Equality is an act, diversity is a fact, inclusion is a need

March 2015: It was on a Thursday, when everyone’s calendar was blocked from 13.00 onwards. 

We were all invited and given the opportunity to attend a training course. 

“Trans-something awareness” 

What is this....?

Neither I nor my colleagues, doctors, nurses, advisers, technicians, administrators had any clue what that was about. Every kind of training activity is more than welcome of course. Who would say no to some free CPD, enriching our CPD portfolio for each one’s annual appraisal? No one.

During that training, I think it was the first time I came across of the gaps and the confusion I had in my mind regarding the definitions gender-sex- sexuality, gender reassignment, self-identification, transition etc. And with the help of the lovely gentleman, who was carrying the training, everything rolled smoothly and everything became clear regarding these topics. This particular training was very interactive and hands-on, with team workshops and a lot of Q&A sessions. All of us agreed that we only benefited from this training.

Few weeks afterwards, I was discussing with some friends, medical professionals, yet, non-OH ones, explaining how helpful and most importantly, eye-opening this training was. I was really shocked by their reactions to the training, their assumptions regarding the messages that, according to them, it was conveying and the stigma that they were putting on the individuals with this characteristic. Their conclusion in short: trans= abnormal. As there was no communication channel, it was pointless to be involved in a conversation with people (medical professionals unfortunately), who were hostages of their own beliefs and prejudice.

 About two years after my initial training, on a packed with periodic medicals day, a 39-year-old man attended his appointment for his routine periodic medical examination. Our nurses had finished the usual screening tests when he ended up to my consultation room for the final examination/assessment.

Reserved but cooperative he responded to all my questions. However, there was an undefined discomfort; in the way he was sitting, speaking, even breathing. Inevitably, I needed to ask him to make sure that he was in position to continue.

-       Are you OK Sir?  Is there anything that you would like to ask me, tell me or add?

It took a few seconds for him to respond, as if he was preparing me for the surprise that would follow:

-       Let’s hope you will not ask me to show you my genitals (pause) as the previous doctor, whom I saw in this office, did.

As a person and doctor, I can hardly recall any occasion that caught me off guard/unprepared. Or, having dealt with a breadth of medical emergencies as a clinician, I thought I was in position to handle everything. In this occasion though, it took 2-3 seconds to process his reaction. Having read all the notes, previous OH reports, specialists reports and management referrals, I was fully aware that I was dealing with a transman. And, obviously, this was not what shocked me nor what surprised me. 

The 2-3-second delay in my response was attributed to my shock: I could not digest how a medical professional would ask a patient/employee to do the above-mentioned. Especially an OH qualified medical professional. Since all the medical evidence were there (fully detailed signed specialists’ reports), I could not figure out the reason why the employee needed to be brought to this position. I have not still managed to give a satisfactory and acceptable answer to this question.

We (doctors I mean, but not only, taking into consideration the diverse and inclusive environments that most professionals work in nowadays) are trained to treat people with respect and in line with the medical ideology and ethics. I would have done so, even if I had not been a medical professional, even if this gentleman did not have a protected characteristic, even if he had not disclosed anything to Occupational Health. But he had. He had kept us fully informed, the business and his line manager as well, who by the way was fully supportive, let alone, he had commented repeatedly that this employee had historically been a top performer.

When I started speaking to him, it took less than two minutes to calm him down and make him feel more comfortable and relieved, as I explained that my approach was different of the one of the previous doctor, as well as informing him that I had undergone the relevant training for tackling with these cases in the workplace. Within 5 minutes he invited me even to his wedding that was about to take place a few weeks afterwards. By the moment he left the clinic his trust had already been restored. The same applied to his line manager, who thanked all the OH team for positive experience of the employee.

When we discussed the topic “mental health” I needed to deal with a second shock: bullying by his colleagues because of his protected characteristic.

Although his manager and the business were fully supportive and understanding, he was telling me how hard it had been for him and his manager to tackle with the bullying stemming from some of his colleagues. 

(Mental health, bullying and harassment in the workplace and stigma are 3 topics that give ground for endless analysis.) Fortunately, his manager was very proactive and had arranged the rosters accordingly so that the employee would not be under any work-related stress. He had even taken into account with whom he would be working in each shift.

Credits to the manager, who liaised and agreed with the employee directly regarding the adjustments that would help the employee best. The manager was even considerate and proactive in the way that he had informed occupational health regarding the adjustments he had in mind (everything was recorded) but he preferred not to send the employee for another potentially “traumatic” experience/assessment.

I can only be proud of how we (as OH unit, business, I as a doctor, employee and manager) dealt with this case and how it finally evolved because: 1) this employee changed his mind and opinion about Occupational Health following our consultation, 2) we gained the trust again of both employee and manager 3)we proved that equality, diversity and inclusion are integral part of the duty of care.

This challenging case is one amongst hundrends or even millions. 

It reveals how immature we are as humans, societies and professionals. Respecting the others’ uniqueneness, protected characteristic and/or disability is not a matter of discretion nor whether these people are acceptable by us and our beliefs. In fact, nobody should ask for nobody’s permission or acceptance.

The existence and only of “stigma” in social structures globally, is a shame for the human race. 

Our role is not that one of the judges. 

All of us, but especially businesses and professionals must upgrade our “mental software” to the needs and requirements that 2022 (almost there) sets out. This means constant training and open-minded approach is not bad. On the contrary, it is a must. 

Support should not be limited to words. It is complete and substantial, when it is followed by actions.

👍 on the topic training: I completed 2 legal courses recently, both of which included in depth analysis of equality, diversity & inclusion and guidance from the legal viewpoint on how our approach should be framed as OH professionals.

- The final part of the first one (about three weeks ago) happened to be in an online simulation of a tribunal. And, as background for my zoom training, I could not pick a better one than my window direct view to the European Court of Justice in Luxembourg.

- The second one (about two weeks ago) was also online. This time I was in London. Yet, the best background would have been direct view to the European Court for Human Rights in Strasbourg. 

👍 at least 6 Christmas cards have already arrived, all from people who are so “special” and from different places of Europe (& other continents as well) each. And I can only be happy for that.

Indeed,

Equality is an Act

Diversity is a Fact

Inclusion is a Need