Tag Archives: Non-binary

No more boxes: A person-centred approach to non-binary friendly healthcare

I gave this talk at a seminar on trans affirmative models of healthcare today at De Montfort University, organised by Prof. Julie Fish (#tgaffirm). The key speakers were Jeremy Wiggins from the Equinox Centre in Melbourne Australia and Dr Ruth Pearce, a Research Fellow in the School of Sociology and Social Policy at the University of Leeds. I would like to thank Julie, and the other speakers for the work they are doing, particularly around establishing an informed consent model for trans related healthcare.

[Content note: mention of mental health problems, abuse incl. csa, suicide, physical and mental conditions]

[image: two new baby cards, one reads "brilliant boy" one "beautiful girl"]An assumption is made on the day we are born that has consequences for the rest of our lives. That assumption is; we should be assigned into a legal and social category based purely on the shape of our genitalia. And if those genitals are ambiguous, we may even have them surgically altered as infants or children, to fit the categories more neatly.

This legal binary of gender has profound implications. For intersex children, it is perhaps the hardest, but women, trans and gender non-conforming people all suffer in different ways from being legally and socially segregated according to their assumed reproductive characteristics. The assumption that our genital shape should say something about who we will be in society can be profoundly damaging. For trans people, it can be impossible to live with.

Since 2004, trans people have had the option of legally re-assigning into the one other prescribed option – they are allowed to change the M for an F, or vice versa. For those who unambiguously align with the “opposite” gender, this is enormously helpful, indeed it is essential. But for many trans people, these two social and legal options, sold to us as non-overlapping opposites, are fraught with difficulty, and may even be impossible to navigate and inhabit.

We are non-binary (NB) trans people, we do not fit the prescribed legal and social binary. Our stories and experiences are many and varied.

So taken-for-granted is the idea that you can force somebody into an identity based on their genital shape that we are surprised when this doesn’t work for some, rather than surprised it works for anyone at all. Society, as a whole, is schooled to look at people and quickly assess from various clues in their appearance what their genitals look like. This will determine our interactions – what salutations and pronouns we use for them, and subtle differences in how we behave that are almost invisible to most of us.

[image: an a diagram of reproductive parts with an arrow saying "this is biology" pointing to it. A sequence of images - school uniforms, birth certificate, toilet doors, with an arrow reading "this is not biology" pointing to them]

What are the implications for this in healthcare settings?

The first issue is about information – what information do we get from a tick on a form that gives options M or F? We are schooled to believe this information is valuable and essential, but in reality if we want to know biological information about our patient – what kind of sex they have, what fertility they may expect, even what their chromosomes are, the tick box approach is neither necessary nor sufficient. Just ask the cisgender lesbian with a cisgender woman partner who is insisting for the 15th time that she cannot possibly be pregnant, or the heavily bearded trans man who has been legally male for many years but is now pregnant with his first child.

One solution is a person-centred approach. To build a relationship with the person in front of you so that you fully understand who they are, what they are here for, and what their needs are, without relying on little boxes that many of us do not fit into, or processes and procedures that are thought to be “one size fits all”.

A person-centred approach liberates us from the idea that biology or identity is simple, and allows us to meet the full complexity of our patients or clients.

I am going to present two essential “anti-box” truths that are central to my work:

  • Both social and biological identity are multi-determined and multi-faceted
  • Wellbeing is founded in human relationships.

What both these things have in common is how important it is not to reduce complex information and interplay down to a set of tick boxes. That does not excuse you from learning all you can about trans people, it simply means you always need to ask the question “I have some understanding of what that means generally, but what does it mean to you?”

Why trans patients are more complicated than most

Research demonstrates that there are a whole bunch of divergent traits that cluster together in the population – non-heterosexuality, left-handedness, genius, synaesthesia, certain tissue disorders such as EDS, gender variance, certain physical appearances, dyslexia, dyspraxia, ADHD, intersex conditions, sensitivity, sensory issues, autism, etc.

[image: A cluster of shapes with various traits as listed previously. The legend reads "Differences (like being trans and autistic) often cluster together - this does not imply causality]

So, “different” people tend to be different in lots of ways.  Break down some of these “things” a bit more, and we see that they are in fact clusters of other traits that come together, like Seurat’s dots, to make a certain kind of picture – and that actually, when you start looking at these individual traits, you discover that no two geniuses, and no two autistic people, have quite the same formula of traits, even though the overall effects can have something in common. Genius isn’t a “thing” and neither is autism, nor transness – these are all many threads of experience woven together to create overall effects that are broadly similar but often diverge in the detail.

How we respond to these traits is interesting in itself. A hundred years ago, left-handedness was seen as unacceptable. In my (left-handed) grandmother’s time, children were forced to write with their right hand. In my (also left-handed) mother’s time, left-handedness was still disapproved of, but reluctantly allowed. Now, I hope, prejudice against left-handed people has all but vanished, though the vestiges of it remain in language in words like sinister.

Society decides which traits are a “problem” and which are not. Nobody is going to diagnose somebody with “genius disorder” and raise funding for a cure. Thus Alan Turing was celebrated for his genius, treated (relatively) neutrally for his left-handedness, isolated for his (probable) autism, and driven to suicide as a result of horrific criminal and medical interventions for being gay.

In an increasingly standardised world, where differences are things to be fixed and overcome, rather than allowed to just be, the pressure on non-binary autistic people is particularly acute. To fit a more normative trans narrative, and to follow the “rules” of gender expression and behaviour that will make them more socially comfortable and acceptable.

How do we include divergent people?

I am going to come back to the person-centred, relational, anti-box approach. Unconscious bias is the biggest obstacle here. It is hard to build a relationship with someone who differs from your internal model of how people should be.

Trans people, and non-binary people in particular, also find their various differences can compound each other. They may, for instance, find it harder for their gender identity to be taken seriously or treated because of co-occurring disabilities, and likewise their narrative around other issues may be disbelieved due to their gender identity. This makes trans people particularly vulnerable.

Because of the way studies seek to standardise participants, gender non-conforming people or people with co-occurring issues have traditionally been excluded from research, meaning diagnostic criteria are often inherently biased against them. This means, for instance, that gender non-conforming people are less likely to be identified as autistic due to skewed and reductive diagnostic criteria.

To give some other examples of what can happen – an autistic, gender non-conforming non-binary trans woman who speaks loudly might have her vulnerability missed and her gender identity doubted. The high intelligence of an androgynous young university student might obscure their emotional vulnerability and mental health symptoms. The level of need of an intersex person who is requiring trans healthcare, treatment for a physical disability that has yet to be diagnosed, and is also claiming a trauma history and a need for assessments for both autism and ADHD, might lead healthcare providers across the board to question the validity of all these issues, and yet these are the kinds of issues that frequently co-occur. Factor in that people who are gender non-conforming are likely to be non-conforming in other ways, such as having non-monogamous relationships and other less common lifestyles, and we have a recipe for prejudice and judgement from professionals, disbelief, and dismissiveness.

Non-binary patients are very quickly labelled as difficult, untrustworthy, unlikeable, attention-seeking, aggressive. Instead of understanding that they HAVE more problems than the average person, they are often seen as BEING the problem.

One of the things that perpetuates this is the lack of recognition of non-binary identities in our current culture and the media backlash against us. The judgement of trans, and particularly non-binary, identities is so automatic we don’t even see we are doing it.

[image: a mosaic of negative headlines about non-binary people]

Minority stress

Back in 2003, an academic called Meyer proposed a phenomenon called “Minority Stress” for LGB people. It’s equally applicable to non-binary people. Meyer’s theory, in a nutshell is that the increased mental health issues for LGB people is directly attributable to the trauma of being mistreated by the general population – stigma, abuse, isolation, erasure, lack of support, all add up to take their toll.

A few studies seem to bear this out for trans people. A Canadian study demonstrated that trans mental health improved given certain factors – family support, access to gender recognition and treatment, social acceptance. A landmark Lancet study provides robust evidence that mental health issues do not directly correlate to gender dysphoria itself, but to the treatment trans people experience.

The horrendous figures for childhood abuse of trans people are just one indicator of how bad things can get when you are not socially supported. The abuse of LGBT people has long been cited by bigots as a “cause” of gender and sexual variance but there is no evidence of this. Rather, it is known that abusers are rather good at picking their prey – like any predator, they look to the margins, to the potential victims who have less pack protection – ones easier to isolate, with less friends, who are less likely to be listened to, supported or believed. Long before many of us consider articulating or asserting our identities, sadly others are spotting our natural and visible differences and realising we can be easy targets for bullying and abuse. Some statistics suggest that both assigned female and assigned male trans people have a close to 50% chance of being abused as children.

Other non-binary related statistics show that 43% of NB people have attempted suicide and 50% of NB employees left a job because the environment was unwelcoming (36% for trans men and women).

The antidote to minority stress is relationship.  If we look at minority stress through a pluralistic lens, we can see it as the result of the many fractures in social relationships a person has experienced.

[image: titled "web model" a diagram that shows how minority stress links to numerous social disadvantages and exclusions]

Walking in the world, a non-binary person receives a continual message – your superficial appearance is more socially valid than the self-experience you have amassed over a lifetime. We know you better than you know yourself. This can chip away continually at a person’s sense of self and threaten their peace of mind and mental health.

If we cannot bring ourselves fully into view then how can we have an authentic relationship with anyone? But if we assert our identity in a world that’s uncomfortable and hostile to it, we risk another kind of rejection. Either way, this threatens our sense of place within the human pack.

Our sense of survival as humans is deeply connected to our sense of belonging. Being outside of the pack in primitive times would have almost certainly meant death, and so our primal fears are triggered by feelings of rejection and unbelonging. To be uncertain of our inclusion in human groups is not simply uncomfortable or unhappy, it is potentially traumatising over time.

The opposite of this is all the hidden social support people get if their experience is better understood and socially validated.

[image: previous slide in reverse, how positive or neutral social interactions create a web of hidden support for people]

Finding our way out of judgement

How do we offer better relationships to non-binary patients and clients?

Hard work.

Like gaining an ear for music by diligent practice, making space for non-binary people in our imaginings takes effort and repetition. To practice no longer gendering the people we see, to practice using “they” as a pronoun whenever possible (e.g. in reports, rather than he/she) so that it rolls off our tongue. To simply notice how the structures of gender influence so much of our thought and behaviour. To reflect on our own deep processes around gender.

Such work will be beneficial to everyone we meet, but it may just give the opportunity to non-binary people for something very rare indeed – the experience of not being automatically judged and found wanting.

The difficulty of inhabiting a socially erased and legally illegitimate identity may seem quite an abstract and academic idea to some. Non-binary people are often dismissed as trendy youngsters, “special snowflakes”, or even the result of political correctness run amok.

But of course, non-binary people (in essence, if not in name) have always been here, and at certain times in history, including in 18th century England, and across the globe we have been recognised perhaps more than we are now. And now, we are having a moment. We have found a new word, “non-binary” to describe ourselves, we are organising, telling our stories, asking for our voices to be heard.

At the root of the current clamour from our community is a need to be met, to be accepted as we are, to be understood as legitimate. Our language, the way we describe ourselves, is communication. It is relational. We need a relationship with the rest of society, including our healthcare givers, and we need inclusion.

Find Sam on Twitter 

 

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101 Makes no Sense Without Non-Binary

I was delighted this month to have two pieces published in Beyond the Binary, an online magazine for non-binary trans people. The first of these addresses the over-simplification of trans people’s experiences, and how when we are training in this subject this can actually be alienating for the audience. The article can be found here.

“people get a much better connection to trans issues in general if non-binary is properly included, and they are not sold a simplified version of trans realities”

Read more

btb

Working with trans students – top tips

Much of the trans awareness/cultural competence training I do is in educational settings – schools, colleges and universities. Last week I found myself at EMFEC training staff from a number of institutions alongside the impressive and trans-famous Lee Gale. My job was to take the afternoon slot and help the assembled professionals think about best practice.

My background as a school and university counsellor gives unique insight into the impact of structures and practices on trans students.

I promised the attendees I would pull together what we had learned into a “10 tips” document for education similar to the one I did for the workplace. Here is that document in handy pdf poster format, and below I give a more in-depth look at these recommendations:

10 tips - students10 tips for working with trans students

Thanks to all the professionals present who got involved in the exercise to consider the needs of trans students , and to Lee for live Tweeting the whole thing. Here are my 10 tips in full:

1. Education, Education, Education

Or more precisely, training. Cultural competence takes work, and without cultural competence, people will either blunder badly (unconscious incompetence) or walk on eggshells (conscious incompetence). Trans lives are not well known about and there is a lot of misinformation out there. As always, go to credible sources and promote knowledge in any way you can. Remember, harm can be done through well meaning ignorance. But even trans people know we can never know everything – we are all still learning.

See my website for some signposts to resources.

The Gender Unicorn from TSER is a good way to start a conversation
The Gender Unicorn from TSER is a good way to start a conversation

Recommendation 1: Mandatory training for all staff (because not all trans students will be known to you) and governors. Gender variance talked about competently and in a non-pathologising way in classes such as PHSE, psychology and sociology. Intersex conditions learned in biology. Trans people visible – on posters, in the curriculum, books in the library.

2. Celebrate trans people and gender variance

A celebratory culture challenges all its assumptions about gender and applauds those who see things differently.  It makes space for people to be different. Trans people are only a “problem” if we don’t accommodate them, and trans kids only have a frighteningly high suicide rate because of the way society treats them.

Lee Gale Tweets: "'Some kids aren't suicidal because they're trans. They're suicidal because it's hard to be trans in this society.' @Sam_R_Hope @emfec_team"
Lee Live Tweeted my talk

Recommendation 2: 

Celebrate anything that challenges gender stereotypes and remember to talk about the trans community during LGBT History month. Share words and images of how gender and gender variance is expressed differently in different cultures across the world.

[Image: 3 Indian Hijiras in traditional female attire]
In India, Hijiras lost many rights after colonisation, but they have fought to regain them
3. Reduce gender segregation

[image: a person stagd in front of gender segregated toilet doors. The sign on the gents reads "get beat up", the sign on the ladies reads "get yelled at"]Trans girls, (assigned male at birth but living as girls), should be allowed to use girls toilets (and vice versa) if they want to, and it would be discriminatory to prevent them. However, gender segregation remains a headache for trans people, causing untold anxiety – particularly for non-binary trans people, but not only for them. Research also shows that emphasising sex differe[image: a gender neutral restroom sign with picture of a toilet]nces can lead to girls under-performing.

Recommendation 3: Reduce segregation as much as possible. With sports, toilets, dress codes and roles there are often ways around the traditional way of doing things. Don’t wait for a trans or non-binary student to show up before you make those changes, because they will benefit everyone and undermine sexism.

4. Be conscious of what story your language tells

The papers tell stories of trans women who “used to be men”, of “sex change” and “having the op”. People often fixate on what is between trans people’s legs and possible medical changes we might make, rather than who we are and how we experience the world. Medicine and psychology treat being trans like an illness that has to be cured. For most trans people, these are narrow and inaccurate stories about a complex and varied experience.

It’s important to allow people to use different words to express their experience of gender without recoiling from “all these labels”. The more stories we hear, the more nuance we allow, the better we will understand.

Lee Gale Tweets: Labels can be important - 'they are the way we tell our stories.' @Sam_R_Hope @emfec_team

Recommendation 4: Be aware of the diversity of language, stories and experience that exist within the trans community. Learn what language hurts or fails to describe trans people. Gender neutral language is a must; find alternatives to expressions like “boys and girls”. Assume nothing about the gender of the person/group you are addressing. Here’s my handy trans language guide.

5. Don’t “out” trans people

Never assume that a trans person wants their trans status to be shared, and that “outing” them may cause harm, as well as contravening legislation. Students may be “out” in some parts of their life but not in others – to family but not to school, or vice versa.

Recommendation 5: Be clear with a trans student exactly what they want shared and with whom. Consider ways in which they could be accidentally outed – e.g. in letters home. Ensure historic name changes and other details do not resurface to expose transitioned students. Know your duties under equality and data protection law.

6. Use inclusive admin systems

Some admin systems are the bane of trans peoples lives: Boxes that ask us sex rather than gender; options that are limited to male or female; insistence on titles (even though these are not legally necessary); and systems that make it difficult or impossible to change our names. These are not small issues because they continually invalidate who we are.

[example of bad practice: options to selct one of the following: male, female, transgender]
Click on the image to find out why this is bad practice
6. Recommendation: Use best practice guidance from Scottish Transgender Alliance on monitoring forms and where gender needs to be asked. If a student cannot legally change their name yet, make sure their “known as” name is what is used. If they have a deed poll, this is a legal document and should be accepted. Alert students to potential issues with exams and certificates – think ahead, and draw up protocols.

7. Rethink Safeguarding

Trans young people are extremely vulnerable to bullying and abuse, including sexual abuse. One of the main reasons for this is that social isolation makes it easier for trans people to be victimised – they are less likely to have people looking out for them, less likely to be listened to, more likely to be seen as attention seeking if they try to speak up about something that has happened.

Because of this, it is essential to re-orientate your thinking – stop thinking of trans people as risky, think of them as at risk and centre them. Support, inclusion, and open lines of communication are far better tools for keeping young people safe than mere vigilance.

7. Recommendation: Don’t isolate trans people – encourage them to form peer support groups and have people to talk to, allow trans kids to be accommodated with their identified gender as much as possible. Focus on the known safeguarding risk (high risk of abuse and suicide for the trans person) rather than imagined risk (trans person somehow overcoming their social stigma and marginalisation enough to have the power to harm other students).

8. Zero tolerence for misgendering and transphobia

Transphobia comes in subtle and blatant forms and is sometimes overlooked by people who see being trans as a choice (hint: it’s not). Trans students who get ridiculed, bullied or excluded are not “asking for it”, and are not somehow extra brave and able to cope with stares, slights, insults and violence.[a trans woman being bombarded with misgendering words]

Misgendering can do a lot of harm, even though it is mostly unintended. Examples are referring to a group that includes a trans boy as “girls”, using incorrect pronouns and gendered words about a person. Though it may seem harmless, it indicates to the trans person the way someone else is thinking about them is at odds with the way they see themself. This undermines the trans person’s sense of self, particularly for non-binary people who have little recognition. As it happens time after time, it can be very damaging.

Recommendation 8: Set a continuous tone of accepting and including trans people, even if trans students are not visible. Act swiftly in response to any transphobia, don’t let it slide. Actively correct any misnaming or misgendering – if it’s you, apologise and move on quickly. Don’t make a big deal about it.

9. Use a person-centred approach

It’s all too easy to make assumptions about what is right for someone else, but really we are all the experts on our own lives, and trans people are no exception. When we think we know better than trans people we make the fatal mistake of thinking our lack of understanding is caused by a flaw in their thinking rather than a flaw in our understanding.

Remember also that trans people may be dealing with multiple issues – a higher incidence of autism, a higher incidence of mental health issues due to trauma, isolation and abuse, as well as all the other things people have to deal with in life. To misquote Dr Stephen Shore, if you’ve met one trans person, you’ve met one trans person.

Lee Gale Tweets: Best practice 11. Person centred approach - include trans people in decisions and solutions to best support them @Sam_R_Hope @emfec_team

Recommendation 9: Listen. Take the time to find out what feels safe and comfortable to the trans person. Don’t make assumptions, and don’t assume you know better.

10. No Gatekeeping

It is unbelievably hard to get treatment as a trans person, despite the fact that overwhelmingly the evidence indicates treatment for those that want it (not all do) is beneficial. This is particularly true for trans children.

Once a trans person gets to a gender clinic, they will still have a very long wait and face a lot of “gatekeeping”. During this wait, some may be suffering as their hormones change their body in ways they don’t want. Extra delays can cause real harm.

Let trans people, including kids, do their thing; it is likely to be harmful to put extra barriers in their way, or be resistant, disbelieving or disapproving. Some trans people experiment with identity before hitting the right formula – that’s okay too, there should be room for diverse self-expression and exploration. It’s healthy.

Lee Gale Tweets: Best practice 12. Most important if you ask me - Respect that trans people know their own minds & identities @Sam_R_Hope @emfec_team

Recommendation 10 : Just allow the trans person to live as they want to live, and make the necessary referrals as quickly as possible. Unless you’re a highly qualified expert on trans people, it is probably best not to make your own judgement about them or try to intervene in the process they are undergoing.

The Complexity of Identity

It was an odd experience, delivering trans awareness training at Nottingham Women’s Centre. I had spent many, many hours within those walls, and one thing you could always rely on was “man in the building” signs when somebody male was invited in for a meeting, training or other work.

“Should we put up “genderqueer in the building” signs?” I agonised, knowing I was walking into a building I am increasingly less comfortable NWCto be in.

The timing was strange – the very next day I would be starting on hormone therapy, a therapy that will probably in time make me look and sound more male. Since making this decision, I am constantly being challenged that I am “really a trans man”. I try to explain to people – I am currently read as a woman, but I am non-binary. In future, I may be read more often as a man, but I will still be non-binary. I may acquire some privilege for passing as a man, but given how out I am, my gender experience will continue to be complicated.

What complicates things further is that I have a lot of experiences in common with trans men, and don’t always want to be excluded from that category. This leads me to somewhat simplistic statements like “I’m a non-binary trans guy” or “I am masculine of centre”. At the same time I still feel a great deal of shared identity with women too. I do not believe there is a clear, neat line that divides our experience or sorts us neatly into boxes.

Gendered language was not made by or for trans people, and one of the key elements of this particular training was to look at how language limits our ability to tell an accurate story about ourselves. Trans language is evolving with our empowerment. We no longer speak about “sex change” and are more keen for people to understand we were always trans, that becoming more visible and/or congruent is not the same thing as becoming something we did not used to be.feinberg - crop

For non-binary people in a binary world this is a complex subject. While I was keen to centre the experience of trans women, who face the worst violence because of the double jeopardy of transmisogyny, the toxic interplay of sexism and transphobia, it was important to acknowledge they would not be the only gender variant people using the Women’s Centre. People like myself, who find ourselves in the uncomfortable no-person’s land between genders, may well find sanctuary there, as I once did.

I suggested to the trainees that we can often resolve conflicts by grasping a “both/and” principle and throwing out our belief in either/ors. “When I say I’m non-binary, for me that doesn’t mean I have no gender”, I tell them “for me personally, and this is different for others, I have a lot of gender, a complex relationship with both being a man and being a woman and sometimes something else entirely.”

Gender variance has always been treated with suspicion, and feminism has fought hard to normalise the idea of women expressing their gender in less constricted ways. As we explored language together at the training, we realised that “woman” is a wide category (“Ladies”, not so much). It is absolutely possible to include trans women and non binary folk who live predominantly as women (regardless of birth assignment) in the fold. Folks like me? Well, I don’t feel I would turn to women only spaces for support, but that’s a personal choice, and one I hope is never inflicted on anyone based on some constructed idea of how one should be a “proper woman” or “woman enough”.

The worst disservice is, of course, that gender variant people assigned female at birth have been pitted against trans women as if one or other deserves protection and inclusion but not both. But the truth is we all experience misogyny, or misplaced misogyny, in different ways and we all belong in the rather larger box labelled “those oppressed because of their gender”. The realisation is growing that the centre can be welcoming and supporting of a diversity of gender variant people, and that, rather than worrying about people forcing their way into the centre, which never actually happens, the true issue is that after a decade and a half of trans inclusion, the service is still very under-used by trans women, who are disproportionately affected by the very issues the centre is there to support, such as domestic violence and sexual assault.

Equally, gender variant folks assigned female at birth are also vulnerable. The isolation and marginalisation that comes with being transgender makes all trans folk vulnerable, and across the board within the trans community, we see increased issues related to assault, mental health, rape and childhood sexual abuse as well as domestic violence. People who feel woman enough to use a women’s centre should simply not have to worry that they will be quizzed at the door as to whether they should be there. For those concerned about safety, in all the years of trans inclusion, there have never been any incidents of cis men trying to gain entry to the centre for nefarious reasons by pretending to be trans. Cis men have other more direct ways, sadly, to violate women’s safety, and part of the learning here was to move away from imaginary panic-based scenarios and to focus on the facts of the vulnerability and need for safe space of members of the trans community.

But how do we deal with the reactions of other building visitors? Another concern. Well, how do we generally deal with people’s prejudices and put them at their ease? How did we get to the point that lesbians are accepted into women’s spaces? The process is no different here, one of modelling good practice and language, displaying comfort with trans visitors, and making trans people visible in literature and displays.

I put up a picture of Harnaam Kaur, picturedharnam right, to explore further. Harnaam is a cis (not trans) woman, but often in my training her image brings to the surface a lot of issues of prejudice – if this person wants to be a woman, I often hear, well they should make the effort to look like one. What does a woman look like? Well in this case, she looks like Harnaam Kaur, a Sikh woman who has decided to keep her natural facial hair.*

I’m thankful that the lovely workers at the centre get it, and show no prejudice. “This person is who they say they are”, is their response to the picture, and “we will use the pronouns they ask us to use and give them a welcome if they self-identify as belonging here”.

It really is that simple, a kind solution but also one that works. We struggled a bit with how to deal with non-binary folks, but in the end the solution is equally simple and elegant – if a non-binary person feels comfortable using the Women’s Centre’s services, which many of us, myself included,  wouldn’t, well then they can be there, because identity is complicated and in the end we choose the spaces and boxes and words that best fit us and avoid the ones that don’t.

With thanks to the open-hearted women of Nottingham Women’s Centre for their warmth and understanding.

 

*Edit: I used this image because Harnaam herself has desired these images to be used to challenge perceptions, and I chose a woman of colour rather than similarly bearded white women to bring into focus the issues of hairiness that exist for brown women. However, I have had feedback (from white people) that I am “using” a woman of colour’s story for my own purposes. I hoped I was educating people on diversity, but perhaps there’s some truth in that, so I have decided not to use this image again.

Learning from my elders

Image: yellow bell-shaped flower with red leaves behindI was told when I was a counselling student that teaching is by far the best way to learn about anything. This month’s learning was gained by delivering Trans Awareness Training to Age UK Nottingham.

The Trans Awareness part comes easily, obviously. Not only am I a lifelong (non-binary) member of the trans community myself, but I have spent years advocating for trans women, particularly in spaces that have not historically been friendly and welcoming for trans women. I wasn’t always a knowledgeable ally, I made a lot of mistakes on the way, but I learnt.

I am also married to a trans man, and am an active participant in my local trans community, and a seasoned campaigner. I like to think, and I hope, that I’ve been good at absorbing and understanding the diversity of stories the trans community has to tell.

But it’s easy to stumble when it comes to listening to our elders. Elders often speak in an older language and we think we know better. Elder trans experiences were forged in an environment unimaginable today, and so sometimes their experiences feel less relevant. When an older person tells me that transgender was just image: Alexis, 64, Chicago - a brown-skinned trans woman, close-up of her face“something she went through” on the way to being a woman, that she rejects the idea of trans as an identity to be proud and accepting of, I know her world is very different from mine, and that I must tune in hard in order to be sure I don’t dismiss what she is saying to me.

Because, particularly in the past, and particularly for women, transgender or transsexual has been a qualifier, a diminisher. When added to the word “woman” it was not a neutral descriptive adjective, but almost a negating one. Where “trans” should have simply stated what kind of woman you were, it instead undermined your woman-ness. No wonder so many people with a transgender history wanted to drop the adjective entirely, and simply be understood as men and women.

I remember, some time ago, speaking to a stealth trans man and telling him how different things are now – that my partner and I have had our struggles, but that we feel relatively safe to be out in our workplaces and in our social lives. Violence and harassment are not a thing of the past but things really are getting better.

My research teaches me how much things have changed, and changed because of pioneers like Christine Jorgensen and Lili Elbe, warriors and outlaws like Kate Bornstein and the late great Leslie Feinberg , campaigners like Press for Change’s Professor Stephen Whittle, and Stonewall veterans Marsha P Johnson and Silvia Rivera.

And it also teaches me how difficult things have been for so very long, and the reason why so many of us have hidden our trans nature until laterImage: Richard O'Brien - full length shot, he is wearing a classy pale skirt and wrap-top, high heels than we might have liked. I think Richard O’Brien’s story brings this home to me more than anything. This is the person who wrote the words “don’t dream it, be it” at age 31, and yet was unable to come out as a non-binary transgender person until the age of 67.

My training brings in the words of two contrasting trans women. The wonderful Alice, whose beautiful poetry I had the chance to hear last year at Brighton Trans Pride, speaks eloquently of her relatively late transition in her My Genderation film. Joanne Keatley, in this recent Daily Beast article, tells the other side of the story, What it was like to transition 50 years ago.

Both tales are mirror images – neither Alice nor Joanne were afforded the opportunity to be out in the open, free of hate and stigma, in their early lives. Both took a long time to find a community and I appreciate the idea of a trans community is still probably an anathema to many trans people who were sold the importance of being assimilated into mainstream culture and becoming as invisible as they possibly could.

I often reflect on how much luckier trans guys (a group I sort-of fall into) are for being relatively invisible, but I don’t think that invisibility is necessarily a good thing, nor is it exactly a privilege. It affords you relative safety from direct violence and harassment, but it is a condition that is inherently psychologically oppressive. To keep your head down and not raise your voice about just how much things need to change is suffocating. Both the closet and a stealth life may afford relative safety but neither are anything close to freedom.

Anyone who knows me knows my passion for intersectionality, the idea put forward by Kimberlé Crenshaw that the feminist movement is nothing if it does not take other oppressions, particularly the oppression of black women, into account. This is equally true when the trans community ignores ageism and how we might neglect and ignore the needs and stories of older trans folks that do not tally with our own.

A realisation hit me as I thought about trans ageing – many trans folk don’t expect to grow old, and if they do, they fear it. The health inequalities, compounded by poverty, assault, HIV, mental health and suicide, and difficulty accessing generic healthcare with a trans history, mean we  have a right to be worried, but the positive health outcomes for our treatment, both physical and psychological, are cause for optimism.

When we do think of ageing, we think of the disrespect and abuse sometimes afforded older, and particularly frail or sick, people. We think of how our trans status might compound this. We think oimage: red hawthorn berries against green leavesf how our sometimes unusual bodies may be treated and responded to when we are given personal care. We wonder how we will fare – whether we will be treated, housed and clothed according to our gender when we lose the freedom to make our own decisions, and we wonder if anyone will understand the vital importance of this.

As more and more of us come out and live our true lives before it’s too late, the necessity of making the world safe and respectful for our trans elders and our future selves becomes increasingly clear to me.

Nature and nurture and why it’s a bogus debate

Let’s talk about love, just for a second, because it’s kind of complex and unknowable and I want to make a point about complicated things being turned into dumbed-down theories . . .

[image: yellow heart-shaped leaf]

So, we know a few things about love. We know that it may be partially socially constructed (from Hollywood movies and songs, and suchlike) and partly biological (from hormones like oxytocin). We know that sometimes the concept of love is used in subtle ways to oppress women. I’m pretty certain, though, that if we saw it as only these things, we’d be accused of reducing something of value and importance. We might not really want other people’s definitions and theories imposed on our own experiences; love has a transcendent quality, that we “just feel” or “just know” in a way that can’t be reduced to biology or construction.

Can you see where I’m going with this? Yep, I’m drawing a comparison with gender. There are no proven definitions of what gender is, nor of where sex ends and gender begins, nor of how much gender is constructed and how much it is biology. Aspects of gender are oppressive, and for some, aspects of gender are valuable and meaningful. There is an endless and pointless nature/nurture debate over gender, and I’m getting a little weary of this unwinnable and pointless back and forth.

[image: book cover for Cordelia Fine's "delusions of gender" featuring a doll wearing a blue dress]Cordelia Fine, in Delusions of Gender, talks about the “sheer exhilarating tangle of a continuous interaction among genes, brain and environment.” Personally, I have something a little more pithy to say about the nature/nurture debate:

It’s both. Get over it.

What troubles me is when people turn their own experience of gender into theory they apply to others, without taking into account their own subjectivity. Often, folks who experience themselves as monogender tend to follow “nature” theories whereas more androgynous or genderqueer people tend to think of gender as less real and innate, more fluid – this would make sense for people who don’t have a profound inner sense of gender, but they are disregarding those who do, by muddling people’s genuine sense of who they are with something that has merely been enforced by society. It would be like someone who has never been in love telling the rest of the world love does not exist, or someone who has been hurt by love saying it should not exist.

ripplesSo some genderqueer or agender people assume theirs is the “real” experience and monogender people are somehow deluded; for them, gender cannot be real because they don’t experience it as real themselves. Monogender people are equally defensive of their own perspective, and can sometimes dismiss or cut across genderqueer or non-binary experiences, or say that explorations of social construction are deliberately eradicating of trans narratives.

When people disagree this much it’s probably because there are elements of truth on both sides, and a lack of empathy bridging the space between – the same thing happens with sexuality; bi people sometimes think that “everyone’s bi really” whereas gay and heterosexual people tend to be suspicious that people could (or should) really be bi.

If we move in our heads from “either/or” to “both/and” maybe we can breathe a little easier with this nature/nurture conundrum. Everyone can have their identities and we can still talk about gender oppression, and challenge our social constructions around gender. We can get behind deconstructing an artificially reinforced gender binary but still accept gender diversity and natural difference.

We don’t need to forcefully maintain gender or forcefully eradicate it. Here’s a truly radical idea – what if we simply accept people’s self-experience and self-expression, and don’t privilege or validate some identities over others? Biology may well be the dominant factor in some but not all people’s experience of gender. Having a strong sense of gender identity or not feeling gendered at all are equally valid individual experiences that could be natural or constructed or a mix of both. The individual balance of nature and nurture is impossible to measure. More importantly, “natural” does not make something more valid; if we learned the idea of love from Shakespeare that doesn’t make it meaningless when we fall head over heels.

We are all the sum of our nature and nurture and the result, however mundane or unique, should be accepted as authentic.

This blog was originally published by me here in 2013 and was a Wordpress’ editor’s pick