Stonewall: Letter to Nursing and Midwifery Council

This letter is now closed to signatories. A copy will be sent to the CEO of the Nursing and Midwifery Council and the 4 UK Chief Nurses.

We will share their responses.

Please click here for our full analysis.

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If you are a current, former or retired NMC registrant or pre-registration student, please read the full text of the letter below and consider adding your name by clicking on this link.

The letter will remain open for signatures until 23.59 on Wednesday 22nd December 2021.

Woman’s Place UK will then send, in confidence, the signed letter to the NMC and the four Chief Nurses.

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Text of Letter

Opinion polls consistently rank nursing as the most trusted profession in the UK. We are governed by our Code of professional standards. Our Code, regulated by the Nursing and Midwifery Council (NMC), rightly demands high standards of practice and behaviour including; respect, dignity, kindness, safeguarding, evidence based practice, clear communication, and to uphold the law and rights of patients. We are to be a model of integrity and leadership for others to aspire to. Our Code sets the standards that patients and the public rightly expect of all nurses, at all times.

Nursing affiliations and impact on policy must be in keeping with our Code and standards. Where affiliations and practice fall short, nurses have a professional duty to raise concerns and prevent reputational damage. The history of Stonewall to promote equality and safeguard the rights of the LGBT community is one to celebrate. However, nursing affiliations must be based on evidence not ideology and judged on current record and strategy, not legacy achievements and reputation.

We believe that as a profession, there is specific risk to the reputation of nurses and our ability to work within our Code from the NMC’s affiliation with Stonewall. We outline our concerns as nurses who love and care deeply about our profession and patients. Please read the full analysis of our concerns with supporting evidence here.

In summary, our six main areas of concern are:

1. Medical care of children and young people

Stonewall supports the experimental and un-evidenced medicalisation of children and young people who present with gender dysphoria, many of whom have co-morbidities and/or co-traumas and likely to grow up to be lesbian or gay adults. Outcomes include reduced bone density, sterility, loss of sexual function and unknown impacts on cognitive development. Stonewall has spoken out against the Bell V’s Tavistock 2020 Judicial Review ruling which raised concerns about the medical interventions offered and the ability of children, including those as young as 12 years old, to provide informed consent. In contrast to Stonewall, we viewed the ruling as a victory for child safeguarding. The subsequent Appeal related primarily to Court jurisdiction and does not counter these concerns. 

2. Misrepresentation of Equality Law

The Equality Act (2010) has 9 protected characteristics; including sex (male or female), gender reassignment and religion/belief (e.g. gender critical philosophical beliefs). It is still lawful to discriminate on grounds of sex, if it is a proportionate means to achieve a legitimate aim. This allows for single-sex spaces, such as hospital wards, refuges and changing rooms for safety, privacy and dignity. Stonewall misrepresents the protected characteristics, for example, sex, and actively undermines provision of single-sex spaces. Stonewall erroneously informs scheme members that access to single-sex spaces is based on ‘gender identity’ and ‘self-ID’. Gender identity is not a concept in law and proposals to introduce self-ID were rejected by the UK Government in 2020 (although still under active consideration by the Scottish Government). Nurses and the NMC are professionally obliged to uphold the law. However, Stonewall evaluates and ranks the NMC as part of its Workplace Equality Index, on alignment to Stonewall principles, and not the law.

3. The treatment of women in healthcare settings and application of the Equality Act (2010)

Nurses enact much of hospital accommodation policy. Stonewall’s advocacy for access to single-sex spaces to be based on gender identity instead of sex has led to many NHS accommodation policies which undermine the ability of nurses to work within our Code and advocate for and safeguard women patients. This is exemplified by Stonewall’s NHS ‘best- practice’ which includes placement of males who identify as a woman, with a history of ‘sexual assaults on women’ on female wards, subject to risk assessment. What else would need to be in the risk assessment if a male with a ‘history of sexual assaults on women’ is not, according to Stonewall, by and of itself sufficient for accommodation away from women patients? Stonewall’s ‘best practice’ is, in reality, anathema to our Code.

4. The safety of other vulnerable groups

Stonewall has campaigned for access to women’s refuges, prisons and mental health wards to be based on gender identity instead of sex. Stonewall ignores the needs of these women for single-sex provision, the role of this provision for therapeutic care, the extreme vulnerability of women in refuges, prison and mental health institutions who have already experienced high rates of trauma, including sexual trauma, and the actual risk, including of rape and pregnancy, that Stonewall’s advocacy now introduces to them.

5. Behaviour towards those who speak out on the subject of gender ideology or challenge Stonewall’s influence.

Stonewall is being sued by Allison Bailey, a black lesbian barrister who alleges that Stonewall pressurised her chambers to sanction her for speaking out and defending the rights of women and girls, in particular, lesbians. This case relates to alleged Stonewall instigated occupational bullying which has relevance to the NMC as an occupational/professional regulator advised by Stonewall. The findings of the trial, scheduled for Spring 2022, are also likely to be relevant.

Stonewall implied that a group that campaigns on issues of women’s rights were a ‘hate group’. 88% of nurses and 99% of midwives are women. NMC affiliation with Stonewall undermines the ability of the vast majority of NMC registrants to speak out for our own rights, and more importantly, for all registrants, including male nurses and midwives, to speak out for the rights and needs of women patients, as professionally obliged.

6. Use of inaccurate terminology and reframing of language.

Stonewall advocates scientifically incorrect and ideologically misleading language, for example, sex is ‘assigned at birth’, and this language is now used by the NMC.  If NMC registrants practised as if sex was assigned at birth, for example, in prenatal scanning and diagnosis, determination of sex-related syndromes in-utero or when supporting pregnant women fearful of forced abortion of a female unborn baby, we would fail in our professional duty, risk endangering patients and be liable to be reported to, and sanctioned by, the NMC. Scientific evidence is clear that sex is biologically determined at conception, and observed at or before birth (apart from a very small number of very rare cases). As the regulator of professions underpinned by scientific and biological facts, NMC use of such language and concepts undermines the evidence base that it exhorts registrants to work within. This is a contradictory and confusing stance for the NMC to take, and we believe it to be highly inappropriate.

Stonewall, until recent public scrutiny, advocated for the removal of words such as ‘woman’ and ‘mother’ in order to prevent these words, central to many of our female patients and their interactions with healthcare, to be linked to female biology. Importantly, this undermines clarity of communication, vital for effective healthcare campaigns, for example, in cervical screening, and places women patients at risk.

The NMC requires registrants to always practise in line with the best available evidence and practice; this is key to good, safe care and public protection. We as registrants have a right to expect the same standard from our regulatory body.

The recent activities of Stonewall do not align with the values and standards of our Code and undermine the ability of nurses to work within our Code.

We call upon the NMC to withdraw from Stonewall’s Diversity Champions programme and Workplace Equality Index.

We call upon the four Chief Nurses of the UK to publicly support the withdrawal of NHS bodies and Trusts from Stonewall’s Diversity Champions programme and to commit that all affiliations and policies requiring action or fulfilment by nurses be fully conversant with our Code.

If you are a current or retired NMC registrant, or pre-registration student, you can sign this letter here.

Please click here for our full analysis.

Press Coverage of this letter

Nurses call for exit from Stonewall Diversity Scheme, The Times, December 2021

Nurses urge regulator to pull out of Stonewall diversity scheme, Personnel Today, December 2021

Nurses call on NMC to withdraw from Stonewall’s diversity scheme, Nursing Standard, December 2021

Hundreds of nurses call on regulator to quit Stonewall, Mail Online, December 2021

Scots midwives and nurses sign petition for exit from Stonewall’s Diversity Scheme, Scottish Daily Express December 2021