Archives for posts with tag: All About Trans

 

Former Church leader caught spreading untruth about healthcare for vulnerable transgender patients.

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David Robertson, former Moderator of The Free Church of Scotland

 

By Paris Lees and Sarah Lennox

In an opinion piece entitled: “Dare to debate this damaging idea that gender is a social construct”, David Robertson, a minister and former Moderator of the Free Church of Scotland, sought to justify his belief that Gender Affirmation Surgery1 is harmful by stating:

Professor Paul McHugh of the John Hopkins Medical School, one of the first in the world to offer gender reassignment surgery, now says the process is so harmful they have stopped doing them.

In fact, the opposite is true. As John Hopkins Medicine (JHM) made clear in 2016:

We have committed to and will soon begin providing gender-affirming surgery as another important element of our overall care program, reflecting careful consideration over the past year of best practices and the appropriate provision of care for transgender individuals.

JHM’s decision to offer the surgery reflects its “evidence-based, patient-centered” approach.

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Paul McHugh

Robertson also failed to note that Paul McHugh retired as director of the Department of Psychiatry at JHM in 2001. McHugh, 87, condemns current medical therapies available to the trans community on grounds of religious ideology: he also considers homosexuality to be an “erroneous desire” and supported California Proposition 8. He advises a fringe group calling itself ‘The American College of Pediatricians’, described by the Southern Poverty Law Center as a “hate group“, with “a history of propagating damaging falsehoods about LGBT people”.

SELECTIVE AND OUTDATED REFERENCES AIMED AT CONFUSING

Dean Hamer, scientist emeritus at the National US Institutes of Health, describes McHugh as using a “selective and outdated collection of references and arguments aimed at confusing rather than clarifying our understanding of sexual orientation and gender identity.”

Following a complaint made through IPSO, The Scotsman have made the following correction:

In an article entitled “Dare to debate this damaging idea that gender is a social construct”, David Robertson, of the Solas Centre for Public Christianity, wrote: ‘Professor Paul McHugh of the John Hopkins Medical School, one of the first to offer gender reassignment surgery, now says the process is so harmful they have stopped doing so.’ 

We have been informed that, although John Hopkins Medical School stopped carrying out genitoplasty under Prof McHugh’s direction in the 1970s, it has since reversed this policy and is now ‘fully committed to providing gender-affirming surgery’. An official statement issued in 2016 confirmed that the decision to resume this surgery was taken as the result of ‘careful consideration over the past year of best practices and the appropriate provision of care for transgender individuals’.  We are happy to set the record straight.

RIDICULOUS CLAIMS

Robertson did not make clear that his claim “One doctor said he was stopping doing such operations because they had an 80 per cent negative outcome” was based on a serious misrepresentation by McHugh of a 2011 study undertaken at the Karolinska Institute in Sweden. Indeed the author of this study, Dr Cecilia Dhjene has gone on record many times to debunk such misrepresentation. “It’s very frustrating!” she says.

I’ve even seen professors use my work to support ridiculous claims. I’ve often had to respond myself by commenting on articles, speaking with journalists, and talking about this problem at conferences. The Huffington Post wrote an article about the way my research is misrepresented … Of course trans medical and psychological care is efficacious. A 2010 meta-analysis confirmed by studies thereafter show that medical gender confirming interventions reduces gender dysphoria.

Nor did Robertson reference the numerous other studies (Murad M., 2010, DeCuypere, 2006, Kuiper M. 1988, Gorton 2011, Clements-Nolle K., 2006) that consistently show how access to gender affirmation surgery significantly reduces the risk of suicide.

Nor, indeed, did he mention the consensus among currently practicing gender specialists regarding the benefits of gender affirming surgeries (where indicated as appropriate according to the World Professional Association for Transgender Health’s current guidelines).

WORRYING TREND

Award winning journalist and equality campaigner Paris Lees said: 

This article contained serious misinformation, which may harm vulnerable people by discouraging them from seeking potentially life-saving treatment. It may also persuade confused family members to withdraw their support, right when the people they love need it most.

This article is part of a worrying trend to cite misleading, inaccurate and outdated evidence in an attempt to deny trans people their rights, driven by ideology. Why do they drag up discredited studies and ‘experts’ from 50 years ago when all recent evidence shows trans people do better with medical support? As David Robertson claims to be a man of God, I’m sure he’ll want to apologise for spreading such misinformation as soon as possible.

Indeed, a programme entitled ‘Transgender Kids: Who Knows Best’, broadcast by the BBC on 12th January 2017, showcased the views of Dr Ken Zucker and Dr Ray Blanchard, the basis of whose theories were developed in the 1970s and 80s. It gave very little airtime to widely accepted current best practice in relation to trans youth.

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Ken Zucker

Blanchard’s theories have been rejected by the World Professional Association for Transgender Health (the largest association of medical professionals who provide care for trans people) as lacking empirical evidence. Zucker has been accused of practicing conversion therapy on trans children. His Toronto Children’s Clinic was shut down by the Clarke Institute of Psychiatry CAMH in December 2015. CAMH’s medical director stated: “We expect CAMH’s services to reflect the latest and best practices in the field. We want to apologize for the fact that not all of the practices in our childhood gender identity clinic are in step with the latest thinking.”

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Ray Blanchard

The evening before the broadcast of this documentary, BBC Newsnight also called on Ray Blanchard to discuss the issues raised by it without revealing that he is a longtime friend, collaborator  and associate of Dr Zucker’s at CAMH Toronto.

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Jenni Murray, presenter of BBC Woman’s Hour

Another instance involves Dame Jenni Murray, whose 30-year reputation as presenter of BBC Woman’s Hour is widely assumed to be one of impartiality and reliability. In a recent comment piece for The Sunday Times she sought to cast doubt on the reliability of evidence for the incidence of suicide risk among young trans people. Giving credence to such doubts without reference to the substantial body of evidence from around the world that Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality could well put young lives at risk.

INACCURATE STATISTIC

Robertson’s piece contained many other misleading opinions.

For instance his assertion that “84 per cent of children who experience gender identity issues resort to their biological gender by the time they are in adulthood” repeats a well-known myth which Dr Helen Webberley – in line with many other current practitioners in the field – describes as an: “inaccurate statistic, which should no longer be used as a proof point in the argument against treating children with gender variance.”

Robertson also states: “Bear in mind that a transgender teenager is twenty times more likely to attempt suicide than a non-transgender”. What he fails to mention is that this figure applies only where children lack access to family and social support and/or appropriate medical therapy. When such social support is in place, studies show self-harm ceases to be an issue.

Recent studies have all reached the same conclusion of positive outcomes for children who undergo supported social transition and, where current guidelines consider appropriate, suspension of puberty with blockers.

DEFAMATION?

Perhaps David Robertson should also apologise for defaming John Hopkins Medicine. In a twitter exchange with Sarah Lennox, co-founder of AllAbout Trans, Robertson claimed that the only reason Hopkins had restarted provision of gender affirmation surgery was “because they have been threatened by trans activists”.

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Given that Hopkins themselves stated their approach as following “evidence-based, patient-centered care” and “reflecting careful consideration over the past year of best practices and the appropriate provision of care for transgender individuals”, Robertson appears to have put on record a prima facie libel against this world renowned medical faculty … that they bowed to pressure from a handful of transgender activists rather than basing their decision strictly on scientific evidence and best practice.

1Gender Affirmation Surgery is the term used by most current practitioners in the field as being more appropriate than the older terminology of Gender Reassignment Surgery

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THE ART OF BEING NORMAL

by Lisa Williamson

(David Fickling Books ISBN: 1910200328)

 

Artof BeingNormal

I’m so surprised and relieved at how much I loved this book. Surprised because I’ve learnt to expect little authenticity from non-trans authors who chose to include trans characters in fiction. Relieved because I don’t feel obliged to explain a long list of problems in a way which may be viewed as ungrateful or even deluded because … hey! … the author was trying to be positive.

Lisa Williamson gets it.

By any standards The Art of Being Normal is well-constructed. The main characters are developed beautifully so that you can’t help empathising with them. There is tension and pathos … it had me in tears at times … and a reveal which I must admit I did not see coming. It also deals movingly with some grittily unpalatable realities, not by any means all to do with being trans, while still being none the worse for a gloriously sentimental denouement.

It’s wonderful to be able to recommend a book which parents, teachers and young adults can be sure they are going to enjoy while at the same time finding an authentic portrayal of trans kids’ lives mostly filled with the same kind of concerns as their own.

The book is written from the viewpoint of two parallel narrators and the only thing which I found consistently jarring was that, once the narrator known as “David” had clearly revealed herself as Kate to Leo, the other narrator, Leo still refers to her as “David’ and uses the pronoun “he”. I’m not suggesting this couldn’t be justified by saying it might authentically have been the case. I do however wish that it had been used as a powerful teachable moment. The struggle to claim our gender identity experienced by trans people … the lack of entitlement … is something which I think few cisgender (non-trans) people grasp. As Paris Lees has written:

Research shows that the majority of trans adults got the memo we were trans at around 5 years old – a realisation most of us felt we needed to hide: “It soon becomes clear that to be different in this way is socially unacceptable and as such the most common response is concealment of their true feelings.” If we also know that 94% of people who walk into gender identity clinics are adults, that means, although the figure is accelerating, only 6% of trans children are currently being identified. In other words, most trans kids are suffering in silence.

Even Williamson’s blessèd publisher, David Fickling, describing in his forward how the book has “changed his perception of the world”, refers to “the boys in this book” despite one of the protagonists on the very first page making no bones about who she feels she is: “I want to be a girl”. Such misgendering may seem like a small thing to most people but to a trans child it is huge.

It probably shouldn’t surprise me either how some of the reviews of the book slip blithely into the usual clichés about “young people struggling with gender identity” (The Guardian), “a tale of a teenager’s struggle with identity” (The Telegraph) when this is so clearly not what Williamson’s book is about. Her characters give no sign of being anything other than clear about who they are. Her story is emphatically not about some imagined internal gender struggle taking place in a vacuum inside the protagonists’ heads. It’s about the struggles young trans people experience when dealing with the gender expectations mainstream cisgender society dumps on them. As such I think it’s a breath of fresh air.

One last thing … before writing this book Lisa Williamson worked at the Tavistock NHS clinic in London which specialises in treating trans children and I have to say I do find the rosy picture she paints of the ready availability of professional support for such children in the UK misleading. While we may assume things have improved somewhat, research only a few years ago found that 1 in 5 GPs are unwilling to help with referrals to gender services and 60% of those who wanted to help felt they lacked the information to do so.

For trans kids and their parents seeking support and advice on this topic, I’d recommend contacting Mermaids, GIRES or Gendered Intelligence. There’s good advice at NHS Choices  and a growing collection of great videos at All About Trans

 

Alex has stopped taking her medication. The other Alex–male Alex– lives in her mind, constantly jibing as fourteen-year-old Alex transitions.

9781922079237I’m reading a review posted at Lambda Literary about a young adult book called ALEX AS WELL already published in Australia and due out in the UK in May. Alarm bells are ringing. This is compounded by a PR release from the UK publisher in which the blurb states “ALEX AS WELL follows the story of Alex, whom doctors described as ‘sexually ambiguous’ when he was born” and then goes on to say that the author, Alyssa Brugman, “is not transgender, she doesn’t personally know anyone who is, so there’s no ‘expertise’ on her side, but she wanted to write a story about a teenager trying to find their identity and Alex As Well just ‘flowed’ out of her.”

The purpose of this blog is mainly to canvas opinion. I am transgender. I am not diagnosed intersex. I am also aware that intersex covers a wide variety. Below are my concerns but I would really like to hear from others … intersex, transgender and indeed cisgender.

The first concern I have … leaving aside the way the PR has conflated intersex and trans … is about the way Brugman has conceived Alex’s gender identity. Reading the first chapter I was immediately struck by how she has imagined Alex almost like Jekyll and Hyde so, while female Alex is buying makeup and being complimented on her bone structure, she is simultaneously bickering with male Alex inside her head, who is making dismissive jokes about boners:

The Clinique girl lays out the different products she has used on my face …
“You have really great bones,” she tells me, handing me my receipt.
One great bone, says Alex. I snort because it’s not a great bone, is it Alex? No, it’s just a teeny, weeny, noodle, you loser.

This device continues through the book. She writes of male Alex as a separate person who accompanies her wherever she goes:

Alex and I are waiting in the office …

My own view is that this may go to the heart of the profound dissonance in the way trans and cis people conceive gender transition. It’s perhaps the case that cis people with no familiarity about trans can only conceive trans in Jekyll and Hyde terms which would explain the endless fascination with transition, before and after photos and names … and indeed with the whole essentialist argument that you are always the gender you are assigned at birth and can only ever either present the ‘opposite’ gender by consciously acting or experience it as some form of dissociative identity disorder. I also suspect that it is this perception which drives the common cis assumptions that trans children will change their minds about their gender identity and those who transition with hormonal or surgical intervention are likely to regret as the result of some internal struggle between two conflicting genders.

Of course we all create alter egos to some extent in different circumstances. One of the major revelations during my own transition was the degree to which I discovered my identity belonged in the minds of other people. We present different faces to different people in our lives. But I think we’re pretty conscious of doing this and at heart we know who we really are.  Before transition I most certainly had a voice inside my head but not in the sense of having a split personality between male and female. It was a voice channeling warnings about the dangers of expressing my gender identity in the way that felt comfortable to me while not presenting in a way which cis society would find legible and socially acceptable.

I would welcome the views of intersex, trans and gender non-conforming (GNC) people on how their gender identity manifests. I’d also welcome the views of cis people on how they imagine a trans gender identity must be and whether familiarity with a trans* person has changed their perception.

My other concerns are specifically to do with how Alex’s intersex diagnosis and treatment are described.  Alex’s mother says Alex was “Sexually ambiguous” at birth.

The baby had a penis, but not a normal sized penis … They said the baby also had no testes, but ovaries, and we could have them removed later …

She goes on to say:

He had injections to replace his hormones … Then when he was four they changed from the injections to oral hormone medication to make sure he kept growing as a boy.

I profess no specialist knowledge about endocrine therapy in such cases but I have never heard of a child of four being prescribed what I assume are imagined as sex hormones. I don’t think it’s ethical even in a work of fiction to promote misinformation … if that is what it is … in an area already surrounded by so much ignorance.

I’d really welcome thoughts on this from anybody with bona fide information.

Finally authors of first person fiction of course invariably write from the POV of somebody quite unlike themselves. There’s also a very long history of writer’s co-opting trans and intersex as a metaphor for other things from Greek mythology through to Orlando by Virginia Woolf. Jeffrey Eugenides made a conscious decision not to meet with any intersex people before writing Middlesex, saying he:

… decided not to work in that reportorial mode. Instead of trying to create a separate person, I tried to pretend that I had this [physical feature] and that I had lived through this as much as I could.

However awareness has moved on and I cannot for instance imagine any white author today deciding to write about the experiences of a black teenager in our society without either having a lot of familiarity with the life of at least one black teenager or making sure they acquired this by research and then consulting constantly during the writing. This should surely apply to all marginalised groups although it never surprises me when people co-opt the experience of others without thinking to check their own privilege. There is much discussion in the trans community at the moment over Jared Leto’s role in the Dallas Buyer’s Club.  The character Leto plays was introduced into the plot as a dramatic device and neither he nor the makers of the film seem to have seen any reason to concern themselves in advance with how the characterisation would be viewed by the trans community. It’s this lack of awareness which of course we are doing our best to combat in a project I helped to create called All About Trans.

Alyssa Brugman is an established young adult author and, from what I’ve read so far the book is well written. The central transition device has been well received so far by cis reviewers describing it as “an amazing story, I was really impressed with how realistic and compelling this story was.” I do not imagine the author’s intentions in writing this book were anything other than good but even the best intentions can cause problems if there is not awareness.

 I’d welcome views on how to react to a novel such as this which may be dramatically satisfying but appears to have co-opted an intersex experience and in my view at any rate is far from realistic in its conception of the identity of a transitioning individual.

I am so thrilled to see Paris Lees top the Independent Pink List 2013 … and Jackie Green also in the top ten at number 8. This is exactly what we need … young possibility models (the term inspirational American actress, Laverne Cox prefers to role model).

The doyenne of UK trans activism, Christine Burns, pointed out recently that the older generation of out trans people were by necessity focussed on challenging the law in order to gain basic human rights. In the UK now … though sadly there’s a long way to go in much of the rest of the world … the focus has moved on towards effecting change in social attitudes. Paris and Jackie epitomise the way a new generation have been enabled by Christine and her contemporaries to emerge from under that smothering cloud of institutional discrimination and to demand the same respect as everybody else in an equal  society … in Laverne’s words, to live out their dreams publicly.

This to me is THE change which trans kids and teenagers, growing up now, and crucially their families need to see. I don’t think we can overestimate the importance of demonstrating to the parents of trans and gender non-coforming kids that … not only can their children be safe … but the door is now open for them to go on and lead fulfilling, indeed enviable lives.

I was particularly struck by a passage in a recent blog by trans activist and author Julia Serano on Transadvocate entitled Considering trans and Queer Appropriation. For me this sums up the assumption Paris, Jackie and other young volunteers have been working on with the All About Trans project:

The more highly stigmatized a group is, the less likely it is that the dominant/majority group will even attempt to appropriate aspects of their identity or culture, as doing so will only lead to them becoming tainted by said stigma. However, if the marginalized/minority group becomes more accepted over time, there will be less of a social price to pay for associating oneself with that group. Thus, as acceptance of the group increases, so do the chances that others will engage in non-EED (erasure, exploitation, and denigration) appropriation.

Paris and Jackie are smart, bright, admirable human beings who are not only living out their dreams but who enrich the lives of everybody they meet … by which I mean everybody … not just trans people (though maybe not the bigots who are on the wrong side of history). They don’t suffer bigotry and will complain when necessary but primarily the focus of their existence is positive … breaking down barriers and I’d go so far to suggest, winning over large numbers of people who want to know them, to associate with the trans ‘group’, even to appropriate a part of our magic.

There’s others on the list who are on the same path … for example Raphael Francis Fox and Lewis Hancox whose inspirational film company Lucky Tooth Productions is starting to attract attention … also musician and inspirational blogger CN Lester. None of them could be leading the lives they are without the work of previous generations of trans activists. There’s plenty to do yet before things are perfect but these are  not just the buds. They are the blooms of a new trans generation. I think it’s hugely appropriate that this year the Pink List celebrates this. There’s a place for handing out medals for long service but, as in any field, the winners of such medals are seldom heard of very far outside their own trade association or field of activity. Paris, Jackie and their generation are already making waves in the wider world and I am in no doubt that we are going to hear so much more from them.

Some are mentioned in the Pink List some are allies but, if I could make my own list of those who are doing the most to encourage the the next generation of trans kids, it would certainly include …
Mermaids (particularly chair, Susie Green, Jackie’s Mum),
Jay Stewart of Gendered Intelligence,
Sue Sanders and Tony Fenwick of Schools Out
Natacha Kennedy, who is dramatically changing perceptions with her papers such as:  Transgender Children: more than just a theoretical challenge

and the best allies ever Nathalie McDermott and Alana Avery of On Road Media whose innovative work with young trans volunteers on All About Trans is truly breaking the mould.

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