Trans-Identifying Men in Aged Care and Community Care – *Ruth

Are transgender rights impinging on those of biological women?


From Luke’s Journal May 2023  |  Vol.28 No.2  |  Unity in Diversity 

The Luke’s Journal editorial team is aware that this article has political implications and that, since publication, legislation may have changed nationally or in your state of residence and practice. Luke’s Journal advises that you contact your State chair if you have any questions or concerns regarding implications for your clinical practice.

Full of Questions

Matrena revels in the day’s weather. Although autumn, the air’s still warm and sweet. White, blinding sunlight assaults her blinking eye. Blazing rays threaten her fair skin with blistering sunburn.

That’s the way I like it, she thinks.

She scans the crowd around her.

I’ve heard most of the people attending this rally identify as feminist lesbians, she thinks. I’ve heard the organiser aligns with Atheism, and that some here favour Communism.

I’m a heterosexual Christian, born into a decade where women had every single right a man had. My Russian grandparents left Eastern Europe for Australia, deeply traumatised by its Communist violence and totalitarian oppression, so that’s not a group I’ve had much experience associating with.

Matrena places her hands on her tummy, then rubs it.

Surprising. I feel calm. I’m not renowned for eloquence and not famous for bravery. Why do I feel so at peace while waiting my turn at speaking?

Although I do have some questions:

  • How will my speech unfoldwith my voice trembling and my body shaking like when public speaking  back in school?
  • Will I even get an opportunity to speak at all? Most of my prior attempts at making this issue public have met with resistance.
  • Will the crowd stop me from speaking about God – I mean, how much free speech can they really handle?
  • And will anyone recognise me from my efforts when campaigning on the ‘No’ side of Australia’s homosexual plebiscite, although that’s a few years ago now?

Matrena’s mind mulls over these thoughts. Then the rally organiser places the microphone in her hand, sending the previously asleep butterflies in her stomach soaring.

Many Voices

Kellie-Jay Keen, a UK women’s rights advocate, recently hosted several free speech rallies throughout Australia during our observance of International Women’s Day. The rallies gave men and women the opportunity to voice their concerns about how the growing rights of transgender people impinges on the rights of biological women.

The speakers and audience came from diverse political persuasions, sexual orientations, cultural backgrounds, religious beliefs, personality types and age brackets. However, they were all united in the belief that only people born female truly are female.

Fetishes in the Workplace

I work in aged care and am grateful to have the opportunity to share my experiences of trans-identifying people in nursing home facilities and in community care.

Aged care workers must dress men in women’s clothing, including women’s underwear and make-up. If we don’t, we could lose our jobs. That’s despite knowing that some people experience transvestism, a paraphilia where dressing as a woman sexually arouses the man concerned.1 It may also be a fetish (using an insensate object to achieve sexual pleasure2).

I have a few stories I could share, but I will limit myself to one:

While working in community care, I dressed a transgender man’s wound at his home. I was always sent alone. The wound was on his back, right where your shirt and pants meet, but he was always more naked than necessary.

“Some trans widows say their transgender partners have a gleam in their eye when they cross-dress. I also noticed that gleam in this man’s eyes.”

When I arrived at his house, he was always wearing just a dressing gown, and the dressing gown was always open at the front. Because I had to pull his gown sideways to access the wound, his backside became exposed and also his vagina, when they didn’t need to be. It was obvious he enjoyed having me see his surgically altered genitals. Some trans widows say their transgender partners have a gleam in their eye when they cross-dress.3 I noticed a similar gleam in this man’s eyes. 

That particular patient had awards in his house for women’s sports competitions that he had won. He would point them out and emphasise that they were women’s events. He would say, “I won this in a women’s sports competition. It was a women’s sports competition.” Then, he would laugh silently. Because of this, I gathered that he knew full well that he was a man and he cross-dressed to cause women distress.

I have seen him at the shops. He is aged in his fifties but wore very short skirts. Young women often wear short skirts, but older women have usually outgrown that. When he dressed like this in public, he appeared elated, but the parent he was with appeared very embarrassed. I thought it sad he didn’t care if his family were embarrassed, although I noticed some family members found his behaviour amusing.

Closed Ears

I called a discrimination/human rights organisation asking if there’s a way I can avoid dressing trans-identifying men in women’s clothing. They said they couldn’t help me and gave me the number to another organisation who gave me the number to another organisation until I received the number for the first organisation. I’m quite sure one of those organisations put me on fake hold while they pretended to be reviewing what could be done about my situation.

I sent an email to a nurses union about the situation asking if I joined their union, could they help me with this situation? They said they couldn’t give me an answer until I had joined. So, I paid the couple of hundred dollars joining fee, then they said they couldn’t help me. When my membership renewal came up the next year, I ticked that I didn’t want to renew my membership. They sent me a perky email asking me why, and if they could improve their service in any way. I told them I wasn’t renewing because they hadn’t helped me with my transgender problem. They sent a short reply saying, “Okay, don’t worry about renewing with us”. 

“I told them I wasn’t renewing because they hadn’t helped me with my transgender problem. They sent a short reply saying, “Okay, don’t worry about renewing with us.””

At my state’s election, the Labour politician was handing out how-to-vote cards. I told him my problem and that I feared losing my job if I refused to dress trans-identifying men in female underwear and make-up. He said I would not lose my job and to talk to my employer about it. It’s clear, however, that people have lost their jobs, been cancelled and had derogatory things written about them when they have opposed LGBTQ issues. A human rights organisation told me it’s still illegal to fire someone for their religious or political beliefs and that those people would have received their jobs back again. Even if that’s true, those people still went through the sacking process and now work in an environment that mustn’t feel very welcoming.

No Support

I emailed a federal politician. He passed my email onto another federal politician who passed it on to the department of health. His reply said, “Your discomfort is due to the fact that you have had little to do with diverse gender identities. Transgender people are entitled to high-quality health care and by law, you have to give it to this person. It must be respectful, kind and caring and valued.” (emphasis mine)

The email I sent had a link to an article written by an academic at an American University called ‘Transvestism (Transvestic disorder).’ This article respectfully states that transvestism often has a sexual component, women are often coerced into the trans person’s behaviour and this hurts the women involved.1 In response to this article, I was told, “Transvestite is an outdated and derogatory term,” so I shouldn’t have used it. The response said:  “Older people grew up in a time when they had limited choices for gender expression outside the male/female gender binary. They knew if they didn’t, they could be imprisoned or undergo attempted ‘cures’. Repression of gender diversity was one of the few safe options for personal safety.

Living out gender diversity late in life can be a liberation for older trans and gender diverse people. The late-life changes may also result in restrictions to gender expression by family members and service providers who hold binary views of gender and members of society who have difficulty adjusting to such changes.

You are encouraged to consider participating in diversity training that your agency provides and imagine how you would like to be treated if you were in a similar situation. Thank you for writing on this matter. I hope this letter provides food for thought.” 

With other politicians and organisations, I have tried to remove myself from this situation on religious grounds. In response, I was sent a copy of an anti-discrimination law and told I must:  

“Act with respect for individual rights to freedom of expression, self-determination and decision-making in accordance with relevant laws and conventions.” 

I also contacted a number of conservative right-wing groups, politicians, political commentators and activists who agreed my situation is wrong but haven’t done anything about it. They haven’t written anything about it, not even a Facebook post.

They believe, as I do, that we can’t leave transgender people to ‘die in their own blood’ (my words). Of course, we must give transgender people high-quality health care and treat them with care, kindness and respect. However, I have read trans-widow stories, and it doesn’t sound like trans-identifying men treat their wives and children with care, kindness and respect.3 It needs to be a two-way street.

A Plea to Find a Solution

In my experience as a personal care worker in healthcare, I’ve seen many different situations:

  • Sometimes female patients refuse to be showered by male carers/nurses because they find that embarrassing.
  • Some male nurses ask female nurses to insert urinary catheters into their female patient’s vaginas because getting urinary catheters into the correct position is difficult and often requires multiple attempts. These multiple attempts can be mistaken for molestation, so some male nurses refuse to insert urinary catheters into women.
  • Some male gynaecologists ask female nurses to be present when examining their patients because it’s a situation that can be misread.
  • Once, a married, male patient was making sleazy comments to me. I asked a male nurse to shower this man for me because I felt uncomfortable with that kind of behaviour at work, especially if the man is married.

If patients and healthcare workers can opt out of these situations when they can find someone else to do it for them, why can’t I opt out of participating in trans-identifying men’s fetishes? Or, at the very least, opt out of dressing them alone?

Healthcare workers are paid to care for the unwell. If we must now participate in men’s fetishes during work hours for pay, doesn’t that make us glorified prostitutes? It was wonderful to see so many people from many backgrounds at the free speech rallies who agreed this situation is wrong. I hope other health care workers will speak out about this situation and help find a solution.

*Ruth (Name changed to protect privacy)
Ruth is an aged care worker with thirteen years’ experience in aged care and three years in community. She has won numerous sporting awards. Ruth has a strong concern for the safety of her fellow aged care and community co-workers and for the preservation of female sports, for both its emotional and physical benefits. 


Would you like to contribute content to Luke’s Journal?  Find out more…


  1. Brown, G.R. Transvestic disorder. MSD Manual [Internet]. 2019 July [cited 2023 March 12]; Available from:
  2. Brown, G.R. Fetishism. MSD Manual [Internet]. 2022 September [cited 2023 March 12]; Available from: