What’s wrong with the Cass Review? A round-up of commentary and evidence

[last updated 10/05/24]

Wednesday 10 April 2024 saw the long-awaited publication of the final report of the Cass Review. This report was commissioned by NHS England, and provides a review of evidence plus recommendations regarding gender identity services for children and young people.

On publication, the Cass Review’s findings and recommendations were welcomed by the majority of UK media outlets, NHS England, the Editor-in-Chief of medical journal the BMJ, conversion therapy proponents such as SEGM, Sex Matters and Transgender Trend, plus spokespeople for the Conservative and Labour parties, who promised to ensure it will be “fully implemented”.

Conversely, the Review has been extensively criticised by trans community organisations, medical practitioners working in transgender healthcare, and scholars working in the fields of transgender medicine plus feminist and gender studies. They have highlighted issues including overt prejudice, pathologisation, poor and inconsistent use of evidence, non-evidenced claims, and the intentional exclusion of service users and trans healthcare experts from the Review process.

This post provides a round-up of links to existing commentary and evidence regarding problems with the Cass Review, plus quotes pulled from each. I hope it will be useful to support actions opposing the full implementation of the Review’s findings, such as:

  • letters to MPs, Parliamentary candidates, and NHS bodies;
  • voluntary sector and trade union advocacy;
  • protests and demonstrations.

I will seek to keep this post updated with new material.


Responses from healthcare professionals

British Association of Gender Identity Specialists (professional body for GIC clinicians)
Initial BAGIS statement on the Cass Review

“We are aware that this week’s release of the Cass review raises many questions and uncertainties for people accessing or wanting to access gender identity services, as well as for the staff working in those services. We also know that this is likely to be a source of significant distress and worry. On first glance, BAGIS Council are deeply troubled by some of the content of the Cass Review and the potential impact thereof. We will be considering this lengthy document carefully, and in detail, before offering a comprehensive response to its recommendations and before making any relevant observations regarding the process that has underpinned them.”

~

Professional Association for Transgender Health Aotearoa
Cass Review out of step with high-quality care provided in Aotearoa

“The final Cass Review did not include trans or non-binary experts […] in its decision-making, conclusions, or findings. Instead, a number of people involved in the review and the advisory group previously advocated for bans on gender affirming care in the United States, and have promoted non-affirming ‘gender exploratory therapy’, which is considered a conversion practice.”

~

The Australian Professional Association for Trans Health (plus others from Australia)
Cass Review out-of-line with medical consensus and lacks relevance in Australian context

“The Cass review recommendations are at odds with the current evidence base, expert consensus and the majority of clinical guidelines around the world.”

~

Therapists Against Conversion Therapy and Transphobia
Our interim response to the Cass Report

“TACTT is deeply concerned by the final report of the Cass Review, whose core underlying premise is effectively an eliminationist agenda, dressed up in the language of ‘reasonableness’ […] We urge clinicians to treat the Cass findings with extreme caution and not to assume that they represent best practice or that they have been arrived at after a full and impartial review of clinical data.”

~

CBC News
What Canadian doctors say about new U.K. review questioning puberty blockers for transgender youth

“While experts in the field say more studies should be done, Canadian doctors who spoke to CBC News disagree with the finding that there isn’t enough evidence puberty blockers can help. ‘There actually is a lot of evidence, just not in the form of randomized clinical trials,’ said Dr. Jake Donaldson, a family physician in Calgary who treats transgender patients, including prescribing puberty blockers and hormone therapy in some cases. ‘That would be kind of like saying for a pregnant woman, since we lacked randomized clinical trials for the care of people in pregnancy, we’re not going to provide care for you.… It’s completely unethical.'”

~

The National
Trans academics warn against ‘politicisation’ of Cass Review in Scotland

“[…] one experienced psychiatrist at a gender identity clinic in England – who did not wish to be identified – told the Sunday National that failure [to include those with lived or professional experience] had concerned many within the field. They said: “The terms of reference stated that the Cass Review ‘deliberately does not contain subject matter, experts or people with lived experience of gender services’ and Dr Cass herself was explicitly selected as a senior clinician ‘with no prior involvement … in this area’. ‘Essentially, ignorance of gender dysphoria medicine was framed as a virtue. I can think of no comparable medical review of a process where those with experience or expertise of that process were summarily dismissed’.”


Responses and publications from academic experts

Dr Cal Horton
The Cass Review: Cis-supremacy in the UK’s approach to healthcare for trans children
(peer-reviewed article for the International Journal of Transgender Health)

“Inductive and deductive reflexive thematic analysis was applied to a collection of Cass Review publications related to trans children’s healthcare published between January 2020 and May 2023 […] Four concerns are presented and explored: (1) prejudice; (2) cisnormative bias; (3) pathologization; and (4) inconsistent standards of evidence. Each of these concerns impacts the Cass Review’s approach to trans children’s healthcare, with negative repercussions for trans children’s healthcare rights and well-being.”

Ten Dangerous Cass Review Recommendations

“Each of the recommendations summarised below is built on a foundation of prejudice, ignorance, cisnormativity and pathologisation of trans lives, running in direct opposition to the evidence base, and running in direct contravention of an NHS duty of care to children’s rights, children’s welfare, healthcare equality and healthcare ethics.”

Social transition, puberty blockers, and the Cass Review [added 08/05/24]

“The Cass Review has shown zero evidence of harms of social transition or puberty blockers. The only harm is this hypothesis that they change the trajectory and outcome, locking children into a trans lifetime. This hypothesis is based on the worst quality evidence I’ve ever seen. This is why trans healthcare researchers are feeling stress and dismay at UK media and politicians cheering on Cass’ evidence-based policy.”

~

Dr Natacha Kennedy
The Cass Review and Trans Exclusionism

“Despite the concern-laden language about “helping” and “supporting” trans children, it is my opinion that what Cass is attempting to establish is an all-enveloping ambient conversion therapy approach to trans children, removing their autonomy, freedom of expression, mental health, helpful support and healthcare. […] If imposed it will, in my view, result in the deaths and deterioration in mental health of many trans children.”

~

Dr Abs S Ashley
The Cass Review’s final report: The implications at the intersection of trans and neurodivergence

“Whilst the report cites adjacent NHS services using 0-25 models to justify a ‘continuity of care’ (224), designating trans persons as ‘vulnerable’ and confining them to child-oriented services indicates that more is at stake. These rhetorics contribute to the shoring up of state surveillance and intervention into the lives of legal adults who want to make choices the state disagrees with.”

~

Dr Chris Noone (and 200 colleagues) [added 26/04/24]
Irish academics say young trans people in Ireland deserve better than the recommendations of the Cass Review

“The Cass Review relies on six systematic reviews of different aspects of healthcare for young people accessing gender identity services. Systematic reviews are a way of compiling information from multiple studies that have looked at the same topic and come to an overall understanding of the results. There are very specific guidelines for how systematic reviews should be done but the Cass Review’s systematic reviews deviated from best practice in systematic review methodology in several ways […]”

~

Dr Gideon Meyerowitz-Katz [added 27/04/24]
Has there been an exponential increase in young people with gender dysphoria?

“One of the main arguments that the Cass review has made is that there has been a dramatic and hard-to-explain increase in the number of children who identify as transgender and attend UK clinics with gender dysphoria seeking help. In a number of places, the review describes this increase as “exponential”, and notes that it appears to have been accelerating in recent years. […] The authors say that this increase is far too big to be caused by social acceptance of trans people, and therefore there must be some form of pernicious influence such as social media, mental health problems, or some other issue causing kids to become trans at increasing rates. […] But if you look at the actual data in the reports that the review is discussing, not only is the increase not exponential, it’s not actually that surprising.”

What the review got right [added 08/05/24]

“I think it’s important to stick to the facts when critiquing a review such as the Cass report. […] I think the review made some serious mistakes in both science and interpretation, but they didn’t simply discard most of the evidence, or sneakily change their methodology to get rid of important research. The real story of the Cass review is much more complex than a single weakness that entirely discredits the work.”

Proving opponents of medical treatment for trans children wrong [added 08/05/24]

“Some of the main arguments AGAINST using hormones and medications for transgender children are contradicted by the Cass review. Barely anyone has noticed, because the review mentions this fact once in a single paragraph, and most of the data is relegated to Appendix 8. […] This should be a key point. A chapter of the review. “Common arguments against giving transgender children medications are wrong”. Instead, it’s a footnote. That raises all sorts of red flags. Why were these key findings shunted to an appendix and largely ignored?”

~

Dr Julia Serano [added 10/05/24]
The Cass Review, WPATH Files, and the Perpetual Debate over Gender-Affirming Care

“[The Cass Review] is just a review. In my previous essay, I cited numerous scientific reviews carried out by experts in the field which all came to a different conclusion than the Cass review: that gender-affirming care is beneficial and gender-disaffirming approaches harmful for trans and gender-diverse youth. If those reviews aren’t “authoritative” enough for you, then how about the American Academy of Pediatrics review, or the Endocrine Society review, or the WPATH Standards of Care, or any of the other health professional organizations who have come to similar conclusions.”

~

Dori Grijseels [added 27/04/24]
Biological and psychosocial evidence in the Cass Review: A critical commentary

“Several issues with the scientific substantiation are highlighted, calling into question the robustness of the evidence the Review bases its claims on, as such, calling into question whether the Review is able to provide sufficient evidence to substantiate its recommendations to deviate from the international standard of care for trans children and young people.”

~

Feminist Gender Equality Network
Letter from academics concerned about The Cass Review

“We suggest that the Cass Review contains unsound methodology, unacceptable bias, and unsupported conclusions. As academics and experts in the field, we regard The Cass Review as potentially harmful to trans children.”

~

Trans Learning Partnership
Initial Statement on the Cass Review

Some of [the] recommendations follow entirely spurious narratives and draw unfounded conclusions. The whole report is positioned in a way which considers continuation of current medication access as harmful, but removal of the current medication access as a neutral or beneficial act, despite no evidence to support this. We are particularly concerned about the content discussing neurodiversity; social transition; and access to medications for children and young people. The report positions the fact that clinicians are unable to predict the future of children and young people’s gender expression as a critical failing of current practice. No service can or should aim to predict the future of children or young people’s lives and the idea that a clinician will know a young person better than they know themselves is in direct contradiction to the United Nations Convention on the Rights of the Child. The aim for clinicians should be to provide a safe, accessible and supportive service which provides individualised care to all children and young people it encounters.”


Responses from trans community organisations

Trans Safety Network
TSN Statement on Cass Review Final Report

“[…] we believe there to be systemic biases in the ways that the review prioritises speculative and hearsay evidence to advance its own recommendations while using highly stringent evidence standards to exclude empirical and observational data on actual patients. This adds to the concerns we have previously had about Cass excluding trans people from the research oversight board – that Cass was set up from the start to impose a particular perspective without input from the patient cohort affected by the outcome.”

Do no harm? The trouble with Cass’ therapy recommendations

“In the absence of effective treatments for dysphoria outside of transition, ‘alternatives’ rely primarily on impossibilising transition […] any therapeutic paradigm for trans and gender-variant young people must explicitly centre the reality and accessibility of transition and affirm all potential genders/embodiments, and should provide information on what pseudo-therapeutic manifestations of anti-trans rhetoric look like, both in clinical and community settings. Models that do not include this risk endorsing the influence of transphobic hostility on identity formation, for instance, or affirming rhetoric that assigned sex is ‘reality’ when this coheres with a given young person’s identity.”

Did the NHS ever stop funding conversion therapy? [added 08/05/24]

“Whether Hilary Cass wants conversion therapy to be institutionalised on the NHS again is immaterial: her recommendations have made space for it. Therapy is a caring profession, and despite the crueller parts of its history, good work happens under its banner – but so does violence. The NHS must set out a clear and actionable plan to keep conversion therapy out of its services, and investigate instances where it may have been allowed to take place. Anything else is complicity.”

Trans Safety Network statement on NICE evidence reviews on trans affirming care

“In June of 2023 it was disclosed to us by members of the Cass Review team that anti-trans author and commentator Dr Az Hakeem was part of “NHS England’s policy working group which commissioned the NICE evidence reviews undertaken in 2020”. Dr Az Hakeem has long been a partisan opponent of gender affirming medical treatments. While Hakeem disavows conversion therapy or trying to dissuade trans people from medical interventions, on his personal website he directs readers looking for specialist support for gender dysphoria to conversion therapy activist groups, such as Bayswater Support Group, and the anti-trans pseudoscientific lobby group SEGM. Hakeem is also a member of CAN-SG who have from their earliest webinars (link) promoted the idea that trans people should be dissuaded from transition and instead either change their minds, or undergo therapy to live with the discomfort of gender dysphoria without accepting their trans identity — in other words, that trans people should undergo conversion therapy.”

~

Trans Actual
The Cass Review is bad science and should not be taken seriously by policymakers

“The report […] strays far beyond its scope and competence in recommending a review of adult services and in suggesting that young people ought to stay under the care of children and young people’s services until the age of 25. The latter is based on highly questionable understandings of brain development which have been repeatedly debunked as an oversimplification of the constant changes in human neurology over the course of our lives. […] Underpinning this report is the idea that being trans is an undesirable outcome rather than a natural facet of human diversity. This is clear not only from the recommendations but also from the exclusion of trans researchers from the design of the review process and the links individual members of the research team have to anti-trans groups, which the Cass team were warned about.”

~

The Cass Report – A Briefing

The Report dismisses almost all evidence around existing protocols for treating trans young people, including lived experience, on the spurious grounds it does not meet unobtainable levels of proof. The team do not apply the same rigorous evidential tests to their own proposals. Indeed, if such evidential requirements were imposed consistently and equally across the NHS, it would mean that many routine treatments, including treatments for menopause, palliative care and mental health, would also have to cease.”

~

Gender Identity Research & Education Society
GIRES Statement following the publication of the Cass Report

“Of note, many other paediatric medications that are routinely used in paediatric care, do not and cannot have the level of evidence that Cass and NHS England demand: medicines for ADHD, for example, anti-psychotic medications, and many others have comparable if not lower levels of evidence.”

GIRES Chair Cat Burton:

“I was invited to consult with the Cass review. After three discussions it was obvious that the review had been written before we started. She totally discounted evidence from trans people from the basis of knowledge or lived experience.”

~

Mermaids [added 26/04/24]
Mermaids’ response to The Cass Review – In Depth

“Young people we have spoken to are concerned about what they have read, including the desire to understand “why” young people are trans, and to place what feel like “limits” on gender expression, further pathologising and medicalising their identities. We share these concerns. We are deeply frustrated with the lack of clarity throughout the report, which has enabled wilful misinterpretation and the spread of harmful misinformation. Clear and accessible language is vital, especially when services are operating in a context where there is significant hostility to and misconceptions about trans people, particularly in the media. “

~

Trans Solidarity Alliance
Statement on the Cass Review

“In the world the Cass Review imagines a trans child will be seen quickly but not given the care they need. They will still wait for years if they want to access gender affirming healthcare. While they wait they will be expected to engage with therapy that risks becoming conversion practice. While they wait, they will go through a puberty they may find profoundly distressing. They will be treated for every other condition they have. They will be treated for conditions they develop as a consequence of denial of trans healthcare and living in a transphobic world. But they won’t get the care they need to feel comfortable in their own skin. This is a model of care that works for cis people who are upset by the idea of a trans child existing.”

~

Transgender Action Block
Our statement on the Cass Review

“The NHS has always been a violent, white supremacist, saneist, transphobic system; the Cass Report was never going to change that system, indeed it was designed to expand it. The NHS does not provide trans healthcare: it disciplines and punishes trans people, so we will transition in any way we can – with community-led care, private care, and overseas care. We will smuggle, borrow, share, and steal the medicine we need. We will take direct action to protect each other. We survive. We rebel. Fuck the NHS.”

~

The Dyke Project
Today, we dropped a 30ft banner

“Politicians will continue to create moral panics to distract and divide us from their own failings. The Cass Review, instead of focusing on a lack of funding, long waiting lists and overstretched staff is ultimately calling to restrict trans healthcare. Enough is enough. Trans youth don’t need to be studied, managed or saved. They need the same opportunities and quality of care that their cis friends and family receive.”


Responses from human rights groups

Amnesty International and Liberty
Cass review on gender identity is being ‘weaponised’ by anti-trans groups

“This review is being weaponised by people who revel in spreading disinformation and myths about healthcare for trans young people. It’s concerning that sections of the media and many politicians continue to spread moral panic with no regard for the possible consequences for trans people and their families. The negative rhetoric by the Government about the dangers of so-called gender ideology, healthcare for young trans people, as well as the push against LGBT-inclusive sex and relationship education is harmful and extremely damaging.”


Critical and investigative journalism

Them
Advocates Say a Controversial Report on Healthcare for Trans Kids Is “Fundamentally Flawed”

“International medical organizations and transgender activists are roundly condemning a new U.K. report on gender-affirming care for minors, saying the report ignores years of research to propagate “harmful” misinformation.”

~

Assigned Media
What’s in the Cass Report?

“The Report included many recommendations for treatment of youth presenting at gender clinics in England. Some of these were fairly technical, describing proposed relationships between NHS entities such as regional centers, centralized authorities, and local/tertiary providers. Other recommendations were broader […] The recommendations synthesize a view of medical transition as a bad outcome to be avoided, and a belief that gender dysphoria can be successfully treated non-medically, despite no non-medical interventions being evaluated in any of the series of systematic reviews[.]”

~

Queer AF
Cass Review excluded 98% of gender-affirming hormone studies to reach its conclusion

“This week, when the Cass Review was released, news outlets rushed to cover the story, highlighting the report’s conclusions without taking time to consider whether the report could be flawed. In doing so, it amplified and solidified to the wider public the report’s key conclusions without balancing it against the evidence it excluded to reach them. […] Crucially, despite a four-year process, it still failed to find any smoking gun of widespread regret among trans folks who transition. It instead had to rely on a methodology that allowed it to exclude any data about how gender-affirming care helps trans people.”

~

What The Trans?!
The Cass Review needs to be thrown out entirely. This is why.

“We contend that the Cass Review is not fit for purpose. We suggest that it was not merely knocked off course by a flawed methodology. We believe the Cass Report is a deliberate part of a political project aiming to reduce the availability of trans healthcare, possibly eventually in its entirety. It is imperative that we understand this and act on it.”

Trans Community in Scotland Protests Against NHS and Scottish Government Betrayal

“The trans and questioning children who are at the centre of this conversation are in community with one another, and they understand exactly what is happening to them. While we are focussed on the bigger picture, I was taken by their confidence and eloquence when speaking of their experiences. [A speaker shared] a story about speaking to a trans kid they knew through their work, who, speaking of their many friends who had died of suicide: “Yeah, you know how it is.” And we do. We are used to just how extreme what is currently happening to us in the UK is, and the real effects it has on us. We have been sounding the alarm for years, but we are now feeling the UK’s uniquely slow and bureaucratic oppression start to bite[.]”

~

Yorkshire Bylines
The Cass review: trans care or trans scare?

“Children’s wellbeing is indeed at stake here, but that includes the wellbeing of children who are actually trans. Far from taking the matter out of politics, the review – and Rishi Sunak’s subsequent praise of it – has put it centre-stage. Some readers will remember the climate of homophobia that suffused the run-up to the 1997 general election, when the Conservative Party, desperate as it is now, brought out the “They’re coming for your children” rhetoric in a last-ditch effort to panic people into voting for it. This review – whose final report has been awaited for some time – feels like an attempt at the same thing.”

~

Erin in the Morning
Opinion: England’s Anti-Trans Cass Review Is Politics Disguised As Science

“It is important to note that the Cass Review contains very little new data and evidence. Any statements it makes are based on the same level of evidence that every major medical organization in the United States, along with some of the largest mental health societies in the world and professional associations of transgender health, have determined to support transgender care. If its claims differ from those institutions, it’s because reviewers made choices to view the evidence around transgender care negatively.”

Dr Cass met with DeSantis Pick Over Trans Ban: Her Review Now Targets England Trans Care

“The Cass Review seems to have emulated the Florida Review, which employed a similar method to justify bans on trans care in the state—a process criticized as politically motivated by the Human Rights Campaign. Notably, Hilary Cass met with Patrick Hunter, a member of the anti-trans Catholic Medical Association who played a significant role in the development of the Florida Review and Standards of Care under Republican Governor Ron DeSantis. Patrick Hunter was chosen specifically by the governor, who has exhibited fierce opposition towards LGBTQ+ and especially transgender people, and then immediately got to work on targeting transgender care. The Florida review was purportedly designed and manipulated with the intention of having “care effectively banned” from the outset, as revealed by court documents. The Florida Review was slammed by Yale Researchers as “not a serious scientific analysis, but rather, a document crafted to serve a political agenda,” and much of their full critique is applicable to the Cass Review as well.”

~

Trans Writes
The 32 things The Cass Review recommends and why they are concerning

“The 32 recommendations, informed by the highly conservative evidence base, look to impose further restrictions and control on trans lives — and not just the lives of trans youth with the scope of these recommendations including 25 year olds. Given that we know The Cass Review has been majorly influenced by anti-trans activists with ties to conversion therapy efforts, it’s probably worth looking at some of the recommendations and how they relate back to what transphobes are doing to organise against trans liberation.”

~

The Autonomy
Between Reproductive Past and Trans Future

“The overall recommendation is to force patients to wait through psychological busywork and relevant-sounding delays, implementing a largely-arbitrary set of hoops to jump through with the hopes the patient just gives up. Focus on the patient’s anxiety, focus on their autism, focus on any other issue except their gender and their desire for a sex change[.]”

~

404 Media
Review Used By UK to Limit Gender Affirming Care Uses Images of AI-Generated Kids

“Earlier this month, WIRED noted that generative AI has a track record of representing queer and trans people as a collage of stereotypes. It is not clear why the Cass team used AI-generated images in this report, which, again, has been used as evidence by the NHS to stop providing gender-affirming care to trans kids.”


Social media

Chamber Voice (published by policy institute Curia) [added 24/04/24]
How politically unbiased is Cass?

“Questions have been raised about the neutrality & evidence basis for the controversial #CassReview. The report’s author Hilary Cass has been asked to provide answers why she is meeting with Women’s Declaration in the House of Lords this week.”

Context note: under their old name of Women’s Human Rights Campaign, the organisation Women’s Declaration International have openly called for the “elimination” of trans people. More information on the meeting can be found here.

~

Ethel Weapon
#Cassflaws threads on Bluesky

“§6.18 presents us with the idea that toy choice is influenced by hormones. To accept this report is to accept that estrogen, for example, has a biological effect that causes a preference for play with toy cooking pans over toy trucks. In §6.23 we are directed to the work of Melissa Hines in support of this hypothesis. Hines was one of the two authors of the “vervet monkey” study that claimed to show such toy preferences in monkeys. A study that implies something about estrogen makes monkeys want to play with cooking pans.”

“Here is Cass citing “Thoughts On Things And Stuff”. This is a YouTuber whose channel includes a host of anti-trans video material, including material from notorious anti-trans figures, including ‘”‘Gays Against Groomers’.”

~

TransSafetyNow

“It has been drawn to my attention that [a booklet produced based on research cited by the Cass Review] was funded by SEGM’s William Malone & anti Trans lobby group Transgender Trend.”

~

猫好きな人

“In 2021, Trilby “Tilly” Langton, the sole gender affirming care “expert” involved in the Cass systematic reviews, went to lobby Kemi Badenoch about the conversion therapy ban. With a featured speaker at the 2024 CAN-SG conversion therapy conference.”

~

Simon Whitten
Did the Cass Review disregard the evidence of all but 2 of 103 studies on puberty blockers & hormones to reach it’s conclusions? Yes and no.

“The review found 5 studies of moderate certainty relevant to psychological health. All 5 supported the conclusion that treatment of trans teens with CSH [cross-sex hormones] improved psychological health. There were no findings of worsening psychological health. What conclusions would you draw from this? Our intrepid authors draw no conclusions from this whatsoever, instead declaring the evidence for every outcome for which there was no high certainty study “inconclusive.” Similar is true for other outcomes and for puberty blockers. This is the sense in which the Cass Review absolutely did ignore almost all evidence on the efficacy & safety of PBs [puberty blockers] and CSH. The majority of moderate certainty studies were included in the results section but then arbitrarily ignored in the conclusion entirely.”


Dr Cass Responds

The Kite Trust
Q&A with Dr Hilary Cass

“The Cass Review Report does not conclude that puberty suppressing hormones are an unsafe treatment. The report supports a research study being implemented to allow pre-pubertal children to have a pathway to accessing this treatment in a timely way and with suitable follow up and data collection, to provide the highest quality of evidence for the ongoing use of puberty suppressing hormones as a treatment for gender dysphoria. In the data the Cass Review examined, the most common age that trans young people were being initially prescribed puberty suppressing hormones was 15. Dr. Cass’s view is that this is too late to have the intended benefits of supressing [sic] the effects of puberty and was caused by the previous NHS policy of requiring a trans young person to be on puberty suppressing hormones for a year before accessing gender affirming hormones. The Cass Review Report recommends that a different approach is needed, with puberty suppressing hormones and gender affirming hormones being available to young people at different ages and developmental stages alongside a wider range of gender affirming healthcare based on individual need.”

Some final thoughts: recommendations such as this from the Q&A are not clearly reflected in the content of the report or the later Q&A published on the Cass Review website. In a blog post accompanying that Q&A, Dr Cass complains about “some of the assertions being made on social media, and occasionally on mainstream broadcast media, which misrepresent the report and its findings, whether wilfully or otherwise“.

In my expert opinion, the critiques linked to in this blog post have yet to be properly addressed by the Cass Review team, let alone any of the politicians or healthcare service directors promising the implementation of the Review’s findings.

Regardless of whatever Dr Cass’ intention may or may not have been, the Review process itself intentionally and explicitly excluded any oversight from service users and trans healthcare experts, and involved collaboration with proponents of conversion practices. The final report relies on poor and inconsistent use of evidence, and makes recommendations that put young trans people in danger.

New job with the Trans Learning Partnership

I am very excited to announce that I will soon begin work on a new project. From the beginning of April I will be working full-time with Spectra as Research Coordinator for the Trans Learning Partnership.

The Trans Learning Partnership is a groundbreaking collaboration between trans and non-binary community representatives, academics, and four organisations who work to directly provide community services: Spectra, Gendered Intelligence, Mermaids, and the LGBT Foundation. The aim of the Partnership is to drive the development of a robust service and advocacy-oriented evidence base, enabling trans services and their service users to have needs-based, impactful services.

This also means that I will be leaving the Trans Pregnancy Project at the University of Leeds, but rest assured that I plan to continue supporting my colleagues from that project in writing up and publishing our findings. We have a number of academic articles currently in the pipeline, along with a themed special issue of the International Journal of Transgender Health.

I will of course continue to update this website periodically with information and reflections on all of my ongoing research.

The Trans Learning Partnership feels like such an important opportunity to design and undertake research intended to directly improve people’s lives. I can’t wait to get started!

 

Trans pregnancy study – new article and podcast

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

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


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

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

Click here to read the article in Feminist Media Studies.

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


Podcast: Making Space for Trans Pregnancy

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

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

Topics under discussion include:

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


Looking forward

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

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

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

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

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

 

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.

LGBTIQA+ research seminar at Åbo Akademi: 11-12 January 2019

In January I will be travelling to Turku, Finland to speak about my trans health research for a seminar at the Åbo Akademi university. Details of the event can be found below.

 

Image shows the grand two storey building main building at Åbo Akademi. It is built in a neo-classical style with fix pillars above the central entrance,and faces onto a cobbled road.

© Samuli Lintula / Creative Commons Attribution-ShareAlike 3.0

Future research on sexual and gender minorities in Finland?
Friday and Saturday, 11-12 January 2019
Åbo Akademi university

At this seminar, keynotes from across Europe will tap into the issue ‘what are relevant and urgent questions for future research on LGBTiQA+ from their respective perspectives and horizons, and hopefully the discussions will nurture thoughts and ideas on new research projects. This seminar is part of the Åbo Akademi University profile on minority research.

Our main keynote contributions are:

“Towards sustainable scholarships on trans and intersex: critical studies of cisnormativity”
Dr Erika Alm, from University of Gothenburg (Sweden)

“Enhancing sexual health, self-Identity and wellbeing among men who have sex with men”
Dr Rusi Jaspal from De Montfort University (UK)

“A brief history of the Finnish closet”
Dr Tuula Juvonen from University of Turku (Finland)

“The politics of trans health: condition or movement?”
Dr Ruth Pearce from University of Leeds (UK)

“The mobilizations of LGBT organisations in Europe between homo-normativity and homonationalism: challenges and opportunities”
Dr Luca Trappolin from University of Padova (Italy)

In addition, some ongoing research projects at Åbo Akademi University will be presented by Panda Eriksson and Minna Laukkanen. Finally, actor Boodi Kabbani, known from the film “A moment in the Reeds”, Dr Julian Honkasalo from University of Helsinki, Dr Jukka Lehtonen from University of Helsinki, and Secretary General Kerttu Tarjamo from Seta, will together provide input and critical comments in a panel discussion.

The seminar is open to students, researchers, activists and people engaged in NGO:s. Coffee, lunch and dinner are included in the registration fee of €50.

Please register no later than the 3rd of January at: https://survey.abo.fi/lomakkeet/10813/lomake.html

 

A slow, painful grind: WPATH 2018 conference report

IWPATH_BuenoAr_Logo_reverse.jpgn the first week of November I attended the 2018 WPATH Symposium in Buenos Aires, Argentina. This biennial event is one of the largest trans studies conferences in the world, with around 800 academics, activists, healthcare practitioners and researchers coming together to exchange knowledge.

Most of the conference consisted of parallel sessions: approximately eight or nine speaker panels occurring simultaneously in different parts of the conference venue. So it is impossible for anyone to take part in the majority of conference events. Nevertheless, I attended as many sessions as possible, and livetweeted from most of these. Links to Twitter summaries of the sessions I attended can be found at the end of this post.

In this post, I comment primarily on my observations of the conference as a sociologist and trans professional.


Opportunities and inclusion

As I anticipated, WPATH 2018 was full of contradictions.

On the one hand, it was exciting to join and learn from so many academics, healthcare practitioners and human rights experts working in the field of trans health. As I report in the Twitter summaries below, the conference provided a great opportunity to participate in debates over new ideas and standards of care, and hear about cutting-edge research findings and advances in clinical practice. It was an especial privilege to learn first-hand about the implementation and impact of Argentina’s pioneering Gender Identity Law, a topic I expand upon later in this post, but hope to write about in more detail in the near future.

I was also glad to have the opportunity to present a paper on research ethics and a poster with initial findings from the Trans Pregnancy project to an international audience.

It was excellent to see that the conference organisers acknowledged and responded to some of the feedback from trans delegates in previous years. Gender-neutral toilet blocks were present on every floor of the conference venue, and pronoun stickers were provided to accompany name badges. The provision of a “trans hospitality suite” enabled trans attendees to relax in a more comfortable environment, and also arrange our own ad-hoc meetings and events. This was inevitably re-branded by its users as an “intersex and trans” room in recognition of the importance of this space also to intersex delegates; I hope conference organisers will learn from this for future events.

This year’s Symposium also benefited from a clear code of conduct and language guide, previously introduced for the 2017 USPATH and EPATH conferences.


Microaggressions and objectification

On the other hand, the cis-centric atmosphere of the event felt like a slow, painful, constant grind. As with previous WPATH conferences, the event was punctuated by constant microaggressions (and, on occasion, outright “macro”aggression); these were damaging to intersex people, people of colour and delegates from the Global South as well as trans attendees. Examples include individuals advocating for intersex genital mutilation, off-colour jokes about trans suicide, the use of outdated language, and misgendering of research participants.

Some research seemed entirely voyeuristic: for example, one poster from the Netherlands purported to report on differing levels of jealousy towards sexual competitors among “mtof and ftom transgenders”. It was often unclear how consent was obtained (if at all) for the use of personal information about research participants and/or patients. This was particularly concerning when numerous posters and powerpoint slides included unnecessary photographs of intersex and/or trans genitalia (a “WPATH conference bingo” grid circulated among intersex and trans attendees of the event included a square for “unexpected genitals”).

As a trans attendee, I felt deeply objectified by the tone and content of this material. It felt dehumanising, and I felt like a thing, subject to the harsh gaze of an abstract, dehumanising curiosity. Yet I was disturbed not only by those engaging in such work, but also in the response of many of their peers. Numerous practitioners and researchers who seemed broadly sympathetic to trans rights and affirmative in their own work often said nothing to counter transphobia, cisgenderism and endosexism in the work of others. It is difficult for intersex and trans people to explain how painful this situation is when most of our colleagues and the senior figures in the field are not intersex or trans; we know that our projects and careers alike may suffer if we speak out too openly or too harshly. I encourage fellow members of WPATH to reflect on their potential complicity in this situation, and consider how we might collectively work to change it.


Tokenism and colonialism

The choice to locate the conference in Buenos Aires felt deeply tokenistic, with numerous attendees from the Global South arguing that this represented a colonial attitude. The vast majority of conference attendees were from the United States or Western Europe. The price of the conference was a significant barrier to many attendees, amounting to the equivalent of the average monthly income in Buenos Aires. The choice to host the event in an expensive Hilton hotel felt like it was taken primarily for the benefit of (the more wealthy) attendees from the West to the detriment of local intersex and trans people, some of whom reported that they risked being profiled by the police if they tried to enter the wealthy area of the city in which the hotel was located.

The sessions on clinical practice in Argentina and human rights in Latin American were some of the most interesting I sat in on, but also least well-attended. I later heard that on one occasion a high-profile lawyer invited to speak on the topic of Argentina’s Gender Identity Law addressed a near-empty room, due to clashes with sessions that focused on Western bioethics, research and medical practice. This sense of tokenism was compounded through the choice to hold the conference in English (the official language of WPATH), with funded translation into Spanish available in a maximum of two rooms at any one time. Some of the conference organisers later stated that they had been worried about the finances of the event, but this felt like a strange claim in the wake of a lavish gala dinner with dancers, DJs, and multiple buffets serving food from various regions of Argentina. As human rights expert and executive director of GATE Mauro Cabral declared in the closing plenary of the conference, “When WPATH decided to come to Argentina, with the most progressive gender identity law in the world, I was excited. But we could only talk among ourselves. You came to this country because of the weather, steak and wine, but not to learn from us”.

While these issues are primarily structural ones that need to be formally addressed by WPATH, the onus is also upon individuals from Western and/or Anglophone countries to take action and reflect upon our relative power and privilege in attending these events. In addition to vocally supporting my colleagues from the Global South, one aspect of my own practice I feel I can address is my use of language in planning talks. For example, I could have undertaken a little extra work to ensure that my slides were bilingual, listing bullet points in Spanish as well as in English. I hope to draw on this lesson in preparing for future international events.


TPATH, human rights monitors, and lessons from Argentina

My experience of WPATH 2018 was improved enormously by the presence of other trans people working in the field of trans health, as well as the intersex activists and human rights experts who came to monitor WPATH’s historic antipathy towards intersex rights. Many of us are members of TPATH (the Transgender Professional Association for Transgender Health), a new and as-yet loosely affiliated group of trans people working in trans health that I helped to co-found during the 2016 WPATH Symposium in Amsterdam. Numerous others were part of a 50-strong delegation of intersex and trans human rights monitors from all parts of the world, who attended in order to conduct a collective human rights audit of the conference.

It was with these individuals that I found myself having the deepest conversations, these individuals with whom I heard the most fascinating research findings and the most rigorous analyses. We also shared a strong sense of solidarity in the face of the many problems apparent at WPATH 2018.

That said, the most important event I attended took place outside of the WPATH event: in Casa Jáuregui, a historic queer cultural centre many blocks away from the Hilton. Here, Frente de Trans Masculinidades (the Transmasculine Front) and other activists based in Buenos Aires hosted a meeting with TPATH members from the Bahamas, Aotearoa/New Zealand, Norway, South Africa, the UK and the USA. We shared information on our various areas of work, and the local activists talked at length about the history, implementation and practical impact of the Gender Recognition Law.

45312673_10156968672567287_3664316683624906752_n.jpg

Argentinian activists host TPATH members at Casa Jáuregui.

While it is important not to deny the significant challenges faced by trans people in Argentina, which include harassment by authorities, economic marginalisation and many forms of violence and discrimination, many of us were struck by how much has been achieved by activists in Argentina and (consequently) how advanced trans rights are in this country. The Gender Identity Law has been carefully written to enable flexibility; this has meant, for example, that it was interpreted to enable non-binary recognition by a judge as recently as last week. It also guarantees access to healthcare, which has meant that every possible medical intervention is available to trans people, either for free or through relatively inexpensive health insurance (in theory, that is: in practice, various legal battles have been necessary). This has been of benefit to cis women and queer people as well as trans people: for instance, through enabling easier access to hysterectomies or breast reductions.

During the meeting, the local activists described gender-affirming medical interventions that most of us had never even considered, such as beard hair implants for transmasculine individuals who cannot or would prefer not to use testosterone. Moreover, while long waiting lists exist for some procedures such as surgeries, those of us attending from European countries and (especially) Aotearoa/New Zealand were astonished by how much shorter they were than equivalent waiting times in our own countries, in part due to the absence of unnecessary gatekeeping procedures and treatment bottlenecks.

I was profoundly moved by the opportunity to attend this meeting, and regretted that so much of my time in Buenos Aires was spent in the sterile environment of the Hilton. However, I was also glad to have the opportunity to work with others to challenge the hierarchies and cisgenderist assumptions inherent in WPATH. We undertook many small interventions: asking questions about ethics, consent and power dynamics in the sessions we attended, raising concerns in private conversations, reporting blatant contraventions of the WPATH code of conduct. I was also pleased to hear many of my colleagues openly critiquing problematic issues identified during an update on the progress of the forthcoming Version 8 WPATH Standards of Care, and take part in attempts to hold our professional body to account during a member’s meeting on the final day.

Overall, I found WPATH 2018 to be a very tiring, draining and frequently unpleasant experience. However, I do not regret attending. I am grateful to have had the opportunity to learn so much from so many. I am also glad to have played a small role in supporting my intersex and trans colleagues and my colleagues from the Global South in attempting to help transform WPATH so it is more transparent, more accountable, and less colonial in attitude and in action.


Session summaries

The following links are to Twitter threads in which I summarise plenaries, talks and mini-symposia I attended at WPATH 2018.

Saturday 3rd November

Opening session and President’s Plenary

Keynote: Employment discrimination against trans people (Sam Winter)

Keynote: Trans legal history in Latin America (Tamara Adrian)


Sunday 4th November

Mini-Symposium: The Argentinian experience of public transgender health after the implantation of the Gender Identity Law

Oral presentations: Services in different parts of the world (Australia, Southern Africa, Scotland)

Mini-Symposium: Trans refugees: escape into invisibility

Mini-Symposium: Latin American perspectives on depathologization of trans and travesti identities

Plenary: Show hospitality to strangers: intersex issues in the time of gender identity laws (Mauro Cabral and respondents)
Note: this was listed as a plenary session in the programme, but actually took place alongside multiple parallel sessions. Consequently, this talk was under-attended by Western healthcare practitioners in much the same way as the Latin American sessions.


Monday 5th November

Oral presentations: Suicidal and non-suicidal behavior

Mini-Symposium: Ethical considerations in transgender health research

Oral presentations: Fertility

Oral presentations: Reproduction


Tuesday 6th November

Mini-Symposium: Child and adolescent medicine Mini-Symposium: Child and adolescent medicine

Plenary: SOC 8 update

Plenary: SOC 8 Q&A

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)

 

This space left unintentionally blank

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!