A couple of days ago I joined Katy Montgomerie’s livestream to work through the current NHS England consultation on child and adolescent gender services. We discussed the background to the consultation, what the questions mean, and what some of the major issues are.
You can take part in the consultation here. It is open until 4th December 2022. Filling it in is a bit of an intense experience, but if you fancy some friendly company and catty cameos, I hope our video will help.
Earlier this year I did a talk for the University of Cambridge Reproductive Justice Research Network alongside my excellent colleague Francis Ray White.
We talked about research findings from the Trans Pregnancy and Improving Trans Experiences of Maternity Services projects, plus reflected on the wider context of reproductive justice for trans people, including media coverage, medical racism, abortion rights, and attacks on young trans people’s bodily autonomy.
You can watch a video of the talk here:
(as a quick aside, I’d like to thank my good friend Harry Tunnicliffe for last use minute of his office so I could do this talk while away from home!)
i.
I discovered recently that my friend Elli had passed away. She was just a few years older than me. I believe she lived a difficult life, but was always true to herself, and was good and kind to others. And meeting her as a teenager changed my world.
I first encountered Elli during the long, messy process of coming out to myself. We were both members of a small online community, created by a young trans person for other young trans people. There were a few of us there in our mid-late teens and early 20s, most of us struggling to imagine what it would be like to live authentically. There were a small handful of “allies” (at least two of whom would later coming out as trans and/or genderqueer themselves). And there were a couple of people who had already transitioned, including Elli.
I don’t think there is a word for people like Elli in the straight world, which can make it hard to express how important she was, even to myself. She was my not-very-much-older Elder. She was my possibility model. She helped to crack my egg. She was a nexus of social contagion, a superspreader in the psychic epidemic, a key trigger for my rapid onset.
Elli was a friendly, patient, community-minded person who showed up for others. She showed us that it was possible to be true to ourselves, to build a life on another side of the sex divide. She was honest and realistic about how difficult things could be, and full of constant reminders that there was, is, and will always be more to life than being queer. She loved ferrets and cats and anime, especially Naruto, because she was a massive nerd.
Elli wasn’t famous or well known. She wasn’t involved in any significant moment of history. She had small friendship circles online and offline. This, though, is how we build queer and trans community: through countless acts of care and mutual aid, rather than grand gestures.
ii.
I found out Elli had died through a mutual friend from the same old community. She had found out through Facebook – she went to look at Elli’s profile, and realised Elli had died months before.
I was horrified. I had spoken with Elli regularly while she was severely ill with covid, reaching out to tell her how much I cared about her, and share numerous pictures of my cat. We hadn’t spoken that regularly for the last decade, but it felt like every now and then we would touch base and check in on one another. I don’t use Facebook very often these days, but it can be a good way to find where long-term, long-distance friends like Elli are doing. After a lot of hardship, I’d been really excited to find out she had a new job where she felt happy and fulfilled, and a new apartment which she made into a real home. And when got sick, I decided to message her until she recovered.
Except. After she started getting better, after she got home from the hospital, I stopped messaging. I was busy and distracted, getting ready to start my new job at Glasgow. I’m aware that I’m a possibility model myself, now, and there’s a lot that comes with that. I regularly receive messages from people who say I helped then to come out, to be themselves, through being a visibly trans woman, and visibly “successful” in my chosen fields of work and activism. I am perpetually busy, and tired, and distracted.
I saw the occasional Facebook update from Elli suggesting a gradual recovery. And so, like before, I dropped contact, assuming that we’d chat again in a few weeks or months.
And of course, the algorithm never told me that she was no longer with us.
I’m not sure if there is a clear moral to all of this. I am trying not to blame myself – how could I know? And Facebook was the very medium by which we remained in touch long after our original community was no longer active.
These days I feel pulled in all directions by friends from different times and places, people I once knew well, people I wish I was better at staying in touch with, people who assume some kind of parasocial relationship with me on the basis of my public profile. Social media feels like the only reasonable way to stay on top of it all. Yet I regret relying on social media – and especially the exceptionally unreliable medium of the feed – to keep up with Elli. I could have just…messaged her, or checked how she was doing.
iii.
It feels like there are two stories here. But perhaps they are the same story.
My experiences of trans community life are pierced through with chance and tragedy: life-changing encounters, terrible losses, and the all-encompassing importance of the Internet. Elli is far, far from the first trans friend of mine to die young. I also know she won’t be the last. When you live in a community where healthcare and socio-economic inequalities are endemic, you are always surrounded by people who are very ill. That’s an inevitable consequence of the forces stacked against us. The least we can do for one another is to collectively find joy and meaning in the life we have, using whatever tools we have at our disposal.
I want to live up to Elli’s memory, and to everything that she gave me. I hope I can be a better friend to others, but also forgive myself for being just one person, in one place, with a limited amount of time available to me. And while I’m at it, you’d better believe I’m going to keep cracking eggs.
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.
You can read some of my published work on ethical research with trans populations here.
You can write to the Cass Review to express your concerns here.
Posted updated 2 July to include new details.
There have been some really exciting developments in England over the last couple of months for trans birth parents (that is: men and non-binary people who conceive, carry, and give birth to their own children).
In April, a groundbreaking report on Trans and Non-Binary Experiences of Maternity Services was published by the LGBT Foundation. I am really proud to have co-authored parts of this report with colleagues in NHS England and the LGBT Foundation, and to have supported the research which informs it.
The report, which was funded by NHS England, offers a sobering account of healthcare inequalities for trans birth parents. However, it also includes important examples of good practice and recommendations for professionals.
Excitingly, it appears that work is already underway on many of these points. For example, last year a fabulous series of resources for practitioners were published by Brighton and Sussex Gender Inclusion Midwives, and I have heard good things about progress on trans-inclusive data collection.
Best of all, NHS England now provide a range of tailored, accessible advice to trans parents as part of their new guide to having a baby if you’re LGBT+. This includes ways to become a parent, advice on testosterone and pregnancy, and chestfeeding/breastfeeding for men and transmasculine non-binary people.
These resources should really be seen as a starting point (for example, there is no advice for trans women who breastfeed). But equally, it is brilliant to see progress being made on the provision of practical advice that will help prospective and new parents. I am especially grateful to an NHS whistleblower who ensured their dissemination through revealing to The i that their publication had been blocked by some senior figures at NHS England for nearly a year.
This all serves as an important reminder that NHS England is not a monolith, and that concerted pressure from community groups and allies can have real long-term benefits.
It’s very easy to be cynical about our NHS given the poor overall state of trans healthcare, as well as opposition to equitable provision by some within the health service. However, all the positive moves I have reported in this post are also the result of hard work by numerous NHS midwives and members of the NHS digital team. Alongside community members who generously offered their time and knowledge, they have collectively fought to ensure that trans birth parents and the practitioners who work with them have access to resources and information.
All of this makes me feel hugely optimistic. These are difficult times, in which prejudice and disinformation are rife. Yet ordinary people are still fighting – successfully! – for positive change. This new research and guidance should be of great help to new parents and their children, and for that we can be grateful.
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.
Tuesday 26th April – Manchester
Trans Healthcare: Past, Present and What Might Have Been
In-person roundtable discussion, with Ellis J Johnson, Stephen Whittle, Krishna Istha, and Laura Salisbury.
6pm-8pm BST, International Anthony Burgess Foundation
3 Cambridge Street, Manchester, M1 5BY
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Wednesday 27th April – Online
Queer and Trans Mobilisations – Possibilities and Challenges
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
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Thursday 5 May – Online
UK Workshop in Trans Philosophy
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”.
Full details TBA – watch this space!
Are you trying to understand anti-trans debates within and beyond feminism? Wanting to get to grips with the relationship between “gender critical” advocacy, medicalisation, and traditional conservative ideologies?
Our Sociological Review edited collection TERF Wars: Feminism and the Fight for Transgender Futures is now more widely available than ever. Challenging the framing of ‘transgender activists versus feminists’, it features a range of peer-reviewed essays from expert writers such as Jay Bernard, Florence Ashley, Julia Serano, and Emi Koyama, on hot-topic issues including gender ideology, autogynephilia, rapid-onset gender dysphoria, detransition, migration, sex work, and public toilets.
None of the authors or editors receive royalties for this work – we simply want to share our knowledge with others.
You can download digital copies of the collection from the Sociological Review website or for free from the Open University.
Hard copies of the book are also available from just £10, e.g. from Foyles (UK), AbeBooks (USA), and (sigh) Amazon. If you can though, please support a local independent bookseller! I am most excited that TERF Wars is available from the amazing Leeds-based queer bookshop The Bookish Type.
Finally, I am deeply honoured to announce that the opening essay of the collection, “TERF Wars: An Introduction” (by myself and co-editors Sonja Erikainen and Ben Vincent) is now also available in Turkish. We are honoured that this version has been published in the latest issue of the journal Kaos Q+. I was so excited to recieve my copy in the post!
If you find this work useful, please do tell other people about it, and feel free to share download links or hard copies with others. We have felt very supported by The Sociological Review, but the publishers SAGE have been absolutely awful at distribution and publicity (if you are an academic, I would definitely recommend against working with them on a book if at all possible). It’s up to use to make this work a success!
To celebrate this year’s umpteenth hit-piece on trans equality, I thought I might tell a little story about toilets.
On Friday, The Times reported that the University of Warwick has been “criticised for its ‘capture’ by Stonewall”, as evidenced by guidance asking people to challenge their biases, plus a proliferation of gender-neutral pronouns and toilets.
This coverage struck me as both unsurprising and bizarre. Unsurprising, as Stonewall have recently been subject to a barrage of homophobic and transphobic coverage from the likes of The Times, the BBC, The Guardian, the Telegraph, the Daily Mail etc etc. But also bizarre, as this is simply not news – all of the initiatives described have been underway for many years now, and they were hardly introduced by Stonewall.
As such, this feels like a good opportunity to explore the forgotten history of one of these initiatives: the introduction of all-gender toilets at Warwick, and in UK universities more widely.
I first became involved in campaigning for all-gender toilets in 2007. Using public toilets was a huge fear for me when I first transitioned. Fortunately, it turned out I was able to use women’s toilets without any trouble, but many of my queer siblings were not so lucky. I met and read about many trans people and other gender-nonconforming individuals, especially butch lesbians, who faced abuse and harassment in toilets due to their appearance. All-gender toilets offer a level of safety and access for people who don’t necessarily tick binary gendered boxes.
I was inspired therefore to learn about campaigns for all-gender bathrooms in US universities, through blogs, forums, and the 2004-05 TV documentary TransGeneration. I teamed up with some friends to write a motion for the 2007 National Union of Students (NUS) LGBT conference, calling on the NUS LGBT to campaign for equal toilet access. The motion passed with a near-unanimous vote, and you can see the text of the resulting policy below:
Of course, we were hardly the first people to undertake such campaigns in the UK. In 2002, Benjamin Cohen wrote an (unsuccessful) motion in favour of gender-neutral toilets for the King’s College London Student Representative Council. In 2005, an NUS LGBT briefing stated that ‘ideally a unisex toilet would […] be provided for those who feel uncomfortable defining into male or female’. Plus, throughout the 2000s “unisex” toilets were introduced in many UK nightclubs, although their owners were generally not so interested in the welfare of clubbers.
Buoyed by the success of our NUS LGBT motion, I took a similar proposal to the Students’ Union (SU) Council at the University of Warwick later in 2007. The motion was passed, albeit with an amendment to say that we would “investigate the possibility” of providing accessible toilet facilities for trans people, instead of committing to actually providing them. I invited Riley Coles, a student campaigner from the University of Bradford, down to Coventry to speak in support of the motion as they had recently introduced all-gender toilets at Bradford SU (you can hear Riley’s side of the story here). In turn, I was invited to speak in support of all-gender toilet policies at various Student Unions, including at Manchester and Sheffield as well as Bradford.
![Trans Access Needs
Proposer: Ruth Pearce
Seconder: [name redacted]
This Union Notes
1) Its own equal opportunities policy.
2) The Sex Discrimination Act 1976, that makes its unlawful to discriminate against gender, and the Sex Discrimination Regulations 1999, that make it unlawful to discriminate against people intending or undergoing gender reassignment.
3) Sex, biologically, is not a straightforward issue as many are born with an ambiguous sex and gender is not binary.
4) That gender is self-defined, as recognised by Union institutions.
5) That trans people are widely discriminated against, facing ignorance, harassment and sometimes violence.
6) Warwick has a hidden population of trans students, including those who are transsexed and those who identify as genderqueer, and there are no doubt also intersex students.
7) Trans students at Warwick are currently forced to use gender specific facilities when some have an ambiguous appearance that invites discrimination, whilst others do not identify within the gender binary.
8) That the NUS LGBT liberation campaign recently passed a motion to campaign for gender-neutral toilets in all educational institutions and student unions.
This Union Believes
1) Trans people should have the right to use the facilities they are most comfortable with, free of discrimination and harassment.
2) Confining gender to a binary distinction discriminates against students unable to define as only either male or female.
3) The availability of gender-appropriate facilities is an access issue, as trans students may be reluctant to make use of the Student Union buildings due to a lack of facilities that they would feel safe and comfortable using.
4) Both those trans students who identify as neither male nor female and those transsexed students who are transitioning in their social role from one apparent gender to another would benefit greatly from the existence of gender-neutral toilets.
5) That gender-neutral toilets may also be made use of by cisgender (non-trans) students.
6) That moves towards making gender-neutral toilets available by student bodies in USA institutions and UK universities such as Bradford and Sussex provide a positive precedent that deserves following.
7) That the redevelopment of Union South provides an unapparelled opportunity for the provision of gender-neutral toilets in the Students’ Union, given the extortionate cost of creating them under normal circumstances.
This Union Resolves
1) To provide accessible toilet facilities for trans people as well as exploring the possibility of gender-neutral toilet facilities.
2) To publicise the existence of these provisions, their locations, and the reasons for them at the beginning of every year.
3) To make feminine hygiene services available in these facilities in a similar manner to in the female toilets, for those trans students with particular needs associated with the female sex, and female students who choose to use them.
4) To mandate the Students’ Union to campaign for the provision of gender-neutral toilet facilities in the University.
5) To support all trans students who wish to use the facilities appropriate to their gender, whether these facilities are gender-neutral or gender-specific.](https://transactivist.files.wordpress.com/2021/11/warwick1.png)
What we rapidly realised was that having a policy isn’t the same as achieving an outcome. NUS LGBT introduced numerous policies at its conference every year, and student officers simply didn’t have time to campaign on all of them. Moreover, at the time the campaign was dominated primarily by cis gay men and lesbians. Consequently, all-gender toilets were not to become an NUS LGBT campaign priority until the 2010s.
Similarly, having a policy at Warwick SU did not translate into the immediate introduction of all-gender toilets in the SU building, let alone across the university campus. It took a concerted campaign across many years to make that happen, involving innumerable staff and students. All-gender toilets were first introduced in odd corners of the SU building, then occasionally elsewhere on campus, and then gradually in new buildings before being more widely rolled out. This process took well over a decade.
In opening up new conversations about toilets, we rapidly realised that all-gender toilets were not just beneficial to trans and gender non-conforming people. For example, single parents benefited from being able to accompany young children of a different gender into facilities, and carers could do the same with people they cared for.
Equally, we knew that all-gender toilets were not appropriate for all people. Some women and men do not share gendered spaces for religious reasons. Women and girls who have experienced male harassment and violence may also not wish to share spaces with men. We therefore campaigned for an “additive” approach, with all-gender toilets available alongside women’s and men’s facilities: the approach eventually adopted by the University of Warwick.
Additionally, some service providers sought to introduce all-gender toilets at the expense of disabled people, much to our frustration. If single-cubicle “accessible” toilets are the only all-gender toilets available, it can increase the number of people using these facilities, to the detriment of disabled people who require them. We therefore urged university bodies that this was not an adequate solution.
These issues were explored in detail in a briefing published by West Midlands Area NUS (WMANUS) in 2007. This document also included a series of sample arguments in favour of all-gender toilets, case study examples of their implementation, and model motions for Students’ Unions. I also included a section on toilets in the Under Construction: Trans Students guide I wrote for the NUS in 2008.
By 2009 I started my postgraduate studies and took a step back from toilet campaigns. However, there was no shortage of new activists to step into the breach. There are too many to name them all, but one of the key figures has been Sam Parr, who continues to push for more accessible toilets for all on the University of Warwick campus through endless meetings and consultation exercises.
By the mid-2010s, all-gender toilets could be found on many university campuses and other public buildings, including at Warwick. In 2017, when I organised a conference about the gender equality scheme Athena SWAN, I was delighted hear a conversation among a group of cis equality and diversity workers about how best to make the case for all-gender toilet provision at their institution.
Meanwhile, when I spoke to a new generation of student activists, I began to hear complaints around how some campaigners focused too much on toilets as an “easy” campaign priority, rather than tackling issues such as trans healthcare, employment, and housing. Certainly, an all-gender toilet will not put food on your plate or a roof above your head. They must be part of a wider struggle for liberation.
Still, that struggle continues. So I was delighted to hear from colleagues this week that sanitary bins will soon be available in all toilets across campus at the University of Warwick, especially for the benefit of trans and/or disabled men who might require them in men’s facilities. You can see a reference to this idea in our original 2007 policy, albeit with some pretty awkward phrasing!
Trans histories tend to be forgotten. They are frequently not written down, and are often lost due to a lack of intergenerational contact. The only way we can change that is through sharing our stories and building back our history. I hope this post can help with that a little.
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I have not named numerous individuals involved in the campaigns I describe in this post as I am aware that doing so could result in harassment. However, if you see yourself in this story and would like to be named, please let me know and I will gladly edit this post to credit your work!
About a month ago I participated in the TPATH conference. This groundbreaking online event centred trans healthcare practice, research, and activism by and for trans people.
I was very impressed with the measures taken by TPATH organisers to ensure the conference was accessible to as many people as possible from around the world. They organised live translation to and from English, French, and Spanish, provided live captioning, encouraged presenters to speak slowly and clearly to enable lipreading, and ensured that generous scholarships were available for those who would not otherwise afford to attend. Most of the event was recorded, and videos are gradually being uploaded to the TPATH Youtube channel.
At the conference I joined Tash Oakes-Monger from NHS England to present initial findings from the ITEMS project (Improving Trans Experiences of Maternity Services). The ITEMS team, led by Michael Petch from the LGBT Foundation, ran a survey in early 2021 to explore the experiences of trans people (including non-binary people) who give birth in England. I supported the design and dissemination of the survey through my former role with the Trans Learning Partnership.
There is some really exciting information emerging from the ITEMS data. For example, it appears that more trans people are giving birth than ever before (see above). However, it was also apparent that trans people face substantial inequalities.
Many of the questions in the ITEMS survey used comparable wording to the CQC Maternity Survey – from this we can see that trans people appear more likely to have negative experiences in NHS maternity services than cis women across the board. Even more disturbing is that 30% of trans respondents gave birth without the support of an NHS or private midwife (rising to 46% among trans people of colour). This indicates a lack of trust in midwifery services among prospective trans birth parents, with potentially lethal consequences for both parent and baby.
To learn more, you can watch our presentation on the TPATH Youtube channel.
A formal report of ITEMS findings should be published in the coming months.
I am very excited to announce that I will be starting a new job at the University of Glasgow this summer!
I have been appointed Lecturer in Community Development at the School of Education. I will be teaching and conducting research on a range of topics relating to social justice theory and movements, community action, and collective empowerment. This will build on my previous work on topics including trans health, queer music scenes, and gender inequalities in Higher Education.
I am also delighted to have been appointed Senior Fellow at the Center for Applied Transgender Studies (CATS) in Chicago. As a Fellow at the Center I intend to collaborate with international colleagues in conducting and disseminating impactful research by and for trans people and communities.
All of this does however mean that sadly I will be leaving my current role as Research Coordinator at the Trans Learning Partnership. We have achieved an enormous amount with this new partnership over the last year, including co-production of community research priorities, design and pilot of shared data collection, participation in public consultations and advisory groups, and support work around groundbreaking research with trans birth parents in England. I wish my former colleagues all the best with their future work, and fully intend to continuing collaborating with them as a university-based researcher.
Dr Ruth Pearce 