In memory of Ellinore Wilson

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.

Photograph of four hen's eggs sitting in a straw nest.

Statement on Equality Minister’s comments

This statement, which I helped to draft, is cross-posted from Spectra.

~

As providers of health and wellbeing services for vulnerable people, we are dismayed by Women and Equality Minister Liz Truss’ poorly-informed comments on transgender issues.

Nobody’s fundamental rights should be subject to ‘checks and balances’, as the Minister suggests. Single-sex spaces are already protected under the Equality Act; trans and non-binary people deserve the same access to relevant services and provisions as everyone else.

Trans and non-binary people face discrimination and exclusion in all areas of life. They are disproportionately likely to experience sexual violence and domestic abuse, plus encounter severe difficulties in accessing healthcare, housing, education, jobs, and benefits. This is especially the case for trans women and girls, plus trans and non-binary people of colour.

Trans and non-binary people of all ages require support in accessing services, and making informed decisions about their own lives and bodies. The Minister’s statement that young people need to be ‘protected’ from making ‘irreversible’ decisions appears to contradict existing legal precedents.

These include the principle of Gillick competence, and the Fraser guidelines, which together protect the rights of minors to make their own decisions around medical treatment, if they can demonstrate appropriate capacity to consent.

Any move to undermine these principles will have deeply concerning implications for all minors. In particular, young people’s confidential access to contraception, sexual health services, abortion services, counselling and therapy will be at risk. Rather than positioning trans and non-binary people as a problem, the Minister, along with the Women and Equalities Committee, should focus on ensuring that the Government delivers on the recommendations of the 2015 Transgender Equality Inquiry.

These include the expansion of healthcare provision, and reform of the Gender Recognition Act 2004 to ensure full legal recognition for trans and non-binary people of all genders, on the basis of self-determination.

~

A brief personal addition. Our communities and activist networks are stronger, louder, and more visible than ever. We will stand resolute against any attempt to roll back the legal rights of trans people and/or young people. If the Minister follows through on her threats, she will find she has severely underestimated us. We will fight and we will win.

 

New article: Transnormativity in the psy disciplines

Today sees the publication of the first full article from the Trans Pregnancy project team, in the journal American Psychologist:

Transnormativity in the psy disciplines: Constructing pathology in the Diagnostic and Statistical Manual of Mental Disorders and Standards of Care

[click here to read in American Psychologist]

[click here to read free open access version]

In this article we provide a brief history of how certain narratives and expectations around how trans people should behave and be treated have been constructed through the disciplines of psychology, psychiatry, psychotherapy, and psychoanalysis, especially in a US context.

It is part of a great new special issue on Histories of psychology after Stonewall, edited by Peter Hegarty and Alexandra Rutherford.

We examine how the interests of cisgender clinicians and transgender patients have variously been opposed and entwined, and contextualise this in relation to wider structures of racism, sexism, colonialism, and binary thinking around sex and gender. We focus especially on how guidance for diagnosing trans people and managing trans healthcare has been contested across various versions of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (the DSM) and the International Harry Benjamin Gender Dysphoria Association (HBIGDA, later WPATH) Standards of Care.

This article does not focus specifically on questions of fertility, pregnancy and childbirth (although we briefly touch very on this topic). Rather, it provides important historical background on the evolution of certain medical services which have help to shape how trans people are treated and percieved. We are also currently writing a number of articles that will report on specific research findings from the Trans Pregnancy project, and I am really looking forward to sharing them also when they are published!

 

Of trans fathers and male mothers – the importance of centering experience

By Ruth Pearce, Sally Hines, Carla Pfeffer, Damien W Riggs, Elisabetta Ruspini and Francis Ray White. Cross-posted from the Trans Pregnancy blog. An article based on this piece has been published in The Conversation.

On Wednesday 25th September the UK’s High Court ruled that Freddy McConnell, a man who gave birth to his child, does not have the right to be registered as a “father” on his child’s birth certificate. The court also ruled out the possibility of registering him simply as the “parent”. McConnell, who is trans, has indicated his intention to appeal.

We feel that this is a disappointing outcome, with concerning consequences for the dignity of trans parents and the safety of their children. The law will continue to require that people who give birth to a child in the UK are always registered as the “mother” – even if they are legally men. For example, McConnell’s legal team noted that, “Freddy is legally a man and his legal papers display the same.”

Most importantly, the verdict wrongs the human rights of the complainant and his child, through failing to provide them with consistent legal documentation and intruding on their privacy. More widely it is wrong in terms of its failure to legally recognise diverse family forms and contemporary practices of intimacy, which question traditional gendered reproductive certainties.

Yet, paradoxically, the ruling brings into being a new legal category of “mother”, which is based on reproductive experience, rather than the traditionally sex/gendered body. From today, a ‘mother’ is not defined through binary sexed characteristics. And so, a man may be a a mother as much as a woman.

Judge Sir Andrew McFarlane is explicit on this point in his ruling. For example, in his concluding comments, he states that, “the term ‘mother’ is free-standing and separate from consideration of legal gender, thus in law there can be male mothers and female fathers” (noteably, there is no distinction between “sex” and “gender” in UK law).

This is why legal cases around gender recognition are so important. Even when they seem to fail the individuals who bring them to court, they very often also radically chip away at normative understandings of gender in unforeseen and unintended ways. Such paradoxes and contradictions are subsequently brought to light, unpacked and, very often, readdressed at appeal stages.

McFarlane’s ruling, then, may be seen as the first step in the legal undoing of binary understandings of reproduction and gender, sex and the body, wherein all families of all genders and all bodies will be recognised.

This is particularly important for the trans and non-binary birth parents we have spoken with for this research project, who seek forms of legal recognition that are consistent with how they experience gender in their everyday life.

Promotional image from the film Seahorse. Photo by Mark Bushnell.

Continue reading

“The Emergence of Trans” – out now, read the introduction!

Emergence of Trans finalThis book is intended as a statement of hope, and of possibility. It is about the context and consequences of trans emergence. It is about how “trans” becomes, and how we “become” trans. It is about how trans people are changed by the experience of emergence, and how trans emergence might change our worlds.

I’m delighted to announce that The Emergence of Trans was published last week!

The book includes essays, poetry and a comic strip on topics such as monsters, eugenics, performativity, epiphanies, music, relationships, language, pronouns, picture books, robots, research methods and ethics.

It was edited by myself, Igi Moon, Kat Gupta and the late Deborah Lynn Steinberg.

If you want to learn more about the book, there is no better way to start than through the introductory chapter. I have uploaded a copy to this website, which you can read for free here:

The Many-Voiced Monster:
collective determination and the emergence of trans

by Ruth Pearce, Kat Gupta and Igi Moon

 
In addition to this introduction (and a number of short editorial essays) the contents of the book are:

Chapter 1: In the Shadow of Eugenics: Transgender Sterilization Legislation and the Struggle for Self-determination
by Julian Honkasalo

Chapter 2: Reconceiving the Body: A Surgical Genealogy of Trans-Therapeutics
by Eric Plemons

Chapter 3: Becoming: Discourses of Trans Emergence, Epiphanies and Oppositions
by Natacha Kennedy

Chapter 4: the seam of skin and scales
by Elena Rose Vera

Chapter 5: Creating a Trans Space
by Kat Gupta

Chapter 6: DIY Identities in a DIY Scene: Trans Music Events in the UK
by Kirsty Lohman and Ruth Pearce

Chapter 7: On Being a ‘Wife’: Cis Women Negotiating Relationships with a Trans Partner
by Clare Beckett-Wrighton

Chapter 8: Sticks and Stones Break Our Bones, and Words Are Damaging: How Language Erases Non-binary People
by stef m shuster and Ellen Lamont

Chapter 9: Response and Responsibility: Mainstream Media and Lucy Meadows in a Post-Leveson Context
by Kat Gupta

Chapter 10: ‘Girl Brain…Boy Body’: Representations of Trans Characters in Children’s Picture Books
by Clare Bartholomaeus and Damien Riggs

Chapter 11: Make Yourself
by Rami Yasir

Chapter 12: Co-producing Trans Ethical Research
by Rhi Humphrey, Bróna Nic Giolla Easpaig and Rachael Fox

Chapter 13: Nonnormative Ethics: The Ensouled Formation of Trans
by Mijke van der Drift

Chapter 14: A Genealogy of Genealogies – Retheorising Gender and Sexuality: The Emergence of ‘Trans’ (ESRC Seminar Series 2012-2014)
by Igi Moon

 

The book is now available in paperback and hardback formats from many bookstores, including publisher Routledge. Ebook and Kindle versions will also be released soon.

Trans health and rainbow futures: learning from Aotearoa New Zealand

This will be the first in a short series of posts on my recent trip to Aotearoa. See also: Part 2: Rainbow resources from Aotearoa.

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Poster in the RainbowYOUTH centre

I recently returned from a month-long journey to Aotearoa New Zealand. This trip was funded by a Rockefeller Foundation Fellowship with the School of Sociology and Social Policy at the University of Leeds.

My aim was to learn more about trans health services and community advocacy, while also sharing findings from my own research in a European context. I feel deeply privileged to have had the opportunity to meet many amazing people, who are doing a great deal of incredible work.

In this post, I share a number of resources and reflections from the trip. However, this is just the tip of the iceberg – I have no doubt that will no doubt that the experiences from the Fellowship will inform my research and thinking for many years to come.

Before I begin, I should quickly acknowledge that many readers of this blog will be unfamiliar with the word “Aotearoa”. This is a term from te reo Māori (the Māori language): it’s the current name for the islands known as “New Zealand” in English. Both are official names for the country that governs this land. For simplicity (and out of respect Māori history and culture, which long predates the arrival of Pākehā, or white European settlers) I use mostly use Aotearoa alone for the remainder of this post.


Whanganui-a-Tara / Wellington: the Gender Centre and Aunty Dana’s Op Shop

20190426_141647After a brief visit to Auckland (where I recovered from the long flight) I began my trip in earnest with a visit to the capital city of Aotearoa New Zealand, on the south-west tip of the North Island. I was told that you can’t beat Wellington on a good day – certainly, the bay of Whanganui-a-Tara is one of the mostly stunningly beautiful places I’ve ever had the fortune to visit.

My first priority was a visit to the Gender Centre. This amazing new community resource, which was founded only last year and is currently based the front room of the 128 Radical Social Centre. It is run by members of Gender Minorities Aotearoa, a group who campaign and provide information for transgender, takatāpui, and intersex people. Takatāpui is a term in te reo which “embraces all Māori with diverse gender identities and sexualities“.

Photos of 128 Radical Social Centre and the Gender Centre, taken with permission.

The Gender Centre includes a small office space, where people working for Gender Minorities Aotearoa can work on current campaigns and meet with visitors. Anyone can drop by to ask for advice or support, or pick up information. For example, the organisation has recently started running a free binder scheme. Materials on display included forms for name and gender changes, advice on accessing healthcare services, and information on the BDMRR bill.

BDMRR stands for Births, Deaths, Marriages, and Relationships Registration. Groups such as Gender Minorities Aotearoa are campaigning for non-binary recognition, and to make it possible for people to legally change the gender marker on their birth certificate without going through an expensive process involving medical oversight. Unfortunately, proposed changes have been delayed by the actions of anti-trans hate groups. UK readers will recognise the similarities with the campaign of misinformation waged against proposed changes to the Gender Recognition Act. This is not a coincidence. Anti-trans groups in Aotearoa are directly influenced by the language, aesthetics and (in some cases) the direct interventions of UK anti-trans campaigners, in what can be understood as a form of neo-colonialism.

While I was at the 128 Radical Social Centre I also visited Aunty Dana’s Op Shop. This is a second-hand clothing and accessories store run by trans and non-binary volunteers and open to people of all genders, with proceeds donated to Gender Minorities Aotearoa. It’s such a great way to raise money for campaigning, while providing an important resource and social space. It can also serve as a less scary space than the Gender Centre for people who are just coming out and looking for support. I had a great time browsing the shelves and chatting with the volunteer who was working there that afternoon.

Photos of Aunty Dana’s Op Shop. Taken with permission.

You can watch a fantastic video about the Op Shop here:


While I was in Whanganui-a-Tara I also took the opportunity to visit a trans and non-binary artists showcase at the NZ Games Festival and meet with some brilliant academics and students working on LGBTIQ research at Victoria University of Wellington. I will be sure to share their work as it is published!


Ōtautahi / Christchurch: queer art and affirmative care

I next travelled to Ōtautahi / Christchurch, taking a train down the east coast of the South Island. During this trip I began to understand the extent of the damage caused by 2010 and 2011 Canterbury earthquakes. There was evidence of huge landslides and roads were still being rebuilt. Several metres of new coastline were visible for many miles, clearly identifiable through rocks bleached white by dead organisms that once lived under the waves. The city itself is still being rebuilt. Huge building projects and areas of empty land can be found throughout the central business district, a reminder of the unforgiving power of the Earth.

Photos: day and night – urban art and public protest.

It was apparent that the people of Ōtautahi were still recovering from tragedy even before the horror of the recent neo-Nazi mosque shootings. Nevertheless, the city struck me as a great centre of culture. I am grateful to have had the opportunity to meet some amazing queer and feminist artists and heard about both radical public interventions and commissioned works. If you want to learn more about this, the websites of Jennifer Shields and Audrey Baldwin are great places to start.

During this visit, I learned about a fantastic initiative to build and publicise new public health pathways for gender-affirming care in the Canterbury region. Until recently, services such as specialist counselling, hormone therapy and surgical referrals were only available on an ad-hoc basis, and information was not easy to find. Relevant information on what services are available and how they can be accessed is now easily available, thanks to the work of the Ko Awatea gender-affirming care co-design group.

These services are still not perfect – several interventions are not publicly funded, and they still involve a certain level of medical gatekeeping. However, they represent an important step forward. Notably, I was informed that these achievements can be credited to the willingness of particularly motivated medical providers, who were prepared to put energy into working directly with trans community representatives to work for reform.


Tāmaki Makaurau / Auckland: RainbowYOUTH

20190511_140445

The next stage in my journey was a visit Kirikiriroa / Hamilton, back on the north island. I was here for the Aotearoa New Zealand Trans Health Symposium. This will be the subject of a future blog post, so I am going to finish this piece with a look at an organisation based in Aotearoa’s largest city.

In finish my journey with a return to Tāmaki Makaurau / Auckland, meeting a number of community workers, activists and academics living and working in the city. I was especially honoured to visit the RainbowYOUTH offices and drop-in centre: a spacious explosion of colour located in an otherwise unobtrusive side street on the edge of the queer distract around K Road.

RainbowYOUTH are an organisation run by and for queer and gender diverse youth, with a remarkably long and successful history. They are currently celebrating their 30th anniversary, having been founded in 1989. The organisation’s members and executive board are all aged 27 or under. Executive advisors aged over 27 are invited to attend and speak at board meetings, but do not have voting rights. I was really impressed by this commitment to centring youth perspectives in support work and activism, something which has been missing from the UK since the dissolation of Queer Youth Network.

I was also interested in how common the language of “rainbow” community was in Aotearoa, as an addition and alternative to acronyms such as LGBTIQ. I like the way this word avoids the “alphabet soup” and potential exclusions tone of the acronym. I can also see how – like the term “gender minorities” – it can work to be inclusive both of intersex people and of takatāpui in a way that is more expansive than just attempting to rework the Western/anglophone framework of “LGBT”.

Photos of the RainbowYOUTH centre. Taken with permission.

The RainbowYOUTH centre was a wonderful building. For a long time, the organisation ran out of a very small office on Karangahape Road, but in recent years an increase in income and activity enabled a move to the new space. This features several offices, a therapy room, a large social space with a TV and gaming consoles, a library, a community wardrobe, free hygiene packs for people in difficult circumstances, and once again a whole range of resources and information. I can see how the very existence of this space is helping to create new possibilities for a generation of young people who I hope will achieve things that currently remain unthinkable.

I left Aotearoa incredibly inspired by the work and imagination of everyone I met, and am hugely grateful to everyone who helped with advice and organisation, made time to speak with me, and shared ideas and information. Ngā mihi nui!

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Clinical research with trans patients: a critique

WPATH_BuenoAr_Logo_reverseIn November I participated in a panel on research ethics at the 2018 WPATH Symposium in Buenos Aires, “Ethical Considerations in Transgender Health Research Practice”.

I presented a talk based on work I have undertaken with Dr Michael Toze (who sadly could not join us at the conference). Entitled Trans Health Research at a Gender Identity Clinic, the talk critiqued clinical research methods employed at a UK gender clinic, using the example of published research on video gaming.

I argued that clinical researchers should be mindful of the power dynamic that exists between them and their patient/participants. I also presented evidence that methodological and ethical issues have resulted in harm to participants, and undermined the validity of empirical claims.

This talk was kindly recorded by Ellen Murray, and you can listen to it below.

 

I have also uploaded produced a transcript of the talk:

Trans Health Research at a Gender Identity Clinic

And you can download the slides here.

Please do feel free to download and share this talk with anyone you think might find it interesting or useful, as long as myself and Dr Toze are credited.

The talk followed a remote presentation by Ali Harris, and preceded a talk by Noah Adams, who discussed the paper we wrote in collaboration with Jaimie Veale, Asa Radix, Danielle Castro, Amrita Sarkar and Kai Cheng Thom: Guidance and Ethical Considerations for Undertaking Transgender Health Research and Institutional Review Boards Adjudicating this Research.

Trans Pregnancy poster: initial findings presented at WPATH

Cross-posted from the Trans Pregnancy blog. Image shows a woman standing in front of a poster display board, smiling.

In early November, I presented a poster at the 2018 World Professional Association for Transgender Health (WPATH) Symposium in Buenos Aires, Argentina. The poster outlined a number of initial findings from our first research interviews, which have so far been conducted in Australia, Canada, the United Kingdom and the United States.

The WPATH Symposium is attended primarily by healthcare professionals working specifically in the field of trans health, so the poster was designed especially with this audience in mind. Our future work will also speak to the needs and interests of trans people who become pregnant as well as professionals specialising in fertility and reproductive health. Plus, we will be exploring what trans pregnancy means for understandings of sex and gender.

You can click on the poster image below to read and download a copy for yourself, or click here for a PDF version.

Through our Twitter account I also reported on two sessions at the WPATH conference which were all about trans fertility and reproduction. You can read these Twitter threads by clicking on the links below:

WPATH oral presentations: Fertility

WPATH oral presentations: Reproduction

To find out more about the context of trans pregnancy and people’s experiences, please do explore our website. We have already published a series of law and policy reviews and are adding more resources all the time.

We are also still recruiting research participants from Australia, European Union countries (including the UK) and the USA. If you are a trans person who has been pregnant and you would like to talk confidentially with us about your experiences, please click here to find out more.

Trans Temporalities and Non-Linear Ageing

Transgender lives may require mixed strategies—not only healing and an achieved coherence but also the ability to represent and to inhabit temporal, gendered, and conceptual discontinuities.’
– Kadji Amin

I’ve recently ha9781138644939d a chapter published in a new book about LGBT ageing: Older Lesbian, Gay, Bisexual and Trans People: Minding the Knowledge Gaps, edited by Andrew King, Kathryn Almack, Yiu-Tung Suen and Sue Westwood. My essay is titled Trans Temporalities and Non-Linear Ageing.

This blog post includes an extract from the introduction to the chapter (updated slightly to reflect my advanced age from the time of writing – what temporal webs we academics weave), along a link at the end where you can download and read a free version of the entire essay.

At the time of writing, I am 12 years old, 16 years old, and 32 years old.
I was born 30 years ago; in chronological terms, I have lived for 32 years. Chronological time is, however, just one means by which ageing might be understood (Baars, 1997). When we talk about age in terms of chronological time, we make a number of assumptions. Most importantly, we assume that our journey through the life course is linear, progressing from birth (at the beginning of the journey) to death (at the end). But my age can also be understood in terms of trans time. As a trans woman, I have experienced non-linear temporalities of disruption, disjuncture, and discontinuity.

By temporality, I refer to ‘the social patterning of experiences and understandings of time’ (Amin, 2014: 219, emphasis mine). Through conceptualising time as a social phenomenon, we might think about other beginnings and other ends, as well as wider temporal shifts and discontinuities across the lifecourse. It is not unusual for trans people do this: for example, through talking about age in terms of trans years in addition to years since birth. What if we were to regarding my coming out at the age of 16 as a beginning (and, for that matter, as an end to my ‘previous’ life)? In this case, I might say that I am 16 years old in trans years. This does not, of course, change my chronological age: I am both 16 and 32. Or, we might regard my commencement of hormone therapy as a beginning, in which case I am 12 (but also 16 and 32, still).

Importantly, trans years are not necessarily linked to chronological years. For instance, two different trans people who are both aged 80 in chronological years might have aged quite differently in trans years: perhaps one of them came out many decades ago, while the other has only been out for a couple of years. These individuals are likely to have had vastly different trans temporal experiences, which belie their apparently similar chronological age.

In this chapter I explore the consequences of trans temporalities for ageing. Non-linear ageing is not simply a matter of theory, but an approach which can enable us to ‘do justice to the complex ways in which people inhabit gender variance’ (Amin, 2014: 219). As Louis Bailey, Jay McNeil and Sonja J Ellis note in chapter 4 of Older Lesbian, Gay, Bisexual and Trans People, ‘Mental Health and Well-Being amongst Older Trans People’, trans people tend to face a range of specific challenges as they age, and may fear accessing mainstream forms of care, such as mental health services. It is therefore vital that academics and service providers alike understand how temporal phenomena such as trans years can shape trans identities and experiences.

I begin by outlining theories of queer and trans temporality that help to make sense of community terminology such as ‘trans years’. I then show how trans people may experience ageing in a variety of quite different ways, drawing on a range of literature as well as findings from two qualitative research projects. Finally, I detail two common features of non-linear trans ageing:anticipation, and delayed adolescence. These discussions draw primarily on evidence, issues and challenges that have been identified in Western European and North American research.

Read the full essay here.

This is an open-access version of my book chapter – you are welcome to read and share it freely. However, if you are a student or academic, please do cite the published version of the essay, and encourage your library to purchase a copy of the book if they have not already done so.

For further reading, I recommend Trans Temporalities, a 2017 special issue of the journal Somatechnics. You can also read more from me on the topic in Chapter 5 of my book, Understanding Trans Health.

A slow, painful grind: WPATH 2018 conference report

IWPATH_BuenoAr_Logo_reverse.jpgn the first week of November I attended the 2018 WPATH Symposium in Buenos Aires, Argentina. This biennial event is one of the largest trans studies conferences in the world, with around 800 academics, activists, healthcare practitioners and researchers coming together to exchange knowledge.

Most of the conference consisted of parallel sessions: approximately eight or nine speaker panels occurring simultaneously in different parts of the conference venue. So it is impossible for anyone to take part in the majority of conference events. Nevertheless, I attended as many sessions as possible, and livetweeted from most of these. Links to Twitter summaries of the sessions I attended can be found at the end of this post.

In this post, I comment primarily on my observations of the conference as a sociologist and trans professional.


Opportunities and inclusion

As I anticipated, WPATH 2018 was full of contradictions.

On the one hand, it was exciting to join and learn from so many academics, healthcare practitioners and human rights experts working in the field of trans health. As I report in the Twitter summaries below, the conference provided a great opportunity to participate in debates over new ideas and standards of care, and hear about cutting-edge research findings and advances in clinical practice. It was an especial privilege to learn first-hand about the implementation and impact of Argentina’s pioneering Gender Identity Law, a topic I expand upon later in this post, but hope to write about in more detail in the near future.

I was also glad to have the opportunity to present a paper on research ethics and a poster with initial findings from the Trans Pregnancy project to an international audience.

It was excellent to see that the conference organisers acknowledged and responded to some of the feedback from trans delegates in previous years. Gender-neutral toilet blocks were present on every floor of the conference venue, and pronoun stickers were provided to accompany name badges. The provision of a “trans hospitality suite” enabled trans attendees to relax in a more comfortable environment, and also arrange our own ad-hoc meetings and events. This was inevitably re-branded by its users as an “intersex and trans” room in recognition of the importance of this space also to intersex delegates; I hope conference organisers will learn from this for future events.

This year’s Symposium also benefited from a clear code of conduct and language guide, previously introduced for the 2017 USPATH and EPATH conferences.


Microaggressions and objectification

On the other hand, the cis-centric atmosphere of the event felt like a slow, painful, constant grind. As with previous WPATH conferences, the event was punctuated by constant microaggressions (and, on occasion, outright “macro”aggression); these were damaging to intersex people, people of colour and delegates from the Global South as well as trans attendees. Examples include individuals advocating for intersex genital mutilation, off-colour jokes about trans suicide, the use of outdated language, and misgendering of research participants.

Some research seemed entirely voyeuristic: for example, one poster from the Netherlands purported to report on differing levels of jealousy towards sexual competitors among “mtof and ftom transgenders”. It was often unclear how consent was obtained (if at all) for the use of personal information about research participants and/or patients. This was particularly concerning when numerous posters and powerpoint slides included unnecessary photographs of intersex and/or trans genitalia (a “WPATH conference bingo” grid circulated among intersex and trans attendees of the event included a square for “unexpected genitals”).

As a trans attendee, I felt deeply objectified by the tone and content of this material. It felt dehumanising, and I felt like a thing, subject to the harsh gaze of an abstract, dehumanising curiosity. Yet I was disturbed not only by those engaging in such work, but also in the response of many of their peers. Numerous practitioners and researchers who seemed broadly sympathetic to trans rights and affirmative in their own work often said nothing to counter transphobia, cisgenderism and endosexism in the work of others. It is difficult for intersex and trans people to explain how painful this situation is when most of our colleagues and the senior figures in the field are not intersex or trans; we know that our projects and careers alike may suffer if we speak out too openly or too harshly. I encourage fellow members of WPATH to reflect on their potential complicity in this situation, and consider how we might collectively work to change it.


Tokenism and colonialism

The choice to locate the conference in Buenos Aires felt deeply tokenistic, with numerous attendees from the Global South arguing that this represented a colonial attitude. The vast majority of conference attendees were from the United States or Western Europe. The price of the conference was a significant barrier to many attendees, amounting to the equivalent of the average monthly income in Buenos Aires. The choice to host the event in an expensive Hilton hotel felt like it was taken primarily for the benefit of (the more wealthy) attendees from the West to the detriment of local intersex and trans people, some of whom reported that they risked being profiled by the police if they tried to enter the wealthy area of the city in which the hotel was located.

The sessions on clinical practice in Argentina and human rights in Latin American were some of the most interesting I sat in on, but also least well-attended. I later heard that on one occasion a high-profile lawyer invited to speak on the topic of Argentina’s Gender Identity Law addressed a near-empty room, due to clashes with sessions that focused on Western bioethics, research and medical practice. This sense of tokenism was compounded through the choice to hold the conference in English (the official language of WPATH), with funded translation into Spanish available in a maximum of two rooms at any one time. Some of the conference organisers later stated that they had been worried about the finances of the event, but this felt like a strange claim in the wake of a lavish gala dinner with dancers, DJs, and multiple buffets serving food from various regions of Argentina. As human rights expert and executive director of GATE Mauro Cabral declared in the closing plenary of the conference, “When WPATH decided to come to Argentina, with the most progressive gender identity law in the world, I was excited. But we could only talk among ourselves. You came to this country because of the weather, steak and wine, but not to learn from us”.

While these issues are primarily structural ones that need to be formally addressed by WPATH, the onus is also upon individuals from Western and/or Anglophone countries to take action and reflect upon our relative power and privilege in attending these events. In addition to vocally supporting my colleagues from the Global South, one aspect of my own practice I feel I can address is my use of language in planning talks. For example, I could have undertaken a little extra work to ensure that my slides were bilingual, listing bullet points in Spanish as well as in English. I hope to draw on this lesson in preparing for future international events.


TPATH, human rights monitors, and lessons from Argentina

My experience of WPATH 2018 was improved enormously by the presence of other trans people working in the field of trans health, as well as the intersex activists and human rights experts who came to monitor WPATH’s historic antipathy towards intersex rights. Many of us are members of TPATH (the Transgender Professional Association for Transgender Health), a new and as-yet loosely affiliated group of trans people working in trans health that I helped to co-found during the 2016 WPATH Symposium in Amsterdam. Numerous others were part of a 50-strong delegation of intersex and trans human rights monitors from all parts of the world, who attended in order to conduct a collective human rights audit of the conference.

It was with these individuals that I found myself having the deepest conversations, these individuals with whom I heard the most fascinating research findings and the most rigorous analyses. We also shared a strong sense of solidarity in the face of the many problems apparent at WPATH 2018.

That said, the most important event I attended took place outside of the WPATH event: in Casa Jáuregui, a historic queer cultural centre many blocks away from the Hilton. Here, Frente de Trans Masculinidades (the Transmasculine Front) and other activists based in Buenos Aires hosted a meeting with TPATH members from the Bahamas, Aotearoa/New Zealand, Norway, South Africa, the UK and the USA. We shared information on our various areas of work, and the local activists talked at length about the history, implementation and practical impact of the Gender Recognition Law.

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Argentinian activists host TPATH members at Casa Jáuregui.

While it is important not to deny the significant challenges faced by trans people in Argentina, which include harassment by authorities, economic marginalisation and many forms of violence and discrimination, many of us were struck by how much has been achieved by activists in Argentina and (consequently) how advanced trans rights are in this country. The Gender Identity Law has been carefully written to enable flexibility; this has meant, for example, that it was interpreted to enable non-binary recognition by a judge as recently as last week. It also guarantees access to healthcare, which has meant that every possible medical intervention is available to trans people, either for free or through relatively inexpensive health insurance (in theory, that is: in practice, various legal battles have been necessary). This has been of benefit to cis women and queer people as well as trans people: for instance, through enabling easier access to hysterectomies or breast reductions.

During the meeting, the local activists described gender-affirming medical interventions that most of us had never even considered, such as beard hair implants for transmasculine individuals who cannot or would prefer not to use testosterone. Moreover, while long waiting lists exist for some procedures such as surgeries, those of us attending from European countries and (especially) Aotearoa/New Zealand were astonished by how much shorter they were than equivalent waiting times in our own countries, in part due to the absence of unnecessary gatekeeping procedures and treatment bottlenecks.

I was profoundly moved by the opportunity to attend this meeting, and regretted that so much of my time in Buenos Aires was spent in the sterile environment of the Hilton. However, I was also glad to have the opportunity to work with others to challenge the hierarchies and cisgenderist assumptions inherent in WPATH. We undertook many small interventions: asking questions about ethics, consent and power dynamics in the sessions we attended, raising concerns in private conversations, reporting blatant contraventions of the WPATH code of conduct. I was also pleased to hear many of my colleagues openly critiquing problematic issues identified during an update on the progress of the forthcoming Version 8 WPATH Standards of Care, and take part in attempts to hold our professional body to account during a member’s meeting on the final day.

Overall, I found WPATH 2018 to be a very tiring, draining and frequently unpleasant experience. However, I do not regret attending. I am grateful to have had the opportunity to learn so much from so many. I am also glad to have played a small role in supporting my intersex and trans colleagues and my colleagues from the Global South in attempting to help transform WPATH so it is more transparent, more accountable, and less colonial in attitude and in action.


Session summaries

The following links are to Twitter threads in which I summarise plenaries, talks and mini-symposia I attended at WPATH 2018.

Saturday 3rd November

Opening session and President’s Plenary

Keynote: Employment discrimination against trans people (Sam Winter)

Keynote: Trans legal history in Latin America (Tamara Adrian)


Sunday 4th November

Mini-Symposium: The Argentinian experience of public transgender health after the implantation of the Gender Identity Law

Oral presentations: Services in different parts of the world (Australia, Southern Africa, Scotland)

Mini-Symposium: Trans refugees: escape into invisibility

Mini-Symposium: Latin American perspectives on depathologization of trans and travesti identities

Plenary: Show hospitality to strangers: intersex issues in the time of gender identity laws (Mauro Cabral and respondents)
Note: this was listed as a plenary session in the programme, but actually took place alongside multiple parallel sessions. Consequently, this talk was under-attended by Western healthcare practitioners in much the same way as the Latin American sessions.


Monday 5th November

Oral presentations: Suicidal and non-suicidal behavior

Mini-Symposium: Ethical considerations in transgender health research

Oral presentations: Fertility

Oral presentations: Reproduction


Tuesday 6th November

Mini-Symposium: Child and adolescent medicine Mini-Symposium: Child and adolescent medicine

Plenary: SOC 8 update

Plenary: SOC 8 Q&A