Forthcoming books!

I’m delighted to announce that I have recently signed not one, but two book contracts. Both books are scheduled for publication in 2018.

My first monograph, provisionally entitled Understanding Trans Health, will be published with Policy Press. This book will draw upon extensive qualitative fieldwork in the UK to examine how trans identities, experiences and healthcare needs are differently understood within community, activist and professional contexts. It shall explore how these different understandings can lead to conflict and mistrust within medical settings, and propose means by which more collaborative relationships might be fostered in the future.

An edited collection, provisionally entitled The Emergence of Trans: Essays on Healthcare, Culture and the Politics of Everyday Life will be published with Routledge. Assembled in collaboration with Dr Iggi Moon and the late Professor Deborah Lynn Steinberg, this book builds on the success of our 2012-2014 seminar series Retheorising Gender and Sexuality: The Emergence of Trans. It will feature international contributions from a range of authors based in different academic disciplines.

Academic books are often unaffordable to lay readers, and unavailable outside of academic libraries. I was therefore really keen that both books would be available in paperback and ebook format as well as the traditional hardback. I’m really pleased to say that both publishers have agreed to print paperback editions in the first run, in recognition of how the book topics are relevant to ordinary people within trans communities.

I’ll be sharing more details on these books as the publication dates approach.

Tickbox diagnosis: can you measure trans feeling?

Nottingham Centre for Transgender Health are currently developing a “Gender Dissonance Severity Scale”.

Gender Dissonance Severity Scale

I can see why some practitioner-researchers might think this is a good idea. The clinical protocols at GICs such as Nottingham currently require trans patients to demonstrate that they can cope with living a “trans” life in order to access “irreversible” treatments such as hormone therapy. At present, this is demonstrated through patients’ adherance to the “Real Life Test”.

“[I]t is the view of many clinicians working in the field – including some of whom are transgender themselves – that living as their experienced gender allows individuals to test their gender identity in the real world before the initiation of potentially irreversible treatments […] transgender people who have poor social and interpersonal skills may be more likely to encounter difficulties when socially transitioning.. […] In order for an individual to be accepted for treatment, they need to socially transition first, which includes not only living as their experienced gender but also changing their name and most legal documents.

(Arcelus et al., 2017)

Wouldn’t it make life easier for clinicians though, if they could also ascertain whether or not their patients feel sufficiently trans?

Enter the Gender Dissonance Severity Scale, which aims to explore “how people feel about their gender, body and quality of life”.


What is being measured?

There are a number of problems with the concept of the Gender Dissonance Severity Scale. The most fundamental is the question of how far you can adequately and consistently measure feeling.

This is a particularly a problem for nebulous concepts such as “gender dysphoria” and “gender dissonance”. That these phenomena exist is not in doubt – many trans and non-binary people across the world can attest to the reality of dysphoric feelings in relation to our bodies and/or gender roles. But these experiences vary greatly from individual to individual, mediated by collective factors such as social context and culture as well as individual differences.

Moreover, dysphoria varies within people as well as between people. A person might feel less dysphoric one day, and more on dysphoric another – depending on factors such as where they’re going, who they’re seeing, how their bodies look, how their bodies feel. A person might feel more dysphoric, for instance, if their facial hair looks particularly thick, if they’re having their period, or if they’re about to attend an appointment at a clinic that assesses their transness. Or they might feel less dysphoric, for instance, if their hair looks great today, if their gender identity feels more aligned with their body, or if they’re about to attend an appointment at a clinic that might grant them access to hormones.

So any attempt to measure gender dysphoria or dissonance may be thwarted by the ever-shifting nature of the thing that is supposed to be measured. One person’s dysphoria can be another person’s euphoria. And a measurement that is “accurate” for a patient on one day might be “inaccurate” on the next.


Who is doing the measuring?

In recruiting participants to assist them in developing the scale, researchers based at Nottingham GIC have argued that the scale will help measure the “effectiveness” of treatment: i.e. how interventions such as hormone therapy and surgeries improve patients’ quality of life. This is no doubt an admirable goal, and will expand upon existing evidence that trans people benefit from having transitioned.

However, there is another proposed use for the scale, as described in the following excerpt from a request for research participants.

From the findings, we hope to develop a new outcome measure that could be used by GP’s to make referrals to transgender health services.

This is a very troubling proposal. It suggests that the Gender Dissonance Severity Scale could perhaps be used as a form of screening mechanism before trans patients are even referred to a gender clinic. Patients could perhaps be refused treatment altogether if they don’t appear to be “dissonant enough” according to the blunt measure of the scale.

Pre-prepared questionnaires are already being used to assess patient distress for those needing to access NHS mental health services through IAPT. Patients are often invited to answer questions on the phone, with access to services depending on how well they meet the questionnaire criteria.

It seems therefore that the Gender Dissonance Severity Scale could potentially be used as an additional layer of gatekeeping, reducing referrals to gender clinics (which are currently seeing a record number of patients) at the expense of those in need of care who happen not to meet the specific criteria of the test.


Subverting measurement

Of course, trans patients have a long-standing approach to dealing with barriers to care: we share information amongst ourselves, learning the “right answers” to give in clinical contexts. This is great for the individual trans person who wants to jump through the necessary hoops in order to access care, but an awful situation for clinical research, where supposedly firm findings might be built upon the decidedly shaky foundation of trans people making up the answers that they think clinicians want to hear.


Towards collaboration?

There is already a lot of mistrust between many trans patients and gender identity specialists. The development of flawed measures such as the Gender Dissonance Severity Scale may only compound this.

While Nottingham GIC does have at least one trans clinician involved in developing their research programme, they have yet to engage more widely with the trans research community. Moreover, few opportunities exist for clinicians to learn about their patients’ desires and interests outside of a context where they have a great deal of power over said patients’ healthcare. But these are issues that can be addressed: through better community outreach, communication, and collaboration, as well as reflexivity and humility on the part of researchers.

WPATH 2016 poster: “A time of anticipation”

Here’s the poster I presented at this year’s WPATH Symposium:

Anticipation poster.png

You can also download a PDF version here.

The magnet is a metaphor for anticipation, which is both a product of and shapes feelings, emotions and experiences of time. This process is mediated by both trans community discourses and medical systems.

It’s very important to note that the majority of research participants had good things to say about the health professionals who helped with their transition. However, there is also a high prevelance of transphobia and cisgenderism within medical systems and clinical pathways. Anxiety and mistrust of practitioners within the trans patient population is endemic, and this is compounded by long waiting times.

My wider research looks critically at how discourses of trans health are differently understood within and between community/support spaces, activist groups and the professional sphere; however, the purpose of this particular poster was communicate some of the difficult experiences that current patients have with waiting. It sparked some productive conversations and I hope that further work will follow from this.

Sources:

Transitional Demands (Jess Bradley and Francis Myerscough)

Experiences of people from , and working with, transgender communities within the NHS – summary of findings, 2013/14 (NHS England)

Current Waiting Times & Patient Population for Gender Identity Services in the UK (UK Trans Info)

 

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It’s been quite a while since I last updated!

That’s not to say that it’s been quiet in the world of trans politics – quite the opposite, in fact. In the UK alone we’ve seen #transdocfail, the furore over cissexism/transphobia from Suzanne Moore and Julie Burchill, the tragic death of Lucy Meadows, the publication of various interesting reports and the creation of various worthy campaigns…in the last few months we’ve seen pain, misery and hope.

I’d like to be writing about all of this. But, as always, the update schedule on this blog is less about what I necessarily think is interesting/important, and more about what I have the time and/or motivation to write about. In recent months I’ve been very busy, and I think I’m likely to remain busy for some time to come.

Much of my energy has been focussed on my PhD research, which looks at discourses of trans health. You can read about there here.

I’ve also been busy with playing music in bands (particularly Not Right) and organising academic events (including Spotlight on: Genderqueer and the Emergence of Trans seminar series).

I suspect there will be a time when I update this blog more regularly once again. Until then, feel free to keep checking back – I’ll be here occasionally!

Women and Gender Graduate Seminar Series: Call for Abstracts

Cross-posted due to my own involvement in the seminar series. It really is a lovely series of events. We welcome a wide variety of papers and absolutely anyone is welcome to attend: we tend to have everyone from professors, to undergraduates, to entirely non-academic types turning up.

Call for Abstracts

The Centre for the Study of Women and Gender at the University of Warwick will host a Graduate Seminar Series in the academic year 2012/2013. We would like to invite postgraduate students working in, but not limited to the following areas:

  • Media, Culture and Gender Representations
  • Work and Family
  • (Trans)national Gender
  • Intersections of Gender, ‘Race’, Class, Disability and Age
  • Gender, Transgender and Sexualities
  • Feminism and Women’s Rights
  • Men and Masculinities
  • Feminist Methodologies
  • New Media and Digital Technologies

We welcome submissions both conventional and innovative from any discipline on gender related topics. Seminars will take place on two or three Wednesdays per term in the afternoon (dates and timings TBC). Each presenter will be allocated 30 minutes: 20 minutes presentation and 10 minutes discussion. Attendance is open to everyone.

The seminar series aims to:

  • Foster discussions on topics of gender
  • Provide a safe and comfortable space for students to present their research
  • Create an opportunity to fine-tune presentation skills

Abstracts should be:

  • Maximum 200 words
  • Submitted along with a brief biography of the author; including their institution, department, and research interests
  • Submitted by Friday the 14th of September, 2012

Please email abstracts to cswgseminarseries@gmail.com. Abstracts will be peer reviewed. If successful, you will hear from us by Friday the 28th of September, 2012 and will be allocated to a seminar between October 2012 and June 2013.

If you have any further questions, please do email us.

Yours sincerely,

CSWG Organising Committee
cswgseminarseries@gmail.com

All change at Press For Change

The long-serving trans campaigning group Press For Change has released a request for new board members and volunteers alongside the announcement of a two-day “organisational development conference” in Manchester at the end of the month.

I’ve been amongst those who have criticised the organisation at one time or another, but it’s undeniable that Press For Change has been a powerful advocate for political change. It played a key role in pushing for the Gender Recognition Act 2004 and trans inclusion in the Equality Act 2010. It has produced huge amounts of guidance and advice for public bodies, private companies and countless individuals (most notably in the groundbreaking Engendered Penalties). At the forefront of much of this has been Professor Stephen Whittle, who is about to step down from his role in managing the organisation.

I’m therefore cross-posting the below message, and urge you to do so also.

Urgently Needed – Board Members and Volunteers

Please re post this request as far and wide as possible

The Future of Press for Change (PFC) has been in the balance for some time, with a lot of uncertainty due to various issues with individual’s health and others been able to commit to the development of the organisation for various reasons.

Press for change are having an organisational development conference in Manchester on the 25th and 26th May to look at how the organisation can be re structured and developed for the benefit of the transgender community.

This is an opportunity for activists to become involved in a well-established organisation with 20 years standing, by helping to develop and run the organisation and get involved with national & local organisations promoting Trans equality.

PFC had intended to look for more board members and volunteers at a conference that will be held at a major health equality & empowerment conference that is in the process of been planned for Feb next year to mark its 21st birthday, once the organisation had been brought up to date and had got some more structure to it, however due to recent circumstances there is a need to get more people involved at an earlier stage if Press for Change is going to continue at all.

Press for Change are looking for individuals to undertake the following:

Management Board
Website development officer
People to attend National and Local meetings and promote trans equality and feedback information/ inelegance to the network on what is going on.
Deliver Trans awareness training
Supporting survivors of Hate Crime and Domestic violence and abuse.
Press and social media officer
Telephone support
Legal case workers

This list is not limited, all ideas welcome and appreciated

If you are interested in getting involved in developing Press for Change and re shaping this organisation to enable it to become fit for purpose and an effective organisation which can advance trans equality, then please e-mail a short statement of how you think you could fit in and what experience and qualifications you have to office@pfc.org.uk and we will get back to you.

Press for change will be able to fund a limited number of individuals to attend the development conference on the 25th and 26th of May.

If you are not invited to the conference it is only due to the lack of funds available to the organisation and should the organisation continue it will be looking for more people to be involved as it moves forward as soon as it is practical as we value any input individuals can give the organisation.

Please re post this request as far and wide as possible

There is never enough research

This morning I’ve found myself reading a new Equalities and Human Rights Commission (EHRC) research review about “identity-based” bullying in schools (as you do!) The report summarises statistics and qualitative data from research into racist, sexist, disabilist, homophobic and transphobic bullying in British schools. Yep, you read that right: the “T” word is very much in there. I suppose all that hot air from government departments and quangos about “equality strands” has to be good for something.

To my dismay, the section on transphobic bullying was tiny. Not because the EHRC didn’t put any effort into it – I’m pretty certain they were giving it their best shot – but because there was so little for them to write about. My heart sank when I came across that that classic phrase…

“there is little existing literature”

As in:

“Transphobia is an understudied area and there are very few UK-based studies which have explored this, especially in relation to transgender young people”

…and:

“In terms of preventing and responding to transphobic bullying, there is little existing literature highlighting particular issues for transphobic individuals”

…meaning that:

further research is needed to help identify young people who may be most at risk of experiencing transphobic bullying and the specific support needs they may have.

This is how it always goes. It doesn’t matter if the research is about bullying in school, access to health care, access to employment and/or benefits, experiences in the street or in the home: it almost always boils down to “further research is needed”. This is the case in pretty much any field (how else would academics gain gainful employment, after all?) but so much more the case with particularly marginalised groups, including travellers and asylum seekers as well as trans people.

There are a few utterly fantastic pieces of research out there dealing with trans experiences of discrimination and harassment, but in the broad scheme of things there’s very little for activists and public sector bodies to draw upon when trying to get a realist picture of what’s going on.

The thing is, there’s very few people doing trans research, and even less people prepared to fund it. With government-backed research councils being massively scaled down because of the cuts, this is only going to get worse. This is pretty disastrous if you’re trying to get public bodies to tackle transphobia, and even more disastrous if you’re trying to get the government to pass trans-friendly legislation. For instance, the Labour government refused to budge on the exclusion of non-binary gender identities from the Equality Act because there was “no evidence” of such people even existing.

Research reviews are all very well and good, but we’re being told over and over again that there isn’t much to say about transphobia: not because it doesn’t happen, but because not enough people have looked at it. It’s time for organisations such as the EHRC and NHS to put their money where their mouth is and actually back some thoughtful, in-depth trans research projects.