Whimsical, queer exploration of all things gender.

As someone who works on non-binary gender identities without unequivocally being an in-group member (though as previously discussed, it’s a little bit complicated), this is an important issue for me. There’s a long and unpleasant history, and not just relating to gender, of people speaking over the voices of groups they are not members of. Of speaking for or about people in ways those people did (or do) not like. This article is not a debate about whether this is a problem or not: it is. Recognition of privilege is something that everyone has a moral imperative to engage with – in part to simply avoid being an ignorant arse who doesn’t recognise hardships others face that they don’t, but also because oppressions are intersectional, which is best illustrated by the comic below – originally posted by Miriam Dobson here.

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However, whilst it’s a good rule of thumb to listen to in-group members telling you things about their group, especially when you’re not a member of that group, there are additional complexities that are worth recognising.

People within marginalised groups disagree.

This should be pretty obvious. Any population big enough to be associated with a social oppression (be that people of colour, queer people, trans people, women, etc.) is going to contain vast swathes of differing opinion. This raises two important points, that may seem a bit contradictory. Firstly, marginalised people can be wrong about things that pertain to the group they’re a member of. Secondly, issues can easily become complex enough that claiming there is a ‘right’ and a ‘wrong’ becomes simplistic or troubling all on its own. It’s important to add that the *possibility* of error on the part of a marginalised person doesn’t mean it’s okay for someone to use this to conveniently dismiss claims they don’t like. Especially those claims that come from direct experience. Experiences of different people can contradict, and don’t respectively erase each other. It’s a complex world we live in.

People new to marginalised groups don’t magically become experts immediately. Some never do.

I heard one transgender activist put it this way: ‘coming out is like saying you want to do a GCSE in maths, but then people start asking you advanced calculus all the time and expecting you to know the answer’. Each person is the authority of their own life. But that’s different to being equipped with an arsenal of political, academic, or activist language and nuanced understandings of what things can mean to different people. It’s different to an awareness of historical or cultural contexts, politics, precedents, or social structures. In some cases, it’s vital to remember that a marginalised person doesn’t need any of those things for their voice to still carry a weight and value that a non-marginalised person’s cannot – such as voicing experience. It’s also a problem to expect everyone to be an expert, as not everyone is or wants to be a scholar or an activist.

Whilst I would suggest most people don’t believe you need to be a member of a demographic to study a particular demographic, it’s a good rule of thumb that lived experiences trump theoretical awareness. Experiencing something doesn’t make someone an expert, but there’s a reason why many people who do experience an oppression do become experts – because they have a particularly powerful motivation to do so. We could of course ‘what does ‘expert’ even mean anyway?’ but that’s a different discussion.

Marginalised people can’t speak for all members of the group they occupy, because no-one can. But…

If a marginalised person says ‘we want this’ or ‘we experience that’, it is more likely to be a slight simplification, or a political statement with a particular purpose rather than something hugely problematic. Their social positioning to the political meaning of the statement is changed and charged by their in-group status.

Experiencing one oppression doesn’t mean someone is sensitive to other forms of oppression, necessarily.

You find racist gay people. You find homophobic disabled people. You find transphobic women. This can often have troubling implications, as if they’re highly politically motivated to fight for the rights and well being of their group, they’re almost certainly leaving someone out in the cold.

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Often, if a scholar does work on a particular group of people, and many members of that group take issue with what they’re saying, it’s extremely pertinent to listen to the actual people, rather than the theorist. This is illustrated rather perfectly not just by history (it was the highly qualified, expert doctors who decided that homosexuality and transgender were mental illnesses, no?) but also by the continued work hate speech of scholars polemicists such as Janice Raymond and Sheila Jeffreys.

Ultimately, knowing who to listen to can sometimes be a complex ethical process, dependent on collecting and processing lots of information. But if in doubt (or even if not, in fact), listening to voices of experience is your best bet. The devil can be in the detail where contradiction comes up, but this only heightens the importance of education.

The enormous extent to which the binary gender system has been enforced – which claims everyone can only be male or female –  has left many people unaware of the existence of anything (or anyone) else. A lot of this has to do with a phenomenon that sociologists understand as the ‘medicalisation’ of sex. Differences in gendered behaviour (whether that be a man doing ‘women’s things’ or vice versa), sexual attraction, or clothing choice became understood as sicknesses, best left to the expertise of a doctor -when before you would’ve called for a priest, or even more likely, not actually been all that bothered. Anthropologists in the 19th century gave fantastical reports of ‘exotic’, ‘alien’ cultures. These social models regarding gender and sexuality were unintelligible to people bound by the western model: that you could be a man (who was attracted to women), or a woman (who was attracted to men). And that’s that. Such ancient and enduring social systems which involve a third gender (or more!) and other ways for understanding sexuality that aren’t readily analogous to ‘gay’, ‘lesbian’, or ‘bisexual’ can be found all over the world, but it isn’t even these that I’m referring to in the title of this article. One doesn’t need to travel far to find hugely mainstream historical precedent for the concept of a third gender. How about one of the most important and influential civilisations in the western world? Ancient Greece.

I want to talk about a particular text, written by Plato. Student of Socrates, teacher of Aristotle, it’s fair to regard him as a founding father of philosophy. The text is a collection of speeches by different important Greek thinkers, written to reflect  each man delivering his speech to the others at a drinking party. This is Plato’s Symposium.

One of the speeches was given by Aristophanes, who was a comic playwright. He asks why is it that when in love, many people report feeling ‘whole’, as if previously incomplete? The explanation, he says, is due to how mankind used to be.

Humans were, according to Aristophanes, originally beings with two heads, four arms and legs, and two hearts, who were very powerful. Each head (and corresponding genitals) could be male or female – so there were three possible sexes! Male, where both were men, female, where both were women, and ‘androgynous’, where you had one male and one female. These powerful double-people decided to storm Mount Olympus, so to stop them Zeus smote them, tearing everyone in half. Each person then desperately tried to find their original pairing – which positions the male and female double-people as gay men and lesbian women, with the third gender representing what we would now label heterosexuality. This comic illustrates perfectly.

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This importantly demonstrates how a two gender system hasn’t always had the total monopoly one might assume it has. Whilst this doesn’t say anything about the thoughts had about gender by the everyday ancient Greek, it simply shows there was recognition of a third gender through stories, and there wasn’t any strangeness or moral failure or sickness associated with it. The same culture gave us Hermaphroditus, the neither-male-nor-female divine child, and root of the word hermaphrodite, often historically used to describe intersex people.

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Whilst the identity labels are new (the word ‘homosexual’ only being created in the late 1860s for example), all evidence shows that the rich human variation of gender identity and sexuality have been around for as long as people have  thought about themselves and who they are.

 

I like the word liminality. It’s a bit obscure, but really useful in certain contexts. Originally in reference to rituals observed by anthropologists, liminality is “the quality of ambiguity or disorientation that occurs in the middle stage […] when participants no longer hold their pre-ritual status but have not yet begun the transition to the status they will hold when the ritual is complete”. To be liminal positions you on the border of the definition of something, or on both sides. There is an uneasiness and a complexity to defining where liminal things sit, without a sense of ‘hm, yes, but…’.

It might be pretty easy for some people to see how this relates to sexuality and gender. In the familiar cultural process of coming out, be that as gay, lesbian, bisexual, transgender, non-binary, or anything else, there can be a period in which you’ve at least vaguely got to grips with accepting a label, but you haven’t told anyone. Maybe you don’t want to. Maybe it’s too scary, or dangerous, or complicated. So say if, like me, you came out as a gay guy. you feel that that’s what you are, so you don’t identify with ‘straight’ any more. But no-one else knows this, and if asked ‘are you gay’? there would definitely have been contexts where I would’ve said no. I was transitioning, getting to grips with things. My visibility as gay (and I’m not referring to my style of dress or other aspects of presentation) was nil. I wasn’t even out and proud in some contexts whilst not in others, so the identity label as gay didn’t hold any public significance to me at all. Because of my personal, internal processing of myself I didn’t fit as straight, but I wasn’t yet ready to take on a ‘gay identity’, and wasn’t ‘positionable’ as such by anyone. I was liminal.

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Some might argue that regardless of my self-awareness or comfort, I was always gay. I don’t think this is the case. There would’ve been times that I would’ve been very distressed or disturbed if someone had tried to convince me of this. Of course this is a product of heterosexist cultural factors,  which make camp, queer, or variant children prime targets not only for bullies but for social disciplining of adults and society alike (“boys don’t cry”, “only girls wear pink!”). Also to think about labels pragmatically, in the case of sexuality and gender, it can really foul things up when you try and force an essentialist definition of labels – that is, “if you do X, you are Y, end of story” – rather than considering how and why people label themselves the way they do.

Regarding gender, things can be more complicated, and non-binary people experience particular challenges. Because gender is socialised as very much ‘one or the other’, there is no way to obviously present as non-binary. Plus, there is no ‘one way to be’ non-binary either. Not that there is one way to be male or female, but because of how things are culturally coded, if pushed people can say ‘they have a masculine walk’, ‘that top is quite girly’, and conglomerate these things into an overall picture. People don’t even have to think consciously about it – made especially easy by the majority of people ‘doing’ their gender in ways that plonk them obviously into the categories of male or female.

Queer scenes  and spaces can mean that clothing and style choices especially can take on new significances, due to the knowledge and understanding people in these spaces tend to have, which means they read people in different ways. There are lots of different ways to have a ‘queer uniform’, but when you’re familiar with such spaces you might recognise dapper, AFAB individuals (or people you assume to be or read as AFAB) in jackets with bow ties, undercut hair dyed all kinds of colours. AMAB (again, assumed) people wearing makeup with an alternative style – who may not ‘appear’ to be gay men, but also not making it obvious that you should assume they are a trans woman and that you should use feminine pronouns. This highlights an important point that isn’t the one I’ve set out to make – that it’s dangerous to make assumptions about people’s genders (and therefore pronouns) and that presentation doesn’t necessarily tell you anything, especially in queer spaces.

The reason why I needed to set all that up in order to get to some personal reflection is this – I don’t really identify as gay anymore (gender, I’ll come back to). This is partly a conscious, social decision in that I don’t strongly identify with a movement that has become predominantly cisgender, white, middle class, and increasingly apolitical or, unrecognising of its comparative privileges. Racism, sexism, transphobia, body shaming, and homonormativity are all common enough for me to find alienating. Secondly, my queer relationships have made me critically engage more. I can be attracted to and engage romantically and sexually with trans men, trans women, binary and non-binary people. Does any of this mean I can’t identify as gay? No, absolutely not (or you’d be back to not only ‘if you do X you are Y’ but also ‘if you do X you CAN’T be Y’ which is shitty and breaks down very easily). But I feel much more of a resonance with the label ‘queer’. It’s a word that doesn’t pin a person down. It leaves ambiguity, in a way that I find to be confident, defiant, and mischievous.  It also doesn’t require me to have a clear cut understanding of my sexuality. I’ve thought about it to the point of exhaustion and came out now so long ago that I’ve in some ways stopped caring. The bottom line is that I’m not straight and things are a bit wibbly-wobbly-sexy-wexy.

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With gender (more complicated!) I’m more cautious. I will readily accept the descriptor of cisgender – I was assigned male at birth, I present as such and I don’t experience gender dysphoria. But my relationship with my gender isn’t entirely straightforward, as I’ve never liked the word ‘man’ or being identified with it, though not to the preference of being positioned into another category. The best way I can articulate it is that I don’t think I ‘feel’ gender very strongly. I don’t feel like I strongly identify with masculinity or femininity – much of the time. Sometimes I lean one way or another – or another, in that I might put on a shirt to ‘play up’ masculinity a bit because I know my partner likes it, I can enjoy expressing myself through drag (in a way that is more important and personal than simply ‘fun dressing up’), or I might feel like expressing myself in ways that aren’t so readily within the binary – for instance wearing foundation, mascara, and a red lipstick with my otherwise typical jeans and jacket, which I have only had then inclination and bravery to do publicly once. With pronouns I don’t have strong feelings about ‘he/him/his’ (perhaps paradoxically?) but I will also happily embrace singular they.

My muted experience of gender doesn’t feel like a nullness – I don’t feel that I am agender or neutrois. Could I be some flavour of demigender  – perhaps demi-agender or demifluid? I’m not sure. However, I am unwilling to position myself as not cis. This is in part due to the fact that I possess cis privilege. Even were I not to simply situate myself as a guy (I really detest referring to myself as a man enough that I don’t even want to write it!), I don’t experience fears and oppressions as a result – it’s entirely something internal (well, until I wrote this) and I wouldn’t want to appropriate or co-opt the personal and political struggles of transgender people. Maybe it’s that I don’t feel I’m ‘non-binary enough’ to dare to use another label. It’s also important that given the nature of my scholastic engagements that I wouldn’t be read by trans people as ‘strategically identifying’ in order to gain access to spaces or conversations, which would be disgustingly underhanded. There are also discourses of people being accused of identifying in particular ways out of an adolescent desire to be a ‘special snowflake’. This has been a very poisonous attack on non-binary people. However, when levied against particular otherkin community members – such as to internet subculture fame, the person supposedly identifying as a dragon who was upset about not being able to eat their mother’s diamonds – it may be seen as a reasonable criticism of younger people detracting from the legitimacy of transgender people’s struggles.

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I am lucky. I’m not shying away from a non-binary identity for fear of violence, or rejection, or even because of how difficult it would be to explain something to people I don’t really understand myself. I don’t identify as other than cisgender because I worry about what that would mean politically, and I’m not certain that I’m not. Ultimately what I am pretty sure about is that I’m queer, and occupy a blurry, uncertain borderlands regarding my identity. I still am liminal, in a new way to before. There can be a great deal of pressure for people to ‘know’ who/what they are. However there is no objective, absolute knowledge of the self! More important is well-being and happiness, which are my priority in preserving even as my life-long journey of self-exploration continues.

 

In case you didn’t know, Facebook allows for a user to fill in their own gender identity, rather than be forced to select ‘male’ or ‘female’. This is great news for everyone, including many people who ARE male or female. But what is meant by many genders can leave some people puzzled.

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Oliver Haimson et al. has gathered some data which shows what people who use the custom gender option actually define themselves as:

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Whilst the numbers total over 100%, that’s due to there being no restriction on how many gender identity labels a person can hold. It’s a good graph to get a rough sense of the identity categories that people are using. There’s also many categories where the differences may not be clear. What’s the difference between transgender and transsexual? What’s the difference between ‘trans’ and ‘trans*’?

Of course, the meaning of a label can differ depending upon who you’re talking to – different terms resonate differently with different people, and two people’s understandings may easily contradict, so there is never going to be an easy ‘factual’ list that can be referred to. Identity is a highly personal thing, and can only be defined by an individual. This post simply acts as a guide to give some basic explanation of these categories. Some labels may seem to overlap completely in one person’s eyes (say, trans man and trans male) whilst highlighting an important difference to someone else. I’ll be grouping some identities together due to similarity, but it’s important to bear this in mind and that of course, much variation can exist between people who may identify with the same gender identity. I’ll also explain some of the differences between some of the labels.

It is important to remember – gender identity is not sexuality! A person of any gender identity may associate themselves with any sexuality (though of course some may be more common than others. Whilst a cisgender man would not identify as a lesbian, a transmasculine person may have a more complex relationship with this identity for example).

This list is not intended to be authoritative or exhaustive. No-one knows your gender identity better than you yourself! If anyone wishes to expand or add in the comments section, please feel welcome.
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 Genderqueer/Non-binary

Often used as umbrella categories, these terms both refer to gender identities other than simply ‘man’ and ‘woman’ – people who exist outside of the gender binary. Neither tells you much about a person’s gender besides that they’re not (exclusively) male and not (exclusively) female. Some genderqueer or non-binary people may embrace or express masculinity, femininity, both, neither, a mix, or vary depending on time, place, or people – regardless of the gender that person was assigned at birth. The possibilities are practically endless.

Gender fluid/Bigender

Being gender fluid can mean that a person sometimes identifies as male/man, sometimes as female/woman, or sometimes as androgynous other non-binary identities. Similarly, people identifying as bigender may experience two differently gendered personas, typically ‘masculine’ and ‘feminine’ which may change. Whilst not frequent enough to come up on the Facebook chart, the identity of trigender may be used by people who can change between male, female, and non-binary identites too. Note that someone may potentially have more than two gender identities and still identify as bigender – a person cannot ‘identify wrongly’. It is simply what a person feels fits with their sense of themselves.

Agender/Neutrois

Sometimes also described or understood as ‘neutral’ or ‘null’, some people may experience these identities as an absence of any gender, or, subtly different, as a neutral gender identity that isn’t male or female. This doesn’t tell you anything else, such as whether a person identifies as transgender, or has any wish to engage with a transition.

Gender nonconforming/Gender variant

These gender identities are quite self-explanatory, and broad. These labels don’t share information about the person’s relationship with maleness, femaleness, masculinity or femininity – but that their gender expression may not fit with cultural expectations of their gender assignation. Someone identifying as gender nonconforming or gender variant may identify as trans, or may not.

Two spirit

A non-western gender identity, two spirit is an umbrella term for gender identities associated with the cultures of some indigenous North Americans, such as the Oglala Lakota (note: I say ‘cultures’ rather than culture to avoid conflating different tribes and groups, which are distinct). There isn’t a simple way to generalise, though historically two spirit people often engaged in work or cultural practices not associated with their assigned birth sex. Called ‘Berdaches’ (a problematic term no longer used, and considered a slur) by western anthropologists, two spirit people may identify with both male and female gender roles and thus be recognised as a third gender within indigenous American cultural contexts.

Transmasculine/Transfeminine

A transmasculine person identifies more with maleness than with femaleness, but may not necessarily identify entirely as ‘a man’ (some however, might – and use this label as an indicator of their position regarding masculinity). Likewise a transfeminine person vice-versa – identifies more with femaleness but not entirely as ‘woman’. In accordance with the ‘trans’ aspect of this identity, transfeminine people are assigned male at birth and transmasculine people are assigned female at birth.

Androgynous/Androgyne

This is an identification with the mixture of masculine and feminine presentation so as to be a mixture of the two, and ambiguous in gender presentation. The terms can be used quite broadly, however.

Other

What can be said here? Other. Something else. Gender unknown space unicorn. Being deliberately vague is often a deliberate political decision.

Neither

Not male or female. If you know the person well you may know more detail (though you probably shouldn’t ask out of idle curiousity). The individual themselves may not have a clearer definition than this – sometimes it’s easier to know what you aren’t than exactly what you are, and that’s completely fine.

Intersex

Intersex people, by arbitrary medical definitions, may not physiologically fit into the gender binary in one way or another (most commonly, through having what are termed ‘ambiguous genitalia’ at birth). Intersex infants may be surgically altered without their consent, in order to assuage the  gendered anxieties of parents and doctors. Some people who may be ‘diagnosed’ as intersex may identify as men, women, or other gender identities, whilst some may feel their intersex status is something they identify with.

Pangender

Whilst pangender may imply an identification with all genders, more usefully it can be understood as fluidly experiencing a multiplicity of genders. A FAQ can be found here – where it is also clarified that appropriation of gender identities from other cultures (such as two spirit, or hijra) isn’t okay.

Gender questioning 

This is the process of questioning or working out one’s own gender, and may not be a permanent identity – though there’s no set amount of time someone might do this for! A questioning person may not be sure of what they identify with, and might not come to an answer – which is absolutely fine.

Transgender/Trans/Trans Person/Transgender person/Trans woman/Trans female/Transgender female/Transgender woman/Trans man/Trans male/Transgender male/Transgender man

Transgender people are people who do not identify with the gender they were assigned at birth. Trans is a shortening of transgender. The differences between ‘man’ and ‘male’, and ‘woman’ and ‘female’ may be something an individual has a solid opinion on, or they may feel unconcerned about the implied difference, or not see one. By specifying ‘person’ in a Facebook gender identity, someone may be iterating that whether they identify as male or female or otherwise isn’t something they want to share there.

Trans*/Trans* Person/Trans* man/Trans* male/Trans* woman/Trans* female

Some people use the asterisk to specifically highlight they are using ‘trans’ as an umbrella term, rather than to refer specifically to (binary identified) transgender people. There have been discussions both for and against the use of the asterisk, further indicating how personal comforts are a big part of identity label choice.

FTM/Female to male/MTF/Male to female

Often used by binary identified transgender people, these identity labels are used as a shorthand way of indicating the gender the individual was assigned at birth, and what they currently identify as. The terms don’t necessarily imply ‘I was a man and I am now a woman’ for example, as many MTFs would also say that they were always women, simply assigned incorrectly at birth based on their genitals. Thus the implication of having changed from one thing to another is something some trans people have a problem with, whilst others still find the identity label useful.

Transsexual/Transsexual person/Transsexual female/Transsexual woman/Transsexual male/Transsexual man

Transsexual is now quite an old-fashioned term, most associated with medical language and discourses of the mid-20th century. Many trans people don’t like the term or may find it offensive, but others may embrace it, particularly older trans people. The term is also typically used in a binary fashion.  Transsexual females/women are women who were assigned male at birth. Transsexual men/males are men who were assigned female at birth. Some people make a distinction between transsexual and transgender based on whether gender affirming surgeries have been undertaken, but this isn’t very common and can problematically create some artificial distinction between men and women who have certain medical procedures and those who don’t.

Cis/Cisgender/Cis female/Cis woman/Cisgender female/Cisgender woman/Cis male/Cis man/Cisgender male/Cisgender man

Cis is simply short for cisgender. Cisgender is the ‘opposite’ of transgender, and is used to indicate that a person identifies with the gender they were assigned at birth. So if at birth the doctor exclaimed ‘it’s a girl!’ and that person grew up to say ‘yes, I identify as female’ – that person is cisgender. Some individuals have claimed this is a slur, which is nonsense – the term exists as a neutral way to talk about people who are not trans, without positioning cisness as ‘the normal’ gender identity, or that ‘man/woman = cis man/cis woman’, which is the product of cissexism.

For all she did, Brenda Howard is relatively obscure as far as queer heroes go – an injustice, given what she achieved.

Brenda Howard

A qualified nurse, Howard was born in New York in 1946, and throughout the 1960s was an anti-Vietnam war activist. She became active in LGBT and feminist politics – and was a distinct minority in all of these spaces as a bisexual woman. After the Stonewall Riots of 1969, Howard organised the commemorative rally one month later, as part of her activities within the Gay Liberation Front (GLF). This helped inspire the 1 year celebrations, also arranged by her, known as the Christopher Street (where the Stonewall Inn was found) Liberation March. This is still celebrated annually across the world today. It was also her idea to expand the celebrations to a week-long series of different events, nucleating all future Pride celebrations. She also was one of those responsible for the popularisation of the name ‘Pride’ for these events.

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Showing enormous dedication to social justice, Howard was chair of the Gay Activist’s Alliance. She also wasn’t afraid to get her hand’s dirty, as proven by her multiple arrests in the name of defending those trampled by an unjust establishment. She protested on behalf of minority groups beyond her own experiences of marginalisation.

Howard was arrested in Chicago in 1988, while demonstrating for national health care and the fair treatment of women, people of color, and those living with HIV and AIDS. She was arrested in Georgia in 1991 for protesting the firing of a lesbian from the state attorney general’s office due to Georgia’s anti-sodomy law.

If this wasn’t impressive enough, Howard also founded the New York Area Bisexual Network in 1988, and the first chapter of Alcoholics Anonymous specifically for bisexual people. She is also credited with aiding Lani Ka’ahumanu in getting bi people included in the 1993 March on Washington – where roughly 1 million people attended.

Howard also identified as polyamorous, and as part of the BDSM community – both strikingly controversial things to be public and proud about during the 1970s, 80s, and 90s. In recognising her world-changing work, PFLAG (Parents and Friends of Lesbians And Gays) created the Brenda Howard Award, presented for work done on behalf of the bisexual community.

Howard passed away from cancer on 28th June 2005 – by some small twist of fate, the date of the Stonewall Riots 36th anniversary. Her impact on a huge number of queer lives is important to remember.

The next time someone asks you why LGBT Pride marches exist or why Gay Pride Month is June tell them “A bisexual woman named Brenda Howard thought it should be”. – Tom Limoncelli

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Bisexual pride flag – image by Peter Salanki.

Dang is the creator of racistsofgrindr.tumblr.com – a site which allows submissions of screenshots of racially problematic encounters on the now infamous app, or similar. He offered me some of his time to talk about this issue.

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Click to enlarge. Montage credit: Dang Nguyen.

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Ben: Hi Dang, so tell me, where and how have you experienced racism in LGBTQ contexts?

Dang: Oh, well, it’s definitely most prevalent online and in hookup culture. I can’t speak for other orientations, but among MSM (men who have sex with men) you see it in people’s profiles as if it’s no big thing – “no Asians” or “no Indians” – or else in the way they see race first and a person second, whether or not they’re trying to be complimentary.

Ben: Do you think it’s more obvious as a digital phenomenon?

Dang: Definitely. It’s a cliché, but I do think it’s easier for people to be douchebags from behind a computer monitor. It gives us a sense of distance and helps us dehumanise the people we’re talking to, so we say and do shit we would never dream of doing in real life. So while a lot of people – I hope – would never verbalise their racism in the flesh, they feel perfectly comfortable doing it online because they can be reasonably confident they won’t get bottled for it.

Ben: What do you think of the defence ‘but it’s just a preference’, that can be used?

Dang: I think that the people who use it haven’t really examined its implications. Of course we all have our preferences, we’re all turned on by different things, but those things are informed by assumptions about those qualities to which we’re attracted. Some people like well-groomed men because of the assumption that they’re classy and genteel, while others like rugged men because of the assumption that they’re strong and masculine. I like well-read men who slow-dance because of the assumption that they’re intelligent and romantic. The same applies to race-pursuing, or dismissing someone based on their ethnicity. To do so is basically making an assumption about it, and in the case of Asian men, it’s assumed we’re effeminate and submissive. It’s even seen in those who are trying to turn it into a compliment. I’ve seen men describe Asians as being “smooth” and “cute” and “polite” – all terms denoting delicacy, infantilism and effeminacy.

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Dang: It’s also fucking stupid in that Asians literally come in every shape, size and colour, from dark Sri Lankans to the most moon-pale Korean, from a big-bellied paterfamilias in Mongolia to a lithe nymph in Vietnam. So it’s not an aversion to the way we look, it’s an aversion to Asianness and all the assumptions that go with it.

Ben: Do you think that most people who fetishise Asian men sexually have a broadly similar conflation of what it means to ‘be’ Asian in mind?

Dang: Oh, definitely! If they specify that they prefer Asian men, ask them why. What is it they like about Asian men? Nine times out of ten they’ll reply with some shit about how Asian boys – and it is almost always “boys”, never men – are smooth, or polite, or friendly, or humble, or some other absurd trope that continues the grand tradition of inscrutable, submissive, sexless Orientals who are never a threat to white masculinity.

Ben: So it’s tied up in a power dynamic, then.

Dang: Partly, although I don’t think it’s a conscious domination thing. I mean, I don’t think white men are sitting at home thinking up new ways to retake Hong Kong and conquer the Celestial Empire for its tea and porcelain, but there’s definitely a reason why so many relationships between Asian men and white men have a not insignificant age disparity, as well as the fact that the language white men tend to use about Asian men has pretty heavy connotations of, well, effeminacy (I keep using that word!) which in turn has connotations of weakness. So yes, I do think there’s a power dynamic there.

Ben: How about responses these guys give to rejection, or being called out?

Dang: In both instances, I’ve found that white men tend to dismiss the people who reject or call them out. They can afford to – whiteness is normalised and reinforced everywhere as being not just the standard or the norm, but the ideal, while Asian men occupy a spot near the bottom of the totem pole of desirability. So if one Asian out of five calls out or rejects their racist bullshit, they can just block him and move on to the next Asian, because a lot of Asian men aren’t as picky. They feel like they can’t be.

Ben: Is it just blocking, or does it ever result in abuse? i’m imagining the potential for guys to be affronted, as if by giving their attention they’ve offered a compliment, positioning you as ‘ungrateful’, for instance. I’m imagining a parallel with when men who compliment women will say things like ‘yeah well you’re ugly anyway’ after a rejection.

Dang: It can. I mean, rejection always hurts, no matter how much of a pig-ignorant punk ass douchewaffle you are. Mostly I just get blocked because I tend to be pretty belligerent, but I’ve had a few men deliver parting blows at my bitchiness. One even called me “a yellow”. He used the particle and everything, it was so retro.

Ben: You say the totem pole – do you conceive of a fairly clear hierarchy then? who is situated where? Can you say a bit more about the idea that Asian men feel they can’t afford to be picky? where does that come from? Especially given how it implicitly positions rejecting racially problematic overtures as a ‘pickiness’!

Dang: There’s a very clear racialised hierarchy of gay attractiveness. White men are at the peak, of course. Beneath them are Latino men. Beneath them in turn are Middle Eastern and Black men, with Asians and Indians at the bottom. There are other hierarchies of attractiveness – body type, clique or “tribe”, scene or fetish – but I’m not sure I’d be qualified to pronounce on those.The fact is that white men are wanted by everyone, including each other. Those who will express interest in Asian men are in high demand but comparatively low supply. Asian men, however, are rarely wanted by anyone. Low demand and comparatively high supply. So when one of the sought-after white men is willing to fuck an Asian man, Asian men jockey for attention. It’s no secret that Asian men – just like men of every other colour – often prefer white men over other Asian men. So an Asian man who is willing to write off a potential white sexual partner is seen as picky, because he’s turning down a chance to have sex with one of the coveted Caucasians.

Ben: What do you think positions Latino men above Black and Middle Eastern men? or indeed those groups above Asian and Indian men?

Dang: The cynic in me wants to say that the racial totem pole is formatted according to proximity to white aesthetic values, but again, I think it’s based on certain assumptions about race. We have the Latin lover stereotype, in which both Hispanic men and women are stereotyped as being promiscuous and passionate. Middle Eastern men have the benefit of being more likely to appeal to Eurocentric aesthetic tastes while retaining a sense of exoticism and Otherness (both in a way that can be fetishised and rejected) while black male sexuality has a long and horrifying history of being stereotyped as threatening, but also wild and exciting. Asian and Indian men both suffer from being seen as intellectual, polite and dispassionate – whitefaced geisha and smiling grocery store owners and short but wealthy businessmen and computer technicians.

Ben: What do you say to people who would argue ‘if you don’t like it, don’t use the app!’ or ‘you can just ignore those people!’?

Dang: I think that I shouldn’t have to make room for the shitty behaviour of others. I shouldn’t have to avoid spaces I want to inhabit for fear of being casually dehumanised. Besides, if I just grin and bear it, I’m basically normalising it as an acceptable status quo.

Ben: Do you think there’s any room for men of colour to use racial profiling to their advantage? Playing up to a fantasy in order to procure sex with someone they like the look of, for instance.

Dang: Oh, definitely. If they’re willing to stomach it, they could have frequent and satisfying sex by playing the role set out for them. Many do. I did for a long time, because I was convinced I wouldn’t get a man any other way. There’s something in Sartre about that, isn’t there? Protect yourself from being objectified by pre-objectifying yourself. Make yourself an obscene object and people lose all their power to hurt you.

Ben: Finally, if you had to give any advice to queer men of colour who struggle with self-image due to racist standards of attractiveness, what would it be?

Dang: Don’t take it lying down. Don’t accept things the way they are. Shout, rant, get angry, spit venom, throw a molotov. Try to make it so that no one else ever has to feel the same way you did.

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Dang Nguyen is a knot of serpents masquerading as a boy. His divinity has spent twenty-two years in its current mortal vessel, which resides in the principality of Melbourne, Australia. His hobbies include embroidery, literary analysis and the pursuit of ageless immortality.

Transgender people have, as a group, an enormous amount of awareness of the problems with accessing gender related support through the NHS. This post will highlight some of these problems. Below is a letter received in February 2015 from the Leeds Gender Identity Clinic, copied verbatim (including all errors, down to mis-spacings and grocer’s apostrophes). The quality of this letter is pretty dreadful, and prompted my critique and questions, to be found below the letter.

The numbers in square brackets are references for my points. Some numbers will repeat, indicating the same response to a repeat of a problem.

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Leeds Gender Identity Service

Frequently asked questions August 2013 [1]

Leeds Gender Identity Service is well established, around 20 years old and has evolved over the years. It is a dynamic process. Below are some frequently asked questions and our answers as they stand in 2013.[1]

1) What are the team’s views and commitment to the client group?

The service has a very committed multi disciplinary team. Fortunately all members of the team (Consultant Psychiatrists, Medical Practitioner[2], Endocrinlogist, Clinical Nurse Specialist’s[3], Occupational Therapist, Prescribing Pharmacist, Clinical Team Manager, Clinical Service Manager and the Team Administrators) Share the belief in the bio psycho social model[4] and its application within physical, mental, social and general health and Gender Dysphoria in particular. All members of the team believe in the recognition of Gender Dysphoria[5] and the need to facilitate and co ordinate gender reassignment in the safest and most effective manner.[6]

The service believe in mutual respect between service provider and service user, informed consent, capacity ,[3] guidelines and a flexible application accordingly[3] to individual needs are paramount to the success of an agreed outcome.

2) What standards of care are followed by the service?

The Harry Benjamin International Standards of Care have a well established and historical influence on standards of care which are considered worldwide, over recent times these have evolved into the WPATH, version 7, and standards of care for the health of transsexual, transgender, and gender nonconforming people. As a team we are mindful[7] of this guidance. The team are guided by the National Royal College of Psychiatrist standards; however these have not been ratified[8] are recognised by NHS England. The Gender Act, ICD10, DSM IV, Nice guidelines, Act of parliament 2004 and the policies of the trust including First Do No Harm all guide our practice.

The service has an active involvement in the development of the National standards of care professionals group. This includes other leading, NHS, Gender Identity Services in the UK. The purpose of the group is to define agreed, UK, baseline standards of care.

A proposed DSM V is due for publication; however this is still in draft format.[9]

The DOH[10] published guidance for G.P.’s[3] and other health care staff in May 2013. Leeds Gender Identity Service along with other NHS teams[11] were involved in the preparation of this document.

3) What is included within the care pathway?

The care pathway is guided by the standards of care which are stated above however has the ability to be flexible to meet individual needs. It includes all the stages of Gender reassignment, assessment, hormone treatment, social gender transition and surgery[12]. The service initiates the 2nd opinion and surgical referral but these are completed outside of the Leeds Gender Identity Service[13] therefore any waiting times associated with these are outside of our control.

4) What is the assessment?

The assessment stage takes up to 4 sessions (4 months) however a minimum of 2-3 sessions completed over a 2-3 month period could be agreed according to individual needs.

The criteria of the assessment is confirmation of the diagnosis of gender Dysphoria and exploring aspects of physical, mental and social health. Issues of eligibility and readiness to move into the next stage would be evidence based.

5) What is the social gender transition (SGT)?

Social gender transition is in its entirety approximately 2 years[14]. In order to complete an assessment of social gender transition the information gathered during this stage of social gender transition needs to be evidence based, this would include:

Living in role full time[15]

Change of name[16]

Some form of occupational activity[17] this could include voluntary work, paid employment, further studies or evidence of engagement/ daily living in the new role[18]. The service looks at occupational activity in the most flexible way and will agree with each service user how they will meet this requirement depending on their individual circumstances. If extra support is required by the service user a referral to the occupational therapist is available.

It is the service user[3] responsibility to collect this evidence. The team’s responsibility is to document it [19].

The hormone stage describe3d in question 6 would also fit into the SGT and will last 12months this would include a surgical referral once a positive 2nd opinion has been received.

Leeds Gender Identity Service is keen to learn from our experiences, working safely and flexibly within the care pathway to meet the changing needs of the client group.

For those clients who feel they are unable to live in full time SGT or do not wish to live in role at all in a specified area of their life e.g. employment ‘special circumstances’  this can be discussed with the clinician. If ‘special circumstances’ is agreed the following criteria must be met:

The client will be assessed as fitting the diagnostic criteria of Gender Dysphoria with a high level of confidence[20]. (In accordance with ICD 10)[3]

Psychotherapy opinion / treatment will be accessed and a detailed report provided to the Gender Identity Service supporting a referral for hormone treatment.

A 12 month plan will be agreed if appropriate to identify additional objective evidence for all other aspects of SGT can be ‘agreed between client and clinician.

6) What is involved in the hormone stage?

The service has an appointed Medical Practitioner, Consultant Endocrinologist and a prescribing pharmacist they are responsible for this stage of the pathway. The lead professional remains involved throughout the stages including the hormone stage. Close liaison with General Practitioner[3]/other professionals are a must. This stage could last for 12-18 months or significantly shorter in individual cases. While attending the hormone clinic Clients[3] will receive regular blood test[3] from their GP and blood test monitoring by the gender service, until such a time that it is safe to transfer all hormone treatment care to the GP including appropriate prescriptions.

7) What is the surgical stage?

Surgery stage:  2nd opinion is a prerequisite to a surgical referral. Once we receive a positive 2nd opinion a referral to the appropriate surgeon is initiated.  Any delays within this stage would be due to delays in variables[21] totally outside the control of the team.

The service will be responsible for referring clients to an NHS Gender Specialist for a 2nd opinion appointment however if individual clients wish to access private 2nd opinion appointments to speed up waiting times it will be the responsibility of the client to self refer or negotiate[22] this with their GP.

Leeds Gender Identity Service is happy to receive and act upon a positive, private 2nd opinion from a reputable[23] Gender Specialist at the appropriate time within the care pathway.

The service usually refers clients to specific identified surgeons however will consider referral to other areas if a client has a specific request and the CCG[24] are willing to fund surgery in the requested area.

Clients will need to have completed 12months,[3] full time, SGT before receiving a mastectomy and have received 6 months hormone treatment[25].

Breast Augmentation is not currently a core treatment[26] commissioned through Leeds Gender Identity Service; however clients can apply for this following completion of 18 months on hormone treatment[27] if there is clear failure[28] of breast growth. This treatment can be applied for through individual CCG’s via individual funding requests.

On occasions clients have requested orchidectomy surgery without a penectomy, the service will work collaboratively with clients to ensure the treatment provided is in line with supporting client choice and within the safety of clear clinical boundaries.

This would include:

Confirmation from the endocrine clinic that current hormone levels are safe, stable and within range.

And

A ‘one off’ appointment from an independent NHS gender Specialist is obtained.

8) How long will it take me to move through the care pathway?

The service follows a care pathways which can be adapted to individual circumstances taking into account transition which has already taken place before attending the service and specifically for those clients holding a Gender Recognition Certificate. An illustration of the pathway could be represented as follow:

The full process from start to finish around 3-4 years[29]

The shortest flexible process depending on individual needs could be condensed to 18-24 months; this has to be realistic taking into account waiting times for second opinions and surgery which are outside of the services[3] control[30].

9) How do the team keep abreast of new developments and ensure client safety and satisfaction?

The service is part of a wider governance group which include most other UK, NHS Gender Identity Service’s[3]. This group meets on a 6 monthly basis and shares views, takes learning’s[3] and discusses standards and guidelines within the area of Gender Identity.

The team are also part of the Specialist Services Clinical governance group within Leeds and York Partnership NHS Foundation Trust who meet on a quarterly basis and also have a team monthly Clinical Governance meeting where issues can be discussed in more detail. Clinical audits, rigorous clinical supervision, evidence based practice are all essential parts of our practice.

Service user feedback is an area which we have worked particularly hard on over recent years. We always provide clients with feedback forms following any new developments and we also ask service users to complete satisfaction questionnaires. Information taken from these forms is used to develop and inform practice in the service[31].

10) Will I get funding to access the service?

The service is commissioned by NHS England therefore potentially we could accept referrals from around the country. Individuals are funded for assessment and if appropriate core treatments which are funded by NHS England.

11) How will I know what is happening in the service?

The team have a specified lead in service user involvement she works alongside service user volunteers to produce a six monthly newsletter. The Newsletter will update all readers on any new developments within the service, will provide feedback on any completed service user feedback form and how this has informed practice and provide service users with an opportunity to display thoughts, feelings, poems or information to others!

The newsletter is posted out to all service users and is available in the waiting area.

You can also access the News letter via Leeds and York Partnership NHS Foundation Trust website.

12) What if I am discharged from the service but am experiencing a Gender related problem?

The service offers “one off” appointments to clients experiencing an issue they need to explore within the specialist service. To access this you will need support from your GP[22] so they can write to the team and ask us to see you. Again this will be funded by NHS England. The “one off” appointments may cover issues which are stated below:

“One off” assessment lasting for an hour n order to advise GP about outstanding problems and submit a medical (psychiatric) opinion.

A “one off” assessment lasting for an hour carried out by our Medical practitioner who is able to advise GP’s on endocrinology issues.

GP’s can also request “one off” extended full day assessment in complex referrals where specialist advice / recommendations are required.

13) How long will I need to wait to be seen once I have been referred?

The service is commissioned to see a specified number of new clients each year by NHS England[32]. Once we have seen these clients a waiting list will start to form for the next financial year. NHS England are kept informed on the waiting list on a monthly basis and will use this information to help identify new assessments to be funded on each rolling year.

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trans_symbol

…And now my bit.

[1] – Well, at least this makes it easy to identify as out of date. Major changes have occurred in the provision of gender based care (such as the release of the DSM V - an important diagnostic tool which actually redefined gender related diagnoses). An update is essential.

[2] – Wait. Only one medical practitioner? For the whole practice? This is alarming not only because of how understaffed it makes the practice appear, but also if any service user has a bad experience with that doctor, there is no-one else. The implication is that access to services all go through this one person.

[3] Grammar is hardly the most important issue here, but when I read an official document providing medical guidance, and it reads as if it was thrown together and not given a second glance, that translates into an uncertainty about the meticulousness and professionalism of the institute being represented. Such primary-school-level errors simply give an unprofessional air, and are easily avoided.

[4] Even with a biology degree I needed Google here, so they could really rephrase to be more user-friendly. How about ‘we understand that personal, social, and psychological factors play a vital part in experiences of gender, and do not seek to reduce service user’s needs to something purely biological’?

[5] – Um. Whilst this is clearly meant to be reassuring, it’s so basic as essential as to come off as alarming at the idea that anyone possibly might not recognise Gender Dysphoria in a Gender Identity Service. If I went to the GP for a vaccination and they said ‘don’t worry, I believe in these!’ I really wouldn’t feel better. There is a history of medical practitioners failing to respect transgender people’s agency, but this statement is hardly an effective way to gain trust.

[6] – I’m so relieved they clarified they wouldn’t do things an unsafe and ineffective manner. Pointless waffle.

[7] – ‘Mindful’ – this is so vague as to be useless. It implies they don’t actually have any external code they’re bound to follow, and can choose to ignore any guidance as and when they see fit. I’m not an alarmist, and I don’t for one minute think guidance would be actively rejected. But not referred to, in preference of one’s own considerations? I can see that happening. Especially as they go on to blanket name six other sets of policies, as if trying to universally appease without actually committing to anything.

 [8] – If not ratified, why chosen/used? I couldn’t easily verify whether this has changed since 2013, but practising with unratified standards seems like it requires explanation, at best.

[9] – This is simply out of date. The DSM V has been published, and this is a really important point. The service is potentially then misinforming service users who may not have much knowledge on the topic.

[10] – Explaining what an acronym is when you use it is widely regarded as a good idea – Department of Health. Should also get a [3] tag for not being ‘DoH’.

[11] – If they’re going to say this, they might as well say who.

[12] – This demonstrates how practice is still quite focused on a model of transgender care that emphasises the gender binary, heavily implying ‘one state of being to another’. It of course is fine for individuals who do feel this way about their gender, but is an approach that fails some of those trans people who are most invisible and marginalised within society.

[13] – Why?

[14] – It doesn’t ‘take’ any time at all, because this is an arbitrary and artificial measure created by the medical establishment. This functions as a method of restriction and control, again policing gender identity along arbitrary and binary boundaries. See here, here. and here for some further considerations, though it’s fair to say it’s a point of contention and much discussion, but lacking much research, especially that which emphasises trans voices.

[15] – Further absolutist, binary conception of gender. The very existence of bigender people blows this out of the water.

[16] – If a person is happy with their name, why should they have to change it? Once again ignoring non-binary people, this also ignores unisex names even amongst binary trans people (Alex, Charlie, etc.)!

[17] – The argument for this is to essentially force trans people into being exposed to the world, again to demonstrate a performance of seriousness and sincerity for medical gatekeepers. Whilst this is argued to provide time within which to learn about oneself and gendered practices, it is highly problematic. Not only the danger this puts people in who wish to and may not pass (before being given access to hormones and procedures that can significantly aid in this) but also for those trans people who may experience mental or physical conditions which makes these demands difficult or impossible. The validity of an individual’s gender identity is not dependent upon how that individual is viewed by others in society.

[18] – ‘new vs. old role’ – a dated, binary based requirement and phrasing that doesn’t work for many trans realities.

[19] – And judge what can or can’t count as ‘acceptable’ evidence, which is coloured by binary and cissexist positionality.

[20] – I went into the ICD (International Classification of Diseases) 10. As it was endorsed in 1990, it was no surprise that it still included ‘transsexualism’ and ‘duel-role transvestism’, and used wince-inducing terms like ‘the opposite sex’. There was no obvious mention of ‘confidence levels’ in relation to diagnoses. Therefore what this actually means, I have no idea and I don’t see how anyone else could readily be expected to either.

[21] – ‘Variables’. Nice and vague there. Such as?!

[22] – The expectation to do this is problematic if someone has a GP who is cissexist or transphobic. Which isn’t as rare as one would hope or expect.

[23] – What defines reputable? Obviously this isn’t easy, but such vagueness only serves to emphasise the position of power which the Gender Identity Service occupies. Obviously it’s vital that standards of care are maintained in private practice as well as state funded, but this wording doesn’t help anyone.

[24] – Clinical Commissioning Group. But everyone knows that, apparently.

[25] – No explanation as to why this is. Further relates to problems with the Real Life Test/Social Gender Transition (SGT) as it stands. Fails to account for those trans people who are very knowledgeable, secure, and stable in relation to their needs.

[26] – More unanswered questions. Why? Estrogen does stimulate breast development yes, but frequently produces small or even unnoticeable development. To create a hierarchy of gendered traits/procedures seems inherently nonsensical as what different trans people value and need for their well-being is obviously variable.

[27] – An excessive, arbitrary, and under-justified restriction. Whilst one can appreciate that with change being stimulated by estrogen, an immediate surgery around that time may risk complications, this absolutism runs contrary to the pledge to individual service user needs and desires.

[28] – And a further restriction. Who decides what, and at what size, ‘failed’ breast development is?

[29] – In true cissexist fashion, prioritising the intensely small minority of individuals for whom gender affirmation procedures are not appropriate, to the disproportionate suffering of a very large number of trans people.

[30] – It’s not the first time, but the service has very clearly distanced itself from responsibility for delays. Obviously this is a recurring problem which has invoked complaints and righteous demands for explanations. Are all of these interactions outside of the service strictly necessary? Could the system be made more transparent so that service users can see what aspects of the pathway causes delays? These are questions that trans people deserve answers to.

[31] – Might it be prudent for the service to also engage with transgender groups, so as to get informed guidance from members of the transgender population who aren’t in the (often stressful) process of accessing these services? Of course the feedback from service users is essential, but by no means the only resource available to them for the optimisation of their services.

[32] – This is of particular note. The idea that only a certain number can be seen, in a way that isn’t dictated entirely by resources (as different individuals require different amounts and types of time and care) but is decided upon in advance doesn’t make sense. It also emphasises one of the biggest problems at the heart of the insufficiencies of NHS Gender Identity Services – lack of funding. The number of individuals seeking aid is growing exponentially, and this remains unrecognised by funding bodies. This isn’t a criticism of the document per se, but highlights one of the more important frustrations with the larger system.

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