Health

Talking Trans to Healthwatch

~ Cheryl

Yesterday, after having to deal with a plumbing disaster in the kitchen (which for me mainly involved phoning the plumber and panicking while she did the work) I headed off to Weston-super-Mare where the Diversity Trust trans health report was due to get its public launch.

This is something that we have been working on for some time now. The core of the research was an online survey that drew responses from 225 trans and/or non-binary identified people from around the South West. The results are unsurprising to anyone who has any knowledge of the day-to-day realities of being trans. You can read the report and/or executive summary here.

The good thing about this is that Healthwatch have a key role in the health service in the UK. In a world of increasingly commerical GP practices, it is the job of Healthwatch to remind them that they are providing a public service, not just making money for the senior management. If the various local Healthwatch bodies that commissioned the report take our recommendations on board, they may be able to drive through some changes that will improve the way GPs treat trans patients.

Of course some of these changes need to be made at a national level. We’ve talked to most of the local Healthwatch bodies in our region, but it would be good to coordinate. If anyone out there working in trans health has also talked to their local Healthwatch I would love to swap notes.

Yesterday on Ujima – Punching Nazis, Ending Violence, Mental Health

~ Cheryl

Yesterday’s radio show began with an interview with Jonathan L. Howard whose latest Carter & Lovecraft book, After the End of the World, sees our heroes transported into a world in which the Nazis won WWII. We discussed how miraculously on point such a book appears these days, and the fabulous Crisis in Earth-X crossover event which sees Supergirl, Flash, Green Arrow and friends doing their own Nazi-punching. Of course we also discussed HPL’s racism and Jonathan’s other projects, including a zombie computer game which might destroy parts of Bristol.

Next up I was joined in the studio by Charlotte Gage of Bristol Zero Tolerance. This is a great project run by Bristol Women’s Voice that aims to make the entire city free of violence against women and girls. Of course this is a bit of an uphill struggle, but at least progress is being made.

Unfortunately, thanks to the continuing squeeze on local council funding, the project (including Charlotte’s job) is currently under threat. There’s a crowdfunding campaign going on, which you can find here, but what Charlotte really needs is for some big company to step up and sponsor the project.

You can listen to the first hour of the show here.

Charlotte and I continued our discussion in the second hour. We talked about how hard it is these days for any charity to get the day-to-day funding it needs to keep operating. Funding bodies are always happy to sponsor one-off projects, but these typically exclude what is called “core funding”, the stuff that keeps your organization running, and often excludes any funding for staff salaries. Up until now charities have often been able to get core funding from local councils who need their expert skills, but this is all being cut. There’s a major crisis brewing here.

We also had a brief chat about trans-inclusive feminism and the difficulty of getting any sort of dialog going. There is so much going on in feminism right now with attacks on reproductive rights, the #MeToo campaign and so on. It is a huge shame that so much time and energy is being wasted on attempts to keep trans women out of feminism.

Finally on the show I talked to Levi, a young man from Bath who has been working on a project about men’s mental health. Suicide is apparently the number one killer of young men in the UK, and the theory is that much of this happens because men are socialized not to talk about their feelings, and so have no one to turn to when things get bad. I also think that one of the main cause of violence against women is that men are socialized to believe that violence is the only properly masculine way to solve any disagreement. So this is really valuable work that Levi is doing. What’s more it has resulted in a handbook being distributed to children’s mental health services all over the country. Here’s hoping the make good use of it.

Here’s the film he and his friends made:

You can listen to the second hour of the show here.

The play list for the show was as follows:

  • Bat for Lashes – Two Planets
  • Jimi Hendrix – All Along the Watchtower
  • Tracy Chapman – Behind the Wall
  • Linda Ronstadt – You’re No Good
  • Renaissance – The Winter Tree
  • Isaac Hayes – Winter Snow
  • Labi Siffre – Sparrow in the Storm
  • Stevie Wonder – Don’t You Worry ‘Bout a Thing

The Labi Siffre song dates from 2006 but is even more on point now. It contains this verse:

The message written on our walls
For the strong to climb : the weak must fall.
This is heresy I guess, but could the strong
perhaps learn to live with less.

Ben, my engineer, joked that I’d be mobbed on social media for playing such heretical views. It has all been quiet thus far, so maybe the world isn’t as far gone as we think.

My next show will be on January 3rd. As I doubt that I will get any guests then, it will probably just be me playing music and highlights from 2017. If anyone wants to do a pre-record interview let me know.

Bristol’s Great Menopause Event

~ Cheryl ~ 17 Comments

I spent yesterday at City Hall in Bristol for the Great Menopause Event which I reported on for Ujima a couple of weeks ago. Of course menopause isn’t something that is going to sneak up on me at any time soon, but a lot of my friends are going through it and as I am on HRT (due to having no gonads) I’m interested to know whether I should be considering lowering the dose as I get older. No one does research on trans people’s long term health issues, of course.

The event had a variety of speakers covering lots of different aspects: the social, the medical, employment rights and so on. My biggest take away is that every woman is different, and therefore every woman experiences menopause in a different way. Some people hardly notice it, others have an awful time. Some women, and this surprised me, go through menopause at 30, which can be a major medical problem. If you have mild symptoms there are all sorts of natural sources of estrogen that you can take, though none of them are as powerful and effective as actual HRT. Lack of GP knowledge about menopause, and unwillingness of some male GPs to even discuss women’s health issues, were highlighted as major issues. It was all very interesting, and all very taboo busting.

I understand that the slides from the various talks will be made available in due course. They will probably be on the City Council’s Women’s Health Task Group web page.

I now have a pile of follow-up to do, much of which involves public policy issues. All of this will doubtless feed in some way into the development of the Women’s Equality Party health policy.

Oh, and no one seemed to object to my being there, which was a great relief considering the torrent of anti-trans propaganda being pumped out by the English media these days.

Today on Ujima – Black History, Egyptians, Menopause & Underworld Goddesses

~ Cheryl

October is a ridiculously busy month in Bristol, being both Black History Month and the time when all of the literary festivals happen. As I had devoted all of my October show to books, I decided to do something for Black History Month at the start of November. I’d only be a few hours late, after all.

So I began the show talking to my good friend, Dr. Olivette Otele of Bath Spa University, who is probably the best known black historian working in the UK. We had a great chat about a whole range of issues to do with black history, including The John Blanke Project.

That was followed up with more black history, albeit with a fantasy twist, as I welcomed local author, Justin Newland, to talk about his novel, The Genes of Isis. Justin and I managed to wander onto all sorts of topics, including the Theosophists.

Normally at this point I would direct you to the Listen Again service, but for some reason the file for the first hour of the show is only 7 minutes long. I will check with the station tomorrow, but I have an awful feeling there has been a software glitch.

The second hour began with Dr. Isabel de Salis of Bristol University talking about the Great Menopause Event. Yes, this was more taboo-busting. I have a ticket for it, and will report back in due course.

Finally on the show I welcomed Deborah Ward who is running a course on Storytelling the Underworld. Deborah and I discovered a common passion for ancient goddesses, in particular Inanna. We may have geeked out somewhat.

Thankfully hour 2 of the show recorded correctly.

The playlist for the show was as follows:

  • Eddy Grant – African Kings
  • Cedric Watson & Bijou Créole – Le Sud de la Louisiane
  • The Bangles – Walk like an Egyptian
  • Peter Gabriel – Here comes the Flood
  • Lianne la Havas – Midnight
  • Little Feat – Old Folks Boogie
  • The Herd – From the Underworld
  • The Pretenders – Hymn to Her

Because November has five Wednesdays in it, I will be doing an extra show on the 15th. In the meantime, if you are local, check out Miranda’s 2:00pm Friday show when she will be interviewing the Mayor of Bristol, Marvin Rees.

Monthly Hugs Launch Party

~ Cheryl

There are plenty of things I could be doing in Bristol this evening, and an Amanda Palmer concert in London, but instead I will be packing to go to Eurocon. One of the things I am not attending is the Monthly Hugs Launch Party being run by the lovely people at No More Taboo. Monthly Hugs is a new, fun and innovative way to tackle period poverty by making that time of the month something people will look forward to on account of the box of goodies that will be arriving. It is a fabulous initiative and if you’d like to know more, or help the project, there is a crowdfunding thing here.

Gendered Voices – Day 1

~ Cheryl

With apologies for the delay, here’s a look back on some of the things that I heard about during the Gendered Voices conference last week. This post is about the first day’s papers. I’ll do one for the second day later.

The first session was all about stereotypes, and began with Sauleha talking about Muslim women in Frankenstein. I had entirely forgotten about this. There is a character in Mary Shelly’s book called Safie who is initially presented as a veiled, cowed Eastern woman, but who throws off her patriarchal shackles and becomes a character with a fair amount of agency and something of a happy ending. It is revealed that her mother was a Good Christian woman who was kidnapped by a Vile Oriental, and intimated that her ability to escape her situation is only because of her Christian blood.

One the one hand, headdesk, Mary, what were you thinking? On the other there are apparently signs of progressive thinking. One of the dafter things that 18th Century Britons believed is the idea that in Islamic theology women have no souls. Goodness only knows where they got this idea from. Apparently Mum (Mary Wollstonecraft) had swallowed this one whole, but Mary Jr. wasn’t so sure. She was, after all, writing about an artificial being, the Monster, whose claim to having a soul was far more dodgy than Safie’s.

Gender and theology and science fiction: I could not have asked for a more interesting start to the day.

Paper two from Leonie was about Vita Sackville-West and the book review program that she had on BBC radio, complete with actual audio from one of the shows. My goodness, that woman had a cut-glass accent. I can quite see where the idea of the Sackville-Bagginses came from. On the other hand, I ended up quite liking her. Vita shared her reviewing duties with a male colleague (whose name I have shamefully forgotten), each doing a show every other week. She listed the books she was going to cover in the Radio Times in advance, and encouraged readers to write in with their own views. She also managed close to a 50:50 gender split on authors. He just turned up for his shows and talked at his audience.

Finally in that session, Sam told us all about her research into gendered attitudes towards pain relief. I am going to be one of her test subjects in early June. Work like this is badly needed because there is very little understanding of how the various aspects of health care are different for women.

On then to session two which was all about religion, kicking off with our first male presenter, Alun, who was talking about the Song of Songs. This is a particularly intriguing part of the Old Testament, because it is basically about sex. Alun is interested in it because of the possibilities for sex-positive theology, which some parts of Christianity could badly do with. I’m interested in the possible origin of these verses.

Other parts of the Old Testament, specifically the tale of Jezebel, suggest that some people in ancient Israel worshiped other gods, including Baal and Asherah, who are of Mesopotamian origin. In Mesopotamia kings have a tendency to legitimize themselves by describing themselves as the Beloved of Ishtar (or some other version of the goddess). It is possible that the Song of Songs was originally a religious rite in which the goddess, in the form of the High Priestess, confirms the king’s right to rule because of his sexual appeal to her and the Daughters of Israel.

Next up was Jade who was talking about female divinity in Catholicism. Specifically she was discussing the figure of Lady Poverty, who features in stories about Saint Francis. She is depicted as someone at least as old as Adam and Eve, and therefore a semi-divine figure of sorts. Of course this being Catholicism her femaleness has to be controlled by marrying her to Francis. Personally I am deeply suspicious of the idea of a man marrying a personification of poverty; it has way too many sexist jokes about it. Interesting paper nonetheless.

Our final religious paper was Chiara who is studying the works of the experimental novelist, Kathy Acker. Acker has a complicated relationship with just about everything, and religion is no exception. Chiara was looking specifically at Childlike Life of the Black Tarantula and My Mother: Demonology, both of which have strong religious elements. Personally I want to read Pussy, King of the Pirates because, well I think that should be obvious.

After lunch we began with a session on fertility. One speaker had to cancel so we were down to two papers, starting with Claire on the subject of pregnancy and childbirth in mediaeval letter. She focused on the famous Paston letters from Norfolk, and in particular the matriarch, Margaret Paston. It is lovely to see sane discussion of pregnancy between a mediaeval husband and wife, though I suspect that the idea that all men through history have been uninterested in “women’s issues” is yet another of those 19th Century lies. If anyone knows why the Paston women were obsessed with eating (presumably very expensive) dates while pregnant, Claire would probably love to talk.

Maria told us all about a fascinating French novel, Constance et la Cinquantaine (Constance in Her Fifties), which is all about a group of feminist friends who panic when going through menopause because their men are deserting them for younger women. Apparently the only thing that results in a happy ending is becoming a lesbian.

The final session was on various expressions of gender. It began with Di explaining the complex history of the image of Medusa from a scary, quite masculine version in Bronze Age Greece to a much more feminine version in later times. The Romans, bless them, used both. I’m particularly fascinated by the image on the pediment of the temple in Bath, which shows the snake hair on the head of a male Celt.

James entertained us with images of gendered behavior from Sparta, which is a fascinating place (and which got very bad press from the Athenians). He didn’t specifically mention non-binary gendered presentation, but we chatted a bit and I do have a few clues to follow up. He did mention the possibility that songs written to be sung by a girl’s chorus celebrated same-sex attraction between women.

The last paper of the day was from Lucy, a fellow fan of Romosexuality, who introduced us to an amazing mosaic from a villa in Spain. On the one hand it is a stunningly beautiful piece of art. On the other it is obvious that it depicts only people (female and male) whom Zeus is said to have raped, and is intended to imply that the man of the house is just as powerful and rapey as old Thunderbolts himself.

That’s it for day one. More later. And if you think the owner of that Roman villa reminds you of Trump, just wait for the next Roman paper.

Yesterday on Ujima – Gareth, Fitness, Trans Theater & Stopping Violence

~ Cheryl

It was a very full show as always on Women’s Outlook yesterday. I started out talking to local author, Gareth L. Powell, about his latest book, a short story collection called Entropic Angel (after a story originally published by me in Dark Spires). We also talked about the differences between writing short fiction and novels, the forthcoming Eastercon, and Gareth’s forthcoming space opera series.

The second slot featured Phoenix Liberty Rain, who is a fitness trainer. April is Health and Wellbeing month on Ujima, so I’m doing my bit despite being one of the most unfit people you could hope to meet. Thankfully Phoenix is very unlike your average fitness trainer. She works entirely online (and has been doing that for 9 years, so it is clearly a viable business). She doesn’t insist on diets, and she doesn’t make you go running in the rain before dawn. She does, however, recommend weight training for women. And she thinks that the main benefit of her courses is the self-confidence they give people. She’s my sort of fitness trainer. And given that she works online, you can sign up for a course from anywhere. This is her website.

You can listen to the first hour of the show here.

Hour 2 began with Alice Nicholas and Maddie Coward of Creative Youth Network talking about a play called Eclipse that they are staging in the same building as our studios later in the month. The play is about a young trans boy, and it sounds like Alice and her team have done a great job on the story. I’m hoping to get to see this one.

Finally I welcomed Nazand Begikhani and Gill Hague of the Centre for Gender and Violence Research at Bristol University. They were going to be launching a book last night at Watestones, and they talked to be about their work around the world, and specifically in Iraqi Kurdistan, to combat violence against women and girls.

You can listen to the second hour of the show here.

The playlist for yesterday’s show was as follows:

  • Cameo – Word Up
  • Savage Rose – Lonely Heart
  • Beyonce – Get Me Bodied
  • Daft Punk – Doin’ it Right
  • Smokey Robinson & The Miracles – Tears of a Clown
  • Amanda Lear – I Am What I Am
  • Tracy Chapman – Behind the Wall
  • Donna Summer & Barbara Streisand – No More Tears

Next week marks the debut of our new team member, Zakiya. She’s also heavily involved in Ujima’s environmental initiative, Green & Black. I’m looking forward to hearing what she does. Yaz will be back with more social campaign news at the end of the month.

Diversity Trust Announces Major Trans Health Needs Survey

~ Cheryl

The spring edition of the Diversity Trust newsletter is now available. You can read and download it here. As usual there is plenty of good stuff in it, but the big news is all the way back on page 16. We have been commissioned by Healthwatch to undertake a survey of the health needs of trans people in the Bath & North East Somerset, Bristol, North Somerset, Swindon and Wiltshire areas. Some person called Cheryl Morgan is quoted as saying:

As a trans woman I know just how badly this work is needed. I’m very grateful to Healthwatch for their support, and delighted that this project will involve trans people at every stage of its design and delivery.

Now I guess Berkeley and I have a lot of work to do.

Obviously there will be a survey at some point so we can collect people’s experiences. Also I will make sure that we cover non-binary and intersex people’s needs. If anyone has any specific ideas about what should be done please do get in touch, either here or via info@diversitytrust.org.uk.

On The Road Again

~ Cheryl

Well, guess who wasn’t home for very long?

I headed off to London this morning, the main reason for which was that it is time for me to be declared sane again. The NHS, bless them, are convinced that trans people are constantly on the verge of suffering massive regret and begging to be changed back to their “real” gender. Fat chance. But I need to go through the hoops to get the medication that I need. It is also good to have regular blood tests to make sure my estrogen levels are OK. I have to pay for all of this privately.

Anyway, it seems that I am still sane and female, so I am spending the night in Camden. I have tomorrow to see people in London, and in the evening I am going to the launch party for next year’s LGBT History Month. This year it is in a little place called the Palace of Westminster. I’ve not been there before so I thought I should check it out. If it is nice I’ll take a few pictures.

Bristol Weather Hates Me

~ Cheryl

When I did the event with Stuart Milk at Bristol University in February it rained heavily. Bristol traffic is bad enough at the best of times, but when it rains the city hits gridlock very quickly. The combination of bad weather and impossible traffic puts people off attending events, no matter how good.

Last night was the first evening event I had arranged at the University since then. It rained heavily. Traffic hit gridlock. And yet out of 46 people registered to attend 32 turned up. We had some great contributions from the panel, and some equally good feedback from the audience. I was very pleased. Thank you, everyone.

There’s no recording of the event as far as I know, but a reporter from ShoutOut Radio was there and she’ll be doing interviews with some of the panelists for a show at a later date, so the discussion will go on.

Alan Clark’s book is very funny, and less than a fiver on Kindle. Jane Traies’ book is very accessible for an academic text. It is inevitably hugely expensive, but if you still have a local library you should be able to order it.

Bristol LitFest Reminder

~ Cheryl

Tonight I will be chairing a Bristol Festival of Literature event at Bristol University. It is titled “Ageing in the LGBT Community” and we’ll be looking at the issues through fiction and history with the help of authors and experts in social care. Details here.

Sadly Alan Clark is unwell and may not be able to attend, but he has sent me the extracts from his novel, Rory’s Boys, that he intended to read. They are very funny, and we will be reading them.

Also on the panel will be Dr. Jane Traies talking about the lives of older lesbians, plus Dr. Paul Willis and Berkeley Wilde talking about what this all means in the community.

It is a free event, and there is space, so do come along if you are in town.

Wales to Get a Gender Clinic

~ Cheryl

Some excellent news for trans people in Wales this week. Stonewall Cymru reports that the Welsh Assembly has put aside £1 million for two new services: a gender clinic and a service for people with eating disorders. Currently all Welsh trans people have to travel to the massively-subscribed Charing Cross clinic in London, which is a huge financial burden on then.

What isn’t clear is how the new service will work. If they put it in Cardiff that will be great for folks in South Wales, but probably little better for someone living in Llandudno. A little thought is required in this respect.

Sadly it probably won’t be of any help to people in Bristol, even though it is just over the bridge. As it is being paid for by the Welsh government you will probably have to be resident in Wales to use it.

New Diversity Trust Newsletter

~ Cheryl

My colleagues at The Diversity Trust have produced their autumn newsletter. There’s not much about me in this one, you’ll be relieved to hear, but there is a lot of information about the work that we do in the field of mental health. I’m also really pleased to see us doing work in the field of clear and simple communication. You can find the newsletter here.

In Which I Do Politics

~ Cheryl ~ 2 Comments

freedomofmind
Photo by Ella Marshall

Last night I did my thing at the Freedom of Mind Festival. You can see me on platform in the photo above. The location is Bristol’s City Hall. The panelists are, from left to right: Jenny Lacey (chair), Councillor Clare Campion-Smith (LibDem), Thangam Debbonaire MP (Lab), Councillor Fi Hance (Green), me (WEP) and Dr. Dominique Thompson who runs Bristol University’s student health service.

There are a couple of things worth noting about the line-up. Firstly there are no Conservatives involved. Gee, I can’t imagine why. Also, all of the panel are women. That, sadly, is also not much of a surprise. I’m doing a lot of work with organizations that deal with mental health issues these days, and the vast majority of the staff are women. Given that suicide is a significant cause of death of men in the UK, this is rather worrying. I’m very pleased that the festival had a specific event devoted to men’s mental health.

Naturally most of discussion was about general mental health issues and the lack of money for dealing with them. Local councils and the health service are both at the mercy of the government’s “austerity” program, which basically means requiring everyone to do more work for less money each year. No one was happy, but short of a major revolt among Conservative MPs there’s nothing that can be done until the next election in 2020.

My point was rather different. Firstly there are still things that are defined as mental health issues that are actually social ones. Technically being trans still marks me as being insane in the UK, because the World Health Organization takes forever to change its diagnoses. However, the USA has declassified trans people (sort of), and the UK government has stated that they don’t think we are mad either. Saying so “cured” several hundred thousand people of insanity overnight, so well done Nicky Morgan!

More importantly, however, there are many people who are suffering stress because of social conditions. Some of those are down to money (unemployment, homelessness, etc.), but many of them are due to prejudice. The work that my colleague, Berkeley Wilde, has done on LGBT+ heath needs has shown very clearly that the mental health of LGBT+ people does still suffer because of social prejudice. The situation is much worse for bisexuals and trans people than for gays and lesbians. Speaking out against such prejudice is something that politicians can do without having to spend any money at all. A less bigoted society is a happier, healthier society.

There are other areas where non-medical intervention can make a big difference too. There has been a lot of talk recently about social pressures on young women. Compulsory sex and relationship education in schools could do a lot to help with this, which is why Thangam made it her number one priority. Done properly it will do a lot for LGBT+ equality too.

Sadly our current government seems to be hell bent on making Britain a less friendly society. Currently we are being encouraged to be The Country That Hates Foreigners. We all know where that leads. When they have run out of one group of scapegoats, they’ll move on to the next.

The Politics of Mental Health

~ Cheryl

There is a really great thing going on in Bristol over the coming week. It is called the Freedom of Mind Festival, and it is a week-long series of events examining mental health issues from different angles. There’s a launch party which will raise funds for Off the Record (and therefore helps keep my amazing friend Henry in a job). There are workshops and films and art events. Nathan Filer will be dropping by for an event on the Thursday. And there will be a discussion panel at City Hall on Monday where local politicians will be asked what they are doing about mental health. One of the people asking awkward questions will be me.

This all comes out of the work I have been doing on the West of England “LGBT Manifesto”. There’s a whole bunch of us involved in that, and mental heath provision is going to be a major plank of what we are asking for. It also comes out of all the trans awareness training work I am currently doing for Bristol Mental Health. We had a planning meeting for that today and they were really positive and keen to get as many staff as possible trained. I will of course be armed with this fine survey done by my colleagues at The Diversity Trust on the health needs of LGBT people in the Bristol area. And as I have an MP on the panel with me I might just mention the Trans Equality Inquiry and the lack of action thereon.

There are, of course, many other social groups as well as LGBT folks who have major mental health issues. But given that up until very recently trans people were deemed insane simply for being trans I think we have a special stake in this and I’m delighted to be involved in the event.

Bristol Festival of Literature Events

~ Cheryl

The full publicity for my two events at the Bristol Festival of Literature is now out.

The “Stories of Strong Women” panel only exists as a Facebook event. You can find that here. Apparently we have 85 people going already, which is awesome.

I have created an EventBrite event for “Ageing in the LGBT Community”, which you can find here. I’m hoping we’ll get good attendance from people who work with the elderly, both via the NHS and the voluntary sector. I certainly got interest when I mentioned it at some of the trans awareness courses I have been doing.

While I’m here I would also like to highlight the Annual General Meeting of OutStories Bristol (of which I am co-chair). This year Bristol University has kindly provided us with a beautiful venue, and we are lucky enough to have the brilliant Dr. Jana Funke of Exeter University to come and talk to us about her research into the archives of Radclyffe Hall. Jana is a great speaker. She did a short version of this for me in February as part of the LGBT History Festival. She’s got twice as long this time. I’m looking forward to it.

Changes Afoot at Charing Cross Gender Clinic

~ Cheryl

News broke this afternoon that Charing Cross Gender Identity Clinic is severing its relationship with its current host, West London Mental Health Trust. In a statement the Trust said:

The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.

As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.

Gay Star News, who are not averse to a big of clickbait, followed this up with a report saying that the clinic was about to close, and that this was brought about by a massive increase in demand. Neither of these things appear to be true, at least in the short term. WLMHT makes it clear in their announcement that they intend to continue services until a new host is found for the clinic. While they do mention increased demand in the announcement, they do not blame it for their decision.

Charing Cross has been in the forefront of gender medicine in the UK since at least the 1930s, and for a long time was the only clinic in the country. It is still the only clinic serving the heavily populated South-East of the country, and the whole of Wales because the Welsh government has been shamefully remiss in failing to provide a proper service for trans citizens. Even some of my friends around the Bristol-Bath area attend Charing Cross rather than the more local Exeter clinic. Losing it would be a major blow, but it is by no means clear what will happen.

Dr. Stuart Lorimer, a widely respected gender specialist with a long history at Charing Cross, popped up on Twitter to say that the decision to cut ties with WLMHT had been made by the clinic, not by the Trust.

https://twitter.com/GenderCareDrL/status/768814047420616704

He also noted that the clinic had alternate hosts already in mind.

https://twitter.com/GenderCareDrL/status/768818899525726208

I can certainly see the advantage of trans services not being so clearly associated with a mental health trust. Equally it is true that Charing Cross has been a problem for WLMHT. I doubt that the Trust’s management will have been pleased with this report by the Quality Care Commission. It is difficult to know whose spin to believe here. Possibly there was simply a breakdown of relationships and a need for a new start.

What is clear is that, to coin a well worn political phrase, Something Must Be Done. Because an awful lot of trans people are dependent on Charging Cross and will be very worried about their future right now.

Hopefully this will be an opportunity for Welsh trans activists to pressure their government for a local service. The Assembly has done a lot of talking but very little spending of money. It is time for that to change.

I also know that Caroline Lucas, the MP for Brighton Pavilion, has been pestering NHS England for a GIC in her city to serve its very large trans population. This may help her cause.

Equally hopefully, one of the organizations that Dr. Lorimer has in mind will come through and take on the job of managing the clinic. They might do a better job. Certainly there’s room for improvement. What worries me is what happens if no London-based NHS organization is willing to take up the challenge.

Indeed, it is worrying that an NHS Trust can say publicly that it doesn’t want to provide services to trans people any more and is dumping them, because that’s what the WLMHT press release says. It may not be true, but if it is what is to stop other NHS trusts all over the country from doing the same?

The alternative is that NHS England will give the contract to a private provider. I note that Dr. Lorimer and some colleagues recently set up a private consultancy providing gender services. I have seen some trans people already expressing concern about this. An NHS England contract would presumably stipulate the certain services had to be provided for free, but a private operator would always be looking to squeeze more profit out of the service and would be likely to cut and run if it could not make enough money doing it.

All in all, it is a mess, and a mess that is likely to continue while there is no serious commitment from government to provide health care for trans people. (Or indeed any health care for anyone where some Tory MPs are concerned.)

Update: Dr. James Barrett, the Lead Consultant at Charing Cross GIC has issued a statement. Dr. Lorimer has distributed it via Twitter:

https://twitter.com/GenderCareDrL/status/768884234996023296

That certainly confirms that the clinic feels that the break happened on their initiative. It doesn’t explain why the WLMHT saw fit to claim that the break was their decision. All in all it seems like there is a breakdown of the relationship between the Trust and the GIC, in view of which perhaps a parting of ways is for the best.

Why Trans People Can’t Get Healthcare

~ Cheryl

In an effort to respond to Parliamentary criticism of their poor treatment of trans patients, health care bosses been trying to find ways to reduce the pressure on gender clinics. The General Medical Council and NHS England have issued new guidelines for GPs on management of trans patients. These include trying to get GPs to comply with long-standing instructions to provide life-time care for trans patients who have completed their medical transition and been discharged by the gender clinic, and more controversially to provide “bridging hormones” to trans patients who are waiting for appointments. The main reason for the latter policy is the large number of trans patients who are self-medicating. The GMC has taken the view that if people are going to take hormones anyway it is much better that they should do via trusted suppliers and under supervision.

I can’t see gender specialists agreeing to this unless they felt it was safe. They are fairly notorious for defending their specialisation, especially against people in private practice. Basically all GPs have to do is prescribe the hormones, take regular blood tests, and only if the results of those tests come back anomalous do they need to consult a specialist. That specialist will probably be an endocrinologist, not a psychiatrist.

Nevertheless, many GPs are outraged about this new development. An organisation called the General Practitioners Committee has written to the GMC to complain that this is requiring GPs to do something that is “clearly outside their expertise and competence”. It is clear that a significant number of GPs do not want to be responsible for providing health care to trans people.

The reason for this is fairly obvious from the comments on those two articles I linked to, which are from a doctors’ website called Pulse. One commenter compared trans people to heroin addicts. Another states:

What if they get PMT and commit suicide? Or testosterone fueled rage attacks?

The fact that trans people are committing suicide in large numbers because they can’t get treatment doesn’t matter to these people. What they are scared of is dealing with patients who, in their eyes, are insane and a menace to society.

Guess where they get that idea? Hello mass media, especially you, New Statesman. Which is why I think the training that The Diversity Trust, Gendered Intelligence and similar organisations do is so important. Sadly, while the NHS has been generally supportive of what we do, GPs themselves are extremely resistant to attending such training.

Fortunately there are GPs who are helpful and understanding. The trouble is that if you live in a country town or village you are unlikely to be able to find one. My own view is that the way forward in the short term is to establish regional centres of excellence, probably in big cities but also perhaps on a traveling basis in areas like Wales where travel is difficult, where trans people can go is they are denied healthcare by their local GPs. Long term, of course, we need proper training in medical schools.

In the meantime, some of those comments are going to find their way into my training slides.

Healthwatch Devon Tackles Trans Equality

~ Cheryl

Last month I was down in Exeter doing some training for Healthwatch Devon. It was a great session, and the people there seems to know a lot about the subject. That’s because they had been spending a lot of time looking into trans equality issues in the NHS. The results of that work have now been published. You can read their report here.

I’m very encouraged by this. It is one thing for the government to make noises about the NHS failing trans people. It is quite another for the NHS’s own customer engagement service to come to the same conclusion, and start trying to do something about it. Hopefully this will be the start of a continuing effort to improve access to healthcare for trans people all over the country.

Update:

Here is the official Healthwatch Devon statement on the report.

And here is some BBC coverage of the launch of the report.

Training the NHS on Trans Issues

~ Cheryl

Today I did trans awareness training at Southmead Hospital in Bristol. Tomorrow I will be in Exeter doing the same thing for Healthwatch Devon. It is great to be able to do this stuff, but the classes are very small in comparison to the number of people who work for the NHS. Last month we had to cancel a course in Frome for Heathwatch Somerset because only one person signed up. Right now I am only reaching the people who want to learn, not those who need to learn.

The biggest need for training is for GPs, but reaching them is very difficult. Like everyone else in the NHS, they are constantly being asked to do more with less resources. Training is at the bottom of their list of priorities. Besides, many of them are old and set in their ways. I’m therefore concentrating on trainee doctors. I did some work with Bristol University Medical School last year, and am talking to them about doing more this year.

That means I reach a few hundred trainee doctors each year, which is great, but it is only one school. Others may not be so forward thinking. We need to keep up pressure on the General Medical Council to make this sort of thing mandatory. I recently became aware of this petition about that very subject, and am delighted to see that it now has over 30,000 signatures. Please consider signing it, and share it widely.