Category Archives: GSRD

High Court Ruling on Puberty Blockers

I have huge concerns over the recent High Court Ruling on puberty blockers for transgender young people. One person’s experience will set back transgender rights for all.

Keira Bell was assigned female at birth. Following several appointments with the specialist services at the Tavistock clinic she takes puberty blockers. Keira is subsequently prescribed testosterone and undergoes top surgery. At this point Keira identified as male. Later, she made the unusual decision to de-transition and now lives and identifies as female.

Longer waiting lists

As a result of the High Court Ruling on Puberty Blockers case individuals aged 16 or under will no longer have access to puberty blockers without the intervention of a further court case. For anyone on the waiting list their treatments are now paused and those already taking blockers are having their medication reviewed.

The Media

The media have reported that booking an appointment with a gender clinic is as easy as booking a GP appointment. It really isn’t. They also report that clinics actively encourage young people to transition and that puberty blockers are prescribed at will. This is incorrect information. There’s a very rigorous process involved. Individuals essentially have to prove to several practitioners that they are transgender before being offered any medication and/or surgical intervention. Assessments are carried out at every stage of the process. So the individual has ample opportunity to reflect on the changes happening to them, their body and their identity.

Over several years Keira had first puberty blockers, then testosterone and finally top surgery. At no stage did she raise concerns about the process or the ‘speed’ of the process. That she regrets her decision is heart-breaking. As yet, it is unclear why she felt unable to raise concerns along the way. This one court case will now negatively impact many transgender individuals who are absolutely sure of their need for puberty blockers, hormone treatment and surgery.

Puberty blockers are not new

The courts have given the impression that puberty blockers are new and dangerous. These drugs have been used for many years to stall early-onset puberty. The medication is simply stopped once the child reaches the age when they would more naturally go through puberty. There is only one difference with transgender people. Puberty blockers are used to gain time for the individual to explore their identity before going through irreversible procedures. Going through a puberty out of alignment is traumatic beyond belief.

The anti-trans lobby now uses Bell as a poster girl. I understand the entire case has been crowdfunded by anti-trans supporters.

Something that really concerns me is that, following this case, many will come away with the idea that somehow transitioning is a dangerous thing that should be put off into adulthood. There are some concerns here:

  1. Your child may not live to see adulthood if gender dysphoria is not recognised and treated
  2. The myth is that more people de-transition than they do and therefore we should prevent transition in the first place
  3. That therapists will, having read incorrect information in the media, support the idea that transition is wrong and will not provide the best care and support to their clients/patients.
  4. That not enough is being done within the NHS or private gender clinic arena to fully support those whose gender sits somewhere between the binary of male and female. See: https://bainesballcp.co.uk/uncategorized/thinking-outside-gender-binary/

This really useful link provides much needed information for people wanting to access gender clinic services.

https://mermaidsuk.org.uk/news/luis-hormone-blockers-qa-for-trans-young-people/

Thinking Outside Gender Binary

http://www.bbc.co.uk/programmes/b07kq5sv

This Radio 4 programme got me thinking outside gender binary. We very much still engage from a binary perspective. People are encouraged to decide either/or. In my experience as a psychotherapist, people tend to identify as male, female, both or neither. Whilst this is oversimplifying that there are potentially as many genders as there are human beings.

Boy or girl?

From the moment a child is born they are presented to their parents as “it’s a boy/girl”. How can we know this until the child has told us how they feel about themselves? Babies are often put in gender binary clothing, given binary names, and expected to express the characteristics of their assigned gender. By the time they go to school they are conditioned as to what male and female roles ‘should’ look like. This is all based on what’s between their legs. No wonder there is so much confusion, fear, and shame.

Until we can simply allow children to express their gender identity as they are experiencing it, we are creating heartbreak. For an individual who identifies as trans, non-binary, gender fluid etc. it’s a very confusing world. For those that don’t identify in this way it can be equally confusing to relate to those that do. Couldn’t we help society as whole if we facilitated children just being that; to explore, to play, to express? This way each person could evolve naturally into who they are, male, female, both, neither. They can then express themselves in a way that is natural for them. In the Radio 4 programme, one of the parents voiced that their child who was assigned female at birth had played with dolls, wore pink etc. So they had no idea that the child identified as a boy until a 12th birthday party ended in tears. 

Fixed ideas about gender

We are not taught that boys and girls can wear whatever they like and be interested in whatever strikes a chord with them. Maybe parents who don’t see it are not looking for anything outside the small box that gets passed from one generation to the next? If we are told ‘this is a girl’ and have a fixed idea of what ‘girl’ means we project all this onto the child. We are not asking them what their idea of being a girl might be.

What feelings are evoked in us if we meet someone who identifies in a way that appears to challenge the male or female binary? Does this projection of gender binary expectation mean  some trans people think they need major surgery? Clearly, for many people, surgery is the only answer. I wonder if some feel they have to physically transition in order to be accepted. Perhaps at the expense of being supported in discovery of their own unique gender identity. Maybe not all would need to if we embrace the idea of gender uniqueness.

Sexuality is different to gender identity. However, there is a similarity here. Too many lesbians are told they “don’t look gay” simply because they have long hair and wear a dress. Similarly if a gay man is not wearing a vest and tight trousers.

Fear keeps us from thinking outside gender binary

I wonder if the crux of this is fear. Historically, it was important to segregate men and women so they each knew who was the oppressed and who was the oppressor. This fear belongs to us all and it could help everyone if we could be brave and think it through in a safe, yet challenging, environment. 

In an educated world, I’d like to think that we could enable people to simply be people, wear whatever they feel comfortable wearing, using names and pronouns that they feel most comfortable with, doing jobs and hobbies that make them feel fulfilled, loving whoever they happen to love.

If you would like to explore your thoughts about gender identity in a safe environment please get in touch by whatever means is most comfortable for you. 

Homophobic attacks must stop

Homophobic attacks must stop. Two dear friends of mine were on the receiving end of a homophobic verbal assault over the weekend as they walked arm-in-arm through their Leicestershire village. Two young men shouted at them from the safety of their car – a cowardly act. In these kinds of situations the young men feel entitled to use another person’s (assumed) sexuality for their entertainment, often with misogynistic overtones if not hatred.

Be proud of who you are

First, I’m sad and concerned for my friends. People shouldn’t have to put up with this kind of behaviour from others. It has the potential to induce shame and make those on the receiving end shrink into silence and erasure – which is why I am speaking out on their behalf. They are proud of who they are.

It also made me wonder about the state of mind of the two young men hurling the abuse. Similar thoughts crossed my mind regarding the two recent nationally reported cases of homophobic attacks on women. How in control, powerful and overpowering might they feel? Why the need to express their feelings in such an unfiltered way? Equally, how inept, insignificant and inadequate might these young men feel to carry out such a cowardly act? As a society, how can we protect the vulnerable, those who are oppressed or marginalised? How can we also help to educate those in the majority that they also harm themselves in the process of attacking those different to themselves?

Increase in hate crime

As you can see, I have far more questions than answers but these homophobic attacks must stop. Some of my concern lies within the context of the current political landscape where tolerance and cohesion are seemingly being rejected in favour of power-play and one-upmanship. Since the EU Referendum there has been an increase in hate crime and sadly we are not seeing it decline any time soon. So I add my voice to those speaking out and declaring that it’s not OK to verbally, physically or mentally abuse another person simply because they are a bit different to you and you feel intimidated by this difference.

JK Rowling’s open letter

I have some thoughts about the recent media row between JK Rowling’s open letter and some trans activists…

Fear seems to be at the heart of the argument. Fear of difference, fear of the unknown, fear of harm and fear of erasure.

Inclusive language

In the initial Tweet, Rowling takes umbrage with the inclusive language “those who menstruate” which includes trans men and non-binary individuals who are not women but who may still menstruate. It’s hard (for me) to see why the inclusion of these groups seems to undermine a sense of ‘woman’ for those who were assigned female at birth and feel that’s the right category for them (cis-gender).

Rowling has clearly had some awful experiences in the past. However, she seems to be confusing all trans women (those assigned male at birth) as predatory and male as though these are linked. They are not. People of all genders can be predatory and abusive. Rowling talks about being ‘triggered’ and it sounds like she might need some additional support for that so she isn’t assuming all men are evil or trans women might want to harm her. One point she seems to miss completely is the vast majority of trans women feel shame around certain parts of their bodies. The last thing on their minds is to expose themselves others.

Binary thinking

It appears she is also operating from a binary male/female perspective in terms of sex which is long outdated and incorrect. Whilst the two most common categories for sex characteristics and chromosomes are male/female, there are also a number of intersex categories. This is aside from any sense of gender identity which is more of a felt experience rather than something that can be ‘tested’ for. What it immediately highlights is that sex and gender is not a binary system, much as it might be safer to think in these terms.

Equality for all genders

Far from eroding the category of woman, supporting equality for all genders adds weight to equality for women. First we need to widen the legal definition of sex so that intersex individuals are included rather than excluded. This will undoubtedly complicate areas of research where so much focus is placed on the binary sex marker. I have no doubt that what we’d see is simply variation within any given category.

JK Rowling’s open letter voices concern re safeguarding children as though by being more inclusive of trans rights we somehow make children less safe; this is simple scaremongering tactics based on her own fears. We are all entitled to our own opinion; we also need to understand the emotion behind the position. It’s no wonder Rowling feels so strongly given her early experiences. Trans individuals feel equally strongly because of the oppression they face day after day.

De-transition rates

Rowling talks about de-transition rates. There will always be people who find it wasn’t the right approach for them. Many of these might be non-binary rather than trans. The more support we can give these individuals the less regret we might see. However, the de-transition rates remains very low. Currently the system still favours those who transition from one side of the binary to ‘the other’ rather than enabling the freedom to simply be whoever they are with all their complexities. Rowling also talks about people transitioning rather than living with the oppression of being gay/lesbian. Surely our efforts need to focus on making it OK to be gay/lesbian rather than to further oppress a particular group?

Is it OK to disagree with Rowling? Sure. Is it OK to be hounded with death-threats? Quite frankly, no! She is entitled to her opinion. Whilst it’s one I do not share, behaving in an abusive way towards her simply feeds the negativity. It also confirms for her that trans women are indeed scary beings who want to harm her. As someone with such a high profile I do think she has a duty of care to better educate herself and to be more aware of the impact of her comments on those who face oppression. Her books have given many people the hope that love and respect will win in the end. Even though not a single character of hers was trans or non-binary.

Transition rates

JK Rowling’s open letter speaks about being concerned about the increase in people seeking transition. It is inevitable that the numbers will increase as people see that it is a possibility for them. Surely this is a positive step; to know that people previously desperately unhappy are now able to receive the support and interventions they require.

Rowling suggests she might have become a man herself “to turn into the son her father always wanted”. Like that’s the reason people are transitioning and would be supported by the health care system. The suggestion is that transitioning is an easy process! Perhaps she is not aware of the incredibly lengthy, and oft times humiliating hurdles that need to be overcome to arrive at a point of transition. Particularly if medical and/or surgical interventions are required.

The way forward

So, I’m left wondering what the way forward might be. We have a situation where some women are deeply frightened of being attacked by someone they have placed into a non-woman category. We also have trans and non-binary people needing safe spaces. Especially to go to the toilet and use changing rooms without being attacked. Instead of attacking each other, how can we work together with an understanding that both groups feel the terror of oppression and abuse?

I’m back to thoughts around fear and erasure. The way forward is surely in ensuring visibility and equality for all? In terms of equality, it might be difficult for women to think of themselves as both oppressed and privileged. Oppressed by men and also with privilege that trans and non-binary individuals don’t yet have. With greater visibility for women (including trans women) and non-binary people, there’s a greater sense of empowerment for all. It’s important to know where we have privilege and where we experience oppression. Together we are stronger.