A queer exploration of all things gender

Posts tagged ‘trans’

Facebook Gender Categories Explained

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.

gender options

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

facebook gender options

 

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.

The 32 Problems I Found with this Gender Identity Service FAQ Guide.

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.

Have you heard of this Trans riot that pre-dates Stonewall?

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.

Plaque_commemorating_Compton's_Cafeteria_riot

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.

Book Review: Everything Must Go by LaJohn Joseph

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!

For any FtM readers in the UK in particular…

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.

What is the Relevance of one’s Legal Gender?

Hey all – sorry for the large hiatus. Due to personal family reasons there isn’t likely to be much activity for the immediate future, but I will be back to writing regularly eventually. In particular there are lots of new book reviews lined up.

 

Whilst I haven’t written anything *new* per se, for those who have an interest in gender through an academic lens, I am posting one of my essays from my Master’s Degree in Multi-Disciplinary Gender Studies. Sorry about the lack of pictures, I don’t think the examining panel would’ve approved. This was written in May 2011.

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What is the relevance of one’s legal gender?

When asking about the relevance of one’s legal gender, one must address various questions that immediately lead from this. Some of these questions are legal in nature and others examine the social context within which the laws are made and executed. The most obvious place to start when asking about the relevance of one’s legal gender is to ask how does the law define one’s gender, and how does it distinguish this (if indeed it does at all) from one’s ‘sex’? One then needs to ask both how and when it is relevant for an individual to be placed in one legal category or another. How does the law deal with individuals whose categorisation is unobvious or contested for the purposes of making a decision for which the outcome varies based on the gender category of the individual in question? How are people who have changed legal category then treated by the law? And finally, is legal gender always relevant when scrutinised in legal proceedings, or indeed is legal gender ever ignored when it should not be? By addressing each of these questions in turn, not only are the factual ‘word of the law’ and the subjective way in which it is interpreted addressed, but the bigger picture of how legal, social and medical hegemony affect each other and come to shape what is accepted and therefore what is legislated is understood.

So how are sex and gender defined under the law? Under present UK law, the categories of ‘man’ and ‘woman’ are recognised, and are indicated on UK birth certificates under the heading of ‘sex’ as ‘boy’ or ‘girl’. This is used to define a person’s legal sex and gender. Whilst it is a legal requirement that births are registered within forty two days in England and Wales (Directgov, 2011) and that a child’s ‘sex’ is given, it is assumed rather than explicitly outlined that ‘boy’ and ‘girl’ are the acceptable possible responses. It is worth nothing that whilst it is common for the words ‘sex’ and ‘gender’ to be used interchangeably in any given context, it is also common particularly in scholarly parlance for ‘sex’ to be used to refer to a person’s categorisation based on biology (broadly understood to refer to a composite understanding based on genital, gonadal and chromosomal sex, which has been increasingly recognised as problematic when considering intersex individuals in particular) and ‘gender’ to refer to a person’s social categorisation, which may rest more on self-definition and social visibility, that which is presented for others to see.

An important legal precedent was established by the case Corbett vs. Corbett heard in 1970. In this case, the husband of the male-to-female (MTF) transsexual April Ashley petitioned for nullity upon the breakdown of their marriage on the basis that as April was legally male the marriage was void (Whittle, 1999). Whilst at the time it was held for the purposes of matrimonial law that hormone treatment and surgery did not result in a legal change of sex, which was then cited in many forthcoming legal cases, this changed with the advent of the Gender Recognition Act 2004.Interestingly, whilst the entirety of this act is written in terms of gender, the terms gender and sex are not formally defined as part of the Act. However, it is specified that “Where a full gender recognition certificate is issued to a person, the person’s gender becomes for all purposes the acquired gender (so that, if the acquired gender is the male gender, the person’s sex becomes that of a man and, if it is the female gender, the person’s sex becomes that of a woman)” (Gender Recognition Act 2004). One might think therefore that once an individual has received a gender recognition certificate, they would be legally indistinguishable from members of the same sex who were born as such. However there are exceptions to this which means that some individuals can problematically find themselves with a currently legal and previously legal gender that are both still legally relevant. Specific examples of where this may occur will be discussed later.

The law then, in its current form rests upon a binary understanding of sex and gender. There are a wide range of different scenarios where membership of a particular category results in different treatment under the law, thus demonstrating legal relevance. Before discussing these scenarios it is important to establish the difference between legal and social relevance. It is well established that the treatment of men and women is socially unequal, as can be evidenced from observing pay gaps that endure between men and women by occupational group (Browne, 2006). These inequalities exist as a result of how individuals are observed, socially categorised and treated by others rather than by a word present on their birth certificate which affects their treatment under particular legal circumstances. Individuals who are observed as ‘woman’ are treated differently to those who are observed as ‘man’, but may or may not be treated in the same way under the law. For instance a male-to-female transsexual who ‘passes’ is likely to have on average ‘a woman’s’ social experiences (the precise meaning of which could receive detailed treatment but is not the focus here), which must therefore be independent of their legal gender – if they remain technically, legally, a man.

Therefore, legal gender is not particularly relevant when considering many questions of women’s rights and women’s treatment under the law. This rather is the relevance of one’s social gender in legal contexts. An example of this would be the treatment of women as flight attendants during the late 1960s and 1970s. Female employees were restricted in ways that male employees were not, which could include not wearing glasses, being unmarried, physical attractiveness, and being under the age of thirty-two (Rhode, 1989). The age and marriage rules resulted in many women leaving their jobs each year, preventing a fair proportion of women from reaching senior positions, thus being unable to reach higher pay brackets and senior staff pension schemes. This discrimination is clearly based on female aesthetic rather than legal gender, and whilst clearly unacceptable under modern legal frameworks, if legally challenged would not need to consider legal gender in successfully arguing illegal sexism. Women are considerably more likely to be the victims of domestic violence, sexual assaults and rape (Walker, A., Kershaw, C., and Nicholas, S., 2006), but this is crime against individuals that is a product of their social rather than legal category as demonstrable by the successful socialisation within the desired gender by transsexuals (who successfully ‘pass’, and are not criminally targeted as a result of their trans status). If a female plaintiff makes a legal case of sexual harassment, it would not be usual practice to scrutinise her legal gender in order to ascertain whether the case was valid. It is chiefly where social and legal genders are not the same, or were once not the same (in the case of transsexual and transgendered people) and where sex does not readily fit into the binary (intersex people) that scrutiny of legal gender becomes most relevant.

There are still many important ways in which legal decisions vary based on a person’s legal gender, and a case with many relevant examples is that of Christine Goodwin v. The United Kingdom, at the European Court of Human Rights in 2002. Whilst this case occurred before the major change seen by the instigation of the Gender Recognition Act in 2004, the case still highlights the relevance of legal gender in several key ways than can be related to current law and to social theory.

In this case, Ms. Goodwin was successful in claiming breaches occurred of articles 8 and 12 of the European Convention on Human Rights, which are respectively the rights to respect for one’s private and family life, home and correspondence, and the right to marry and found a family. There were three key claims that were the basis of her case. Firstly,that the UK Government had not taken any steps to address the suffering experienced by post-operative transsexuals despite international court warnings to keep this under review. Secondly, rapid changes in regards to the social attitude towards transsexuals were taking place worldwide, and thirdly that discriminatory legislature regarding pension age and access to her NI number by her employee lead to significant distress and difficulty (Council of Europe, 2002). The European court’s response shows agreement that aspects of UK legislature were unsatisfactory by this time at dealing with social reality relative to trans people’s legal gender. By making the points that: “The stress and alienation arising from a discordance between the position in society assumed by a post-operative transsexual and the status imposed by law which refused to recognise the change of gender cannot, in the Court’s view, be regarded as a minor inconvenience arising from a formality”, “The Court is struck by the fact that nonetheless the gender re-assignment which is lawfully provided is not met with full recognition in the law” and “it appears illogical to refuse to recognise the legal implications of the result to which the treatment leads” (Council of Europe, 2002), demonstrates the necessity for legal gender to be harmonious with an individual’s (chosen and observed) social gender in all ways in order to avoid obvious inconsistencies leading to unequal treatment. Legal gender then, is highly relevant in the sense that there are many medical and professional contexts where one can be demanded to provide one’s legal gender. How necessary this is may be controversial, but due to being the reality which may impact heavily on an individual’s right to privacy, the relevance is undisputable. Yet, the requirements and responsibilities of individuals remain poorly defined. This point is well made by Whittle when he says: “If the trans man were born outside of Britain then his identity in each of these areas of the law would be dependent upon the nation state he was born in. yet the trans man would be classified on his driving licence (through the codification system) as a man. But what if the trans man is required to give his ‘sex’ to the court as he is facing a driving disqualification? Presumably the purpose of that disclosure is to ensure that the driving licence records of the correct person are marked up. Should he say he is a man or male, or should he say he is a woman or female? What is the requirement of the law, which would ensure that the correct person has his or her driving records amended? It is no defence to a criminal act to argue that you had no knowledge of the law or that you did not understand it” (Whittle, 1999). This also raises the question of how ‘relevant’ does legal gender have to be in order to justify a requirement for disclosure? There is no simple answer to this, but one could potentially argue that in the case of a driving offence, simpler alternative ‘non-gendered’ alternative records of identification could be used.

The Court also considered the potential significance of medical and scientific perspectives in the legal recognition of transsexuals. Whilst it was concluded that medical science did not offer any determining argument (Council of Europe, 2002) it highlights the fact that the law uses the medical and scientific perspective, and may offer this perspective a position of privilege in making judgements that then impact upon the social world. Certainly this method was used by Judge Ormrod in the creation of his sex determination text used in the Corbett vs. Corbett case, consisting of a consideration of the chromosomal, gonadal and genital features of an individual at birth (Whittle, 1999). This reflects the Foucaultian point made in The History of Sexuality that society regards minority issues of sexual orientation and identity through a medical lens (literally and figuratively), and that ‘knowledge’ of what ‘legal gender’ in this case is not set in terms of law and repression, but of power. The law does not look to sociologists for potential ‘truths’ to aid decisions which find legal gender to be relevant, but it is increasingly recognised that whilst hard science can present molecular fact about bodies, the social processing of such does not give a rational reason to infer decisive significance to that information. It can be argued therefore, that the Court in this case supported Ms. Goodwin’s claims of breaches of articles 8 and 12 due to her social experience as a trans-woman, and the behaviour of others as a result of this social experience resulting in the breaching of these articles, in spite of her legal gender at the time.

The difficulty that medical science can encounter when attempting to establish what an individual’s ‘real’ sex is for the purposes of treatment, law, and ultimately identity can be readily problematized. This is seen most clearly in the story of Agnes, whose treatment and narrative was published by Stoller and Garfinkel in the 1960s. Upon physical medical examination Agnes was seen to have female secondary sexual characteristics (hair pattern, breasts, fat distribution) but with male external genitalia, which resulted in her being identified as ‘male’ on her birth certificate, and treated and raised as male until late adolescence. She was found to have no uterus or ovaries, some atrophy of the testes, and moderately high female hormone activity.Agnes was also observed to present as a “120 per cent female” in terms of behaviour and identity, with a history suggesting not only typical but stereotypical female behaviours and attitudes such as passivity, coyness, avoidance of rough games, etc. (Garfinkel, 1967). It was concluded that Agnes was suffering from an unusual case of an already very rare condition, ‘testicular feminization syndrome’, whereby the testes produce oestrogen and ‘feminize’ the genetically male foetus – however in this case the possession of Agnes of a normal sized penis and testes remained present and relatively unexplained.

The fact that Agnes presented as she did convinced the medical establishment to allow and perform surgery in 1959 where: “the penis and scrotum were skinned, the penis and testes amputated, and the skin of the amputated penis used for a vagina where the labia was constructed from the skin of the scrotum”. This was incredibly unusual for the time given both social and legal contexts, and rested heavily upon Agnes’ ‘gendered performance’. It is interesting that in scrutinising whether Agnes was to be considered a ‘real’ woman and deserving of surgery, it was explicit that she must’ve experienced no sense of homosexual desire – that is, attraction to women, despite the irony that based on her legal gender, attraction to men would be homosexual, of course illegal at this time. It was still true once homosexuality was legalised that the medical establishment looked for “a distain or repugnance for homosexual behaviour” in trying to identify the ‘true transsexual’ (Billings and Urban, 1996). This attitude would be characterised by Butler as “the heterosexualisation of desire” (Butler, 1990). Individuals can be considered to be trapped by the social sex and sexuality chosen for, and required of them.It was also a matter of concern that it was unable to be ascertained that her penis was not used with erotic purpose (Garfinkel, 1967), as this would be seen as evidence with identifying with a ‘male’ sexuality. This is evidence that Agnes’ legal gender was not of huge relevance to the doctors, which makes sense given that it would be implicitly understood that given her unique physiology, this would provide a shallow understanding of her sex/gender that would not usefully allow them to ascertain a deeper ‘truth’. As said by Whittle: “A quick glance at birth determines whether a child has a penis of appropriate length. If it has, it is designated as a boy/man, if not, it is designated a girl/woman. Here in the UK, that cursory glance and the decision made as a consequence is transcribed onto the record of birth, and will remain with the child for ever more. The sighting at birth will be the ‘citing’ for the remainder of life” (Whittle 2002). It may be considered somewhat worrying that being labelled with a legal identity that may have very real and complex consequences for a significant minority can be routinely made in such a fleeting and inexpert manner. That said, this is assuming that the categories available are even satisfactory in the first place!

The most crucial element to Agnes’ narrative is that she was able to receive legitimisation of her gender identity and be granted privileged access to the treatment required to ‘match’ the category of female as she so wished – by the fact that she lied. Agnes later revealed to her doctors that she had been taking oestrogens since the age of 12 (Garfinkel, 1967). By withholding this information, Agnes was capable of manipulating the medical establishment into providing her with social legitimisation. Given social context, people ‘suffering’ from intersex conditions were treated (both with pity, and medically), whilst ‘transsexuals’ and ‘transvestites’, whilst also pathologised, were degraded, blamed, and considered perverse. Social legitimisation, gained through passing in the desired category (of man or woman, strictly) was the chief goal, and has been the holy grail for trans people for longer than the term trans has even existed. This was far more relevant to Agnes’ experiences than her legal gender, as highlighted by the report of the attitude of Agnes’ family regarding her performance of her gender as female before and after medical legitimisation: “The aunt, said Agnes, reflected the attitude of other family members. This attitude, said Agnes, was one of gender acceptance prior to the trip to Midwest city [when she had lived as a boy], consternation and severe disapproval after the return [she ran away to attempt to live as a girl], and relieved acceptance and treatment of her as a “real woman after all” (Agnes’ quotation of the aunt’s remark) following the operation” (Garfinkel, 1967).

It can be said then, that Agnes was (really) a transsexual who was able to be successfully accepted as having indeed ‘always’ been a girl as she so claimed, rather than a boy who ‘became’ a girl. To have the sex/gender of desire accepted as the individual’s only reality is a common desire of many trans people. It has been pointed out that for many trans people, ‘success’ in one’s gender is to become entirely removed from the ‘trans identity’ – one is not a man who feels they are a woman, one is not a trans woman, one is a woman (or vice versa)! The limitation of legal gender as strictly relevant (it wasn’t for Agnes, as despite her success it was legally impossible at the time for the sex on her birth certificate to be altered)is challenged by Roz Kaveny who asks: “how does changing our birth certificates and passing and disappearing into the wider community free us from discrimination and oppression? Some bigots, some of the time, will spot us, or think they spot us, and be able to discriminate against us, or anyone else they think is one of us, with impunity, arguing in self-defence that they were doing no such thing. If there is no document that states who we are, our right not to be discriminated against as TS disappears. The possibility, or even probability, that someone passes most of the time is no defence for them on the rare occasions when they do not. You are only as safe as your roughest day” (Kaveny, 1999).

How relevant then is possession of a legal gender that does not accurately reflect one’s gendered life experience, especially when this problem is equally true for those who may indeed embrace their trans identity as more than transitional, and those who feel their intersexuality is not something that can be ‘vanished’ by ‘correction’ to one of the two available legal categories. This is concordant with the conclusions from the Goodwin case, in that it can be argued that to truly live without fear of judgement one needs a concurrency between legal and socially identified gender which can at best only be partially achieved within current legal categorisation.In her social discourse, Butler points out that “The binary regulation of sexuality suppresses the subversive multiplicity of a sexuality that disrupts heterosexual, reproductive, and medicojuridical hegemonies” (Butler, 1990). Indeed, as it is increasingly recognised that to be transgender and have one’s legal gender recognised as independent from one’s ‘birth biology’, the monopoly held by medical practitioners on what gender variance means is lessened. It is now no longer the case (in theory) that one under UK law must receive surgery to have one’s legal gender change recognised. However in practice a review board will take this into account when considering whether to approve an application for a gender recognition certificate particularly in the case of trans women (the surgery that may be undertaken by trans men is recognised as more complex with greater risk).The trans advocate group ‘Press for Change’ states that in regards to having reassignment surgery: “unless for reasons of health, it is not a good idea to simply say you do not want it. Better to state that you intend to have it in the future when the surgical waiting list has spaces” (Press for Change, 2011)

What is the relevance of one’s legal gender when possessing an intersex condition? Unless an individual can be placed into one legal gender category or another, one may encounter difficulties in receiving the rights of both or either categories. Within western culture, there has been a prevailing view that being ambiguous in sex is a dramatic problem, as highlighted by this quotation from a textbook on intersexual disorders published in 1969: “One can only attempt to imagine the anguish of the parents. That a newborn should have a deformity…[affecting] so fundamental an issue as the very sex of the child…it is a tragic event which immediately conjures up visions of a hopeless psychological misfit doomed to live always as a sexual freak in loneliness and frustration” (quoted in Fausto-Sterling, 2000). Given the incredibly dramatic language, it is somewhat surprising that this account does not directly justify its purple prose by mentioning that intersex disorders may be associated with some serious medical dysfunction. This is not always the case by any means, and it is worth saying that the term ‘intersex’ is used to refer to a wide range of conditions, many of which may remain undetected for an entire lifespan.

The American Academy of Pediatrics is quoted as having said “The reasoning behind this [early ‘corrective’] genital surgery is the need for a clear and unambiguous sex assignment to save intersex children from being ostracized and to enable parents to bond with their baby girl or boy” (quoted in Benatar, 2006). The assignment of intersex children to one legal gender category or another, and modifying surgery to better justify this regardless of whether or not there is a physiological need for this in terms of medical wellbeing is thus justified on social grounds, and reinforced by the legal requirement for a child’s sex to be declared.

The relevance of one’s legal gender can therefore be said to rest heavily on how social genders are viewed, because it is the view of society that is used to form legislature. Alison Shaw makes the point that “Sex and gender are not always either mutually exclusive or corresponding categories because ideas about the nature and significance of anatomical and physiological sex differences vary and can influence the rigidity or flexibility of gender categories and, conversely, the social significance of gender in any given context may in turn influence the ways in which biological differences are perceived” (Shaw, A., 2005). The fact that there is no straightforward biological test to show a ‘man’ or ‘woman’ that can’t be problematized through social discourse means that likewise a legal difference between ‘father’ and ‘mother’ is also problematic.

When it comes to parental status of trans people in the UK, there is no obvious or simple answer to the range of questions that may be asked. UK law maintains the categories of ‘mother’ and ‘father’ as distinct legal terms. Whilst both parents receive joint responsibility of a child that is born or adopted if the couple are married (or civilly partnered), should partners not have their relationship legally recognised parental responsibility is always given entirely to the ‘mother’. This presents the obvious problem of trans parents being registered as the ‘parent type’ that does not match their legal gender, and thus compromises their social treatment by the lack of the total recognition of their (new) legal gender as  their only legal gender. The argument that the mother is defined by ‘that parent which carries the child’ is rendered insufficient by the existence of both adoption and surrogacy. Parenthood is a scenario whereby legal gender is afforded more attention than can be justified – parental aptitude is not strictly sex/gender dependent nor would any court following equality frameworks claim such in the modern day. The legal categories of mother and father are arguably linguistic artefacts stemming from the social and psychological need of most individuals to categorise people by the binary gender system upon sight, or upon receiving information concerning a given individual.

Another example of where current legal gender and past legal gender may both be brought into question is in the context of military service. Whether a trans man would be called up on the basis of a new legal gender or a trans woman could be called on the basis of an old or unchanged one would depend upon the legal systems (and of course, social attitudes) of the country in question, but the most obvious problematisation would again be in a visible context. How would a barracks deal with an individual who appears and is judged to be female in every visible capacity, only contested actively by documentation? There is an interaction between the social and the legal in that, as we have seen, social categories lead to legislation, but the legislation leads to problematisation of the social, and vice versa. There will always be some level of problem with legislation on categories of sex and gender, due to the necessary black-and-white nature of the law. As Judith Butler puts it: “the notion that there might be a “truth” of sex, as Foucault ironically terms it, is produced precisely through the regulatory practices that generate coherent identities through the matrix of coherent gender norms…the cultural matrix through which gender identity has become intelligible requires that certain kinds of “identities” cannot “exist” – that is, those in which gender does not follow from sex and those in which the practices of desire do not “ follow” from either sex or gender” (Butler, 1990). Would the creation of further legal categories (trans, intersex, ‘other’, etc.) make legal gender more relevant to more individuals? Only in the sense that this logically goes hand in hand with social recognition. Legal recognition is quite separate from acceptance, as can be historically considered from the comments of Lord Arran at the third reading of the Sexual Offenses Bill in 1967 decriminalising homosexuality in the UK: “let me remind them that no amount of legislation will prevent homosexuals from being the subject of dislike and derision, or at best of pity. We shall always, I fear, resent the odd man out. That is their burden for all time” (Hansard, 1967). Whilst obviously discussing a different variation, Kaveny makes the related point that “It is less important to pass than to be accepted. If being transgendered is valued as a human variation, then many problems disappear. And it is more likely to be valued if we value it ourselves – being out and proud and prepared to defend ourselves is probably rather less risky than being in the closet, ashamed of our pasts and relying on a piece of paper” (Kaveny 1999). Legislation is an extension of social acceptance, affording people the rights afforded to others regardless of gender identity based on a liberal and rational society. This does not compromise the special protection and needs that individuals may require (for example, maternity leave for birth mothers who experience physical stress that requires remit and recovery time), as this may be provided in a manner that does not dictate and limit in a manner that restricts based on category but provides based on need.

To conclude then, what is the relevance of one’s legal gender? It is nothing if not dependent on a web of factors including location, personal identity, circumstances, and perhaps most importantly social context. Individuals are not ‘invisibled’ through lack of adequate legal category when there is no-one contesting those individuals legitimacy – often not merely to rights, but to existence, or at least visibility. An entirely positivist approach to answering questions of gender conclusively have been considered flawed as it has been “shown to be driven by the value-laden but unexamined presumptions of scientists themselves in numerous fields, especially medicine and human biology” (Carver 2007). As this medical justification was used for body policing in a thoroughly Foucaultian power-play, legal concession resulted in order for those outside of the gender hegemony to be silenced by inclusion in ‘normality’ and normativity. This ironically allowed a defence of gendered variance from within the normative system, which moves with social progression as further legal rights are demanded worldwide to solve questions of gender injustice. Legal gender will be relevant for as long as there are questions where legal (and therefore social) outcomes are contested by individuals based on personal rights and freedoms. It must be understood however that the impact of legal gender as a defence from social repression is limited, and does not have the impact on day to day existence as the willingness of the general public to accept difference.

 

References:

Benatar, D., 2006, ‘Cutting to the Core: Exploring the Issues of Contested Surgeries’, p. 80

Billings, D. B. and Urban, T., 1996, ‘The socio-medical construction of transsexualism – an interpretation and critique’, in Ekins, R. and King, D., ‘Blending Genders – social aspects of cross-dressing and sex-changing’, p. 105

Browne, J. 2006, ‘Sex segregation and inequality in the modern labour market’, p. 11

Butler, J., 1990, ‘Gender Trouble’, p. 17

Butler, J., 1990, ‘Gender Trouble’, p. 19

Butler, J., 1990, ‘Gender Trouble’, p. 17

Carver, T., ‘‘Trans’ trouble – trans-sexuality and the end of gender’ in Browne, J., ‘The future of gender’, p. 129

Council of Europe, 2002, ‘Case of Christine Goodwin v. The United Kingdom’, p. 17-18

Council of Europe, 2002, ‘Case of Christine Goodwin v. The United Kingdom’, p. 22-23

Council of Europe, 2002, ‘Case of Christine Goodwin v. The United Kingdom’, p. 24

Directgov website, legal information on registering and naming one’s baby: http://www.direct.gov.uk/en/Governmentcitizensandrights/Registeringlifeevents/Birthandadoptionrecords/Registeringorchangingabirthrecord/DG_175608

Fausto-Sterling, A., 2000, ‘Sexing the Body: Gender Politics and the Construction of Sexuality’, p. 47

Garfinkel, H., 1967, ‘Passing and the managed achievement of sex status in an “intersexed” person part 1’ (in collaboration with Stoller), in Garfinkel, Studies in ethnomethodology, chapter 5, p. 3

Garfinkel, H., 1967, ‘Passing and the managed achievement of sex status in an “intersexed” person part 1’ (in collaboration with Stoller), in Garfinkel, Studies in ethnomethodology, chapter 5, p. 24

Garfinkel, H., 1967, ‘Passing and the managed achievement of sex status in an “intersexed” person part 1’ (in collaboration with Stoller), in Garfinkel, Studies in ethnomethodology, chapter 5, p. 36

Garfinkel, H., 1967, ‘Passing and the managed achievement of sex status in an “intersexed” person part 1’ (in collaboration with Stoller), in Garfinkel, Studies in ethnomethodology, chapter 5, p. 7

Gender Recognition Act, 2004, section 9, subsection 1. Accessed at: http://www.legislation.gov.uk/ukpga/2004/7/crossheading/consequences-of-issue-of-gender-recognition-certificate-etc

Hansard, The parliamentary debates, House of Lords official report, volume 285, p. 523

Kaveny, R., 1999, ‘Talking Transgender Politics’, in More, K. and Whittle, S. ‘Reclaiming Genders: Transsexual Grammars at the Fin de Siècle’, p. 148-149

Ibid.

Press for Change website, accessed last on 2/5/11: http://transequality.co.uk/Legislation.aspx

Rhode, D., 1989, ‘Justice and Gender – Sex discrimination and the law’, p. 94

Shaw, A., 2005, ‘Changing Sex and Bending Gender: An Introduction’ in Shaw, A., and Ardener, S., ‘Changing Sex and Bending Gender’ – p. 3

Walker, A., Kershaw, C. and Nicholas, S. (2006) ‘Crime in England and Wales 2005-6’

Whittle, S., 1999, ‘The Becoming Man: The Law’s Ass Brays’ in More, K. and Whittle, S. ‘Reclaiming Genders: Transsexual Grammars at the Fin de Siècle’, p. 18

Whittle, S., 1999, ‘The Becoming Man: The Law’s Ass Brays’ in More, K. and Whittle, S. ‘Reclaiming Genders: Transsexual Grammars at the Fin de Siècle’, p. 19

Whittle, S., 2002, ‘Respect and Equality, Transsexual and Transgender Rights’, p. 5

Whittle, S., 1999, ‘The Becoming Man: The Law’s Ass Brays’ in More, K. and Whittle, S. ‘Reclaiming Genders: Transsexual Grammars at the Fin de Siècle’, p. 28-9

Why trigger warnings are essential…

Tumblr is fun. I’m still rather new to it all, but one aspect I’ve enjoyed is the ability to search by topic, using tags – and then scrolling through a whole bunch of often relevant and interesting subject matter.

I did this for ‘LGBT’ and one of the things that came up (*trigger warning* – attempted rape) was this.

In case you were not comfortable reading this but would like some context, behind the link is a short, personal account of a sixteen year old gay guy and his visceral description of nearly being raped but being rescued by some drag queens. The tone sets up a horrific situation whilst then expressing gratitude for the awesome ‘guardian angel’ ladies.

I had no problem with this story being posted. But I did and do have a problem with the fact that it went up with no trigger warning at all.

Here is a good explanation of what a trigger warning is.

I wrote a small message to the person who posted the piece, and received a quick reply. Below is what was said:

Me:

Hey – saw your post about the 16 year old’s experience and the saviour drag queens. Any possibility of a trigger warning being put on it? Due to some of my own life experiences it was pretty distressing to read. Thanks 🙂

Them:

I’m sorry it was distressing for you. I had considered putting a warning on it, but ultimately decided not to because I want people to read it and I’m afraid a warning will deter people from reading it, which ultimately defeats the purpose of me posting and now having re-posted it. Unfortunately, the very reasons that it’s likely distressing you are the same reasons it’s compelling to read.

So again, I’m sorry if you were offended, but I hope you understand my reasons for not going ahead with a warning. 🙂 (boldness added by GenderBen)

Okay… No. No no no no. Trigger warnings are there in order to protect the well-being of those people who need them. If a person is deterred from reading something because they have been informed of the content and see that it could be harmful to their well-being, this is a good thing. Whilst personally my reaction was relatively small from being disturbed from the post, it is vital to think about someone who has perhaps survived a sexual assault may feel on reading such a piece. Distress, depression, self-harm, and even attempted suicide are all very real possible outcomes from an individual being triggered. Such people are not the target audience. Wanting more people to read what one has posted ranks below people’s welfare in importance.

Also, for some people, whether a person feels like they are in an emotional place where they can comfortably read something or not be very time dependent. It may be the case that a survivor wishes to read something, but that ‘now is not a good time’. Trigger warnings act as a basic courtesy, which grants people agency. Often a clear title or subtitle can do this job, if an article is entirely or has a large focus on a distressing issue (for those who didn’t follow the link to the original post, this particular instance had no title).

A good way to think about trigger warnings is like when on TV you might see ‘this program contains strobe effects’ – a warning required to prevent triggering for people with types of epilepsy. Not having the warning there would be irresponsible, as the content can damage the individual’s health. The only difference here is the type of potential damage.

Unfortunately, the very reasons that it’s likely distressing you are the same reasons it’s compelling to read.

Hopefully without coming across as snarky, I think it’s fair to say that unless I take the time to personally discuss it with someone, they can’t know why something like this is distressing to me, or anyone else for that matter. Making assumptions is not so great.

It may sometimes be easy to think “I don’t see how this could possibly be triggering” – you don’t need to. A little reading around and/or empathy shows the importance of trigger warnings on a wide range of issues for a wide range of people. In the grand scheme of things, not much of the huge amount of stuff that is created and posted every day needs trigger warnings, but if it’s to do with rape or sexual assault, medical conditions and description, eating disorders, racism, homophobia, transphobia/cissexism, and ableism – then it quite likely does. This list is by no means exhaustive.

Here is a whole community blog dedicated to education and awareness about trigger warnings!

The only other point I’d like to address in the response I received – I wasn’t offended, and I’m not really sure where this interpretation came from. The original post itself certainly isn’t offensive to me. This post/response is born from the importance of putting safeguards in place to avoid harm to people.

GenderBen is now on Tumblr!

So I’ve finally started exploring the wonderful queer and gender-y nooks and crannies and communities present on Tumblr. I’m currently in the process of posting links on there to older blog works on here, but I’ve also found there’s so much good stuff (particularly images) that I want to share, i’ll be reposting lots of things on there that won’t actually be found here.

So if you want more gender fun, beauty and thought in your life, then follow:

http://genderben.tumblr.com/

Because this sort of thing is all kinds of awesome.

The story of Agnes – Gender recognition and surgery in the 1950s

This post is based off a chapter of a book. It’s a rather obscure book called ‘Studies in Ethnomethodology’, which may be among the least catchy possible titles for a book, even given that the chapter was originally published as a paper in 1967. Bear in mind that much of the way in which this story is discussed will be reflecting on attitudes held widely on gender in the 1950s and 1960s.

Don’t give up on me just yet, as the contents are rather unexpectedly fascinating.

The paper was written by one Dr. Garfinkel and his experience treating a patient called Agnes, whom he first met in November of 1958. Agnes had sought medical attention in her home town, been referred to a doctor in Los Angeles, who referred her to a colleague of Dr. Garfinkel who saw her with him.

The nineteen year old Agnes was the youngest of four children, supported by her mother who worked in an aircraft plant. Her father died when Agnes was a child. She was raised Catholic, but no longer believed in God.

These particular sisters may not have put Agnes back on the path to righteousness…

She also had a penis, and testes.

Agnes was presenting with what nowadays would be referred to as an intersex condition – in that she possessed physiology typically associated with the social categories of ‘male’ and ‘female’ at the same time. To quote from Dr. Garfinkel’s account directly:

Agnes’ appearance was convincingly female. She was tall, slim, with a very female shape. Her measurements were 38-25-38. She had long, fine dark-blonde hair, a young face with pretty features, a peaches-and-cream complexion, no facial hair, subtly plucked eyebrows, and no makeup except for lipstick. At the time of her first appearance she was dressed in a tight sweater which marked off her thin shoulders, ample breasts, and narrow waist. Her feet and hands, though somewhat larger than usual for a woman, were in no way remarkable in this respect. Her usual manner of dress did not distinguish her from a typical girl of her age and class. There was nothing garish or exhibitionistic in her attire, nor was there any hint of poor taste or that she was ill at ease in her clothing, as is seen so frequently in transvestites and in women with disturbances in sexual identification. Her voice, pitched at an alto level, was soft, and her delivery had the occasional lisp similar to that affected by feminine appearing male homosexuals. her manner was appropriately feminine with a slight awkwardness that is typical of middle adolescence.

As tempting as it is to pick apart the frankly amazing number of problems there are with anyone, let alone a doctor scrutinising someone in such terms, this isn’t actually the focus of where this is going. Please feel free to pick it apart in your own delicious, juicy minds.

This is a fairly common intersex (and more generally, trans) pride symbol. To think that being intersex is to be a ‘mix’ of male and female (rather than its own state of being, not framed in terms of a binary) as the stereotypical pink-purple-blue colour scheme suggests may be a bit simple.

Agnes wanted to get treatment for what she regarded as a very problematic condition. She thought of her penis and scrotum as being nothing more than a tumour that she wished to have removed so she could get on with living a ‘normal female life’. The fact that she had been born with a penis had meant that for the first 17 years of her life she had been treated and socialised as a boy by her family others who knew her. When she was around 12 years old, she was delighted when she noticed breasts beginning to develop, and other female secondary sex characteristics associated with the onset of puberty.

After much medical scrutiny, it was decided Agnes had a rare disorder known as ‘testicular feminisation syndrome’ , where the testicles, rather than producing testosterone, instead produce lots of oestrogens, causing an XY fetus to develop female genitalia and female traits at puberty. Agnes was seen to be a unique variation on this, in that she had a penis and scrotum and no vagina, and also no ovaries or womb. The doctors were a bit confused by this, but it was the best they could come up with – particularly given how ‘obviously female’ Agnes was to them in all other respects.

Agnes considered herself to be entirely apart from feminine homosexuals, “transvestites” (n.b. I put this in inverted commas because this was the term Dr. Garfinkel and Agnes herself were using at the time to refer to cross-dressers. The term ‘transvestite’ may be considered offensive, and it’s important that this be borne in mind), or any other gender variant individuals, considering them to be “freaks”, and nothing like her whatsoever. She went to an incredible amount of trouble to ensure that she was never scrutinised as being anything other than a ‘normal female’. To again quote directly from Garfinkel’s account:

“I’m not like them” she would continually insist. “In high school I steer clear of boys that acted like sissies … anyone with an abnormal problem … I would completely shy away from them and go to the point of being insulting just enough to get around them … I didn’t want to feel noticed talking to them because somebody might relate them to me. I didn’t want to be classified with them.”

Just as normals frequently will be at a loss to understand “why a person would do that, i.e. engage in homosexual activities or dress as a member of the opposite sex, so did Agnes display the same lack of “understanding” for such behavior, although her accounts characteristically were delivered with flattened affect and never with indignation. When she was invited by me to compare herself with homosexuals and transvestites she found the comparison repulsive.

Agnes was also very anxious about how her situation may affect her relationship with her boyfriend, Bill. Agnes met bill in April of 1958, seven months before she received medical scrutiny. Her refusal to let him allow his hands to wonder below her waist was met with much frustration by him, only temporarily alleviated by claims of her modesty and virginity. Agnes disclosed her situation to him in June, and whilst Bill accepted that it was “like an abnormal growth”, he found it difficult to understand why Agnes attended sessions every Saturday to discuss the condition with the doctors (over 70 hours of interviews were recorded and analysed). This was because Bill did not know that Agnes had been raised as a boy, and she sure as hell wasn’t intending for him to find out. She was also somewhat scared about the fact that Bill might himself be ‘abnormal’ (i.e. homosexual…) due to staying with her after disclosure – though she put this worry to rest after remembering that he took interest in her before he ever knew.

In March 1959, Agnes received a castration operation, where her penis and scrotum were removed, and a vagina constructed in their place. Before the surgery, she was scared that the doctors would make the decision that she was ‘actually’ male, and would amputate her breasts without telling her – but was reassured when told this definitely would not happen. With some time for healing and the use of a penis shaped mould, she was able to acclimatise her new genitals such that she was able to have vaginal sex.

After surgery, Agnes was well accepted by her immediate family and Bill. This was because the doctor’s treatment legitimised her claims of having been ‘female all along’, and that her being raised as male was simply an unhappy mistake due to a condition. The medical justification also meant that her “man-made vagina” was seen as ‘legitimately deserved’ by her, unlike individuals making claims of being women, whilst being ‘unambiguously’ physiologically and genetically ‘male’. Sorry for all the inverted commas, but I hope you see I’m illustrating the beliefs of Agnes and wider society at the time, rather than my own.

PRIDE SHARKTOPUS. I swear, coming up with images to break up the text of this post in a relevant way has been nearly impossible. But I could not resist this badass. For anyone wondering, they’re brandishing the (from bottom left going clockwise): the STRAIGHT ALLY flag, the ASEXUAL flag, the BISEXUAL flag, the PANSEXUAL flag, the GENDERQUEER flag, the INTERSEX flag, the TRANSGENDER flag, and the rather more common LGBT flag. This link is the best I could do towards crediting. 

Five years after her surgery and consultation sessions had finished, Agnes returned to catch up with the doctors who had helped her. Whilst she was no longer with Bill, none of the men she had been with sexually since him had ever given any reason to think they found her in any way out of the ordinary. She was still worried however, so Garfinkel arranged for her to see an expert urologist, who confirmed that “her genitalia were quite beyond suspicion”.

Agnes then dropped a massive bombshell.

During the hour following the welcome news given her by the urologist, after having kept it from me for either years, with the greatest casualness, in mid-sentence, and without giving the slightest warning it was coming, she revealed that she had never had a biological defect that had feminised her but that she had been taking estrogens since age 12. In earlier years when talking to me, she had not only said that she had always hoped and expected that when she grew up she would grow into a woman’s body but that starting in puberty this had spontaneously, gradually, but unwaveringly occurred. In contrast, she now revealed that just as puberty began, at the time her voice started to lower and she developed public hair, she began stealing Stilbestrol from her mother, who was taking it on prescription following a panhysterectomy. The child then began filling the prescription on her own, telling the pharmacist that she was picking up the hormone for her mother and paying for it with money taken from her mother’s purse. She did not know what the effects would be, only that this was a female substance, and she had no idea how much to take but more or less tried to follow the amounts her mother took. She kept this up continuously throughout adolescence, and because by chance she had picked just the right time to start taking the hormone, she was able to prevent the development of all secondary sex characteristics that might have been produced by androgens  and instead to substitute those produced by estrogens. Nonetheless, the androgens continued to be produced, enough that a normal-sized adult penis developed with capacity for erection and orgasm till sexual excitability was suppressed by age 15. Thus, she became a lovely looking young ‘woman’, though with a normal sized penis…

This 19 year old girl with no medical training, by sheer, unadulterated luck, and using a method that now would be essentially impossible, managed to achieve the treatment and recognition she desired in a time when any gender or sexuality variance was seen near-universally as sickness and/or criminal.

Try reading all that again, bearing in mind what you now know about Agnes. Do you find yourself thinking of her in any way differently? It’s quite amazing how even today, many people still consider legitimacy in gender identity to require the green light from the medical establishment. Agnes’ genius manipulation of the system gives a great big middle finger to anyone who would try and question or prevent her legitimacy. For her, being transgender wasn’t an identity she felt any connection with. She had no interest in waging a political fight, or in challenging any aspect of social norms. There’s no way to really comment on whether her disgust at gender and sexual minorities was an act or real. She got what she needed.

Respect.

The original chapter can be read here (at least in part), through Google books.

Shameless little mini-plug, but it involves a lot of my voice, so.

Last night by a string of happy coincidences, I was invited to be part of a panel answering questions on issues of welfare and gender in Cambridge! It was super enjoyable, so thanks to the lovely people who got me involved.

For those who also may know her, the other guest speaker on the show was the wonderful Ruth Graham, feminist extraordinaire and currently Women’s Officer for Cambridge University Student Union.

The show can be heard by clicking here.

The link should be active for the next six weeks or so, I guess until 22/03/2012.

Scroll down a little bit, and look on the right for the box labelled ‘Listen again’. Click the link that reads ’20:00 08/02/2012′ and there you go!

The show also features a really brilliant interview with Sarah Brown, Cambridge City Councillor and the only openly Trans politician in the country. Another small interview with Sarah can be read in Diva magazine from last year, here.

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