My book Understanding Trans Health is cited prominently in the new Philosophy Tube video on complaint, systematic inflexibility, and England’s NHS trans health crisis.
It’s a great video, which manages to capture the sheer horror of NHS failings while still delivering silly jokes, ridiculous costumes, and a strong analysis. In addition to drawing on my work, Philosophy Tube’s Abigail Thorne consulted me on the script for this episode, and I appreciated the opportunity to use my research in this way.
I am personally more optimistic than Abigail about the opportunities offered by the four NHS England ‘pilot’ clinics. These are beginning to slash waiting times, and several are now effectively run by trans people, for trans people. However, I do think it’s important to still critique the very logic that underpins many trans healthcare systems, especially the highly questionable ways in which the medical diagnosis of ‘gender dysphoria’ is constructed, and used to try and control us.
You can buy Understanding Trans Health directly from Policy Press here. It’s also available from all major booksellers, plus many independent queer book stores (e.g. Leeds’ brilliant The Bookish Type). I have also written to my publisher for permission to put a chapter of the book online for free – watch this space! In the meantime, free links to much of my other academic writing can be found here.
I was dismayed to read that the UK Government are amending the Gender Recognition Act. Specifically, they are removing the offence under section 22(1) of the Gender Recognition Act 2004 for the disclosure of protected information, to enable this disclosure where it is “necessary for the purposes of facilitating, assisting or undertaking relevant research”.
This amendment enables NHS England to obtain trans people’s confidential information about their medical treatment for the purpose of research into child and adolescent gender services by the Cass Review. Specifically, it enables the acquisition of information (a) that could contain personal identifying details, (b) without that person’s consent, and (c) for individuals who obtained specific legal protections with the reasonable belief that these would remain in place. There has been no community consultation ahead of this move.
As a social researcher and expert in ethical methodologies, I believe that any research undertaken under these circumstances would represent an enormous breach of the basic principles of research ethics. Moreover, it will could significantly undermine the already extremely low existing low level of trust between trans community members, researchers, and medical practitioners.
Finally, the amendment also represents a significant weakening of the Gender Recognition Act’s legal protections for trans people (although for a full and measured analysis, see this post by What The Trans).
I have therefore written to the NHS England’s Gender Identity Programme Board to express my concerns about this development. I also hope that any university or NHS ethical panel overseeing the approval of such research will prevent it from taking place.
I am speaking at a series of exciting events over the next few weeks! All are free to attend, you will just need to register in advance if you’d like to come.
I am incredibly honoured to be giving a keynote talk for this two-day event hosted by the Department of Sociology, University of Hyderabad, and the Centre for Writing and Pedagogy, Krea University. I will be speaking about “Building Queer and Trans Communities in the UK” towards the end of the first day, and am enormously excited to be learning from colleagues in India during the event.
10am-6pm IST, 27-28 April Register online to attend
I will be delivering a keynote on the first day of this groundbreaking event hosted by the University of Glasgow. My talk is provisionally titled “Let’s (not!) fight a TERF war: Trans feminism in a time of moral panic”.
9:30am-4:30pm BST, 5-6 May Register online to attend
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Wednesday 11 May – Online Reproductive Justice Research Network seminar (link to come)
I will be joining colleagues from the Trans Pregnancy project to discuss findings from our international study of trans and non-binary people’s experience of conception, pregnancy, and childbirth. Our talk is provisionally titled “Reproductive Justice for Trans People”.
This Friday (25th September) I will be presenting findings from the Trans Pregnancy Project at the LGBT Foundation’s Future of Trans Healthcare conference. Topics under discussion will include men, transmasculine and non-binary peoples’ experiences of conception, the impact of testosterone, and the language of reproductive health services.
The conference runs for two days through Thursday and Friday, and is free of charge. It’s possible to drop in and out or attend the whole thing. My session is scheduled for 1pm on the second day.
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 Projectat 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!
During my April/May visit to Aotearoa (New Zealand) I picked up a lot of amazing resources. In this blog post, I share some brief reflections on three great documents which contain an enormous amount of interesting and useful material produced by and for Rainbow communities (takatāpui, lesbian, gay, bi, trans, intersex and queer people), on topics that include disability, Māori experiences of gender and sexuality, and affirmative care.
These documents will be of interest to people who want to know more about rainbow activism, communities and healthcare in Aotearoa, but also clearly have a wider relevance and importance. In writing about them, my intention is to highlight the expert contribution of the authors. As a UK-based scholar and activist, I learned a great deal and it is my hope that readers will too.
“Imagine how engaged our communities would be if we were curious about our strengths and values, rather than our limitations.”
This beautifully illustrated guide addresses topics such as structural stigma, intersectionality, accountability, minority stress and (de)colonialism from the perspective of a queer disabled politics. It promotes a mode of solidarity and understanding that recognises and works with difference.
All of Us was created by Stace Robertson, a queer trans man of Pākehā (European or non-Māori) descent who lives with Cerebral Palsy.
Robertson explains that the project came about after he noticed that people are often not fully included even in minority communities if they experience multiple forms of marginalisation.
He therefore decided to create a resource that shared the perspective of people with these experiences, drawing on that advise of mentors, and advisory group and 14 people from a range of backgrounds who offered to share their stories in the document.
This resource will be of interest to people who want to learn more about experiences of multiple marginalisation. It will be useful to those who are new to this topic, as well as those who want to understand more about factors such as ableism or migrant status impact LGBTIQ experience and vice-versa.
There is also an excellent easy-read version of the guide available in the second half of the document.
“Takatāpui is a traditional term meaning ‘intimate companion of the same sex.’ It has been reclaimed to embrace all Māori who identify with diverse genders and sexualities such as whakawāhine, whakawāhine, lesbian, gay, bisexual, trans, intersex and queer.”
The document was created to provide information and support for takatāpui and their whanau (family), but it will also be of interest to people wanting to learn more about mātauranga Māori (Māori knowledge or wisdom) with regards to sexual and gender diversity. It was written by Dr Elizabeth Kerekere, a renowned takatāpui activist, scholar, and founder/chair of the Tīwhanawhana Trust.
Through colonialism, Aotearoa inherited the sexism and homophobia of the British legal system. Takatāpui narrative were erased through pathologisation, colonial records, and the imposition of the nuclear family model. In light of this, Kerekere highlights the importance of pre-colonial histories, and of contemporary resilience and the importance of pride, family and community support.
In the UK, we have begun to talk more in recent years about how binary gender norms were imposed on many societies by British invaders through colonialism. These conversations can only become deeper and more nuanced through respectful engagement with knowledge produced by Indigenous peoples on this topic, rather than relying on the flawed work of colonial anthropologists. As a white trans woman who experiences both gender marginalisation and unearned privileges afforded by the legacy of colonialism, I am grateful for the opportunity to learn directly from takatāpui perspectives.
“These guidelines are based on the principle of Te Mana Whakahaere; trans people’s autonomy of their own bodies, represented by healthcare provision based on informed consent.”
These guidelines were produced by a coalition of healthcare practitioners, academics and community members, with the support of the Northern Region Clinical and Consumer Advisory Group. They are intended to supplement the World Professional Association for Transgender Health Standards of Care, providing guidance relevant to District Health Boards in providing gender affirming healthcare throughout Aotearoa.
An important feature of the guidelines is the use of Māori health expert Professor Mason Durie’s health framework. The document highlights two key principles for health promotion development: Te Mana Whakahaere (autonomy) and Ngā Manukura (community leadership). There is therefore is an emphasis on trans and gender diverse people having collective control over their own destiny and decisions around healthcare.
Furthermore, Te Whare Tapa Whā, as described by Durie, conceptualises health and wellbeing as the four cornerstones of the wharenui (meeting house). As noted in the guidelines, this model recognises the equal importance of Taha Wairua (spiritual health), Taha Whānau (family health), Taha Hinengaro (mental health) and Taha Tinana (physical health). These four cornerstones provide the structure for the document.
Consequently, the guidelines highlight topics such as Māori and Pasifika genders, minority stress, social transition, health in the family and in schools, and mental health, positioning these as equally important a consideration as physical transition (for those who desire/require medical interventions). This strikes me as a really important move, de-centring hormones and surgery to instead provide a more holistic view on trans health needs.
Like many similar documents, the guidelines are not perfect. I met a number of clinical practitioners in Aotearoa who considered this document to be a good starting point for conversations around improving care, but with some limitations outside of the relatively well-resourced Northern region in which they were primarily written. I have my own concerns around the citation of somewhat inaccurate information produced by cis clinical researchers (for example, Table 5, based on the Endocrine Society Guidelines, underestimates how long it might take for certain bodily changes to take place). I also feel that the definition of “informed consent” used in the document could perhaps benefit from tightening to specify what does and does not constitute appropriate oversight in determining whether or not patients are “adequately prepared” for medical interventions.
Regardless, I am deeply grateful for the work from so many people that goes into producing guidelines such as this, and I hope they can contribute usefully to the ongoing depathologisation of trans health.
I recently returned from a month-long journey to Aotearoa New Zealand. This trip was funded by a Rockefeller Foundation Fellowship with the School of Sociology and Social Policy at the University of Leeds.
My aim was to learn more about trans health services and community advocacy, while also sharing findings from my own research in a European context. I feel deeply privileged to have had the opportunity to meet many amazing people, who are doing a great deal of incredible work.
In this post, I share a number of resources and reflections from the trip. However, this is just the tip of the iceberg – I have no doubt that will no doubt that the experiences from the Fellowship will inform my research and thinking for many years to come.
Before I begin, I should quickly acknowledge that many readers of this blog will be unfamiliar with the word “Aotearoa”. This is a term from te reo Māori (the Māori language): it’s the current name for the islands known as “New Zealand” in English. Both are official names for the country that governs this land. For simplicity (and out of respect Māori history and culture, which long predates the arrival of Pākehā, or white European settlers) I use mostly use Aotearoa alone for the remainder of this post.
Whanganui-a-Tara / Wellington: the Gender Centre and Aunty Dana’s Op Shop
After a brief visit to Auckland (where I recovered from the long flight) I began my trip in earnest with a visit to the capital city of Aotearoa New Zealand, on the south-west tip of the North Island. I was told that you can’t beat Wellington on a good day – certainly, the bay of Whanganui-a-Tara is one of the mostly stunningly beautiful places I’ve ever had the fortune to visit.
Photos of 128 Radical Social Centre and the Gender Centre, taken with permission.
The Gender Centre includes a small office space, where people working for Gender Minorities Aotearoa can work on current campaigns and meet with visitors. Anyone can drop by to ask for advice or support, or pick up information. For example, the organisation has recently started running a free binder scheme. Materials on display included forms for name and gender changes, advice on accessing healthcare services, and information on the BDMRR bill.
BDMRR stands for Births, Deaths, Marriages, and Relationships Registration. Groups such as Gender Minorities Aotearoa are campaigning for non-binary recognition, and to make it possible for people to legally change the gender marker on their birth certificate without going through an expensive process involving medical oversight. Unfortunately, proposed changes have been delayed by the actions of anti-trans hate groups. UK readers will recognise the similarities with the campaign of misinformation waged against proposed changes to the Gender Recognition Act. This is not a coincidence. Anti-trans groups in Aotearoa are directly influenced by the language, aesthetics and (in some cases) the direct interventions of UK anti-trans campaigners, in what can be understood as a form of neo-colonialism.
While I was at the 128 Radical Social Centre I also visited Aunty Dana’s Op Shop. This is a second-hand clothing and accessories store run by trans and non-binary volunteers and open to people of all genders, with proceeds donated to Gender Minorities Aotearoa. It’s such a great way to raise money for campaigning, while providing an important resource and social space. It can also serve as a less scary space than the Gender Centre for people who are just coming out and looking for support. I had a great time browsing the shelves and chatting with the volunteer who was working there that afternoon.
Photos of Aunty Dana’s Op Shop. Taken with permission.
You can watch a fantastic video about the Op Shop here:
While I was in Whanganui-a-Tara I also took the opportunity to visit a trans and non-binary artists showcase at the NZ Games Festival and meet with some brilliant academics and students working on LGBTIQ research at Victoria University of Wellington. I will be sure to share their work as it is published!
Ōtautahi / Christchurch: queer art and affirmative care
I next travelled to Ōtautahi / Christchurch, taking a train down the east coast of the South Island. During this trip I began to understand the extent of the damage caused by 2010 and 2011 Canterbury earthquakes. There was evidence of huge landslides and roads were still being rebuilt. Several metres of new coastline were visible for many miles, clearly identifiable through rocks bleached white by dead organisms that once lived under the waves. The city itself is still being rebuilt. Huge building projects and areas of empty land can be found throughout the central business district, a reminder of the unforgiving power of the Earth.
Photos: day and night – urban art and public protest.
It was apparent that the people of Ōtautahi were still recovering from tragedy even before the horror of the recent neo-Nazi mosque shootings. Nevertheless, the city struck me as a great centre of culture. I am grateful to have had the opportunity to meet some amazing queer and feminist artists and heard about both radical public interventions and commissioned works. If you want to learn more about this, the websites of Jennifer Shields and Audrey Baldwin are great places to start.
During this visit, I learned about a fantastic initiative to build and publicise new public health pathways for gender-affirming care in the Canterbury region. Until recently, services such as specialist counselling, hormone therapy and surgical referrals were only available on an ad-hoc basis, and information was not easy to find. Relevant information on what services are available and how they can be accessed is now easily available, thanks to the work of the Ko Awatea gender-affirming care co-design group.
These services are still not perfect – several interventions are not publicly funded, and they still involve a certain level of medical gatekeeping. However, they represent an important step forward. Notably, I was informed that these achievements can be credited to the willingness of particularly motivated medical providers, who were prepared to put energy into working directly with trans community representatives to work for reform.
Tāmaki Makaurau / Auckland: RainbowYOUTH
The next stage in my journey was a visit Kirikiriroa / Hamilton, back on the north island. I was here for the Aotearoa New Zealand Trans Health Symposium. This will be the subject of a future blog post, so I am going to finish this piece with a look at an organisation based in Aotearoa’s largest city.
In finish my journey with a return to Tāmaki Makaurau / Auckland, meeting a number of community workers, activists and academics living and working in the city. I was especially honoured to visit the RainbowYOUTHoffices and drop-in centre: a spacious explosion of colour located in an otherwise unobtrusive side street on the edge of the queer distract around K Road.
RainbowYOUTH are an organisation run by and for queer and gender diverse youth, with a remarkably long and successful history. They are currently celebrating their 30th anniversary, having been founded in 1989. The organisation’s members and executive board are all aged 27 or under. Executive advisors aged over 27 are invited to attend and speak at board meetings, but do not have voting rights. I was really impressed by this commitment to centring youth perspectives in support work and activism, something which has been missing from the UK since the dissolation of Queer Youth Network.
I was also interested in how common the language of “rainbow” community was in Aotearoa, as an addition and alternative to acronyms such as LGBTIQ. I like the way this word avoids the “alphabet soup” and potential exclusions tone of the acronym. I can also see how – like the term “gender minorities” – it can work to be inclusive both of intersex people and of takatāpui in a way that is more expansive than just attempting to rework the Western/anglophone framework of “LGBT”.
Photos of the RainbowYOUTH centre. Taken with permission.
The RainbowYOUTH centre was a wonderful building. For a long time, the organisation ran out of a very small office on Karangahape Road, but in recent years an increase in income and activity enabled a move to the new space. This features several offices, a therapy room, a large social space with a TV and gaming consoles, a library, a community wardrobe, free hygiene packs for people in difficult circumstances, and once again a whole range of resources and information. I can see how the very existence of this space is helping to create new possibilities for a generation of young people who I hope will achieve things that currently remain unthinkable.
I left Aotearoa incredibly inspired by the work and imagination of everyone I met, and am hugely grateful to everyone who helped with advice and organisation, made time to speak with me, and shared ideas and information. Ngā mihi nui!
I am very grateful to have been awarded a Rockefeller Foundation Travelling Fellowship by the School of Sociology and Social Policy at the University of Leeds. This will be used to fund a research trip to Aotearoa New Zealand.
The object of the Rockefeller Fellowship is to enable early career researchers working in the Social Sciences to make personal contacts and/or visit universities overseas. My aim is to build networks with trans health activists, researchers and practitioners, plus share research findings from the Understanding Trans Health and Trans Pregnancy projects.
I will be in Aotearoa from 18 April to 12 May, visiting Auckland, Wellington, Christchurch and Hamilton. In addition to strengthening existing relationships, I hope to spend time meeting new people and learning more about trans health services and community advocacy. While the UK and Aotearoa differ in many ways, we are both island nations with public health systems that face various forms of privatisation; we are both seeing a rapid growth in the visible trans population; and we are both currently seeing proposals for reform within trans healthcare. I am very much interested in exploring how activists, researchers and practitioners in both countries might be able to exchange ideas and information.
I am excited to been invited to present my work at the University of Waikato, Hamilton during the visit.
On Friday 3 MayI will be speaking about my PhD research in the Department of Psychology at the University of Waikato. My talk, The “Gender Experts”: Clinical Discourses and Becoming Trans, will explore how expertise is contested within and between trans communities and clinical settings, reflecting on what this might mean for patient experience and differing understandings of trans possibility.
On Saturday 4 May I will be describing initial findings from the international Trans Pregnancy project at the Aotearoa New Zealand Trans Health Symposium. In this talk I will look at how and why some trans men and non-binary people choose to conceive and bear children. I shall explore some of the challenges and opportunities that arise for trans birth parents, and explain what kind of support research participants want to see from healthcare providers.
If you are a trans activist, trans health researcher or healthcare provider in Aotearoa and would like to meet during my visit, please do be in contact – I would love to hear from you!
In 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:
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.
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.
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.
In November I participated in a panel on research ethics at the 2018 WPATH Symposium in Buenos Aires, “Ethical Considerations in Transgender Health Research Practice”.
Dr Ruth Pearce 