Category Archives: teh trans

Sarah’s Arts and Media Review

Posted on by

A curious thing happened on Twitter, and in the papers over the course of the last week.

As far as I can tell, a small clique of journalists, apparently united by their love for lobster and champagne (yum!), and dislike for trans people (boo!), got upset over the discovery that Twitter isn’t like writing for a newspaper, where you can say something outrageous and any protest is filtered by a letters editor. Instead, if you say something outrageous, people tend to talk back.

One of them responded very badly to this discovery. A few people, most of whom probably weren’t trans, had engaged with her over an article she’d written. Initially this was apparently quite polite – certainly more polite than a lot of the stuff I get people tweeting at me.

In a display of “how not to do social media if you want a quiet life, free from throwing crockery at the wall”, she then tweeted a bunch of stuff about “getting your dick cut off” and suchlike.

This didn’t go down very well, and lots of people told her what they thought about this. Some of them were probably not polite, most of them were probably not trans. This led to what those audience members savvy in the ways of the Internet might term a “flounce” or a “rage quit”; she deleted her account and subsequently claimed to have been “hounded off Twitter”.

This was followed by one of her friends trotting out some line about how trans people are “bullies” and a “cabal”, and another of her friends publishing a letter detailing her resignation from humanity in the Observer (or was it the Guardian? It seems to depend whether you were reading it in dead-tree format, or online). The letter included snippets about how trans people are all bed wetters in bad wigs, how they use strange Latin words which she didn’t like the sound of, had twenty PhDs each, are “shemales”, and how we wouldn’t like her when she’s angry.

To be honest, she doesn’t sound terribly likeable when she’s not, especially when it seems she’s previously written stuff about how it would be a good thing to shoot sex workers. Some of my friends are sex workers, and they’re nice people, and I’m not keen on the idea of them being shot, so not liking her is probably not much of a loss.

This whole episode can be seen in different ways. On the one hand, it can be seen as a failed attempt for newspapers trying to embrace social media in the face of a business model brought into decline by the existence of the Internet.

It probably works better as some sort of grotesque piece of theatre, in which trans people are portrayed as a shadowy cult, manipulating world governments through the art of wig-wearing and lobster munching luvvie journos, are pining for the return of the 1990s glory days in a world they no-longer understand; a world which includes trans people and iPhones, and trans people using iPhones.

You should probably skip it and go and see Les Mis instead.

It’s Time for the Media to Change the Record on Trans Healthcare

Posted on by

Transgender healthcare is in the news again. It’s been widely known amongst trans people for some time, but on the 6th of January, Guardian journalist David Batty reported that the General Medical Council is investigating private trans healthcare specialist, Dr Richard Curtis. In his article, Batty paints a picture of misdiagnosis, patient regret, and inappropriate prescribing.

Those of us who follow this stuff might be forgiven for experiencing a sense of deja-vu. Dr Curtis took over the private practice of Russell Reid from 2005. In 2007, Dr Reid faced a General Medical council fitness to practice hearing which was reported on by no other than Guardian journalist, David Batty. In his reports, Batty spoke of misdiagnosis, patient regret, and inappropriate prescribing.

It’s entirely proper for the GMC to investigate allegations of misconduct, and for the press to report on it, but it’s difficult for trans people not to notice how terribly one-sided it all seems to be. The doctors who seem to end up in front of the GMC seem to be those ones who are generally well regarded by trans people, and who have a reputation for helping us when nobody else will. Press reports concentrate on regrets about procedures which have satisfaction levels beyond the dreams of most other fields of medicine, where much larger regret rates are regarded as par for the course. They rigidly stick to a narrative about a dangerous procedure which gullible people are tricked into by reckless doctors and end up bitterly regretting.

The reality experienced by trans people ourselves is not recognisable from the press reports. In reality large numbers of us are used to being ignored, abused and ridiculed by doctors when we seek treatment. We are denied referrals, denied funding, denied prescriptions and humiliated by a medical establishment which many experience as institutionally transphobic.

Batty’s recent article prompted me to take to Twitter to highlight the hypocrisy of the media in how they report trans healthcare. I wrote:

I had a misdiagnosis which led to surgery I regret, and which has caused long term problems.

Here press press press! I, a trans person, had surgery due to misdiagnosis and I regret it. Come and get it, you know you want to.

The scarring will never fade. My mutilated appendage will never be fully functional again. It’s all true. Nice and juicy! Come and get it!

I was offered surgery after only two appointments with the specialist.

Less than five minutes later, and despite my painfully obvious trolling, the phone rang. It was a newspaper noticing that I’d spoken about surgical regret and could I elaborate? They lost interest when I said it was all true, but I was talking about surgery I had on my right hand in 2011. I apologised for wasting their time.

The misdiagnosis which led to me having surgery on my hand when I shouldn’t have done, and which made the existing problem worse, won’t ever be the subject of a GMC fitness to practice hearing, nor would I want it to be. There’s nobody at fault for what happened; it’s just one of those things which falls within the limitations of modern medicine. I may ultimately lose one or more fingers because of it, but these things happen and I am simply unlucky.

But I could not have wished for a more perfect example of the double standards at work here. Prompted by this, a few trans people started sharing stories of how they had been mistreated by their doctors with me. The next morning, I made a Twitter hashtag, #TransDocFail, to share stories about mistreatment and prejudice at the hands of the medical community. I expected a few dozen. Later that day I stopped counting at 2,000 and several days later, it’s still receiving new reports. Lots of the descriptions are harrowing: people being called “abominations” by their doctors, people bleeding to death being refused treatment by A&E departments, vast numbers of GPs telling people to pull themselves together, or “sacking” them as patients, sexual assault by unnecessary and repeated genital examinations, and so on.

The reports went on and on. Trans people watched it with sadness and resignation. Non trans people stared, open mouthed, barely comprehending how the healthcare system can treat people like this with barely a whisper in the national media. If this was happening in any other area of medicine it would be a national scandal, comparable in magnitude to the Saville affair, staying in the headlines for months and prompting widespread investigations.

I’m thrilled because I managed to speak about it for 5 minutes on local radio.

The media needs to end its transphobic obsession with transition regretters, because this wilful tunnel vision is blinding it to routine and systemic abuse of transgender people when we try to access health services. The LGBT movement wouldn’t tolerate it if the bulk of LGB coverage in the press was about loud and proud ex-gays. We shouldn’t tolerate this either.

My Speech to the LGBT+ Lib Dems/Stonewall Fringe

Posted on by

This is the speech I gave as part of the panel in the LGBT+ Lib Dems/Stonewall Fringe at the Lib Dem autumn conference in Brighton.

I want to talk a little bit about the nature of homophobia. This is an area where one has to choose words carefully, but if you’ll bear with me for a minute, I’ll attempt a working definition of homophobia as the hatred of someone who experiences same sex attraction, or who is perceived to experience same sex attraction.

The point about perception is important, because not only do you not have to be homosexual to experience homophobia: bisexual people experience it too, for example. You don’t even need to experience same sex attraction. You can be entirely and conventionally heterosexual in your sexual behaviour and desires, and still be a victim of homophobia.

Indeed, plenty of people are on the receiving end of homophobia before they are sexually active at all – we all know that homophobic bullying happens to kids from a very young age.

Actual sexual behaviour isn’t really a causative factor in most homophobic abuse. I have experienced homophobic abuse in public, and I, like most people, don’t actually have sex in public. As an elected representative of the people, that sort of thing is frowned upon.

So when someone screams “faggot!” or “dkye!” at someone in the street, what are they actually keying off that triggers that homophobic reaction? What is it about certain people that homophobic bigots decide to home in on? Gay, lesbian and bisexual people are just like everyone else, apart from the sex thing, right? Right?

Well, no. Spend even a short amount of time in LGBT circles and it becomes pretty obvious that there is something different, not about everyone, but about a lot of people.

I’m going to suggest that what a lot of people are picking up on, and reacting with homophobia towards, is something they perceive as transgressive about the target of their abuse. It could be the way they look, or the way they talk, or the things they’re doing, or whatever. I’m going to further suggest that the apparent transgressions that are being picked up on are, in fact, perceived transgressions of gendered behaviour.

About gay men, homophobes use words like, “mincing”, “flamboyant”, “limp wristed”, “camp”, “ducky”, “effeminate”. Jokes about airline stewards and their handbags are often made. If you’re a lesbian woman, as I am, you might get homophobes telling you that you’re ugly, that you need to shave, that you should get back in the kitchen, that you “wear comfortable shoes” (I do actually wear comfortable shoes – life’s too short not to). If we have short hair or don’t wear any makeup, they pick up on that.

So I’m going to say something perhaps a little bit controversial here. Much, probably most, homophobia which gets directed at people is about what we might call non cisnormativity. Most homophobia is, in fact, rooted in and emergent out of, transphobia.

So what’s transphobia? I’ll attempt a working definition again. Transphobia is the hatred of people who identity, or who are perceived to identify, in a way that is commonly associated with a gender other than the one they are assigned at birth. You don’t need t be trans to experience transphobia. Someone just has to decide that you are not meeting their standards of what a real man, or a real woman should be.

A lot of the abuse that gets hurled is the same as for homophobia, because really transphobia and homophobia are two sides of the same coin. Trans women, for example, will often get called “ducky” and “sissy” and “faggot”, just as gay men will. Trans men will often have “dyke” hurled at them by an abuser. We’re all basically being abused for the same thing – that is we are transgressing what someone regards as acceptable gendered behaviour.

I’m not stopping here though, because I think transphobia itself is a manifestation of a deeper gendered neurosis in our society, and that is misogyny – hatred of women and the feminine.

Think about it: if someone comes out as gay at work and gets abused as a result, a lot of the abuse will centre around whether they are the one who takes on the so-called “female role” in sex. To be penetrated is to have sex like a woman, and that is degrading and not something a “proper man” would permit himself to be subjected to.

It’s similar with women who have sex with women, and indeed with trans men. Both groups are seen as trying to “better” themselves in ways that they aren’t really “entitled to”. Lesbians are derided as never being able to truly satisfy a woman. Only a proper man can do that. We just need to experience the real thing, so the story goes, and we will be straightened out into well adjusted heterosexual women, barefoot and pregnant in the kitchen.

I’m reminded of a sketch on the Catherine Tate show. You know the one – she plays a passive aggressive woman who gets into a trivial situation and starts screaming, “Man! Man!”. In one episode there is a slight twist. Her car breaks down, and she starts her usual mantra. A woman comes along and offers to help and once again she starts yelling for a man. The other woman says, “it’s OK, I’m a lesbian”, and proceeds to fix the car.

Comedy like this reflects society’ attitudes towards LGBT people. We’re a bunch of men who taint ourselves with the effeminate, and a bunch of women who try to shed what’s seen as pathetic femininity to be proper people, i.e. men.

Homophobia is rooted in transphobia, and transphobia is rooted in misogyny, and if we are to challenge any of this we desperately need to engage in joined up thinking. There’s a school of thought that LGB people will gain acceptance if we can convince the homophobes that we’re just like the rest of them, apart from what we do in the bedroom. For some of us, that might be true, but for a lot of us it isn’t. I think this approach to try and address homophobic bullying and abuse is largely futile because it doesn’t deal with the core problem. Some people will always express behaviour which is seen as not gender normative. Our message needs to be that there is nothing wrong with that, and furthermore there is nothing wrong with femininity either.

We need to get our own houses in order. When we see transphobia in the LGB community, we need to challenge it. When we see misogyny an sexism in any part of our community, we need to challenge that. Every time a drag queen refers to women as “fish”, every time the LGB establishment turns a blind eye to transphobia in its own ranks, we serve to further the attitudes that underly homophobia bullying. We need to get this right ourselves, because if we don’t, who will?

Political Conference Background Checks – Putting Our Case to the Lib Dem Federal Conference Committee

Posted on by

Political conferences are amazing places – for a few days you’re mixing with like minded people from all over the country, getting to talk to MPs, peers and ministers in briefing, workshop and Q&A sessions, socialising at “fringe” events, and occasionally getting to have a word in the ear of someone who can effect real change in the UK.

Of course, they’re also a bit of a nightmare for security services, especially when they’re being held by a party of government. There have been attacks on them in the past – perhaps most notably the 1984 Brighton Bombing where the Provisional IRA tried to take out the then government.

In the conferences I’ve attended, there have often been airport-style x-ray machines and metal detectors on the way in, and while people grumble about the queues, this is generally accepted as probably necessary (although obviously it wouldn’t have protected against Brighton-style attack). For a long time, the two larger parties in the UK, Labour and the Conservatives, have had “vetting”, where anyone wanting to attend has to first submit to a background check by the police (who, presumably, bring in other agencies).

Liberal Democrats haven’t traditionally had this – we take the view that all party members should be allowed to attend our conference, which unlike the other two big parties, is sovereign in policy making – votes at conference set our party policy. Ordinary members get the choice to speak in conference debates and influence the votes that set our party policy. Most memorable for me was the debate in 2010 which made our commitment to marriage equality and gender recognition reform policy.

Now we’re in government, Federal Conference Committee, the party body responsible for organising conference, has come under pressure to bring in vetting for our autumn conference. This has caused quite a lot of upset in a party that prides itself on a strong pro-civil liberties stance, but I’m not writing about that aspect (although I have participated in that debate too) right now; I’m writing about the effect it has on people who have changed their identity. In particular, I’m writing about the effect it has on trans people.

Last week, myself and Zoe (who are executive members of the LGBT+ Liberal Democrats) had a chat with the chair of the FCC about the issues facing trans people and background checks. As a result, both of us and the chair of the LGBT+ Lib Dems were invited today to a meeting of the FCC in London, just over the road from the Houses of Westminster in LD HQ, to talk about the issues trans people face when dealing with background checks by the authorities and answer questions. I spent about ten minutes speaking from notes, which I’ll include here:

Basic problem – lots of trans people are “stealth”. Consequences of previous identity being revealed to their social group are potentially devastating.

Even those of us who are “out and proud” like to keep some control for things like security checkpoints, etc.. It’s a personal safety thing, as well as dignity. In casual public encounters, people can be extremely tactless,
leading to public humiliation. Quite apart from being outed, association with former identity can be extremely traumatic. I suffer PTSD symptoms around it, and I know I’m not alone – the thought of applying to last year’s autumn conference actually gave me acute physical stress symptoms.

Police forces have a track record of institutional incompetence with regard to our identities. What is a simple administrative error to them (leaking old name) can be devastating to us. People can and do suffer violence as a result, have to leave the communities they’re in, etc.

Police track record on this is dreadful. Even when they get LGBT liaison officers involved, they generally don’t get it because most LGBT liaison officers concentrate almost entirely on the issues around sexuality, not gender identity. The mishandling of the public toilets at Pride 2008 in London which led to a trans woman being sexually assaulted was caused, in part, by an LGBT liaison officer getting things disastrously wrong.

Bottom line – convincing trans people that the police can be trusted is an impossible task because we know they can’t.

We are being asked to trade a hypothetical danger of physical harm to someone else against a very immediate danger of physical harm towards ourselves, and it’s not fair to ask people to do that.

Anything that involves a possibility of outing will result in some simply staying away. Setting up a “special channel” for people to apply wont help – the CRB have such a special channel and I know from direct personal experience that it leaks – it’s done so with me.

Some trans people are not in a position to obtain consistent personal documentation, often because of institutional or personal transphobia.

Lib Dems attract trans people because we’re a group which is systematically abused by society, government and other institutions. The world is essentially a hostile environment and so civil liberties and equality issues are very important to us.

Obviously I fleshed these out a bit, and went into details of how the Met Police LGBT Liaison officer got things so very wrong at Pride London 2008, how the Criminal Records Bureau accidentally revealed my old name when I was applying to do healthcare voluntary work a few years ago (and then wrote to the organisation asking them not to open the letter and send it back – somewhat akin to asking someone not to think of an elephant), and talked about how I’ve had friends who have had to move when “outed”.

Zoe added some details too, and afterwards we answered a few questions. Having made our case, we left them to it.

An hour or so after we left, one FCC member tweeted, “FCC very keen to find way of #ldconf being able to go ahead without accreditation, so registration opening will be delayed pending solution”

And another said, “Thanks for coming this evening. What you both said was very moving and shocking – such discrimination and abuse is unacceptable.”

I guess that means what we said has been taken very seriously, and it’s a case of waiting to see what happens now.

My Equal Marriage Letter

Posted on by

After chatting to the political journalist for the local paper, Cambridge First, I was asked to submit a letter about the current equal marriage consultation in the UK. The consultation also looks at gender recognition, and if you’re in the UK I would encourage you to respond (I’ll post my response here when I make it). Here’s the letter:

Last week the government launched a consultation into marriage equality in England and Wales.

Assuming legislation on equal marriage is passed in this parliament, it will mark nearly a decade since the signing into law of two sibling pieces of legislation, the 2005 Civil Partnership Act and the lesser known 2004 Gender Recognition Act. These two acts together changed the landscape for lesbian, gay, bisexual and transgender (LGBT) people in the UK, but they were both half-measures. They created a situation which satisfied neither those LGBT people seeking equal treatment before the law, nor their critics who wanted to retain the status-quo.

The Gender Recognition Act allowed transgender people to gain legal recognition of their gender. This granted them marriage and employment protection rights which other people took for granted, but at a cost – if you were in an existing marriage or civil partnership, you had to have it annulled first, otherwise your rights were kept from you. This was more than an inconvenience; it had profound consequences. A woman who would be seen as such were she naked in a gym changing room would be treated by the law as a man, including being locked up with male prisoners if she was to be given a custodial sentence by a court.

The Civil Partnership Act created a form of relationship which was “seperate-but-not-quite- equal” for same sex couples wanting to recognise their commitment to each other with a marriage. Despite civil partnerships commonly being referred to as “gay marriages” by the press and public, they do not confer the same rights as a marriage. Being regarded as next-of-kin when abroad is not assured even in countries which have full marriage equality, for example.

Couples in marriages where one partner had undergone gender transition were treated particularly unfairly by these half-finished laws. Some of the strongest marriages around were, in a cruel irony, subject to state-coerced divorce, with gender recognition being used as both the carrot and the stick for those who refused to end what had become, in effect, a same-sex marriage. Lib Dem Equalities Minister, Lynne Featherstone, described this treatment as “cruel and unusual”.

I was one of those who suffered confiscation of my marriage. One spring morning in 2009, my wife and I stood before a judge and had our marriage annulled. We had convinced ourselves that this was a matter of bureaucracy, that a few days later when we underwent a civil partnership ceremony nothing would have changed, but it wasn’t true. We left the court in tears and holding hands. Less than 2 weeks later, when a registrar pronounced us “civil partners”, it felt like the final indignity. It was very clear to us that the state regarded our relationship as second class.

We still celebrate the anniversary of our marriage, the real one. This year should have been our eleventh anniversary. It is to us, but to the state that’s a fiction; our marriage never existed – it has been erased.

The plans the government is now consulting on will end this for those who come after. Divorce will no-longer be the price for legal recognition and protection, and same sex couples will be able to be married in civil ceremonies. I am proud that Liberal Democrats in the coalition government are delivering this; we are the only one of the three main parties to have marriage equality as party policy.

I would like to see the proposals go further. While churches which don’t want to marry same-sex couples won’t have to under the proposals, lobbying by some churches has resulted in proposals that will ban those religions which do want to conduct same-sex marriages from doing so. It is an affront to religious freedom that one sect presumes to speak for all in this way. While civil partnerships will remain for those same-sex couples who want them instead of a marriage, they will not be extended to opposite-sex couples who feel such a status better reflects the nature of their relationship. Finally, those marriages which were confiscated by the state, such as mine, will not be reinstated.

I will be responding to the government’s consultation by asking them to go further; to do the job properly this time, to not give in to the bullying of a few religious figures who presume to speak for all, and to put right the grave injustice of state-mandated divorce. I urge your readers to do the same.

Those wishing to respond to the consultation can find out more at www.abouttime.org.uk

Councillor Sarah Brown – LGBT+ Liberal Democrats Transgender Working Group Chair


Towards a Less Simplistic Perception of Gender

Posted on by

One thing I come across again and again when encountering public attitudes towards gender variant people is just how simplistic a model many people seem to be operating with. In order to illustrate, it might help to briefly consider sexual orientation, the modelling of which has some similar issues;

Everybody knows about the Kinsey Scale of sexual orientation, right? You have 0 at one end, which means you’re exclusively heterosexual and 6 at the other end, which means you’re exclusively homosexual. There’s then a scale inbetween with varying degrees of hetero/homoflexibility and bisexuality. The wikipedia entry I linked to above also includes an X for “non-sexual”.

Most people seem to be able to grasp this model and understand it, and firmly declare themselves to be a zero. Phew, that’s sorted that out then! None of that gayness here, except after a few pints, when they might venture they’re actually a one, maybe. I jest, but Kinsey is a very simplistic model and the way people use it to express their sexuality can often be very simplistic.

Klein extended Kinsey into his “Sexual Orientation Grid”, which was an attempt to deal with some of the shortcomings of Kinsey: Your ideal situation could be different from your behaviour, as could your fantasies, and orientation and behaviour can change over time.

Taking things in a different direction was Michael Storms, who proposed that “attraction to men” and “attraction to women” can be considered two independent variables. I think this improves dramatically on one of the main issues I have with Kinsey and Klein – that they see a spectrum with “straight” at one end and “gay” at the other. Instead, Storms suggests, you can be attracted to men and attracted to women in different proportions. The diagram on the right (click to enlarge) illustrates this. One thing it does which Klein and Kinsey don’t do so well is takes asexuality into account.

These are still simplistic – they don’t take into account non-binary and queer identities, for example, nor do they account for the fact that “man” and “woman” can be broken down into multiple attributes in their own right. Someone can, for example, be attracted to a person with very large breasts (to the point of a fetish – something else none of these models handle well), but be less concerned with other aspects of “femaleness” in a sexual partner.

Regardless of their shortcomings, I think people can generally understand them and realise that there are bisexual people (Kinsey), that you can fantasise about same sex encounters while being straight (Klein) and even that you can be independently attracted to men and women, or not (asexuality). Many people will have a conservative reaction to anything other than Kinsey (or even anything other than heterosexuality) and declare it to be nonsense, or perversion, or symptomatic of pathology, but they can usually understand it.

What about Gender?

What depresses me is that while Kinsey has penetrated (oh shush) the public consciousness, and refinements on it can be understood, the same can’t be said for gender.

A grid for just one aspect of gender identity?

From my perspective, I see that there are multiple variables to gender. You can have identity, visible expression, behavioural expression, and so on. Like Klein, each one of these can change over time, can be “fantasised” about, and can be different in terms of expression and ideal. We can construct a Storms grid for each one of them; there’s one on the left and each person might have, say, twelve, or something, each representing a different aspect of their gender identity (such as their presentation, or their identified gender, or their desired social gender, and so-on).

In addition, each one of these can be fluid, and there are probably a whole host of things I haven’t thought of. This stuff is rich, very rich. Instead what we get are media depictions and a public discourse on gender variant people which is simplistic to levels that I find incredibly frustrating: trans stories have to be accompanies with photographs or video of over-the-top expressions of stereotypical femininity or masculinity; anyone without a simple, binary identity, is considered too challenging; surgical status is everything, “If you’ve got a penis, you’re a man”; “But chromosomes”, and so-on.

I also get the impression that the more “educated discourse”, which ought to have at least moved to a point where it acknowledges that this stuff might be complicated, gravitates all too often to the sort of navel-gazing narrative employed by the Julie Bindels and Janice Raymonds of this world – Gender is bad, it exists only to oppress women, gender must be destroyed, gender variant people are either trying to prop up male gender hegemony themselves, or are unwitting tools of some sort of psychiatric illuminati with the same agenda, gender variant people can’t possibly have anything to offer progressive thought, we hate trans people.

There’s good work being done on this. I have very little awareness of much of it – I’ve mostly picked up my level of understanding, which I don’t claim to be anything like complete or even particularly sophisticated, from moving in gender-variant circles. It depresses me that even this places me in a tiny minority. Some work is done by gender variant people, some of it is done by academics who haven’t drunk the Raymond kool-aid. None of it gets enough attention, and it seems to me that while public awareness of trans people has increased, public perceptions of the rich tapestry of gender variance and gender identity are resolutely stuck in a sort of intellectual pre-stone-age.

Gender Governance Group – Be Very Afraid

Posted on by

Thanks to “Freedom of Information Queen”, Emma Brownbill, a number of us have been in possession of the minutes of the so-called “Gender Governance Group” (or G3) from 2003 to the present. This is a group consisting of clinicians mostly working in the east midlands and north of England, as well as Scotland and Northern Ireland, who are working in the field of gender dysphoria. They’ve been meeting twice a year for the last eight years, and I imagine many trans people might wish we could be a fly on the wall in these meetings.

Well now, thanks to the wonders of the Freedom of Information Act, we can be! The whole set of minutes are vast, full of administrivia, and take a long time to read. Here, for your delectation, I have presented an excerpt. Zoe O’Connell and Emma Brownbill herself have also blogged on this, and we timed our releases to occur simultaneously. Their entries are here and here.

In general, the minutes present a bunch of people who seem to be generally well meaning, but are disturbingly ill-informed about the range of transgender identities. Their desire to maintain paternalistic style control over trans people is quite apparent, but they do seem to want to do the right thing (even if I sometimes profoundly disagree with what the right thing is – many of them seem to still be in the “prevent transition unless it’s absolutely necessary” mindset).

More recently, they seem to be on the receiving end of a trans community with patients who enter the services with high expectations and with a good understanding of their rights in law. This appears to be causing some considerable flailing amongst the G3 clinicians, and I do sense they’re getting rattled. Anyway, on with the show. It starts somewhat slowly, but do stick with it – some of this stuff is really quite shocking:

April 2004

“Local issues discussed including patients being referred from other clinics and if the assessment has to start from the beginning and if so does the patient have to go through the Real Life Experience again.”

This is the “bad old days”. This question isn’t answered, but it’s apparent from something that is said later on that the answer is quite often, “yes”.

Pickings are quite thin at first. The group is in its infancy and the meetings seem short and preoccupied with admin issues. Fast forward to:

November 2005

[Dr Kevan Wylie, specialist in gender identity disorder working at Sheffield Gender Identity Clinic] had received an email from the [Royal College of Psychiatrists] about an application to a Member of Parliament asking if they could be noted as “no gender” and wanted to know if it was a recognised condition. Kevan had discussed it at a previous meeting but no one had heard of it before and said he would bring it to the G3 meeting.

Tim Terry [vaginoplasty surgeon working at Leicester] said there was a condition called Scoptic Syndrome where they don’t want to be either sex but want to lose the penis and testes.

This is appalling. I transitioned in this month, by coincidence, so I was doing a lot of searching around online for transgender medical resources. Genderqueer and non-binary gender issues were not as prominent as they are now, but there was stuff there, and I came across it quickly. For a specialist clinician working in the area not to be aware of non-binary people is bad enough. For the body supposedly writing a UK Standards of Care document (more on this shortly) to not know of the existence of non-binary people is utterly scandalous. Sadly, this non-binary blindness and resistance to anything other than “traditional binary transition” seems to persist onwards.

By the way, “Scoptic Syndrome” appears to be something akin to dyslexia! edit: It’s a typo – see comments.

For myself, I am aware of a number of cases locally to me who can’t get referred to a gender clinic because they have non-binary identities. It seems that the old advice that you have to lie to clinicians to get treated is still valid for non-binary people. There are a few who are clueful, and we mostly know who they are. Otherwise, beware.

March 2006

[The Royal College of Psychiatrists (the people who had never heard of gender neutral people 4 months earlier, remember?) had circulated their final draft of their Standards of Care document for comment.

You read it right – despite them already apparently realising they don’t actually have much of a clue about the range of transgender identities that exist, they’re trying to put together a document that describes the care pathway in the UK. This terrifies me.

Kevan said that due to NHS waiting times Sheffield would not be intending to provide support to the prisons.

Yeah, whatever. Prisoners are expendable and stuff anyway, right? Just ask the Daily Mail. Serves them right for stealing a loaf of bread and breaking a window pane, or something.

November 2006

Kevan Wylie reported that Helen Barker, Student Doctor carried out a survey, with a small select group and asked about how they felt about complying with the ‘Real Life Experience’. It was found that overall patients felt it was very important.

Of course, patients are going to tell the people who can STOP THEIR TRANSITION AT ANY TIME the complete truth, and not what they want to hear, or anything.

Many patients had raised the issue that they had not been advised fully regarding [scrotal] hair removal prior to their [vaginoplasty] surgery.

This should be explained – if you don’t get that done, you risk vaginal hairballs. These are not funny – they can result in a permanent infection and severe surgical complications. What does “not advised fully” mean anyway? Is it the same as “not told”?

November 2007

Leeds expressed concern over surgery due to Leicester being closed to new referrals. Leicester expressed views on that they were not aware of this…

Riiiight. Left hand, meet right hand. This isn’t the only time this happens, as we shall see.

October 2008

[Northampton’s] main problem is patients who come into the service who are already taking hormones bought off the internet. This raises the issue of whether to stop the patient taking them. If this is the case it does depend on how long they have been on them and the individual case. The patient would be told if they are buying hormones it is against medical advice. [Dr Deenesh Khoosal] told the group a patient parted from their service as a way forward could not be reached as they were receiving injections from the internet.

It was noted that Nottingham would start a patient from the “start” even if they had been in the private sector, whereas Leeds will continue a patient on hormones following assessment if they are able to provide evidence that they are meeting criteria for hormone treatment. etc. Nottingham added that they would not take a patient off hormones.

This is serious. Around half of trans people are on hormones before our first appointment at a clinic, for various reasons. Being made to come off them is brutal. Discharging people because they refuse to is disgraceful.

March 2009 – This is … well

[Dr Deenesh Khoosal] spoke to the group about the issue of unintentionally creating ‘she-men’: patients who have breasys and are on hormones but don’t have final surgery as they don’t want to go any further. These patients continue to live full time as female but with male genitalia. Many of the services present at the meeting had examples of this happening.

This is the level of understanding of gender issues of some of the people treating us. Not only do they seem oblivious to non-binary identities, but they have apparently appointed themselves the genital police. If somebody is non-operative, that is no business of their gender specialist, and does not make them a “she man” or a “he woman” or any other transphobic slur.

October 2009

Orchidectomy [castration]
The Leeds service had reported that they have seen an increase in patients requesting for this. […] the team was wary about patients who only want orchidectomy.

Again, the obsession and fear about trans women keeping our penises. What is wrong with these people? They’re supposed to be helping us.

The Chief Executive for the Department of Health has recently written to every lead reminding them of their responsibilities legally with regards to trans care.

April 2010

Kevan is of the opinion that we as professionals are not gatekeepers unless there are mental health problems or for monetary making reasons.

Or if you want to keep your penis, or dare to take hormones that we didn’t prescribe, or (continued, pp. 94-106)

Entry into GIC
Leeds are recommending for a recent (within 12 months) mental health, together with evidence of physical examinations, plus full bloods.

Nottingham accepts primary care referrals and then asks GPs to carry out physical examinations

As has recently come to light, “physical examinations” means “GP inspects genitals”. The only person who inspected mine was my surgeon. There’s really no reason to insist on this. It’s degrading and unnecessary.

October 2010

York
Vast increase in size of university population, resulting in demanding youngsters being referred. Waiting list is currently four and a half years, most students only at Uni for three years. This means the service users are arriving very unhappy and then going to London for treatment.

The clinician working at York actually seems very upset about this – she’s getting almost no support from the local NHS. A waiting list of four and a half years though. Four. And. A. Half. Years.

Dr Beaini wanted clarification for a patient who has got a GRC already and they have been gender dysphoric for 25 years. Now they have asked for phalloplasty, do they need to seek second opinion or not?

Been in Leeds Gender Clinic for a while and been treated. 20-25 years gender reassignment, done mastectomy etc.

[…]

GRC is not an access to surgery. Need a one to one assessment with the patient. Readiness and robustness is a must. The way they are presenting, they are not robust enough

Yes, here is someone who has been transitioned for two decades. They’ve had mastectomy, they are legally male. They are presumably living their life, but they won’t be referred for surgery because their gender-presentation is “chaotic”. I think that at 2 decades, they might have proven that they’re serious about transition, no?

Equality Bill(SIC – it was actually the Equality Act by this point)
Glasgow would like to know how gender services are going to adapt to the changes. The bill is now allowing that anyone with gender issues are covered by the same legal as discrimination [That was almost English]. Will this have an impact on the services? The easy answer is we are covered by WPATH and standards of care. We are a medical health.

Glasgow currently have a patient who has highly intellectualised the gender issues, he is biological male and in between somewhere. No evidenced based to treat it, but knows he(SIC) rights and how can he be treated.

Equality bill only mentions the male to female or female to male.

So much wrong with this. They seem actually hurt that trans people have legal rights – surely our lives belong to them! HOW DARE a patient “intellectualise” their gender issues. Note also the continued cluelessness about genderqueer issues – “in between somewhere”.

March 2011

North East
A group of young people under 18 created a voice and demanded a service.

My god! They’re at the gate with boiling oil. These people are revolting!

Leicester
Surgery is cheaper on private than it is on the NHS.

I tried to tell my PCT this back in 2007, and they refused to believe me.

Amal reported that surgeons stopped taking mastectomy referrals and no-one told Leeds – they heard from their patients.

Again, the left hand doesn’t know what the right hand is doing.

October 2011

Leeds have struggled recently with GIRES putting pressure on them regarding hormones and real life experience. There is need to clarify RLE for future. Leeds clarified that they have two stages of RLE, the stage before hormone and assessment 6 months, RLE 2 years before surgery.

That’s right – they make people undergo social transition for 6 months with no medical support. They’re then flabbergasted when people self medicate, and increasingly arrive demanding to be treated with a modicum of human dignity. GIRES are a trans activism and research organisation. Leeds seem almost upset that their “turf” is being intruded upon by trans groups.

[On the new WPATH SoC]
RLE, eligibility and readiness – been completely removed from the SoC […] Amal gave an example of a patient from Leeds going to the GMC.

Leeds also pointed out that the DoH leaflet, doesn’t reflect what they do. When they didn’t do what it said in the leaflet, they got harassing emails which wasn’t very pleasant.

This is almost comedy gold – WPATH, the organisation responsible for publishing the global standards of care document, has moved on and realised that the way we have been treated in the past has been inappropriate. The department of health seems to have certain expectations too. Here we see clinicians realising the world is moving on without them, and desperately trying to hang on to the past.

[On the Equalities and Human Rights Commission’s recent document looking at trans healthcare in the UK]
Sheffield, Leeds or Nottingham confirmed that they haven’t been contacted for any information. The teams are not happy with this document.

Note the bemusement. It’s almost as if government departments and equality bodies are talking to trans people (I know they are – we keep in touch regularly), without honouring the unwritten rule that we belong to the medical professionals who treat us.

As I said coming in, these people seem to be generally well meaning, but the way they talk about us to each other suggests a way of looking at us that ignores our humanity and is incompatible with our equalities and rights aspirations.

These people are dinosaurs, and they haven’t realised that the comet they can see is heading straight for them.

Hunting Trans People For Sport, Profit, Charity and Teh Lulz

Posted on by

My phone apparently knows who I am

A few things happened to me this week which, together, encouraged me to write this post. First is a little toy app I downloaded for my iPhone. It goes and looks at tagged images on your FaceBook and then tries to identify people in them if you point the camera at them. It works surprisingly well – the image on the right is the result of holding the phone up and telling it to use the front facing camera. The image follows me around in real-time.

The second was a revolting advertising campaign by Irish bookies, Paddy Power. They have created an advert which invites people to “spot the stallions from the mares” at the Cheltenham Ladies’ Day, where “stallions” refers to transgender women in the crowd. I won’t go into why this is problematic – Paris Lees has written an excellent analysis at Pink News and I would urge you to read it. She goes straight to the crux of the matter:

The problem with “spot the trans lady” though is that, for one person in the game, it’s really not that fun. Ask any trans woman. Most of us, at some stage, have faced the humiliation of strangers playing it on us – Paris Lees

It has also transpired that in an apparent collusion with the Beaumont Society, who are doing well with own goals at the moment, they’ve arranged for numerous transgender women to be planted in the crowd for Paddy Power’s punters to spot. Hilarious laddish fun, especially for those who happen not to be aware of this “game” and are unwittingly dragged into it. If they’re lucky, all they’ll face is humiliation, but these things can turn nasty very quickly.

The third is the unveiling of a high tech advert by charity, Plan UK, which shows a video to people standing at a bus stop at Oxford Street, but only if it determines that they are women. It does this by using biometrics – distance between the eyes, jawbone shape, nose size and shape, etc.. Essentially it’s looking for the absence of what testosterone does to a skull.

Plan claim it is “90% accurate” at guessing the “gender” (they mean sex) of the person standing in front of it. I suspect their tests were using mostly, or exclusively, cis people. Given the stated biometrics are those which can often give trans people difficulty, and which many trans women endure harrowing surgery to rectify, I can imagine the accuracy of the guess is significantly below 90% for trans people.

In other words, this advertising gimmick doubles up in function as a trans person outing device.

Quite apart from the transgender angle, I can’t imagine what Plan UK were thinking. Really, the scene in Minority Report where the protagonist walks through a mall and is recognised by electronic adverts which call to him by name and try to sell him things was, I suspect, penned as a cautionary tale and not an aspirational one.

Imagine if when this technology becomes widespread – a world in which billboard adverts guess the gender of the person looking at them and then try to target ads based on that guess. While this may sound like an advertiser’s dream (I note that gender seems to be the key determinant when targeting ads online – I’m quite sick of sites that know I’m female trying to sell me diets), it’s pretty much a nightmare to trans people, who rely on relative anonymity in crowds to live a tolerable life in a world which is really quite a hostile place to us.

These ads will misgender cis people too, but for trans people, their constant misgendering will serve to confirm the suspicions of the sort of people who still stare at me even now, after six years of oestrogen HRT (at least they mostly just stare now – it wasn’t always limited to that).

This and the Paddy Power stunt seem to be confirming that when it comes to advertising, no idea is too bad, nor too vulgar, nor too invasive of privacy, nor too unpleasant to vulnerable minorities to run. Trans people are an obvious target – a society as neurotic about gender as ours finds us hilarious, possibly as a way of coming to terms with just how much it feels disgust at existence and what we represent. If we can’t hide in plain sight in the safety of a crowd, then we’re easy prey for those who would abuse and assault us.

Putting all this together suddenly caused a light to go on in my head. Technology isn’t inherently good or evil; its what you use it for that matters. It seemed obvious though that we were only a small step away from smartphone apps which didn’t just recognise your friends; they would soon be able to guess the sex of total strangers, based on the same sort of technology that Plan are using. Furthermore, given the obvious public appetite (so well demonstrated by Paddy Powers) for humiliating transgender people by outing us in public, such technology would soon be used to bully people suspected of being transgender.

And then a second light came on – what if I wasn’t just worried about the future? In trepidation, I had a look in the app store. Yes, a “gender scanner” app already exists, and apparently there’s one for Android too. I’ve tested it out on myself, and what it said is perhaps less important than the possibility that it will be used to bully people suspected of the terrible crime of Being Trans in Public.

Along with Paris, I’ve been the subject of “games” of “spot the tranny”. I’ve been photographed on trains by groups of older kids who seem to find the presence of a trans person hilarious. It was pretty humiliating. I fear that the immorality of advertisers and the relentless march of face-recognition technology are only going to make life harder for us, perhaps in ways we can’t fully anticipate yet.

Is it House-Trained? Does it Bite? Has it had The Surgery?

Posted on by

Yesterday, my dear friend, Paris Lees of Trans Media Watch appeared on Breakfast TV, prior to Trans Media Watch making a submission to the Leveson Inquiry. Now since Paris runs a WordPress blog, she’s able to see what sort of search terms people are using to find her, and yesterday lunchtime she tweeted this:

“paris lees before he was a woman,” “is paris lees post op” & “paris lees on the game” – just a few of the Google searches done on me today.

As an aside, this is a WordPress blog too, so if you got here by googling about my genitals, I’ll know and will be daydreaming about doing unpleasant things that you won’t enjoy, even if you are kinky.

Anyway, this got me thinking about how many cis people think very differently about etiquette around the subject of trans people, our bodies and our identities, than someone embedded in the trans community tends to. I appreciate that I probably used to before I consciously identified as transgender too, but that was a very long time ago and I can’t really remember it very well. As a result, when this difference is thrust visibly into my path, it can cause a moment of cognitive dissonance.

See, I’m a trans woman, and I have many trans people as friends, as well as many people who also have trans people as friends. Generally these people observe a sort of etiquette around bodies and identities that I would regard as “polite and healthy”. I’m not attempting to formalise this in any way, but roughly it’s like this:

  • You don’t ask someone about their genitals.

  • You don’t ask someone what their old name was.

  • You don’t volunteer the old name of someone else.

  • Or yourself.

Obviously there can be exceptions, and they usually involve people who know each other very well, and well understood and/or negotiated boundaries.

Lots of cis people (and actually some trans people) don’t seem to follow this etiquette, however. I generally regard this as “rude and unhealthy”, but it does, alas, seem to be common.

Lots of people know my old name. Sometimes they use it. This makes me feel violated..

Lots of people who I don’t know very well ask me about my genitals. This makes me feel violated.

People have asked me what the old name, or surgical status of one of my friends is. This makes me feel awkward, like I’m being ask to violate someone else.

People have revealed the old name of a mutually known trans person, or if they’re trans, have revealed their own old name without asking if it’s OK to do that. This feels like a violation of one or both of us.

The last two perhaps bear some explanation. I know a lot of trans people. Some I know the old names of (mainly because I knew them pre-transition), most I do not. Some I know the genital surgical status of, some I do not. What seems to come as a surprise to many cis people is that I don’t want to know what the old name or surgical status of a random trans person is.

With surgical status, it’s usually just a case of it being not relevant; it’s something I don’t care about (unless we’re about to have sex). That said, I’m usually happy to discuss surgery with other trans people and sometimes, cis people, on my own terms.

When it comes to old names, it goes beyond me not caring – I actively do not want to know.

Many cis people seem to find this attitude odd. Even people who have a morbid curiosity about trans people seem to mentally respect the fact that someone else might be indifferent. What seems harder to grasp is the idea that being told someone else’s old name is something that leaves me feeling violated.

When someone reveals their old name to me, I appreciate that’s their prerogative, but I’d really rather not know and my first reaction is, “pass the brain bleach!” Actively forgetting something is quite difficult, in a not Losing The Game kind of way. Sometimes people have had their old name blurted out by their parents or something, and that’s really awkward. For the avoidance of doubt, you generally shouldn’t do this.

Imagine if you and I were good friends, and we were sitting down in a cafe chatting, and we’d got to dessert. I’m eating a lovely steaming chocolate fudge cake. As I take a mouthful of runny chocolatey gooey goodness, you suddenly and in a high level of detail, describe your previous bowel movement, complete with telling me about how it had bits of undigested sunflower seeds poking out and everything.

Two things would happen. One is that I’d probably not finish my dessert. The second is that I would decline our next meal date.

I appreciate that I wrote a LiveJournal transition blog, and that it was quite popular, and in it I revealed my old name a few times. I’m sorry about that – I didn’t realise how one can come to feel about this, and I can only apologise. In my defence, most people reading it at the point where I did reveal that info already knew it. For anyone seeking out my transition blog, be aware that it does that (I’m not going to retroactively censor it, but if I ever transfer it somewhere else it might get edited a bit).

Anyway, the take home message here is, please don’t casually toss around surgical status and old names, because these things are likely to upset people, and make them feel violated, and hurt. If you continue to do so with the knowledge that you’re probably hurting people, that’s your choice, but I probably don’t want to know you.

Phew, that was heavier than I intended. To lighten the mood, I’ll finish with an anecdote that this called to mind, about how trans women can develop a very odd attitude towards genital surgery ourselves (those who’ve sat in on a bunch of drunk post-op trans women talking about surgery will appreciate this). Last year, I bumped into my own erstwhile surgeon at a meeting in London. The person with whom he was chatting made to introduce us:

Third party: Do you know Sarah?
Me, interrupting: Yes, extremely intimately, although I was asleep at the time.
Surgeon: It’s OK, I’ve just about forgiven you for that.

Few things make me go bright red and giggly, but that did.