Today’s papers have the news that the UK government is ready to move forward on reform of trans rights. The government has leaked to the Sunday Times that it will not be implementing the proposed changes to the Gender Recognition Act (GRA), and will instead be introducing proposals to protect the British people from dangerous trans folks.
By far the most remarkable part of this is the revelation that 70% of respondents to the government survey on GRA reform were in favour of the proposals put forward by those notorious radicals, Theresa May and Amber Rudd. However, the proposals are still being rejected because the government believes that the Wrong Sort of People responded to the consultation.
If only they had been so sensible about the 52% of people who voted for Brexit, eh?
Also, given that trans people make up around 1% of the population, I find it hard to understand how we could have swamped responses to a public consultation, especially because almost every national media outlet, including the Guardian and the BBC, were encouraging people to reject the reform proposals.
But we are where we are. The government is determined to move forward as it sees fit, and it has made clear that even a supermajority of public opinion will not be allowed to stand in its way. So what does it all mean? Like most things pertaining to trans people, the announcement in the Sunday Times is full of coded language that can seem harmless but may hide all sorts of nastiness.
I should note, by the way, that I have no reason to believe that the Sunday Times has got this wrong. One of their reporters who led their campaign against trans people until recently was rewarded, after the General Election, with a post as a senior advisor to the Prime Minister.
One way in which we can try to decode what the announcement means is to look at what is already being done. Some time ago the government announced a legal inquiry into the operation of the Tavistock and Portman clinic in London, which provides the vast majority of health care for trans youth in the UK. The Tavi is well known to be deeply conservative in its practices. When asked to recommend international best practices for trans youth I normally point people to the official guidelines in the USA and Australia. However, a week and a half ago NHS England issued new guidelines for the treatment of trans youth that characterised the services that the Tavi provides as experimental and dangerous. This gives the inquiry no choice but to find that the Tavi is operating improperly, and to either order them to change their practices or close them down.
Those new guidelines also cast doubt on the safety and efficacy of treatment for trans adults.
One of the proposals listed by the Sunday Times is as follows:
There will be a crackdown on “quack” doctors to ensure that only reputable medics can give approvals.
This is obviously a direct attack on Dr. Helen Webberley and her Gender GP service, but the UK has a long and inglorious history of attacking anyone who sets up in private practice to help trans people. All of these people have been reputable medics with appropriate qualifications, but they have all been attacked (with the connivance of senior NHS doctors). Every single private gender expert that I have seen has been forced out of business. As I understand it, Dr. Webberley has moved her operations overseas.
The reason that private operations such as these exist is that waiting times for a first appointment at UK Gender Identity Clinics (GICs) were around 3 years as of before the pandemic. All services are currently on hold. Once services start up again that will have increased signifcantly. That’s 3 years before you see anyone at all, and probably at least another 6 months before a second appointment and approval for you to start treatment.
One of the ways in which trans people have navigated this problem is to initiate transition themselves. They transition socially. They may obtain medication from someone like Dr. Webberley. And until recently NHS guidelines suggested to GPs that they could provide a “bridging prescription” to tide people over until they could get officially taken on by a GIC. That guidance was withdrawn fairly recently. (Sometime last year, as I recall.) So one of the questions I am asking is, what if “quack doctors” include GPs who have provided treatment to trans patients who are not yet with a gender clinic? Will they soon be banned from doing so, under pain of being struck off?
It is rather ironic that a government that is hell-bent on privatising as much of the NHS as possible is also trying to prevent any private practice in the case of trans health.
The Sunday Times also talks about new national guidelines on access to toilets. They talk about how the general public does “not support transgender women with male anatomy accessing female-only facilities”. This is deeply disingenous of them. The current treatment protocols for trans people require that you show you can live full time in your correct gender for a period of time. The GRA states 2 years, though most GICs currently require less than that. This so-called “real life test” includes navigating public life. If trans women are not able to use public toilets, changing rooms and so on, they will fail the test and not be allowed surgery or a legal gender change.
The Sunday Times report also talks about a crackdown on the provision of gender neutral toilets. This does not protect cisgender people in any way. When asked to give advice on toilet provision I always note that gender neutral facilities should either be an addition for those who need them, or that they should be entirely separate cubicles such as you find on trains and aircraft. Gender-specific toilets can still exist alongside them. That way anyone who is unconfortable accessing a “male” or “female” toilet will have somewhere safe to go. That will include non-binary people, and butch lesbians, as well as pre-surgery trans women. It looks like this option will be banned.
Then there are the waiting lists. There are currently thousands of trans women in the UK who have transitioned successfully but have either yet to be accepted by a GIC, or are still waiting for a date for surgery. All of these women will be left in limbo by such regulations. Even going to work will be difficult for many of them. Thank goodness for Lockdown, because currently no one is surprised that we are afraid to leave home.
What about people like me? I successfully completed all of the required tests years ago when treatment protocols were much more stringent. I’ve had genital surgery and I am legally recognised as female. Will I be safe under these new proposals? Possibly not.
To start with, in the 20+ years since surgery I have had continual problems with GPs who have been unwilling to provide me with the hormones I need to stay healthy. There has been an ongoing spat between the GICs and the Royal College of GPs, with the latter pushing for a position that all health care for trans people should be conducted by GICs because it is “too complicated” for ordinary GPs. The GICs, being massively overloaded, have pushed back against this. They discharge people into GP care as soon as they have had all of the surgery they want.
Remember that I suggested that GPs might be banned from providing hormones to trans people before they access a GIC? What happens if they are banned from providing hormones after surgery as well? The government will say that there is no problem because people like me will be able to go to a GIC for prescriptions. But there will be at least a 4-year waiting list, and having thousands of people like me apply to be taken on will only make matters worse.
None of this will even require any legislation. All that is required is for the NHS to change official guidelines and threaten GPs with being struck off if they disobey. As we have seen with the changed guidelines for trans youth, they are already willing to do this.
Another point raise by the Sunday Times is as follows:
Safeguards will be put in place to protect “safe spaces” for women, reaffirming provisions in the Equality Act.
What does this mean?
UK readers will remember that the Tories have long been opponents of equalities legislation. David Cameron’s government spent a long time trying to find a way to repeal the Human Rights Act. The fact that they were unable to do so while still part of the EU was a significant driving force behind Brexit. The government does not want to do anything to equalities legislation except dismantle it.
A key feature of anti-trans arguments (for example Rowling’s recent screed) is that trans rights somehow take away rights from cis women. They want equalities legislation changed so that “sex-based rights” always trump the rights of trans people. This sort of thing appeals to the government because it can be endlessly extended. If they get this done, then they can argue that the rights of religious people trump the rights of LGBT+ people, that the rights of Christians trump those of non-Christians, that the rights of white people trump the rights of non-white people, and that the rights of men trump those of women.
The government knows that it is impractical to pass a law banning trans women from “women-only” spaces. It doesn’t want to be seen to be responsible for putting police guards on toilets and changing rooms. What they will do instead is to amend the guidance for the Equality Act to note that any person or organisation that allows a trans woman (whether she is legally female or not) access to a “woman-only” space is committing an act of discrimination against cis women. They will then sit back and wait for the rash of law suits that will force organisations to rescind their trans-inclusive policies.
In the USA a couple of days ago the *Unpresident changed legal guidance so that it is no longer an offence to refuse medical treatment to trans people. What I think the UK government is proposing is far worse. They will make it a crime for an orgnisation to be trans inclusive, even if it wants to be.
Finally there is the point about outlawing gay conversion therapy. This is generally being seen as a sop to the LGB community, and an effort to further divide them from their trans allies. “Don’t make a fuss over the trans thing,” the government is saying, “and we will give you this other thing you have always wanted.” But it could be much more than that, because the anti-trans movement has long claimed that gender reassignment is, de facto, gay conversion therapy.
Back when I transitioned, it was absolutely essential that I claimed to be sexually attracted to men, otherwise I would be deemed not feminine enough to be allowed to transition. Thankfully that wasn’t a problem for me, but others had to lie to get through. Suppose, however, that claiming to be sexually attracted to men was also taken as proof that I was “really gay”, because I was “really a man”. Anti-trans LG people firmly believe this is the case, and that “their people” are being stolen by gender clinics.
If the government listens to the anti-trans lobby, and they have shown every sign of doing so enthusiastically, then they could quite easily define gender transition as “gay conversion therapy” as an excuse to ban it.
Now of course none of this has happened yet. It is possible that the government is not in fact as devious and cruel as I think it is. But I’m not going to bet on that. We need to be prepared for the possibility that such changes will be introduced, and that they will be disguised by weasel words to make them seem harmless. The misinformation campaign over GRA reform has shown just how dishonest the opposition can be when it comes to trans rights.
The question is, will anyone care? Obviously vastly more people who do care are on our side than are not. The results of the consultation proved that. But the vast majority of the UK population did not respond. Nevertheless, they should care about what is being done to trans people right now, because we are the canary in the coal mine. Also we are running out of time.
Last week the government confirmed that they would not be seeking an extension to the Brexit negotiations because of the pandemic, and that they will be continuing their intransigent negotiating stance. This means that a very hard Brexit currently looks inevitable, and as a consequence the UK will suffer a massive economic disaster in January. We need to stop this. We need causes to rally around. The Black Lives Matter campaign appears to be one of them. I am hoping that the sheer cruelty of the government’s treatment of trans people might be another one.
The other interesting political wild card is Scotland. The Scottish government has published a Bill implementing the proposed GRA changes, and has promised to progress it once the pandemic is over. I have long wondered why Nicola Sturgeon has insisted on this, given that one of her main allies, Joanna Cherry, is violently transphobic. My assumption is that for the SNP independence always comes first, and that Ms. Cherry is privately prepared to accept a temporary increase in trans rights in Scotland if that provokes a massive row with Westminister.
We surely live in interesting times.
As usual with such things, comments are closed on this. You know how to find me if you need to talk.