When Medical Chaperones aren’t really Chaperones: The Reality for Transitioned Women.

Introduction

When we talk about medical chaperones, what are we really talking about?

Officially, a chaperone is someone present during medical examinations, particularly intimate ones, to safeguard both patient and healthcare professional. They’re there to ensure transparency, comfort, and dignity. In practical terms, this means preventing misunderstandings or abuse, providing emotional reassurance to patients, and ensuring accountability for healthcare providers. From a healthcare professional’s perspective, chaperones help protect against allegations of misconduct or assault, while also offering emotional support to patients during potentially uncomfortable examinations.

Except, when you’re a transitioned woman navigating healthcare, things become less clear, and what should be a comfort often turns into another point of anxiety.

The General Medical Council (GMC) and Nursing and Midwifery Council (NMC), the professional bodies governing doctors and nurses in the UK both emphasise that chaperones should be offered for intimate examinations, prioritising patient dignity and consent. What they don’t do is specify the gender, social sex (what you are seen and treated as) or biological sex of the Chaperone. Hospital policies, however, typically underline the patient’s right to request a chaperone of the same gender or sex.

It is within this framework that the waters become murky for transitioned women, where the line between biological (invisible) sex and social (visible) sexing is not always neatly respected or understood.

In practice, while most hospital policies explicitly mention that patients can request a chaperone of the same gender or sex, what if your comfort, your dignity, your emotional safety means requesting someone of the opposite visible sex? For example, could a trans woman request a male chaperone?

Official guidelines don’t explicitly forbid it, nor do they actively encourage it. The Leicestershire Partnership NHS Trust, and certain professional bodies, have started acknowledging the importance of flexibility and sensitivity toward trans patients, but these considerations aren’t yet universal.

As transitioned women, we often find ourselves in uniquely vulnerable positions during medical care. There’s anxiety not just about physical discomfort, but about emotional vulnerability, unwanted disclosure, and navigating cisgender assumptions. Too often, this is coupled with a subtle yet pervasive sense of othering, curiosity, or even entitlement by cisgender staff who, under the guise of professionalism, feel justified in scrutinising our bodies.

It is this sense that is profoundly uncomfortable for some transitioned women. Too often, rather than “emotional support”, Chaperones can feel intrusive and unwanted, we accept them because we want medical care, not because we want a Chaperone.

Generally, transitioned women want as few people as possible looking at their intimate area, so it can feel like, rather than being a supportive presence, Chaperones amplify distress and unease. We are not only concentrating on staying calm during a procedure but also on managing the Chaperone we have been assigned.

Healthcare providers have the opportunity, and indeed the responsibility, to listen, respect our needs, and provide care that feels genuinely safe and inclusive. It’s about allowing us to set our own boundaries clearly and unapologetically, ensuring our emotional wellbeing is as carefully protected as our physical health. However, in reality, things are quite different.

A Personal Reflection of Care by Chaperones

I’ve needed a chaperone twice, both times with a provider who regularly sees trans patients for surgical revisions, but over a decade apart. I was already anxious – hoping the procedure would improve things rather than worsen them and I longed for a familiar, comforting presence. Each time, I asked if my partner could be there; each time, I was denied. My choices boiled down to forfeiting treatment or being examined in front of extra people I hadn’t chosen. In both instances, I was assigned a cis female nurse with no conversation about what kind of support I actually wanted or needed.

During the first surgery, I felt awkward and exposed, but the nurse was kind. She stood by me, she held my hand (I’m usually reassured by touch and conversation so this was a random win, and I had enough trust in her – this was before the mainstream transphobia in the press and government). It wasn’t ideal, but I got through it and appreciated the small gestures of comfort.

My second experience was starkly different. Tensions around trans women in the media weighed on my mind, and I was immediately uneasy with the chaperone. Lying there, vulnerable and hoping for the best, I was jolted by her joking suggestion that I “kick the doctor if he did anything wrong.” It felt careless, especially when I wanted the surgeon to feel safe and focused: my outcome depended on it. Then came her attempt at “empathy”: she commented on how we trans women “go through so much,” as if these procedures proved we weren’t “real” women. Instead of offering support, she made me feel othered, and I found myself awkwardly reassuring her that dilation is actually routine and not all transitioned women have to do it (depending on their partner!), all while my body was on display.

Ideally, I’d like my partner as well as a chaperone to feel safe. While Chaperones are preferably medically trained with knowledge of the procedure, this seems in stark contrast to the broader definition of Chaperone. How can transitioned women feel “safe” when nurses out their trans colleagues, when they are paraded to the media and the cruelty of gender-critical activists? The general experience of transitioned women that I know of has been that there is no discussion about who should be a chaperone, or how we feel most supported. Chaperones have always been selected as cisgender women with no regard as to how we personally feel or what we feel is most supportive, and those cisgender women are supposedly just magically expected to know what transitioned women’s anxieties and needs actually are. They do not know how to support us.

Held, Not Caged: A Wider Appreciation of “Chaperone”

A chaperone, in its simplest definition beyond the word in a medical context, is “a person who accompanies and looks after another person or group of people.” Beyond the formality of the word is something deeper, something more human. A chaperone, by broader definition can be more than a guardian, more than an overseer – they can be a presence of care, a quiet protector, someone who holds space without taking it away.

The best kind of chaperoning isn’t about control; it’s about empowerment. It’s about standing beside, rather than in front. It’s about watching over, not having control over you. It’s the hand held in a hospital room, love steadying the weight of uncertainty. It’s the presence that doesn’t demand anything, yet makes everything feel safer.

I have felt this. In my darkest, most vulnerable moments, when I woke up in a hospital bed, disoriented and raw, my partner was there – her love unwavering, her hand in mine. I don’t remember the fall, but I remember her. I remember wanting to wake up, to be there for her, to find my way back just to tell her it’s okay, I’m still here.

I have felt it with others too, in conversations with my therapist, Charlotte. When I’ve had no one else to turn to about the weight of the world, about my mental health, about the jagged edges of society, about boundaries and belonging she is there. Sometimes, there are no perfect answers. But sometimes, just being there, being heard, opens doors in my mind that I couldn’t open alone. With her I have gone from fear to tears to laughter so deep it made my sides ache – all in the span of minutes, because I was safe enough to feel beyond fear and anxiety.

This is what it means to be watched over with love, not control, what it means to be held, not caged. When someone is present in a way that feels safe, when they watch over you without taking over, when they care without trying to define you is when chaperoning becomes something more. It’s almost like temporary parenting without ownership or control, it is well beyond “acceptance” or “tolerance”, it is a nurturing presence, an informed advocate.

The Social and Political Context cannot be Ignored.

It’s impossible to talk about chaperoning for transitioned women without acknowledging the wider social context in which we’re forced to navigate healthcare and life in general. Over the past few years, public discourse in the UK has shifted sharply against trans women, often painting us as “biological males” and positioning us as threats to cisgender women’s safety and privacy. These narratives saturate mainstream media, influence policies, and filter down to everyday interactions, including those in medical settings.

We see the ripple effects in countless instances: trans women excluded from certain sports; barred from domestic violence shelters; turned away from sexual violence support services that were initially set up to protect women from harm. In Fife, a trans woman was forcibly outed in a local media storm for using changing facilities: what should be ordinary, everyday spaces. It quickly escalated into public outing, humiliation and calls for her exclusion, and for every other transitioned woman in the UK. In Darlington, similar anxiety was whipped up over the presence of trans women in changing rooms, turning “undressing” into a battleground.

These cases are symptomatic of a broader social environment where the default assumption is that our existence endangers or offends cisgender women, thereby justifying our forced removal or exposure. This social positioning of trans women as a threat creates a cruel contradiction. Cisgender women are granted an expectation of privacy from trans women, but transitioned women are not entitled to privacy from cisgender women. This plays out in the medical field in deeply unsettling ways.

In healthcare, this often manifests as having chaperones, nurses, or other personnel assigned to us without real consultation about our comfort or sense of safety. Even in non-medical contexts, trans women endure extra scrutiny over our bodies, as though our transitions invalidate our own need for dignity and security. Over time, this constant questioning or forced exposure can wear us down, making something as routine as a GP visit feel like a gauntlet.

This vulnerability extends to those of us seeking support after trauma. Remarkably, some transitioned women find the only comprehensive help available is from services designated for male survivors. While these agencies, like Survivors UK, make every effort to be inclusive because they know that if they don’t provide support then trans women are left with nothing. The reality remains that transitioned women are already seeking support in traditionally male-only spaces, even though it can be uncomfortable – meaning regularly having to disclose that you transitioned, but that it’s preferential to being exposed to cisgender women’s fear of us – and everything that involves. Although the best of poor choices, it can trigger yet another round of explanations and justifications: proof that even in spaces offering help, our privacy is fragile.

Against this backdrop, the concept of chaperoning at least as it’s officially described, makes perfect sense: a second person to ensure dignity and safeguard against wrongdoing. But when a society mistrusts or sensationalises your identity, a chaperone can morph into yet another intrusion, another set of eyes imposing scrutiny, another reminder that you are perpetually deemed “other.” The result is that what should be a protective practice can all too easily become an invasive, anxiety-inducing one. It leads to pervasive questions and anxieties that dominate the interaction: is this woman gender-critical? Will she expose me to the press? Will she talk with her friends about my intimate area? Will it lead to mocking and derision in their communities?

Putting it all together

For many of us, having real choice and autonomy over who is present during our examinations is about much more than policy – it’s crucial to our emotional survival, respect, and genuine safety. In this uneven social landscape and balance of power, we need providers who are not just ticking off a policy box, or protecting themselves form “misconduct” charges, we need people who truly grasp the emotional toll of accessing healthcare, especially anything involving our intimate anatomy.

A chaperone should provide reassurance, dignity, and protection. But for transitioned women, the presence of a chaperone in medical settings often does the opposite: it amplifies anxiety, reinforces othering, and strips away autonomy. The issue is not just about who is present, but about the wider social context in which we exist, where our privacy and bodily autonomy are consistently compromised.

A cisgender woman can reasonably expect that her dignity and privacy will be respected in intimate medical settings. She can request a female chaperone, and this request will be honored as a matter of course. But a transitioned woman making the same request? There are very few trans nurses or doctors, and those that are, are being hounded from the profession.

Our comfort is not assumed, nor is our right to advocate for it. If a trans woman prefers a male chaperone for her own emotional safety, it becomes a debate. If we request privacy, we are treated as suspect, as though our discomfort must take a backseat to cisgender curiosity or control.

This entitlement to scrutinize, to intrude, to manage trans women’s bodies is the logical endpoint of a media and political environment that positions us as objects of fear and regulation. It is why cases like those in Darlington and Fife happen – where trans women were forcibly exposed, humiliated, and made into public spectacles.

When chaperones exist within this hostile context, they become something else entirely. They stop being a source of reassurance and instead become an extension of a system that already watches us too closely. Their presence no longer signals safety – it signals danger.

Chaperones: A Double-Edged Sword

There is a stark difference between the idea of a chaperone and the experience of one. Many of us do not get to choose who accompanies us in these vulnerable moments. Instead, we are assigned a cisgender woman, with no regard for whether that makes us feel safer or more exposed.

The assumption is that all trans women would be most comfortable with another woman present, but this ignores the fact that many transitioned women have had distressing experiences with cisgender women acting as gatekeepers, sources of scrutiny, or even outright hostility. Neither the NMC nor the GMC specify that a Chaperone should be of the same biological or hidden sex, or the same social, or visible sex.

However, I should be clear that I am not advocating getting rid of Chaperones altogether, the need for protection by a chaperone is real. There have been cases where medical professionals have abused their power, such as a GP who told a pre-transition woman that she would only receive a referral to a Gender Identity Clinic if she stripped naked in front of him. Without another person in the room, these violations can go unchecked.

What We Need From Chaperones

For chaperoning to be genuinely protective rather than intrusive, transitioned women need:

• Autonomy: The ability to choose whether a chaperone is present at all, and if so, who that person should be.
• Understanding: Chaperones who are trained in trans healthcare realities and do not carry gender-critical biases.
• Respect for Boundaries: A recognition that transitioned women may feel less safe with an assigned cis woman than they would with a male chaperone.
• Creative, Challenging, Compassionate Thinking: Is there a way for a transitioned woman’s partner to be there, with an additional chaperone?

The broader issue is not just about who the chaperone is, but about why transitioned women are given so little agency over this decision. When a practice designed for protection instead reinforces vulnerability, something is deeply broken. Chaperoning should not be a default intrusion – it should be a choice. And that choice should rest with the people who are most vulnerable in that room: us.

Credits:
With love and thanks to Charlotte, Evelyn and Steven, to my loving partner, and to every transitioned woman who has courageously shared their vulnerability and experiences.