Cass Review GRA study an appalling breach of research ethics

Logo of the Cass Review

I was dismayed to read that the UK Government are amending the Gender Recognition Act. Specifically, they are removing the offence under section 22(1) of the Gender Recognition Act 2004 for the disclosure of protected information, to enable this disclosure where it is “necessary for the purposes of facilitating, assisting or undertaking relevant research”.

This amendment enables NHS England to obtain trans people’s confidential information about their medical treatment for the purpose of research into child and adolescent gender services by the Cass Review. Specifically, it enables the acquisition of information (a) that could contain personal identifying details, (b) without that person’s consent, and (c) for individuals who obtained specific legal protections with the reasonable belief that these would remain in place. There has been no community consultation ahead of this move.

As a social researcher and expert in ethical methodologies, I believe that any research undertaken under these circumstances would represent an enormous breach of the basic principles of research ethics. Moreover, it will could significantly undermine the already extremely low existing low level of trust between trans community members, researchers, and medical practitioners.

Finally, the amendment also represents a significant weakening of the Gender Recognition Act’s legal protections for trans people (although for a full and measured analysis, see this post by What The Trans).

I have therefore written to the NHS England’s Gender Identity Programme Board to express my concerns about this development. I also hope that any university or NHS ethical panel overseeing the approval of such research will prevent it from taking place.

You can read some of my published work on ethical research with trans populations here.

You can write to the Cass Review to express your concerns here.

Posted updated 2 July to include new details.

Resources for trans pregnancy a cause for optimism

Cover of the Trans and Non-Binary Experiences of Maternity Services report. Cover art depicts two Black transmasculine people - one standing and smiling with a visibly pregnant belly, and the other is kneeling next to them and has their face pressed against the belly, with their eyes closed and a peaceful expression on their face. The title text and clothing for the people on the cover uses the colours of the non-binary flag - yellow, black, white, and purple.

There have been some really exciting developments in England over the last couple of months for trans birth parents (that is: men and non-binary people who conceive, carry, and give birth to their own children).

In April, a groundbreaking report on Trans and Non-Binary Experiences of Maternity Services was published by the LGBT Foundation. I am really proud to have co-authored parts of this report with colleagues in NHS England and the LGBT Foundation, and to have supported the research which informs it.

The report, which was funded by NHS England, offers a sobering account of healthcare inequalities for trans birth parents. However, it also includes important examples of good practice and recommendations for professionals.

  • Trans people’s experiences of perinatal care are consistently worse across the board compared with cis women.
  • 30% of trans birth parents didn’t access perinatal healthcare at all during pregnancy – this compares to less than 2.1% of the general population.
  • Transphobia and racism in perinatal care intersect to produce particularly poor outcomes for trans parents of colour.
  • Recommendations include: supporting the delivery of personalised and trauma-informed perinatal care; proactively adopting inclusive language and targeting outreach to trans birth parents; and implementing IT and demographic monitoring systems to enable the sensitive collection of data about gender identity and trans status in perinatal services.

Excitingly, it appears that work is already underway on many of these points. For example, last year a fabulous series of resources for practitioners were published by Brighton and Sussex Gender Inclusion Midwives, and I have heard good things about progress on trans-inclusive data collection.

Best of all, NHS England now provide a range of tailored, accessible advice to trans parents as part of their new guide to having a baby if you’re LGBT+. This includes ways to become a parent, advice on testosterone and pregnancy, and chestfeeding/breastfeeding for men and transmasculine non-binary people.

These resources should really be seen as a starting point (for example, there is no advice for trans women who breastfeed). But equally, it is brilliant to see progress being made on the provision of practical advice that will help prospective and new parents. I am especially grateful to an NHS whistleblower who ensured their dissemination through revealing to The i that their publication had been blocked by some senior figures at NHS England for nearly a year.

This all serves as an important reminder that NHS England is not a monolith, and that concerted pressure from community groups and allies can have real long-term benefits.

It’s very easy to be cynical about our NHS given the poor overall state of trans healthcare, as well as opposition to equitable provision by some within the health service. However, all the positive moves I have reported in this post are also the result of hard work by numerous NHS midwives and members of the NHS digital team. Alongside community members who generously offered their time and knowledge, they have collectively fought to ensure that trans birth parents and the practitioners who work with them have access to resources and information.

All of this makes me feel hugely optimistic. These are difficult times, in which prejudice and disinformation are rife. Yet ordinary people are still fighting – successfully! – for positive change. This new research and guidance should be of great help to new parents and their children, and for that we can be grateful.

Upcoming talks: April-May 2022

I am speaking at a series of exciting events over the next few weeks! All are free to attend, you will just need to register in advance if you’d like to come.

Tuesday 26th April – Manchester
Trans Healthcare: Past, Present and What Might Have Been

In-person roundtable discussion, with Ellis J Johnson, Stephen Whittle, Krishna Istha, and Laura Salisbury.

6pm-8pm BST, International Anthony Burgess Foundation
3 Cambridge Street, Manchester, M1 5BY

Wednesday 27th April – Online
Queer and Trans Mobilisations – Possibilities and Challenges

I am incredibly honoured to be giving a keynote talk for this two-day event hosted by the Department of Sociology, University of Hyderabad, and the Centre for Writing and Pedagogy, Krea University. I will be speaking about “Building Queer and Trans Communities in the UK” towards the end of the first day, and am enormously excited to be learning from colleagues in India during the event.

10am-6pm IST, 27-28 April
Register online to attend

Thursday 5 May – Online
UK Workshop in Trans Philosophy

I will be delivering a keynote on the first day of this groundbreaking event hosted by the University of Glasgow. My talk is provisionally titled “Let’s (not!) fight a TERF war: Trans feminism in a time of moral panic”.

9:30am-4:30pm BST, 5-6 May
Register online to attend

Wednesday 11 May – Online
Reproductive Justice Research Network seminar (link to come)

I will be joining colleagues from the Trans Pregnancy project to discuss findings from our international study of trans and non-binary people’s experience of conception, pregnancy, and childbirth. Our talk is provisionally titled “Reproductive Justice for Trans People”.

Full details TBA – watch this space!

Fantastic “TERF Wars” and where to find them

Are you trying to understand anti-trans debates within and beyond feminism? Wanting to get to grips with the relationship between “gender critical” advocacy, medicalisation, and traditional conservative ideologies?

Cover of the book TERF Wars: An Introduction.

Our Sociological Review edited collection TERF Wars: Feminism and the Fight for Transgender Futures is now more widely available than ever. Challenging the framing of ‘transgender activists versus feminists’, it features a range of peer-reviewed essays from expert writers such as Jay Bernard, Florence Ashley, Julia Serano, and Emi Koyama, on hot-topic issues including gender ideology, autogynephilia, rapid-onset gender dysphoria, detransition, migration, sex work, and public toilets.

None of the authors or editors receive royalties for this work – we simply want to share our knowledge with others.

You can download digital copies of the collection from the Sociological Review website or for free from the Open University.

Hard copies of the book are also available from just £10, e.g. from Foyles (UK), AbeBooks (USA), and (sigh) Amazon. If you can though, please support a local independent bookseller! I am most excited that TERF Wars is available from the amazing Leeds-based queer bookshop The Bookish Type.

Finally, I am deeply honoured to announce that the opening essay of the collection, “TERF Wars: An Introduction” (by myself and co-editors Sonja Erikainen and Ben Vincent) is now also available in Turkish. We are honoured that this version has been published in the latest issue of the journal Kaos Q+. I was so excited to recieve my copy in the post!

Photo of a parcel with a copy of the journal Kaos Q+ sitting on top. The journal cover features a person with blond hair and make-up lying on a table, looking blankly towards two spoons and a knife, their face reflected in a place mat.

If you find this work useful, please do tell other people about it, and feel free to share download links or hard copies with others. We have felt very supported by The Sociological Review, but the publishers SAGE have been absolutely awful at distribution and publicity (if you are an academic, I would definitely recommend against working with them on a book if at all possible). It’s up to use to make this work a success!

Trans inequalities in English perinatal care

About a month ago I participated in the TPATH conference. This groundbreaking online event centred trans healthcare practice, research, and activism by and for trans people.

I was very impressed with the measures taken by TPATH organisers to ensure the conference was accessible to as many people as possible from around the world. They organised live translation to and from English, French, and Spanish, provided live captioning, encouraged presenters to speak slowly and clearly to enable lipreading, and ensured that generous scholarships were available for those who would not otherwise afford to attend. Most of the event was recorded, and videos are gradually being uploaded to the TPATH Youtube channel.

At the conference I joined Tash Oakes-Monger from NHS England to present initial findings from the ITEMS project (Improving Trans Experiences of Maternity Services). The ITEMS team, led by Michael Petch from the LGBT Foundation, ran a survey in early 2021 to explore the experiences of trans people (including non-binary people) who give birth in England. I supported the design and dissemination of the survey through my former role with the Trans Learning Partnership.

Bar chart indicating that increasing numbers of trans and non-binary people are giving birth in England every year.
Bar chart indicating growth in number of trans people giving birth in England each year.


There is some really exciting information emerging from the ITEMS data. For example, it appears that more trans people are giving birth than ever before (see above). However, it was also apparent that trans people face substantial inequalities.

Many of the questions in the ITEMS survey used comparable wording to the CQC Maternity Survey – from this we can see that trans people appear more likely to have negative experiences in NHS maternity services than cis women across the board. Even more disturbing is that 30% of trans respondents gave birth without the support of an NHS or private midwife (rising to 46% among trans people of colour). This indicates a lack of trust in midwifery services among prospective trans birth parents, with potentially lethal consequences for both parent and baby.

To learn more, you can watch our presentation on the TPATH Youtube channel.

A formal report of ITEMS findings should be published in the coming months.

New roles: University of Glasgow and CATS

I am very excited to announce that I will be starting a new job at the University of Glasgow this summer!

I have been appointed Lecturer in Community Development at the School of Education. I will be teaching and conducting research on a range of topics relating to social justice theory and movements, community action, and collective empowerment. This will build on my previous work on topics including trans health, queer music scenes, and gender inequalities in Higher Education.

St Andrew’s Building, University of Glasgow

I am also delighted to have been appointed Senior Fellow at the Center for Applied Transgender Studies (CATS) in Chicago. As a Fellow at the Center I intend to collaborate with international colleagues in conducting and disseminating impactful research by and for trans people and communities.

All of this does however mean that sadly I will be leaving my current role as Research Coordinator at the Trans Learning Partnership. We have achieved an enormous amount with this new partnership over the last year, including co-production of community research priorities, design and pilot of shared data collection, participation in public consultations and advisory groups, and support work around groundbreaking research with trans birth parents in England. I wish my former colleagues all the best with their future work, and fully intend to continuing collaborating with them as a university-based researcher.

Trans Pregnancy: new articles on conception and pregnancy loss

Cross-posted from the Trans Pregnancy project blog.

We are delighted to announce that the first two peer-reviewed articles on findings from our research interviews are now available. Both draw on an analysis of 51 interviews with people who had concieved. One looks at experiences of pregnancy loss among a subset of research participants, and the other explores routes to conception.

More information on each of these articles can be found below, along with links to open-access versions which are free to read.

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Men, trans/masculine, and non-binary people’s experiences of pregnancy loss: an international qualitative study

Abstract text for the article. Follow the link to read it.

Published in BMC Pregnancy and Childbirth (BioMed Central). The article is fully open-access and free to read.

This article examines male, trans/masculine and non-binary gestational parents’ experiences of pregnancy loss, an experience that more broadly affects millions of people every year. We found that, like cisgender parents, our research participants often faced grief following a pregnancy loss, and like heterosexual cisgender men in particular, they often faced barriers to support.

However, the research participants also reported experiences specific to pregnancy loss among male, trans/masculine and non-binary gestational parents, including difficulties in accessing inclusive healthcare, and resistance to “failed” or “wrong” body narratives. We therefore make recommendations for healthcare providers regarding the importance of appropriate language, and the need to sensitively attend to emotions attached both to the loss itself and to the possible desire to attempt another pregnancy.

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Men, trans/masculine, and non-binary people negotiating conception: Normative resistance and inventive pragmatism

Abstract text for the article. This can be read by following one of the links to the full article.

Published in the International Journal of Trangender Health (formerly the International Journal of Transgenderism). An open-access version of the article can be read for free here.

This article explores how men, trans/masculine and non-binary people navigated different social norms and/or practical obstacles to conception. It shows that individuals engage in diverse practices that normalise their experiences of conception, while also highlighting the unique needs and challenges they can face.

The article will also form part of a special issue of the International Journal of Transgender Health that we are editing which will be published in full in early 2021. This special issue will more broadly explore issues of fertility, reproduction, and sexual autonomy among trans and non-binary people. Two other great articles from the special issue have also already seen advance publication:

Administering gender: Trans men’s sexual and reproductive challenges in Argentina, by Andrés Mendieta & Salvador Vidal-Ortiz.

“Just because I don’t bleed, doesn’t mean I don’t go through it”: Expanding knowledge on trans and nonbinary menstruators, by A.J. Lowik.

There is of course a lot more to come – watch this space for more new research findings from both ourselves and our colleagues in the field.

Free talk: Making Trans Pregnancy Possible

This Friday (25th September) I will be presenting findings from the Trans Pregnancy Project at the LGBT Foundation’s Future of Trans Healthcare conference. Topics under discussion will include men, transmasculine and non-binary peoples’ experiences of conception, the impact of testosterone, and the language of reproductive health services.

The conference runs for two days through Thursday and Friday, and is free of charge. It’s possible to drop in and out or attend the whole thing. My session is scheduled for 1pm on the second day.

Read more and register to attend here.

Beyond the TERF Wars

For the past couple of years, I have been working quietly on a new edited collection with my colleagues Sonja Erikainen and Ben Vincent. It is titled TERF Wars: Feminism and the fight for transgender futures.

Cover of the Sociological Review Monograph: TERF Wars.

TERF Wars is being published as part of the Sociological Review monograph series. This means it is available digitally as a special issue of the century-old journal The Sociological Review, and will also be available to buy as a reasonably-priced paperback book.

Digital special issue
(available now with a subscription to The Sociological Review)

Paperback pre-order
(Europe only for now – more and better links coming soon!)

Read the Introduction for free

Our aim has been to provide a critical, scholarly response to the growing circulation of both “pro-trans” and “anti-trans” ideas within feminism, especially in the academic context in which we work. As the “trans debate” has grown ever more extensive and complex, newcomers often express confusion around why this has happened, what the fiercely contested language actually means, and how it has all become so polarising.

The collection therefore addresses a range of issues, including (but not limited to) definitions of sex and gender, trans/feminist histories, racism, autogynepilia, “rapid-onset” gender dysphoria, detransition, access to public toilets, and contestation over the “TERF” acronym (“Trans Exclusionary Radical Feminism”) itself. We have been privileged to work with a range of amazing authors, including Jay Bernard, Lua da Mota Stabile, Jen Slater, Charlotte Jones, B Camminga, Rowan Hildebrand-Chupp, Florence Ashley, Julia Serano, María Victoria Carrera-Fernández, Renée DePalma, Emi Koyama, Cristan Williams, and Sally Hines.

I am proud of what we have achieved, and hope the collection will serve to move some of these debates forward. However, I also believe it is important to emphasise that trans people face far more significant issues than debates within feminism.

I have long felt that the “TERF wars” are a distraction from the endemic discrimination and gross inequalities faced by trans people in all areas of public and private life. There is a reason that my own research and activism has focused primarily on healthcare, both before and during the editing of this collection (which I have very much treated as a side project). Arguing with strangers about sex and gender on Twitter won’t reduce waiting lists or stop doctors from sexually assaulting patients. Equally, it becomes harder to concentrate on the task in hand when vicious anti-trans columns are constantly published in the mainstream media, and when your research plans are derailed by a malicious Freedom of Information requests from anti-trans campaigners hope to access your work emails.

There is no easy solution to this conundrum. However, I urge readers to consider how they, personally, might aim to move beyond the TERF wars. My main hope for this edited collection is that will be helpful for people to better understand this particular realm of transphobic discourse, and to counter harmful and inaccurate arguments. Having done so, I urge you to turn to the real tasks of trans liberation: fighting sexism, racism, and ableism, protecting personal autonomy, building collective solidarity and mutual aid networks, providing services to our communities, and imagining new worlds.

Public lecture: Clinical Discourse and Becoming Trans

“Who is the gender expert? How did they get to be a gender expert?”

Last year I undertook a research visit to Aotearoa New Zealand, to learn more about trans activism and healthcare provision, and speak about my own work. During the visit, I gave an invited lecture at the University of Waikato, titled The Gender Experts: Clinical Discourse and Becoming Trans.

I drew on my PhD research to explore how understandings of what it means to be trans, and what it means to be an expert on being trans, are shaped by power relations in medical contexts.

My talk was recorded using lecture capture software, so is now publicly available for anybody to watch!