"Pre-operative assessment questions - trans people"

I recently attended a pre-operative assessment appointment at Raigmore Hospital in Inverness, ahead of upcoming orthopaedic surgery on my foot at the National Treatment Centre in Inverness in July. I had the same operation on the other foot in July last year, so I do have a fairly clear idea of what to expect this time round.

During the assessment appointment I was asked to complete a list of yes/no questions about what I can and can't manage to do. I don't remember anything quite the same at the corresponding appointment last year. It is possible that I was asked some of the questions last time, but it certainly wasn't in the same format and some of the questions seemed new to me. What made it stand out as different from before was that the sheet was given to me in stiff laminated plastic, along with a red marker pen, with which I was expected to tick the appropriate box for each question.

Most of the questions seemed fairly harmless (if a little uncomfortably reminiscent of DWP work capability assessments), like whether I could cook for myself, walk a certain distance, do the washing, etc. And for those the yes/no format wasn't particularly a problem. But for some of the other questions I was surprised that there was only the binary yes/no choice. No option to tick that it did not apply. Trivial example: my house doesn't have stairs and I rarely ever find myself going anywhere where I am called on to go up steps or stairs, so I'm never really gauging my performance in that regard.

Then there was a question about participation in active sports, where my situation was that I would avoid such activity not because I am incapable, but rather on grounds of caution, to avoid the risk of injury because of my particular inherited medical history.

But the question that I found most difficult to know how to respond to in the yes/no fashion was one that was asking if I was able to participate in sexual activity. Laying aside the thought of what that might have to do with my fitness for an operation on my foot, as someone who has undergone various forms of NHS gender identity healthcare treatments, this is simply not a question that can be answered in such a simplistic binary manner. In the moment, I rather stumbled and hesitated aloud, going as far as to suggest that a question like that really did call for a bit more nuance, or at the very least a n/a or unwilling to say option box to tick.

By that time, on my particular list, I had ticks for yes against every other one of the long list of boxes, apart from the sports one, where I had felt that I ought to err towards the caution of avoiding injury and so had ticked no. When I drew attention to my doubts about the sex question, I still got the impression that I was expected to complete every single question, so in the end I chose to tick no for that one too. But in the case of someone like me, no one could possibly draw any useful inference one way or the other, whichever box I had chosen to tick for that question. And, given the sensitivity of question like that, and the many people who for personal, cultural or whatever other reason might be hesitant about giving an answer, it seems to me that there should be a prefer not to answer box, or the nurse should be ready to make it clearer that not every box needs to be ticked.

As a trans person, you do get used to occasional situations of this kind where you don't fit the usual pigeon holes. Some trans people will confidently and/or defiantly tick a male or female box when those are the only two choices offered. Others will hesitate, wishing that there was a "prefer to describe myself" option. And  for any non-binary person, of course, that male/female choice erases the validity of their identity entirely. Similarly diversity questioning that asks gay, lesbian or heterosexual, is using labels that become ambiguous at best when applied to trans, non-binary or other non-straight, self-identifying individuals.

I suppose it is an example of how we can all benefit at times from pausing and taking a step back to reflect on what we are asking. It may seem straightforward and obvious when viewed through the lens of our own, particular life and experience. But, walk in the other person's shoes, who maybe sees and experiences the world in a profoundly different way, and that simple, straightforward question may represent a major hurdle to be overcome.