Why the NHS shake-up leaves me baffled

If you live here in England, you’ve probably noticed that the government has decided to give £80 billion of public money to GPs (read: private companies working with GPs) and scrap primary care trusts. David Cameron claims “We are not reorganising the bureaucracy, we are scrapping the bureaucracy.”

One of my biggest problems with the NHS is that the bureaucracy of the health system is incredibly unwieldy. All too often the left hand doesn’t seem to know where the right hand even is, let along what language it speaks. I’m also usually in favour of devolution and the localisation of services. I can’t conceive of how this particular change will be an improvement though.

We currently have 150 primary care trusts (PCTs) and the government is proposing to replace them with between 500 and 600 GP consortia – in order to save money. Surely though the cost of doing this in the first place is going to be ridiculous?

Surely this move will do nothing to remove the NHS bureaucracy: it’ll just shift it from (publicly owned) PCTs to (privately-owned, but publicly funded) consortia. This will mean that thousands upon thousands of people working in admin will lose their jobs…and thousands of new jobs will be created elsewhere. It’s being claimed that individuals who currently work for a PCT could seek work with a consortium but…this is just stupid. Thousands of admin workers will basically be relocated to new bodies, and this is going to cost a huge amount of money: it’ll cost to close down the PCTs, it’ll cost to make redundancies, it’ll cost to advertise for the new jobs and to run interviews and to basically re-train pretty much all of the non-hospital admin staff for the NHS in England. What planet is Andrew Lansley living on?

Additionally, each PCT tends to have its own individual policies, guidelines, patient booklets and outreach/advertising schemes for various services. It costs money to produce all of this: surely it’s going to cost more money for 500+ variations on a theme than 150?

Okay, so suppose the government is right about how best to save money whilst providing better services on the NHS (hah!) and all of the above will be cancelled out by the long-term savings. How easy will it be to hold all of this hundreds of these new consortia to account?

A few days ago I posted up a new policy for trans name changes we’ve sorted out with the local PCT. Within three years that change is probably going to be a bit pointless, and I won’t be surprised if things regress within the Coventry area. There’s a lot of very decent GPs out there, but others aren’t: a bunch of them are bigoted arseholes who will deny treatment to LGBTQ people at the drop of a hat. If GPs are going to be responsible for deciding who gets funding and hospital referrals, trans people who seek medical treatment could be in a lot of trouble. I’m not just talking about trans people who want to transition medically: I’m talking about any trans person who wants any kind of treatment, since the whole “we don’t serve your kind here” attitude is still highly prevalent. Of course, under current rules the NHS as a whole in the UK has to provide treatment (including aspects of medical transition) for all trans people, but that hasn’t stopped certain areas (such as, say, Wales)  from refusing to provide treatment.

Right now, if we’re lucky enough to have the PCT on our side (as we finally do in Coventry…tentatively, at least) then we can have them pressure the GP to sort it out. This system is far from perfect, since many PCTs simply don’t want to listen (see: Oxfordshire) but I imagine it’s going to be far harder to bring about positive social change in five or six local consortia than it is with a single PCT.

Moreover, one of the biggest problems with the NHS is communication. One of my friends was given a referral to Charing Cross gender clinic by a psychiatrist after years of waiting, but then had to move house and ended up in a different PCT. The PCT refused to acknowledge the referral and made her start again from scratch, effectively postponing her access to hormones by two years. I can’t imagine that this kind of thing will be less common with the NHS split up into more bodies.

So what can we do? Well, I suspect there’s very little we can do, but now is the time to act. We should be fighting on every front: writing to politicians, talking to the media, participating in protests and taking part in any consultation event we can find out about, and at every stage we should be asking awkward questions about how these changes will impact minority groups such as trans people (‘cos I’m pretty certain it will disproportionately screw over others, such as people living in poorer areas).

Finally, a couple of thoughts from The Guardian:

GPs are doctors, not accountants

“Imagine this bedpan is full of money…”

Desirability

A version of this article was originally written for a local feminist zine themed around sex.


The poster I see is on the London Underground, but I later find out they’re part of a wide campaign backed in part by the National Health Service. On the poster is a photograph of a person’s face that, due to the limitations of our language, is all too easily described as “masculine”. This individual is wearing somewhat exaggerated make-up: bright blue eye-shadow, bright red lipstick, and a heavy layer of foundation that’s clearly covering up an extensive five o’ clock shadow. Said make-up is quite heavily smeared.

If you drink like a man”, the poster declares, “you might end up looking like one.

Although the model used in the photograph may well be a man, this poster is hardly a reassuring one for women with a “masculine” appearance. “If you’re a woman who looks like a man”, it says, “you’re a skanky whore who drinks too much”. Needless to say, this is a pretty misogynistic message. As a post on the F-Word points out, it relies on narrow and incredibly stereotypical ideals of beauty and gendered norms of acceptable behaviour.

But there’s a further subtext to this poster, and a pretty blatant one at that. “If you drink”, declares an advertising campaign that was apparently “approved” by various equality bodies, “you’ll end up looking like a dirty, ugly tranny*, and then how are you gonna get laid, huh?”

And this is the crux of the issue, and it’s why I’ve been pretty pissed off every time I’ve seen one of these bloody posters. They’re just a tiny, tiny part of the message that can be found on billboards, in magazines, in the cinema, on the television, in newspapers, in books, and in even in freakin’ academic papers. It’s quite a simple message, and it runs as follows: transsexed women are deeply unattractive and undesirable.

I understand where this idea is coming from. Trans women tend to have lived as men (or at least as boys) for some part of their life, and what’s more undesirable than a man? Hell, she might still have a penis. That’s disgusting. What kind of red-blooded male could possibly want to bed one of them? (Since we’re talking larger societal trends here, it is of course men who are supposed to sleep with women…what are you, some kind of lezzer?)

Actually, scrap that last point. This is an issue which is prevalent in the so-called LGBT community as well. Whilst it’s true that not every daughter of Lesbos is a card-carrying separatist who annually attends the Michigan Festival for Womyn-born-Womyn, I’d wager that the majority of gay women – and even a large proportion of bisexual women – are a bit funny about the idea of being attracted to a trans woman, let alone sleeping with one. It’s pretty telling after all that the one trans character in The L Word (that seminal piece of lesbionic television) is a trans man, ‘cos it’s the lady bits and tits that count, innit? The actress who plays him is even made up deliberately to look like a pretty (if slightly butch) woman on the DVD covers. What a cheek.

It took me a fair while to become confident in my own sexuality. Some of that was down to my own body image and related issues, but the media bombardment (“you’re ugly! No one will ever love you!”) hardly helped, and neither did the attitudes of people around me. If a girl’s a bit ugly or has a radical dress sense, she might “look like a tranny”. That, of course, is meant to be an insult.

Regressive stereotypes obviously play their part in this. After all, in this very image-obsessed culture with its very limited repertoire of available attractive body types, why would any self-respecting straight man or gay woman accept their attraction to a woman who looks like a man? (this is, of course, assuming that said man or woman is gracious enough to accept a trans woman’s gender identity in the first place). It’s an attitude that goes beyond image though: if you were to present our disappointingly average straight man (and our gay woman) with a trans woman who conformed to society’s ideals of an attractive female body, they’re still likely to be wary. Once a woman is known to be transsexed, her appearance often becomes irrelevant as gender essentialism and/or misguided homophobia comes into play: she’s  innately unattractive.

In an impressive twist, this can even happen retrospectively, with a trans woman becoming hideously ugly after someone has had sex with her if they found out she’s transsexed (or: if the person she slept with already knew and was trying to keep it quiet, but then someone else finds out that a bit of rumpy-pumpy occurred between the two). This kind of idiocy would be hilarious, if not for the treatment trans women get as a result of this. There’s even an exciting legal manoeuvre known as the “trans panic” defence, whereby the defendant attempts to excuse a transphobic assault or murder by claiming that after having sex with the victim, they “panicked” upon discovering that they’d done the dirty with a trans person.

It’s at this point in the article that I realise things are getting a bit depressing. Let’s face it, this kind of bullshit isn’t particularly pleasant. It’s not a lot of fun  knowing that these attitudes are highly prevalent. I’m fortunate enough to “look just like any other woman” (whatever that means), which is all very well and good for ensuring that I don’t get beaten up on the street, but I’m perfectly aware that I’m not meant to be sexually desirable to, like, anyone. This situation is a lot worse for trans women who find it harder to pass as cis women; no wonder the trans community often places so much undue emphasis on looking like “normal people”. It certainly makes life easier if you happen to do so.

But you know what? Fuck ’em.**

Trans people come in all kinds of shapes and sizes. I’ve been talking a lot about transsexed women, but there’s also transvestites, genderqueer people (who might not necessarily consider themselves to be female or male), genderfluid individuals whose identities regularly shift, and a whole spectrum of gender diversity under the trans umbrella. We all tend to look quite different, act quite different, have different interests and ideas and aims and projects, but we’re all bloody gorgeous.

That’s not just my stubborn pride talking either. There are those trans people who do, in fact, conform to societal ideals of beauty. As for those who don’t: in many queer circles, androgyny and gendered ambiguity are highly valued (and the actual gender identity of said androgynous individual is usually respected, regardless of whether that identity is female, male, or something entirely different). In butch/femme lesbian communities, extremely “masculine” woman are often considered to be incredibly hot. We’re all attracted to different people in different ways. I’m pretty certain that there are straight men out there who fancy heavily built women, gay men who fancy men with vaginas, straight women who can handle androgyny. There’s also a good reason why trans men are sometimes fetishised by lesbians and shemale porn is consumed by many, although I’d prefer for that attraction to be there without us being reduced to mere sex objects.

Still, for all our supposed undesirability, I find it pretty telling that most trans people I know are in a happy relationship with someone who’s also pretty damn attractive. Actually, a lot of the trans people I know have several partners; I figure once you’ve dealt with society’s disapproval of your gender identity, you don’t tend to give a crap what others think about ethical, negotiated polamory. By contrast, I personally happen to be a serial monogamist, but to each their own, y’know?

People who have serious body image issues can find someone who has the hots for them. These individuals aren’t deluding themselves in the slightest. The real lie is in societal norms of acceptable attractiveness, but sexual attraction can’t always be restrained by those norms.

And we have a lot of fun sex too. Vanilla sex, kinky sex, gay sex, straight sex; I’m talking everything from straightforward sex to really weird sex. We’ve all got our own ways of negotiating desire, identity and our own bodies. Some trans people just don’t care and will go at it any old how. Others will throw  essentialism out the window and redefine their own bodies. I know pre-operative trans women who describe their genitals as a large clitoris; I know non-operative trans women who describe their penis as a penis. It’s just, y’know, a girl penis. It’s on a girl’s body after all, so what else could it be? Meanwhile some trans people are asexual, but that doesn’t necessarily mean they won’t enjoy happy love hugs.

Quite frankly, a bet a whole load of women would love to be as confident and good looking as I am. I’ve got a pretty face, great hair, fantastic legs, and I’ve recently grown some rather shapely breasts (going through puberty during your twenties is a pretty weird experience, but better late than never!) I’m in a long-term relationship with a sensitive, caring, bloody handsome man, and we have awesome funtimes.

Do you look like a transsexual this morning? No? Well, unlucky. You’re missing out.

* I deliberately use this word only in a sarcastic fashion. It’s a loaded term and can be deeply offensive, so please think carefully about any context in which you use it.

** Actually, don’t fuck them. Find someone else who actually deserves a good shag, and do them instead.

I used to get angsty, but now I get angry

This post is part two of my response to misha the Duck of Doom, who commented on this post.

In the second half of her comment, misha wrote:

“Its easy. Why do so many of you lot {Angst transsexuals}
get in such a tizzy.
Frak, transitioning is dead easy.
So enjoy it

Also stop making it “the world is against me”
coz it isn’t.
TBH, most of the world doesn’t give a stuff & barely notices us.

So get a grip!
And don’t overcomplicate things.
It really is easy.”

I’ve come across various versions of this argument in different trans communities and in different parts of the net. It’s reflected also in the attitude of many cis people who decry identity politics, suggesting that we’d be more accepted if we piped down and stopped trying to claim special rights; after all, this is the 21st century and we’ve moved beyond the need to define people by particular traits they happen to have.

I don’t buy it.

The world is a very, very difficult place for many trans people. When I say “trans” here, I’m not just referring to transsexed people, but also to the wider spectrum and gender/sex diversity…cross-dressers, drag kings and queens, genderqueer individuals, transgender…what brings us together is that we’re all discriminated against for defying societal sex/gender norms in one way or another.

There are those, of course, who don’t have such a hard path. As misha says, transitioning (for those who transition) can be “dead easy” for some. In my case, for instance, I think I’ve been pretty lucky. Despite the fear, shame and guilt about being trans, I managed to come out in my teens, and generally had a good reaction and support from my friends and family. I managed to access most of the medical services I needed for free on the NHS, a process which took a mere six years with minimal incompetence on the part of Charing Cross. I’ve received relatively little direct discrimination: it’s very rare that I’m denied services or harassed on the street, and these occurrences have become increasingly uncommon as my appearance has changed. I’m very grateful for all of this.

I’m also highly privileged to have had such a smooth transition. It helps that I’m a white, abled, middle-class woman, but I’ve got lucky more generally. I had access to online support networks, meaning that I was able to come out to myself and understand my transness at a relatively young age. My supportive friends and parents mean that, unlike some of my trans friends, I didn’t get abused or kicked out of my home as a teenager or beaten up in the street. The fact I’ve always lived in a PCT that has a decent care pathway means I haven’t had to self-medicate, I haven’t had to wait over a decade to get through the medical system, and I haven’t had to threaten legal action to get treatment which is meant to be guaranteed on the NHS. The fact that I “pass” with ease means that my appearance doesn’t constantly mark me out as different.

This doesn’t mean that my path has always been easy. After all, I have been discriminated against, I have been harassed and insulted in the street, I have experienced extreme shame before coming to terms with myself, and I did have to put up with years and years on waiting lists whilst my body became broader and more hairy. I knew that until recently, it was perfectly legal to deny me access to shops and services.

Knowing that these experiences are pretty tame compared to what other trans people have to go through makes me pretty angry. If I shouldn’t have had to go through what I went through, then there’s absolutely no excusing what others experience. Trans people are likely to be discriminated against in every aspect of public life: when accessing services, in the workplace, during leisure activities and in the street. The attempted suicide rate is unusually high, and violence from others is common. Our identities are systematically erased in the media, which (when not portraying us as freaks) ensures that the only trans bodies that are ever seen are those of middle-aged, middle-class white trans women.

I have a good life and am generally happy these days. The positive benefits of transition have pretty much eliminated most of my angst. But I am so, so angry about the injustices committed in the world. I don’t want a complicated life, but I can’t stand by and let others suffer. I want to harness my rage, and use it to bring about positive social change. This is why I’m an activist, and it’s why I’m ready to take on the world.

My response to a Nationwide customer survey

I’ve always enjoyed banking with Nationwide. The service has been good and the website easy to use. However, I’ve had it up to here with the transphobic bullshit used to advertise Nationwide services. The television advert based on the “bad transvestites” from Little Britain portrays an interaction between staff and customers which would be highly inappropriate if experiences by actual trans people – whether transvestites, transsexed women, or genderqueer individuals. We have quite enough of this crap in our everyday lives, thanks. Seeing two offensive characters toddling across the computer screen whilst I’m trying to check my account doesn’t help.

This, combined with Nationwide’s continued (and clearly unlawful) demand that trans people present them with a Gender Recognition Certificate when changing their name with the bank, means I will soon be closing my account and moving elsewhere.

Good riddance.

“Censoring Julie Bindel”: a response

Beatrix Campbell has written a delightful article about Julie Bindel’s involvement in feminism’s “trans wars”. I couldn’t help but noticed that it’s riddled with inaccuracies…

“Airing the complications and troubles of transgender politics is being traduced as “transphobia”.”

No. Arguing that transsexed people shouldn’t exist, consistently belittling and propagating prejudice is being characterised as transphobia. It’s possible to air the complications and troubles of ‘transgender poltitics’ without being a bigot.

“Transgender people who used to live as men and now live as women persuaded the May 2009 NUS women’s conference to mandate its officers to share no platform with Julie Bindel.”

The motion wasn’t proposed by trans women.

Moreover, characterising trans attendees of women’s conference as ‘transgender people who used to live as men’ merely demonstrates your own ignorance.

“The NUS women’s campaign shows no solidarity with women who are offended by the presence in their safe spaces of people who used to be men.”

That’s true! Well, minus the ‘used to be men’ bit…but that’s a whole other kettle of fish which I’m sure others will address at length. We also show no solidarity with straight women who are offended by the presence of lesbian women, or white women who are offended by black women. In fact I might go so far as to argue that it is these ‘offended’ people who undermine the ideal of a safe space…

“This month, her enemies mustered a picket outside Queer Question Time in a London pub. They’re not censoring her, they say, you can read her, they say, just don’t go to hear her.”

“The transgender vigilantes should listen up, wise up and grow up, participate in, not proscribe, the debate they started.”

First off: it’s worth noting that the NUS has nothing to do with the picket outside Queer Question Time, which was organised by independent activists.

Also, you’re inaccurately depicting the arguments of those who would prefer not to see Bindel given a high-profile speaking slot at a supposedly queer-friendly venue. Unlike journalists with newspaper and magazine columns, we usually don’t have access to an audience to listen to our side of the story outside of blogs and community publications. We don’t have the opportunity to ‘participate’ on the level that Bindel does.

This doesn’t mean that we want transphobes to be entirely censored: rather, we wish it to be recognised that there are events at which it is inappropriate to invite a bigot to speak. Moreover, in what way is it fair for people to ‘debate’ our very existence? This, incidentally, is why we’re so ‘offended’ – and why we don’t give much credence to the ‘offence’ experienced by those who would discriminate against us.

See this man?

This is Peter Robert Forster, the Lord Bishop of Chester.

He wants to deny my genderqueer friends and trans children protection from discrimination. (see Clause 7)

Some of my friends are regularly abused by their parents, beaten up in school, or regularly receive abuse at university. They have been shouted at, taunted and raped. They have been harassed on the streets, in the workplace (if they can get a job) and by the police.

Fuck you, sir. I bet Jesus is really fucking pleased with you.

Take your fancy pen and fucking well shove it up your arse.

The Well of Loneliness

I finished reading The Well of Loneliness last night.

As a novel it’s not fantastic. The plot plods along in a relatively predictable fashion, following Stephen – the protagonist – as they grow up, get a job, and meet people. The writing is mediocre and occasionally quite dull.

As a giant “fuck you” to the world, it’s very powerful and still disturbingly relevant. The story follows Stephen, a female-assigned “invert”. Invert is a late nineteenth century/early twentieth century term that’s often said to refer to homosexuality, but there’s a whole body of literature out there discussing whether or not it’s more to do with gender identity than sexuality. It’s now considered somewhat backward to associate lesbianism with necessary masculinity, which has led to a great deal of criticism by latter-day activists. However, if Stephen – and other female-assigned inverts such as Jamie – are seen as trans men, everything begins to make a whole lot more sense Certainly Stephen’s story often reads more like that of a trans man than a lesbian.

I’ve come across several pieces that describe The Well of Loneliness as a plea for tolerance. It strikes me more as a demand for tolerance, and one that’s still disturbingly relevant. . The condemnation of those “good people” who oppress others for differing from society’s norms still holds true. The demand to accept the very existence of those who transcend sexual and gender stereotypes still holds true.

I got pretty depressed earlier today reading the mindblowingly ignorant comments following a Guardian article about trans rights. It made me think about how there’s still a lot of people out there who happily move through their “normal” lives whilst handing out casual bigotry whenever it suits them. We’ve come so far, yet we still have so far to go.

On a brighter note, a guy I know from Queer Youth Network was in a positive documentary on Channel 4 last night, which you can still watch on 4od. The fact that we’ve got to the point where we can tell a positive story like this on national television shows that progress.

Transphobia, seen from the outside

I just had an odd experience.

My boyfriend and I had gone down to Crown Way to post a couple of letters and buy some peppers and a card. There were a bunch of boys who must of been in their early teens at the very most hanging around outside, and we were treated to a somewhat confused barrage of abuse that shifted rapidly from homophobia to transphobia.

“Lesbian!”

“Lemon, lemon, lemon!”

“Dyke!”

“Are you a shemale?”

“Have you got a dildo?”

I haven’t experienced this kind of harassment for a long time, but at the same time I’m quite used to it. I’d kind of resigned myself to it when we left the shop again…only to realise when we ran the gauntlet again that they were exclusively addressing my boyfriend, who is a trans man.

“Are you a boy or a girl?”

“Have you got a dick?”

Transphobia is always uncomfortable and somewhat distressing, but this is the first time I’ve experienced it happening to someone else first-hand whilst knowing I’m not being targeted myself. It shows the powerful nature of “passing privilege”: if you’re assumed to be cis rather than trans, your gender identity is taken entirely for granted and upheld by people around you. Whereas the moment you’re percieved as trans, you’re instantly a potential victim.

I still don’t really know what to do in these situations either. I feel strongly that anyone who harasses someone else in the street for how they look or who they are should be confronted, but there’s so many dangerous ways in which situations like that can deteriorate. We didn’t feel particularly threatened by the children since they were so small and stupid, but what’s it going to be like for any gay couple or trans person they come across when they’re older?

Anyways, quote of the day goes to the woman behind the counter in the newsagents. She was complaining about the kids and then commented that she didn’t know what half of the things they were saying meant.

“What’s a dildo anyway?”

NUS Women’s Campaign No-Platforms Transphobic Speakers

The NUS Women’s Campaign passed a motion at its annual national conference today to ensure that it never again offers a platform to transphobes.

The clauses ensuring this read are copied out below in full.

That the women’s officer or members of the committee shall not share a platform with Julie Bindel or others transphobic speakers.

The NUS Women’s campaign shall not offer a platform to a transphobic speaker, nor shall it officially support any event that does.

The motion makes an example of Julie Bindel, a journalist who has frequently written articles attacking trans people, amongst others. A couple of years ago, the NUS Women’s Officer found herself in the difficult position of sharing a platform with Bindel at the rally following London’s Reclaim The Night march. The new policy means that similar incidents should not happen in the future.

The motion, entitled “T is NOT for Tokenism”, also calls for a broad discussion with trans students about how best to advertise NUS Women’s events in a trans-inclusive fashion, and ensures that the NUS Women’s trans caucus is open to FtM spectrum individuals who “experience discrimination rooted in their having been assigned a female gender role” or “their being perceived as women”.

The NUS Women’s Campaign is already inclusive of trans women. Policy passed in 2007 ensured that campaign events are open to all women on a self-defining basis. There is a trans representative on the Women’s Committee elected by members of an autonomous trans caucus at the campaign’s annual conference. This year’s event featured a workshop exploring links between LGBT activism and feminism, and another discussing the role of trans people in women’s spaces.

Other significant policy passed at the conference included a call for greater representation of black women within the campaign (the vote for which followed a dignified protest the previous evening by most of the few black women present at the conference), a condemnation of sexism from student marketing “specialist” NUSSL, and continued support for pro-choice organisations, sex workers’ unions and groups fighting against the exploitation of women’s bodies in the media and Student Unions.