Transgender, and a visit to A&E

So, the‘demographic’ information on everyone’s NHS records has been changed; instead of the standard sex marker, everyone’s records now show ‘sex observed at birth.’ For most people, this is purely a minor change, but for transgender people it is horrible – it means that everyone with access to our medical records will see that we are transgender. Not everyone is out and all of us are very selective about who we are out to. Transgender patients' being outed is actually recognised as a risk/consequence in the NHS’ own system. Incidentally, this dropped with zero notice. I wondered how on Earth I had missed the fact that it was coming, but I’ve been on a call with other transgender people, including from the health sector, and none of us had been expecting it. We were all shocked and bewildered. This will have a huge negative effect on our medical care.

The next Domino has now fallen: The Health Secretary has confirmed that in future (although she didn’t give a starting date), transgender people will have to be placed on hospital wards of our birth sex, or in an individual room. Outed much?? Well, yes, but quite honestly there is a major problem with bed availability at all, let alone available for transgender people. Let me tell you about the start of this year, and let me apologise if any of this is TMI. I’m recounting it for a reason.

One January morning, I started weeing what looked like very dark cranberry juice; beetroot had not been involved. So, I rang NHS 111 and was promptly told to go to Urgent Care (part of our local A&E) that afternoon. I was given an arrival time of 2pm. Remember that time! I expected to be prescribed antibiotics and sent home, but at triage I was sent through to ‘Majors’, where after a good while I was scanned (ultrasound) several times and a rather undignified tube was inserted. Given that my kidneys and bladder were being scanned, I told them that I am trans because the radiographer wasn’t going to see a uterus or ovaries and wasn’t going to see a hysterectomy scar. The fact that I am trans was the top line in my notes for the rest of my stay.

After 12 hours (yes, 12!) I was wheeled up to a ‘boarding bed’ on the Urology ward. I had been sitting on a plastic chair for that period, as had many other people. There were simply not enough beds for anyone to be moved more quickly than that. Remember when we had a four-hour target? There were people who had been waiting longer than my 12 hours for admission or discharge, and people who looked a lot more poorly than me. The staff were clearly run ragged and were doing amazing jobs in spite of the pressure they were under. Huge respect to them!!

One chap assaulted his girlfriend when she tried to stop him leaving when he really needed treatment, and it took a good few staff members to restrain him for the minute or so it took security to get there. A little later, the sister in charge asked everyone who was accompanying a patient, rather than a patient themselves, to leave because they needed all the seats for the next group of people to come through from triage. In a bay very close by, a doctor who hadn’t spent the whole of his life in the UK learned a new slang term that made him laugh out loud while he was examining a male patient with a delicate problem. We were genuinely trying not to overhear. No-one dared to catch anyone else’s eye because – poorly as we were - we would all have ‘lost it’ completely. The thing is, though, that there was nowhere else he could have been examined.

The boarding bed turned out to be a bed outside the Urology ward, just in front of the nurses’ station, with movable privacy screens. There were two such beds there, by the way. I was there for a couple of days, and I cannot praise the medical and ancillary staff highly enough. They were caring, professional, and humorous. I was started on some blooming strong antibiotics (thank goodness – they caught things in time).

[TMI] One of the mornings I woke up there, I was trying to work out where I was – I wasn’t at home so was I in a hotel or a hospital? I was confused and genuinely did not know. I eventually worked out that I was in hospital, and figured out which one a little after that. I was also prescribed anti-emetics; I did not realise why I was nauseous, or what toxins were floating around my bloodstream, or what the dangers of that were. At least, being near the nurses’ station, I could call out when I needed someone. [/TMI]

I was referred to the haematuria service as a matter of urgency before being sent home as the meds took effect. I was presented with a party bag of even more drugs than usual.

I had to have more ultrasounds and an invasive procedure (day surgery) in the next few weeks – and the NHS were brilliant. Our local Care Commissioning group includes two hospitals in local trowns as well as the one I was in, and I was given appointments at all three hospitals to get horrible things ruled out quickly. Again, the personnel were brilliant.

I found myself back in our local hospital after that invasive procedure – in the surgical hub, where patients were admitted and seated in numbered chairs that counted as beds. The area was mixed sex, and luckily there was what the press call the Blitz spirit among us. Some of the patients had been in those chairs for 36 hours. Because the seats were counted as beds, patients being newly admitted to the wards got a bed if one became available, because we were counted as being in bed already!

I am fine now, it was ‘just’ a kidney infection. I have spent quite some weekend time since then bothering rocks, visiting art galleries, peering at birds and wildflowers, and at concerts. I’m looking forward to doing those things even after I retire in a few months’ time.

So, overcrowding, long waits, lack of bed availability, ‘boarding’ beds. Emergency care is in a state of organised urgent chaos, and medical/surgical wards are under huge pressure. And they want to separate transgender people from the rest of the population? In the name of all that is holy, how?? Where on Earth are they going to put us???