Pending Legislation

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Statement on Equality Minister’s comments

This statement, which I helped to draft, is cross-posted from Spectra.

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As providers of health and wellbeing services for vulnerable people, we are dismayed by Women and Equality Minister Liz Truss’ poorly-informed comments on transgender issues.

Nobody’s fundamental rights should be subject to ‘checks and balances’, as the Minister suggests. Single-sex spaces are already protected under the Equality Act; trans and non-binary people deserve the same access to relevant services and provisions as everyone else.

Trans and non-binary people face discrimination and exclusion in all areas of life. They are disproportionately likely to experience sexual violence and domestic abuse, plus encounter severe difficulties in accessing healthcare, housing, education, jobs, and benefits. This is especially the case for trans women and girls, plus trans and non-binary people of colour.

Trans and non-binary people of all ages require support in accessing services, and making informed decisions about their own lives and bodies. The Minister’s statement that young people need to be ‘protected’ from making ‘irreversible’ decisions appears to contradict existing legal precedents.

These include the principle of Gillick competence, and the Fraser guidelines, which together protect the rights of minors to make their own decisions around medical treatment, if they can demonstrate appropriate capacity to consent.

Any move to undermine these principles will have deeply concerning implications for all minors. In particular, young people’s confidential access to contraception, sexual health services, abortion services, counselling and therapy will be at risk. Rather than positioning trans and non-binary people as a problem, the Minister, along with the Women and Equalities Committee, should focus on ensuring that the Government delivers on the recommendations of the 2015 Transgender Equality Inquiry.

These include the expansion of healthcare provision, and reform of the Gender Recognition Act 2004 to ensure full legal recognition for trans and non-binary people of all genders, on the basis of self-determination.

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A brief personal addition. Our communities and activist networks are stronger, louder, and more visible than ever. We will stand resolute against any attempt to roll back the legal rights of trans people and/or young people. If the Minister follows through on her threats, she will find she has severely underestimated us. We will fight and we will win.

 

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GRA consultation: A guide for feminist and LGBTQ+ academics and allies

The UK’s Government Equality Office is consulting on possible changes to the Gender Recognition Act 2004 (GRA). Anyone can respond. The consultation link is here: https://www.gov.uk/government/consultations/reform-of-the-gender-recognition-act-2004.

The consultation ends at 11pm on 19 October 2018.

There has been a large backlash from people hostile to trans rights. It is important that academics who support trans rights respond to the consultation, ideally with reference to relevant evidence from scholarly research. This guide provides advice on doing so.

(Note: post updated 15/10/18 to include additional links and my full consultation response)


Background

At present, the GRA enables adults to obtain a Gender Recognition Certificate (GRC) and change the gender on their birth certificate from female to male, or vice-versa.

  • This has consequences for the registration of sex/gender upon marriage or civil partnership and affects some insurance and pensions.
  • It is of symbolic importance for many trans people.
  • Non-binary genders and trans people under the age of 18 are not recognised.

The GRA is not relevant to legal changes of name or sex/gender marker in any other arena.

  • Trans people are already able to change their name and sex/gender marker with organisations such as banks, schools, universities, social services, the DVLA and NHS. No medical evidence is required for this process.
  • Trans people are already able to change the sex/gender marker on their passport with a letter from a doctor.

Trans people have criticised the GRA for being unnecessarily bureaucratic and intrusive.

  • Applicants submit evidence – including medical records, letters from mental health specialists, and proof that they have lived in their ‘acquired’ gender for at least two years – to the Gender Recognition Panel.
  • The process costs £140 (plus additional costs) and there is no right to appeal.
  • An official list of people who have changed their sex/gender in this way is kept on a ‘gender recognition register’.

Note: I use the term ‘sex/gender’ as current UK law does not distinguish between ‘sex’ and ‘gender’: the two are used interchangeably.

 

Backlash

Since the GRA consultation was announced, numerous single-issue anti-trans groups have emerged to oppose amendments to the GRA and argue for a wider push back against the social recognition of trans people’s genders and access to sexed/gendered spaces.

Anti-trans groups have spread misinformation about the GRA.

  • e.g. the purpose and function of the GRA has been conflated with the Equality Act 2010, which governs trans people’s access to sexed/gendered public spaces.

These groups have a powerful voice in the mainstream media.

These groups have access to significant funding that trans groups do not.

  • Tens of thousands of pounds have been spent on billboards and newspaper adverts opposing trans rights.
  • Anti-abortion American fundamentalist groups such as ‘Hands Across the Aisle’ and far-right publications such as Breitbart and The Federalist have extensively promoted the work of ‘feminist’ anti-trans groups and shared crowdfunding pages.

These groups claim to represent feminism.

  • They wrongly argue that gender recognition poses a threat to women’s rights.
  • Trans women are often represented as potential or actual sexual predators.
  • Trans men and non-binary people often are represented as tragic or deluded.
  • By contrast, numerous groups who work with vulnerable women (e.g. Scottish Women’s Aid) have supported trans affirming reforms to gender recognition.

These groups are encouraging their supporters to respond to the GRA consultation.

  • This happened in response to a similar consultation by the Scottish government. While in that instance most respondents supported extending trans rights, thousands of anti-trans responses were also submitted.


Responding to the consultation as academics

As academics, it is important that we support good governance grounded in empirical evidence and the principles of equality and equity for all. As feminists and/or LGBTQ+ people, it is important that we recognise that current attacks on trans rights echo and are linked to similar attacks on women’s and LGBTQ+ rights.

In responding to the consultation:

Concisely reference scholarly evidence where possible.

  • Assert your own expertise where relevant.
  • In the linked PDF below, I have used in-text citations for brevity. However, Government bodies tend to prefer links or full-reference footnotes, so please bear this in mind.

Ensure your response to each question makes sense as a stand-alone comment.

  • Don’t build an argument across the entirety of your consultation response or cross-reference your previous answers.
  • Consultation responses will be analysed on a question-by-question basis.

Responses from organisations are given more weight by the government.

  • If it is possible to submit a response on behalf of your department, school, centre, professional organisation or academic special interest group, please do so in addition to your personal response.

If you have limited time and energy just responding to the tick-box questions will make a difference.

Please share this information with your colleagues to ensure a large, evidence-based trans-positive response to the consultation.


Resources

Here are two documents I have produced to help you and your colleagues in responding to the consultation.

GRA consultation – suggested starting points for responding to consultation questions
This document includes information on each consultation question, including relevant evidence and citations that you might want to use in your submission.

GRA consultation – a guide for feminist and LGBT+ academics
This document includes the full content of this blog post plus the suggested starting points for responding to consultation questions.

For guides to the consultation from non-academic organisations, see:
Amnesty International
LGBT Foundation
Mermaids
Stonewall
National Union of Students
GIRES and TELI (focuses on recognition for trans youth)

You can see my complete personal response to the consultation here: GRA response.

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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.

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Transgender action plan: an initial analysis

“Advancing transgender equality: a plan for action” was today published on the Home Office website. The document is the latest step in a historic programme of trans engagement undertaken by the current government. So, how does it shape up?

THE GOOD

Regular readers of this blog will be quite aware of how much I distrust and dislike the Conservative-led government. Their work on trans equality (in a purely liberal sense) has, however, been quite impressive on the whole.

Under the leadership of Equalities Minister Lynne Featherstone – who has long been a trans ally in Parliament – the Home Office has pursued a programme of engagement and genuine consultation that quite outstrips anything achieved by the previous Labour government (who generally passed trans equality legislation only when ordered to by the European courts).

The action plan promises a robust response to needs expressed by the trans community on a whole variety of fronts. Most of the government’s promises involve the production guidance for various individuals, organisations and/or sectors: this may not sound like much, but the value of this documentation should not be underestimated. Some of the biggest challenges we face arise simply from the fact that doctors, civil servants and others simply don’t know what they’re doing when confronted with trans issues, so it’s good to see this addressed. Of course, we’ll have to see how these promises actually pan out.

So, what do we have?

The Headlines

  • The big news is arguably the
    introduction of trans hate crime legislation    . The government plans to amend existing laws in order to provide for:

“[…] sentences to be aggravated for any offencemotivated by hostility towards the victim onthe grounds of being transgender, and for a30 year starting point for murders motivated by hostility towards the victim on the groundsof being transgender.”

  • The government has also promised to “review” how gender identity is represented in passport application forms, and in passports. It’s not inconceivable that this may lead to the introduction of gender-neutral passports, particularly as the IPS admitted in September that they are “considering” this option. The explicit recognition of “non-gendered” individuals in the action plan itself is also an interesting move on this front.

The nitty-gritty

Various government departments are assigned responsibility for a whole host of actions, including:

  • the issuing of statuatory guidance to increase head teachers’ power to tackle bullying (inc. transphobic bullying)
  • further emphasis upon “prejudice-based bullying” (inc. transphobic bullying) in Ofsted inspections*
  • working to build trans equality into existing practices within primary, secondary and further education (e.g. in PSHE lessons, teacher skills programmes, FE equalities training)
  • updating “advice for employers on recruiting and employing transgender employees”
  • revising guidance for Job Centre staff
  • additional “pre-employment support” for marginalised groups (inc. trans people)
  • clear guidance on trans pension rights on the DWP website, and better handling of pension claims
  • guidance on holding public sector bodies to account through the Equality Duty (an aspect of the Equality Act 2010)
  • “clear and concise” guidance  on transition treatment pathways for GPs and PCTs
  • information on trans health (including sexual health) on the NHS Choices website
  • ensuring that health consultations are trans-inclusive
  • updating privacy guidance within government departments (inc. provide better guidance on the use of privacy markers to protect privacy for employers and benefit claimants)
  • a guide to equality legislation and policy for trans people
  • community outreach on the democratic system and relevant government programmes
  • working with housing providers to produce best practice guidance on trans accomodation (inc. advice on tackling transphobic anti-social behaviour)
  • “Work[ing] with the transgender community” during the marriage equality consultation
  • continuing to play an active role in condemning transphobic violence and discrimination through the Council of Europe and the United Nations
  • providing better guidance on gender identity and trans individuals within the asylum system

Moreover, there a number of actions the government has already taken:

  • police forces have been required to collect data on transphobic hate incidences since April 2011
  • trans people are included (just about) in the Charter against homophobia and transphobia in sport
  • a module on gender identity has been launched as part ofthe training course for asylum decision-makers
  • transphobic bullying was included in an anti-bullying guidance for headteachers
  • UK diplomats worked to promote a historic United Nations Human Rights Council resolution condemning homophobic and transphobic violence and discrimination

THE BAD

My general impression of the document – and planned actions within – is broadly positive. However, there were a few items of concern within the action plan:

As part of the Government’s wider work to
develop a new NHS Commissioning System,
ensure greater consistency in commissioning
gender identity services, increased patient choice
and more cost effective treatment plans for
gender dysphoria.

The term “more cost effective treatment plans” certainly rings alarm bells. How many ways can transition become less expensive to the NHS whilst retaining an appropriate level of care? Moreover, “increased patient choice” definitely sounds like it’s part of the government’s dodgy privatization agenda. On the other hand, this point may simply entail a removal of bureaucratic barriers, and the “greater consistency” should, hopefully, be a positive development overall. Time will tell.

Deliver a framework for evaluating the Equality
Act, including the implementation of the
exceptions on gender reassignment.

Will this work to prevent companies from exploiting loopholes in order to discriminate against trans people, or will it help organisations such as Rape Crisis deny access to vital services?

Run a workshop for the transgender community
to increase their understanding of the public
sector Equality Duty and how they can hold
public bodies to account

A single workshop for the “transgender community”? I hope we’re all invited!

Finally, there’s a lot of talk about “considering” and things that might be “possible”. I do wonder how many of these points will be translated into firm action.

THE UGLY

Fortunately, there’s not too much of this, but there’s the odd action point that stinks. There have clearly been Tory spin-doctors at work on this document, because at times it’s clearly attempting to push the government’s agenda in a number of areas rather than, y’know, trans equality. Whether or not you agree with this agenda is up to you (personally, I’m against for all sorts of reasons) but surely this kind of action plan shouldn’t really be about pushing the government’s pet projects?

Some choice quotes (emphasis mine):

“Transgender people, from transsexual to nongendered,
want to be able to participate in and make their contribution to society and the economy.“

Wait, I thought this was about equality and fairness, rather than corporate drone culture?

Equality of opportunity in employment is
fundamental to building a strong economy and
a fair society. We know that workplaces that are
more inclusive are also more productive.

Glad to see the government has its priorities sorted.

Take active measures to ensure that the views of
transgender users shape the Government’s Care
and Support White Paper and create a care
market that is more responsive to diverse needs.

Because “care” should be bought and sold, and markets are necessarily efficient.

Promote, via government information portals,
relevant funding streams to the transgender
community to ensure they are aware of funding
available to participate in the localism agenda.

That totally makes up for all the national funding that’s been cut, right?

Ensure that National Citizen Service (NCS) for
16 year olds is an inclusive and safe environment
for all participants, including transgender people,
by encouraging NCS providers to build equality
issues into their information and training for staff.

Another pet project! To be fair, at least they’re putting some effort into ensuring its actually accessible and all.

AND FINALLY…

An absolute howler courtesy of the “headline findings” from the community surveys that fed into the action plan:

Nearly two-thirds of respondents (47%) thought that intervention, such as guidance or training, would be best focussed in secondary school

And if that’s not confirmation that the government needs to invest properly in education, I don’t know what is.

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Save the NHS: Block the bridge, block the bill

UK Uncut are planning an unprecedented act of civil disobedience at 1pm on Sunday 9th October in protest against the government’s NHS reforms. Over one thousand people have already announced their intention to participate in the action, which aims to demonstrate the level of public opposition to the Bill and put pressure on sympathetic peers in the House of Lords by occupying Westminster Bridge.

The activist group are also encouraging people to contact peers and ask them to block the bill.

Full details of the demonstration can be found on the UK Uncut website.

There is also a Facebook event page.

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Save the NHS, part 2: lobby the Lords

The NHS “reform” bill passed the Commons on its third reading yesterday by 316 votes to 251.* It will now go to the Lords for further scrutiny.

It’s not too late to save the NHS. A number of groups are recommending an unprecedented public lobby of the Lords in order to stop (or at least fundamentally alter) the bill.

The TUC have set up a page to help you do this: Adopt a Peer.

There is also a Facebook page with a fair bit of information.

 

“This is really important. I don’t think anyone has ever engaged en masse with members of the upper house on an issue like this before. They don’t have constituencies, and they can’t be voted out at an election. Nevertheless, many peers cherish their role in scrutinising bad legislation. They need to know there is a widespread dislike for these changes.”

– Christine Burns

*A grand total of four Liberal Democrat MPs voted against the bill. I can’t comprehend why anyone who cares about public services would ever want to vote Lib Dem again. May the party crash and burn come the next election.

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ACT NOW to save the NHS

MPs are currently debating the controversial NHS reform bill. The £2 billion re-haul of our health system will be voted upon after just two days of debate in Parliament in spite of Conservative promises to oppose any “top-down” reorganisation of the NHS. Lawyers have warned that the changes will fundamentally undermine political accountability and further privatise the health system.

We’ve currently got one of the most economically efficient health systems in the world. It’s hardly perfect – and indeed, I strongly believe that the the NHS benefits from criticism – but we’re incredibly lucky to have it.

This is your chance to tell MPs that we can’t and won’t accept them messing with our health system.

Take action now:

Call your MP (via 38 Degrees)

Email your MP (via 38 Degrees)

Sign the e-petition (HM Government e-petition site)

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Protect the NHS

Opposition to the government’s ill-conceived NHS reforms is growing. I wrote an angry post about the issue last year, but the argument against the proposals is perhaps best summed up in this video by MC Nxtgen:

Co-ordinated protests are apparently taking place across the UK today, but I haven’t seen much in the way of media coverage on the issue so far. We need to be raising awareness of the issue ourselves and building opposition as a broad movement.

I’m always in favour of a good demonstration, but armchair activism also has its place. As such, here’s a couple of initiatives from 38 Degrees (who were in part responsible for the government’s U-turn on the sale of state-owned forests).

“Save The NHS”: petition

Email your MP

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What’s in a consultation?

The media is currently getting itself into a massive tizzy over government proposals to allow gay couples to have civil partnerships in religious buildings. The predictable right-wing wonks are being wheeled out to moan about it being a slippery slope that will end up with any given Christian priest (no-one cares about what Jews, Muslims or (God forbid) Pagans might think, it seems) being forced to marry a couple of scary gay men with Nazi tattoos.

Meanwhile, left-leaning and right-leaning papers are falling over themselves to predict that full gay marriage (and, weirdly, heterosexual civil partnership) will be next, despite the fact that there has been no confirmation of this from anyone in government. I mean, let’s take a look at the actual statement from the equalities minister, Lynne Featherstone:

“Over the past few months I’ve spoken to a lot of lesbian, gay, bisexual and transgender people and campaign groups, and it quickly became clear that there is a real desire to address the differences between civil marriage and civil partnerships. I’m delighted to announce that we are going to be the first British government to formally look at what steps can be taken to address this.”

Yep, there’s certainly a lot in there confirming that gay marriage is around the corner. I’m hoping that it will be (hell, we could immediately take the next logical step and start pushing for legal recognition of polyamory or something!) but have my doubts. After all, the Tories aren’t really that keen on gay marriage. The Liberal Democrats have policy on it and Nick Clegg says that he’s in support, but if you can’t trust the Lib Dems on student fees, trident, detention policies, supporting the poor, the disabled, women or just about anyone else really, then I’m not convinced that you can trust them on equal marriage either.

Moreover, there’s that little issue of the consultation. Government consultations can take forever! I first started campaigning on amendments to the proposed Single Equality Bill (as it was then) back in 2007, and the first consultation was held well before then. The Equality Act eventually emerged in 2010 after being rushed through at the last minute by a desperate Labour party. Ben Summerskill of Stonewall has (for a change) made a pertinent point relating to this:

“If there’s a genuine commitment to making progress in this area, it is painfully slow. Equalities minister Lynne Featherstone has explicitly said she would consult on proposals the government intends to implement in the lifetime of this parliament. If that is to happen by 2015, then consultation should begin now.”

I’d take his word for it: Summerskill knows a thing or two about just how “painfully slow” progress on equal marriage can be.

So this will probably take some time. But it’s interesting that whilst this particular consultation is likely to take ages as civil servants painstakingly gather the views of any given bigot at hand, another important consultation is little more than a formality.

The government is still planning to radically reinvent the NHS despite massive opposition from those who actually understand our health service and care about the welfare state. The “consultation” on this has been minimal to say the least, and health services have already had to start preparing for changes that may have a huge negative impact upon service provision for some of the most vulnerable people.

Funny that the government is so keen to hold a consultation on religious civil partnerships when the relevant law is already there (as part of the Equality Act), but is happy to push ahead with its NHS clusterfuck with as little input from others as possible. Draw your own conclusions.