Mel Carron after giving an IDAHOBIT talk. L to R is Jodie Geissler (CEO), Mel Carron, Bronwyn Simpson (Diversity and Inclusion Manager). Photo: Austin Health
Enrolled nurse Mel Carron has worked at Austin Health for three decades. Mel has always been incredibly proud to be an Austin Nurse – except in one respect: ‘in this respect, there was nothing to be proud of,’ Mel says. ‘We were hurting our staff. We were hurting our patients.’
Mel, who is trans non-binary and whose pronouns are they/them, is talking about Austin’s historical approach to inclusive cultural safety for members of the LGBTIQA+ community.
Historical, because Austin has recently begun making positive steps at actively addressing its past systemic failings. The Austin Health Rainbow Health Working Group has been formed to address and champion the specific health needs and experiences of the LGBTIQA+ community. Significantly, it’s much more than just a box-ticking exercise, Mel says.
It is personal
Most of Mel’s colleagues at Austin try to be inclusive. ‘By and large, the staff at Austin are amazing and really do try their best. But good intentions among the staff are not enough – particularly at Austin Health where we have a gender clinic, so there is an expectation in the community that we are already an inclusive health service.’
Staff need to become allies, but that can only happen with education and support, Mel notes. ‘Allies are so important. To be an ally you need to listen, learn, think, pay attention to [our] experiences and take them on board. But also realise that you can be the best ally in the world, and still not have a true understanding.’
By way of example, Mel shares an anecdote: ‘Hospitals are now routinely asking patients their pronouns on admission. Not too long ago, when I asked a new patient their pronouns that patient became verbally abusive and aggressive, to the point that a code grey was called. The speed of the escalation was really frightening.’
Continuing, they explain: ‘As a nurse with someone screaming abuse at you, you’re thinking: is this going to become physical aggression? So, there’s that level of fear. But as a trans person, I was also experiencing transphobia. Now I’m usually the cool cucumber in aggression situations, but I was very shaken and distressed after that event.
‘It was transphobic aggression, and I am transgender; that was personal.’
‘My colleagues tried to reassure me, and the line a couple of them used was: “It isn’t personal.” Which is what we often say, because it’s not. But in this case it was transphobic aggression, and I am transgender; that was personal. The patient’s vitriol was aimed at all trans people, and that’s my community; that is me.’
Interestingly, the current reporting mechanisms don’t easily capture specific triggers to OVA incidents, such as transphobia, homophobia, racism or misogyny. This has resulted in a collaboration between Austin Health and ANMF to explore ways this could be improved, not just within the Austin but hopefully statewide.
Sharing another example, Mel recalls a trans man on their ward who was out and proud. And pregnant. ‘That was fairly challenging for some of the staff,’ they explain. ‘They got his pronouns right in the room. But they’d step out of the room to the desk – which was within earshot of the patient – and would promptly call him “she”. I hope the patient never heard that, but I suspect he did.’
Mel notes that misgendering trans people can been described as death by a thousand paper cuts. ‘I think it’s hard for cisgender people to get their heads around, because they’ve never doubted their gender. And no one else has ever doubted their gender. It’s just so innate to them that it’s nigh impossible to imagine any other existence or experience.
‘But when you’ve come through life knowing that the gender you were assigned at birth doesn’t fit, and you have fought so hard for so long to finally find the missing key to who you are, to then have that denied every day, through misgendering, is beyond heartbreaking.’
Using they/them pronouns can be difficult for people to adjust to, Mel notes. ‘It takes a lot of support and education on how to use different pronouns and the importance of it (not to mention, all the other aspects of gender diverse lives!)’. But since they transitioned five years ago, they have been misgendered pretty much every shift – ‘none of it intentional but hurtful all the same.’
Systemic issues need systemic solutions
Such missteps are rarely the fault of individuals, Mel notes. ‘What we’re looking at are systemic issues: the hospital as a health network had a responsibility it was not living up to. Back when I transitioned, it wasn’t in a place to be able to live up to it. The only education that was provided was a single session I manage to organise, but transition support in the workplace is certainly not meant to be DIY! So, it’s been wonderful to watch the journey in my workplace, where it is now seriously addressing these, and many other issues.’
Around the time that Mel transitioned, Austin was only doing the ‘easy tick-box exercises’ such as supplying rainbow badges for staff to wear. But ‘you can’t have staff with badges on if they don’t understand what those badges mean, and how to actually practice inclusiveness meaningfully. Because what can happen – and I have seen it happen – is a nurse wearing a pride badge who then says something uneducated, and likely hurtful.’
They add that ‘to create an expectation of inclusiveness and then not follow through is infinitely worse.’
This lack of meaningful inclusiveness also affects our patient care, Mel explains. ‘Trans and gender diverse folk are highly likely to have had poor interactions in the healthcare setting. Many have experienced significant trauma whilst in our care. So much so, they are reluctant to seek out timely health care with the consequent negative impacts to their health. For public health services, that should be deeply concerning.’
What Austin didn’t have at the time that Mel transitioned were policies, guidelines, protocols. They had no education. But with a change in upper management came a commitment to cultural change.
‘They formed the rainbow Rainbow Health Working Group to look at inclusive practice for queer folk at Austin,’ Mel says. ‘I am involved because I have lived experience as a queer person and as a nurse at the bedside….and it is my passion!’
Mel Carron. Photo: supplied
It’s healing
The working group is still in the early days but has already proved its worth to Mel and their queer peers. ‘For me, even just to see it happen is a dream come true. But to be part of that group is transformative because five years ago, I had no voice. So, to come into this group that is so passionate, so committed and so respectful, and to finally feel like I have a voice that is heard is inspiring but more importantly it’s healing.’
The ultimate goal of this group is for Austin Health to achieve rainbow tick accreditation. It’ll be ‘a hell of a lot of work’ but Mel is quietly positive. ‘I hope I’m not being overly optimistic,’ they say. ‘But if we do, I think it’s going to transform the care at the Austin.’
Further to their passion for improving LGBTIQA+ inclusive practice, Mel has been involved in the formation of an ANMF LGBTIQA+ Reference Group. ‘It has taken longer than we hoped to get off the ground but we are now launching on 29 October, with our first meeting.’ The aim is to be a ‘supportive, dynamic, activist environment for people to come together, share their experiences, and then start to drive change for staff and patients.
‘If this is something that interests you, please get in touch, we’d love to welcome you on board!’
Resources
TransHub: transhub.org.au
Transgender Victoria: tgv.org.au
Rainbow Mob: vaccho.org.au/rainbowmob
Minus 18: minus18.org.au
Interlink: ilink.net.au
Equality Australia: equalityaustralia.org.au
If you or a patient need support:
Switchboard Victoria: switchboard.org.au
