PRESS RELEASE: Experts warn new transgender training for NHS maternity services based on ‘bogus’ research
6 January 2023 – WithWomen.org
A group of NHS health practitioners and researchers has warned that 40 NHS England Trusts are at risk of ideological capture based on flawed research if the new Maternity Gender Inclusion Programme (MGIP) proceeds.
Signatures on an open letter to NHS England are being collected by the campaign group With Woman, which represents maternity and infant health practitioners including midwives and obstetricians who are concerned about the influence of gender ideology in the sector.
The experts have called for a pause on the MGIP training programme – which would train midwives at 40 NHS Trusts on the use of “trans inclusive language” and pronouns – due to it being based on the Improving Trans Experiences of Maternity Services (ITEMS) report launched by the LGBT Foundation in April 2022, which is not peer reviewed and contains significant flaws in its methodology and analysis.
The ITEMS report directly compares its own survey of 121 trans maternity service users who gave birth in the past 30 years with an official UK maternity services survey that surveyed 17,151 women who gave birth in 2019.
Despite being commissioned to fill a knowledge gap on transgender maternity service users, the ITEMS research does not mention any specific medical needs that trans individuals and their babies may have as a result of treatments such as testosterone use or chest masculinisation mastectomy.
The ITEMS report also recommended the introduction of ‘inclusive language’ for all maternity service users, which typically includes the addition of de-sexed terms such as ‘pregnant people’ and ‘chestfeeding’. This recommendation is at odds with evidence and current MBRRACE-UK, NICE and Public Health England guidance to use plain English and be inclusive of women with low literacy or English skills.
Members of the With Woman network typically remain anonymous in order to protect their jobs within the NHS, but within just 24 hours of being circulated the letter had been signed by over 650 healthcare practitioners, researchers and members of the public. With Woman plans to send the letter to NHS England’s National LGBT Programme Manager Lizzie Streeter, who is coordinating the programme, on Monday.
A spokesperson for With Woman said: “Given how poorly the ITEMS research was undertaken it simply cannot be relied upon to inform training or healthcare guidance.”
“Despite its bogus methodology and analysis, the ITEMS report underpins NHS England’s new training for midwives on transgender service users. We want trans and non binary people giving birth to have good experiences and evidence-based care, and are therefore making an urgent call to pause the programme.”
The letter warned that a scandal similar to the events that led to the closure of the Tavistock Gender Identity Development Service (GIDS) could be repeated in NHS maternity services due to reliance on poor research and the influence of activist organisations. Across several sectors including healthcare and education, training courses run by advocacy groups such as Stonewall and Mermaids have had to be withdrawn in recent years at great cost to public bodies.
The current estimate of prevalence of trans and non binary maternity service users is at most 1 in 2000. With Woman says this makes it hard to justify the level of funding and hours dedicated to this training across 40 NHS England Trusts at a time when the health service is under immense and urgent pressure.
In the open letter With Woman calls for the £100K allocated to the programme to instead be directed to the development of high-quality data on the prevalence and clinical needs of transgender maternity service users.
Ali Ceesay from Woman’s Place UK said: “We support NHS efforts to improve maternity services in their provision of safe, person-centred care. Any policy development, including training, must be based on carefully considered evidence, sound methodology and clinical need. This training proposal fails to do this.”
“Sex inequalities in health care provision are well documented as are race inequalities in maternity care. We urge the NHS to focus their funding and expertise to make well documented improvements so that services are safe for women.”
Dr Louise Irvine said on behalf the Clinical Advisory Network on Sex and Gender: “As the Cass interim report implied, areas of the NHS such as GIDS have been subject to ideological capture at the cost of person-centered, evidence-based care. We hope NHS maternity services do not make the same mistake.”
Consultant psychiatrist David Bell, formerly a staff governor at the Tavistock & Portman NHS Trust which included GIDS, added: “As someone who was instrumental in exposing the damage done to patients by an unthinking acceptance of ideologically based claims, which had no evidence base, I am shocked at this repetition of ideology again trumping careful examination of the evidence and little thought as to the likely damage.”
Concerns have also been raised about the training provider procurement process. NHS England opened the £100K contract for the Maternity Gender Inclusion Programme on 16 December 2022 with a closing date of 11 January 2023, giving prospective training providers less than a month over the Christmas holiday period to apply.
With Woman’s spokesperson said: “One wonders if they already know who will win this contract and what their training will look like.”