Trans pregnancy study – new article and podcast

Over the last year I have been working on the largest international study of conception, pregnancy and childbirth among trans men and non-binary people: the Trans Pregnancy project. We have now undertaken fifty interviews with trans and non-binary people about their experiences in Australia, Bulgaria, Canada, Germany, the UK and US, plus further interviews and focus groups with young people and healthcare professionals.

In this post, I share a new peer-reviewed commentary and podcast from the project.


Article: Beyond the pregnant man: trans pregnancy in A Deal With The Universe

Our first published academic article is now available in the journal Feminist Media Studies, authored by myself with my colleague Francis Ray White. This is a short commentary on the representation of trans pregnancy in the media, centring on a review of Jason Barker’s autobiographical film A Deal With The Universe.

Click here to read the article in Feminist Media Studies.

If you do not have access to this journal through an institutional login (e.g. through a library) or personal subscription, I have uploaded an “open access” version of the article to this website. Click here to read the article for free.


Podcast: Making Space for Trans Pregnancy

In November 2018, Francis and I presented initial findings from the project at the Gendered Intelligence Transforming Spaces conference in London, UK.

This presentation was recorded, and is now available as part of the Transforming Spaces podcast series.

Topics under discussion include:

  • cultural amnesia around trans pregnancy
  • contradictions in UK law and policy
  • the importance of trans “possibility models”
  • the myth of testosterone and infertility
  • gendering in pregnancy
  • trans birth parents in international guidelines


Looking forward

There is a lot more to come! Over the next few months, we will be undertaking our final interviews and focus groups, conducting an in-depth analysis of these, and publishing a law and policy report focusing on the European Union.

Early next year we will discuss our research findings in a report and free conference. We are also planning to write many more academic articles on a range of topics, which will be published gradually over the next few years.

We are hugely grateful for everyone who has shared their story with us so far – thanks to your contributions, we have an enormous amount of material to work with. We very much look forward to sharing more of our work with you.

This post is based on material originally written for the Trans Pregnancy website.

You can also follow our research through the Trans Pregnancy Twitter account.

 

Rainbow resources from Aotearoa: accessibility, takatāpui, and healthcare

This is the second in a short series of posts on my recent trip to Aotearoa. See also:
Part 1: Trans health and rainbow futures


During my April/May visit to Aotearoa (New Zealand) I picked up a lot of amazing resources. In this blog post, I share some brief reflections on three great documents which contain an enormous amount of interesting and useful material produced by and for Rainbow communities (takatāpui, lesbian, gay, bi, trans, intersex and queer people), on topics that include disability, Māori experiences of gender and sexuality, and affirmative care.

These documents will be of interest to people who want to know more about rainbow activism, communities and healthcare in Aotearoa, but also clearly have a wider relevance and importance. In writing about them, my intention is to highlight the expert contribution of the authors. As a UK-based scholar and activist, I learned a great deal and it is my hope that readers will too.


All of Us

59b7fa1e4a1c5a438395612258da“Imagine how engaged our communities would be if we were curious about our strengths and values, rather than our limitations.”

This beautifully illustrated guide addresses topics such as structural stigma, intersectionality, accountability, minority stress and (de)colonialism from the perspective of a queer disabled politics. It promotes a mode of solidarity and understanding that recognises and works with difference.

All of Us was created by Stace Robertson, a queer trans man of Pākehā (European or non-Māori) descent who lives with Cerebral Palsy.

Robertson explains that the project came about after he noticed that people are often not fully included even in minority communities if they experience multiple forms of marginalisation.

He therefore decided to create a resource that shared the perspective of people with these experiences, drawing on that advise of mentors, and advisory group and 14 people from a range of backgrounds who offered to share their stories in the document.

This resource will be of interest to people who want to learn more about experiences of multiple marginalisation. It will be useful to those who are new to this topic, as well as those who want to understand more about factors such as ableism or migrant status impact LGBTIQ experience and vice-versa.

There is also an excellent easy-read version of the guide available in the second half of the document.


Takatāpui: Part of the Whānau

Screen+Shot+2017-02-26+at+4.12.09+PM“Takatāpui is a traditional term meaning ‘intimate companion of the same sex.’ It has been reclaimed to embrace all Māori who identify with diverse genders and sexualities such as whakawāhine, whakawāhine, lesbian, gay, bisexual, trans, intersex and queer.”

The document was created to provide information and support for takatāpui and their whanau (family), but it will also be of interest to people wanting to learn more about mātauranga Māori (Māori knowledge or wisdom) with regards to sexual and gender diversity. It was written by Dr Elizabeth Kerekere, a renowned takatāpui activist, scholar, and founder/chair of the Tīwhanawhana Trust.

Through colonialism, Aotearoa inherited the sexism and homophobia of the British legal system. Takatāpui narrative were erased through pathologisation, colonial records, and the imposition of the nuclear family model. In light of this, Kerekere highlights the importance of pre-colonial histories, and of contemporary resilience and the importance of pride, family and community support.

In the UK, we have begun to talk more in recent years about how binary gender norms were imposed on many societies by British invaders through colonialism. These conversations can only become deeper and more nuanced through respectful engagement with knowledge produced by Indigenous peoples on this topic, rather than relying on the flawed work of colonial anthropologists. As a white trans woman who experiences both gender marginalisation and unearned privileges afforded by the legacy of colonialism, I am grateful for the opportunity to learn directly from takatāpui perspectives.


Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealand

Guidelines for Gender Affirming Health low res.pdf“These guidelines are based on the principle of Te Mana Whakahaere; trans people’s autonomy of their own bodies, represented by healthcare provision based on informed consent.”

These guidelines were produced by a coalition of healthcare practitioners, academics and community members, with the support of the Northern Region Clinical and Consumer Advisory Group. They are intended to supplement the World Professional Association for Transgender Health Standards of Care, providing guidance relevant to District Health Boards in providing gender affirming healthcare throughout Aotearoa.

An important feature of the guidelines is the use of Māori health expert Professor Mason Durie’s health framework. The document highlights two key principles for health promotion development: Te Mana Whakahaere (autonomy) and Ngā Manukura (community leadership). There is therefore is an emphasis on trans and gender diverse people having collective control over their own destiny and decisions around healthcare.

Furthermore, Te Whare Tapa Whā, as described by Durie, conceptualises health and wellbeing as the four cornerstones of the wharenui (meeting house). As noted in the guidelines, this model recognises the equal importance of Taha Wairua (spiritual health), Taha Whānau (family health), Taha Hinengaro (mental health) and Taha Tinana (physical health). These four cornerstones provide the structure for the document.

Consequently, the guidelines highlight topics such as Māori and Pasifika genders, minority stress, social transition, health in the family and in schools, and mental health, positioning these as equally important a consideration as physical transition (for those who desire/require medical interventions). This strikes me as a really important move, de-centring hormones and surgery to instead provide a more holistic view on trans health needs.

Like many similar documents, the guidelines are not perfect. I met a number of clinical practitioners in Aotearoa who considered this document to be a good starting point for conversations around improving care, but with some limitations outside of the relatively well-resourced Northern region in which they were primarily written. I have my own concerns around the citation of somewhat inaccurate information produced by cis clinical researchers (for example, Table 5, based on the Endocrine Society Guidelines, underestimates how long it might take for certain bodily changes to take place). I also feel that the definition of “informed consent” used in the document could perhaps benefit from tightening to specify what does and does not constitute appropriate oversight in determining whether or not patients are “adequately prepared” for medical interventions.

Regardless, I am deeply grateful for the work from so many people that goes into producing guidelines such as this, and I hope they can contribute usefully to the ongoing depathologisation of trans health.

Trans health and rainbow futures: learning from Aotearoa New Zealand

This will be the first in a short series of posts on my recent trip to Aotearoa.

20190510_171124

Poster in the RainbowYOUTH centre

I recently returned from a month-long journey to Aotearoa New Zealand. This trip was funded by a Rockefeller Foundation Fellowship with the School of Sociology and Social Policy at the University of Leeds.

My aim was to learn more about trans health services and community advocacy, while also sharing findings from my own research in a European context. I feel deeply privileged to have had the opportunity to meet many amazing people, who are doing a great deal of incredible work.

In this post, I share a number of resources and reflections from the trip. However, this is just the tip of the iceberg – I have no doubt that will no doubt that the experiences from the Fellowship will inform my research and thinking for many years to come.

Before I begin, I should quickly acknowledge that many readers of this blog will be unfamiliar with the word “Aotearoa”. This is a term from te reo Māori (the Māori language): it’s the current name for the islands known as “New Zealand” in English. Both are official names for the country that governs this land. For simplicity (and out of respect Māori history and culture, which long predates the arrival of Pākehā, or white European settlers) I use mostly use Aotearoa alone for the remainder of this post.


Whanganui-a-Tara / Wellington: the Gender Centre and Aunty Dana’s Op Shop

20190426_141647After a brief visit to Auckland (where I recovered from the long flight) I began my trip in earnest with a visit to the capital city of Aotearoa New Zealand, on the south-west tip of the North Island. I was told that you can’t beat Wellington on a good day – certainly, the bay of Whanganui-a-Tara is one of the mostly stunningly beautiful places I’ve ever had the fortune to visit.

My first priority was a visit to the Gender Centre. This amazing new community resource, which was founded only last year and is currently based the front room of the 128 Radical Social Centre. It is run by members of Gender Minorities Aotearoa, a group who campaign and provide information for transgender, takatāpui, and intersex people. Takatāpui is a term in te reo which “embraces all Māori with diverse gender identities and sexualities“.

Photos of 128 Radical Social Centre and the Gender Centre, taken with permission.

The Gender Centre includes a small office space, where people working for Gender Minorities Aotearoa can work on current campaigns and meet with visitors. Anyone can drop by to ask for advice or support, or pick up information. For example, the organisation has recently started running a free binder scheme. Materials on display included forms for name and gender changes, advice on accessing healthcare services, and information on the BDMRR bill.

BDMRR stands for Births, Deaths, Marriages, and Relationships Registration. Groups such as Gender Minorities Aotearoa are campaigning for non-binary recognition, and to make it possible for people to legally change the gender marker on their birth certificate without going through an expensive process involving medical oversight. Unfortunately, proposed changes have been delayed by the actions of anti-trans hate groups. UK readers will recognise the similarities with the campaign of misinformation waged against proposed changes to the Gender Recognition Act. This is not a coincidence. Anti-trans groups in Aotearoa are directly influenced by the language, aesthetics and (in some cases) the direct interventions of UK anti-trans campaigners, in what can be understood as a form of neo-colonialism.

While I was at the 128 Radical Social Centre I also visited Aunty Dana’s Op Shop. This is a second-hand clothing and accessories store run by trans and non-binary volunteers and open to people of all genders, with proceeds donated to Gender Minorities Aotearoa. It’s such a great way to raise money for campaigning, while providing an important resource and social space. It can also serve as a less scary space than the Gender Centre for people who are just coming out and looking for support. I had a great time browsing the shelves and chatting with the volunteer who was working there that afternoon.

Photos of Aunty Dana’s Op Shop. Taken with permission.

You can watch a fantastic video about the Op Shop here:


While I was in Whanganui-a-Tara I also took the opportunity to visit a trans and non-binary artists showcase at the NZ Games Festival and meet with some brilliant academics and students working on LGBTIQ research at Victoria University of Wellington. I will be sure to share their work as it is published!


Ōtautahi / Christchurch: queer art and affirmative care

I next travelled to Ōtautahi / Christchurch, taking a train down the east coast of the South Island. During this trip I began to understand the extent of the damage caused by 2010 and 2011 Canterbury earthquakes. There was evidence of huge landslides and roads were still being rebuilt. Several metres of new coastline were visible for many miles, clearly identifiable through rocks bleached white by dead organisms that once lived under the waves. The city itself is still being rebuilt. Huge building projects and areas of empty land can be found throughout the central business district, a reminder of the unforgiving power of the Earth.

Photos: day and night – urban art and public protest.

It was apparent that the people of Ōtautahi were still recovering from tragedy even before the horror of the recent neo-Nazi mosque shootings. Nevertheless, the city struck me as a great centre of culture. I am grateful to have had the opportunity to meet some amazing queer and feminist artists and heard about both radical public interventions and commissioned works. If you want to learn more about this, the websites of Jennifer Shields and Audrey Baldwin are great places to start.

During this visit, I learned about a fantastic initiative to build and publicise new public health pathways for gender-affirming care in the Canterbury region. Until recently, services such as specialist counselling, hormone therapy and surgical referrals were only available on an ad-hoc basis, and information was not easy to find. Relevant information on what services are available and how they can be accessed is now easily available, thanks to the work of the Ko Awatea gender-affirming care co-design group.

These services are still not perfect – several interventions are not publicly funded, and they still involve a certain level of medical gatekeeping. However, they represent an important step forward. Notably, I was informed that these achievements can be credited to the willingness of particularly motivated medical providers, who were prepared to put energy into working directly with trans community representatives to work for reform.


Tāmaki Makaurau / Auckland: RainbowYOUTH

20190511_140445

The next stage in my journey was a visit Kirikiriroa / Hamilton, back on the north island. I was here for the Aotearoa New Zealand Trans Health Symposium. This will be the subject of a future blog post, so I am going to finish this piece with a look at an organisation based in Aotearoa’s largest city.

In finish my journey with a return to Tāmaki Makaurau / Auckland, meeting a number of community workers, activists and academics living and working in the city. I was especially honoured to visit the RainbowYOUTH offices and drop-in centre: a spacious explosion of colour located in an otherwise unobtrusive side street on the edge of the queer distract around K Road.

RainbowYOUTH are an organisation run by and for queer and gender diverse youth, with a remarkably long and successful history. They are currently celebrating their 30th anniversary, having been founded in 1989. The organisation’s members and executive board are all aged 27 or under. Executive advisors aged over 27 are invited to attend and speak at board meetings, but do not have voting rights. I was really impressed by this commitment to centring youth perspectives in support work and activism, something which has been missing from the UK since the dissolation of Queer Youth Network.

I was also interested in how common the language of “rainbow” community was in Aotearoa, as an addition and alternative to acronyms such as LGBTIQ. I like the way this word avoids the “alphabet soup” and potential exclusions tone of the acronym. I can also see how – like the term “gender minorities” – it can work to be inclusive both of intersex people and of takatāpui in a way that is more expansive than just attempting to rework the Western/anglophone framework of “LGBT”.

Photos of the RainbowYOUTH centre. Taken with permission.

The RainbowYOUTH centre was a wonderful building. For a long time, the organisation ran out of a very small office on Karangahape Road, but in recent years an increase in income and activity enabled a move to the new space. This features several offices, a therapy room, a large social space with a TV and gaming consoles, a library, a community wardrobe, free hygiene packs for people in difficult circumstances, and once again a whole range of resources and information. I can see how the very existence of this space is helping to create new possibilities for a generation of young people who I hope will achieve things that currently remain unthinkable.

I left Aotearoa incredibly inspired by the work and imagination of everyone I met, and am hugely grateful to everyone who helped with advice and organisation, made time to speak with me, and shared ideas and information. Ngā mihi nui!

59691782_1996458760649278_9127576502169239552_n

 

Rockefeller Fellowship – visit to Aotearoa New Zealand

University of Leeds logo

I am very grateful to have been awarded a Rockefeller Foundation Travelling Fellowship by the School of Sociology and Social Policy at the University of Leeds. This will be used to fund a research trip to Aotearoa New Zealand.

The object of the Rockefeller Fellowship is to enable early career researchers working in the Social Sciences to make personal contacts and/or visit universities overseas. My aim is to build networks with trans health activists, researchers and practitioners, plus share research findings from the Understanding Trans Health and Trans Pregnancy projects.

I will be in Aotearoa from 18 April to 12 May, visiting Auckland, Wellington, Christchurch and Hamilton. In addition to strengthening existing relationships, I hope to spend time meeting new people and learning more about trans health services and community advocacy. While the UK and Aotearoa differ in many ways, we are both island nations with public health systems that face various forms of privatisation; we are both seeing a rapid growth in the visible trans population; and we are both currently seeing proposals for reform within trans healthcare. I am very much interested in exploring how activists, researchers and practitioners in both countries might be able to exchange ideas and information.

I am excited to been invited to present my work at the University of Waikato, Hamilton during the visit.

On Friday 3 May I will be speaking about my PhD research in the Department of Psychology at the University of Waikato. My talk, The “Gender Experts”: Clinical Discourses and Becoming Trans, will explore how expertise is contested within and between trans communities and clinical settings, reflecting on what this might mean for patient experience and differing understandings of trans possibility.

On Saturday 4 May I will be describing initial findings from the international Trans Pregnancy project at the Aotearoa New Zealand Trans Health Symposium. In this talk I will look at how and why some trans men and non-binary people choose to conceive and bear children. I shall explore some of the challenges and opportunities that arise for trans birth parents, and explain what kind of support research participants want to see from healthcare providers.

If you are a trans activist, trans health researcher or healthcare provider in Aotearoa and would like to meet during my visit, please do be in contact – I would love to hear from you!

Clinical research with trans patients: a critique

WPATH_BuenoAr_Logo_reverseIn November I participated in a panel on research ethics at the 2018 WPATH Symposium in Buenos Aires, “Ethical Considerations in Transgender Health Research Practice”.

I presented a talk based on work I have undertaken with Dr Michael Toze (who sadly could not join us at the conference). Entitled Trans Health Research at a Gender Identity Clinic, the talk critiqued clinical research methods employed at a UK gender clinic, using the example of published research on video gaming.

I argued that clinical researchers should be mindful of the power dynamic that exists between them and their patient/participants. I also presented evidence that methodological and ethical issues have resulted in harm to participants, and undermined the validity of empirical claims.

This talk was kindly recorded by Ellen Murray, and you can listen to it below.

 

I have also uploaded produced a transcript of the talk:

Trans Health Research at a Gender Identity Clinic

And you can download the slides here.

Please do feel free to download and share this talk with anyone you think might find it interesting or useful, as long as myself and Dr Toze are credited.

The talk followed a remote presentation by Ali Harris, and preceded a talk by Noah Adams, who discussed the paper we wrote in collaboration with Jaimie Veale, Asa Radix, Danielle Castro, Amrita Sarkar and Kai Cheng Thom: Guidance and Ethical Considerations for Undertaking Transgender Health Research and Institutional Review Boards Adjudicating this Research.

Trans Pregnancy poster: initial findings presented at WPATH

Cross-posted from the Trans Pregnancy blog. Image shows a woman standing in front of a poster display board, smiling.

In early November, I presented a poster at the 2018 World Professional Association for Transgender Health (WPATH) Symposium in Buenos Aires, Argentina. The poster outlined a number of initial findings from our first research interviews, which have so far been conducted in Australia, Canada, the United Kingdom and the United States.

The WPATH Symposium is attended primarily by healthcare professionals working specifically in the field of trans health, so the poster was designed especially with this audience in mind. Our future work will also speak to the needs and interests of trans people who become pregnant as well as professionals specialising in fertility and reproductive health. Plus, we will be exploring what trans pregnancy means for understandings of sex and gender.

You can click on the poster image below to read and download a copy for yourself, or click here for a PDF version.

Through our Twitter account I also reported on two sessions at the WPATH conference which were all about trans fertility and reproduction. You can read these Twitter threads by clicking on the links below:

WPATH oral presentations: Fertility

WPATH oral presentations: Reproduction

To find out more about the context of trans pregnancy and people’s experiences, please do explore our website. We have already published a series of law and policy reviews and are adding more resources all the time.

We are also still recruiting research participants from Australia, European Union countries (including the UK) and the USA. If you are a trans person who has been pregnant and you would like to talk confidentially with us about your experiences, please click here to find out more.

Trans Temporalities and Non-Linear Ageing

Transgender lives may require mixed strategies—not only healing and an achieved coherence but also the ability to represent and to inhabit temporal, gendered, and conceptual discontinuities.’
– Kadji Amin

I’ve recently ha9781138644939d a chapter published in a new book about LGBT ageing: Older Lesbian, Gay, Bisexual and Trans People: Minding the Knowledge Gaps, edited by Andrew King, Kathryn Almack, Yiu-Tung Suen and Sue Westwood. My essay is titled Trans Temporalities and Non-Linear Ageing.

This blog post includes an extract from the introduction to the chapter (updated slightly to reflect my advanced age from the time of writing – what temporal webs we academics weave), along a link at the end where you can download and read a free version of the entire essay.

At the time of writing, I am 12 years old, 16 years old, and 32 years old.
I was born 30 years ago; in chronological terms, I have lived for 32 years. Chronological time is, however, just one means by which ageing might be understood (Baars, 1997). When we talk about age in terms of chronological time, we make a number of assumptions. Most importantly, we assume that our journey through the life course is linear, progressing from birth (at the beginning of the journey) to death (at the end). But my age can also be understood in terms of trans time. As a trans woman, I have experienced non-linear temporalities of disruption, disjuncture, and discontinuity.

By temporality, I refer to ‘the social patterning of experiences and understandings of time’ (Amin, 2014: 219, emphasis mine). Through conceptualising time as a social phenomenon, we might think about other beginnings and other ends, as well as wider temporal shifts and discontinuities across the lifecourse. It is not unusual for trans people do this: for example, through talking about age in terms of trans years in addition to years since birth. What if we were to regarding my coming out at the age of 16 as a beginning (and, for that matter, as an end to my ‘previous’ life)? In this case, I might say that I am 16 years old in trans years. This does not, of course, change my chronological age: I am both 16 and 32. Or, we might regard my commencement of hormone therapy as a beginning, in which case I am 12 (but also 16 and 32, still).

Importantly, trans years are not necessarily linked to chronological years. For instance, two different trans people who are both aged 80 in chronological years might have aged quite differently in trans years: perhaps one of them came out many decades ago, while the other has only been out for a couple of years. These individuals are likely to have had vastly different trans temporal experiences, which belie their apparently similar chronological age.

In this chapter I explore the consequences of trans temporalities for ageing. Non-linear ageing is not simply a matter of theory, but an approach which can enable us to ‘do justice to the complex ways in which people inhabit gender variance’ (Amin, 2014: 219). As Louis Bailey, Jay McNeil and Sonja J Ellis note in chapter 4 of Older Lesbian, Gay, Bisexual and Trans People, ‘Mental Health and Well-Being amongst Older Trans People’, trans people tend to face a range of specific challenges as they age, and may fear accessing mainstream forms of care, such as mental health services. It is therefore vital that academics and service providers alike understand how temporal phenomena such as trans years can shape trans identities and experiences.

I begin by outlining theories of queer and trans temporality that help to make sense of community terminology such as ‘trans years’. I then show how trans people may experience ageing in a variety of quite different ways, drawing on a range of literature as well as findings from two qualitative research projects. Finally, I detail two common features of non-linear trans ageing:anticipation, and delayed adolescence. These discussions draw primarily on evidence, issues and challenges that have been identified in Western European and North American research.

Read the full essay here.

This is an open-access version of my book chapter – you are welcome to read and share it freely. However, if you are a student or academic, please do cite the published version of the essay, and encourage your library to purchase a copy of the book if they have not already done so.

For further reading, I recommend Trans Temporalities, a 2017 special issue of the journal Somatechnics. You can also read more from me on the topic in Chapter 5 of my book, Understanding Trans Health.