WPATH 2016 poster: “A time of anticipation”

22/06/2016

Here’s the poster I presented at this year’s WPATH Symposium:

Anticipation poster.png

You can also download a PDF version here.

The magnet is a metaphor for anticipation, which is both a product of and shapes feelings, emotions and experiences of time. This process is mediated by both trans community discourses and medical systems.

It’s very important to note that the majority of research participants had good things to say about the health professionals who helped with their transition. However, there is also a high prevelance of transphobia and cisgenderism within medical systems and clinical pathways. Anxiety and mistrust of practitioners within the trans patient population is endemic, and this is compounded by long waiting times.

My wider research looks critically at how discourses of trans health are differently understood within and between community/support spaces, activist groups and the professional sphere; however, the purpose of this particular poster was communicate some of the difficult experiences that current patients have with waiting. It sparked some productive conversations and I hope that further work will follow from this.

Sources:

Transitional Demands (Jess Bradley and Francis Myerscough)

Experiences of people from , and working with, transgender communities within the NHS – summary of findings, 2013/14 (NHS England)

Current Waiting Times & Patient Population for Gender Identity Services in the UK (UK Trans Info)

 

WPATH 2016: the activist fringe

16/06/2016

I’m currently in Amsterdam for the World Professional Association for Transgender Health (WPATH) biennial symposium. It’ll be the largest such conference that has ever been run, with 800 participants from across the globe. This will hopefully be the first of several posts exploring my experences at the conference (no promises, though!) – and I’m also planning to occasionally livetweet.

WPATH is an international body best known for publishing the Standards of Care, which offer guidance for practitioners supporting patients seeking to transition. The organisation has undergone a great deal of change over the years, reflecting wider shifts in understanding around trans people and our experiences. At present, the organisation’s wide scope incorporates a considerable range of views on how transition should and could be managed.

I’m here partly to present a poster detailing some of my research findings around patient experiences of waiting in the UK. However, as a sociologist with an interest in the evolution and negotiation of discourse and activism around trans health, I’ve been interested to see that at least two fringe conferences have been organised in Amsterdam to coincide with WPATH. I also thought it would be beneficial to share what’s going on with a wider audience – so, here goes!


GATE pre-conference

Global Action for Trans* Equality (GATE) is a loosely-organised international trans rights organisation: a genuinely diverse multinational network of activists with strong representation from the Global South. One of their key priorities has been to campaign for the depathologisation of trans, although members have also been involved in activism around other issues, such as access to care.

Over the past two days GATE held their own conference in Amsterdam to discuss trans health. The event both stood alone as an independent conference, and provided activists with an opportunity to discuss WPATH. I wasn’t able to attend in person, but have heard that a broad consensus was reached on a couple of issues related to the classification of trans in the World Health Organisation’s International Classification of Diseases (ICD).

The current version of the document – ICD-10, published back in 1992 – classifies ‘Gender Identity Disorder’ and ‘Gender Identity Disorder of Childhood’ as mental health issues. These diagnoses are widely used in gender clinics in countries such as the UK (note: these differ from the diagnosis of ‘Gender Dysphoria’ present in the American Psychiatric Association’s DSM). Recent statements from the World Health Organisation indicate that the long-awaited ICD-11 will replace diagnoses of ‘Gender Identity Disorder’ with ‘Gender Incongruence’, and move these to the sexual health section of the document.

Whilst GATE’s long-term goal is depathologisation, at present they have decided to focus upon pushing for this move from classifying trans diagnoses as mental health issues to regarding them as sexual health issues, as a compromise that should ensure continued funding for transition from insurance companies and public health organisations. In addition, they are arguing against the existence of the category ‘Gender Identity Disorder of Childhood’, on the grounds that this is an unnecessary medicalisation of gender diversity in young children, whilst the ‘adult’ category is sufficient to guide medical interventions for adolescents. This perspective feeds into a wider discussion around the category that is also recognised in the WPATH programme, with time set aside for a formal debate.

GATE activists will be attending WPATH to argue these points, and also to advocate more widely for trans-affirming approaches to treatment.
FREE PATHH

FREE PATHH is an event that will take place this Saturday (18th), concurrently with the first day of the WPATH symposium proper (a handful of formal pre-conferences are taking place on Friday). Hosted by Dutch trans activists, it is a free event that anyone can attend. FREE PATHH organisers argue that the high fees for the WPATH event mean that ordinary Dutch trans people are unable to attend this event held in their own country to learn more about their own health. As such, there is little interaction between WPATH and local Dutch trans communities.

The few transgender people who can afford to be present at this important symposium, are exceptions. They can go, because they have to be present for work or because they have enough personal financial means. (FREE PATHH)

As one of those few trans people who can attend the WPATH symposium (in my case, because I was lucky enough to gain a grant in order to do so), I feel this is a really important point. WPATH undoubtedly exists to share information amongst professionals in a formal setting; at the same time, the issues at hand require input from the very people who are directly impacted. With trans people disproportionately likely to be on low incomes, even early career professionals might find themselves effectively frozen out.

The FREE PATHH programme includes talks and workshops in Dutch and English on a range of issues related to trans health, and will be filmed for later disseminaton. At the end of the day, a panel with individuals who have attended both WPATH and FREE PATHH will summarise both events. This should be a valuable opportunity to share insights from both international and Dutch work on trans health, from professional and community perspectives.

You can read the FREE PATHH programme here.

 

Video: (Mis)understanding Transgender Health

12/05/2016

Regular readers (hi!) will have noticed that I’ve not been posting on this blog much at all over the past year or so. Between part-time jobs and my PhD thesis, I’ve been pretty busy – however, I’m nearing the end of thesis writing, so hopefully that might change in the near future. We’ll see!

One thing I’m hoping to do after I hand in the thesis is to talk about my findings in the public domain as much as possible. So, here’s an initial step towards that – a video from the re:publica TEN conference on Internet and society, where I was invited to talk about trans health.

The talk was aimed at a very general audience, many of whom weren’t familiar with trans issues, so there’s an extensive introduction to some of the basics as well as a discussion of one small area of findings and some related studies.

 

Gender recognition: where next?

08/01/2016

I recently co-wrote a short report for UK Trans Info with CN Lester. Entitled ‘Gender recognition: where next?’, it reports upon the findings of a short survey about possible replacements for the Gender Recognition Act. The survey was created in response to calls for reform of the Gender Recognition Act 2004, in the wake of a Transgender Equality Inquiry conducted by the UK Parliament’s Women and Equalities Committee.

The headlines are as follows:

  • There is strong support for some form of legal gender recognition grounded in self-declaration – comparable perhaps to creating a statutory declaration or deed poll – as opposed to the current system of applying to a ‘Gender Recognition Panel’ with huge amounts of evidence and hoping for the best.
  • We asked what respondents were not prepared to compromise on in any change of law; a considerable majority stated that they regarded non-binary recognition as a red line in any negotiation. This will no doubt be very difficult to achieve due to the lack of any precedent in law for the recognition of non-binary gender identities, but it’s vital that trans advocates make the effort to push for this over coming months, for the sake of solidarity and inclusion.

You can read the report here.

“Living as a woman” – MPs take on the Real Life Test

01/11/2015

I’m currently writing up a section of my thesis that describes trans people’s experiences of navigating the public health system in the UK. A large part of this is related to the “real life test”, a stage of treatment which patients are required to live for a period of time in their “acquired gender” in order to demonstrate that they are suitable candidates for hormone therapy and/or surgery.

This requirement (which, incidentally was absent from the latest version of the international World Professional Association for Transgender Health Standards of Care) has a lot of issues. These include the prioritisation of cisnormative standards, little-to-no recognition of non-binary identities, white-centric cultural insensitivity, and the frequent demand that patients hold down “an occupation” as part of the test (particularly pernicious in a time of high unemployment).

It was therefore very interesting to see MPs questioning the idea of the real life test during the fourth and final session of the UK Parliament Women & Equalities Committee’s inquiry into transgender equality earlier this week. The conversation, in which MPs quizzed Ministers and NHS England representative Will Huxter, went as follows:

Jess Phillips MP:
“I think I’d like to go back again to this idea of living in one gender identity: I wonder if you can tell me – clinically – what ‘living like a woman’ – or alternatively, man – actually means?”

Will Huxter:
“I’m not a clinician I can’t tell you what that’s – ”

Jess Phillips MP:
“Do you think that there is a clinical way to live as a woman? Or a man?”

Will Huxter:
“The point I am making is that we are guided by specialists who work in this area, the clinical consensus among gender identity specialists about how services should operate. We are absolutely open to looking at how that might change, but I’m not in a position to make a change to the way in which those services are commissioned without having gone through a clinical process”.

Maria Miller MP:
“Mr Huxter, sorry, I think we’re going to have to press you on that. Is – this is just factual, we have read that people have to ‘live like a woman’ or ‘live like a man’, we as a committee have struggled to know what that looks like in a day and age where men and women live in very similar ways. What do you – factually – what does that mean?”

Will Huxter:
“Well in terms of what is required by the clinic I’d be very happy to provide some details from clinical colleagues after this because it’s not – I don’t deliver the services nor am I a clinician. I feel I could give a better representation to the committee if I provided that outside.”

Maria Miller MP:
“Is the Minister comfortable with the fact that the government requires this information to be available, or that individuals have to live ‘like a man’ or ‘live like a woman’ in order to be able to change their identity?”

Jane Ellison MP:
“Well, I mean, put as you put it to us, I mean obviously you know it gives cause for concern in a sense that, you know, who wouldn’t have sympathy for someone put in that situation etc , clearly the committee has heard I know some really difficult evidence and I quite understand why you wish to reflect that. I mean I think that as Will has said you know there is actually currently a review going on anyway about this very issue, which is essentially about looking at the current guidelines, about understanding that represents current better practice, about giving some challenge to that. There are a number of – compared to even five years ago – there wasn’t a mechanism for the NHS to receive that sort of, you know, feedback from critical friends or otherwise. Those now exist, the transgender network has been set up, the various stakeholder groups that are, you know, really locked into the process. So I think what I’m saying is I don’t think there is ever, you know, clinical understanding of situations is rarely completely frozen in time, I mean this one particularly isn’t, because for a lot of people this is a very new speciality, and therefore I would imagine over the next ten years for example, the next few years, you will see an evolution. And that process is underway, which is exactly why the NHS is consulting and is looking at, particularly at its clinical, you know, specification. That process is actually going on at the moment and, as Will has said, very open to the committee’s recommendations being fed into that. But I know I’m not a clinician too, and I know from other areas of my portfolio perhaps better than this one because I’ve been doing it longer, I do know that you do need to test. Because once you commission to a standard, once you’ve got that, you know you do, you need to make sure you’ve tested your views, and that you actually capture a clinical consensus, because that’s the only way you can move forward. But that consensus will evolve.”

Jess Phillips MP:
“Okay, I just – from the Minister – just, I suppose, what I’m looking to hear, is that you recognise that there is not a single list of attributes that represents what it is to be a woman and/or a man; and therefore, there cannot be a clinical list of things that a person can be told to do by a doctor in order to tick those boxes. Do you recognise that fact?”

Jane Ellison MP:
“Well I understand what you’re saying and I think that it would be very helpful if we – subsequent to this hearing – write to the committee with some – with an example from a clinician operating in the field as to what they would mean by that, because obviously you know people are sitting down with individual people and saying, you know, requiring them to do that and they must have an idea of what that requirement is, what that looks like. So I think we should ask the question of clinicians and supply the committee with some, perhaps some examples, obviously anonymised, of where that’s already happening in clinical practice, and what that looks like.”

You can watch the footage here.

women and equalities

All of this is relevant to the law – in addition to clinical practice – because of the current functioning of the Gender Recognition Act. In order to gain “full” legal recognition as female or male (non-binary options aren’t available) people who have transitioned are required to apply for a Gender Recognition Certificate (GRC). In addition to £140, a whole load of paperwork and scrutiny from the national Gender Recognition Panel (no, really), individuals wishing to acquire a GRC need clinical approval. It’s no wonder that many trans people simply refuse to play along, leading to consequences such as the Tara Hudson case.

As it turns out, there is an answer to be found in the clinical literature. Charing Cross GIC clinical lead James Barrett has the following to say on the subject of the real life test in his book, Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management:

“The question immediately arises of what constitutes ‘success’ in a chosen gender role. In essence, ‘success’ amounts to occupation, sexual, relationship and psychological stability. Of these, the first can be measured by whether or not the patient can manage to hold down a full-time (or equivalent part-time occupation in the chosen role for a year, in the course of the real life experience […] ‘Success’ in an occupation is achieved if the patient is treated by most others as if they are of the assumed sex. It is not necessarily that those around the patient believe that they are that sex […] Rather than being believed to be the assumed sex, the goal should be taken as an treated as that sex.”

[…]

“Some patients fiercely maintain that they do not care what others think of them, and that their own conviction of their gender is what matters. This position is at odds with the philosophy of a real life experience and if followed seems not to be predictive of a good longer-term outcome.”

Barrett further qualifies that “success cannot occur within a “purely transvestite or transsexual environment”, because “others may be supranormally accepting”.

So there you have it: “living as a woman” or “living as a man” means being taken as such within a cis environment. A very postmodern basis for clinical excellence!

Some tips on opposing Kenneth Zucker’s new article on trans children

12/08/2015

This morning it came to my attention that notorious child psychologist Kenneth Zucker has co-written a chapter on trans issues for the new (6th) edition of Rutter’s Child and Adolescent Psychiatry. The chapter, entitled “Gender dysphoria and paraphilic sexual disorders” effectively draws upon flawed and outdated research to promote reparative therapy for trans children. You can read most of it via Google Books here.

Cover of Rutter's Child and Adolescent Psychiatry

Abusing children – for science!

This is a big deal because Zucker draws upon harmful theories (including Ray Blanchard’s deeply reductive typology of transsexualism) to promote the idea that issues faced by gender variant children are due to a problem with the child, rather than societal gender norms. He therefore promotes a form of treatment that (to quote his new article) encourages parents to “set limits with regard to cross-gender behaviour, and encourage same-sex peer relations and gender-typical activities” in an attempt to cure them of difference. This is the kind of treatment that leads children to internalise the idea that non-normative gendered expression is shameful or wrong.

Rutter’s Child and Adolescent Psychiatry, meanwhile, is a widely-used textbook and can be found in university libraries and on reading lists in many countries.

I’m not sure what the best way is to stop this article from influencing practice. However, some ideas could include:

  • Write to professional organisations and ask them to explicitly oppose reparative therapy for trans youth
  • Write to University libraries and courses, asking them to consider sticking with the 5th edition of Rutter’s
  • Write to University departments and ask them to teach critical texts alongside the 6th edition of Rutter’s, and/or avoid putting the new edition on reading lists
  • Borrow the book from a local library if it becomes available, and write critical comments in the margins
  • Write to the book’s editors and/or publisher and question why Zucker has been given a platform for his outdated ideas
  • Comment on this post and/or join this new Facebook page to discuss possible ways forward.

The new edition isn’t yet widely available in libraries, so now is a good time to act.

If you’re writing letters or raising awareness of this as an issue, here is some useful information on opposing the article:

  • Zucker’s approach to treatment can seriously harm children
  • Zucker’s Gender Identity Service at the Toronto-based Centre for Addiction and Mental Health was recently suspended pending investigation in the wake of a large number of complaints – his approach to treatment is now also arguably illegal in the province of Ontario
  • Zucker’s new article represents poor academic practice. He cites himself 17 times, relies upon papers at least 20 years out-of-date to make many of his arguments, and also draws strong inferences from statistically insignificant quantitative findings
  • Zucker’s considerable academic position is based in part upon a small “invisible college” of academics who regularly peer-review and cite one another, thereby gaining many publications with a high profile whilst avoiding external criticism
  • There is a considerable evidence-based case to be made against Blanchard’s work. See for instance “The Case Against Autogynephilia“, a peer reviewed article by Julia Serano.

Thanks and respect to Peter Le C for raising awareness of this issue, and to oatc for suggested edits.

TeachHigher: a critique of claims from the University of Warwick

14/04/2015

Edit: a couple of months after this post was published, the University of Warwick ‘disbanded’ TeachHigher.

Last week I received an email from a departmental secretary about TeachHigher. The department I am based in – Sociology – has been enrolled in the TeachHigher pilot scheme for several months now, but this is the first time that PhD students have been officially informed of this.

TeachHigher emailI strongly suspect that this email (identical to emails also sent to PhD students in the Politics & International Studies and Philosophy departments) was written to counter some of the negative publicity received by TeachHigher over the past couple of weeks. It repeats a number of claims also made on social media and in press statements by University management and their representatives.

It’s a horrible feeling to have, but I honestly believe that our institution is being deeply dishonest with us.

In this post, I outline why this is the case, with reference to claims both made in the above email and more widely.


“TeachHigher [is] designed to give a fairer, more transparent and consistent approach to the recruitment and remuneration of hourly paid teachers and researchers”

The actions of the University over the past few months suggest that TeachHigher will be anything but fair, transparent and consistent.

  • Hourly-paid staff have not been consulted about the implementation of TeachHigher.
  • The TeachHigher website has been edited on numerous occasions over the past few weeks in order to remove elements that have attracted criticism. [1] For instance, all references to Warwick Employment Group (WEG) have been removed from the site. However, it appears that TeachHigher is still part of WEG. [2]
  • The University of Warwick has a poor record on remuneration. Hourly-paid teachers are usually not paid for preparation time, office hours or module meetings. In many departments, hourly-paid teachers are also not paid for marking.
  •  At present, hourly-paid teaching and research staff at the University of Warwick are provided with contracts of employment. [3] TeachHigher will instead provide “Temporary Worker Agreements” that “[do] not give rise to a contract of employment”. This will have a significant (negative) impact upon the employment status of hourly-paid staff.
  • The University and College Union (UCU) has made numerous requests for information about remuneration for workers hired through TeachHigher. It has still not received a response.
  • At the University of Leicester, hourly-paid teaching staff employed through TeachHigher sister company Unitemps are paid £11.75 an hour for teaching, with no payment for preparation time. [4] This is not an inspiring record for WEG.

These concerns could be dispelled if the University was to share information demonstrating that hourly-paid staff will be paid fairly.


TeachHigher is “not an outsourcing”

Many critics of TeachHigher have described the new body as a scheme for outsourcing teaching work within academic departments. Warwick has been keen to counter these claims, noting that TeachHigher is owned by the University.

This situation is not a straightforward one, and the comparison with Unitemps is important for understanding why.

Unitemps is run through a wholly-owned subsidiary of the University of Warwick. This means that it is owned by the University, but also that individuals working through Unitemps are technically working for a body distinct from the University. This has consequences for pay and conditions (as Unitemps employees can be treated differently to other University staff effectively doing the same work). It also has consequences for industrial action, which I discuss later.

This is a very canny business move. Rather than use an external employment agency to hire workers on less favourable terms and conditions, Warwick has created its own.

All existing evidence points to TeachHigher also being run through a subsidiary.

Warwick map

In a sense, hiring teaching staff in this way could more accurately be described as ‘internal outsourcing’. I have also seen it described as ‘insourcing’. Regardless of what you choose to call it, however, the entire point of these organisations is to create a situation where university departments have (at least) two tiers of academic workers. This makes it easier to treat the lower tier poorly, and to prevent different groups of academic staff from working together for better conditions.

It’s also worth making the point that Unitemps is already used to employ hourly-paid staff at a number of universities (including Leicester and Nottingham) and Warwick is intending to roll out TeachHigher to other institutions also. This will by definition amount to the outsourcing of teaching and research staff.


TeachHigher is “an academic services department”

I’ve seen this phrase used a lot by University management and their representatives. The more prominent recent example would be in the Warwick Insite news article Update on TeachHigher, which states the following:

“Discussions over the last few months clearly established that TeachHigher should be constituted as an academic services department. That has been done and staff and students will now find it listed amongst the other academic services departments on the University’s website.”

I’m not sure what this is supposed to mean. TeachHigher is indeed now listed on the “Services and facilities” quick links mean at the bottom left of the Warwick home page; as is Unitemps. This classification, however, tells us nothing about TeachHigher’s place in Warwick’s corporate structure, nor about the way it will treat hourly-paid staff.


Staff hired through TeachHigher will have the same opportunity to participate in union activity

There have been no official statements on this issue, but numerous discussions have occurred both on social media and in private correspondence. The University line appears to be that TeachHigher will recognise UCU, and that staff hired through TeachHigher will therefore be able to participate in union activity in the same manner as at present.

However, the TeachHigher Temporary Worker Agreement clearly states that: “TeachHigher may terminate this Agreement and TeachHigher or the Client may terminate any Assignment at any time without prior notice or liability.”

Whilst in theory hourly-paid staff working through TeachHigher cannot be fired for participating in industrial action, in practice it will be hard to prove that this has happened.

Moreover, as Philosophy Head of Department Matthew Nudds has noted, hourly paid staff will “not [be] covered by collective bargaining”.


An equitable solution?

There are two actions that senior University management can take to dispel criticism around TeachHigher.

1)    Provide written confirmation that TeachHigher is not (a) a subsidiary company, (b) run through a subsidiary company.

2)   Replace the Temporary Worker Agreement with a proper contract of employment that clearly states how staff will be paid for every hour worked.

I would like to see more than this, of course, but would personally welcome these actions as important steps in the right direction.

I’ll end with a quote from UCU Warwick:

“Teach Higher claims that it wants to make the employment of casualised academic staff more ‘standardised and efficient’. We say that the best way to achieve this is to end casualised contracts and give fractional and fixed-term staff the same rights as permanent staff.”

[1] TeachHigher front page before and after modification (click to enlarge):

 TeachHigher front page old
[old front page]

TeachHigher frontpage new[new front page]

[2] Note: the WEG website has also been edited. The site previously stated unambiguously that TeachHigher was part of WEG. This has been replaced with a somewhat more coy (and less meaningful) statement: “[WEG] is also supporting the new TeachHigher service at Warwick which is an Academic Services Department designed to support university departments engage their flexible teaching resource”. However, TeachHigher is listed as part of WEG in this map of the University’s services (also reproduced above).

[3] In theory. In practice, contracts can take months to arrive, and are often inaccurate.

[4] Source: PhD student teaching at the University of Leicester.

I have seen the future of feminism, and it is beautiful

17/02/2015

Yesterday’s social media furore over a dodgy letter to the Observer left me questioning my place within the women’s movement for the umpteenth time. However, within hours I was powerfully reminded that those who advocate an exclusive feminism are less influential and important than they might like to think.

Last night I joined a room of people committed to building a feminism that is compassionate, reflexive, inclusive of all women and sensitive to our different experiences.

Last night I found myself in a room of brown, black and white faces; gay, bi and straight; cis and trans; working class and middle class; disabled and abled. Last night I heard a teenage Muslim woman speak out about the importance of representing all faiths in activism after a question from a Jewish woman in the audience. Last night I heard from a white middle-class straight woman who has turned up to learn with an open mind. Last night I heard cis women talk about about trans rights, and felt that my identity and experience as a woman was simply not in question.

I had been invited to contribute to a panel discussion at the University of Bristol Students’ Union (UBU). Entitled How do we make the Women’s Movement intersectional?, the panel was was of UBU’s “Festival of Liberation“, which also includes events looking at the challenges faced by LGBT people, disabled people, and people of colour. I was honoured to share a panel with three truly awesome women: Susuana Antubam and Sammi Whitaker of the NUS Women’s Campaign, and Fahma Mohamed of Integrate Bristol.

Panellists at UBU's intersectional feminist event
Last night was promising and encouraging and heartwarming, and was not unusual in being so. I have seen similar scenes repeated across the country over the last few years at talks, workshops, protests and riot grrrl gigs.

This is the new feminism. A feminism that is discarding the model of monolithic female oppression and in its place building a movement around diversity and inclusion. A feminism that seeks to base both theory and action upon what different groups of women have to say about their lives and experiences, rather than imposing a top-down model of liberation drawn from academic theory. A feminism that sees cis and straight women take responsibility for supporting the work of their trans and queer sisters, white women take responsibility for supporting the work of their sisters of colour, abled women take responsibiity for supporting the work of their disabled sisters and so on.

Last night we talked about the importance of intersectionality as feminist praxis: of putting ideas into action. We talked about the importance of education: of sharing the knowledge and tools necessary for women’s liberation with people of all genders. We talked about the importance of representation: of working to ensure that women of all backgrounds feel welcome and able to attend feminist events through the use of accessible venues, ensuring diversity within organising teams and (where relevant) speakers/acts, and thinking about the language we use. We talked about the benefits of building groups around intersectional identities (such as black womanhood); groups that can then work alongside other bodies of people with a broader remit, feeding in ideas and holding them to account.

We talked about calling people out and challenging oppressive behaviour both within wider society and within the feminist movement. We also talked about being kind and prepared to forgive, and allowing people space to learn and grow. We talked about how everyone will make mistakes, because intersectional feminism is a constant experience of doing and being, rather than a closed process where you jump through a series of hoops and then become a Good Feminist who is capable of always passing judgement upon others.

We talked about our experiences of activism. Fahma talked about giving a piece of her mind to a nervous Michael Gove, resulting in a letter to every school in the country about FGM. Sammi talked about productive conversations with working class male friends, and building liberation into the very fabric of Anglia Ruskin’s fledgling Students’ Union. Susuana talked about her work on addressing lad culture as a gendered, racialised and classist phenomenon. I talked about my contributions to trans and non-binary inclusion within the NUS Women’s Campaign, and how we seek a diverse range of performers for Revolt, Coventry’s feminist punk night. We heard stories and ideas and questions from the audience, and I reflected on how we were not “experts” with a monopoly on solutions, but just one part of a wider movement.

These are just some of the things that we talked about.

So why have I been led to question my place within the women’s movement?

Because I see Julie Bindel referring to other feminists as “stupid little bellends” whilst misgendering trans women, arguing that bisexuals do not experience oppression, and stating that Muslim women who wear religious dress are necessarily oppressed. Because I see Rupert Read suggesting that trans women should not be allowed to use public toilets. Because I see Beatrix Campbell repeating and defending these ideas.

When I read things like this, I am repelled by a feminism that is harsh, bitter and exclusionary.

When feminists gaslight me by claiming repeatedly that the individuals who wrote these articles are not transphobic I am saddened and confused.

When I hear about feminists disrupting conversations at events such as AFem in order to promote an agenda that excludes trans people and sex workers, I am disappointed and worried.

When I see exclusionary events like Radfem 2013 and Femifest 2014 promoted within feminist spaces and supported by organisations like Women’s Aid and Reclaim The Night London I am alarmed and concerned.

When I see feminist women and men – including both public figures as well as personal friends and acquaintances – sign a misleading letter that condemns attempts to debate and contest the above, I wonder how voices of those who work for an inclusive and diverse feminism can possibly stand against a “letter mob” representing the discursive might of the liberal Establishment.

The stakes are high. Too many of my friends have considered suicide. Too many of my friends have died. When I talk to my trans friends and fellow activists, I hear about fragile mental health, doctors and shopkeepers refusing to provide services, threats of violence and attacks in the street. All of these things are fuelled by the dehumanisation of trans people, the idea that we require intervention to save us from the misguided path of transition, the implication that we do not deserve to exist within public spaces. These discourses are perpetuated by feminists and defended by liberals in the name of “free speech”.

I don’t believe in historical inevitability and don’t buy into progression narratives. I had a debate about trans-exclusive feminisms with Jack Halberstam recently. Jack echoed my PhD supervisor in arguing that trans-exclusive feminisms are outdated and irrelevant, long-dismissed within the academic world. But the academic world is often divorced from the reality of the feminist movement on the ground. In this reality, exclusive feminisms continue to fester.

In spite of all of this, last night reminded me of the power and appeal of the new, intersectional feminism. It is this feminism that is popular amongst young people who are more interested in working together than apart, and veteran activists with the humility to share their ideas and wisdom with newcomers on an equal footing.

This feminism requires work and nurture, but – as I argued last night – this does not need to be an entirely arduous task. Working together across our differences and ensuring that more people feel welcome and included makes us stronger. Learning new things from others can be interesting and exciting. Having the strength to learn from our mistakes solidifies friendships and alliances. Discovering a more diverse range of feminist histories, activisms and performances can be fun and empowering.

The new feminism is beautiful. Let’s keep building.

No, I will not help Sundog make a documentary on trans “regret”

23/10/2014

This afternoon I received an unsolicited email in my work account from an employee of Sundog Pictures. An excerpt follows:

I’m currently working on an idea alongside Channel 4 following transgender individuals who have come to regret their sex changes and are keen to undergo further treatment / operations to reverse the change. The doc will be insightful and sensitive and will look at the way in which transgender individuals are treated in society and whether the process before someone is permitted an operation is robust enough.

I’m currently looking for real life cases to include in my pitch document and was wondering whether you might be able to recommend people I could speak to, or places I could contact to find individuals who are currently thinking about a reverse sex change. Any help would be really appreciated.

Given the email account used, I feel that I can safely assume that I was contacted because of my academic work, which looks at discourses of trans healthcare provision. Sundog seem to hope that I will (without compensation) draw upon my community contacts and research findings to recommend participants for their television programme.

I couldn’t think of anything more inappropriate.

There’s a lot to be said about research ethics and a duty of care towards participants, but plenty has been written about that elsewhere (the BSA Statement of Ethical Practice offers a decent broad overview). So in this post I focus on the huge problems that come with the proposed topic of the documentary: that of trans “regret”.


The numbers

The mainstream media take an undue interest in trans “regret”. It’s very easy to come across such stories on daytime television and in both tabloid and broadsheet newspapers. The popularity and frequency of such stories suggests that it’s not too unusual for people who have undertaken a physical transition from male to female, or from female to male, to consider or undertake a “reverse sex change”.

In reality, research has shown time and time again that the actual rate of regret is extremely low. For instance, only 2% of respondents in the Trans Mental Health Study (the second-largest trans study undertaken in the UK) reported “major regrets” about the physical changes experienced during transition. Reported regrets from participants included:

“…not having the body that they wanted from birth, not transitioning sooner/earlier, surgery complications (especially loss of sensitivity), choice of surgeon (if surgery required revisions and repairs), losing friends and family, and the impact of transition on others.”

It’s clear therefore that “regret”, when it occurs, is likely to stem from societal and surgical issues rather than the process of physical transition in and of itself. The Trans Mental Health Study also demonstrates a clear link between physical transition and wellbeing in terms of mental health, body confidence and general life satisfaction.

With so few trans people regretting physical transition – and even less considering some kind of “de-transition” – it’s no surprise that sometimes the same individuals are trotted out time and time again to re-affirm a discourse of regret.


What’s missing from this story?

It’s pretty clear from the email I received that that the author has not done their research. Given the existence of organisations such as Trans Media Watch and All About Trans who are entirely keen to offer advice, this does not exactly inspire confidence.

For a start, transition is conflated with “sex change”, a term that is not only most frequently associated with transphobic tabloid headlines, but is also broadly meaningless. At what point can we talk about a “sex change”? When an individual undertakes hormone therapy? Chest surgery? Genital surgery? What about individuals who transition socially, but only undergo some (or even none!) of these processes? It’s not the kind of language that suggest an “insightful and sensitive” documentary can be made.

There’s a couple of more fundamental mistakes in the proposal, however. The first is the question of “whether the process before someone is permitted an operation is robust enough”. My own initial research findings suggest that if anything, the process in question is too robust – in that patients requiring surgery are typically required to wait many years before treatment is available.

The World Professional Association for Transgender Health Standards of Care require patients to undergo at least 12 months of hormone therapy prior to genital surgery. In reality, patients in England and Wales face a substantial waiting list (sometimes lasting years) before they are able to attend an NHS Gender Clinic, where two separate clinicians are required to approve a regime of hormone therapy before it can be undertaken. An additional two opinions are needed at a later date before a referral for genital surgery can take place. There are many, many opportunities and a great deal of time for patients to consider and re-consider their option – and that’s even before we take into account the horrific scale of the current crisis in surgery provision for trans women.

The current system is not constructed to facilitate transition so much as prevent the very possibility of regret. The result is increased suffering – in terms of the mental and physical health impact upon individuals who are forced to wait many years for hormones and surgery, whilst fearing (sometimes with good reason) that they will be denied treatment on spurious grounds. It’s no surprise that the Trans Mental Health Study found that “not transitioning sooner/earlier” is a major cause of “regret”, as individuals who have waited until breaking point to transition soon discover that there is still a long, long road ahead of them.

The second fundamental problem with Sundog’s proposal is their idea that trans people who aren’t too happy with their transition might be “keen to undergo further treatment / operations to reverse the change”. This is a very binaristic notion that both stems from and reinforces the notion that transition is a one-way process, from one (binary) gender to the other. In reality, there are many people for whom transition is a complex, ongoing process. For instance,  an individual who initially transitions from male to female might later feel that their identity is better understood as genderqueer, and may allow or pursue further physical changes to reflect this.


The wider political context

Given the tiny proportion of trans people who “regret” transition and the realities of service provision, the choice of a documentary about the subject appears at best to be somewhat misguided. However, the impact of insensitive coverage on this topic is such that I believe that I believe this documentary could be actively harmful, particularly as Sundog’s email asks “whether the process before someone is permitted an operation is robust enough”.

This is in part because the way in which discourses of regret are handled makes it harder for trans people to get treatment. Gender clinics in the UK require urgent intervention to make life easier for individuals who transition, not harder. Media hysteria over the possibility of regret reinforces the current system’s approach, which is to require people to demonstrate over and over again that they are trans before there is any hope of treatment.

But it’s also because discourses of regret are employed by those who campaign against trans liberation, including conservative commentators and anti-trans radical feminists who would deny funding for transition on the NHS altogether. Writers such as Julie Bindel are all too keen to use any example of individual regret to argue that transition is unnecessary mutilation, undertaken by sad, sick individuals who might have done otherwise if only they’d been given the option of, say, some form of reparative therapy.

The focus on the medical process is therefore politically loaded. Yes, some people do de-transition, and their stories are important and of worth. But these stories have yet to be told by the mainstream media in a non-sensationalised manner, in a way that doesn’t reinforce (intentionally or otherwise) a pernicious anti-trans agenda. Sundog’s proposal appears to feed right into this agenda.

This proposed documentary should not be regarded as a curiosity piece taking place in a cultural vacuum. It draws upon and will contribute to damaging and inaccurate tropes about transition. Ill-informed media accounts ultimately play a part in creating and maintaining a situation where “regret” frequently stems from the responses of friends and family, delays to transition and other negative experiences that come with transitioning in a transphobic society.

I hope therefore that any future attempts to examine trans health issues in this way will involve better research into the topic at the initial stages, and a greater sensitivity to both the personal and political consequences of exposing trans lives to media scrutiny.

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06/10/2014

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