trans

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Trans health in Canada: reflections and resources from CPATH

At the end of October I attended the CPATH 2017 (Canadian Professional Association for Transgender Health) conference in Vancouver. It was a fascinating event from which I learned a great deal. I’m keen to share some of my thoughts and experiences with others, as I feel there is a great deal that trans health researchers, practitioners and activists can learn from the progress that’s been made in Canada, as well as the limitations of that progress.

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Poster: “In Our Dream B.C….”, by Drawing Change. Based on Trans Care BC consultation with gender creative, trans, and two-spirit youth and their families..

In this post, I reflect briefly on my impressions of the conference, and link to Twitter threads I wrote during various sessions. You can also read my initial thoughts on the conference here.


CPATH took a broadly holistic approach to trans health

Over 300 people took part in the three-day CPATH 2017 conference and two-day pre-conference. In attendance were GPs, nurses, endocrinologists, psychologists, psychiatrists, therapists and counsellors, social workers, healthcare administrators, peer and parent support group facilitators, academic researchers, lawyers, politicians, and various trans campaigners.

CPATH 2017 treated “health” as a social phenomenon as well as a purely embodied matter, and this made for some very productive conversations. For example, numerous sessions explored how trans healthcare might best be provided in the context of primary health. Gender identity services are frequently provided by GPs with support from external specialists, a model of care that is currently under consideration for England. In some Canadian Provinces, organisations such as Trans Care BC help to connect providers in primary care to relevant specialists, and support trans people in obtaining interventions such as hormone therapy and surgeries.

This approach enables continuity of care in a local context, with family doctors enabled to provide trans-specific care for their patients alongside everyday services. It reduces barriers to access such as waiting times and the necessity of long-distance travel. It also enables GPs to help their trans patients access a wider range of specialist services: for instance, trans people with mental health issues might benefit from a referral to a peer support group as well as or instead of formal therapy (depending on patient desire and need). Many practitioners provide services on the basis of informed consent, rather than using mental health assessments as gatekeeping measures. It was heartening to see generalist and specialist healthcare professionals, social workers, trans activists and others engaged in open discussions about how best to manage care through this kind of system.

I was also particularly struck (and moved) by a session entitled Trans and Two Spirit Youth Speak Back! The 40 or so adults in attendance – mostly healthcare professionals or researchers of one stripe or another – were asked not to speak at all during this workshop. We were instead invited to listen to the stories and experiences of trans and two-spirit young people, who sat dotted around the room and answered pre-prepared questions delivered by a youth group facilitator. This session structurally prioritised the voices of young trans people who are so often silenced, and also offered an opportunity for us to hear how the healthcare needs and challenges faced by these individuals were shaped by their cultural heritage, family life, schools and peer groups.


CPATH took intersectional trans voices seriously

Trans and Two Spirit Youth Speak Back! was just one example of how trans voices were frequently centred at CPATH 2017. As an attendee from the UK, I was very impressed by this! Our trans healthcare conferences, seminars and workshops tend to be organised by and for community groups, researchers or healthcare providers, with relatively little overlap between attendees at these events. Very few practitioners are (openly) trans, meaning that trans people tend to talk to one another at community and research events, but are heard less often at healthcare conferences for doctors, nurses and mental health specialists. Moreover, the speaker line-ups at all these events tend to overwhelmingly prioritise the most privileged individuals, such as white people and men. The only possible exception is cliniQ’s Trans Health Matters conference, and that event too feels like it’s taking the first steps towards something better.

During the opening plenary of the CPATH conference proper, we were informed that around one third of speakers at the event were trans, and around a tenth were Indigenous (i.e. of First Nations heritage). I’m not sure how many people of colour were represented at the event more generally, but the all-white panels which are a norm at UK events seemed few and far between.

Importantly, the trans women, trans men, non-binary and two-spirit platformed as speakers and workshop facilitators were usually also professionals. We weren’t simply present at CPATH to represent a “patient perspective”: rather, we were the experts. This reflects the hard work of individuals in pursuing a career, and the collective work of CPATH in supporting trans professionals; it also reflects the actions of local providers in various parts of Canada who have made an active effort to employ trans people, or secure funding for partnerships with trans-led organisations.

In my previous post I noted that the opening plenary of the conference proper centred Indigenous voices. This included a formal welcome from Musqueam Elder Jewel Thomas, and talks by trans and two-spirit Indigenous educators from different parts of North America. I was happy to see that the plenary session on the second day of the conference continued to centre the voices of individuals who tend to be marginalised within even trans spaces. Two-spirit physician Dr James Makokis and Latina trans activist Betty Iglesias – who discussed issues faced by trans sex workers and migrants – were platformed alongside an Member of Parliament from Canada’s ruling Liberal Party, resulting in a thoughtful and challenging debate.


CPATH (and the rest of us) still have a lot of work still to do

I left CPATH with a very positive impression, but Canada is by no means the promised land for trans health. Professionals and patient representatives alike frequently discussed the challenges they faced in providing gender-affirming services. Transphobia and cisgenderism are still very much prevalent within healthcare provision and legal frameworks, particularly outside of urban areas: there is therefore a great need for better education among trainees and further reform of laws and guidelines. Limited funding and different approaches across the country’s Provinces and Territories also mean that not everyone has the same access to treatment, and waiting lists persist for publicly-funded care. These are challenges that exist across the world, and may benefit from greater international collaboration and strategy-sharing.

At the end of the first day of the conference proper, there was a reception specifically for trans people attending the conference. I later reflected on the experience of attending this reception in conversation with a genderqueer colleague; both of us felt ourselves relaxing enormously upon entering the trans-only space. For all the positives of CPATH, it was a huge relief to step away from cisgenderist expectations and microaggressions that quietly persisted throughout the conference proper. These included a range of unspoken ideas about how we should dress, act, and talk “professionally”, limitations on our ability to name transphobia within healthcare settings without fearing repercussions, and the occasional terrible intervention from self-righteous cis professionals.

As ever, facing down these challenges is hardest for the most marginalised trans people, including (for instance) disabled individuals, sex workers, migrants, and people of colour. I was aware that while CPATH 2017 took a broadly intersectional approach, instances of ableism, racism, sexism and so on persisted: and this could take the form of unexamined prejudices on the part of more privileged trans people too. Moreover, white people were still heavily overrepresented among conference attendees; a phenomenon that was particularly noticeable at an event held in a city as diverse as Vancouver.

What I’m taking from this is a reminder that equality work is never “done”; rather, it is something that we should strive to always “do”. We should aim constant improvement in our relations to one another rather than assuming that solidarity and equality are things that we can simply achieve. It is in this spirit that I’ve attempted to use my own privilege as an academic to bring back lessons from Canada for the UK and beyond.

So, I’ll end this post with a serious of links to Twitter threads from the event. I livetweeted extensively from CPATH 2017, sharing summaries of the numerous talks and workshops I attended. This is by no means a comprehensive summary of any of the sessions I was at, let alone the wider conference (as numerous parallel sessions took place simultaneously). However, I hope the ideas and approaches will be as useful and interesting to you as they are to me.


Pre-conference (training) Twitter threads

Day 1:

Introduction to Gender-Affirming Practice

Pre-puberty/Puberty: Addressing On-coming Puberty

 

Day 2:

Adolescence: Moving Forward With Gender-affirming Care for Youth

Cross Country Health Clinic Practice Panel: Models of Care and Clinical Practices

 

Conference Twitter threads

Day 1:

Plenary: Centering Indigeneity and Decolonizing Gender

Interpersonal Communication Needs of Transgender People

Ethical Guidelines for Research Involving Trans People: Launch of a New Resource

Investigating the Medicalization of Trans Identity

Primary Care Approaches to Caring for Trans Youth

 

Day 2:

Plenary: Fostering Safety and Inclusion in Service Provision, Systems and Sectors

Non-binary Inclusion in Systems of Care

Trans Data Collection and Privacy

Legal, Ethical, Clinical Challenges: Youth Consent to Gender Affirming Medical Care

 

Day 3:

Pregnancy and Birth

Plenary: Supporting Older Trans People

 

 

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CPATH: diversity, inclusion and decolonisation in trans health

I’m currently attending the CPATH (Canadian Professional Association for Transgender Health) conference in Vancouver. It’s a fascinating event which I’m hoping to write about more in the coming days. I’ll also be livetweeting whenever possible.

The first two days of the event are a “pre-conference” training session aimed largely at healthcare professionals, followed by a more standard three-day conference over the weekend. I’m fortunate enough to be attending the whole thing, funded through the ESRC-sponsored Trans Pregnancy project. I’m here to learn about how gender-affirming care is being practiced in North America, and to connect with people working in reproductive health and in supporting transition.

What’s really struck me so far is how much more intersectional and inclusive of actual trans people this event is when compared to professional events in Western Europe, particularly last year’s WPATH conference.

I was struck at the how the first pre-conference session I attended – billed as an introduction to gender-affirming care – had questions of diversity, power, and consent absolutely embedded into the presentations. Attendees were encouraged to reflect critically on their own privilege and social position, and that of key writers and trend-setters in the field. We discussed how social determinants of health (such as wealth, education, citizenship etc) play a huge role in determining inequalities within trans populations as well as between trans people and the cis majority.

These are pretty standard topics within sociology, but even so I felt the session was very well-presented and I learned a lot from the informative but open and deeply self-aware approach taken by the two presenters, Gwen Haworth and Jenn Matsui De Roo. It was immensely refreshing to see this kind of conversation take place in an event attended largely by healthcare providers. Too often, I feel clinical providers and researchers in the UK find themselves at loggerheads with trans patients. Often this may be because they haven’t thought to take a step back and consider the cultural context of their patient’s life and the systemic issues that this person might have encountered, let alone the deeply unequal power dynamic of the clinical encounter.

It was also really important for me as a non-clinician to take the time to listen to the stories and experiences of healthcare professionals, and learn more about the energy and care they put into the vital work that they do. I fear too many sociologists looking into issues around healthcare don’t actually attend medical conferences, and as such miss out from directly hearing about professional views and experiences.

I was also delighted to see that the space is pretty trans-friendly. People are generally sensitive around language, there are gender-neutral toilet blocks, pronoun stickers, and there’s also a “safer space” quiet room. At the WPATH conference last year, a number of trans attendees were attempting to make all of these things happen through forms of quiet guerilla disruption, for instance through putting holographic stickers on the toilets that switched between “male” and “female” images. At CPATH, trans language, trans culture and trans needs feel like part of the fabric of the event.

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My CPATH 2017 Conference name badge.
Under my name is a sticker reading “preferred pronoun: she/her”.

Finally, it’s good to see that there’s a serious decolonial agenda at CPATH. The conference booklet acknowledges that Vancouver is built on unceded lands; there are numerous sessions led by indigenous practitioners, researchers and activists; indigenous perspectives and issues are regularly discussed by non-indigenous attendees; and the introductory plenary for the conference proper on Friday will feature an opening speech and talks from indigenous activists and healthcare providers.

Of course, while all of this looks good for CPATH, the progressive appearance of the conference can hide the struggles that make real inclusion and recognition possible. I’ve heard that the opening plenary was the outcome of a struggle over indigenous representation after a number of papers were rejected. So, however good CPATH looks to me as a (white, British) outsider, it’s important to acknowledge the ongoing, silent (silenced) work that so often takes place behind the scenes to make this happen.

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Some reflections on Trans Health Matters 2017

Last week I joined over a hundred other attendees at the Trans Health Matters conference in London. The event (which takes place on a mostly annual basis) was organised by cliniQ, the city’s holistic trans sexual health clinic.

For impressions of the day, you can visit the Twitter hashtag for the event here.

When I attended the first cliniQ Trans Health Matters conference in 2013, I found it to be immensely valuable and informative, but left with a feeling of deep-seated distress that persisted pretty much ever since. For at that event, I gained a better understanding of the scale of the problems that plague trans healthcare provision.

These include widespread ignorance and often also active discrimination from practitioners, plus enormous (and growing) waiting lists for gender clinics. All things I already knew about, but swapping notes with other researchers and activists helped me realise just how common and severe the issues were. My impressions from the conference were also reflected in the initial findings from my PhD fieldwork, which I was undertaking at the time.

By contrast, I left this year’s event with a greater sense of optimism and hope.

That’s not to say that trans health isn’t still a disaster area. It really is. However, I feel that since 2013, there has been a real growth in community health initiatives, and also in cis practitioners’ active engagement in the issues. This was actively reflected in the conference programme, which focused largely on what is being done and what we can do to make things better.


What is “trans health”?

Interestingly, another positive aspect of the conference for me was that gender clinics and transition processes were barely discussed at Trans Health Matters 2017.

That isn’t to say that these aren’t important things to talk about – they absolutely are – but one of my observations over the last few years has been that discussions of “trans health” focus so overwhelmingly on gender identity services that an outside observer would be forgiven for thinking that transition is the only healthcare issue that really exists for trans people.

Which, of course, would be completely wrong. Trans people face extremely high rates of discrimination, harassment, internalised stigma, poverty, physical violence and domestic abuse. These challenges can be be linked to endemic mental health problems, suicidality, substance abuse, “risky” sexual practices and disability within trans populations. Moreover, there is the matter of everyday transphobia and cisgenderism in everyday encounters with healthcare practitioners.

So it was genuinely refreshing to attend a trans health conference that focused largely on sexual health (particularly HIV prevention, reflecting cliniQ’s role as a sexual health clinic), with some additional discussion of matters such as therapy, sex work, data collection, and intersectionality. These are all deeply important issues that really deserve the attention they received on the day.

Of course, the absence of discussion on gender identity services would be a real issue if these conversations weren’t already happening elsewhere. But they are. This year alone, I’ve attended two UK trans health conferences which centred issues of transition, and I know there have been plenty of other such events that I haven’t been able to go to. This is another cause for optimism: a great increase in activist, academic and professional events looking at trans health from a range of angles, reflecting the rapid growth and increasing visibility of our communities.


Towards inclusive care

While there are a growing number of trans-specific sexual health services available in UK cities, it was really good to see a lot of discussion around how trans people can be included in services (and the promotion of these services) more generally. A great example of this was a short film that’s been made about PrEP, from which extracts were shown at the conference.

I was also really heartened to see that Trans Health Matters was a somewhat more intersectional affair this year. Two of the four speakers on the keynote panel were trans women of colour. We got to hear a particularly inspiring speech from Mexican/US activist Alexandra Rodríguez, who explained how she created a pioneering HIV prevention service for trans Latinas in California after realising there were no existing services, and reflected on the importance of providing care and support for trans migrants.

I also attended an afternoon session on barriers to access and strategies for inclusion for some of the most vulnerable trans populations in the UK: black and minority ethnic trans people, non-British trans people, and economically marginalised trans people (these are, of course, groups that frequently intersect!)

Barriers to healthcare access for BAME and/or non-British trans people.
Photos taken with permission during breakout session.

One of the most important lessons from this session was the importance of reaching out for service providers, rather than expecting that the most marginalised people will feel that a service is necessarily for them. This is particularly the case if a service is normally primarily attended by and promoted to a relatively privileged demographic.

The work of reaching out may involve an element of discomfort for white and/or middle class providers; it can involve sensitively negotiating access to new spaces (e.g. club nights and community groups run by and for people of colour and/or working class people), learning from mistakes and being open to listen and learn with humility. But it is vital to ensure that community services are truly inclusive.


Reproductive health survey

The importance of the work of inclusion really came to the fore in a plenary session where we were shown initial findings from a trans reproductive health survey undertaken by Public Health England.

The survey is still open: you can take it here.

This is the first major stastical study looking at trans people’s reproductive health and experience of services in the UK. As the survey hasn’t yet closed and the data still requires some additional processing, we were asked not to report on specific figures. However, what I can say is that (unsurprisingly) there were generally high levels of dissatisfaction with existing service providers and sexual health education, reflecting an urgent need for improvement and trans inclusion.

The aspect of the survey that inspired the most discussion and debate amongst conference attendees, however, was the lack of diversity among existing survey respondents. A majority of respondents had received a university education, and an overwhelming number were white. This reflects a wider trend in trans community responses to online surveys: it is the most privileged individuals who are more likely have access to these.

I asked the speaker if there had been a paper version of the survey produced: these can help obtain a greater number of responses from individuals less likely to access an Internet survey, including trans people of colour, working class trans people, and older trans people. He noted that unfortunately the research team (which I believe consists just of himself and a single support worker) are underfunded and are trying to do their best with the resources they have. However, other audience members noted that there were still things that could have been done to increase the response rate from underrepresented groups. For instance, the research team could have reached out to UK Black Pride and asked for help with dissemination.

To me, this conversation really brings home the importance of active inclusion, which was the main thing I have been thinking about since attending Trans Health Matters. We can’t just assume that all members of our communities will be able to access services and research: rather, we need to make the effort to ensure that they are accessible. This can involve additional work, but the real challenge is overcoming the ignorance that can arise from our own privilege, even if we are ourselves marginalised in different ways.

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New job at the University of Leeds

I’m delighted to announce that I’ve just begun Research Fellowship in the School of Sociology and Social Policy at the University of Leeds. I’ll be working as part of an international team on the ESRC-sponsored projected Pregnant Men: An International Exploration of Trans Male Practices of Reproduction, which is being led by Sally Hines. This study will explore the sociological, health care and policy implications of trans men’s reproductive practices.

Some initial information on the scope and plans for this research are currently available on the project website. I’ll be writing more about the project there (and here!) as it progresses.

 

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Concerts in Coventry: 24th June, 29th July

I’m involved in organising two exciting events at Coventry’s Tin Music and Arts over the coming month.

This coming Saturday sees the return of feminist club night Revolt, complete with bands, DJs, spoken word, zines and our Feminist Library. I’ll be opening the night with my band Dispute Settlement Mechanism.

For tickets and more info, click here.

Revolt #10
On Saturday 29th July we’ll be treated to a performance by CN Lester, who will be performing songs from their new album Come Home and reading from their great new book Trans Like Me.

For tickets and more info, click here.

CN Lester.png
Entry will also be available on the door on a donations basis (suggested donation £5, but no-one will be turned away for lack of funds).

 

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WPATH 2016: the activist fringe

I’m currently in Amsterdam for the World Professional Association for Transgender Health (WPATH) biennial symposium. It’ll be the largest such conference that has ever been run, with 800 participants from across the globe. This will hopefully be the first of several posts exploring my experences at the conference (no promises, though!) – and I’m also planning to occasionally livetweet.

WPATH is an international body best known for publishing the Standards of Care, which offer guidance for practitioners supporting patients seeking to transition. The organisation has undergone a great deal of change over the years, reflecting wider shifts in understanding around trans people and our experiences. At present, the organisation’s wide scope incorporates a considerable range of views on how transition should and could be managed.

I’m here partly to present a poster detailing some of my research findings around patient experiences of waiting in the UK. However, as a sociologist with an interest in the evolution and negotiation of discourse and activism around trans health, I’ve been interested to see that at least two fringe conferences have been organised in Amsterdam to coincide with WPATH. I also thought it would be beneficial to share what’s going on with a wider audience – so, here goes!


GATE pre-conference

Global Action for Trans* Equality (GATE) is a loosely-organised international trans rights organisation: a genuinely diverse multinational network of activists with strong representation from the Global South. One of their key priorities has been to campaign for the depathologisation of trans, although members have also been involved in activism around other issues, such as access to care.

Over the past two days GATE held their own conference in Amsterdam to discuss trans health. The event both stood alone as an independent conference, and provided activists with an opportunity to discuss WPATH. I wasn’t able to attend in person, but have heard that a broad consensus was reached on a couple of issues related to the classification of trans in the World Health Organisation’s International Classification of Diseases (ICD).

The current version of the document – ICD-10, published back in 1992 – classifies ‘Gender Identity Disorder’ and ‘Gender Identity Disorder of Childhood’ as mental health issues. These diagnoses are widely used in gender clinics in countries such as the UK (note: these differ from the diagnosis of ‘Gender Dysphoria’ present in the American Psychiatric Association’s DSM). Recent statements from the World Health Organisation indicate that the long-awaited ICD-11 will replace diagnoses of ‘Gender Identity Disorder’ with ‘Gender Incongruence’, and move these to the sexual health section of the document.

Whilst GATE’s long-term goal is depathologisation, at present they have decided to focus upon pushing for this move from classifying trans diagnoses as mental health issues to regarding them as sexual health issues, as a compromise that should ensure continued funding for transition from insurance companies and public health organisations. In addition, they are arguing against the existence of the category ‘Gender Identity Disorder of Childhood’, on the grounds that this is an unnecessary medicalisation of gender diversity in young children, whilst the ‘adult’ category is sufficient to guide medical interventions for adolescents. This perspective feeds into a wider discussion around the category that is also recognised in the WPATH programme, with time set aside for a formal debate.

GATE activists will be attending WPATH to argue these points, and also to advocate more widely for trans-affirming approaches to treatment.


FREE PATHH

FREE PATHH is an event that will take place this Saturday (18th), concurrently with the first day of the WPATH symposium proper (a handful of formal pre-conferences are taking place on Friday). Hosted by Dutch trans activists, it is a free event that anyone can attend. FREE PATHH organisers argue that the high fees for the WPATH event mean that ordinary Dutch trans people are unable to attend this event held in their own country to learn more about their own health. As such, there is little interaction between WPATH and local Dutch trans communities.

The few transgender people who can afford to be present at this important symposium, are exceptions. They can go, because they have to be present for work or because they have enough personal financial means. (FREE PATHH)

As one of those few trans people who can attend the WPATH symposium (in my case, because I was lucky enough to gain a grant in order to do so), I feel this is a really important point. WPATH undoubtedly exists to share information amongst professionals in a formal setting; at the same time, the issues at hand require input from the very people who are directly impacted. With trans people disproportionately likely to be on low incomes, even early career professionals might find themselves effectively frozen out.

The FREE PATHH programme includes talks and workshops in Dutch and English on a range of issues related to trans health, and will be filmed for later disseminaton. At the end of the day, a panel with individuals who have attended both WPATH and FREE PATHH will summarise both events. This should be a valuable opportunity to share insights from both international and Dutch work on trans health, from professional and community perspectives.

You can read the FREE PATHH programme here.

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Some tips on opposing Kenneth Zucker’s new article on trans children

This morning it came to my attention that notorious child psychologist Kenneth Zucker has co-written a chapter on trans issues for the new (6th) edition of Rutter’s Child and Adolescent Psychiatry. The chapter, entitled “Gender dysphoria and paraphilic sexual disorders” effectively draws upon flawed and outdated research to promote reparative therapy for trans children. You can read most of it via Google Books here.

Cover of Rutter's Child and Adolescent Psychiatry

Abusing children – for science!

This is a big deal because Zucker draws upon harmful theories (including Ray Blanchard’s deeply reductive typology of transsexualism) to promote the idea that issues faced by gender variant children are due to a problem with the child, rather than societal gender norms. He therefore promotes a form of treatment that (to quote his new article) encourages parents to “set limits with regard to cross-gender behaviour, and encourage same-sex peer relations and gender-typical activities” in an attempt to cure them of difference. This is the kind of treatment that leads children to internalise the idea that non-normative gendered expression is shameful or wrong.

Rutter’s Child and Adolescent Psychiatry, meanwhile, is a widely-used textbook and can be found in university libraries and on reading lists in many countries.

I’m not sure what the best way is to stop this article from influencing practice. However, some ideas could include:

  • Write to professional organisations and ask them to explicitly oppose reparative therapy for trans youth
  • Write to University libraries and courses, asking them to consider sticking with the 5th edition of Rutter’s
  • Write to University departments and ask them to teach critical texts alongside the 6th edition of Rutter’s, and/or avoid putting the new edition on reading lists
  • Borrow the book from a local library if it becomes available, and write critical comments in the margins
  • Write to the book’s editors and/or publisher and question why Zucker has been given a platform for his outdated ideas
  • Comment on this post and/or join this new Facebook page to discuss possible ways forward.

The new edition isn’t yet widely available in libraries, so now is a good time to act.

If you’re writing letters or raising awareness of this as an issue, here is some useful information on opposing the article:

  • Zucker’s approach to treatment can seriously harm children
  • Zucker’s Gender Identity Service at the Toronto-based Centre for Addiction and Mental Health was recently suspended pending investigation in the wake of a large number of complaints – his approach to treatment is now also arguably illegal in the province of Ontario
  • Zucker’s new article represents poor academic practice. He cites himself 17 times, relies upon papers at least 20 years out-of-date to make many of his arguments, and also draws strong inferences from statistically insignificant quantitative findings
  • Zucker’s considerable academic position is based in part upon a small “invisible college” of academics who regularly peer-review and cite one another, thereby gaining many publications with a high profile whilst avoiding external criticism
  • There is a considerable evidence-based case to be made against Blanchard’s work. See for instance “The Case Against Autogynephilia“, a peer reviewed article by Julia Serano.

Thanks and respect to Peter Le C for raising awareness of this issue, and to oatc for suggested edits.

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Imagining a trans-inclusive Stonewall

“The meeting actually went pretty well, didn’t it?”

I heard a number of variations upon this statement echo around the pub we gathered in yesterday evening, as some 40-odd trans activists digested the day’s work. There was an undertone of incredulity: most of us had managed our expectations carefully in advance of the day. This was due in part to the fractious nature of trans communities, but also stemmed from our difficult history with Stonewall.

Back in 2008, many of us had been present at a loud, colourful demonstration outside the Victoria and Albert Museum as it hosted the annual Stonewall awards. We were there to express our displeasure at an organisation that didn’t simply exclude trans people, but seemed to keep making mistakes that caused harm to us.

A lot can happen in six years. Change has come from two directions: from continued external pressure from trans people, but also from a genuine willingness to reconsider matters from Stonewall following a shift in management in February.

In this post, I outline the themes and outcomes of a meeting held on Saturday to discuss potential options for trans inclusion in Stonewall. I will repeat some of the points made by CN Lester and Zoe O’Connell in their accounts of the day, but recommend you also have a look at what they have to say. For an idea of what is at stake, I recommend posts by Natacha Kennedy and Kat Gupta, as well as my previous writing on the topic.


A meeting with trans activists

The meeting – held in central London – was attended by a large number of trans activists who had been directly invited to the event, as well as three cis attendees: new Stonewall CEO Ruth Hunt, Jan Gooding who is Chair of trustees for the group, and a facilitator (who, incidentally, did a very good job).

A number of us felt that a more open meeting or more transparent means of securing invitation would have been beneficial. I’ve made my own views about this clear (particularly on social media) but in this post I will focus upon what we actually achieved, and what will happen next.

The event was in some ways quite diverse, and in others ways very limited in terms of representation. There were a wide variety of experiences represented, and views from across the political spectrum. There were a great range of gender identities represented, although a particularly large part of the group were trans women. There were attendees from across England and Wales, with James Morton from the Scottish Transgender Alliance present to talk about the situation in Scotland (where Stonewall is an LGBT organisation). The group was overwhelmingly white. There were a number of disabled people present, but not many with experiences of physical impairment.

Several commentators have stated that Stonewall were responsible for the make-up of the meeting, and therefore could have made more effort in terms of inviting a diverse range of participants. This is true, but I feel that trans activists also need to step up and take some responsibility here. Most of our loudest voices are white trans women like myself. We need to keep our own house in order: by reaching out to communities of trans people from under-represented groups, by “boosting the signal” and talking about the work of trans people from under-represented groups, and by ensuring that it’s not just us with places at the table.

It’s worth noting that this event was framed by Ruth as one part of a far wider consultation on Stonewall’s future engagement with trans issues. If you’re trans please ensure that your voice is heard in this. You can do so by writing to Stonewall here, or by emailing: trans@stonewall.org.uk. There will be more about the next steps of consultation later in this post.

The meeting ultimately had two purposes: to move on from the problems of the past, and examine potential options for future collaboration between Stonewall and trans communities.


An apology from Ruth Hunt

The day began with a refreshingly honest admission of fault on the part of Stonewall from Ruth. She offered a point-by-point account of how Stonewall has let trans people down over the past few years, and offered both apology and explanation for these incidents, as well as an account of how these are now being addressed.

This was not the main focus of the day, instead clearing the air from the start to enable a productive discussion. However, I feel it is important to provide a public record of this session: if we are to collectively move on from the past, then we need to remember that Stonewall has demonstrated a commitment to change.

Some of the issues discussed by Ruth included:

  • Nominating transphobic individuals for awards. This was acknowledged as a mistake, and we were assured that nominees are now scrutinised more carefully (not just for transphobia).
  • Insensitive use of language in Fit, Stonewall’s video resource for schools. Ruth explained that the inappropriate section has been removed from the DVD.
  • Stonewall’s campaign with Paddy Power, who were severely rebuked by Advertising Standards Authority for a transphobic advert in 2012. Ruth noted that Stonewall is now using its relationship with Paddy Power feed back on advertising they consider to be offensive (interventions which are not just limited to addressing homophobia) which has resulted in a number of changes being made.
  • Stonewall representatives speaking out inappropriately and/or not speaking out on trans issues whilst lobbying Government and MPs. There’s a long and complex history here that I’m not going into in this post: suffice to say that one aim of Saturday’s meeting was to ensure that this is done better in the future.

There was also significant evidence that Stonewall is undergoing major institutional change in regards to trans issues. I was pleasantly surprised to hear that Ruth had emphasised seeking a solution to the organisation’s difficult relationship with trans people when applying for the position of CEO, and that this was viewed favourably by trustees who considered her job application. Trans employees of Stonewall are reportedly more likely to be “out” and feel comfortable speaking about trans issues and concerns.


What’s on the table?

We then moved onto the main point of the event: to discuss proposals for a new relationship between Stonewall and trans people. There were four options for us to consider in group conversations, with attendees also encouraged to suggest any additional solutions that might not have been considered.

The options were:

  1. A fully inclusive LGBT Stonewall, which considers campaigning on trans issues to be a full part of its remit.
  2. Stonewall becomes nominally LGBT, but also funds and provides resources and guidance for the creation of a new, effectively autonomous trans organisation to work on trans campaigns. This organisation will eventually become independent, but can work closely with Stonewall.
  3. Stonewall remains LGB, and provides grants for a number of trans organisations so they can do their own campaigning work.
  4. Stonewall remains LGB, and works to be better ally.

Ruth explained that option (4) was not really favoured by Stonewall, particularly given the appetite for a closer relationship amongst many trans activists. The general feeling of the room reflected this, and we focussed our discussion upon the first three options.

Option (3) was largely rejected also. Criticisms raised included concerns about who would get the money, the impact of competition between smaller trans organisations, about what the conditions might be for such grants, and the amount of money and energy that would be spent by both Stonewall and trans groups on managing the system and applying for grants – money and energy that could be better spent on actual campaigning. Ruth further pointed out that Stonewall doesn’t actually have a lot of money to spare, outlining how money is currently spent on Stonewall’s employees and existing campaigns.  If the grant scheme was to go ahead, then there would likely be a knock-on effect on (for instance) campaigning in schools, and Stonewall might need to apply for extra money from funding pots that are already used by trans groups.

Options (1) and (2) both had great deal of support from within the room. Several groups suggested variations upon an “option 1.5” that sat between the two – proposals included the creation of a “trans department” within Stonewall, and semi-autonomous “sibling” organisation linked permanently to Stonewall.


Outcomes

There was a pretty clear consensus on the following points at the end of the day:

  • Barring the unexpected (e.g. widespread opposition from trans people contributing to the public consultation) Stonewall will become an LGBT organisation, in one form or another.
  • Any eventual solution should provide for joint ‘LGBT’ campaigning on shared issues, such as homophobia and transphobia in schools.
  • Any eventual solution should provide for campaigning on trans-specific issues, such as on relevant legislation (e.g. the Gender Recognition Act and amendments to the recent Marriage Act) and on addressing issues with health care.
  • Future campaigning work must be intersectional, recognising the diversity of trans experience in areas such as gender identity, race, disability and age.

 

What happens next?

  • The public consultation will continue for several months. If you’re trans, please make sure your voice is heard!
  • There will be further meetings held with people from under-represented groups. This is a vital opportunity to address the problem of diversity at Saturday’s meeting. Stonewall are planning meetings with people from a number of groups, including intersex people as well as trans people of colour, disabled trans people and young trans people. If you want to attend one of these meetings, please contact Stonewall: trans@stonewall.org.uk
  • There will be a formal proposal for trans inclusion in Stonewall made in January 2015 in the shape of a report. This will then be consulted upon internally (i.e. within Stonewall) and externally (i.e. amongst trans people).
  • A final decision on the future of Stonewall should be made in April 2015. If this involves full trans inclusion and/or the creation of a new trans group, this will take several months to implement.

It’s important to note that this is not a process that can take place overnight! The process of consultation is lengthy in order to take on board the views of as many trans people as possible. We have such a range of perspectives that there is no chance that everyone will be happy, but the aim is for change to be trans-led, and to reflect the desires and interests of as many people as possible.

Once the consultation ends, its results cannot be implement immediately either. Stonewall may need to revise its priorities and work plans, and Ruth noted that a full-scale programme of training on trans issues and awareness will be necessary for the organisation’s staff.


Personal reflections

I feel positive about the future. There is so much unnecessary suffering amongst the trans population that allies are vital, and Stonewall could be a particularly large and powerful ally.

I believe in diversity of tactics to bring about change, and Stonewall takes a particularly centrist, “insider” approach to this. It is vitally important that Stonewall is never the only voice in LGBT activism, and that other groups continue to take more radical approaches to trans campaigning. It is also important that we remain capable of critiquing Stonewall, and holding it to account. Ultimately though, I’d rather be a critical friend than an entrenched foe.

by

DSM-II

On Monday we released the second Dispute Settlement Mechanism EP, DSM-II. You can listen to it below. I perform on lead vocals, and also play clean bass guitar on our cover of Seven Nation Army.

NHS Vulva may be of particular interest to readers of this blog. It deals with issues of medical malpractice, transphobia in the legal system, and cultures of transition.