Black Lives Matter

I want to express my unconditional solidarity with Black Lives Matter protesters in the US, UK, and beyond.

Over the last week I have watched the unfolding events in the United States with growing horror. I have been dismayed by the murder of George Floyd by police, the brutal, violent, but all-too predictable response to protesters from US authorities, and subsequent murders of further Black men including Tony McDade, James Scurlock and David McAttee.

I have so much respect for those who have taken to the streets again and again to call for a change to the corrupt, racist systems that made this violence possible. In this post, I want to take advantage of my platform to share pre-existing information and resources.

As a white woman living in the UK, I am aware that such deep systemic racism is hardly limited to the US. We know that Black and Asian people are more likely to die of coronavirus. This is due to pre-existing social and economic inequalities that result from racism, which mean that many racial minorities are more likely to have pre-existing health conditions, and work in low-income jobs which put them at risk. We know that 1,741 people in the UK have died in police custody or following contact with the police since 1990, and no police officers have been convicted; we know that Black people and other people of colour are disproportionately represented among these deaths. We also know that Black people are even more likely to be imprisoned in the UK than the US, and this disproportionate prison population is a consequence of overt discrimination in both the criminal justice system and wider society.

These problems do not result from the actions of “bad apples”. They are systemic, the consequence of a system of white supremacy on which the wealth of the UK was built, and from which those of us who are white continue to benefit, regardless of what other challenges we face in our lives. To bring about change, we – those of us who are racialised as white in a system of white supremacy – need to think seriously about what we can do in our everyday lives to address our own complicitly, support our Black neighbours, and bring this system down.

I am writing this post because I know this blog has a readership; however, I hope to primarily direct your attention elsewhere. I am not the person whose work you should be reading to learn more about this, nor to think through the actions you might take. I recommend turning to the existing work of Black writers to understand what is going on, and to support Black activists in the US, UK, and beyond. The remainder of this post includes a (non-exhaustive!) series of links that might help fellow non-Black readers especially with this, especially if you are not currently able to take to the streets. But please also do your own research.

Educate yourself. A list of readings, videos, and podcasts on a range of topics including racism, protest, allyship, and prison abolition.

Donate to bail funds. In the US, suspects who can afford bail may be released from custody prior to a trial. In practice, this disproportionately impacts low-income communities, and hence disproportionately impacts Black people. Protesters and innocent bystanders alike have been subject to mass arrests in the last week alone.

Donate to other causes in the US. These include funds for victims, Black-owned businesses impacted by the protests, and related organisations and initiatives.

Donate to Black Lives Matter UK.

Support QTIPOC and BAME LGBTIQ+ groups in the UK. Follow, listen, learn, and donate.

Support people subject to harassment on the streets. Take action when you witness racist acts.

Challenge racist systems in your workplace. Think about how you might work through a union and/or work collectively with your colleagues to address racist hierarchies, taking into account factors such as management structures, hiring practices, insecure contracts, and the operation of class.

Challenge everyday racism among your friends and family. Make time and space for difficult conversations. Create space for others to question and challenge your pre-existing prejudices in turn.

Finally, I encourage fellow white people to think critically about where they are putting their support. Is your local UK “Black Lives Matter” protest actually being organised by white people and centring white voices? Is it associated with a group like the SWP front Stand Up To Racism, who have been criticised by Black feminists for their deep complicity in rape culture? Are you putting more energy into discussing what does and does not constitute “violence”, or condemning people for taking the streets during a pandemic, than you are into condemning and acting against the racist sickness that is the cause of the protests? Are you spending more time thinking about your own white guilt than how you might make productive changes in your life and in the lives of people around you?

Again, I urge you to educate yourself, and read what Black writers and activists have to say about these issues. I will be striving to do the same.

The GRA, LGBT Survey, Action Plan and conversion therapy ban – what just happened?

On Tuesday, the UK Government (finally!) launched a long-awaited consultation on reforms to the Gender Recognition Act 2004 (GRA). This has been timed to coincide with several other events, including the publication of initial data from the Government Equality Office LGBT Survey, the launch of the Government’s new LGBT “Action Plan”, and the formal launch of the Memorandum of Understanding on Conversion Therapy.

While it makes sense – politically speaking – for all of these things to happen at once, it can be pretty confusing. The sheer amount of information to process alone is monumental. Part of my job is to engage with these events, and since yesterday morning my head has been spinning! So in this post I aim to briefly summarise what has happened, why it happened, and what this might mean for the future – especially with regards to trans rights.


GRA Consultation

Planned reforms to the GRA was announced in the wake of the 2017. The Government promised a consultation, which has taken a year to materialise.

Nevertheless, it’s now open and anyone can respond to it. The consultation outlines a number of issues that civil servants have identified with the GRA as it stands, and asks for your views on these.

You can read about and respond to the GRA consultation here.

There are a couple of issues with the GRA which trans rights advocates have highlighted as notably absent from the consulation, which you may wish to invite the Government to also address. These are:

  • The lack of provision for gender recognition for trans people under the age of 18.
  • No mention of the Gender Recognition Register, which currently lists all people who have successfully applied for gender recognition. This may prove a danger to trans people if a more authoritarian government were to come to power, as in the US.

In the past year there has been a moral panic in the UK media in response to proposals for GRA reform. You can find out more about this (and my thoughts on why the consultation is happening now) in my earlier post on the topic.


LGBT Survey

In 2017 the Government Equality Office launched the National LGBT Survey. This was the largest survey of LGBT (in)equalities ever conducted – not just in the UK, but the world. A total of 108,100 valid responses were recieved, of whom approximately 14,000 were trans (which also makes it the largest ever survey of trans people in the UK by an astonishing margin). Credit for this is due to the civil servants who quietly pushed through its implementation at a time of political turmoil and reshuffles in the wake of the general election, as well as the LGBTQIA+ organisations who promoted it extensively.

An initial research summary report was published on Tuesday. This provides a basic account of the research findings. The full research report was released late on Wednesday. This huge document provides a far deeper and more extensive look at the survey results. However, there is such an enormous amount of data available that researchers will probably be analysing the findings for years to come.

The timing of these publications is not a coincidence. The research included questions about gender recognition; the findings demonstrated a strong demand for reform from the trans population, with negligible opposition to proposals from cis respondents. The Government will therefore use this to back their attempt to reform the GRA.

You can read the reports of the LGBT Survey here (along with various data annexes).

You can read my initial reflections on the summary report in this Twitter thread.


LGBT Action Plan

In response to the findings of the LGBT Survey, the UK Government has produced a 75-point Action Plan. This describes the actions they propose to take to promote LGBT equality, which include drafting new laws, producing new policy and guidance, and ringfencing money from the Government Equality Office budget for carrying out equalities work.

It’s very easy to be cynical about “action plans” such as these, but they can actually have a real impact. For example, the Coalition Government’s 2011 Transgender Action Plan was widely regarded as useless by trans activists in following years, but (as I show in my research) its requirement for the implementation of new gender identity service protocols by April 2013 helped bring about important improvements in NHS England gender clinics. This included an end to the requirement for a local mental health assessment prior to a gender clinic referral, which reduced the number of waiting lists that transitioning patients have to endure.

The legislative centrepieces of the Action Plan are the proposed reform of the Gender Recognition Act, and a proposed ban on conversion therapy. Both potentially represent important steps forward for the law, but would also require relatively minimal action from the Government to tackle pressing issues highlighted elsewhere in the survey data (such as the enormous economic inequality experienced by LGBTQIA+ people). There are, of course, matters which weren’t asked about in the survey either, such as the UK’s treatment of LGBTQIA+ migrants and asylum seekers.

Therefore, in addition to holding the Government to account for implementing the LGBT Action Plan, we need to continue campaigning on matters such as austerity, immigration rights and the provision of public services.

You can read the LGBT Action Plan here.


Memorandum of Understanding on Conversion Therapy

On Wednesday afternoon I attended the formal launch of an effective ban on conversion or reparative therapy that has been agreed upon by the UK’s major professional bodies for therapists, counsellors, psychologists and psychiatrists. This is a really big deal because it represents an attempt to stamp out practices that aim to “cure” or “convert” a person’s gender identity or sexual orientation.

The Memorandum of Understanding was originally agreed upon in 2016. This document only addressed LGB conversion therapy. but (following a series of careful meetings and difficult negotiations) an updated version was published in 2017, which explicitly addressed conversion therapy targeting people on the grounds of gender identity. This was effectively a “soft launch”, ensuring that the document was made available to those who needed it.

Today “officially” launched the document in the House of Commons, with numerous MPs and representatives of religious and therapeutic organisations present. The idea was to promote the Memorandum of Understanding more actively, and draw attention to the issue of conversion therapy among all of these groups.

I was not very much involved in the drafting of the Memorandum of Understanding, but did attend one of the early meetings that discussed how it might be extended to ensure asexual and trans inclusion. At this meeting we struggled with the lack of formal evidence that trans people in particular were undergoing conversion therapy, although I supported others in arguing that the prevalence of deeply concerning anecdotal accounts alone necessitated action.

By coincidence(?) today’s formal launch event coincided with yesterday’s publication of the first ever statistics on LGBTQIA+ conversion therapy in the UK, as part of the LGBT Survey summary report. These figures are stark: 5% of respondents reported being offered conversion therapy, and 2% underwent it. That might sound like a small figure, but given the enormous response to the survey, what it means is that thousands of vulnerable LGBTQIA+ people have experienced these damaging practices in the UK. Worryingly, the survey also shows that young people continue to experience conversion therapy, and that the situation is more severe for trans people. Around 10% of trans respondents reported having been offered conversion therapy, and 4% stated that the had been subject to it.

Dr Igi/Lyndsey Moon from the Coalition Against Conversion Therapy, who played a key role in ensuring that the document was updated to include trans people, spoke passionately at the event. In addition to talking through some of the above figures, they also argued that simply attempting to “ban” conversion therapy may not result in the change we need to see. What needs to happen now is the long, hard work of cultural change – both within religious organisations, and within healthcare services.

You can read the Memorandum of Understanding on Conversion Therapy here.
Edit: I updated this post on the morning of Thursday 5th July to include a link to the full research report, which is now also available.

WE ARE REVOLTING: my first Trans Pride

There are a couple of looks I am very familiar with as a trans person.

One is primarily a look of confusion. It is the kind of look you might expect to receive if you were wearing a boot on your head. You have disrupted the everyday order of things, and people don’t know how to respond.

One is primarily a look of disapproval, communicating a barely-contained sense of disgust or revulsion. It is the kind of look you might expect to receive if you have smeared shit all over your face and are walking down the street as if nothing is wrong. You have disrupted the everyday order of things, and people are very unimpressed, but perhaps aren’t quite yet ready to shout or spit at you. But you imagine that they would quite like to.

I’m very used to these looks because I have received them a lot over the course of my life. More often when I was younger, my face and body as yet unchanged by oestrogen. But I still receive such looks now and again to this day, particularly when I put less effort into conforming to stereotypical expectations about how a woman should look or carry herself. Perhaps I have put on less makeup, or I am wearing baggy clothes, or I haven’t brushed my hair for a couple of hours.

Other trans people – particularly other trans women, and especially trans women of colour – are less fortunate than me. People don’t just look at them. The looks are merely where it starts. Then people shout at them, or spit, or throw stones. People pinch their arses or grope their breasts. I hear these stories from my trans friends pretty regularly. It’s like everyday sexism with the volume turned up.

Other trans people – particularly other trans women, and especially trans women of colour – are less fortunate still. People stalk them. People assault them. People rape them. People kill them.

They do this because we are revolting.

It starts with a look. Call it the cis gaze.

~

Today I saw so many looks of confusion and disapproval. I felt the revulsion. It was visceral. It was contained. It could not harm me. I was amongst hundreds like me.

Today I took part in a Trans Pride march for the first time.

placard

Waiting for a bus before the march. Photo by Sophie Wilson.

Trans people have, of course, taken part in LGBT Pride marches for as long as they have existed. Trans Pride marches, however, are a relatively new phenomenon. The first Trans Pride in the UK took place in Brighton in 2013.  I attended Trans Pride Leeds, which is in its first ever year.

I have previously marched in LGBT Pride parades in Birmingham and London, and attended Pride parties in Coventry and Leamington Spa. On these occasions, people throng the streets. There is a sense of celebration. There is a giant street party. People come out to see the happy gays. They mostly look on with enjoyment. It is a family affair.

At Birmingham Pride one year, I was stopped by a “community safety officer”, who objected to my placard. It was not family friendly, he said. If I didn’t destroy or cover it up, he would call a police officer and I would be arrested. At London Pride one year, some people sought to control entry to a women’s toilet, ejecting at least one trans woman in the process.

Trans people are not necessarily welcome at LGBT Pride events. Or, if we are, we are not as welcome as many of our cis gay, lesbian, bi and queer siblings. Or, if we are, we are not seen or celebrated in the same way. We are not as safely contained.

But: there are a lot more cis gay, lesbian bi and queer people at LGBT Pride than there are trans people. We disappear into the crowd. We cause less confusion. We bring less disapproval. We do not so easily revolt.

This is why Trans Pride is important. This is why Trans Pride is necessary.

 

 

~

Today is Trans Day of Visibility, apparently. In the UK, trans people are more visible than ever.

Visibility has brought new dangers. We are currently subject to an unprecedented hate campaign in the media, spearheaded by “respectable” publications such as The Times and The New Statesman. On the Internet, we have attracted the dangerous attentions of a resurgent neo-nazi movement, their anti-trans campaigns bolstered by useful idiots who claim to oppose trans rights in the name of feminism.

Visibility has brought new opportunities. We see more of one another. We are more organised than ever. We have grassroots organisations in every city. We are producing art, music, plays, and films that speak to our own interests and concerns. We are marching in protest, we are marching in Pride. We seek gender liberation.

It will be a very long, very hard fight, but we are going to change the world.

We are revolting.

~

Today I saw so many looks of confusion and disapproval. I returned the gaze. I held my placard high. I shouted, joyously. They could not harm me. I was amongst hundreds like me.

I could not, would not be shamed, for I felt the power of Pride.

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Trans Pride placards. Photo by Natasha Handley.

 

NHS Gender Identity Services consultation: it’s really important, and you can take part

 

For the past few months, NHS England have been running a consultation on Gender Identity Services for Adults (i.e. services typically provided through a Gender Identity Clinic, or GIC).

There’s still just over a week to respond: the consultation is open until Monday 16th October, and you can respond here.

Unfortunately, NHS England have not made the consultation process particularly clear. The documents are quite long and the whole thing can appear unnecessarily complex. So in this blog post, I explain what the consultation is about, why it matters, and how you can participate. I also outline some key issues within the consultation.

 

What is this all about?

NHS England have prepared two draft service specification documents: one for surgical services (including genital and chest surgeries), and one for non-surgical services (basically everything else, including assessment and diagnosis, hormones, counselling, voice therapy etc.

These draft documents are currently under consultation, with stakeholders (i.e. trans people, medical professionals and other interested parties) invited to comment on them.

 

Who is affected?

Basically everyone who is accessing (or intends to access) a GIC or surgery through the NHS in England, and every medical professional and NHS worker involved in delivering these services. This includes all patients based at England GICs. It will also indirectly affect patients in Wales who access treatment through Charing Cross, and patients across the whole of the UK who access surgical services in England. In time, Wales should get its own GIC, but this isn’t due to happen yet for some time.

 

What will this consultation do?

Following the consultation, the service specification documents will be used to commission services. That means: a GIC will need to meet the requirements of the service specification in order for NHS England to commission them.

If the GIC does not meet the requirements of the service specification, they may lose their right to provide services through the NHS.

So, in the future the service specification documents can (in theory) be used to hold GICs to account. If certain inappropriate or discriminatory practices at a GIC are seen to contravene the service specification, then they might effectively have their funding pulled.

There are a lot of clauses in the new service specification documents that would effectively ban a range of potentially harmful practices that currently exist in some GICs. For example, some GICs require that patients undergo unnecessary genital examinations prior to hormone therapy, while others insist that family members attend assessment meetings in order to corroborate patients’ accounts of gender dysphoria. Both of these practices are explicitly prohibited in the draft guidelines.

At the same time, there are some really questionable elements that remain in the service specification, such as the requirement for GIC patients to be registered with a GP. This can discriminate against people of no fixed abode, such as asylum seekers, homeless people, Travellers and many sex workers.

In responding to the consultation, you get a say on what the new guidelines should look like – the bits you think are good, and the bits you think need re-thinking.

 

What will this consultation not do?

An issue I have with this consultation is that it doesn’t address the fundamental power imbalance that currently exists between GIC gatekeepers and trans patients.

The consultation also doesn’t directly address the commissioning of new services; instead, it focuses on existing services. So, interventions that aren’t already currently funded as standard by NHS England (such as breast augmentation and facial feminisation surgeries) are not included.

These are things you may wish to comment on in your response (I have done so). However, you should bear in mind that this consultation is primarily about improving existing practice, rather than undertaking fundamental reform. So, by responding you should definitely be able to help improve people’s lives in the short term, but we also need to continue being proactive with trans health activism in order to bring about bigger changes in the long term.


But wait, haven’t we been here before?

Yes. NHS England previously consulted on draft commissioning documents in 2013 and 2015. On both occasions, a considerable number of trans stakeholders indicated that the documents weren’t fit for purpose: they were too strict, too binary, and pathologised trans people too much. Each time, NHS England went back to the drawing board.

I studied these documents for my PhD. One of the really interesting things about them, is that each time they’re revised and come back to consultation, they’re more progressive, reflecting interventions from trans health advocates. For example, non-binary and genderqueer identities and experiences were barely mentioned in the 2013 document. There was some level of inclusion in 2015, and then the current non-surgical specification makes a real effort to avoid binary language altogether.

From the lessons I’ve learned in my work, I also think that this time around, the service specification will be implemented. This is a bigger and more wide-ranging consultation from before, and at events NHS England representatives have given a strong indication that they’re very keen to re-commission services during 2017-18. So, this is our major chance to bring about change in some areas.

 

Okay, so how do I take part?

There are three documents to read. There are the two service specification documents:

Surgical specification.

Non-surgical specification.

There is also a third document: the consultation guide. This one’s a bit of a mess.

The consultation guide provides information on the background to the consultation (pages 5-8), and includes some questions for respondents to consider (pages 9-12).

Four options are outlines for how hormone prescriptions might be managed in the future (pages 13-20).

Finally, there’s an equality impact assessment, which summarises the impact (both positive and negative) that NHS England thinks the document will have upon particular marginalised groups, including older and younger trans people, disabled trans people, trans people of different genders and sexualities, married trans people, trans people of colour, and trans people of faith (pages 21-32).

Once you’ve read the documents, you can email your thoughts about what you think is good and what needs changing to NHS England: england.scengagement@nhs.net.

You can also take part in an online survey: https://www.engage.england.nhs.uk/survey/gender-identity-services-for-adults/consultation/.

The survey refers to the three main consultation documents at various points, so have these handy when you take it.

Altogether, reading the documents and responding to the survey took me about four hours. If that feels like a really long time, bear in mind that you don’t have to respond to everything in the documents in order to take part in the consultation. You can choose to respond just to particular key issues (see below for two examples), or do it a bit at a time.

In particular, it’s worth bearing in mind that the online survey allows you to save your response and come back to it later.


Key issues

Since this is such a big consultation, there’s a lot to talk about. I’m trying to keep this post relatively concise, so I can’t cover it all (although I do link to some further reading at the end if you want look into this further).

So, here’s a couple of things that I feel are particularly worth focusing on.

  1. Prescribing arrangementsUnder the current system, patients are referred by their GP to a GIC. At the GIC they are assessed for gender dysphoria. Upon receiving a diagnosis, the GIC instructs the patient’s GP to prescribe hormones, if this is something the patient wants.The consultation proposes that this approach potentially be changed. It offers four options for different systems, which are outlined in the consultation guide, on pages 13-20. Option A is the status quo, as described above.

    Options B and C offer variations on this: in Option B, the GIC provides the first prescription and then the GP provides prescriptions thereafter. This would mean that patients can pick up their first prescription pretty much immediately. Option C requires prescriptions to be provided by the GIC for the first year. This would mean that patients would approach the GIC for a repeat prescription during this time.

    Option D proposes a major change: the appointment of a local specialist by each Clinical Commissioning Group, which means (in theory) there is a GP specialising in trans hormones in each local area. It is not entirely clear whether or not these GPs would continue to rely on GICs for assessments, nor if other GPs will be able to prescribe hormones still as they do at present.

    Option D is the most interesting option here in part because it offers the most radical change. There are some serious potential benefits and drawbacks. For example, this approach might lead to a decentralisation of care, whereby patients might access hormones (and potentially other services) from a specialist GP working in collaboration with an endocrinologist. On the other hand, it might lead to less GPs providing basic services as they do at present, which might be a problem particularly in rural areas.

    Ultimately, none of these options are perfect. Personally, I feel some combination of A and D could be beneficial: but I recommend reading through the options yourself and having a think.

  2. Referral to GICs
    At present, English patients are generally referred to GICs by their GP, although they can also be referred by a local mental health provider. This contrasts with Wales, where at present patients are referred first to a local mental health provider who then refers on to the GIC, and Scotland, where some providers accept self-referral.The draft service specification for non-surgical services currently insists that all patients be registered with a GP, who provides the referral to a GIC. The rationale for this is that – under the existing system – patients require a co-operative GP in order to provide hormone prescriptions.However, not all NHS patients are registered with a GP. This is acknowledged in the equality impact assessment included in the consultation guide, which states that people of no fixed abode might not have access to gender identity services as a result. Moreover, trans patients sometimes have to search for a long time for a GP who will provide them with a referral.

    I propose that NHS England follow the existing NHS Scotland guidelines in allowing for self-referral. This means that patients have the opportunity to find a supportive GP while they are on a waiting list and/or undergoing assessment. Moreover, it would be beneficial if some arrangement can be made to support patients who are still without a GP following diagnosis (perhaps some variant on Option C for hormone prescriptions).

 

Further reading

The above two issues are by no means the only pressing matters in the consultation: just two that I feel are particularly important. You may feel otherwise!

For more information, thoughts, reflections and ideas for responding to the consultation, here is a range of further reading.

My response to the consultation (Twitter thread)

My summary of a consultation event in Leeds (Twitter thread)

Response from UK Trans Info

Response from the National LGB&T Partnership

Thoughts from Michael Toze (general)

Response from Michael Toze (hysterectomies)

Response from Edinburgh Action for Trans Health (Trans Health Manifesto)

 

Of conduct and controversy: trans health activism at EPATH

Here in the UK, health is a key priority for many trans activists. While progress is sometimes painfully slow, numerous debates, protests and consultations have informed gradual change within a range of healthcare settings, and a growing number of health professionals are prepared to actively support trans peoples’ access to affirmative care. However, discussion of trans healthcare in the UK has remained focused largely on the specifics of the UK context, even as important events that influence gender identity services in particular are increasingly taking place on the world stage.

In this post, I look at recent activism at “PATH” (Professional Association for Transgender Health) conferences in Amsterdam and Los Angeles, as background to unfolding events at this week’s EPATH conference in Belgrade.


WPATH Symposium 2016

Last year I wrote briefly about international activism taking place at the World Professional Association for Transgender Health (WPATH) symposium in Amsterdam, the Netherlands. This included two unofficial fringe events: a Global Action for Trans* Equality (GATE) pre-conference, organised primarily by trans activists from the Global South, and the FreePATHH event, run by Dutch trans people living locally who couldn’t afford to attend the expensive WPATH event.

I myself experienced the WPATH symposium as exhausting, inspiring and frustrating. A myriad of positions on trans health care represented amongst the researchers, practitioners and activists present at the event, which is as it should be at any good conference. However, amongst the thought-provoking and challenging interventions, and numerous examples of progressive approaches and good practice, I also found myself overwhelmed by microaggressions from cis attendees, and thrown by the cognitive dissonance of experiences such as emerging from a session on trans-affirmative care only to find myself attempting to retain a professional demeanour whilst walking past individuas such as Kenneth Zucker. Zucker has been accused of subjecting gender questioning children to reparative therapy, and will also be known to UK readers for his participation in a recent BBC documentary (“Transgender Kids: Who Knows Best?”), to which Trans Media Watch responded with an extensively researched letter of complaint.

It was in this context that numerous interventions – both formal and informal – were organised by trans attendees at WPATH. GATE held sessions on depathologisation for trans and intersex people. FreePATHH created a range of notes with “free advice for better transgender care”, which were distributed in a social area for conference attendees to read. Someone gender-neutralised the (binary gendered) toilets with holographic signs. I also heard informally about South African trans women confronting a racist presenter on a panel.

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In this way, the WPATH symposium felt like a sometimes discouraging, sometimes productive site for real debate and contestation, both professional and political. My impression was that the the interventions that took place there would probably have a gradual impact on how trans health is understand and practised in the years of come, particularly following the creation of TPATH, a group for trans people working in trans health.  What I didn’t realise was the extent to which events would accelerate in the coming months.


USPATH Conference 2017

In February the first USPATH (United States Professional Association for Transgender Health) conference took place in Los Angeles, USA. At this event, tensions over the place of pathologising forms of care in general – and Kenneth Zucker’s ideas and practices in particular – came to a head.

In a Twitter thread written during the event, health researcher Zoé Samudzi describes how a number of academics and health practitioners, led by trans women of colour, spoke out against the inclusion of Zucker on the conference programme. One session (the first of two at which Zucker was due to speak) was briefly interrupted by an impromptu speech and later quietly picketed, after which hotel security threatened to call the police on a number of attendees.

The next day, community representatives – again led by trans women of colour – met with USPATH and WPATH organisers to read a list of demands. In the wake of this intervention, Zucker’s second talk was cancelled, and a formal apology for the initial heavy-handed response to protesters was posted to the WPATH website. This post, which also promised action to better involve trans communities in general and trans people of colour in particular in the work of WPATH, was removed from the website just two weeks later.


EPATH Conference 2017

Today (6th April) the EPATH (European Professional Association for Transgender Health) conference will begin in Belgrade, Serbia. This event is likely to be a somewhat more conservative affair than the USPATH conference due to disciplinary differences between trans health practitioners in the US and Europe: however, like the WPATH symposium, the conference programme incorporates a wide range of perspectives.

There will once again be an associated FreePATHH event on Saturday 8th/Sunday 9th, which is being organised by Serbian trans activists in collaboration with some of the Dutch individuals behind last year’s FreePATHH. It will include free talks and panels on trans and intersex issues in the former Yugoslav region, as well as arts performances and a football match. At the EPATH conference itself, TPATH will have a presence, seeking to bring together trans people working in the field.

One point of potential contention at EPATH is a code of conduct which has been drawn up for the event. In many ways, this document reflects standard conference etiquette, through (for instance) condemning individual harassment of attendees. However, there are also a number of points that appear to have been written specifically in response to recent events.

We expect all conference participants to be respectful in person and online towards other delegates, speakers, organisers, staff and volunteers.

We are committed to providing a harassment-free conference and training experience for everyone, regardless of gender, gender identity and expression, sexual orientation, disability, physical appearance, body size, race, or religion.  Harassment of participants, speakers, staff or volunteers in any form will not be tolerated.

 Harassment includes offensive verbal comments, and other forms of using disrespectful and pathologising language inconsistent with human rights standards, deliberate intimidation, stalking, following, harassing, photography or recording without explicit consent, sustained disruption of talks or other events, inappropriate physical contact, and unwelcome sexual attention. Conference participants asked to stop any harassing behaviour are expected to comply immediately.

Upon reading the code of conduct, I was immediately reminded of accounts written by trans woman who have accused controversial practitioners of inappropriately photographing them at past events. This is particularly interesting given that he’s been confirmed to speak at the conference. The reference to “pathologising language” also appears to be a nod to some of the practices at previous conferences that have distressed trans attendees.

However, the question remains about what counts as “offensive verbal comments”, “sustained disruption of talks or events”, or “recording without consent”. If a similarly filmed disruptive event occurs at EPATH as took place at USPATH, it could conceivably be framed as “harassing behaviour” within the context of the of the code of conduct, leading to protesters being ejected from the event. This is concerning because the participation of controversial clinicians such as Zucker is typically defended on the grounds of enabling “free speech” within the context of the conference: however, on these grounds, we might expect that conference attendees wishing to peaceably protest or strongly critique bad science might also be afforded freedom of speech.

I won’t be attending EPATH myself this year; like the FreePATH attendees, I simply can’t afford the expensive conference fees. However, I will be following events with great interest, and encourage other non-attendees with a personal or professional interest in trans health and/or trans activism to do the same.

LGBT+ History Month Talks

I’ll be discussing my research at two public events this month.

16473316_204490776693175_8365624470453169582_nThursday 16th February
Condition or Movement? A Century of Trans Identities
University of Warwick

6:30pm, OC0.02, Oculus Building.

I will be giving a talk about the role of medical discourse and social movements in the emergence of ‘trans’ identities during the 20th and 21st Centuries.

 

16602955_10210179504518384_1245278100974843955_nTuesday 21st February
Trans experiences of health care panel
Pembroke College, University of Cambridge

6pm, Nihon Room.

I will be taking part in an LGBT+ History Month panel on the British health care system, alongside Morgan Potts, Amy Clark, Ray Filar and Tschan Andrews. Our respective talks will be followed by a Q&A session.

WPATH 2016: the activist fringe

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.

Gender recognition: where next?

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.

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

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

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.