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.

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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

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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!

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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.

Family Planning workshop at Trans Health Matters (23 October)

In a couple of weeks I will be attending the Trans Health Matters conference, which is held at Resource for London on Tuesday 23 October.

You can read about and book tickets for Trans Health Matters 2018 here.

Co-hosted by holistic sexual health centres cliniQ (London) and Clinic T (Brighton), this event offers an insight into cutting edge practice and research, particularly with regards to sexual and mental health.

I will be speaking at a workshop entitled Trans Family Planning: Contraception, Fertility, Pregnancy and Childbirth, alongside Kate Nambiar, Michael Toze and Francis Ray White.

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Resource for London, Holloway Road

Trans people often find there is a lack of information available on their own fertility, or that they have been misinformed about the reproductive capacity of their own bodies. Similarly, trans people wishing to form families continue to face social, legal and medical barriers to parenthood. The workshop will comprise three short interventions, reflecting on current challenges and opportunities for trans reproductive autonomy, and an opportunity for attendees to reflect on how this might relate to their own work.

Kate Nambiar is a medical doctor and researcher who works at Clinic T. She will be discussing issues around contraception for trans people.

Michael Toze is a Research Fellow in the School of Health and Social Care at the University of Lincoln. He will talk about UK medical practice and law with regards to trans fertility, parenthood, and sterilisation procedures.

Francis Ray White is a Senior Lecturer in Sociology at the University of Westminster, and I am a Research Fellow in the School of Sociology and Social Policy at the University of Leeds. We will be discussing intial findings from the Trans Pregnancy Project.

 

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.