FAQs: transphobia position statement

Frequently asked questions about the CSP's position statement on transphobia

Why is the CSP taking a position on trans rights?

We stand for human rights and against all forms of discrimination and hatred. CSP members treat trans patients, work with trans colleagues, and some CSP members and staff are trans. Transphobia in the workplace and within healthcare is damaging and destructive for transgender and non-binary people. Like any form of discrimination, it is a barrier to the culture of safety needed to progress physiotherapy in an equitable, diverse and inclusive way. 

Why has this taken the CSP so long to publish a statement on transphobia?

The CSP has long had a declared position of opposing transphobia, but unlike other forms of discrimination there is no legal or consensus definition of transphobia. So we had to go through a process to develop our position. This has taken longer than it should have, for which we apologise. We know this has caused hurt and suspicion among some members and we are sorry for this. We will take the learning from this to inform future work on equity, diversity and belonging.

What action is the CSP actually going to take?

  1. We will encourage the development of safe spaces for education around transgender issues.

  2. We will provide advice for members on protection at work for transgender people.

  3. We will provide guidance on treating transgender patients to ensure appropriate and fair treatment.

  4. We will inform members about transphobia through our member campaign on equity, diversity and belonging.

  5. We will challenge transphobia within healthcare.

  6. We will show allyship by challenging transphobia outside the profession.

  7. We will not allow transphobic comments to be published on the CSP website, on iCSP, in our e-bulletins or in Frontline.

  8. We will produce an operational plan showing the timescales for delivering these commitments and who is responsible for the delivery of each commitment.

Who will monitor performance against the plan?

The CSP equity, diversity and belonging committee and Council are responsible for assuring that EDB commitments are being met. The EDB committee will actively monitor progress.

What will we do if transphobic comments are posted about CSP news stories or posted on iCSP?

We are committed to preventing our channels being used to spread transphobia. We do not monitor posts in real time but will remove or edit comments that do not conform to the position statement as soon as we can. If you have concerns about anything you see on our channels, please contact enquiries@csp.org.uk as soon as possible.

Is the CSP saying CSP members are transphobic?

We are not accusing all the profession of personal bias but we recognise there is systematic discrimination in society, which will also be reflected in the profession, and also instances of individual discrimination as attested to by trans members who shared their experiences with us.

Will the CSP take disciplinary action against transphobic members?

We would expect members to respect the position set out, but the CSP is not the regulator of physiotherapy. It is for the HCPC to judge complaints about the professional conduct of physios. Their requirements of registrants have been strengthened in relation to equalities and are cited in the statement.

As the statement makes clear, the CSP is updating our voluntary professional code and this statement will inform that work.

Where does the CSP stand on sex?

The statement is about transphobia and trans rights and does not refer to sex, sexism or misogyny. We oppose sexism and misogyny alongside transphobia and all other forms of discrimination. 

The CSP equity, diversity and belonging glossary sets out the following definition of sex which is unaffected by the statement: sex is a biological scientific fact determined at the point of conception, based on genetic, hormonal and biological factors that influence how an organism reproduces. In most species it is divided into male and female. It is not a perspective, approach, belief, political position or paradigm.

What does the CSP think about trans athletes?

Trans people should not be excluded from any walk of life simply because they are trans. However, we are not experts on the sporting safety or other issues which may apply in individual sports, so will not be taking a view on the ways different governing bodies approach the inclusion of trans athletes.

What legislation has been used to inform this statement?

The legislation used to inform this statement is the Equality Act 2010.

Who has the statement been written by?

The statement has been co-created by members of the CSP LGBTQIA+ community, equity, diversity and belonging committee, Council members and CSP staff. CSP Council are elected CSP members and the equity, diversity and belonging committee members are appointed by CSP Council.

How were women involved in developing this statement?

The statement was developed through co-production between the CSP LGBTQIA+ network, the equity, diversity and belonging committee and Council, informed by CSP staff. We do not have a separate women’s network as the majority of our members are women and this is reflected in the make-up of both the committee and Council. Briefing for both bodies, and submissions made to the committee, have raised that women members have different perspectives on this issue.

How were transgender people involved in developing the statement?

The statement was developed through co-production between the CSP LGBTQIA+ network, the equity, diversity and belonging committee and Council, informed by CSP staff. The committee heard lived experience testimony as part of their deliberations and the members of the LGBTQIA+ network were directly involved in developing the statement.

What resources can I use to find out more about trans issues in physiotherapy?

Am I legally protected if I express my gender critical beliefs in public?

This is a complex area of law where the protection you have will depend on the specific circumstances you find yourself in. What you say, and where and how you say it, can all be relevant. It is likely to depend on what you do, and how this impacts on the legal rights of others.

As a trade union, we can advise members confidentially on your rights under employment law.

Employment Tribunals have accepted that gender critical beliefs can fall under the protective provisions of the Equality Act 2010. However, behaviour, rather than your beliefs, may not be protected.

Employment Tribunal judgments relating to belief are often nuanced, so care should be taken in relying on the reported outcomes of cases.

It is also important to remember that Employment Tribunal judgments do not set precedents. Another court (including another Employment Tribunal) is not obliged to follow an Employment Tribunal judgment.

What does the CSP think about the Cass review?

The Cass review looks at issues of clinical governance and practice in relation to highly specialist services for young people. It should not be used to question the legitimacy of transgender identities, adult transitioning or gender reassignment because that was never the focus of the report.

The CSP notes the Cass review as it highlights important issues in the complex area of gender identity in young people. It reflects many of the topics we see as important in physiotherapy such as access to services, workforce skills and development, evidence-based care, and holistic, personalised approaches to patient management.

This is a complex and difficult area to discuss and, as the report highlights, remains a topic with conflicting views, particularly regarding clinical approach. As an evidence-based profession, the CSP would support the notion of improving care for young people in this area by improving the ability for research to be carried out and joining up paediatric and adult gender services. Ensuring that every child is assessed in a holistic manner, with consideration of all contributing factors, is also something important to physiotherapy. We must apply holistic, personalised care to all the patients we interact with.

As the report rightly states, behind each one of the headlines we see, there are real children and families. There are conflicting views in this space and, first and foremost, we should approach any discussions or clinical interactions with kindness and compassion. The CSP guidance for clinicians when interacting with trans patients will be out later this year to offer support for members in this area, albeit for the adult population.

Can trans women be excluded from women-only physio services?

The CSP position is that all health services should be trans inclusive.

Under the Equality Act 2010 there are some grounds for providing women-only services. However:

  • It is unlikely to be lawful to exclude trans women from these services if they have legally changed their sex by obtaining a Gender Recognition Certificate.
  • While there are some limited exceptions, it will not normally be lawful to discriminate against someone based on the protected characteristic of gender reassignment. As soon as someone is clear in their intention to permanently change the gender in which they live, they have the protected characteristic of gender reassignment.

Does the criminal law protect people from transphobic abuse online?

Note: this is provided as general information and not specific legal advice. Details of how to access legal advice as a CSP member can be found on our legal services page.

How the criminal law sees transphobic abuse depends on multiple factor including the specific circumstances, where you are in the UK, and the willingness of the local police and prosecutors to take up cases. Some of the legislation which may be relevant includes:

Malicious Communications Act 1988 and the Malicious Communications (Northern Ireland) Order 1988

These apply respectively in England and Wales, and in Northern Ireland.

An offence may be committed where a message is sent to someone, or posted on a network, that is indecent, grossly offensive, obscene, threatening or menacing.

Harassment Act 1997

This only applies in England and Wales.

Where there are at least two examples of content that causes alarm or distress, this may constitute the offence of harassment.

Protection from Harassment (Northern Ireland) Order 1997

This only applies in Northern Ireland.

The order forbids someone from taking two or more actions that harass someone or which they know or ought to know amounts to harassment of the other.

Hate Crime and Public Order (Scotland) Act 2021

This only applies in Scotland.

Under the Act, it is an offence to communicate in a way that a reasonable person would consider to be threatening or abusive where that abuse is based on the victim’s transgender identity or other prescribed characteristics.

This does not necessarily make comments or actions that someone considers transphobic illegal in Scotland. Behaviour or material that is critical of matters relating to transgender identity are not automatically regarded as hateful even if they offend, shock or disturb others. 

Does the CSP recognise trans lesbianism?

The CSP recognises the unique journey, history and identity of all lesbians.

Transgender people have the same range of sexual orientations as cisgender* people, and there are many trans lesbians and gay trans men.

* Cisgender means someone whose gender identity is the same as the sex they were assigned at birth. Non-trans is also used by some people.

Who is the CSP working with to produce guidance on treating transgender patients?

The CSP professional committee set up a working group that consisted of members from:

The group conducted a literature search via the CSP e-library service team, extensive research of other guidance in existence and also conducted focus groups with transgender people with lived experience of accessing healthcare.

The next step is for this guidance to be reviewed by the CSP professional committee followed by ratification by CSP Council.

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