is a staff network representing the protected characteristic of sex in healthcare.
We’re a small part of a wider
#SEEN
community that promotes sex equality and equity
Here’s some of our colleagues who are doing great work in their field 🧵 1/11
Cervical cancer can develop in women, particularly if they have been infected with certain types of HPV virus. It is important to have screening for this infection and for abnormal cells in the cervix as this cancer is very treatable if caught early.
Let’s talk about prostates. This is a gland only found in men, and it is retained even if a trans identified male has had surgery to remove male genitalia.
The cervix is short thick, mostly tightly closed except during labour when it thins, stretches and dilates up to 10cm to allow that passage of the baby’s head and body. Miscarriage can be caused by cervical insufficiency if it is unable to keep tight closed in pregnancy.
Although different approaches to terminology in healthcare remaining respectful may be required depending on the context,
@DrKarleenG
suggests inclusivity statements or definitions in circumstances where desexing language isn’t appropriate because of the confusion it introduces.
Referring to ‘chests’ rather than ‘breasts’ regarding breastfeeding is medically inaccurate. Chest = everything within the ribcage, breast = mammary glands.
There has been an incremental creep of desexed language within healthcare communications. For example, replacing ‘Mothers’ & ‘Women’ with ‘Birthers’ & ‘Menstruators’, respectively. Desexing language in relation to males occurs less frequently.
In 2022 the Women's Health Strategy was launched.
@lregan7
was appointed the first women's ambassador for England.
The strategy can help organisations promote sex equality and equity by improving training, policies and services for women. 1/9
The ambiguous alternative terms used involving body parts e.g. ‘cervix havers’ is perceived as dehumanising and ‘invisiblising women’. Women have unique experiences, needs and rights in relation to pregnancy, birth and breastfeeding that are not, and cannot, be shared with others
New mothers, pregnant & birthing women have unique vulnerabilities and also require protection.
Each day, approx 810 women die during pregnancy worldwide (WHO).
Postpartum psychosis affects 1-2/1000 mothers and is a leading cause of maternal death through suicide
The intention behind this is to acknowledge women with a gender identity alternative to their natal sex, a strategy championed by EDI departments. However, the unintended consequences of this on other women are often not deliberated resulting in sex-based rights being overlooked
Who are ‘postnatal people’? Are they the mothers who’ve just given birth or the healthcare staff providing postnatal care?
Who are ‘breastfeeding people’? Are they the mother or the infant, or both?
Misleading language introduces inaccuracies and creates confusion. E.g.
“1 in every 8 people develop breast cancer”.
“1 in every 10 people have endometriosis”
Today is National ODP (Operating Department Practitioners) Day, thank you to our amazing ODPs, our theatres cannot run without you. Registrants are increasingly female (64%) in this allied health profession
#ODPday
It is vital to know the sex of an individual when they present to a health care setting with genitourinary symptoms, and we encourage the NHS to ensure accurate recording of sex in the electronic record.