Whimsical, queer exploration of all things gender.

In the spirit of the international Transgender Day of Remembrance (20th November), I’ll be looking at one of the earliest 20th century events which helped to nucleate the organisation of LGBTQ movements and rights as we know them today.

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The occurrence I’m referring to was the Compton’s Cafeteria Riot of 1966. A full three years before the much more famous Stonewall riots, this riot occurred in August but the exact date is lost to history. The cafeteria was located in the Tenderloin district of San Francisco, known in part as a rough patch – so unsurprisingly, had large populations of drag queens, prostitutes, and other marginalised members of society. The cafe was open 24 hours a day, which made it a popular spot for the queer underworld to frequent in the small hours. This didn’t mean the management were sympathetic to their queer customers however. The management is said to have called the police to remove a group of queens from the premises, under the pretext of noisiness, and hanging around too long without spending very much. At this time, it was extremely common practice for the police to stop people visually judged as gender variant, as it would be most likely such individuals wouldn’t match the name or appearance of any ID they might have, allowing for easy arrests. There had previously been a history of laws in the US prohibiting cross-dressing, and whilst struck down in Chicago there was still a strong association culturally with perceived cross-dressing as being associated with fraud and ‘anti-social conduct’ – so-called nuisance crimes that were often used to arrest queer people.

So, the police were called, and they were used to dealing with ‘people like that’. But when trying to arrest the queens, one of them threw her cup of coffee in the officer’s face. This sparked full scale resistance – everyone started throwing everything they could get their hands on, and so the police called for backup. Chairs and tables started being thrown. The plate glass windows of the cafeteria were smashed. The fear and rage that the queer community had experienced a build-up of in response to long term, systematic abuses at the hands of the police finally overflowed. A police car was vandalised. A news stand was burned to the ground.

One would think that fighting of this scale would be easy to date when it’s still within living memory. However police recording isn’t archived that far back, and more tellingly there was no newspaper coverage of the riot. One of the earliest references to the riot was 6 years later, in the program of the first San Francisco gay pride parade, in 1972.

The night after the riot, the cafeteria would not allow anyone judged to be transgender (or a queen, or ‘people like that’) in to be served. This resulted in the new plate windows installed in the daytime to be smashed again.

So what was the impact (beyond chairs into windows)? The queers who rose up weren’t actually completely disorganised when this riot took place. Only a couple of months earlier an organisation called Vanguard had been founded by activist ministers of Glide Memorial United Methodist Church, a very liberal church (for the time in particular) who tried to help all marginalised members of the community. Vanguard was ‘an organisation of, by, and for the kids on the streets’ – a detailed revisit of Vanguard can be found here. Vanguard’s meetings were held at Compton’s, and many of the rioters were most certainly Vanguard members. The networking and sense of urgency that the riot engendered (pardon the pun) amongst the community took activism forward. 1966 was an important year in transgender history because of the publication of the book The Transsexual Phenomenon by Harry Benjamin, which argued from a medical position that transsexuality wasn’t something that could be ‘cured’, and that doctors had a responsibility to help trans people feel happy with the gender they identified with. Such post-riot networking and in the context of this publication led to the set-up of the National Transsexual Counselling Unit by 1968, which was peer-run.

Much of the work that exists on Compton’s was put together by Susan Stryker, author of the book Transgender History (an important reference for this article) and director of the 2005 film Screaming Queens: The Riot at Compton’s Cafeteria. In these works a great deal more social and political context is provided. However it is crucial to remember the impact of past struggles for basic rights and respect, along with the victims and warriors who have fallen on the path towards transgender liberation.

In the UK that is. I want to talk about that.

So let’s start by going back to 2004, when the Civil Partnership Act was brought about (well, gained Royal Assent anyway. The first actual UK civil partnership happened on 5th December 2005). I’m not going to talk about why it was a bad thing for there to be nothing in place for LGBTQ people before this (and all the rights it gave), but I will outline why it still wasn’t good enough. This isn’t necessarily all that obvious for a lot of people and deserves making clear. I’ll then move on to what the problems are that STILL remain with the new marriage set up! This is one of those rare instances when I hope that the contents of this post don’t age all that well. I hope I’ll be able to look back on this and think about how things have changed for the better. There’s all sorts of finickity angles this article could’ve taken, and a lot more to say. But it’s long enough as it is. I’ve tried to stick to what I see as core issues.

Many of the problems with the old Civil Partnership Act and the Marriage (Same Sex Couples) Act 2013 are due to their inability to account for transgender people, but we’ll get to that.

One of the most obvious ways in which the ‘separate but equal’ claim regarding civil partnerships vs. marriage is the disservice done to any LGBTQ person who might be religious. It was prohibited for civil partnerships to contain religious readings, music (such as hymns) or symbols. This is still the case actually, which is interesting given that not every organised religious practice (or even every organised Christian practice) opposes ‘same sex’ marriage – just certain major ones such as the Catholic Church, and the Church of England. Reformed Judaism and (some) churches following Quakerism for example were supportive of same-sex unions, but the government still deemed it a matter of law to decide how a civil partnership could be conducted in terms of religious content.

Okay, okay. So the government (eventually) recognised this was bad, so in 2011 after the Equality Act of the previous year, civil partnerships could now take place in religious venues – though in accordance with the protection of (homophobic) religious freedom, places of worship could not be compelled to conduct civil partnerships. However, the costs and administration created large and unequal barriers for willing places of worship to be positioned to legally conduct civil partnerships, even when they already did marriages, which makes… no sense.

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Credit to: https://www.flickr.com/photos/carbonnyc/ (under creative commons)

Arguably more serious though was the financial inequality that civil partnerships allowed. This video explains this very eruditely – how a widow or widower of a marriage was able to get significantly larger pensions as a result of their deceased partner, in comparison to survivors of a civil partnership ended by death. It also highlights that civil partnerships may not be recognised abroad in some countries, regardless of whether they have gay marriage or their own civil partnership equivalence, or not. Andrea Woelke (the chap in the video) also makes the valuable point that being in a civil partnership could put people in a position where they have to ‘out’ themselves when required to declare their marital status, which carries the potential to experience fear, or harm.

Whilst there are other bits and bobs that made marriage and civil partnerships fundamentally different experiences under the law, (such as the potential criteria for ending each type of union), the ugly problem of the gender binary within law is starkly revealed when looking at how the government chose to deal with marriage and civil partnerships in relation to trans people. Christine Burns talks about this, and also gives attention to the context of and interplay with the Gender Recognition Act of 2004 as well.

Up until the Gender Recognition Act (so pre-2004), trans women were still legally classified as men, and trans men were legally classified as women. The fact that people still are until dealing with the gauntlet of the Gender Recognition Certificate is not a discussion for here. What I mean to say is simply that until this time, there was no possibility of a trans person’s gender identity to be recognised under the law. This meant that a trans woman could legally marry a cis woman, because it was technically an ‘opposite sex’ marriage (and vice versa, with a trans man marrying a cis man). Many transgender people also would remain married after transitioning – rendering them legally married, yet for all visible social and personal purposes, a same-sex couple. However, the Gender Recognition Act coming in gave the government a problem – if these married transgender people could have their genders legally recognised (and therefore changed), marriages would start to exist between two men, or two women. Therefore it was made law that before a transgender person could receive a Gender Recognition Certificate, they had to divorce their partner. They could then get the GRC as a single person, and then get a civil partnership again afterwards.

It’s not like this is an immense hassle in terms of logistics? Or that it is deeply insulting or upsetting to have to do this to attain legal rights? Or that both individuals have to put the legal safety nets that marriage grants at risk in order to do this process? Except they do. And I say ‘do’ because this is still the legal status quo. Unlikely though it might be, if one partner died during the period of not being married or civilly partnered, it could quite obviously screw just about everything up. Especially if children, a co-owned or shared residence, life insurance, and pensions are involved. Whilst in theory that conversion process can happen within a day, this depends upon, as Burns puts it: “Lengthy meetings on the logistics of such a tortuous process indicated that if everyone had read the instructions and followed them to the letter, it would be possible”. But that’s a fairly sizeable ‘if’.

This is all also true the other way around. If say, you have a trans woman (legally considered male), who is straight (attracted to men), she could legally be civilly partnered. But in order to gain legal gender recognition, that would have to be dissolved first because heterosexual civil partnerships are still banned in the UK. As for how easy it might be for a trans person to have a religious marriage (rather than a civil one), within the Church of England this is apparently okay – though clergy do have the right to refuse to conduct such marriages as long as their church is still made available.

So this has brought us to where things are now. Yes, they introduced civil marriage, so now same-sex couples can get around the above stuff. Unless you’re trans where you still have to do that ridiculous get-divorced-to-get-recognised-and-get-remarried-again thing. HOWEVER. They have introduced a way for a member of a married couple to get their gender recognised without separating first. The same provision allows a civilly partnered couple involving a transgender person to simply ‘convert’ that civil partnerships into a marriage without separating first. This comes into effect on 10th December 2014. The big problems are first: if you are civilly partnered, you HAVE to change it to a civil marriage or split before anyone can get a Gender Recognition Certificate. Because no heterosexual civil partnerships, remember? Second: before a married trans person can have their gender legally recognised, their spouse has the right to veto this. Sarah Brown says:

So basically, if your spouse can’t, or won’t sign the consent form, you have to divorce them to get your rights. This creates what is possibly the most passive-aggressive legally sanctioned way to initiate a divorce ever, i.e. “I don’t want to divorce you, but I’m going to veto your human rights until you divorce me”.

Getting a GRC is a heavily involved process, and requires that a person has lived as their identified gender for at least two years. Pretty hard to do that in most marital arrangements without working out what the future holds for the relationship. As this article highlights, some partners are not supportive of their partner’s transitions, and may throw up roadblocks to try and prevent this from happening. Selfishly and delusionally hoping that by making transition considerably more torturous, their partner might decide ‘it’s not worth it’. This misunderstands transition in the same way that the government clearly has. It isn’t a choice like going on holiday, whereby not doing so makes you disappointed. Not being able to transition can cause enormous harm, or cost lives. The partner should not have any legal right to block this. Any relationship with healthy communication going on would either have already ensured that it’s fine and they’re staying together, or have already separated or begun separations. Or made a decision one way or another. This simply creates the possibility for spiteful, transition blocking action on the part of estranged partners.

Another thing there is to understand is that in the United Kingdom of Great Britain and Northern Ireland, marriage is a devolved issue. This means that England, Scotland, Wales, and Northern Ireland get to make up their own minds on what they want to be allowed. The first same sex marriages will be able to occur in Scotland on 31st December 2014, for instance. Northern Ireland however has decided not to allow same-sex marriages, and will treat same-sex marriages from other jurisdictions as civil partnerships… hopefully from having read the above, you can see obvious problems with this. Public opinion is almost a dead even split, but this shouldn’t really matter. Human rights shouldn’t be put up for a vote, especially when the ones voting aren’t the ones affected.

For as long as the unions between two (or more…?) people are bound up in legal and religious anxieties about the genders of the people involved, we will never have true equality. Don’t forget that as regards non-binary people, there isn’t a single official word on what they can or can’t have.

It’s a term some may never have heard of and others may have an inkling of the meaning, but it wasn’t until I did a little digging that I got some insight into the individuals who identify with this term. You might know that ‘pick up artists’ are guys who go about regularly trying to seduce women, perhaps with cheesy lines or a confident attitude. But it’s a little bit more involved (but not much, and in no good way).

Pick up artists, or PUAs – they really like pretentious acronym useage –  purport to use a range of (morally and technically dubious) techniques to increase their odds of getting given phone numbers, making out in a club, or getting someone to go home with them for sex. Learning these techniques and how to apply them is called ‘game’, and I’ll talk about the insidious misogyny even in just that name in just a minute.

One of the central ideas to many PUA’s ‘game’ is Neuro-Linguistic Programming, or NLP. Tellingly, NLP is actually pretty difficult to define because of how ” those who started it and those involved in it use such vague and ambiguous language that NLP means different things to different people.” Wiki’s simple statement on it is that “Its creators claim a connection between the neurological processes (“neuro”), language (“linguistic”) and behavioral patterns learned through experience (“programming”) and that these can be changed to achieve specific goals in life.” It seems to be a combination of two things. On the one hand, changing yourself and your mental processes through the use of language in a manner similar to self-hypnosis, and on the other hand, affecting other people in a similar sort of way to create a favourable situation for yourself. Which doesn’t in any way sound coercive or morally dubious. Nope.

It’s also quite crucial to note that Neuro-Linguistic Programming is now academically understood to be a pseudoscience. As this quote from the Annual Review of Psychology  highlights: “after several years of conflicting and confusing results, Sharpley (1984, 1987) reviewed the research and concluded that there was little support for the assumptions of NLP.” Being reviews of multiple pieces of research, this obviously isn’t a claim based on one simple piece of debunking literature, even though I only cite this here.

I mean, you can’t literally be this guy. But don’t be a pick-up ‘artist’. Please. If you happen to be the guy in the photo reading, you can be this guy.

The psychology underpinning the ‘seduction community’ ultimately rests upon claims that ‘nice guys finish last’. That to attain your goal of sex with women, you can (and should) take a systematic approach that will enable you to manipulate people and situations so that you can get laid. Doing this reduces women to puzzles or challenges that have to be cracked for the sake of male gratification. This isn’t a method that is sincerely offered as a way for shy men to overcome personal difficulties and establish meaningful connections, or even engage in casual sexual fun in an egalitarian and consensual manner. You have men literally competing to see who can collect more phone numbers, or advocating a ‘technique’ whereby a man is advised to grab a girl by the throat, put a finger to his lips, and go ‘shh’. Yes, this is part of ‘game’, for some at least. By calling these techniques ‘game’, it implies that sex is something that can be won, and that the process is all just fun, not serious, no real consequences.

That last one sounds pretty outrageous right? You may have seen the particular guy who sells this idea, Julien Blanc, in the news recently when he was forced to leave Australia after his Visa was cancelled, and his pick-up seminars cancelled.

That men like Julien Blanc are able to make a living from this also highlights another important aspect – the sad extent to which men are prepared to pay huge amounts of money to people who offer the ‘secrets’ of how to succeed with women, and ‘what women really want’. For a start it rests on flawed and highly simplistic (but also highly prevalent) assumptions that men and women think in intrinsically alien ways, and that all men and all women are two broadly homogeneous groups. Many of the devices used by pick-up artists (and really, I hate this term. There is nothing artistic about what these people do) explicitly buy into such narratives. For example, ‘negging’ – defined as a deliberate self-confidence undermining insult veiled as a compliment or offhand comment, designed to make women seek that man’s approval. Because that’s apparently what women do. The comic from XKCD actually captures the idea in its entirety.

Credit: http://xkcd.com/1027/

But people actually do this! Though whilst it looks like a joke, relatively harmless sleaze that no woman would fall for, many of the devices are less detectable. Like professional con-artists, devices don’t work so well if people can tell that you’re trying to be manipulative. You might not want to give this guy the YouTube hit, but this video discusses how to, in quite predatory terms, manipulate situations to allow men to touch and kiss women without worrying about that annoying little fundamental issue of consent. He also explicitly talks about how ‘it’s easier to work the situation around to touching and kissing her when you’re the one talking, but some women just won’t shut up. When they’re talking you [men] are thinking about how to get them to have sex with you’.

Whilst NLP has been debunked, whether or not any of the techniques used actually succeed in getting numbers, or sex, is really besides the point. The point is that thinking about women in this way is inherently sexist. Manipulating women in this way is inherently sexist. This is made all the more obvious by members of forums, or local groups (somewhat fittingly and creepily called ‘lairs’) actually discussing ways to shrug off the guilt. Some of these men convince themselves that it doesn’t matter because “The average woman is 10X, no 100X more conniving than the most underhanded, slimiest pickup sleazeball on the planet.” Others don’t even care, through either a complete lack of respect or empathy, being so engrossed in succeeding at their ‘game’ that they don’t actually stop to think, or some kind of Randian philosophy that rewards unapologetic self-interest.

I’ve framed this discussion entirely around men picking up women – because of social power relations between men and women, and the way in which power and sexuality are socially constructed, this overwhelmingly makes up the majority of ‘seduction communities’. However, at least one female pick-up artist exists, and has talked about her experiences and reasoning. Whilst unpacking this would take a lot more time and thought, I feel that the bottom line is that any kind of pick-up philosophy ultimately rests upon manipulation, and the idea of people being there as a resource for you to get what you want. Which is gross. I’m certainly not saying that people can’t enjoy casual flings, or making out in clubs and bars rather than simply looking to settle down in a traditional manner. But one shouldn’t – and doesn’t have to – craft a method around murky, underhanded, or abusive ‘tactics’ in order to connect with people sexually.

 

Hello kind readers, this installation of GenderBen! Sees a new book review – though somewhat different to the usual fare. Firstly rather than one of the usual academic-y books I normally cover, today’s page-turner is a novel, and quite a new one. Everything Must Go is the debut novel of La JohnJoseph, who from what I can tell is a tour de fource of queer, campy, radical, postmodern dadaism – reminding me in some ways of a modern day Rose Sélavy (though this comparison in no way means to collapse Joseph’s gender identity to the cis crossdressing of Duchamp). Supporting an artist whose work (and perhaps existance?) explores and fucks with gender is the reason why I accepted the offer of reviewing this work, and felt it would be relevant to your interests, dear readers.

Everything Must Go was released on the 25th March by ITNA press, and you can buy the kindle edition here and the paperback here.

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If you’ll forgive me by opening my review with a quotation from the work I’m meant to be reviewing, I think it sets the stage incredibly well in appreciating what you’re in for when you open this book:
“If you go about looking for sense, asking for logic, and putting your faith in reason, then you are asking for trouble and you will deserve it when two big thugs named Senseless Violence and Why God Why? drag you down and alley and beat you up.”

The narrative is tolld first person by the protagonist, Diana, and her journey to go about ending the world. How, why, and who with might be less important than you may think as this story is much less about what is said than how it is said. Diana and their view of the world is the grand constant. Practically any rule about time, space, place and possibility is broken, bent, or queered at some point along the line. Sex and violence are likewise turned inside out and upside down – queering morality as much as reality, so brace yourself if shockable.

This book has a surrealist streak unlike anything I’ve ever read before, which made it both interesting and memorable. However this does necessitate letting go of some of the fundamental qualities one may usually expect from a narrative, with little to no explanation of the surreal aspects of the story’s reality. This became one of the things I liked most however, as the casual, blasé way in which fantastical happenings were dropped into the descriptions of every scene added an additional cheeky, self-aware dimension to the (abyssally black) humour. This also made me all the more willing to utterly suspend reality, though this wasn’t for the sake of intrigues with the plot or the substance of the characters, but chiefly due to the beautiful use of language. Even when discussing rape and murder with a nonchalant ennui so confounding you can only smirk. Gobs of historical and cultural trivia are scattered around quite naturally that helped connect the world of the book to the recognisable. This was also aided by the delightful depth and variety in the descriptions throughout. I never felt like the range of situations and descriptions were self indulgent or random for randomness’ sake, which is impressive given how out there much of the content is.

On the back of the book, one of the comments reads “my brain feels completely sullied and violated. Do it again please!” Which is bizarrely accurate. Whilst still reading I felt like the experience that was this book might be somewhere between a stroke and an orgasm. It’s certainly horizon-expanding. Totally bewildering, definitely. I think it’s fair to say as well that a good number of people may hate this book. However, I imagine that the people who love it are amongst the most interesting, queer, and fabulous. This book was indulgent and a joy to read, if sometimes unbridled and uncomfortable!

Chances are, you haven’t heard of this guy. He’s a bit of a historical badass though, and I shall explain why.

Badass except for the comb-over, perhaps. 

This gentleman is often considered to be the world’s first gay activist. We’re talking about activism that happened over 100 years before the Stonewall Riots, many decades before the word ‘gay’ came to have any connection with same sex attraction… and before the word ‘homosexual’ was coined.

Karl Ulrichs was born in 1825 in Hanover, what is now North-West Germany. Like many queer men, records show that Ulrichs engaged with ‘female’ toys, clothes, and had more girls as friends as a child. He graduated in law and theology when he was 21 from  Göttingen University. He then studied history in Berlin before becoming a legal advisor in 1848. He resigned in 1854 to avoid being dismissed or disciplined for his homosexuality – which was known about – and although not illegal at this time in Hanover, it was a problem because he was a civil servant.

Ulrichs was so self-aware, that despite the lack of words existing to describe his same-sex attractions, despite a total social invisibility beyond disapproval and punishment, he actually created new words to use to describe himself, and identities we now recognise today.

The word Ulrichs coined was ein Urning, which was adapted from German into English to be Uranian. This was in 1862, when he came out to his family and friends – and seven years before Homosexual was used in a published work, by Karl-Maria Kertbeny (a lot of pretty cool people by the name of Karl at this time, it seems). Ulrichs considered uranians like himself to be members of a ‘third sex’, people who had a ‘female soul trapped inside a male body’ – because Ulrichs made the assumption that love and attraction towards men was a somehow female quality. This conflation between what the ‘gender of your soul’ was and the nature of a person’s sexual attractions means that by today’s standards, discussion about people who would now be termed gay and discussion about people who would now be termed trans are rather difficult to disentangle, as neither groups of people had been really defined by anyone. This was the start!

‘Sodomite’, the only descriptor that really existed before this time, specifically only described men who committed the act of sodomy, so said nothing about any (shared) sense of identity. What’s more, Ulrichs, Kertbeny and a very small number of others were the first to put forward that same-sex attraction wasn’t ‘wickedness’, and was something people were born with. This idea connected sexuality with biology, unfortunately leading to consideration in medical terms – and the conception of homosexuality as a mental illness. One can be confident that Ulrichs would’ve been unlikely to conceive of himself or his fellow urnings as ‘sick’, but this was the homophobic social development that occurred as popular consensus shifted from a spiritual understanding to a ‘scientific’ one.

Furthermore, Ulrichs was brave enough to come out publicly – in front of the German Association of Jurists – in *1867*. This was only four years before Paragraph 175 was introduced in 1871 – the German legal provision that criminalised homosexual activity right up until 1994. Paragraph 175 came about throughout the new German Empire (German unification occuring in January 1871) because homosexuality was already criminalised in old Prussia. Ulrichs fought bravely to avoid the instigation of this paragraph, using arguments that homosexuality was an innate quality with a biological basis, which flew in the face of contemporary thought. He was also rational enough to modify his position over time as his thinking on sexuality developed. In 1870, Ulrichs published Araxes: a Call to Free the Nature of the Urning from Penal Law – an essay that stated:

The Urning, too, is a person. He, too, therefore, has inalienable rights. His sexual orientation is a right established by nature. Legislators have no right to veto nature; no right to persecute nature in the course of its work; no right to torture living creatures who are subject to those drives nature gave them.

The Urning is also a citizen. He, too, has civil rights; and according to these rights, the state has certain duties to fulfill as well. The state does not have the right to act on whimsy or for the sheer love of persecution. The state is not authorized, as in the past, to treat Urnings as outside the pale of the law.

Demonstrating the powerful tone he was capable of striking. Throughout his life Ulrichs wrote prolifically, though found limited support. Generally funding and publishing his writings himself, he found his work banned throughout Saxony and Prussia pre-German unification. In 1879 he relocated to Italy, where he died in 1895. The spirit of this man is captured beautifully by this quotation:

Until my dying day I will look back with pride that I found the courage to come face to face in battle against the spectre which for time immemorial has been injecting poison into me and into men of my nature. Many have been driven to suicide because all their happiness in life was tainted. Indeed, I am proud that I found the courage to deal the initial blow to the hydra of public contempt.

 

Below is my PhD proposal, which has been accepted to start later this year. I am going to be looking into problems that exist within medical policy and the medical establishment that unfairly hinder transition.

I am a cis (queer, but cis) white male, and I want you to believe that I recognise how problematic it could be, me trying to do this kind of work without having directly experienced the relevant issues myself. This is why it is going to be of utmost importance to me for this project to be lead by trans* voices. Not to just go around begging for interviews and treating people like data and stats. I intend to earn and keep the trust of anyone and everyone who agrees to work with me in the course of my work over the next few years.

What’s my motivation? Other than the obvious anger anyone who knows even a little bit about systematic cissexism should experience with regards to legistlative and policy structures, my best friend was an incredible trans man who I was very close to, but tragically he took his own life. Also I have been privileged in supporting my (now ex) long term partner through his own transition some time after this.

Bottom line is: please be in touch if you have anything to say about this project. I will take all criticism/encouragement/suggestions very seriously, as my cis-privilege means I should. Do feel free to pass this on to anyone you may feel would be interested, and follow this blog for further updates on this project – most of which won’t take off until October or afterwards, but yeah. So below is my proposal, as it was accepted:

Female to Male Transgender Transitions through the NHS – Addressing Policy Problems

There is no reason why psychiatrists and other mental health professionals cannot be charged with the responsibility of recognizing gender-identity issues without the necessity of labelling them as disorders.

Gianna E. Israel and Donald E. Tarver in Transgender Care: Recommended Guidelines, Practical Information and Personal Accounts

Research Context

Transgender people often experience an urgent need for medical treatment in order to facilitate a transition in gender presentation. Whilst data is lacking, it has been estimated that suicide risk in post-operative trans people is potentially seventy times higher than the risk for the overall US population (Haas et al. 2011), and suicide risk has been estimated at 19-25% for those seeking surgical gender reassignment (Dixen, Maddever, van Maasdam, Edwards, 1984). Whilst distress for trans individuals may result from the dissonance experienced between the mental and physical self (characterised as gender dysphoria), lack of support, as with any serious personal issue, may have an extremely detrimental effect on the individual’s ability to cope with their situation. This research will address medical (and legal) policy in the UK regarding transgender transition for AFAB (assigned female at birth) individuals. The reason for this particular focus is that treatment routes and transition difficulties are extremely different depending upon the direction of transition, and this focus will allow for both a wider consideration of AFAB experiences and greater depth of analysis. This research is particularly timely due to the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) being due for release in May 2013, which should have some ramifications for how gender identity dissonance is addressed clinically.

Currently there exists no specific gender and sexuality minority training as part of UK medical degrees or clinical training. This leads to primary care physicians often being ill-equipped to deal with the needs of trans patients – and in some cases directly doubting or dismissing the patient’s needs, resulting in risk of harm. Of the knowledge of transgender issues amongst the primary care medical population, much is extensively pathologising. This is due to the historical status quo of the power dynamic between doctor and patient, whereby medical ‘expertise’ trumps lived experience and identity (Cohen-Kettenis and Friedemann, 2010). Similarities can be seen with the discourse generated by the reversal of knowledge/power relations between the medical establishment and HIV positive gay men in the 1980s, who also often had a more detailed grasp of their options and needs than their physicians did (Weeks, 1990). However, a key difference is the grassroots push towards recognition by the medical establishment that trans* identities are not inherently pathological – as reflected partially by the upcoming revisions to theDiagnostic and Statistical Manual of Mental Health Disorders (DSM-V). ‘Gender Identity Disorder’ will henceforth be understood as ‘Gender Dysphoria’, and ‘Transvestic Fetishism’ as ‘Transvestic Disorder’.

Relating to the Literature

Whilst the crux of this project will be the analysis of qualitative data generated by interview schema (as detailed in the methodology section), it will be important to further contextualise individual’s experiences in terms of queer theory. This will provide evidence of the extent of cissexist positions and behaviour within gatekeepers and other positions of social authority, and the social context of how this has come to be the case. Cissexism (the belief and treatment of transgender people as inferior to non-trans people) within society has already been considered by such important authors as Julia Serano and Riki Wilchins. It is also important to consider that in the formation of policy concerning gender and health, a binary model of gender is likely to be utilised, which may not provide recognition of the identities of all individuals who wish to transition (Bilodeau, 2005). The way in which any individual’s behaviour patterns (such as a doctor to a patient) are externally effected will depend upon the local cultures, geographies and other individuals they find to be their environment (Stevens 2004). A nuanced understanding of this may be aided by consideration of Social Identity Theory (Tajfel, 1981) and concepts such as dramaturgy – The idea that human actions are dependent upon where, when, and with whom they occur (Goffman, 1959).

Feminist epistemology will be used to address the intersection of patriarchal oppression (particularly when presenting as female) and trans identities, such as with the ‘border wars’ of butch lesbian, transmasculine and trans male identities (Halberstam 1998), transition from one group to another and how this can impact upon support networks and involvement in (for example) female-only spaces.

Research Questions

A key question of the thesis will be how and why did undesirable scenarios experienced by trans men happen? It is recognised that demand is greater than supply regarding appointments with NHS gender identity clinics, with 22% of users in October 2006 of the Charing Cross Gender Identity Clinic waiting over a year for a first appointment (Reed, Rhodes, Schofield and Wylie, 2009). Patients are required to have two meetings at such a clinic before being granted access to hormonal treatment, and the desperation and loss of morale that can accumulate in this time can result in risky self-medication using the internet to purchase hormones, self-harm, and suicide. The research will explore the space that exists between medical claims that may exist for the importance of the current framework that governs these appointments and the demands for improvement and change vocalised by the trans male population.

Other questions include asking to what extent may dissatisfaction with the medical establishment be a lack of detailed understanding of well founded (as opposed to well-intentioned but ultimately flawed) commitment to the well-being of patients? To what extent is the current medical establishment policy built on subtle cissexist assumptions and responses? A common argument for example, for the extent of hoops that need to be jumped through is that treatment with testosterone has certain irreversible physiological changes, and that protection must be offered to those who may ‘change their minds’, and be later caused distress and dysphoria by the retrospective treatments. The cisgender (to hold the same gender identity as was assigned at birth) perspective of how traumatic it would be to have one’s physiological gender markers (voice, fat distribution, breast tissue, musculature, etc.) altered in an undesirable way is arguably given a greater sense of importance than the provision to the treatment of trans people is (Taylor, 2010). It is considerably easier for a cis person to empathise with the former hypothetical scenario than it is with a trans person’s lived experience. The negative impact of undesirable physical traits is not at issue, but the insidious way in which what one is born with (or without) can be afforded a privileged position over the need for change.

 

Methodology

This project will have a multi-faceted and interdisciplinary approach, utilising both empirical data and queer theory to synergistically explore the reality of trans experiences and the political and social frameworks within which these exist and are shaped. The precedent for transgender activism leading to a revision of policy is the framework upon which I will build this thesis. Through qualitative methodologies such as semi-structured interviews and surveying, I will collect and analyse accounts of trans men’s experiences with both NHS and private medical establishments, paying particular attention to delays and dissatisfactions with prescription to testosterone and approval for surgical procedures.

Whilst the focus of this project would be the experiences of self-defined male experiences, I believe it is also important to cross-examine such data with the experiences and knowledge (or lack thereof) of both primary and secondary care medical practitioners regarding their practice and knowledge of both transgender treatment provisions and what may be termed political considerations, such as pronoun usage and the phrasing of questions, and their necessity and appropriateness. Collecting qualitative data from staff who are involved with any of the administrative processes which dictates a trans person’s trajectory through medical systems may also prove valuable, though whether this direction is taken or not may be informed by information gathered from trans reports. Recognition and treatment of those AFAB individuals with non-binary gender identities is also to be involved. Whilst medical transition processes and lived experiences do vary in a clear and divisible way based on assignation at birth (before consideration of intersexed individuals at any rate), the social model of binary genders is being increasingly recognised as a dissatisfactory lens through which to view the wide spectra of queer identities which have gained visibility over the last fifty years (Hubbard, 1996). It is a common conception by many trans people that in order to achieve the (variable) desired end-goals of engagement with the medical establishment, a favourable narrative may need to be constructed in order to be considered ‘right’ (Rubin, 2003).

Policy Implications

“I just want a therapist who ‘gets’ me. I don’t want to have to explain gender, sex, and all that other stuff. I have been to so many therapists where I have to educate them. I have to tell them first that I am not a ‘freak’. Then, I have to make sure they feel comfortable. And then we get down to my real issues.” – Luke, 21 year old transgender man

Handbook of Multicultural Counselling Competencies, Erickson Cornish J. A. et al.

The ultimate goal of the project is to offer a rigorous academic approach to both assessment of the efficacy of systems designed to alleviate suffering, whilst also exploring important questions of identities and power. The ramifications of such work would hopefully lead to policy review such that trans voices and experiences are better heard by medical establishments. Systems for recognising cissexism in policy (or where it could be enacted by free agents in positions of authority) can be created and used in protection from and prevention of cissexism, for transgender populations. This work will provide a rigorous, empirical approach to policy formation that will help provide a greater voice for an often poorly understood minority, undeniably improving lives.

References

Biloeau, B. (2005) ‘Beyond the Gender Binary: A Case Study of Two Transgender Students at a Midwestern Research University’, Journal of Gay and Lesbian Issues in Education, Vol. 3, Issue 1

Cohen-Kettenis, P. T., Friedemann, P., (2012) ‘The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults’. Archives of Sexual Behaviour, 39:499-513.

Erickson Cornish J. A. et al. (2010), Handbook of Multicultural Counselling Competencies, John Wiley & Sons.

Dixen, J. M., Maddever, H., van Maasdam, J., Edwards, P. W., (1984). Psychosocial characteristics of applicants evaluated for surgical gender reassignment. Archives of Sexual Behaviour, 13(3), 269-276.

Goffman, E. (1959), ‘The Presentation of Self in Everyday Life’. Anchor books.

Haas, A. P. et al. (2011), Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations. Journal of Homosexuality, 58:10-51.

Halberstam, J. (1998) Female Masculinity, Duke University Press.

Hubbard, R. (1996) Gender and Genitals: Constructs of Sex and Gender, No. 46/47, Science Wars, pp. 157-165.

Reed, B., Rhodes, S., Schofield, P., and Wylie, K. (2009) Gender Variance in the UK: Prevalence, incidence, growth and geographic distribution, GIRES.

Rubin, H. (2003) Self-Made Men – Identity and Embodiment Among Transsexual Men, Vanderbilt University Press.

Serano, J. (2007) Whipping Girl – A Transsexual Woman on Sexism and the Scapegoating of Femininity. Seal Press.

Stevens, R. A. (2004), ‘Understanding Gay Identity Development Within the College Environment’, Journal of College Student Development, Vol. 45, No. 2, pp. 185-206.

Tajfel, H. (1981), ‘Human Groups and Social Categories: Studies in Social Psychology’, Cambridge University Press.

Taylor, E. (2010) ‘Cisgender privilege: on the privileges of performing normative gender’, in Gender Outlaws: The Next Generation by Bornstein, K. and Bergman, S. B., Seal Press.

Weeks, J. (1990) Coming Out, Quartet Publishing.

Wilchins, R. (2004), ‘Queer Theory, Gender Theory’. Alyson books, Los Angeles.

This post was written for Gender Agenda, the Cambridge University Student’s Union Women’s Campaign termly magazine. Their website (where this and many other great resources and reads for women in particular) can be found here.

 

Whilst over the centuries it’s a horrible, abhorrent fact that women have had to struggle to be seen and heard in virtually all professional arenas, we are very, very lucky that art can endure. We are lucky that many women (though not as many as might have) dared to push against societal pressures by training in and executing their gifts in various times and places – when it undoubtedly may have been easier (albeit unhappier) to quietly run the home and children, and little else. Likewise it seems to me a further product of patriarchal systems that many female-dominated ‘applied arts’ such as weaving, embroidery, etc. are viewed with considerably less social significance compared to the historically male dominated ‘fine arts’. Embarrassingly, many fans of fine art may find themselves unable to name more than a handful of female artists. In contemporary terms Tracy Emin and Yoko Ono spring to mind though are often callously dismissed as ‘mad’ or ‘talentless’. To go back further chronologically, could I even confidently declare Frieda Kahlo and Barbara Hepworth as household names with the same confidence as Van Gogh or Michaelangelo? I sadly doubt it. The following list of artists was selected to represent a cross-section across different times, cultures, and styles – I really hope you’ll Google these women, as the effort it will have taken to produce their works only heightens their deservedness of an audience.

1. Claricia (13th Century)

One of the few positions in life which provided the freedom for artistic expression in the middle ages was in monasteries and nunneries. Claricia was thought to be a lay student at an Abbey in Augsberg in Germany where she illustrated herself into a psalter – her body swinging as the tail to an ornate capital Q.

 

2. Artemisia Gentileschi (1593 – 1656)

The daughter of a professional painter, Artemisia was trained in her father’s workshop. She was the first woman to be accepted into the Academy of the Arts and Drawing, in Florence. The vast majority of her work displays women in positions of power relative to men. Judith from the Bible in particular, who does some pretty knarly beheading of one Holofernes. Caravaggio painted the same scene, though if you compare the two paintings it’s Gentileschi who really captures a sense of brutal determination. Caravaggio’s Judith (here she is!) lacks this to me, perhaps because Gentileschi could better empathise with and capture such a sense in a woman. Caravaggio’s Judith comes across to me as a dainty flower who isn’t quite sure how she ended up with a sword in a chap’s neck.

3. Louise ÉlisabethVigée Le Brun (1755 – 1842)

Another artist whose access to teaching stemmed from having an artist father, Le Brun was painting portraits professionally by her early teens, progressed to be Marie Antoinette’s official portrait painter, and caused a scandal by breaking convention when she painted herself smiling showing her teeth.

4. Julia Margaret Cameron (1815 – 1879)

Cameron can be regarded as a pioneer in photography, despite taking the art form up at the age of 48, when given a camera by her daughter. Some of her images are unbelievably crisp as a result of her perfectionism, given she was working in the 1860s. Cameron was neighbour and friend to Alfred Lord Tennyson, and the great aunt of Virginia Woolf.

5. Edmonia Lewis (1844 – 1907)

Lewis managed to obtain impressive success in her lifetime as a Neoclassical sculptor despite not only gendered barriers, but the fact that she was mixed race (Haitian, African, and Ojibwe Native American). Orphaned at a young age, Lewis made money with her aunts by selling Ojibwe baskets, and was able to attend college from the financial success of her brother. Through her determination Lewis was able to take herself to study in Rome, and later achieved hugely lucrative commissions and had the President Ulysses S. Grant sit for her. Many of her sculptures contain poignant messages on race.

6. Mary Cassatt (1844 – 1926)

A friend of Edgar Degas and a fellow Impressionist, Cassatt, whilst attaining tuition at the Pennsylvania Academy of Fine Arts after a privileged education around Europe, felt rightly restricted by the attitudes towards women (for example, being forbidden from studying nudes) so left without graduating and pursued her own study. She moved to Paris and applied to study privately with masters due to women being forbidden from the École des Beaux-Arts. Many of her paintings focus on themes of motherhood, and in later life she was committed to the cause of women’s suffrage.

7. Augusta Savage (1892 – 1962)

Beaten by her father who viewed her sculpture as ‘graven images’ until she sculpted a Virgin Mary which changed his mind, Savage was able to make significant money from her clay sculpture in her early life, but did not experience widespread financial success. Upon rejection in 1923 from a French art program due to being black, her civil rights activism was begun. In 1934 she opened a multiracial studio where she taught anyone who wanted to learn how to paint, draw, or sculpt.

8. Claude Cahun (1894 – 1954)

If the term had existed, Claude Cahun may well have accepted the label of Genderqueer. Settling with her partner (also her stepsister) in Paris before later moving to Jersey in 1937, both engaged in resistance during Nazi occupation. They would take English-to-German translations of BBC reports of Nazi atrocities, paste them into poetic formats, dress as German military officers so as to infiltrate military events and leave the poems where they would be read. Whilst arrested and sentenced to death in 1944, both survived the war.

9. Ogura Yuki (1895 – 2000)

Ogura specialised in nihonga painting, which is the utilisation of strictly traditional Japanese methods and styles. She painted much nude portraiture of friends and family throughout the 50s and 60s, in natural, familial settings. Only one other female painter (UemuraShoen) has received the Japanese Order of Culture.

10. Kay Sage (1898 – 1963)

Born in New York, Sage floated around Europe with her mother during her early childhood, exposing her to a variety of culture and also giving her an informal fluency in French and Italian. Whilst she spent 10 years married to an Italian nobleman she found this life deeply unsatisfying, and later obtained a divorce. She was exposed to surrealism in the 1930s and impressed André Breton (the founder of the movement), though he did not believe her paintings could’ve been done by a woman.

11. Rachel Whiteread (1963 – )

Gaining some fame as the first woman to win the Turner Prize in 1993, for a cast taken of an entire Victorian terraced house, Whiteread is also one of the artists to have a piece on the empty fourth plinth of Trafalgar Square – an upside down resin cast of the plinth itself, potentially the largest ever object to be made of resin. Her work often explores ‘negative space’ – the space inside an object not actually taken up by the object itself.

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