Nuclear Medicine and the LGBTQ+ Community

The title of this month’s blog may raise a few eyebrows, as many of you may not realise that we in Nuclear Medicine have much of a link with the LGBTQ+ community. But we do. An important part of our job in Nuclear Medicine is to make sure we abide by good radiation protection practices and that we maximise the benefits of radiation exposure to our patients. And that applies to all our patients. This includes those whose gender identity does not fit into what is considered societal norms of ‘male’ and ‘female’. 

When I first started thinking about writing a blog on this subject, I was going to say that you may have an opinion on the subject, but that your opinion really doesn’t matter. I was going to say that what matters is that we don’t irradiate any unborn babies unnecessarily, that we don’t have any babies fed breast milk which may contain radiation, and that we are able to ensure we report our scans accurately, without confusion about unusual uptake arising from the unexpected presence of organs aligned to a patient’s sex at birth. 

However, I’ve changed my mind about that, for a number of reasons. I feel like we are reaching a point in our society where neutrality isn’t an option any more. The brutal murder of Brianna Ghey has deeply upset me, as I’m sure it has many of you. There is an ongoing commentary in some parts of our national media on the Trans community particularly which I find divisive and upsetting. Language is important, and I feel to have our NHS Constitution changed to remove more inclusive wording is wrong. 

We should be providing compassionate care to our patients. To all our patients. We should be striving to be compassionate leaders. And compassion should mean without judgement. It should mean making everyone feel included. It should be about provision of not only the best care, but also support, acceptance and understanding. If we in the caring professions cannot do that, then who will?   

I’m putting my head above the parapet on this. My son is at University, and is part of the LGBTQ+ community. That I was unsure about whether to share this with you, rather than saying instead that he knows many people in the LGBTQ+ community says a lot. I shouldn’t be giving it a second thought. It’s not something to be ashamed of; I am proud of my son. He is smart – currently in his 2nd year of a 4-year Physics Masters. He’s kind, thoughtful, loyal, loving and empathic – and great if you want someone to talk things over with. And more, I’m proud of him for living an unapologetically authentic life. And I’m proud of myself for helping to give him the confidence to do so. Apart from his incredible level of untidiness – it genuinely stresses me out to be in his room – he is a pretty all-round wonderful person.  I honestly think that how someone identifies, what their sexuality is, is an irrelevance. To me it’s just part of the spectrum of what is normal. Of what is human. Everyone sits somewhere on a normal distribution curve, so what does it matter whereabouts that is?

I know at least 4 young people who are Trans. They are all dealing with their own struggles around this, and most of that is not because their peers don’t accept them; however much of it is because of our wider society. But the world is changing, whatever some of the headlines may lead us to believe. Especially with younger people, who are generally so much more open about and accepting of variety and individuality.

I know that if you wear the wrong trainers to school then your life can still be made a misery. In my school days, my parents made me wear polyvelt shoes - do you remember them? My dad once cut my hair (how wonky and short can one fringe get?), and my mum made me have a perm. I was a bridesmaid at her cousin’s wedding. It was BAD. So you can imagine what my secondary school years were like. That hasn’t changed all that much really. I have to buy my youngest expensive Nike Air Force One trainers in black as he was getting bullied for his well-fitting but much less cool Clarkes shoes. 

But in terms of sexuality and gender, my experience is that more younger people do accept that for many, this is more fluid and less rigidly defined. And with around 4.5% of the UK population identifying as Trans or Non-Binary, we will see an increase in people attending our departments to whom this applies as time goes on, and we need to be prepared.

To help with this and to hopefully make a small step towards helping all our patients feel included, the BNMS has written some guidance on how to interact with our patients in an inclusive way. This applies particularly when checking for possibility of pregnancy, or the potential for unexpected uptake of a tracer. It’s not about randomly asking granddad John Smith whether he could be pregnant as soon as he walks into the department. I’m sure none of us would do this. It’s about tactfully finding out for whom further enquiries and conversations are needed. We have already done our first pregnancy test on a non-binary patient in the Nuclear Medicine department here, so there is a need to have a process in place sensitively identify and support those individuals who are transgender or non-binary, as well as those with diversity in their sex characteristics whilst at the same time providing compassionate and respectful care for all patients. 

As you may realise, this is a subject I feel passionately about. I saw Miriam Margolyes on the Graham Norton Show a few weeks ago. There’s something about someone who sounds so proper saying such naughty things which really makes me laugh, but during this interview she was talking earnestly about how she became a Trans ally. She said ‘I was very keen on grammar, and so when people started talking about pronouns, and that they wanted ‘them’, and not ‘he’, ‘she’, I thought, what are they talking about? It’s clear, it’s grammar, the structure of language. But I met a wonderful actress in Australia, and she’s Trans, and she had a discussion with me about it. She said, what does it matter to you? If you can make somebody happy by calling them ‘they’ instead of ‘he’ or ‘she’, why not do it? And I thought, that’s right. It doesn’t matter about grammar. If you can make someone happy and give them a sense of themselves, then do it.’ 

You can probably tell I feel exactly the same. I am a bit nervous about how some may perceive what I’ve written this month, but I strongly feel that, as an ally myself, the time has come to stand up and be counted, especially in light of the BNMS guidance soon to be published. I hope that when it comes out in March, you find the document helpful. And thank you for your support. 

Ms Jilly Croasdale

BNMS President