A series of online pages offering advice and information to transgender and nonbinary pregnant people has now been published on the NHS website after a whistleblower revealed to i that it had been blocked for nearly a year by senior figures at NHS England.
Meetings within NHS England and nhs.uk, the main website for the health service, took place on Monday after an outpouring of responses to Sunday’s story from concerned readers.
Many questioned whether the decision not to publish the information was a breach of equality laws, with some deeming it evidence of anti-trans views within the institution – as the whistleblower also believed.
In response, senior NHS staff decided to overturn the blocking of this information, and published it in its original form on nhs.uk on Tuesday.
The whistleblower told i: “I feel relieved to see that they’re doing the right thing. But it’s a real shame that it took this [speaking to the media] for it to happen.
“It shows that there are still people working at NHS Digital who really care and who will advocate for minoritised groups.”
Since the pandemic, they said, the need for this content is even greater. “We live in a world now where online materials are a major source of information to people. If it’s not there then it’s evidence that your health is [deemed to be] worth less than others, so people feel afraid to go and seek care, because even the NHS website isn’t providing it for them.”
A study by the LGBT Foundation earlier this year found 30 per cent of trans and nonbinary people access no healthcare during their pregnancy for fear of the treatment they might receive.
The whistleblower hopes that this will now change and that the NHS must consider its commitment to inclusivity and equality.
“The NHS should learn that transphobia, homophobia, and discrimination is not going to be tolerated,” they said.
An NHS spokesperson said: “The NHS website provides information for everyone, and we add pages to the site to keep it in line with the best clinical evidence and make it as helpful as possible to everyone who needs it.”
The total number of trans and nonbinary people who have become pregnant or given birth is not known.
Medical knowledge has grown over the last decade as more transgender men have had children either using their male partner’s sperm or through IVF. However, specific medical advice is needed during pregnancy on a range of issues from how and whether to stop taking testosterone, to coping with vaginal atrophy if they’ve been on testosterone a long time.
Although maternity services are, according to the NHS, for everyone, some trans and nonbinary people have reported feeling excluded and have feared the reactions they might receive when accessing these services.
One NHS trust has led the way in trying to provide information and language that is inclusive of everyone needing perinatal and birthing care. Last year, Brighton and Sussex University Hospitals maternity services launched the first clinical and language guidelines for midwives, following years of work understanding the needs of patients.
While stating that they will continue to refer to pregnant women and breastfeeding, when working with trans and nonbinary patients they will use language that recognises these patients’ gender identity and transition.
“I’m looking forward to a time when this standard of inclusive care is in fact business as usual for the whole of the NHS,” Amanda Clifton, head of midwifery, said at the launch. But since then, there have been no national guidelines.
The impact of the information now published by nhs.uk could therefore be transformative for many trans and nonbinary people planning to get pregnant or already expecting a baby, according to the whistleblower.
“It means that people will be able to get the information that they need to have healthy pregnancies and to have a healthy birth,” they said.
“It represents equality. It’s about removing one of the things that makes trans and nonbinary people feel stigmatised, different or worth less.”
Freddy McConnell, who made a documentary called Seahorse: The Dad Who Gave Birth about his experiences of becoming pregnant and giving birth as a trans man, had spoken to i about the earlier decision not to publish the online content, which was highlighted by the whistleblower on Sunday.
He had said: “It’s so upsetting because people like me who have given birth on the NHS and are trans or nonbinary are not often represented and included in the thinking.
He added that while his own experiences with NHS staff had been largely positive, if the advice were published, trans people “could be reassured of a warm, knowledgeable welcome, so that they wouldn’t be met with surprise or shock or possibly even disgust and judgement”.