I have seen the future of feminism, and it is beautiful

Yesterday’s social media furore over a dodgy letter to the Observer left me questioning my place within the women’s movement for the umpteenth time. However, within hours I was powerfully reminded that those who advocate an exclusive feminism are less influential and important than they might like to think.

Last night I joined a room of people committed to building a feminism that is compassionate, reflexive, inclusive of all women and sensitive to our different experiences.

Last night I found myself in a room of brown, black and white faces; gay, bi and straight; cis and trans; working class and middle class; disabled and abled. Last night I heard a teenage Muslim woman speak out about the importance of representing all faiths in activism after a question from a Jewish woman in the audience. Last night I heard from a white middle-class straight woman who has turned up to learn with an open mind. Last night I heard cis women talk about about trans rights, and felt that my identity and experience as a woman was simply not in question.

I had been invited to contribute to a panel discussion at the University of Bristol Students’ Union (UBU). Entitled How do we make the Women’s Movement intersectional?, the panel was was of UBU’s “Festival of Liberation“, which also includes events looking at the challenges faced by LGBT people, disabled people, and people of colour. I was honoured to share a panel with three truly awesome women: Susuana Antubam and Sammi Whitaker of the NUS Women’s Campaign, and Fahma Mohamed of Integrate Bristol.

Panellists at UBU's intersectional feminist event
Last night was promising and encouraging and heartwarming, and was not unusual in being so. I have seen similar scenes repeated across the country over the last few years at talks, workshops, protests and riot grrrl gigs.

This is the new feminism. A feminism that is discarding the model of monolithic female oppression and in its place building a movement around diversity and inclusion. A feminism that seeks to base both theory and action upon what different groups of women have to say about their lives and experiences, rather than imposing a top-down model of liberation drawn from academic theory. A feminism that sees cis and straight women take responsibility for supporting the work of their trans and queer sisters, white women take responsibility for supporting the work of their sisters of colour, abled women take responsibiity for supporting the work of their disabled sisters and so on.

Last night we talked about the importance of intersectionality as feminist praxis: of putting ideas into action. We talked about the importance of education: of sharing the knowledge and tools necessary for women’s liberation with people of all genders. We talked about the importance of representation: of working to ensure that women of all backgrounds feel welcome and able to attend feminist events through the use of accessible venues, ensuring diversity within organising teams and (where relevant) speakers/acts, and thinking about the language we use. We talked about the benefits of building groups around intersectional identities (such as black womanhood); groups that can then work alongside other bodies of people with a broader remit, feeding in ideas and holding them to account.

We talked about calling people out and challenging oppressive behaviour both within wider society and within the feminist movement. We also talked about being kind and prepared to forgive, and allowing people space to learn and grow. We talked about how everyone will make mistakes, because intersectional feminism is a constant experience of doing and being, rather than a closed process where you jump through a series of hoops and then become a Good Feminist who is capable of always passing judgement upon others.

We talked about our experiences of activism. Fahma talked about giving a piece of her mind to a nervous Michael Gove, resulting in a letter to every school in the country about FGM. Sammi talked about productive conversations with working class male friends, and building liberation into the very fabric of Anglia Ruskin’s fledgling Students’ Union. Susuana talked about her work on addressing lad culture as a gendered, racialised and classist phenomenon. I talked about my contributions to trans and non-binary inclusion within the NUS Women’s Campaign, and how we seek a diverse range of performers for Revolt, Coventry’s feminist punk night. We heard stories and ideas and questions from the audience, and I reflected on how we were not “experts” with a monopoly on solutions, but just one part of a wider movement.

These are just some of the things that we talked about.

So why have I been led to question my place within the women’s movement?

Because I see Julie Bindel referring to other feminists as “stupid little bellends” whilst misgendering trans women, arguing that bisexuals do not experience oppression, and stating that Muslim women who wear religious dress are necessarily oppressed. Because I see Rupert Read suggesting that trans women should not be allowed to use public toilets. Because I see Beatrix Campbell repeating and defending these ideas.

When I read things like this, I am repelled by a feminism that is harsh, bitter and exclusionary.

When feminists gaslight me by claiming repeatedly that the individuals who wrote these articles are not transphobic I am saddened and confused.

When I hear about feminists disrupting conversations at events such as AFem in order to promote an agenda that excludes trans people and sex workers, I am disappointed and worried.

When I see exclusionary events like Radfem 2013 and Femifest 2014 promoted within feminist spaces and supported by organisations like Women’s Aid and Reclaim The Night London I am alarmed and concerned.

When I see feminist women and men – including both public figures as well as personal friends and acquaintances – sign a misleading letter that condemns attempts to debate and contest the above, I wonder how voices of those who work for an inclusive and diverse feminism can possibly stand against a “letter mob” representing the discursive might of the liberal Establishment.

The stakes are high. Too many of my friends have considered suicide. Too many of my friends have died. When I talk to my trans friends and fellow activists, I hear about fragile mental health, doctors and shopkeepers refusing to provide services, threats of violence and attacks in the street. All of these things are fuelled by the dehumanisation of trans people, the idea that we require intervention to save us from the misguided path of transition, the implication that we do not deserve to exist within public spaces. These discourses are perpetuated by feminists and defended by liberals in the name of “free speech”.

I don’t believe in historical inevitability and don’t buy into progression narratives. I had a debate about trans-exclusive feminisms with Jack Halberstam recently. Jack echoed my PhD supervisor in arguing that trans-exclusive feminisms are outdated and irrelevant, long-dismissed within the academic world. But the academic world is often divorced from the reality of the feminist movement on the ground. In this reality, exclusive feminisms continue to fester.

In spite of all of this, last night reminded me of the power and appeal of the new, intersectional feminism. It is this feminism that is popular amongst young people who are more interested in working together than apart, and veteran activists with the humility to share their ideas and wisdom with newcomers on an equal footing.

This feminism requires work and nurture, but – as I argued last night – this does not need to be an entirely arduous task. Working together across our differences and ensuring that more people feel welcome and included makes us stronger. Learning new things from others can be interesting and exciting. Having the strength to learn from our mistakes solidifies friendships and alliances. Discovering a more diverse range of feminist histories, activisms and performances can be fun and empowering.

The new feminism is beautiful. Let’s keep building.

Business as usual? A look at the draft English protocol for gender dysphoria

The main achievement of England’s new draft protocol for transition-related services is not to offer progress, but to codify certain elements of existing practice.

In this sense, it somewhat resembles Scotland’s new protocol, which was published a couple of weeks ago.

The Scottish protocol appears to have been based largely upon the services offered by Sandyford, the nation’s largest gender identity clinic. The English protocol seems rooted in current practice at Charing Cross, which plays a similar role within England and Wales. The differences between the documents hinge largely on the differences between the progressive policies instituted at Sandyford, and the more conservative attitude of Charing Cross.

In this article I’m going to examine some aspects of the draft English protocol that have really struck me, before discussing political elements of difference between the English and Scottish protocols. I also briefly talk about the survey that is being distributed alongside the draft guidance.

The Good

LanguageThe language used within the draft English protocol largely acknowledges the complexity and diversity of trans experience. It encourages a respect for patient identities in terms of correct name, pronoun usage etc. (regardless of legal status). There’s even an explicit acknowledgement of non-binary identities, although this is somewhat undermined by binary assumptions elsewhere in the document, and a focus upon transitions that follow the typical “female to male” or “male to female” routes.

Referrals – The document provides some important clarifications for referral to a gender clinic: that individuals do not have to have lived in their preferred gender role prior to referral, that neuro-diversity and mental/physical health issues should not be a barrier to referral, and that psychotherapy is not a necessary precursor to referral. However, these points are not made as strongly as they could be, leaving some room for (mis)interpretation.

Treatment process The document states that two appointments should be sufficient for a diagnosis of gender dysphoria (to be diagnosed according to the ICD-10 criteria, as opposed to DSM-IV). The prescription of hormones should (if appropriate and desired) follow this diagnosis, and surgery should follow within approximately two years. This might all sound very familiar to Charing Cross patients, but may work to reign in some of the more eccentric practices of smaller gender clinics such as Nottingham.

Overall – It will be beneficial to have this protocol at hand to bring local referral practices and the actions of smaller GICs in line with national standards.

The Bad

Referrals – Referrals must come from a GP or specialist (psychiatrist or psychologist), with clinics able to insist upon referral from a specialist. This means that long-winded battles for referral look set to continue as normal. In contrast, the new Scottish system appears allows individuals or GPs to refer to any clinic.

Treatment process – The protocol states that it is informed by the most recent edition of the WPATH Standards of Care. However, it seems (again, contrary to the Scottish protocol) to ignore large parts of the Standards of Care in favour of current Charing Cross practice.

For instance, FtM spectrum individuals must have been on hormones for at least six months and full-time for at least a year before top surgery is considered, and patients must wait at least two years before being offered genital surgery (although a referral appointment for surgery may take place after 18 months under some circumstances). This last point in particular is justified with reference to ICD-10. Interesting here that guidance for diagnosis from 1992 is given precedence over guidance for care from 2011.

Trans youth– There is an acknowledgement of the benefits of hormone blockers for under-18s, but (unlike the Scottish protocol) no real engagement with the possibility of hormones and surgery for trans people aged between 16 and 18. The protocol continues to relegate all young people to specialised – and limited! – youth services.

Overall – The document pays lip service to the WPATH Standards of Care but does not really live up to the spirit of those guidelines. This is particularly evident when the draft document is compared to the Scottish protocol. Patients are expected to put up with a long-winded, complex system in which treatment is spread out over many years.

The Ugly

Get a job – Patients are still expected to be in education or employment in order to gain a referral for genital surgery. If you don’t have a job or you’re not on a course, you’re expected to be involved in some volunteering role. It’s all about demonstrating your ability to move through the world in your “new” gender prior to irreversible surgery.

This requirement is patronising, stupid, and fetishises trans genitals. What other surgery requires that those who undergo it are in work? Why is it that genital reconstruction is seen such a massive step, but the permanent changes that come with long-term hormone therapy is not? Yes, surgery is a big deal, but it’s clear that clinicians regard this surgery as something else entirely.

I can’t understand how this can possibly be acceptable at the best of times, but at a time of recession and mass unemployment it strikes me as particularly cruel and unreasonable. How to account for individuals who cannot find a volunteering role in their local area? Individuals with anxiety issues? Individuals who are told by the Job Centre not to volunteer, with the threat of benefit withdrawal hanging over this order? And how can this possibly be acceptable when trans people face considerable inequalities in the job market (with trans unemployment estimated at 50% in some European countries).

Physical examination – GPs are apparently “expected” to perform a physical examination of trans patients. Why? No reason is given. The document simply states that: “The GP will be required to carry out a basic physical examination and investigations, as a precursor to those physical treatments which may later be recommended.

I simply cannot comprehend where this idea comes from. For many trans people – particularly those contemplating physical transition – the very idea of a physical examination is extremely unpleasant and can cause severe distress. There are times when pre-operative trans people might require a physical examination: such as immediately prior to surgery, or during a sexual health check-up. These experiences can be deeply unpleasant, but at least they’re necessary.

GPs are not trained to understand the complexities of trans people’s relationships with their bodies. In fact, most GPs don’t receive any training on trans issues whatsoever. What are they meant to be looking out for during such an examination, and how are they supposed to know? An invasive examination such as this should only be performed when necessary, by someone who knows exactly what they’re doing.

Discussion: England vs Scotland

The headlines from the Scottish protocol included a number of moves to bring treatment more in line with the most recent edition of the WPATH Standards of Care. These included provisions for self-referral and referral by GP, less waiting time for surgeries, access to a wider range of treatments (e.g. hair removal) and full access to treatment for individuals aged between 16 and 18.

Whilst representatives from groups such as the Scottish Transgender Network played a vital role in putting provisions such as these on the national agenda, it’s important to recognise that many of them had already been implemented by Sandyford GIC.

The message seems to be that the English clinics – who are almost entirely responsible for the development of this draft protocol – are not interested in developing new practice, let alone conforming with the seventh edition of the WPATH Standards of Care. Instead, they seem keen to maintain a tight control over the processing of patients, an approach that renders the draft protocol even more strict than a new national commissioning policy that is being simultaneously developed.

Survey

The survey that accompanies the draft protocol is extremely short. This makes it quick and easy to fill in, but the form also seems to have been designed to shut down unwanted criticism. The Department of Health appears interested only in how current experiences match up to the proposed protocol, and seems keen to avoid any kind of critical feedback on the document.

It is, however, possible to offer you opinion on the nature of the protocol itself. Here are some tips for doing so:

  • Where your experiences differ from the protocol in a positive manner (e.g. you didn’t receive a physical examination from your GP), emphasise how your experience was more positive than would be the case should the protocol be implemented as-is.
  • Where your experiences differ from the protocol in a negative way, emphasise any manner in which you think the protocol could go further to ensure better treatment.
  • If you have sought care outside of the NHS for necessary treatments (e.g. hair removal for trans women) explain why this treatment should be a necessary part of the protocol

Final thoughts

The introductory text to the survey suggests that current political and financial pressures on the NHS prohibit the introduction of any real changes within the draft protocol:

DH wants the final document to outline the current position for transgender people seeking gender reassignment services through the NHS. The document should outline what support and services a transgender person can expect to receive in the tight financial constraints currently placed on the NHS.

This doesn’t really make a huge amount of sense. Yes, if more trans people have access to services (e.g. laser hair removal), this will cost money. But surely there is a lot more money to be saved through progressive reform?

Insisting on longer real-life tests, longer waits for surgery and so on won’t save a lot of money in the long term. A similar amount of trans people will be accessing services: they’ll just have to wait longer as individuals in order to access the a services. The money will still be spent. So why have such long waiting times?

Insisting on referral through a specialist (i.e. psychiatrist or psychologist) won’t save money. How does the NHS possibly benefit financially from insisting that trans people see more specialists rather than having them directly referred to a gender clinic by their GP? This is particularly the case when specialists decide that they need to assess people over multiple appointments before referring them to a gender clinic. The individuals concerned experience a frustrating delay, and it costs more money because the NHS is paying for all these extra appointments.

This isn’t really about the money. It’s about gatekeepers maintaining a certain level of control over patients, and putting certain ideologies into practice. It’s about picking and choosing which parts of ICD-10 and WPATH SOC 7 fit best with their pre-existing ideas, and using those elements to justify existing practice. It’s about conservativism over progression: a wasted opportunity.