{"id":108,"date":"2025-06-21T22:52:05","date_gmt":"2025-06-21T21:52:05","guid":{"rendered":"https:\/\/transiness.com\/?p=108"},"modified":"2025-12-27T16:05:53","modified_gmt":"2025-12-27T16:05:53","slug":"nmc-failure-trans-nurses-forced-outing","status":"publish","type":"post","link":"https:\/\/transiness.com\/?p=108","title":{"rendered":"Open letter response: The Nursing and Midwifery Council (NMC) spectacularly fails trans women and people."},"content":{"rendered":"\n

When we first wrote<\/a> to the Nursing and Midwifery Council (NMC) in February, we hoped for a response that would acknowledge the harm being done to trans patients and healthcare workers. The letter was clear, direct, and rooted in the NMC\u2019s own Code of Conduct. It outlined how gender-critical activists were weaponising the nursing profession to dehumanise trans people: misgendering them publicly, outing them without consent, and fostering a culture of hostility within healthcare spaces. We had hoped that the NMC might condemn these actions as violations of their ethical duties. Instead, they replied with a carefully worded statement that, while technically compliant, avoided addressing the systemic harm at its core.<\/p>\n\n\n\n

The NMC\u2019s response begins by acknowledging \u201cthe importance of hearing about people\u2019s experiences,\u201d which is not entirely untrue. They emphasise their commitment to equality and non-discrimination, stating: \u201cWe are clear on our stance that there is no room for discrimination, bullying or harassment of any kind towards anyone in the health and care sector.\u201d These words align with the principles I outlined in my letter, which stressed the NMC\u2019s responsibility to \u201cuphold the reputation of the profession\u201d (Clause 20.1) and ensure \u201csafe, compassionate, equitable care\u201d for all patients (Clause 16.1).<\/p>\n\n\n\n

However, this commitment is not matched by action. The NMC\u2019s reply focuses on policy frameworks – freedom of expression guidelines, case studies of disciplinary actions, and education standards, but it fails to acknowledge the specific allegations we raised. For instance, they mention examples like a nurse who \u201cpersistently makes comments to [a trans colleague] about \u2018accepting the body they are in\u2019\u201d or a nurse who \u201cdeliberately misgenders a transgender person.\u201d These cases are framed as isolated incidents of harassment, not as part of a broader pattern of ideological hostility<\/strong>. The NMC\u2019s language suggests that their role is to address individual violations of the Code, but it does not acknowledge the systemic weaponisation of professional authority by a collective of gender-critical nurses.<\/p>\n\n\n\n

This omission is glaring. In my letter, I wrote: \u201cThe silence of the NMC in the face of this growing hostility is not neutrality; it is complicity.\u201d Yet the NMC\u2019s response never directly addresses this claim. Instead, they frame their role as \u201chearing people\u2019s experiences\u201d and \u201censuring professionals are non-discriminatory,\u201d which feels like a passive acknowledgment rather than an active condemnation of harm. They avoid explicitly stating that gender-critical nurses\u2019 actions: such as using uniforms to promote transphobic ideologies in the press, are violations of the Code.<\/p>\n\n\n\n

The NMC fails to engage with the specific issue of forced outing, which I emphasised as a critical violation of privacy and dignity. The Code\u2019s Clause 5 states: \u201cYou must respect the confidentiality of information about people in your care.\u201d Forced outing, which exposes a trans person\u2019s gender history without consent, directly contradicts this principle. Yet the NMC\u2019s response does not mention this at all<\/strong>. Instead, they focus on \u201cinappropriate expression\u201d of beliefs, such as harassment or misgendering in clinical settings, but they do not condemn the misuse of professional authority to incite public hostility.<\/strong><\/p>\n\n\n\n

The result is a response that feels like a reassurance rather than a commitment to action. The NMC\u2019s language is neutralising, phrases like \u201cwe are clear on our stance\u201d and \u201cthere is no room for discrimination\u201d sound aspirational but lack concrete measures to address the real-world consequences of their inaction. For trans nurses and patients, this silence sends a message: \u201cYour safety and dignity are not priorities.\u201d<\/strong><\/p>\n\n\n\n

This gap between the NMC\u2019s stated values and their actual response is deeply troubling. When institutions fail to protect vulnerable communities, they risk perpetuating harm. The Supreme Court ruling that trans women are not \u201cwomen\u201d has already legitimised anti-trans hostility in public discourse, but the NMC\u2019s failure to address systemic issues within healthcare exacerbates this crisis. Fear and exclusion are not just abstract concepts – they are lived realities with extensive impact on health.<\/p>\n\n\n\n

The NMC\u2019s response is not just inadequate; they have confirmed that it is complicit. By evading direct engagement with the weaponisation of nursing professionalism and the harm caused by forced outing, they leave trans people to navigate a healthcare system where their safety is repeatedly compromised. This silence is not neutrality, it is an endorsement of the very hostility that threatens our lives.<\/p>\n\n\n\n

As I write this blog, I am reminded of the words from my original letter: \u201cThe future of nursing depends on your actions.\u201d The NMC must decide whether to uphold its ethical duties or continue enabling harm. For trans women in healthcare, their response is not just a regulatory issue, it is a matter of survival.<\/p>\n\n\n

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No condemnation of forced outing.<\/mark><\/strong><\/p>\n\n\n\n

The most glaring omission was their silence on forced outing: the deliberate exposure of a trans person\u2019s gender history without consent. This is not merely an ethical breach, it is a violation of privacy, trust, and dignity. Yet the NMC\u2019s response omits this issue entirely, leaving trans nurses and patients to navigate a landscape where their safety and autonomy are dangerously undermined.<\/p>\n\n\n\n

Forced outing is the act of publicly revealing a trans person\u2019s gender history or identity without their consent. It is not a “personal belief” or an ideological debate, it is a concrete violation of privacy, confidentiality, and human rights. It is not something that could affect cisgender, heterosexual people, whose lives have not been historically policed with the violence all too present in trans women’s lives. For transitioned women, this violence is neither abstract, nor theoretical. In the Galop transphobic hate crime report (2020), 5 years ago when tensions were arguably less intense, 4 in 5<\/strong> trans people experienced some<\/em> hate-crime in the previous 12 months<\/strong>, 1 in 4<\/strong> experienced a physical assault or threat and nearly 1 in 5<\/strong> experienced a sexual assault or threat. 70 %<\/strong> said hate crime harmed their mental health and 55 %<\/strong> felt less able to leave home.

Forced outing causes immediate emotional and psychological distress, causing a sense of betrayal by trusted professionals. Publicity surrounding transitioned women identifies them as a target, which can lead to intense anxiety, depression, and further traumatic experiences. Transitioned women feel a loss of personal autonomy, a loss of control, and a loss of safety. Outing can expose trans people to targeted harassment, hate crimes, and workplace hostility. For trans healthcare workers, this creates a hostile environment that enforces an intolerable culture which encourages them to leave the profession entirely.<\/p>\n\n\n\n

If nurses are seen as enforcers of exclusionary ideologies rather than healers, the entire nursing community loses credibility. When nurses use their uniforms, titles, or professional standing to promote transphobic ideologies -whether in media, social media, or within healthcare settings, they are not merely expressing personal beliefs. They are leveraging institutional trust to harm marginalised communities. This is a direct betrayal of the NMC\u2019s duty to “promote professionalism and trust” (Clause 20). It creates a culture where trans people are seen as threats rather than people with human rights and dignity, and where discrimination is normalised under the guise of “professionalism.”<\/p>\n\n\n\n

The NMC\u2019s failure to address forced outing is not neutrality: it is complicity. By refusing to condemn or investigate these actions, they implicitly endorse a system where trans people are silenced, exposed, and excluded. Their response, which focuses on “individual cases” rather than systemic harm, leaves trans nurses and patients vulnerable to ongoing violence against us.<\/p>\n\n\n\n

We discussed the NMC’s response with one of our trans members who is a registrant. This is what that silence feels like, in the words of one of our own::<\/p>\n\n\n\n

“It has never been easy as a transitioned woman at work, even before the Supreme Court ruling. I\u2019ve always tried to make myself as small as possible: changing in the staff room when no one was around, and hiding out of view when I just need to cry about how awful things are becoming. But now? Now it\u2019s intolerable. I\u2019m having to hide all the time<\/em>. I use toilets away from my workplace, sometimes even outside the grounds, just to cope. And my trust in others is suffering, I\u2019m terrified of my colleagues – every glance, every whisper feels like a threat – people who I previously felt safe with. Nothing feels safe anymore. When I\u2019m at work, I should be focused on my patients, but instead, I\u2019m constantly worrying about standing outside the disabled loo, wondering who might recognise me or what gossip might spread among my colleagues. And I\u2019m terrified of ending up in the press: even when I\u2019m super careful, because you don\u2019t know what they [gender-critical nurses] are going to do next. This has taken a devastating toll on my mental health. I\u2019ve been really unwell recently, so much so that I\u2019ve needed care myself. It\u2019s not just about being trans; it\u2019s about being a nurse and feeling like I can no longer exist in the very profession I chose to serve others. I\u2019m constantly asking: Why is this happening? Why are we being treated like threats instead of patients or colleagues? Why does the NMC say they\u2019re against discrimination, but their silence lets this continue?”<\/p>\n\n\n\n

The Supreme Court ruling has not just invalidated our identities, it has legitimised gender-critical hostility in professions where trans people are already vulnerable. Nursing, midwifery, and other female-dominated fields have long been spaces where cisgender women dominate, but now the NMC sends its own chilling message: complicity.<\/p>\n\n\n\n

This isn\u2019t just about legal definitions – it\u2019s about power. It reinforces the idea that trans women are not \u201creal\u201d women, and therefore not entitled to the same rights or safety or privacy in spaces like hospitals, wards, or even toilets. For trans healthcare workers, this creates a sense of being \u201cpoliced\u201d – constantly under surveillance by cisgender colleagues who may view us as outsiders, threats, or \u201cinfiltrators.\u201d<\/p>\n\n\n\n

The NMC\u2019s response only makes things worse. By focusing on overt misgendering and individual cases, they imply that only visible acts of discrimination matter. But what about the subtler, more destructive behaviors? The quiet hostility in workplaces, the unspoken rules that exclude us, the fear of being outed or targeted by colleagues who don\u2019t see us as human?<\/p>\n\n\n\n

The NMC\u2019s reply says: “We\u2019ll only protect you from overt misgendering.” But it leaves deeper, more insidious harms unchecked. It sends a chilling message to trans workers: you’re fair game.<\/p>\n\n\n\n

This isn\u2019t just about one ruling or one council. It\u2019s about a system that continues to marginalise us within the medical profession. Trans nurses and midwives are people: they are caregivers, healers, and advocates. But if they can\u2019t exist safely in healthcare spaces, how can we expect trans patients to receive appropriate, dignified care?<\/p>\n\n\n\n

The wider issues are compounding.<\/mark><\/strong><\/p>\n\n\n\n

When trans nurses are forced into silence or fear, it sends a devastating message to trans patients: \u201cYou may not be safe here.\u201d It erodes trust in the profession and in healthcare system itself. Patients who already face barriers, like trans individuals but also other minorities, will avoid care entirely if they believe their dignity will be violated. For example, a trans person might skip a routine check-up or delay treatment for fear of being mistreated, outed, othered, or harassed by staff.<\/p>\n\n\n\n

The NMC\u2019s failure to address systemic issues like forced outing and ideological hostility undermines the very principles it claims to uphold. The NHS Constitution is clear: \u201cThe NHS must treat people as individuals\u2026 and respect their dignity and rights.\u201d But when institutions like the NMC fail to act, this promise is a hollow one.<\/p>\n\n\n\n

Gender-critical ideology has not only infiltrated healthcare but has captured key institutions including the Nursing and Midwifery Council (NMC), the Equality and Human Rights Commission (EHRC), and government ministries. These bodies, which are meant to protect vulnerable communities, have instead become platforms for legitimising harm.<\/p>\n\n\n\n

This is not accidental, it\u2019s a strategic capture of institutions by activists who frame their ideology as \u201cprotecting women\u201d or \u201cupholding professional standards.\u201d By embedding themselves in regulatory frameworks, gender-critical advocates have created a self-reinforcing cycle:<\/p>\n\n\n\n