NHS staff at Birmingham and Solihull Mental Health Trust have been advised to stop addressing patients as “sir” or “madam” to avoid offending transgender individuals.
Internal training documents instruct staff to use gender-neutral language when patients’ pronouns are unknown, recommending that they substitute terms like “lady” or “man” with “person” or simply use the patient’s name. For example, the documents advise “the lady with the yellow scarf on the third row” should be referred to in a gender-neutral way.
The guidance also covers telephone interactions, warning staff not to assume a caller’s gender based on their voice—as transgender individuals may have higher or lower-pitched voices than expected.
Staff are told it is inappropriate to refer to someone as “sir” if their records indicate otherwise. The bespoke training programme, delivered by the charity Birmingham LGBT, is offered to all 5,300 employees across 40 sites, though participation is voluntary.
The trust emphasized that it is “a values-based, inclusive organisation” that prioritizes person-centred care and asserts that correctly using pronouns
is a simple but powerful way to affirm identity, build trust and create safe environments for transgender staff and patients.
Fiona McAnena, director of campaigns at the charity Sex Matters condemned the new guidance, saying
something has gone very wrong when an NHS trust is directing staff to use robotic, impersonal language just to avoid terms such as ‘sir’ and ‘madam’.
Separately in south London, nurse Jennifer Melle of Epsom and St Helier NHS Trust was reinstated following an internal disciplinary review. Melle had been suspended after a dispute with a transgender patient—and convicted paedophile—who reportedly racially abused her after she addressed him as “Mr.” Due to her Christian beliefs, Melle explained she could not use female pronouns for the patient but could call him by his name. The disciplinary hearing cleared her of further action, and she has returned to her clinical duties.
