Here in the UK, health is a key priority for many trans activists. While progress is sometimes painfully slow, numerous debates, protests and consultations have informed gradual change within a range of healthcare settings, and a growing number of health professionals are prepared to actively support trans peoples’ access to affirmative care. However, discussion of trans healthcare in the UK has remained focused largely on the specifics of the UK context, even as important events that influence gender identity services in particular are increasingly taking place on the world stage.

In this post, I look at recent activism at “PATH” (Professional Association for Transgender Health) conferences in Amsterdam and Los Angeles, as background to unfolding events at this week’s EPATH conference in Belgrade.

WPATH Symposium 2016

Last year I wrote briefly about international activism taking place at the World Professional Association for Transgender Health (WPATH) symposium in Amsterdam, the Netherlands. This included two unofficial fringe events: a Global Action for Trans* Equality (GATE) pre-conference, organised primarily by trans activists from the Global South, and the FreePATHH event, run by Dutch trans people living locally who couldn’t afford to attend the expensive WPATH event.

I myself experienced the WPATH symposium as exhausting, inspiring and frustrating. A myriad of positions on trans health care represented amongst the researchers, practitioners and activists present at the event, which is as it should be at any good conference. However, amongst the thought-provoking and challenging interventions, and numerous examples of progressive approaches and good practice, I also found myself overwhelmed by microaggressions from cis attendees, and thrown by the cognitive dissonance of experiences such as emerging from a session on trans-affirmative care only to find myself attempting to retain a professional demeanour whilst walking past individuas such as Kenneth Zucker. Zucker has been accused of subjecting gender questioning children to reparative therapy, and will also be known to UK readers for his participation in a recent BBC documentary (“Transgender Kids: Who Knows Best?”), to which Trans Media Watch responded with an extensively researched letter of complaint.

It was in this context that numerous interventions – both formal and informal – were organised by trans attendees at WPATH. GATE held sessions on depathologisation for trans and intersex people. FreePATHH created a range of notes with “free advice for better transgender care”, which were distributed in a social area for conference attendees to read. Someone gender-neutralised the (binary gendered) toilets with holographic signs. I also heard informally about South African trans women confronting a racist presenter on a panel.

In this way, the WPATH symposium felt like a sometimes discouraging, sometimes productive site for real debate and contestation, both professional and political. My impression was that the the interventions that took place there would probably have a gradual impact on how trans health is understand and practised in the years of come, particularly following the creation of TPATH, a group for trans people working in trans health.  What I didn’t realise was the extent to which events would accelerate in the coming months.

USPATH Conference 2017

In February the first USPATH (United States Professional Association for Transgender Health) conference took place in Los Angeles, USA. At this event, tensions over the place of pathologising forms of care in general – and Kenneth Zucker’s ideas and practices in particular – came to a head.

In a Twitter thread written during the event, health researcher Zoé Samudzi describes how a number of academics and health practitioners, led by trans women of colour, spoke out against the inclusion of Zucker on the conference programme. One session (the first of two at which Zucker was due to speak) was briefly interrupted by an impromptu speech and later quietly picketed, after which hotel security threatened to call the police on a number of attendees.

The next day, community representatives – again led by trans women of colour – met with USPATH and WPATH organisers to read a list of demands. In the wake of this intervention, Zucker’s second talk was cancelled, and a formal apology for the initial heavy-handed response to protesters was posted to the WPATH website. This post, which also promised action to better involve trans communities in general and trans people of colour in particular in the work of WPATH, was removed from the website just two weeks later.

EPATH Conference 2017

Today (6th April) the EPATH (European Professional Association for Transgender Health) conference will begin in Belgrade, Serbia. This event is likely to be a somewhat more conservative affair than the USPATH conference due to disciplinary differences between trans health practitioners in the US and Europe: however, like the WPATH symposium, the conference programme incorporates a wide range of perspectives.

There will once again be an associated FreePATHH event on Saturday 8th/Sunday 9th, which is being organised by Serbian trans activists in collaboration with some of the Dutch individuals behind last year’s FreePATHH. It will include free talks and panels on trans and intersex issues in the former Yugoslav region, as well as arts performances and a football match. At the EPATH conference itself, TPATH will have a presence, seeking to bring together trans people working in the field.

One point of potential contention at EPATH is a code of conduct which has been drawn up for the event. In many ways, this document reflects standard conference etiquette, through (for instance) condemning individual harassment of attendees. However, there are also a number of points that appear to have been written specifically in response to recent events.

We expect all conference participants to be respectful in person and online towards other delegates, speakers, organisers, staff and volunteers.

We are committed to providing a harassment-free conference and training experience for everyone, regardless of gender, gender identity and expression, sexual orientation, disability, physical appearance, body size, race, or religion.  Harassment of participants, speakers, staff or volunteers in any form will not be tolerated.

 Harassment includes offensive verbal comments, and other forms of using disrespectful and pathologising language inconsistent with human rights standards, deliberate intimidation, stalking, following, harassing, photography or recording without explicit consent, sustained disruption of talks or other events, inappropriate physical contact, and unwelcome sexual attention. Conference participants asked to stop any harassing behaviour are expected to comply immediately.

Upon reading the code of conduct, I was immediately reminded of accounts written by trans woman who have accused controversial practitioners of inappropriately photographing them at past events. This is particularly interesting given that he’s been confirmed to speak at the conference. The reference to “pathologising language” also appears to be a nod to some of the practices at previous conferences that have distressed trans attendees.

However, the question remains about what counts as “offensive verbal comments”, “sustained disruption of talks or events”, or “recording without consent”. If a similarly filmed disruptive event occurs at EPATH as took place at USPATH, it could conceivably be framed as “harassing behaviour” within the context of the of the code of conduct, leading to protesters being ejected from the event. This is concerning because the participation of controversial clinicians such as Zucker is typically defended on the grounds of enabling “free speech” within the context of the conference: however, on these grounds, we might expect that conference attendees wishing to peaceably protest or strongly critique bad science might also be afforded freedom of speech.

I won’t be attending EPATH myself this year; like the FreePATH attendees, I simply can’t afford the expensive conference fees. However, I will be following events with great interest, and encourage other non-attendees with a personal or professional interest in trans health and/or trans activism to do the same.