tag:theconversation.com,2011:/africa/topics/gender-diversity-3699/articlesGender diversity – The Conversation2024-03-12T21:27:08Ztag:theconversation.com,2011:article/2255432024-03-12T21:27:08Z2024-03-12T21:27:08ZDetransition and gender fluidity: Deeper understanding can improve care and acceptance<figure><img src="https://images.theconversation.com/files/581420/original/file-20240312-16-b238nw.jpg?ixlib=rb-1.1.0&rect=143%2C377%2C5748%2C3727&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The increasing visibility of gender transitioning and detransitioning has come with a helping of sensationalization and polarization.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>If you have been following recent coverage about gender-affirming health care, <a href="https://ici.radio-canada.ca/tele/enquete/site/episodes/864008/episode-du-jeudi-29-fevrier-2024">detransition will not be an unfamiliar topic</a>. From <a href="https://www.nytimes.com/2024/02/02/opinion/transgender-children-gender-dysphoria.html">mainstream</a> <a href="https://nationalpost.com/news/canada/wpath-files-transgender-care-children">journalists</a> to transgender <a href="https://www.rollingstone.com/culture/culture-features/detransition-baby-book-torrey-peters-1193653/">authors</a>, many have taken an interest in people who underwent a medical gender transition and chose to return to their former identity.</p>
<p>The <a href="https://nationalpost.com/news/canada/wpath-files-transgender-care-children">increasing visibility</a> of gender transitioning and detransitioning has also come with a helping of sensationalization and <a href="https://theconversation.com/the-real-threat-to-gender-diverse-children-is-the-politicization-of-care-issues-like-puberty-blockers-and-detransition-223170">polarization</a>. But a divided media landscape that presents detransitioners as either “<a href="https://www.them.us/story/new-york-times-detransition-youth-op-ed-pamela-paul-chase-strangio">misinformation</a>” or victims of “<a href="https://www.heritage.org/gender/commentary/how-big-tech-turns-kids-trans">gender ideology</a>” hurts all gender-diverse people, including those who are detransitioning.</p>
<p>We are <a href="https://scholar.google.com/citations?user=BH8jEdkAAAAJ&hl=en">transgender</a> and <a href="https://scholar.google.com/citations?user=0mJq6LQAAAAJ&hl=en">cisgender</a> <a href="https://scholar.google.com/citations?user=9qiUwT0AAAAJ&hl=es">researchers</a> who study gender-affirming health care, and we are among a <a href="https://doi.org/10.1080/0092623x.2020.1869126">few in the world</a> who are <a href="https://www.thedarestudy.com/">currently investigating detransition</a> (detrans, for short — a label adopted by some with this lived experience). We also know many people who have detransitioned personally, whose first-hand perspectives have helped us to improve how we approach this topic.</p>
<h2>Detransition is not new, but we are seeing new gender-diverse experiences</h2>
<p>Detransition is not new. Providers of gender-affirming medicine have long been aware of adults who medically transitioned and later returned to live in their former “gender role” or showed signs of regret. </p>
<p>Dr. Harry Benjamin, the endocrinologist who was among the first to offer gender-affirming medical interventions in the United States, wrote about one such case in his 1966 book, <a href="https://www.goodreads.com/en/book/show/1229462"><em>The Transsexual Phenomenon</em></a>.</p>
<p>In 1992, German clinicians Friedemann Pfäfflin and Astrid Junge published a <a href="https://web.archive.org/web/20070812100135/http:/www.symposion.com/ijt/pfaefflin/6002-6.htm#Treatment%2520Results">comprehensive review</a> of followup studies published over the previous 30 years, reporting 25 cases of “role reversal” or regret among adults who had undergone surgery. Later, in 1998, Dutch clinicians Abraham Kuiper and Peggy Cohen-Kettenis published a <a href="https://www.researchgate.net/publication/270273121_Gender_Role_Reversal_among_Postoperative_Transsexuals">qualitative study</a> of 10 adults who returned to their original “gender role” or expressed feelings of regret after surgery.</p>
<p>Pioneers of gender medicine were interested in understanding these stories because regret, along with suicide, was considered an outcome <a href="https://doi.org/10.1300/J056v05n04_05">that should be prevented</a> at all costs. </p>
<p>The logic of <a href="https://pubmed.ncbi.nlm.nih.gov/34666278/">preventing regret</a> was part of what inspired <a href="https://nyupress.org/9781479899371/trans-medicine/">doctors’ strict gatekeeping</a> practices and the requirement that <a href="https://doi.org/10.1215/23289252-9311060">gender transitions be binary</a>: male-to-female or female-to-male. Using strict measurement criteria, they estimated that detransition was rare: <a href="https://doi.org/10.1097%2FGOX.0000000000003477">around one</a> to <a href="https://doi.org/10.1007/s10508-014-0300-8">two per cent</a>.</p>
<p>But today, gender is no longer thought of as binary. And while there is evidence that <a href="https://doi.org/10.1089/lgbt.2020.0437">detransition</a> has <a href="https://doi.org/10.1136/archdischild-2022-324302">increased</a> in <a href="https://doi.org/10.3390/healthcare10010121">recent years</a>, debates about numbers can distract from a more delicate conversation about the real need for LGBTQ+ communities, organizations and gender-affirming care providers to develop a <a href="https://doi.org/10.1080/26895269.2023.2279272">nuanced understanding of gender fluidity and detransition</a>.</p>
<p>Although detransition may not be new, what is new is a small but emerging gender-diverse population in our society who <a href="https://doi.org/10.1542%2Fpeds.2021-056082">transitioned socially</a> and/or medically as <a href="https://doi.org/10.1080/26895269.2022.2085224">children, youth</a> or <a href="https://doi.org/10.1007/s10508-023-02716-1">young adults</a> who are now <a href="https://doi.org/10.1001/jamapediatrics.2024.0077">re-identifying</a> with their <a href="https://doi.org/10.1002/icd.2402">birth-assigned sex/gender</a>, or moving from a binary trans identity (trans man or woman) <a href="https://doi.org/10.1037/sgd0000678">to non-binary</a>.</p>
<h2>Understanding detransition can help us to enrich gender care</h2>
<p>We have long known that <a href="https://doi.org/10.1007/s11930-016-0092-z">sexuality can be fluid</a> for some LGBTQ+ people. New <a href="https://doi.org/10.1080/00224499.2023.2244926">research</a> shows that it is not uncommon for trans and <a href="https://doi.org/10.1371/journal.pone.0293868">gender-diverse</a> young people to report <a href="https://doi.org/10.1177/00333549231223922">shifts in gender identity</a> over time — dynamically moving between binary trans girls or trans boys, to non-binary, or to <a href="https://www.jahonline.org/article/S1054-139X(22)00832-1/pdf">cisgender</a>. In some cases, these identity-shift patterns can influence <a href="https://doi.org/10.1016/j.jadohealth.2022.10.020">changes in desires for gender-affirming interventions</a>. </p>
<figure class="align-center ">
<img alt="Painted stripes in the colours of the rainbow pride flag" src="https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581421/original/file-20240312-28-x8knjn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Rigorously studying detransition can help build a more robust understanding of gender identity development, and improve gender care.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>However, when a person’s gender identity or their desire for how they want to express their gender changes after already completing medical or surgical interventions, this may contribute to feelings of decisional regret. This poses <a href="https://actaspsiquiatria.es/index.php/actas/article/view/36">important dilemmas</a> for providers of gender-affirming medical interventions.</p>
<p>Many people who detransition are <a href="https://doi.org/10.1136/bmj-2022-073584">LGBTQ+</a>. But because detransition and regret are being <a href="https://www.nytimes.com/2023/05/16/us/politics/transgender-care-detransitioners.html">instrumentalized in debates</a> about trans people and gender-affirming health care, organizations and care providers serving sexual minorities and gender-diverse communities may feel that offering outward support for detransitioners is politically risky.</p>
<p>But if organizations and care systems fail to offer formal recognition and support, where can detransitioners turn to for help?</p>
<p>Discussion of anything but positive outcomes from gender-affirming hormonal or <a href="https://www.nytimes.com/2018/11/24/opinion/sunday/vaginoplasty-transgender-medicine.html">surgical treatments</a> was long <a href="https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/">considered unspeakable</a> in mainstream culture and in the trans community. As a result, regret went underground, to online social media networks and <a href="http://doi.org/10.1001/jamanetworkopen.2022.24717">detrans peer support networks</a>. Apart from a small number of therapists working privately with this population, there are few support services.</p>
<h2>Detransitioners’ voices</h2>
<p>Some detrans people have decided to go public and tell their <a href="https://www.nytimes.com/2024/02/02/opinion/transgender-children-gender-dysphoria.html">stories in the media</a>, to <a href="https://www.washingtonpost.com/nation/2023/12/06/detransitioners-transgender-care-laws/">testify in state legislatures</a> and to <a href="https://www.nysun.com/article/lawsuits-by-regretful-detransitioners-take-aim-at-medical-establishments-support-for-gender-transition-treatments-for-minors">take legal action</a>. As social scientists who study gender-affirming health care, we understand what motivates these pursuits: a desire to be understood, and to seek validation and justice.</p>
<p>Detransitioners’ voices, though, may be strategically positioned toward <a href="https://thehill.com/opinion/4284777-matthews-here-come-the-gender-detransitioner-lawsuits/">gender-affirming care restrictions</a>, rather than to improve research or to develop comprehensive detransition-related care services. This positioning may further contribute to stigma and division between trans and detrans people.</p>
<p>It is our view that detransition should be rigorously studied to build a more robust understanding of gender identity development, and to improve gender care — so that nobody’s needs or lived experiences are neglected.</p>
<p>We wrote about some of these ideas and recommendations in the medical journal <a href="https://doi.org/10.1136/bmj-2022-073584"><em>BMJ</em></a>, including what we know about detransition so far. We <a href="https://www.yorku.ca/laps/2023/10/31/laps-professor-kinnon-mackinnon-and-team-launches-a-research-website/">also developed</a> an <a href="https://detransinfo.com/">online support resource</a> to communicate the most up-to-date research and care guidance.</p>
<h2>Identity evolution and detransition are LGBTQ+ experiences</h2>
<p>In our own emerging research with detransitioning people, we have observed that these experiences <a href="https://rjs.inrs.ca/index.php/rjs/article/view/294/182">can often overlap with trans people’s</a> and the broader LGBTQ+ community. Indeed, some who understand themselves as detrans may also identify as <a href="https://doi.org/10.1002/icd.2402">non-binary, gender-fluid</a>, bisexual, queer, butch, gay, <a href="https://doi.org/10.1080/00918369.2021.1919479">lesbian and/or gender nonconforming</a>; and many continue to experience <a href="https://doi.org/10.1080/26895269.2023.2279272">gender minority stress and homophobia</a>. </p>
<p>Some might only <a href="https://doi.org/10.1089/lgbt.2020.0437">detransition temporarily</a> due to <a href="https://doi.org/10.1001/jamanetworkopen.2022.24717">lack of support</a>, external pressures and transphobia, and re-affirm a trans identity in the future.</p>
<p>Regardless, detransition can bring about <a href="https://doi.org/10.57814/8nd4-6a89">loss of community supports, stigma</a>, <a href="https://doi.org/10.1001/jamanetworkopen.2022.24717">shame and health care avoidance</a>. <a href="https://doi.org/10.1080/00918369.2021.1919479">Many</a> — <a href="https://doi.org/10.1371/journal.pone.0293868">but not all</a> — detransitioners experience regret over past medical interventions. Other feelings may be present as well, including <a href="https://doi.org/10.1002/icd.2402">satisfaction, ambivalence, grief and self-discovery</a>.</p>
<p>Identity shifts can be hard to predict. However, in hindsight, some detransitioners do feel that they were influenced by their cultural environment to <a href="https://doi.org/10.1007/s10508-023-02556-z">interpret their feelings</a> and behaviours through the <a href="https://doi.org/10.1002/icd.2402">lens of gender dysphoria</a> or to <a href="https://doi.org/10.1037/sgd0000678">adopt a trans identity</a> without considering alternatives. At the same time, some detrans people recount that environments that suppressed or <a href="https://doi.org/10.57814/8nd4-6a89">doubted their initial trans identity</a> only meant that later on, in detransition, it was hard to disclose to loved ones and care providers that their identity had changed.</p>
<p>In any case, gender fluidity does not negate the reality of detrans people’s authenticity in their own gender-diversity. While we understand that some of this information is new and may be uncomfortable to embrace, a gender-affirmative stance must hold space for the full breadth of gender diversity being reflected in our society today.</p>
<p>Rigorous, on-going research that is inclusive of these experiences is fundamental to being gender-affirming. Gender fluidity and detransition deserve further understanding and formal care services, not controversy.</p><img src="https://counter.theconversation.com/content/225543/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kinnon R. MacKinnon receives funding from the Social Sciences and Humanities Research Council of Canada.</span></em></p><p class="fine-print"><em><span>Annie Pullen Sansfaçon receives funding from the Social Sciences and Humanities Research Council of Canada and the Canada Research Chair Program.</span></em></p><p class="fine-print"><em><span>Pablo Expósito-Campos receives funding from the Predoctoral Research Fellowship Program of the Government of the Basque Country, Spain. He is a student member of the World Professional Association for Transgender Health (WPATH) and a member of the "Gonad, identity, and sexual differentiation" Working Group of the Spanish Society of Endocrinology and Nutrition (GT-GIDSEEN).</span></em></p>Gender fluidity and detransition deserve nuanced understanding. Polarization that presents detransitioners as either ‘misinformation’ or victims of ‘gender ideology’ hurts all gender-diverse people.Kinnon R. MacKinnon, Assistant Professor, School of Social Work, York University, CanadaAnnie Pullen Sansfaçon, Professor of Social Work, Université de MontréalPablo Expósito-Campos, Predoctoral researcher in Psychology, Universidad del País Vasco / Euskal Herriko UnibertsitateaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2231702024-02-13T16:22:48Z2024-02-13T16:22:48ZThe real threat to gender-diverse children is the politicization of care issues like puberty blockers and detransition<p>Under the pretext of protecting children, Pierre Poilievre, leader of the Conservative Party of Canada, has <a href="https://www.cbc.ca/news/politics/poilievre-transgender-puberty-blockers-1.7107486">said he is opposed</a> to the use of puberty blockers for gender-diverse children.</p>
<p>“I think that we should protect children and their ability to make adult decisions when they’re adults,” Poilievre said.</p>
<p>Poilievre is one among many politicians to wade into debates surrounding gender-affirming health care in recent years. Alberta Premier Danielle Smith has <a href="https://www.cbc.ca/news/canada/edmonton/danielle-smith-unveils-sweeping-changes-to-alberta-s-student-gender-identity-sports-and-surgery-policies-1.7101053">proposed controversial policies that would affect gender-diverse youth</a>, including prohibiting puberty blockers for children aged 15 and under.</p>
<p>But the growth of politicization and misinformation on this issue — on top of already <a href="https://nyupress.org/9781479899371/trans-medicine/">longstanding ideological battles</a> over the <a href="https://www.thestar.com/news/gta/closing-of-camh-clinic-fans-controversy-over-gender-questioning-children/article_ba7595a8-f367-53bc-bc8e-f19555880bf4.html">care of minors</a> — probably pose a bigger threat to gender-diverse people than puberty blockers.</p>
<p><a href="https://www.researchgate.net/profile/Pablo-Exposito-Campos">We are researchers</a> who study the <a href="https://scholar.google.com/citations?user=BH8jEdkAAAAJ&hl=en">experiences of transgender</a> and gender-diverse people who have accessed gender-affirming health care. <a href="https://www.advocate.com/politics/transgender/2014/09/17/photos-meet-first-trans-man-win-gay-games-gold-powerlifting#:%7E:text=Last%2520month%252C%2520Kinnon,before%2520the%2520competition.">One of us is transgender</a> and also a parent. And <a href="https://scholar.google.com/citations?user=9qiUwT0AAAAJ&hl=es">we are among a few</a> who also research <a href="https://doi.org/10.1136/bmj-2022-073584">detransitioning</a> — the process of discontinuing or reversing a gender transition. </p>
<p>We both personally know countless people who have been helped by transitioning, as well as others who were <a href="https://doi.org/10.1371/journal.pone.0293868">let down by the promises of gender-related treatments</a> that can have <a href="https://globalnews.ca/news/10281751/alberta-says-it-consulted-widely-in-drafting-controversial-transgender-rights-policy/">life-altering consequences</a>.</p>
<p>We have noticed that what is presented as “fact” in these debates has distorted real complexities of gender-affirming health care, creating a rift between conservative and progressive information outlets. The result has left many in the dark about what is really at stake.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/GmzDMeLLPPA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Conservative leader Pierre Poilievre speaks to the media about puberty blockers and trans children.</span></figcaption>
</figure>
<h2>Fertility and gender-affirming medicine</h2>
<p>Take the <em>New York Times</em> as an example. Two opinion columnists recently wrote about gender-affirming care for minors, making drastically different remarks about the fertility implications of this care. </p>
<p>Opinion columnist <a href="https://www.nytimes.com/2023/12/01/opinion/politics/life-without-regret.html#:%7E:text=Most%2520chilling%2520to,become%2520biological%2520parents.">Lydia Polgreen</a> asserted that it is a “mistaken belief” that infertility routinely results from treatments for gender-diverse children, while <a href="https://www.nytimes.com/2024/02/02/opinion/transgender-children-gender-dysphoria.html#:%7E:text=hormone%2520therapy%2520discontinue%2520its%2520use%2520within%2520four%2520years%252C%2520though%2520the%2520effects%252C%2520including%2520infertility%252C%2520are%2520often%2520irreversible.">Pamela Paul</a>, writing about detransition, claimed that hormonal therapy causes “often irreversible” infertility.</p>
<p>But the reality of fertility and gender-affirming treatments is in the details. Research on fertility outcomes is lackluster to begin with, but outcomes are highly sensitive to whether <a href="https://doi.org/10.1215/23289252-8553202">puberty blockers were taken prior to starting cross-sex hormones and the stage of puberty</a>.</p>
<p>For children who start puberty blockers followed by cross-sex hormones without ever undergoing natal puberty, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979264/#:%7E:text=The%20Endocrine%20Society,cross%2Dsex%20hormones.">infertility is presumed</a> because reproductive maturity is not achieved, and saving sperm or eggs for the future is <a href="https://transcare.ucsf.edu/guidelines/fertility#:%7E:text=Currently%2520it%2520is,undergoing%2520natal%2520puberty.">not possible</a> with current assisted reproductive technologies. However, for transgender people who begin cross-sex hormones after undergoing at least some natal puberty, fertility does not seem to be permanently affected. </p>
<p><a href="https://doi.org/10.1016%2Fj.xcrm.2022.100858">Early</a> <a href="https://doi.org/10.1089/trgh.2022.0023">research</a> indicates that for those who went through natal puberty, taking cross-sex hormones alone is <a href="https://www.huffpost.com/archive/ca/entry/fertility-treatment-trans_ca_5ddeebdce4b00149f728e7c0#:%7E:text=The%2520actual%2520egg,whenever%2520we%2520are.">unlikely to cause permanent sterility</a>.</p>
<h2>Puberty blockers</h2>
<p>The history of transgender medicine and reproductive rights has been fraught with injustice. When puberty blockers <a href="https://doi.org/10.1007/s10508-011-9758-9">were first tested for use with gender dysphoric youth</a>, transgender adults were being coercively sterilized. In 2014, the Netherlands struck down a policy requiring <a href="https://www.hrw.org/news/2020/12/01/netherlands-apologizes-transgender-sterilizations#:%7E:text=The%20Dutch%20government%20has%20apologized%20to%20transgender%20people%20for%20previously%20mandating%20surgeries%2C%20including%20sterilization%2C%20as%20a%20prerequisite%20for%20legal%20gender%20recognition.%20During%20a%20Cabinet%20meeting%20this%20week%2C%20government%20officials%20also%20announced%20plans%20to%20compensate%20people%20who%20underwent%20the%20operations.">sterilizing surgeries to legally change genders and paid out financial reparations as an apology</a>.</p>
<p>Pediatric gender medicine is a <a href="https://www.psychiatrictimes.com/view/gender-affirming-care-for-adolescents-separating-political-polarization-from-medicine">relatively new field</a>, and while the <a href="https://doi.org/10.1146/annurev-med-043021-032007">evidence base is growing steadily</a> it also <a href="https://doi.org/10.1111/apa.16791">shows its novelty</a>. </p>
<p>In fact, fertility is not the only issue at stake with puberty blockers. There are uncertain <a href="https://doi.org/10.1080/15265161.2018.1557284">impacts on bone health, neurodevelopment and social development</a>, as well as <a href="https://www.nytimes.com/2022/06/15/magazine/gender-therapy.html#:%7E:text=Shrier%2520also%2520quoted,stage%2520of%2520development.">sexual function</a> — issues clinicians and researchers are paying close attention to. </p>
<figure class="align-center ">
<img alt="A mother and child and a doctor seen from behind" src="https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575131/original/file-20240212-22-do3611.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Poilievre gives the wrong impression by saying that ‘we should protect the rights of parents to make their own decision with regards to their children,’ because, given the age of the child, parents are typically involved in the decision to start puberty blockers.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>A team of Dutch clinicians who were among the first to offer transgender children puberty blockers <a href="https://doi.org/10.1093/jsxmed/qdac029">recently acknowledged</a> that these drugs may not be just a “pause button” to explore identity, as originally intended. Instead, they should be thought of as the first step of a medical gender transition, because a <a href="https://doi.org/10.1093/jsxmed/qdac029">majority eventually go on to take hormonal treatments</a>.</p>
<p>But there are also major <a href="https://doi.org/10.1093/oso/9780192895400.003.0008">consequences involved in delaying or withholding treatment with puberty blockers</a>, which could hurt transgender girls more than boys. Testosterone’s effects on the body can be difficult to reverse, so undergoing a masculinizing puberty could render transfeminine kids more <a href="https://doi.org/10.1186/s12939-022-01632-5">vulnerable to future anti-trans discrimination</a>. Irreversible body changes from puberty can not only heighten distress and reduce social acceptance, but also contribute to a need for future surgeries.</p>
<p>Given that puberty may occur as early as <a href="https://www.nytimes.com/2022/05/19/science/early-puberty-medical-reason.html#:%7E:text=But%2520the%2520study,observed%2520in%2520boys.">eight or nine years old</a> for some children, this is a high-stakes medical decision never taken lightly by families or clinicians. <a href="https://www.cbc.ca/news/politics/poilievre-transgender-puberty-blockers-1.7107486">Poilievre gives the wrong impression</a> by saying that “we should protect the rights of parents to make their own decision with regards to their children,” because, given the age of the child, parents are typically involved in the decision to start puberty blockers.</p>
<p>However, there is <a href="https://psycnet.apa.org/record/2024-16010-001">always some risk of getting it wrong</a> — in either direction.</p>
<h2>Detransition debate</h2>
<p>Puberty-blocking drugs are not the only politicized topic in gender-affirming health care. <a href="https://doi.org/10.1136/bmj-2022-073584">Detransition also tops the list</a>. </p>
<p>On one side, opponents of gender-affirming care distort studies to argue detransition has <a href="https://www.nytimes.com/2024/02/02/opinion/transgender-children-gender-dysphoria.html#:%7E:text=Studies%2520show%2520that%2520around%2520eight%2520in%252010%2520cases%2520of%2520childhood%2520gender%2520dysphoria%2520resolve%2520themselves%2520by%2520puberty%2520and%252030%2520percent%2520of%2520people%2520on%2520hormone%2520therapy%2520discontinue%2520its%2520use%2520within%2520four%2520years%252C">reached epidemic proportions</a> and draw from testimonies of regretful detransitioners as a “<a href="https://www.foxnews.com/opinion/stop-mutilation-girls-gender-affirming-care#:%7E:text=Yet%2520the%2520harrowing%2520stories%2520of%2520former%2520trans%252Didentified%2520individuals%2520serve%2520as%2520a%2520cautionary%2520tale%2520against%2520medical%2520transitioning">cautionary tale against medical transitioning</a>.” </p>
<p>Proponents retort by dismissing detransition either by alluding to its <a href="https://www.cbc.ca/kidsnews/post/gender-affirming-care-what-it-means-and-why-its-in-the-news#:%7E:text=However%252C%2520research%2520says,of%2520family%2520support">“rarity,” using outdated</a> and <a href="https://slate.com/technology/2024/02/transgender-youth-health-care-regret-pamela-paul-nyt-data.html">flawed studies</a>, or by <a href="https://www.cbc.ca/kidsnews/post/gender-affirming-care-what-it-means-and-why-its-in-the-news#:%7E:text=Detransitioning%2520or%2520reversing,related%2520care%2520needs.">decoupling the experience from regret</a>.</p>
<p>As a result, the public is exposed to two different sets of “facts,” none of which reflect the heterogeneity that we and others have encountered in <a href="https://slate.com/technology/2023/12/trans-health-care-detransition-research-studies-new.html">researching detransition</a> — different <a href="https://actaspsiquiatria.es/index.php/actas/article/view/36">psychological, medical and social motives</a> for detransitioning; a range of emotions including <a href="https://doi.org/10.1002/icd.2402">regret, resilience, and satisfaction</a>; expansive patterns of <a href="https://www.tandfonline.com/doi/abs/10.1080/00224499.2023.2244926">identity discovery and fluidity</a>. All of it must be studied for gender-related medical care to continue being evidence-informed.</p>
<p>But threats, or outright restrictions, from politicians will not advance this care. What is badly needed from governments is investments in higher quality research and systems of care so treatments can be accessed in the safest possible terms. There are currently gaps in the <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293868#:%7E:text=We%20found%20that,accessing%2C%20care%20services.">Canadian gender-affirming care system</a> affecting access, quality, and safety.</p>
<h2>Guidelines, dilemmas and the need for high-quality research</h2>
<figure class="align-center ">
<img alt="A stethoscope and a transgender flag in the shape of a heart" src="https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=264&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=264&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=264&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=331&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=331&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575130/original/file-20240212-18-4obcs3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=331&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Debate should not centre on whether to ban treatments or not, but how to build an accessible and high-quality health and social care system that can support all gender-diverse people.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>This area of health care already <a href="https://doi.org/10.1080/26895269.2022.2100644">has guidelines</a> developed through a review of the evidence and <a href="https://www.psychiatrictimes.com/view/gender-affirming-care-for-adolescents-separating-political-polarization-from-medicine#:%7E:text=In%2520September%25202022,in%2520the%2520process.">international expert consensus</a>. But that does not mean the science is settled or that the medicine has no room for improvement.</p>
<p>Gender-affirming care is riddled <a href="https://doi.org/10.1007%2Fs10508-018-1287-3">with ethical</a> <a href="https://doi.org/10.1007/s10508-020-01762-3">dilemmas</a> that have <a href="https://nymag.com/intelligencer/article/bell-v-tavistock-transgender-health-care.html#:%7E:text=There%2520are%2520signs,after%2520anguishing%2520month.">spilled over into an explosive political situation</a>. The changing landscape of transgender health care, <a href="https://doi.org/10.1111/apa.16791">debates about puberty blockers</a> and <a href="https://www.nysun.com/article/lawsuits-by-regretful-detransitioners-take-aim-at-medical-establishments-support-for-gender-transition-treatments-for-minors">detransition</a> are all low-hanging fruit for opportunistic politicians like Poilievre.</p>
<p>On the polarization of these topics, anthropologist and medical doctor <a href="https://doi.org/10.1215/23289252-8553202">Sahar Sadjadi</a> — who <a href="https://doi.org/10.14506/ca34.1.10">studied in-depth some of the first American pediatric gender clinics</a> — wrote:</p>
<blockquote>
<p>“It is tempting to take the opposite position of one’s enemy, by defending all medical interventions currently associated with gender transition in children and insisting that they are safe and save children’s lives.” </p>
</blockquote>
<p>But by not being able to tolerate some of the unknowns, or banning treatments outright, we miss a crucial opportunity to advance knowledge that is needed to help gender-diverse children and their families.</p>
<p>Debate should not centre on whether to ban blockers, but on how to build a high-quality health and social care system that can support all gender-diverse people. Doing so depends on our collective ability to tolerate complexity.</p><img src="https://counter.theconversation.com/content/223170/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kinnon R. MacKinnon receives funding from the Social Sciences and Humanities Research Council of Canada.
He is a member of the World Professional Association for Transgender Health (WPATH).</span></em></p><p class="fine-print"><em><span>Pablo Expósito-Campos receives funding from the Predoctoral Research Fellowship Program of the Government of the Basque Country, Spain. He is a student member of the World Professional Association for Transgender Health (WPATH) and a member of the "Gonad, identity, and sexual differentiation" Working Group of the Spanish Society of Endocrinology and Nutrition (GT-GIDSEEN).</span></em></p>On both sides of the transgender care debate, what is presented as ‘fact’ distorts real complexities of gender-affirming health care, leaving many in the dark about what is really at stake.Kinnon R. MacKinnon, Assistant Professor, School of Social Work, York University, CanadaPablo Expósito-Campos, Predoctoral researcher in Psychology, Universidad del País Vasco / Euskal Herriko UnibertsitateaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2225792024-02-02T18:51:32Z2024-02-02T18:51:32ZAlberta’s new policies are not only anti-trans, they are anti-evidence<iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/albertas-new-policies-are-not-only-anti-trans-they-are-anti-evidence" width="100%" height="400"></iframe>
<p>What did Alberta Premier Danielle Smith get wrong in her new anti-trans policies? Spoiler alert — everything. </p>
<p>Let’s spend some time fact-checking Smith. </p>
<p>She recently promised a <a href="https://globalnews.ca/news/10255444/alberta-parental-rights-legislation-introduction/">new “parental rights” policy</a> would be introduced by her United Conservative Party government.</p>
<p>Like other experts, <a href="https://edmontonjournal.com/opinion/columnists/opinion-parental-rights-legislation-increases-risk-of-harm-for-alberta-students">we worried these policies would mimic the parental rights legislation</a> recently introduced in Saskatchewan and New Brunswick.</p>
<p>But we grossly underestimated the breadth of the Alberta measures.</p>
<p>Smith <a href="https://globalnews.ca/video/10264944/danielle-smith-unveils-albertas-proposed-guidelines-on-parental-consent-gender-affirming-care-rules">has unveiled a suite of policies</a> that directly attack trans and gender-diverse children and youth in Alberta. Spanning health care, education and sports, these policies extend well beyond the expected changes to the use of chosen names and pronouns in schools.</p>
<p>Smith intends to implement the most <a href="https://egale.ca/egale-in-action/egale-canada-and-skipping-stone-foundation-condemn-albertas-attack-on-2slgbtqi-people-and-promise-legal-action/">extensive, draconian and unbalanced proposals</a> of any conservative province to date, all under the guise of “preserving choice” for kids. </p>
<p>As we explain below, these policies are at odds with research about gender-affirming care, curriculum and sports. </p>
<p>As a result of ignoring the evidence, these policies could cause significant harm to the <a href="https://www.cbc.ca/news/canada/edmonton/alberta-2021-census-gender-age-dwelling-1.6432469">many transgender and non-binary youth</a> who live in Alberta or access gender-affirming care in the province (like youth from the Northwest Territories, for example).</p>
<h2>Evidence on trans-affirming care</h2>
<p>Smith’s new policy will forbid access to puberty blockers and hormone therapy for the purpose of gender reassignment or affirmation for youth 15 years of age and under, except for those who have already started those treatments. For youth 17 years and under, top and bottom gender reassignment surgeries are not permitted. </p>
<p>This particular policy deliberately spreads disinformation — <a href="https://www.centreforsexuality.ca/learning-centre/transitioning/">parents are already required to give consent</a> for their pubescent children to receive puberty blockers and for teenagers to access hormone replacement therapy. Bottom surgeries are <a href="https://www.grsmontreal.com/en/frequently-asked-questions.html">already restricted to adults</a>. </p>
<p>Puberty blockers slow down the onset of puberty and are often prescribed for <a href="https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817#:%7E:text=This%20usually%20involves%20medicine%20called,be%20given%20at%20longer%20intervals.">cisgender girls who experience puberty before 10 years old</a>. </p>
<p>According to <em>Scientific American</em>, puberty blockers have been <a href="https://www.scientificamerican.com/article/what-are-puberty-blockers-and-how-do-they-work/">studied extensively</a> and have been used safely since the 1980s. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979264/">Any risks</a> associated with puberty blockers are already included in <a href="https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.210064">Standards of Care</a> for transgender patients, and are not being prescribed to pubescent youth <a href="https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth">without careful consultation</a>. </p>
<p>Like all medicines, side effects are a risk but <a href="https://read.dukeupress.edu/tsq/article-abstract/7/3/508/166964/The-Vulnerable-Child-Protection-Act-and">researchers caution</a> against <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13441">fear-mongering</a> in response to gender-affirming care. </p>
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<p>The <a href="https://doi.org/10.1016/j.jadohealth.2016.06.012">evidence about trans-affirming health care</a> for youth is clear — it saves lives. Evidence suggests that puberty blockers lead to <a href="https://doi.org/10.1542%2Fpeds.2019-1725">positive mental health outcomes</a> and that the <a href="https://doi.org/10.1186/s13633-020-00078-2">biggest benefits</a> of gender-affirming hormone therapy (HRT) are realized when <a href="https://www.umass.edu/news/article/gender-affirming-care-can-save-lives-transgender-youth#:%7E:text=Nguyen%20was%20part%20of%20the,at%20age%2014%20or%2015.">HRT is started at age 14 or 15</a>. </p>
<p>Rather than restrict life-saving medical care, <a href="https://www.sciencedirect.com/science/article/pii/S0015028221000820">experts in fertility medicine</a> call for increased accessibility for trans people to fertility services.</p>
<h2>Sex education evidence</h2>
<p>Paralleling <a href="https://www.cbc.ca/news/canada/saskatchewan/sask-parental-rights-law-1.7002088">Saskatchewan</a> and <a href="https://www.cbc.ca/news/canada/new-brunswick/gender-identity-policy-713-pronouns-school-1.6954807">New Brunswick</a>, Alberta youth 15 and under now require parental consent to use chosen names and pronouns at school. Notification is required for 16- and 17-year-olds to do so. </p>
<p>Classroom instruction on gender, sexuality and sexual orientation also now requires parental notification and opt-in. Finally, third-party resource materials on gender, sexuality and sexual orientation in schools need to be pre-approved by the ministry to make sure they’re “age-appropriate.”</p>
<p>Education experts agree that what is needed to <a href="https://www.actioncanadashr.org/resources/sexual-health-hub/sex-ed/sex-ed-preventing-violence-and-increasing-safety">protect youth — including cisgender and heterosexual kids — from potential abuse</a> is robust and consent-based sexual health education. Youth have the right to knowledge and skills about their bodies, consent, safe/unsafe touch and healthy relationships. </p>
<p>By creating conditions that could result in youth receiving no or limited information, <a href="https://content.c3p.ca/pdfs/C2K_SportEdition_ParentsGuide_eng.pdf">Smith has put children and youth at greater risk of violence and harm</a>. </p>
<h2>Risk of parental, peer rejection</h2>
<p>Requiring parental consent for youth to use their chosen name and pronouns at school could <a href="https://www.cp24.com/world/saskatchewan-pronoun-policy-doesn-t-do-enough-to-mitigate-harms-say-legal-professors-1.6602093">cause irreparable harm</a>. This process essentially requires schools to “out” youth to their parents, who may reject their children. </p>
<p>Smith incorrectly suggests that <a href="https://www.cpac.ca/headline-politics/episode/alberta-premier-danielle-smith-discusses-gender-identity-policies?id=5b8e0a28-da27-4f0e-afe4-d771e34fbed1">parental rejection of 2SLGBTQIA+ kids is rare</a>. </p>
<p>According to a Canadian study by The Family Acceptance Project, 30 per cent of families reject their child when they come out, and <a href="https://familyproject.sfsu.edu/sites/default/files/documents/Family%20Acceptance%20Project-rr%20Overview.pdf">many are removed from their homes</a>. Among youth who are homeless, 20 per cent identify as 2SLGBTQIA+. </p>
<p>For those who experience family rejection, the rates of suicide are incredibly high. According to the <a href="https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf">2015 U.S. Transgender Survey</a>, <a href="https://doi.org/10.1080/27703371.2023.2192177">79 per cent of those rejected by their families experienced suicidal ideation and 43 per cent have made a suicide attempt</a>. </p>
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<h2>Trans athletes evidence</h2>
<p>Smith’s policy will also ban trans girls and women athletes from participating in competitive women’s sports. They will be forced to play in gender-neutral or co-ed divisions.</p>
<p>Yet again, Smith hasn’t listened to the experts. <a href="https://www.cces.ca/sites/default/files/content/docs/pdf/transgenderwomenathletesandelitesport-ascientificreview-e-final.pdf">Some scientists maintain</a> that trans women and girls have no <a href="https://www.cces.ca/transgender-women-athletes-and-elite-sport-scientific-review">“biological advantage”</a> over cisgender girls and women. </p>
<p>A <a href="https://www.hup.harvard.edu/books/9780674725324">book on the topic</a> that reviewed evidence on testosterone determined there is no direct relation between the hormone and athletic performance. It found that while testosterone can be linked to muscle mass and muscle memory, there’s no connection to other capacities like endurance and flexibility.</p>
<p>High levels of athleticism are actually correlated with <a href="https://pubmed.ncbi.nlm.nih.gov/24616603/#:%7E:text=In%20addition%2C%20the%20possession%20of,as%20determinants%20of%20sport%20expertise">coaching and specialized training</a> — including access to competitive leagues — not to “biological sex.” </p>
<p>Trans sports participation is vital for health and well-being. That’s why the Canadian Centre for Ethics in Sport recommends “<a href="https://cces.ca/sites/default/files/content/docs/pdf/cces-transinclusionpolicyguidance-e.pdf">policies governing the participation of trans athletes should be evidence-based</a>.” According to a <a href="http://doi.org/10.1001/jamapediatrics.2023.3266">study published by the <em>Journal of the American Medical Association</em></a>, youth participation in sport is associated with positive physical, mental and emotional well-being.</p>
<p><a href="https://indd.adobe.com/view/publication/40b5fe5b-48b2-48a3-81b2-8ed970144e66/1/publication-web-resources/pdf/Working_Towards_a_Sport_for_Them.pdf">Inclusive sports environments</a> — not segregated leagues — are associated with greater self-esteem and school retention.</p>
<h2>What’s the truth?</h2>
<p>In <a href="https://transpulsecanada.ca/results/report-health-and-well-being-among-trans-and-non-binary-youth/">survey data collected from 2,873 non-binary and trans people in Canada</a>, youth reported high levels of harassment (72 per cent), rejection from family (25 per cent) and suicide ideation (40 per cent). </p>
<p>In contrast, trans youth who are <a href="https://www.glsen.org/activity/inclusive-curriculum-guide">affirmed in schools</a>, <a href="https://www.wpath.org/publications/soc">health care</a> and in <a href="https://www.psychiatry.org/news-room/apa-blogs/lgbtq-participation-in-sports">sports</a> have better <a href="https://doi.org/10.1080/09589236.2023.2285984">self-confidence and relationships with their parents</a>.</p>
<p>Smith has <a href="https://www.cpac.ca/headline-politics/episode/alberta-premier-danielle-smith-discusses-gender-identity-policies?id=5b8e0a28-da27-4f0e-afe4-d771e34fbed1">incorrectly warned</a> there are risks associated with affirmation and inclusion in schools for trans kids.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/in-the-alberta-election-the-stakes-are-high-for-2slgbtq-youth-205966">In the Alberta election, the stakes are high for 2SLGBTQ+ youth</a>
</strong>
</em>
</p>
<hr>
<p>What the evidence actually demonstrates is what truly puts trans kids at risk are <a href="https://doi.org/10.1111/cdep.12405">transphobic, misguided and ill-informed policies and practices</a> that deny them the right to live authentically and to express themselves fully without fear. </p>
<p><a href="https://www.ctvnews.ca/politics/federal-ministers-accuse-alberta-premier-danielle-smith-of-putting-trans-youth-at-risk-1.6751597">Federal cabinet ministers</a> are speaking out against Smith’s proposed restrictions. Ottawa may oppose the policies in court.</p>
<p>In Alberta, Skipping Stone Foundation in Calgary and Egale Canada — advocacy groups for 2SLGBTQI people — have <a href="https://egale.ca/egale-in-action/egale-canada-and-skipping-stone-foundation-condemn-albertas-attack-on-2slgbtqi-people-and-promise-legal-action/">publicly condemned Smith’s policies</a> and have partnered to file a court injunction. </p>
<p>These policies are clearly meant to satisfy Smith’s electoral base, but her government is now going to have to go head-to-head with the experts — and the evidence — in future legal battles. </p>
<p><em>This is an updated version of a story originally published on Friday, Feb. 2. It includes more information on clinical guidelines for the prescription of puberty blockers for the purposes of gender-affirming care.</em></p><img src="https://counter.theconversation.com/content/222579/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Corinne L. Mason receives funding from SSHRC.</span></em></p><p class="fine-print"><em><span>Leah Hamilton receives funding from SSHRC.</span></em></p>Alberta Premier Danielle Smith’s anti-trans policies are likely meant to satisfy her base, but her government will now have to go head-to-head with the evidence in future legal battles.Corinne L. Mason, Associate Professor, Women's and Gender Studies, Mount Royal UniversityLeah Hamilton, Professor in the Faculty of Business & Communication Studies, Mount Royal UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2206182024-01-10T13:29:31Z2024-01-10T13:29:31Z‘Thirst trap’ and ‘edgelord’ were recently added to the dictionary – so why hasn’t ‘nibling’ made the cut?<figure><img src="https://images.theconversation.com/files/568127/original/file-20240107-19-mm0vw0.jpg?ixlib=rb-1.1.0&rect=59%2C29%2C4902%2C3211&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A rose by any other name would smell as sweet – but would it sound as sweet?</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/little-rose-royalty-free-image/1280008568?phrase=open+dictionary+flowers&searchscope=image%2Cfilm&adppopup=true">Alicia Llop/Moment via Getty Images</a></span></figcaption></figure><p>A student in my graduate seminar recently mentioned seeing her “niblings” at Thanksgiving. Some of the students in my class were clearly familiar with the term. But others frowned, suggesting that they hadn’t heard the term before, or didn’t know what it meant.</p>
<p>A nibling is the child of one’s brothers or sisters. The word is a blend of the “n” in “niece” and “nephew” with “sibling,” and it was coined in the <a href="https://www.degruyter.com/document/doi/10.1515/9783110857610/html">early 1950s</a> by linguist Samuel Martin.</p>
<p>But even though it’s been around for over 70 years, the word <a href="https://www.merriam-webster.com/dictionary/nibling">isn’t included</a> in the online Merriam-Webster dictionary. </p>
<p>The <a href="https://www.merriam-webster.com/wordplay/new-words-in-the-dictionary">most recent crop</a> of terms added to the dictionary includes words like <a href="https://www.merriam-webster.com/dictionary/edgelord">edgelord</a> – a person who makes provocative statements online – and <a href="https://www.merriam-webster.com/dictionary/thirst%20trap">thirst trap</a>, which is an online photo that’s meant to grab attention. Edgelord was first recorded in 2015, and thirst trap dates from 2011.</p>
<p>So why have these newbie words made the cut? Why have they been chosen for inclusion, but not nibling?</p>
<p>In making such decisions, the dictionary’s editors note that they employ <a href="https://www.merriam-webster.com/help/faq-words-into-dictionary">two criteria</a>. First, a term “must be used in a substantial number of citations that come from a wide range of publications.” Second, these citations need to cover “a considerable period of time.”</p>
<p>But there may be another litmus test that the editors employ, perhaps subconsciously: aesthetics. </p>
<h2>Blended words</h2>
<p>Many new terms are a blend of two words that already exist. </p>
<p>Some of these mashups are now so familiar that they aren’t even perceived as such, such as <a href="https://www.merriam-webster.com/dictionary/smog">smog</a>, a combination of “smoke” and “fog,” and <a href="https://www.merriam-webster.com/dictionary/motel">motel</a>, a union of “motor” and “hotel.”</p>
<p>Dictionary editors are conservative because they want to enshrine just the new words that remain reasonably popular and that are likely to have some staying power. But dictionaries are full of terms that have fallen out of use. When is the last time you heard someone refer to a <a href="https://www.merriam-webster.com/dictionary/houppelande">houppelande</a> or a <a href="https://www.merriam-webster.com/dictionary/blatherskite">blatherskite</a>?</p>
<p>Editors have chosen to exclude some terms despite the fact that they have been around for a long time. <a href="https://www.dictionary.com/e/aunt-uncle-niece-nephew-words/">Nibling</a> is one, and <a href="https://www.merriam-webster.com/grammar/no-antidisestablishmentarianism-is-not-in-the-dictionary">antidisestablishmentarianism</a> is another, even though the latter was first used over a century ago, <a href="https://www.oed.com/dictionary/antidisestablishmentarianism_n?tab=meaning_and_use#1726801">in 1900</a>.</p>
<p>But after 70 years in the shadows, nibling may finally be having its moment. In 2020, Jennifer Lopez used it in an <a href="https://www.nbcnews.com/feature/nbc-out/jennifer-lopez-shares-video-about-transgender-nibling-brendon-n1237838">Instagram post</a> to refer to her sister’s transgender child. Her post was viewed over <a href="https://www.instagram.com/p/CENEADXpCao/?utm_source=ig_embed&ig_rid=0dff33a9-c77e-4da7-8a49-e8983a791088">2 million times</a>. The term was also used in the sixth season of the TV show “<a href="https://bigbangtheory.fandom.com/wiki/Four_Hundred_Cartons_of_Undeclared_Cigarettes_and_a_Niblingo">Young Sheldon</a>” to refer to the title character’s unborn niece or nephew.</p>
<p>However, nibling has <a href="https://www.nytimes.com/search?dropmab=false&query=nibling&sort=best">never graced</a> the pages of The New York Times, and it’s appeared <a href="https://www.washingtonpost.com/search/?query=nibling">just twice</a> in The Washington Post, in articles from late 2023.</p>
<h2>The importance of aesthetics</h2>
<p>With English speakers becoming more comfortable with gender-neutral terms, such as the <a href="https://www.merriam-webster.com/wordplay/singular-nonbinary-they">singular “they</a>,” nibling seems like a natural addition to English’s gender-neutral lexicon.</p>
<p>But it seems that, in addition to utility and widespread use, a third factor plays a role: aesthetic quality. Nibling simply sounds off-putting, too similar to “nibbling” – and not exactly something that you want to associate with family members.</p>
<p><a href="https://www.dailymail.co.uk/femail/article-9627475/Do-call-niece-nephew-nibling-1950s-gender-neutral-term-wildly-popular.html">A 2021 Daily Mail article</a> agreed, calling nibling “skin crawling and awkward.” </p>
<p>And consider the case of Latinx, a word that was coined to be gender-neutral and inclusive. Although it has appeared in Merriam-Webster since 2018, it may end up going the way of an expression like “<a href="https://www.merriam-webster.com/dictionary/colored">colored</a>,” a term that was once “<a href="https://www.npr.org/sections/codeswitch/2014/03/30/295931070/the-journey-from-colored-to-minorities-to-people-of-color">a term of racial pride</a>,” according to the Oxford English Dictionary, but which is now considered offensive and has fallen out of use.</p>
<p>No matter how useful Latinx may be, the term is <a href="https://theconversation.com/stop-using-latinx-if-you-really-want-to-be-inclusive-189358">widely disliked</a> in the Hispanic community. A major reason seems to be the word’s lack of aesthetics. One Latina interviewed by Billboard described it as <a href="https://www.billboard.com/music/latin/latinx-term-latin-community-9514370/">sounding “ugly</a>,” and people can’t seem to agree on <a href="https://www.merriam-webster.com/wordplay/word-history-latinx">how to pronounce it</a>. The more pronounceable <a href="https://www.bestcolleges.com/blog/hispanic-latino-latinx-latine/">Latine</a> has been proposed as an alternative.</p>
<h2>“Phablet” not fabulous?</h2>
<p>Aesthetics may also help explain why some other blended words, such as <a href="https://www.oed.com/dictionary/phablet_n?tab=meaning_and_use#302938524">phablet</a>, a fusion of phone and tablet, have failed to catch on. A term for large cellphones, it’s been in use since <a href="https://www.oed.com/dictionary/phablet_n?tab=meaning_and_use#302938524">at least 2010</a>, although it doesn’t currently appear in Merriam-Webster’s word list.</p>
<p>Phablet made its <a href="https://archive.nytimes.com/boss.blogs.nytimes.com/2013/01/21/this-week-in-small-business-facebook-search/?searchResultPosition=1">first appearance</a> in The New York Times in 2013 and was set off by quotation marks – a standard way of demarcating a new term. In its <a href="https://www.nytimes.com/2019/01/05/opinion/sunday/apple-china.html?searchResultPosition=4">last appearance</a>, excluding in puzzles, in that newspaper in 2019, it was still bracketed by quotation marks. </p>
<p>Why did it fail to catch on?</p>
<p>In a <a href="https://www.theatlantic.com/technology/archive/2013/01/what-is-a-phablet/319563/">2013 article</a>, The Atlantic characterized phablet as “horrible,” “stupid” and “clumsy.” The piece suggested that it reminded people of words like “flab” and “phlegm.” Usage data compiled by Oxford English Dictionary editors indicates that phablet <a href="https://www.oed.com/dictionary/phablet_n?tab=frequency#302938524">peaked in popularity</a> in 2018 and has been dropping ever since.</p>
<h2>Utility versus aesthetics</h2>
<p>In some cases, however, utility has clearly trumped aesthetics. The initialism LGBT, which is clunky to say, has been used since at least 1992 and has appeared in <a href="https://www.nytimes.com/search?dropmab=false&query=lgbt&sort=oldest">almost 6,000 articles</a> in The New York Times since 2000.</p>
<p>LGBT has sprouted a number of <a href="https://www.nytimes.com/2018/06/21/style/lgbtq-gender-language.html">more inclusive variants</a>, such as LGBTQ, LGBTQ+ and LGBTQIA, which makes it difficult to know <a href="https://thecentercv.org/en/blog/the-guide-to-lgbtq-acronyms-is-it-lgbt-or-lgbtq-or-lgbtqia/">which one to use</a>. </p>
<figure class="align-center ">
<img alt="A sign reading 'LGBTQIA+ Info' is taped to a blue tarp." src="https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=468&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=468&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=468&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=588&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=588&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568082/original/file-20240105-19-uhx6n4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=588&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘LGBTQ,’ even as an ever-evolving mouthful, has caught on.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/march-2022-berlin-lgbtqia-info-is-written-on-a-poster-news-photo/1239046196?adppopup=true">Annette Riedl/Picture Alliance via Getty Images</a></span>
</figcaption>
</figure>
<p>Nevertheless, these ungainly initialisms remain popular, despite their awkwardness, because they clearly fill a need.</p>
<p>Will nibling go the way of phablet, or will it become as common as LGBTQ? </p>
<p>Merriam-Webster’s editors have nibling on their list of <a href="https://www.merriam-webster.com/wordplay/words-were-watching-nibling">words they are watching</a>. But it remains to be seen whether a useful but awkward blend will appeal to a more inclusive world.</p><img src="https://counter.theconversation.com/content/220618/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Roger J. Kreuz does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Pleasant-sounding words might have a leg up.Roger J. Kreuz, Associate Dean and Professor of Psychology, University of MemphisLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2047772023-08-31T12:20:15Z2023-08-31T12:20:15ZTrans students benefit from gender-inclusive classrooms, research shows – and so do the other students and science itself<figure><img src="https://images.theconversation.com/files/541976/original/file-20230809-15-2j6fem.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Teaching sex and gender more accurately can counter gender stereotypes and encourage all students to study STEM.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-in-denim-t-shirt-with-rainbow-symbol-wear-royalty-free-image/1365444357">Iurii Krasilnikov/iStock via Getty Images Plus</a></span></figcaption></figure><p>Across the U.S., legislators are debating how and when sex and gender should be discussed in the classroom and beyond. Specifically, <a href="https://www.transformationsproject.org/state-anti-trans-legislation">these bills</a> are considering whether anything beyond male or female can be included in library books and lesson plans. These bills are part of a larger debate on how to define and regulate sex and gender, and there are no immediate answers that satisfy everyone.</p>
<p>Many of the bills draw on science to make claims about sex and gender. For example, <a href="https://www.flsenate.gov/Session/Bill/2023/1069">Florida House Bill 1069</a>, which legislates pronoun use in schools, assumes that all of a person’s sex markers – listed as sex chromosomes, “naturally occurring” sex hormones and internal and external genitalia at birth – will align as female or male “based on the organization of the body … for a specific reproductive role.” The bill claims that “a person’s sex is an immutable biological trait and that it is false to ascribe to a person a pronoun that does not correspond to such person’s sex.”</p>
<p>Invoking biology is a way to sound objective, but it’s not so simple. Science itself is still grappling with the nature of sex and gender.</p>
<p>My co-author Sam Long and I are <a href="https://doi.org/10.1525/abt.2021.83.7.427">high school</a> and <a href="https://scholar.google.com/citations?user=rZ-cbGUAAAAJ&hl=en">college science educators</a> who research how to <a href="https://www.genderinclusivebiology.com">increase student motivation, interest and retention in biology</a>. Our work and that of our colleagues show that teaching sex and gender more accurately in classrooms benefits not only gender-diverse students but all students and the field of science.</p>
<h2>Science of sex and gender</h2>
<p>Bills like Florida’s define sex as a binary set of biological traits. But scientists know that sex is far more complicated.</p>
<p>In nature, there is a <a href="https://doi.org/10.1371/journal.pbio.1001899">huge diversity</a> in how sexes are arranged within bodies. For example, the sex of some organisms is classified by the size of their gametes, or sperm and eggs. Some species produce both gametes in one body. Some change whether they produce sperm or eggs over their lifetime. Others technically don’t have a sex at all.</p>
<p>Sex in humans is actually an <a href="https://doi.org/10.4324/9780203127971">amalgamation of many traits</a>, which include the type of gametes a person produces as well as their reproductive tract anatomy, hormone levels and secondary sex characteristics like hair growth and chest shape. These traits are determined not just by a few genes on the X and Y chromosomes but also by a <a href="https://doi.org/10.1038/s41598-019-53500-y">myriad of genes</a> on other chromosomes as well as the <a href="https://doi.org/10.1038/s41598-019-53500-y">developmental environment</a>. When <a href="https://courses.lumenlearning.com/wm-biology1/chapter/reading-polygenic-inheritance-and-environmental-effects/">many genes</a> contribute to a trait, it appears as a continuum.</p>
<p>The continuum of human sex is illustrated by the experiences of intersex individuals. For nearly two out of every 100 people, a binary definition of sex <a href="https://www.hachettebookgroup.com/titles/anne-fausto-sterling/sexing-the-body/9781541672895/">would not work</a>. People <a href="https://theconversation.com/not-everyone-is-male-or-female-the-growing-controversy-over-sex-designation-172293">who are intersex</a> don’t have chromosomes, hormones or internal and external genitalia that completely match cultural expectations of what males and females should look like. Under these bills, what pronouns would they be allowed to use? There is <a href="https://doi.org/10.1038/518288a">no universal scientific rule</a> for pronoun assignment.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/kT0HJkr1jj4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Sex is a spectrum.</span></figcaption>
</figure>
<p>If sex is not binary, then <a href="https://theconversation.com/sex-and-gender-both-shape-your-health-in-different-ways-98293">gender</a> – or personal perceptions of masculinity, femininity, a mix of both, or neither – cannot be either. A 2022 Pew Research Center survey found that roughly <a href="https://www.pewresearch.org/short-reads/2022/06/07/about-5-of-young-adults-in-the-u-s-say-their-gender-is-different-from-their-sex-assigned-at-birth/">1.6% of U.S. adults</a> describe their gender as not aligned with their sex assigned at birth, which can be captured by the terms transgender or nonbinary.</p>
<p>Overall, science <a href="https://doi.org/10.1086/692517">does not have a definitive answer</a> for how to define sex and gender in people that lawmakers can draw upon – science only indicates that these traits are nuanced and complex.</p>
<h2>Limiting teaching on sex and gender affects everyone</h2>
<p>Bills limiting how sex and gender are taught exacerbate the disproportionate obstacles that transgender students already face. The 2019 National School Climate Survey of over 16,700 students in the U.S., conducted by national education nonprofit Gay, Lesbian and Straight Education Network, or GLSEN, reported that trans teens in <a href="https://www.glsen.org/research/2019-national-school-climate-survey">schools without gender-inclusive curricula</a> experienced more bullying, a decreased sense of belonging, poor academic performance and low psychological well-being.</p>
<p>Restrictive bills also discourage LGBT students from studying science. The 2013 GLSEN Network National School Climate Survey found that LGBT teens were <a href="https://www.glsen.org/sites/default/files/2020-03/GLSEN-2013-National-School-Climate-Survey-Full-Report.pdf">less interested in majoring in STEM</a> and the social sciences when the high school classes they took in those fields were not taught with inclusive curricula. </p>
<p>I and my colleagues found similar downstream effects on <a href="https://doi.org/10.1187/cbe.21-12-0343">college students</a>: Trans and nonbinary students reported feeling isolated and uncomfortable in biology courses that teach sex and gender only as a binary. They felt they couldn’t form relationships with their teachers or peers, and this lack of a supportive personal network prevented them from requesting letters of recommendation or getting involved in research. Some dropped out of STEM, and many others contemplated it.</p>
<p>Limiting gender-inclusive curricula in schools can ultimately have negative effects on all students. Children begin <a href="https://doi.org/10.1146/annurev.psych.093008.100511">developing and testing</a> their understanding of sex and gender starting as young as 2 years old. Erasing gender diversity even in elementary schools reinforces <a href="https://doi.org/10.1037/amp0000307">inaccurate conceptions of sex and gender</a> that can last a lifetime. For example, a 2018 study of 132 college students found that those who read a paper emphasizing binary sex and typical gender roles exhibited <a href="https://doi.org/10.1007/s11199-017-0786-3">increased prejudice against transgender people</a>. A 2019 study of 460 eighth through 10th grade students found that those taught an oversimplified and inaccurate definition of sex – as defined by sex chromosomes – had increased beliefs about the genetic basis of sex and in <a href="https://doi.org/10.1002/sce.21502">stereotypes about men and women</a>, including unchangeable sex differences in intelligence and scientific ability. These studies suggest that teaching oversimplified narratives about sex and gender influences not only how students conceive sex and gender but also beliefs about their own and others’ abilities.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Protestors holding signs reading 'Protect trans kids' and other slogans" src="https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/541788/original/file-20230808-27-jcydy2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People rally in front of the Kentucky State Capitol on Mar. 29, 2023, to protest the passing of Senate Bill 150, a ‘Don’t Say Gay’ bill that bans gender-affirming care for trans youth, limits discussion of LGBTQ topics in K-12 schools and allows teachers to misgender students.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-many-of-whom-are-adolescents-gather-during-a-rally-news-photo/1249909096">Jon Cherry/Stringer via Getty Images</a></span>
</figcaption>
</figure>
<p>The trans and nonbinary college biology students we interviewed suggest there is another long-term harm of oversimplifying sex and gender: <a href="https://doi.org/10.1187/cbe.21-12-0343">lack of preparation</a> for a future career in science or medicine. An oversimplified understanding of sex and gender does not train students to work with the diverse patients and clients they might encounter, and it can <a href="https://mashable.com/article/transgender-healthcare">worsen health disparities</a> for trans people.</p>
<p>Lack of exposure to a broader range of sex and gender roles also limits potential scientific discoveries. Being taught only binary sex and genders biases the research questions scientists consider and the way they interpret their findings.</p>
<p>The study of <a href="https://theconversation.com/women-have-disrupted-research-on-bird-song-and-their-findings-show-how-diversity-can-improve-all-fields-of-science-142874">birdsong</a> offers one example of how this bias can influence research. A common stereotype is that male birds are more competitive than female birds. Because competition occurs partially through song, researchers studied birdsong only in males for a long time. Some scientists recently challenged these beliefs about sex roles by finding that females sing in <a href="https://doi.org/10.1098/rsbl.2019.0059">about 64% of songbird species</a>, opening doors to greater understanding of the function of birdsong.</p>
<h2>What educators and scientists can do</h2>
<p>When science is being misrepresented to justify oversimplified ideas about sex and gender in schools, scientists and science educators have an important role to play. </p>
<p>Sharing perspectives about gender diversity with school boards and elected officials can make a difference. Bringing conversations about sex and gender into the classroom can help all students feel seen and reduce gender stereotypes. Through his work with educators, my co-author, Sam Long, knows it can be intimidating to get into these conversations, but they do not have to be fights about who is right or wrong. Encouraging curiosity about human variation and questioning the portrayal of any trait as pathological simply because it is different or uncommon can help students think critically about sex and gender in respectful ways. </p>
<p>Disability advocates offer an <a href="https://odpc.ucsf.edu/clinical/patient-centered-care/medical-and-social-models-of-disability">inclusive approach</a> that focuses on changing the environment to fit the person rather than changing the person to fit the environment. Physical and mental variations do not inherently reduce a person’s ability to thrive; instead, it is environmental and culture barriers that are limiting or disabling. Educators can pose questions that encourage students to explore this idea. For example, red hair is as rare as intersex traits. Of the two, why are only intersex traits often framed as a disorder? Likewise, human height varies across people. How are buildings, products and services designed to accommodate a spectrum of heights? Why haven’t other physical variations been accommodated in the same way?</p>
<p>Initiatives like <a href="https://www.genderinclusivebiology.com/">Gender-Inclusive Biology</a>, <a href="https://projectbiodiversify.org/sex/">Project Biodiversity</a>, and <a href="https://welcomingschools.org/resources">Welcoming Schools</a> offer additional resources to help adapt the curriculum to acknowledge and celebrate variation in the living world. My co-author Sam is a founding member of Gender-Inclusive Biology.</p>
<p>Encouraging students to think critically about the complexity of sex and gender will encourage everyone to pursue their passions regardless of gender stereotypes, promote creative thinking in science and medicine and support trans students. In this way, teaching about sex and gender complexity can benefit everyone.</p><img src="https://counter.theconversation.com/content/204777/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Eddy receives funding from the National Science Foundation.</span></em></p>‘Don’t Say Gay’ bills claim to use science to justify a binary definition of sex based on certain traits. But the biology of sex and gender is not so simple.Sarah Eddy, Assistant Professor of Biological Sciences, Florida International UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2074472023-06-21T13:52:42Z2023-06-21T13:52:42ZBathrooms are political: how gender-inclusive toilets can combat indignity and violence<figure><img src="https://images.theconversation.com/files/531679/original/file-20230613-22-8i55jf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Swasdee/Getty Images</span></span></figcaption></figure><p>A new hate crimes bill is inching <a href="https://ewn.co.za/2023/03/14/national-assembly-passes-bill-to-criminalise-hate-speech-and-hate-crimes">closer</a> to the possibility of becoming law in South Africa. The <a href="https://www.justice.gov.za/legislation/hcbill/B9-2018-HateCrimesBill.pdf">bill</a> entrenches human dignity as a foundational value of the country by providing for penalties for explicit acts of violence and discrimination motivated by prejudice and intolerance.</p>
<p>However, prejudice and intolerance can also be expressed and experienced in everyday ways that are often taken for granted. The bill does not necessarily acknowledge this. It’s crucial to acknowledge that acts of discrimination happen not only in obvious forms of hate speech and violence in public spaces. They also happen in the everyday private spaces that form part of our homes, faith spaces, workplaces and, in particular, the bathrooms available in these spaces. </p>
<p>As <a href="https://www.psyssa.com/divisions/sexuality-and-gender-division-sgd/">psychologists</a> and <a href="https://orcid.org/0000-0001-7406-147X">scholars</a> working in the fields of sexualities and gender in a country with high levels of <a href="https://books.google.co.za/books/about/Rape.html?id=72NcjgEACAAJ&redir_esc=y">gender-based violence</a>, we are sensitive to the anxieties of all people and, in particular, women, who voice an almost omnipresent sense of the <a href="https://www.tandfonline.com/doi/abs/10.1080/17450101.2021.1942171">threat</a> of violence in public spaces. But we’ve also come to <a href="https://www.tandfonline.com/doi/abs/10.1080/10130950.2017.1369717">understand</a> that people whose gender appearance may be “non-normative” often feel unsafe in public bathrooms.</p>
<p>As the debate around gender-inclusive toilets rages around the world, we argue that shared bathrooms create more inclusive societies that ultimately protect human dignity.</p>
<h2>Bathrooms are public-private spaces</h2>
<p>The bathroom, a seemingly private yet inherently public space, has become subject to intense scrutiny. Especially regarding the rights of trans and gender diverse individuals, both in <a href="https://www.iol.co.za/capeargus/news/petition-against-unisex-bathrooms-at-schools-garners-thousands-of-signatures-cf9c8046-27d6-4ec1-9729-b4d6316177db">South Africa</a> and <a href="https://www.pbs.org/newshour/show/more-states-consider-bills-limiting-which-bathroom-trans-people-can-use">abroad</a>. (A transgender person identifies with a gender different from that of their sex that’s assigned at birth. A gender diverse person has a gender identity or expression that’s at odds with what’s perceived as being the social norm.)</p>
<p>The public bathroom has become a lightning rod for a general social anxiety about safety and gender. Are women safe if a trans woman uses the same bathroom? What does it mean to the gender (and indeed sexuality) of men if a trans man uses the “men’s bathroom”? Aren’t children at risk if anyone can “decide” they are trans and walk into a public bathroom? Why can’t we keep things simple and make people go to the bathroom according to their sex assigned at birth? </p>
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Read more:
<a href="https://theconversation.com/how-did-public-bathrooms-get-to-be-separated-by-sex-in-the-first-place-59575">How did public bathrooms get to be separated by sex in the first place?</a>
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<p>It’s in this context of moral and personal panic, we argue, that in fact it’s trans and gender diverse people who are most at risk of a “quiet violence” as they attempt to access and navigate these everyday spaces.</p>
<p>This discrimination is “quiet” because it does not appear as the kind of overt act of violence that the hate crimes bill seeks to legislate against, such as a transphobic slur or assault. However, it remains a form of violence because trans and gender diverse people <a href="https://www.tandfonline.com/doi/abs/10.1080/10130950.2017.1369717">feel</a> policed and threatened navigating these spaces.</p>
<h2>Bathrooms as political arenas</h2>
<p>Bathrooms hold more than a functional purpose; they’re historically significant sites of overt and covert political struggles. Throughout social justice movements worldwide, bathrooms have played pivotal <a href="https://www.pennlive.com/news/2016/05/bathrooms_culture_wars_front_l.html">roles</a>. In the US, bathrooms became contested <a href="https://books.google.co.za/books?id=dQO5DwAAQBAJ&pg=PA235&dq=history+of+bathroom+struggles+in+the+united+states&hl=en&newbks=1&newbks_redir=0&sa=X&ved=2ahUKEwjk17-ym77_AhUMBcAKHYYUB_8Q6AF6BAgJEAI#v=onepage&q&f=false">spaces</a> during civil rights movements for women’s rights, desegregation and disability rights.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two people of colour pass an entrance to a public facility that has a large sign above it reading " src="https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=843&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=843&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=843&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1059&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1059&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531956/original/file-20230614-27-g23dqy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1059&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">South Africa, 1977.</span>
<span class="attribution"><span class="source">Andrzej Sawa/Sunday Times/Gallo/Getty Images</span></span>
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<p><a href="https://www.sahistory.org.za/article/history-apartheid-south-africa">Apartheid</a> also <a href="https://www.whiteswritingwhiteness.ed.ac.uk/traces/reservation-of-separate-amenities-act-1953/">enforced</a> strict policing and segregation of public amenities including swimming pools, beaches and toilets. This perpetuated institutionalised racism and a disregard for the dignity and worth of people of colour. </p>
<p>This legacy <a href="https://ccs.ukzn.ac.za/files/amisi%20nojiyeza.pdf">endures</a> in historically marginalised communities, where the “<a href="https://www.statssa.gov.za/?p=15574">bucket system</a>” (non-flush toilets where a bucket is used to collect waste), <a href="https://www.news24.com/news24/southafrica/news/body-of-4-year-old-girl-found-in-eastern-cape-school-pit-toilet-20230309">pit latrines</a> and <a href="https://theconversation.com/flushing-toilets-arent-the-solution-to-south-africas-sanitation-problem-194768">inadequate sanitation facilities</a> persist.</p>
<h2>The gendered nature of bathrooms</h2>
<p>Choosing between “men’s” and “women’s” bathrooms subjects an individual to a normative system that organises and disciplines their body based on a sex-segregated understanding of gender. </p>
<p>This system enforces a binary of gender, defined solely by two biological sexes – male and female. For trans and gender diverse individuals, selecting a bathroom becomes a calculation of self-preservation. This requires <a href="https://www.tandfonline.com/doi/full/10.1080/0966369X.2015.1073699?src=recsys">self-surveillance</a> in an effort to minimise the likelihood of <a href="https://galop.org.uk/resource/transphobic-hate-crime-report-2020/">harassment</a> and violence for deviating from normative gender presentations.</p>
<h2>Violence and discrimination in bathrooms</h2>
<p>Bathrooms are often <a href="https://academic.oup.com/hsw/article-abstract/46/4/260/6378750">reported</a> to be distressing spaces for trans and gender diverse individuals, becoming sites where they experience discrimination and exclusion. Occupying gendered facilities can <a href="https://www.tandfonline.com/doi/full/10.1080/10538720.2021.1920539?src=recsys">lead</a> to discomfort, verbal abuse and physical assault. Being forced to “hold in” basic biological functions can also <a href="https://psycnet.apa.org/record/2016-35588-001">result</a> in health problems.</p>
<p>Calls for these individuals to use bathrooms aligned with their assigned sex at birth don’t only demonstrate the binary model of gender. They are discriminatory and foster <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/casp.851">conditions</a> that perpetuate violence, confusion and negative attitudes towards trans individuals. It’s crucial to recognise that violence against trans and gender diverse people is often overlooked. </p>
<h2>Ensuring recognition and safety</h2>
<p>It’s critical to acknowledge women’s concerns regarding the prospect of sexual assault in using gender-inclusive bathrooms. It’s equally crucial to challenge the notion that bodies assigned male at birth are inherently violent and that safety can only be guaranteed through gender-specific or sex-segregated bathroom arrangements. </p>
<p>Studies from <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407760/">Australia</a>, the <a href="https://journals.sagepub.com/doi/pdf/10.1177/1948550617737601?casa_token=vK1Yv9s3sAkAAAAA:dDCHBNWF8DmsYge3J8CB5cFXlYZBvOHVIrjM7PD8MkSt6vgCaeoK6Mj95LucYLhlfqKrjGfiz9xr8xk">US</a> and the <a href="http://shura.shu.ac.uk/21258/1/Around%20the%20Toilet%20Report%20final%201.pdf">UK</a> have suggested that gender-inclusive facilities do not compromise <a href="https://link.springer.com/article/10.1007/s13178-018-0335-z">safety</a> or privacy. </p>
<p>In fact, they serve as <a href="https://escholarship.org/uc/item/19r9v71k">catalysts</a> for social change, challenging binary constructs and debunking the notion of inherent male violence. Reducing violence to a specifically gendered body overlooks the <a href="https://link.springer.com/referenceworkentry/10.1007/978-1-4614-5583-7_605">complex</a> social psychology of violence, which is rooted in gendered power asymmetries, control and dehumanisation.</p>
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<strong>
Read more:
<a href="https://theconversation.com/lgbtiq-learners-at-risk-in-south-africa-as-conservative-christian-groups-fight-plans-for-safer-schools-194823">LGBTIQ learners at risk in South Africa as conservative Christian groups fight plans for safer schools</a>
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<p>By recognising the discrimination that trans and gender diverse people face in these spaces and implementing new gender-inclusive bathroom arrangements which accommodate all people, we believe that inclusive societies can challenge harmful assumptions and contribute to the cause of dignity for all.</p>
<p><em>This article was revised.</em></p><img src="https://counter.theconversation.com/content/207447/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jarred H Martin sits on the Executive Committee for the Sexuality and Gender Division of the Psychological Society of South Africa. </span></em></p><p class="fine-print"><em><span>Pierre Waldemar Brouard is affiliated with the Sexuality and Gender Division of the Psychological Society of South Africa and is a board member of the Professional Association of Transgender Health South Africa.</span></em></p>Studies show unisex toilets don’t lead to violence – and they create a safer space for gender diverse people.Jarred H Martin, Senior Lecturer in Clinical Psychology, University of PretoriaPierre Waldemar Brouard, Acting director of the Centre for Sexualities, AIDS & Gender, University of Pretoria, University of PretoriaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2039302023-04-19T05:48:20Z2023-04-19T05:48:20ZACMI’s Goddess asks us rethink our gaze – and the bias it contains – when we look upon women on the screen<figure><img src="https://images.theconversation.com/files/521765/original/file-20230419-19-zlj6co.jpg?ixlib=rb-1.1.0&rect=0%2C6%2C4493%2C2984&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">ACMI's Goddess: Power, Glamour, Rebellion. </span> <span class="attribution"><span class="source">Eugene Hyland Photography</span></span></figcaption></figure><p>The most fascinating aspect of screen museum ACMI’s new exhibition <a href="https://www.acmi.net.au/whats-on/goddess/">Goddess: Power, Glamour, Rebellion</a>, and the major contribution it makes, is the way it generates fresh understandings of women on screen, including in relation to Australia. </p>
<p>Goddess has been in planning for five years, celebrating 120 years of women and the moving image. Curated in Australia by Bethan Johnson for ACMI, the museum will eventually travel it globally. </p>
<p>Geena Davis and her institute on <a href="https://seejane.org">Gender in the Media</a> are the perfect partners for the new show; not only because Davis is a screen goddess herself, but because of her leadership. Gender in the Media is a research and advocacy organisation which looks at the representation of gender and sexuality, race, disability, age and body types on screen.</p>
<p>“You cannot be what you cannot see” frames not just the mission of Davis’ institute, but points to the key message of the show: the power and significance of representation. </p>
<p>The exhibition features cinematic moments, iconic costumes, sketches, posters, photographs, magazines and interactive experiences. You can even make a goddess image of yourself to take home.</p>
<p>Stars we ordinarily think of as goddesses are showcased, such as Marilyn Monroe, Pam Grier and Davis in clips and costumes of their iconic roles. </p>
<p>But the show also asks audiences to rethink what a “goddess” might be understood to be, do and mean.</p>
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Read more:
<a href="https://theconversation.com/where-are-the-women-scientists-tech-gurus-and-engineers-in-our-films-70032">Where are the women scientists, tech gurus and engineers in our films?</a>
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<h2>Aussie goddesses</h2>
<p>Curators draw their inspiration and vision from the culture within which they operate. The exhibition, therefore, has something to say about – or from – this country and its talent.</p>
<p>The Australian lens shaping the selection, presentation and commentary about characters, stories and experiences is initially invoked by the soundscapes created by Melbourne-based composer, DJ and musician Chiara Kickdrum. </p>
<p>This continues further inside, in a darkened room where audiences see a montage of clips of stars speaking at awards and events about industry ageism, sexism, racism, advocacy for women and female courage. First Nations filmmaker Leah Purcell, in full regalia at the AACTA awards, says: </p>
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<p>It’s truth telling that this country needs to hear [so] we can move to the future with better understanding of who we are as a nation. </p>
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<p>Elsewhere, the exhibition features “Fearless Nadia” (Mary Ann Evans), an Australian actor who became Bollywood’s leading stunt woman in the 1930s, swinging from chandeliers, leaping from speeding trains and taming lions. She was one of the earliest female leads of Hindi cinema.</p>
<p>Australian Hollywood costume designer <a href="https://en.wikipedia.org/wiki/Orry-Kelly">Orry-Kelly</a> won three Academy Awards and the show includes the iconic costume he created for Marilyn Monroe for Billy Wilder’s Some Like It Hot (1959). </p>
<p>In the book that accompanies the exhibition, a quote from Monroe gives an insight into being typecast by her body: </p>
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<p>I am tired of the same old sex roles. I want to do better things. People have scope, you know. </p>
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<h2>The body of the goddess</h2>
<p>A key element of this exhibition is the spectacular display of the body of the screen goddess – from classical Hollywood to contemporary popular culture.</p>
<p>ACMI is framing the goddess not just by the tired “starlet” and “bombshell” tropes, but as a woman who pushes boundaries, questions norms and stereotypes.</p>
<p>At the beginning of the exhibition we encounter fashion model Winnie Harlow in Monroe’s iconic pink dress from <a href="https://www.youtube.com/watch?v=bfsnebJd-BI">Diamonds are a Girl’s Best Friend</a>, a performance in the 1953 film Gentlemen Prefer Blondes.</p>
<p>The beautiful Harlow is a spokesperson for the skin condition vitiligo (where her skin has lost colour in parts). Her gaze is confident: she invites our gaze in return, challenging notions of perfection. Her flesh becomes costume, and I think of the idea “it is not what you wear, but how you wear it” — a kind of mantra for individualism (although what she wears also has its own meanings and legacy). We are all unique, but her skin conveys this idea. </p>
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<a href="https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=750&fit=crop&dpr=1 600w, https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=750&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=750&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=943&fit=crop&dpr=1 754w, https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=943&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/521763/original/file-20230419-16-gvtlwq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=943&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Winnie Harlow.</span>
<span class="attribution"><span class="source">Photo: Albert Sanchez</span></span>
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<p>In clips we see the pressure on female actors to achieve an impossible standard of beauty. </p>
<p>Olivia Colman argues for the messy, imperfect body: </p>
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<p>I’m an actor, not a model and I think you should be able to look horrendous […] that’s what I love doing. </p>
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<p>A young Helen Mirren asks a journalist whether he means “serious actors cannot have big bosoms?” </p>
<p>Speaking across the decades Audrey Hepburn, Kate Winslet, Michelle Yeoh and Ellen DeGeneres all offer commentaries about how their ageing bodies have influenced their selfhood and careers. </p>
<p>A youthful Jane Fonda alludes to her experience of being a body and not a mind: </p>
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<p>people seem to think that if you’re a girl, you have to behave in a way that is not militant or political, especially if you’re an actress […] how dare an actress think or be political!</p>
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<p>Gender fluidity, women of colour, queer women, culturally diverse goddesses, and high-kicking action heroines all have something to say about the myriad of ways that we can understand a goddess in 2023. </p>
<p>As this exhibition has it, the goddess can be anything she wants to: not just swing from chandeliers, leap from speeding trains or the backs of lions (while being drop dead gorgeous). </p>
<p>In the battle to be represented, she has been seen, she has offered a female gaze — one where they are individuals rather than ideals or icons. Goddess asks us to rethink our own gaze, and the bias it contains, to see the ways in which identities are constructed in media, according to the belief systems of the culture that created them. In this, the exhibition admirably succeeds.</p>
<p><em>Goddess: Power, Glamour, Rebellion is at ACMI, Melbourne, until October 1.</em></p>
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Read more:
<a href="https://theconversation.com/changing-the-portrayal-of-women-in-film-means-getting-more-women-behind-the-lens-60021">Changing the portrayal of women in film means getting more women behind the lens</a>
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<img src="https://counter.theconversation.com/content/203930/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lisa French was a guest speaker for ACMI's Public Program aligned to the Goddess exhibition: 'Being Seen on Screen: The Importance of Representation'.
RMIT University, ACMI’s Major Research Partner.</span></em></p>Stars we ordinarily think of as goddesses are showcased, but the show also asks audiences to rethink what a ‘goddess’ might be.Lisa French, Professor & Dean, School of Media and Communication, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2027432023-04-03T20:07:00Z2023-04-03T20:07:00ZFamily support protects trans young people – but their families need support too<figure><img src="https://images.theconversation.com/files/518924/original/file-20230403-16-95dw67.jpg?ixlib=rb-1.1.0&rect=0%2C17%2C5747%2C3759&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sacramento-ca-us-october-9-2021-2055065948">Shutterstock</a></span></figcaption></figure><p>In her address to the <a href="https://www.npc.org.au/speaker/2023/1143-georgie-stone-oam">National Press Club of Australia</a> today, actress, writer and advocate Georgie Stone OAM is sharing her experience as a young trans person growing up in Australia. </p>
<p>Georgie’s story highlights her courage and determination to overcome barriers that prevent young trans people from accessing gender affirming health care and support. At just 22, Georgie has been <a href="https://transcend.org.au/about/georgie-stone/">recognised</a> for her tireless work to reduce discrimination and remove systemic barriers for young trans people, who were subjected to attacks at recent <a href="https://www.theguardian.com/australia-news/2023/mar/25/whats-behind-the-terrifying-backlash-against-australias-queer-community">protests</a> in Melbourne, Sydney and Canberra. </p>
<p>In the face of this negativity, Georgie’s story emphasises how we can better support the trans community and calls particular attention to the pivotal role families play in supporting trans children and adolescents to thrive and reach their full potential.</p>
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<h2>The positive impact of family support for young trans people</h2>
<p>Although many young trans people experience anxiety and depression as a result of stigma and discrimination, <a href="https://theconversation.com/yes-words-can-harm-young-trans-people-heres-what-we-can-do-to-help-176788">family support</a> acts as a protective buffer for their health and wellbeing. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390536/">Research with trans adults</a> shows family support is most strongly linked with mental health and resilience compared to support from friends or connectedness to the trans community. </p>
<p>Similarly, for young trans people, parental support is significantly associated with higher life satisfaction and <a href="https://www.jahonline.org/article/S1054-139X(13)00384-4/fulltext">fewer depressive symptoms</a>, as well as <a href="https://www.researchgate.net/publication/284988129_Impacts_of_strong_parental_support_for_trans_youth_A_report_prepared_for_Children's_Aid_Society_of_Toronto_and_Delisle_Youth_Services">reducing reported suicide attempts</a> from 57% to 4%.</p>
<p>When family support is missing, trans people experience <a href="https://www.researchgate.net/publication/284988129_Impacts_of_strong_parental_support_for_trans_youth_A_report_prepared_for_Children%27s_Aid_Society_of_Toronto_and_Delisle_Youth_Services">more homelessness</a>. Many who do not have parental support <a href="https://www.sciencedirect.com/science/article/abs/pii/S0190740922001931">end up in out-of-home care</a>. </p>
<p>In a recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962554/#R7">study</a>, young trans people in the United States were asked about family support and identified numerous ways parents can help. Some – such as expressions of love and affection, open communication, and the provision of advice, encouragement and financial support – were not directly related to the young person’s gender diversity. Others were directly related, including emotional support at the time of coming out, willingness to listen to the young person’s experience of gender, use of chosen names and pronouns, and support for <a href="https://www.transhub.org.au/language">social, legal and/or medical gender affirmation</a>. </p>
<p>Notably, some young trans people said their parents weren’t comfortable, or didn’t have knowledge and understanding about gender diversity. So, how can we help parents better support their trans children?</p>
<h2>3 things that help build family support for young trans people</h2>
<p><a href="https://www.tandfonline.com/doi/abs/10.1080/1550428X.2021.1991541?journalCode=wgfs21">Surveys</a> of families of young trans people have identified ways parental support can be facilitated. </p>
<p><strong>1. Learning as much as possible</strong></p>
<p>First, parents of young trans people say <a href="https://journals.sagepub.com/doi/10.1177/0192513X19888779">becoming educated on trans-related issues</a> and accessing relevant information is really important. </p>
<p>Such information includes knowledge about <a href="https://raisingchildren.net.au/pre-teens/development/pre-teens-gender-diversity-and-gender-dysphoria/gender-identity">gender diversity</a>, <a href="https://raisingchildren.net.au/pre-teens/development/pre-teens-gender-diversity-and-gender-dysphoria/when-your-child-is-gender-diverse-family-feelings">its impact on families</a>, <a href="https://www.lgbtmap.org/policy-and-issue-analysis/advancing-acceptance-for-parents">trans affirming parenting practices</a>, and <a href="https://healthmatters.nyp.org/what-to-know-about-gender-affirming-care-for-children-and-adolescents/">gender affirming health care</a>. </p>
<p>While many parents can obtain this information online, family-based peer support groups and health professionals <a href="https://auspath.org.au/providers/">with expertise in this area</a> (including general practitioners and community-based and <a href="https://www.cambridge.org/core/journals/educational-and-developmental-psychologist/article/role-of-school-counsellors-and-psychologists-in-supporting-transgender-people/72C95FCB9D72874931A7C59E3FCEE583">school</a> <a href="https://www.tandfonline.com/doi/abs/10.1080/09515070.2021.2001313?journalCode=ccpq20">psychologists</a>) are often critical sources of additional and reliable knowledge. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/5-books-for-kids-and-teens-that-positively-portray-trans-and-gender-diverse-lives-202832">5 books for kids and teens that positively portray trans and gender-diverse lives</a>
</strong>
</em>
</p>
<hr>
<p><strong>2. Families supporting families</strong></p>
<p>Secondly, as Georgie’s story illustrates, families of young trans people can play a powerful role through the provision of peer support. Support groups for parents of trans young people <a href="https://journals.sagepub.com/doi/10.1177/0192513X19888779">provide a space</a> to share stories and obtain support from people in similar situations. This helps parents feel less alone and to navigate the challenges facing their children, including in <a href="https://www.tandfonline.com/doi/full/10.1080/14681366.2021.1912158">schools</a> and <a href="https://jamanetwork.com/journals/jamapediatrics/article-abstract/2782148">health institutions</a>. </p>
<p>Family-based support groups can provide connections to the broader trans community. This can help foster a sense of pride in gender diversity but also give young trans people role models that show trans people enjoying positive, fulfilled lives. Family-based peer support groups are essential and <a href="https://stories.uq.edu.au/policy-futures/2022/the-critical-role-of-family-support-in-accessing-gender-affirming-health-care/index.html">should be funded</a> to meet the growing demand of parents requiring assistance.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/trans-people-arent-new-and-neither-is-their-oppression-a-history-of-gender-crossing-in-19th-century-australia-201663">Trans people aren’t new, and neither is their oppression: a history of gender crossing in 19th-century Australia</a>
</strong>
</em>
</p>
<hr>
<p><strong>3. Accessing multidisciplinary care</strong></p>
<p>Many parents seek access to gender-affirming healthcare for their trans children. Multidisciplinary gender clinics (that could involve mental health, endocrinology, adolescent medicine and nursing specialists) and other health care professionals have an important role in providing parents with the support they need. This needs to be done in an <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003138556-15/australians-diverse-sexual-orientations-gender-identities-cristyn-davies-kerry-robinson-atari-metcalf-kimberley-ivory-julie-mooney-somers-kane-race-rachel-skinner">inclusive, respectful manner</a> and incorporate <a href="https://psycnet.apa.org/record/2022-65999-001">best practices</a>, such as addressing parental concerns from a risk/benefit perspective, understanding the parent journey, and adopting a shared decision-making approach to a young person’s care. </p>
<p>More broadly, research identifies the need for <a href="https://www.thelancet.com/action/showPdf?pii=S2589-5370%2823%2900006-8">integrated service provision</a> that is comprehensive, efficient, and provides <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8765569/">continuity of care</a> across all the health professionals involved, whether they be general practitioners, mental health clinicians or paediatricians. This applies not only to the health system but also welfare, education and legal sectors too. For example, a social worker may assist a trans young person and their family with referral pathways to available support services in their local area. They can also work with the young person’s school to ensure an inclusive school environment.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/-_dpLOXfOUE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Georgie’s story.</span></figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/supporting-trans-people-3-simple-things-teachers-and-researchers-can-do-149832">Supporting trans people: 3 simple things teachers and researchers can do</a>
</strong>
</em>
</p>
<hr>
<h2>Protecting young people</h2>
<p>Families serve a critical protective role for young trans people, helping to minimise poor mental health and to promote wellbeing. </p>
<p>Listening to trans young people and their parents and carers, is vital to help families provide effective support and nurturing. Engaging families in partnerships to reconfigure health and support services that are <a href="https://journals.lww.com/jbisrir/Fulltext/9900/Barriers_and_enablers_to_culturally_safe_care_for.132.aspx">culturally safe</a> and meet their needs is essential.</p><img src="https://counter.theconversation.com/content/202743/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cristyn Davies reports voluntarily being co-chair of the Human Rights Council of Australia; co-chair of the Child and Youth Special Interest Group for the Public Health Association of Australia; a board director of the Australian Association of Adolescent Health; an ambassador to Twenty10 Incorporating the Gay and Lesbian Counselling Service of New South Wales; and co-chair of the research committee for the Australian Professional Association for Trans Health. </span></em></p><p class="fine-print"><em><span>Cris Townley is a member of the advocacy network Parents for Trans Youth Equity (P-TYE).</span></em></p><p class="fine-print"><em><span>Ken Pang is a paediatrician at the Royal Children's Hospital in Melbourne. He receives research funding from the Australian National Health and Medical Research Council, the Royal Children's Hospital Foundation, and the Hugh D T Williamson Foundation. He is a member of the Australian Professional Association for Trans Health (and its research committee), as well as the World Professional Association for Transgender Health</span></em></p><p class="fine-print"><em><span>Rachel Skinner is an paediatrician in Adolescent Medicine at Sydney Children’s Hospitals Network and Senior Clinical Advisor in Youth and Wellbeing at the NSW Ministry of Health. She holds research funding from the Australian National Health and Medical Research Council, the Medical Research Future Fund and Cooperative Research Centre project scheme. She is a member of Royal Australasian College of Physicians, Australian Association for Adolescent Health; Australian Professional Association for Trans Health, Society for Adolescent Health and Medicine and World Professional Association for Transgender Health</span></em></p><p class="fine-print"><em><span>Kerry H. Robinson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Families can educate themselves, look for other families to connect with and push for coordinated health and social services.Cristyn Davies, Research Fellow in Child and Adolescent Health, Faculty of Medicine and Health, University of SydneyCris Townley, Postdoctoral research fellow, Western Sydney UniversityKen Pang, Team Leader, Murdoch Children's Research InstituteKerry H. Robinson, Professor in Sociology, School of Social Sciences, Western Sydney UniversityRachel Skinner, Professor in Paediatrics, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2028322023-03-30T21:56:32Z2023-03-30T21:56:32Z5 books for kids and teens that positively portray trans and gender-diverse lives<figure><img src="https://images.theconversation.com/files/518331/original/file-20230330-26-jxm86e.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5607%2C3732&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Alexandra Gray/Unsplash</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><a href="https://www.stonewall.org.uk/about-us/blog/trans-day-visibility-global-perspective">International Transgender Day of Visibility</a> is an opportunity to celebrate trans and gender-diverse people – and to raise awareness of the ongoing discrimination they experience.</p>
<p>Trans and gender-diverse people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826417/">experience</a> higher levels of depression, anxiety, self-harm and suicidal behaviours than the general population. </p>
<p>Recent events in <a href="https://www.theguardian.com/australia-news/2023/mar/25/whats-behind-the-terrifying-backlash-against-australias-queer-community">Australia</a>, <a href="https://time.com/6250646/united-kingdom-scotland-transgender-bill/">the United Kingdom</a> and <a href="https://www.vice.com/en/article/5d378d/anti-trans-bills-2023">the US</a> remind us of the need to promote acceptance of trans and gender-diverse young people, and to support their mental health and wellbeing.</p>
<p>Community, school and family <a href="https://link.springer.com/article/10.1007/s40894-019-00118-w">are vital</a> tools for this. </p>
<p>So are books that positively represent trans and gender-diverse experiences, themes and issues. Such books can expand young people’s awareness, understanding and acceptance of gender differences from an early age. They also validate the lived experience of trans and gender-diverse youth.</p>
<p>The five books below all positively portray trans and gender-diverse lives in age-appropriate ways.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/trans-people-arent-new-and-neither-is-their-oppression-a-history-of-gender-crossing-in-19th-century-australia-201663">Trans people aren’t new, and neither is their oppression: a history of gender crossing in 19th-century Australia</a>
</strong>
</em>
</p>
<hr>
<h2>1. My Shadow is Purple by Scott Stuart (ages 4-9)</h2>
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<a href="https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518358/original/file-20230330-24-jxm86e.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p>This picture book, <a href="https://larrikinhouse.com.au/products/my-shadow-is-purple">My Shadow Is Purple</a>, considers gender diversity through the use of colour. The story focuses on a boy whose shadow is purple: presumably a blend of masculine blue and feminine pink.</p>
<p>Early in the story, the boy celebrates his gender hybridity, enjoying a range of both traditionally masculine and feminine activities. Stuart also explores the way society regulates and limits gender expression, and how this can have negative effects on individuals.</p>
<p>That said, the picture book is positive and offers a promising message to readers. Through both resistance and collective support, we can acknowledge and celebrate the spectrum of colours our shadows might take. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/supporting-trans-people-3-simple-things-teachers-and-researchers-can-do-149832">Supporting trans people: 3 simple things teachers and researchers can do</a>
</strong>
</em>
</p>
<hr>
<h2>2. Too Bright to See by Kyle Lukoff (ages 10-12)</h2>
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<a href="https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=906&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=906&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=906&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1138&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1138&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518360/original/file-20230330-16-i75ehz.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1138&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p>In his <a href="http://www.kylelukoff.com/my-books/tbts">award-winning</a> junior novel, <a href="https://www.penguin.com.au/books/too-bright-to-see-9780593111178">Too Bright to See</a>, Kyle Lukoff uses the ghost story to explore <a href="https://www.nhs.uk/conditions/gender-dysphoria/">gender dysphoria</a> and grief. </p>
<p>Trans boy Bug, aged 11, lives in a house with relatively benign spirits. However, during the summer before school starts, Bug’s uncle dies and a new ghost takes up residence in the house.</p>
<p>It is not only the grief of his uncle’s death that Bug must learn to live with. His best friend, Moira, is eager to give him a feminine makeover and the new ghostly resident seems intent on sending him a message.</p>
<p>Bug’s investigation of the ghost and his journey of self-discovery and self-acceptance is sensitive and nuanced, allowing readers to learn about transgender issues (and grief) alongside Bug. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/yes-words-can-harm-young-trans-people-heres-what-we-can-do-to-help-176788">Yes, words can harm young trans people. Here's what we can do to help</a>
</strong>
</em>
</p>
<hr>
<h2>3. Euphoria Kids by Alison Evans (ages 12+)</h2>
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<a href="https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=943&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=943&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=943&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1185&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1185&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518361/original/file-20230330-21-g5ctxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1185&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p><a href="https://www.echopublishing.com.au/books/euphoria-kids">Euphoria Kids</a> is an urban fantasy young adult novel that centres on three trans and gender-diverse teenagers: Iris, who grew from a seed; Babs, the daughter of a local witch; and the boy, named so because his current name does not fit him.</p>
<p>The world Evans creates is one of strange magic, free from the trauma and gender dysphoria often associated with representations of transgenderism <a href="https://theconversation.com/friday-essay-transgenderism-in-film-and-literature-71809">in literature and film</a>. The characters’ quest to break a curse enables them to demonstrate their resilience, develop their confidence and experience euphoria.</p>
<p>Evans explains (in the author note) their decision to create a positive narrative for trans youth:</p>
<blockquote>
<p>I want people to know about gender euphoria. I want them to learn about it before gender dysphoria. I want young trans kids that will read this book to be proud of who they are, and imagine wonderful magic lives for themselves.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/queer-young-adult-fiction-isnt-all-gloomy-realism-here-are-5-uplifting-books-to-get-you-started-141125">Queer young adult fiction isn't all gloomy realism. Here are 5 uplifting books to get you started</a>
</strong>
</em>
</p>
<hr>
<h2>4. Meet Cute Diary by Emery Lee (ages 14+)</h2>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=906&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=906&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=906&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1139&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1139&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518362/original/file-20230330-24-n1uzfa.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1139&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p><a href="https://www.harpercollins.com.au/9780063038837/meet-cute-diary/">Meet Cute Diary</a>, a heartfelt young adult romantic comedy, explores gender identity and sexuality – and recognises self-discovery entails continuous questioning, rather than a linear progression.</p>
<p>Noah Ramirez, a Japanese, white, Afro-Caribbean 16-year-old trans boy, loves the idea of falling in love. He writes fictional trans love stories for his blog, “Meet Cute Diary”. Noah is confronted in real life by Drew, a white cisgender boy who Noah has featured on his blog. After Noah explains his actions, Drew agrees to pretend to date him, in order to validate his stories. Their pretending quickly becomes real.</p>
<p>Things become complicated, though, when Noah finds himself attracted to his nonbinary and asexual coworker, Devin. The narrative explores the changing nature of relationships and love.</p>
<p>Lee creates interesting characters and complex relationships that respect gender fluidity and recognise the blurry boundary between the platonic and romantic.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/transgender-youth-on-puberty-blockers-and-gender-affirming-hormones-have-lower-rates-of-depression-and-suicidal-thoughts-a-new-study-finds-177812">Transgender youth on puberty blockers and gender-affirming hormones have lower rates of depression and suicidal thoughts, a new study finds</a>
</strong>
</em>
</p>
<hr>
<h2>5. Felix Ever After by Kacen Callender (ages 14+)</h2>
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<a href="https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=903&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=903&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=903&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1135&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1135&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518363/original/file-20230330-15-ydtva1.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1135&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">felix ever after.</span>
</figcaption>
</figure>
<p>Felix, the 17-year-old protagonist of <a href="https://www.harpercollins.com/products/felix-ever-after-kacen-callender?variant=32280909578274">Felix Ever After</a>, is Black, queer and trans. The marginalisation and transphobia he experiences are exacerbated when pre-transition images of him are prominently displayed at his school. Felix’s search for revenge sees him open up more about himself to others. And he forms new relationships, including with his friend, Ezra Patel.</p>
<p>Similar to Lee’s depiction of self-discovery in Meet Cute Diary, Callender suggests that learning about yourself and your identity is an ongoing process. Felix continues to make new discoveries about himself, including the realisation that he is not a boy but a <a href="https://queerintheworld.com/what-does-demiboy-mean/">demiboy</a>.</p>
<p>Callender’s writing is engaging, and the cast of diverse characters that populate the narrative reflects the variation in our communities. This tender trans young adult romance sensitively explores the complexity of friendship, forgiveness and self-discovery.</p><img src="https://counter.theconversation.com/content/202832/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Troy Potter does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>March 31 is International Transgender Day of Visibility. These 5 books for young readers raise awareness, understanding and acceptance of gender differences in age-appropriate ways.Troy Potter, Lecturer, The University of Melbourne, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1985022023-02-02T18:50:12Z2023-02-02T18:50:12ZCuts to telehealth in Ontario mean fewer trans and non-binary people will have access to life-saving health care<figure><img src="https://images.theconversation.com/files/507193/original/file-20230130-20-owp5y.jpg?ixlib=rb-1.1.0&rect=24%2C20%2C2707%2C1798&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Exemptions from funding cuts are needed to ensure trans and non-binary people can get medical care.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/cuts-to-telehealth-in-ontario-mean-fewer-trans-and-non-binary-people-will-have-access-to-life-saving-health-care" width="100%" height="400"></iframe>
<p>Amid a <a href="https://www.ctvnews.ca/health/i-thought-i-might-die-at-home-canada-s-health-care-system-is-crumbling-experts-say-1.6036628">crumbling</a> health-care system and <a href="https://www.cbc.ca/news/canada/canada-us-transgender-hate-1.6503087">rising transphobia</a>, trans and non-binary people in Ontario are facing a new challenge: reduced access to gender-affirming care. Changes to how the Ontario government funds virtual health-care services have led to the closure of a key resource, <a href="https://www.connect-clinic.com/">the Connect-Clinic</a>. </p>
<p>The clinic provides vital health-care services, and its closure means fewer trans and non-binary people will get the life-saving medical care they need. Gender-affirming care providers should be exempt from these rate cuts to maintain trans and non-binary people’s access to health-care services.</p>
<h2>Connect-Clinic closes</h2>
<p>The Connect-Clinic is a specialized virtual clinic that provides <a href="https://transcare.ucsf.edu/guidelines/overview">gender-affirming care</a> to trans and non-binary people across Ontario. The clinic provides hormone therapy and surgery referrals that many trans and non-binary people describe as <a href="https://www.cbc.ca/radio/day6/gender-affirming-care-1.6664121">life-saving</a>. But the Connect-Clinic is now unable to provide virtual consultations because of recent changes to how doctors are paid for virtual appointments.</p>
<p>When the COVID-19 pandemic began, doctors were paid the same amount for an appointment by video or phone call as they were for an in-person appointment. This allowed for <a href="https://doi.org/10.1186/s12875-022-01902-9">greatly expanded access to virtual care</a> across Ontario. </p>
<p>But <a href="https://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/redux/bul220901.aspx">as of Dec. 1, 2022,</a> the Connect-Clinic can only bill $20 for a video appointment and $15 for a phone appointment. Previously, <a href="https://torontolife.com/city/my-clinic-saves-lives-the-ford-governments-funding-cuts-to-virtual-health-care-will-shut-us-down/">the Connect-Clinic could receive $67 or more per appointment</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A doctor speaking with a person on a laptop screen." src="https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/507444/original/file-20230131-10300-p8sct7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Reduced billing rates for telehealth appointments mean fewer trans and non-binary people will be able to access medical services.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The new reduced rates aren’t enough to cover the specialized care that the Connect-Clinic provides. As a result, the clinic has <a href="https://www.connect-clinic.com/virtualhealthcare">paused appointments</a> for their 1,500 patients and closed their waitlist of over 2,000 trans and non-binary individuals.</p>
<h2>Gender-affirming care saves lives</h2>
<p>Gender-affirming care is essential to trans and non-binary people’s health and well-being. Research has consistently found that gender-affirming medical care significantly improves the <a href="https://doi.org/10.1080/19359705.2021.2016537">mental health</a> and <a href="https://doi.org/10.1210/jendso/bvab011">quality of life</a> of trans and non-binary people.</p>
<p>Based on a large survey of trans and non-binary people in Ontario, members of our <a href="https://transpulsecanada.ca/">Trans PULSE Canada</a> research team found that having access to all desired gender-affirming medical care <a href="https://doi.org/10.1186/s12889-015-1867-2">reduced suicidal ideation by 62 per cent</a>.</p>
<p>Unfortunately, accessing gender-affirming care is difficult in Ontario. Services are provided through a patchwork of community health centres, hospital-based clinics and individual family physicians. Many clinics are dealing with <a href="https://ottawacitizen.com/opinion/johnstone-time-to-act-on-gender-affirming-health-care-in-ontario">long waitlists</a> and demand that far exceeds capacity. Our <a href="https://doi.org/10.9778/cmajo.20210061">own research</a> found that one-third of trans and non-binary people who need gender-affirming medical care were on a waitlist.</p>
<h2>The importance of virtual care</h2>
<p>Virtual care can help bridge this gap. In 2020, our research team surveyed 820 trans and non-binary people in Canada. <a href="https://doi.org/10.2196/40989">We found that 33 per cent of participants</a> would prefer to access health care virtually rather than in-person once the COVID-19 pandemic was over. </p>
<p>Participants living with anxiety or chronic health conditions were even more likely to prefer virtual care. Our participants emphasized the importance of flexibility in access to both in-person and virtual care. </p>
<p>The Connect-Clinic has helped thousands of trans and non-binary people across Ontario access gender-affirming care through virtual appointments. Their services are especially important for people living in rural and remote areas who do not have any gender-affirming care providers in their area.</p>
<p>The closure of the Connect-Clinic has added even more stress to a health-care system facing already <a href="https://www.cihi.ca/en/news/ongoing-pandemic-driven-pressures-impact-activities-and-workload-of-health-care-workers-across">severe worker shortages</a> and <a href="https://globalnews.ca/news/9329715/ontario-long-waiters-pandemic-surgery/">long wait times</a>. Trans and non-binary people will suffer as a result.</p>
<figure class="align-center ">
<img alt="A man in a dark suit speaking at a podium with a sign that reads: Your heath, Votre sante." src="https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=407&fit=crop&dpr=1 600w, https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=407&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=407&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=511&fit=crop&dpr=1 754w, https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=511&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/507192/original/file-20230130-15020-h2qs7p.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=511&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ontario Premier Doug Ford makes an announcement on health care in the province with Health Minister Sylvia Jones in Toronto on Jan. 16, 2023.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Frank Gunn</span></span>
</figcaption>
</figure>
<h2>Compounding barriers to access</h2>
<p>Even before the closure of the Connect-Clinic, trans and non-binary people in Ontario had a much harder time accessing health care than their cisgender (non-trans) peers. </p>
<p>While all primary care providers are able to prescribe hormone therapy and refer patients to surgeons, gender-affirming care is <a href="https://doi.org/10.1089/trgh.2016.0010">rarely covered in medical education</a>, and many family doctors <a href="https://doi.org/10.1186/1472-6963-12-110">do not feel confident or experienced enough</a> to provide gender-affirming care. As a result, many trans and non-binary people turn to specialized clinics, such as the Connect-Clinic. </p>
<p>In 2019, we surveyed nearly 3,000 trans and non-binary people from across Canada. <a href="https://doi.org/10.9778/cmajo.20210061">We found that only 55 per cent of participants</a> from Ontario had a primary care provider with whom they were comfortable discussing their gender. Furthermore, 42 per cent of Ontario participants had at least one unmet health care need in the past year. </p>
<p>In comparison, <a href="https://doi.org/10.25318/1310083601-eng">less than seven per cent of the general population</a> said the same in 2019. The closure of the Connect-Clinic is likely to make accessing health care even harder for trans and non-binary people.</p>
<h2>The need for an exemption to rate cuts</h2>
<p>Other medical providers, such as those providing <a href="https://globalnews.ca/news/9180526/addiction-doctors-ontario-government-deal-virtual-care/">addiction medicine</a>, were given an exemption from the physician services agreement. That exemption allows them to continue to be paid the same amount for virtual and in-person appointments. </p>
<p>Considering the unique needs of trans and non-binary patients, gender-affirming care must be provided the same exemption. Addiction medicine and gender-affirming care both require specialized expertise and non-stigmatizing providers that are not always available to patients locally.</p>
<p>Maintaining the previous billing rates for virtual visits is essential to enable the Connect-Clinic and other clinics to continue providing vital gender-affirming care for trans and non-binary people in Ontario.</p><img src="https://counter.theconversation.com/content/198502/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Greta Bauer receives funding from the Canadian Institutes of Health Research for trans health research and for work on research methods. She is a Principal Investigator of Trans PULSE Canada and Trans Youth CAN! Studies, funded by the Canadian Institutes of Health Research.</span></em></p><p class="fine-print"><em><span>Ayden Scheim receives funding from the National Institutes of Health for research unrelated to this article. He is Co-Principal Investigator of Trans PULSE Canada, funded by the Canadian Institutes of Health Research. </span></em></p><p class="fine-print"><em><span>Kai Jacobsen receives funding from the Social Sciences and Humanities Research Council for their Masters thesis about access to gender-affirming care. Trans PULSE Canada is funded by the Canadian Institutes for Health Research.</span></em></p><p class="fine-print"><em><span>Leo Rutherford receives funding from the Canadian Institutes of Health Research Strategy for Patient Oriented Research Transition to Leadership award for his dissertation project about experiences of gender-affirming care. </span></em></p><p class="fine-print"><em><span>Jose Navarro does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The closure of the virtual Connect-Clinic means fewer trans and non-binary people will get the vital health-care services they need.Greta Bauer, Adjunct Professor of Epidemiology and Biostatistics, Western UniversityAyden Scheim, Assistant Professor of Epidemiology, Drexel UniversityJose Navarro, Medical Student, Queen's University, OntarioKai Jacobsen, MA Sociology Student, Carleton UniversityLeo Rutherford, PhD Candidate, Social Dimensions of Health, University of VictoriaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1982372023-01-23T19:18:10Z2023-01-23T19:18:10ZIt’s not all about gender or ethnicity: a blind spot in diversity programs is holding equality back<figure><img src="https://images.theconversation.com/files/505777/original/file-20230123-64502-vwc5k1.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4166%2C2105&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Diversity, inclusion and equity policies are now broadly endorsed in Australian organisations. But not all diversities are equal. <a href="https://opus.lib.uts.edu.au/handle/10453/164749">Our research</a> suggests while programs for women and some racial minorities are being embraced, other diversities are excluded. </p>
<p>In particular social class is ignored, and people with invisible, subtle or complex diversities are seldom considered. </p>
<p>The almost exclusive and independent focus on gender and race is not surprising, given Australia’s history. Colonisation and the dispossession of Indigenous Australians, the legacy of the White Australia Policy and persistent discrimination against women at work are all realities with which, as a nation, we have not fully reconciled with.</p>
<p>But if everyone in Australia is going to get a fair go at work, all the disadvantages people face need to be recognised.</p>
<h2>What our research involved</h2>
<p>Our research project involved three Australian organisations over four years. One was the Australian subsidiary of a global technology business, another a national sports organisation, and the third a state government agency. </p>
<p>These organisations were selected because they operated in different sectors yet were known for their best-practice approach to diversity and inclusion. We spent up to nine months in each organisation, giving us enough time to learn about their cultures and see how initiatives and ideas played out. The agreement was that we would keep their identities anonymous in exchange for such access and freedom to report our findings, even if unflattering. </p>
<p>There was much to be impressed by. The chief executives supported equality in the workplace, diversity was seen as fundamental to developing the business, there was investment in diversity initiatives, and employees knew where their organisations stood.</p>
<h2>Hierarchies of diversity</h2>
<p>But we also found that how senior leaders managed diversity and inclusion created unintended consequences. Each organisation had a “hierarchy of diversity” – in terms of what, and who, got attention.</p>
<p>What stood out in all three organisations was that when women, or men from a culturally diverse minority, were in senior positions they still almost always came from a similar socio-economic background as other executives.</p>
<p>Though the term is not often used today in what many assume to be a socially mobile Australia, they shared what used to be commonly called “class” attributes. Almost exclusively, those in positions of power had similar experiences and interests borne from having been educated in an elite university and living in affluent suburbs. </p>
<p>This was apparent to staff who commented on how leaders tended to be involved in similar weekend activities and spent time in the same places (including restaurants) outside of work hours.</p>
<p>If they were women in senior leadership positions there was an expectation they would “play the game”, behaving in ways consistent with the “White male” executive norm. Coming from at least an “upper middle class” background made this much easier for them.</p>
<p>This reality, based on social and socio-economic privilege, was something barely talked about. But the lack of diversity on this dimension was palpable. </p>
<h2>Acknowledging ‘intersectionality’</h2>
<figure class="align-right ">
<img alt="Kimberlé Crenshaw, a professor at the UCLA School of Law in California and Columbia Law School in New York, first used the term intersectionality in 1989." src="https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=811&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=811&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=811&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1019&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1019&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505780/original/file-20230123-38981-2xo56m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1019&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Kimberlé Crenshaw, a professor at the UCLA School of Law in California and Columbia Law School in New York, first used the term intersectionality in 1989.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>That some forms of systemic exclusion or discrimination are recognised and addressed while others remain largely invisible has been explored through the concept of “<a href="https://time.com/5786710/kimberle-crenshaw-intersectionality/">intersectionality</a>”, which draws attention to how different forms of diversity and disadvantage intersect, creating unacknowledged forms of discrimination.</p>
<p>The term was <a href="https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1052&context=uclf">first used in 1989</a> by American legal scholar Kimberlé Williams Crenshaw, and stemmed from her work developing critical race theory and the lived experienced of poor African-American women in the US, who have face discrimination different to that by white women or black men.</p>
<p>We saw this reality in our research.</p>
<p>The director of one of the organisations we studied, and the only Indigenous woman in a leadership position, told us:</p>
<blockquote>
<p>I get often treated by some managers and executives like I’m not really on the executive. I don’t get treated with the same respect as my peers by some of them. […] Partly it’s obviously because I’m black, partly it’s I’m a woman.</p>
</blockquote>
<p>Having observed this organisation over a lengthy period, we can attest that her perceptions are legitimate. There may be no “conscious” bias involved, but it is fair to conclude that a female executive who wasn’t Indigenous would have a different experience.</p>
<hr>
<figure class="align-center ">
<img alt="Intersectionality recognises the effect of different combinations of identities and attributes, rather that treating those things discretely." src="https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=524&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=524&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=524&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=659&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=659&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505781/original/file-20230123-8930-gi4nqc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=659&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Intersectionality recognises the effect of different combinations of identities and attributes, rather that treating those things discretely.</span>
<span class="attribution"><span class="source">First Book</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<hr>
<p>Even though these organisations didn’t acknowledge intersectionality in their policies and practice, employees were certainly aware of it. One person we spoke to cited the case of a senior manager, a woman born in India:</p>
<blockquote>
<p>She’s a smart woman from an Indian background and she’s always being treated like the last wheel.</p>
</blockquote>
<p>In another case, one of the people we spoke to talked about two of his Indian colleagues: </p>
<blockquote>
<p>You couldn’t bottle them both up and say ‘they’re both Indians’, because they’re completely different. One’s from a rich background and one’s from a poorer background. They’ve got different mentalities and different ambitions. They’re different workers and different people.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-is-intersectionality-all-of-who-i-am-105639">What is intersectionality? All of who I am</a>
</strong>
</em>
</p>
<hr>
<h2>Diversifying diversity</h2>
<p>Diversity and inclusion polices and programs are contributing to progress in reducing entrenched forms of discrimination and disadvantage in the workplace. But if these programs are to truly benefit our most disadvantaged groups, such as Indigenous people who come from low socio-economic backgrounds, much more will have to be done. </p>
<p>The way we understand diversity needs to be diversified. If we continue to privilege gender and race as if they are the only ways by which people are treated differently and excluded from leadership, many inequalities will remain. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/six-misunderstood-concepts-about-diversity-in-the-workplace-and-why-they-matter-181289">Six misunderstood concepts about diversity in the workplace and why they matter</a>
</strong>
</em>
</p>
<hr>
<p>Our research highlighted the intersectionality of race, gender and class as significant oversights in how we manage diversity. But there are many other intersections to consider – including the treatment of those with different sexual and gender identities, and people with different physical and neurodivergent abilities. </p>
<p>It’s up to all of us to challenge ourselves to understand how we privilege some differences over others. Reducing complex differences to a limited number of simple measurable categories blinds organisations to how privilege and discrimination operate at work.</p><img src="https://counter.theconversation.com/content/198237/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>If diversity programs are to truly benefit Australia’s most disadvantaged groups, such as Indigenous people, more acknowledgement must be given to class and ‘intersectionality’.Carl Rhodes, Professor of Organization Studies, University of Technology SydneyAlison Pullen, Professor of Management and Organization Studies, Macquarie UniversityCelina McEwen, Senior Research Fellow, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1937012022-12-05T21:29:31Z2022-12-05T21:29:31ZHow hiring more women IT experts improves cybersecurity risk management<figure><img src="https://images.theconversation.com/files/496840/original/file-20221122-22-gpfi1q.jpg?ixlib=rb-1.1.0&rect=284%2C25%2C5190%2C3207&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When women are present on boards of directors, cyber risk management improves.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/how-hiring-more-women-it-experts-improves-cybersecurity-risk-management" width="100%" height="400"></iframe>
<p>Despite the contributions women have made to the information and technology field, they continue to be underrepresented. <a href="https://www.famousscientists.org/ada-lovelace/">Ada Lovelace</a>, for example, was the world’s first computer programmer. <a href="https://www.famousscientists.org/grace-murray-hopper/">Grace Murray Hopper</a> developed the first compiler. And <a href="https://www.famousscientists.org/hedy-lamarr/">Hedy Lamarr</a> co-invented the <a href="https://www.sciencedirect.com/topics/engineering/spread-spectrum-communications">modern spread-spectrum communication technology</a>, which is found in Bluetooth, Wi-Fi and GPS technology.</p>
<p>Today, the leading figures in the IT field are all men. Although 39 per cent of the board members of Silicon Valley’s biggest tech companies are women, all the chairpersons and CEOs are men: <a href="https://www.apple.com/ca/newsroom/2011/11/15enCA-Apple-Names-Arthur-D-Levinson-Chairman-of-the-Board/">Arthur D. Levinson</a> and <a href="https://www.britannica.com/biography/Tim-Cook">Tim Cook</a> for Apple, <a href="https://www.britannica.com/biography/Satya-Nadella">Satya Nadella</a> for Microsoft, <a href="https://www.britannica.com/biography/Jeff-Bezos">Jeff Bezos</a> and <a href="https://ir.aboutamazon.com/officers-and-directors/person-details/default.aspx?ItemId=7601ef7b-4732-44e2-84ef-2cccb54ac11a">Andrew Jassy</a> for Amazon, <a href="https://www.britannica.com/biography/Mark-Zuckerberg">Mark Zuckerberg</a> for Meta, and <a href="https://hennessy.stanford.edu/biography/">John L. Hennessy</a> and <a href="https://www.britannica.com/biography/Sundar-Pichai">Sundar Pichai</a> for Google. </p>
<figure class="align-right ">
<img alt="A watercolour painting of a woman dressed in 19th century fashion" src="https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=862&fit=crop&dpr=1 600w, https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=862&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=862&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1083&fit=crop&dpr=1 754w, https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1083&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/496839/original/file-20221122-25-freza.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1083&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A watercolour portrait of Ada King, Countess of Lovelace, circa 1840.</span>
<span class="attribution"><span class="source">(Science Museum Group)</span></span>
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</figure>
<p>But progress is being made. A study from Osler, a business law firm, found that <a href="https://www.osler.com/osler/media/Osler/reports/corporate-governance/Osler-Diversity-Disclosure-Practices-report-2022.pdf">23 per cent of S&P/TSX 60 company boards seats were held by women</a>. This is an increase from data we — as accounting researchers — collected <a href="https://doi.org/10.1007/s10551-020-04717-9">on Toronto Stock Exchange companies between 2014 and 2018</a> that found the following: 11.7 per cent of companies had one woman on the board of directors, 27.7 per cent had two women, and 56.3 per cent had at least three women. </p>
<p>But when it came to the number of women IT experts on boards, the number was even lower. Only 22 out of 683 board members in 2018 were women IT experts. Although this number had doubled since 2014, it remained very low. It’s important to increase the number of women working in IT — not just for equality reasons, but because women improve key organizational outcomes.</p>
<h2>Cybersecurity is key for success</h2>
<p>Our recent research on <a href="https://doi.org/10.1007/s10551-020-04717-9">the impact of board gender diversity on how corporations respond to cyber risk</a> shows that, when women are present on boards of directors, cyber risk management improves. Proper cyber risk management is key to the success of tech companies.</p>
<p>Cybersecurity involves taking appropriate actions and making ethical decisions to mitigate cyber risks. In particular, it addresses the financial and technical risk caused by <a href="https://home.kpmg/us/en/home/insights/2020/09/digital-acceleration.html">digital acceleration</a> — the increased rate of digital transformation caused by the pandemic. </p>
<p>Because of digital acceleration, organizations are more vulnerable to unethical uses of technology. Facebook and Google’s history of <a href="https://sloanreview.mit.edu/article/business-technology-and-ethics-the-need-for-better-conversations/">inappropriate and unethical uses or suppression of information</a> has shined a spotlight on the importance of an ethical approach to cybersecurity. The most high-profile example of this occurred when <a href="https://www.nytimes.com/2018/04/04/us/politics/cambridge-analytica-scandal-fallout.html">Facebook sold data to companies that were trying to influence the 2016 U.S. presidential election</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ada-lovelace-and-others-inspire-women-in-tech-but-we-must-make-careers-worth-their-while-32975">Ada Lovelace and others inspire women in tech, but we must make careers worth their while</a>
</strong>
</em>
</p>
<hr>
<p>Organizations <a href="https://theconversation.com/a-unified-cybersecurity-strategy-is-the-key-to-protecting-businesses-182405">should construct cybersecurity based on ethical principles</a> concerning privacy, data collection, deposit and use, artificial intelligence and algorithms development and profiling.</p>
<p>One way to approach cybersecurity is through a <a href="https://global.oup.com/academic/product/corporate-governance-4e-9780198809869?q=bob%20tricker&lang=en&cc=ca">board of directors</a>. Boards represent stakeholder interests, monitor firm management and troubleshoot any problems that arise between the shareholders that own publicly listed firms and the firm’s management. They also have a duty to ensure their companies adopt appropriate and effective cybersecurity measures.</p>
<h2>Women improve cybersecurity</h2>
<p>Our study found a positive association between the level of cybersecurity disclosure and board gender diversity. In other words, the presence of women IT experts on boards resulted in improved cyber risk management — board monitoring, management supervision and corporate governance in particular. </p>
<p>Women brought new perspectives to the decision-making process and added a greater variety of skills and capabilities, which in turn, improved boards’ decision-making. </p>
<figure class="align-center ">
<img alt="A woman sitting at the head of a board meeting" src="https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/496838/original/file-20221122-11-qexdt7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The presence of women IT experts on boards resulted in improved cyber risk management.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Women are more informative, meaning they tended to value communication and disclosures more than men did, and collaborated better with stakeholders. Women also <a href="https://www.wolterskluwer.com/en/expert-insights/risk-appetite-and-risk-tolerance-whats-the-difference">had lower risk tolerance</a>, enhanced ethical practices and engaged less in fraudulent practices. </p>
<p>These specific skills, combined with their IT expertise, meant women improved the cybersecurity risk monitoring of their companies. Ultimately, having more women IT experts on boards could result in a more integrative cybersecurity approach that brings technological, business and ethical perspectives together.</p>
<h2>Suggestions for improving equality</h2>
<p>To close the gender gap, there must be a concerted effort to provide girls and women with IT-related education and skills. Firms should develop programs to promote the presence of women with IT skills and fund scholarships and grants for women. </p>
<p>Women should be encouraged to choose IT-related education and careers. At the earliest stage, schools should motivate tech-related curiosity and interest in children. While there are universities that offer graduate programs, diplomas and certificates in cybersecurity, more should be created. NGOs can also be a part of the solution by embracing and championing women IT experts. </p>
<p>Another way to close the gender gap is to promote more women to executive positions. As of 2020, the <a href="https://laws-lois.justice.gc.ca/eng/annualstatutes/2018_8/page-2.html#docCont">Canada Business Corporations Act requires public companies</a> to provide information on policies and practices related to diversity on boards and within senior management. More young women should be promoted to IT leadership positions to feed the pool of potential candidates for the board.</p>
<p>Updating the skills of existing board members should also be a priority. Ethics and cybersecurity should be a training priority for all board members. As such, <a href="https://corpgov.law.harvard.edu/2020/10/07/board-practices-quarterly-diversity-equity-and-inclusion/">updating ethics and cybersecurity skills of all board members</a> is a step towards improving the skills of women on boards.</p><img src="https://counter.theconversation.com/content/193701/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Camélia Radu receives funding from Social Sciencies and Humanities Research Council of Canada and Canadian Academic Accounting Association. </span></em></p><p class="fine-print"><em><span>Nadia Smaili does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A new study finds that women improve cyber risk management by bringing new perspectives and skills to the decision-making process of company boards.Camélia Radu, Associate Professor in Accounting, Université du Québec à Montréal (UQAM)Nadia Smaili, Professor in Accounting (forensic accounting), Université du Québec à Montréal (UQAM)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1942372022-11-16T13:29:14Z2022-11-16T13:29:14ZHealth rights for trans people vary widely around the globe – achieving trans bliss and joy will require equity, social respect and legal protections<figure><img src="https://images.theconversation.com/files/495180/original/file-20221114-18-ruhqzj.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2189%2C1369&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Achieving equity in global health requires addressing the root sources of inequity.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/happy-young-multiracial-people-having-fun-together-royalty-free-image/1398829422">Sabrina Bracher/iStock via Getty Images Plus</a></span></figcaption></figure><p>While transgender people might be more <a href="https://time.com/135480/transgender-tipping-point/">culturally recognized in the U.S.</a> than ever, visibility is <a href="https://www.alokvmenon.com/blog/2017/3/12/trans-visibility-isnt-trans-justice">not the same as justice</a>.</p>
<p>Transgender is an <a href="https://www.dukeupress.edu/Imagining-Transgender">umbrella category</a> that emerged in the U.S. in the 1990s to encompass diverse gender identities that don’t fully correspond with an individual’s assigned sex at birth. Although local communities worldwide have adopted this term, it can also <a href="https://doi.org/10.1215/23289252-2685615">erase and collapse</a> other diverse gender identities people have used across time, location and culture. </p>
<p>People who are today called trans, nonbinary and intersex have existed for centuries throughout the world. The rights of trans people <a href="https://www.penguinrandomhouse.com/books/203953/transgender-warriors-by-leslie-feinberg/">have not always</a> been up for debate in mainstream society, and nonnormative sex and gender categories appear in <a href="http://buddhism.lib.ntu.edu.tw/museum/TAIWAN/md/md08-52.htm">ancient Buddhist texts</a>, as well as <a href="https://www.ucpress.edu/book/9780520382053/trans-talmud">Jewish rabbinic literature</a>. Yet <a href="https://doi.org/10.1215/10642684-2009-022">colonial conquests</a> have violently stamped out sexual and gender diversity globally.</p>
<p>Trans people’s right to exist <a href="https://doi.org/10.4324/9781003206255-33">has been challenged</a> throughout time and across the world in multiple ways. Worldwide, trans people face <a href="https://doi.org/10.1080/14461242.2020.1868899">disparities across many areas</a>, including access to health care, legal support and economic security. Governments, global organizations and the legacies of colonialism also enact high levels of <a href="https://www.sup.org/books/title/?id=32715">violence and stigma</a> against them. </p>
<p>At the same time, <a href="https://globalhealth5050.org/2019-report/">95% of global health-related organizations</a> do not recognize or mention the needs of gender-diverse people in their work, resulting in the “<a href="http://doi.org/10.1089/trgh.2020.0026">near-universal exclusion</a>” of trans people from health practices and policies. There is also a <a href="https://doi.org/10.1111/1467-9566.13563">lack of holistic trans-inclusive research</a> around the world. For instance, searching for the word “transgender” on the website for the <a href="https://www.healthdata.org/search?search_terms=transgender">Institute for Health Metrics and Evaluation</a>, the global health metrics giant of the Bill and Melinda Gates Foundation that <a href="https://www.healthdata.org/news-release/who-and-ihme-collaborate-improve-health-data-globally">collaborates with the World Health Organization</a> to improve global health data, currently returns zero results.</p>
<p><a href="https://scholar.google.com/citations?user=N3VopfkAAAAJ&hl=en&oi=ao">As a sociologist</a>, I study how health outcomes are affected by various social conditions, including global economic policies, institutions and cultural values. In particular, I analyzed how government-endorsed medical tourism, or health-related travel, has affected <a href="https://doi.org/10.1016/j.socscimed.2022.114950">Thai transgender women</a>. Broadly, I seek to understand how the body acts as what French philosopher Michel Foucault calls an “<a href="https://www.penguinrandomhouse.com/books/55035/the-foucault-reader-by-michel-foucault/">inscribed surface of events</a>,” imprinted upon by an ever-changing social context that can afford or withhold resources, rights, recognition and power. </p>
<p>With their health and well-being shaped by the social context worldwide, the bodies of transgender people are no exception.</p>
<h2>History of gender-affirming care</h2>
<p>Medical institutions and authorities are a major pathway to health and how one lives in one’s body. They <a href="https://www.jstor.org/stable/2083452">define, classify and pathologize</a> a range of human conditions, from <a href="https://doi.org/10.1016/j.socscimed.2010.02.019">male pattern baldness</a> to <a href="https://doi.org/10.1111/j.1475-682X.2008.00271.x">fatness</a>. </p>
<p>The German physician <a href="https://theconversation.com/the-early-20th-century-german-trans-rights-activist-who-transformed-the-worlds-view-of-gender-and-sexuality-106278">Magnus Hirschfeld</a> coined the now antiquated term “transvestite” in 1910 to define those who desired to express themselves in opposition to their sex assigned at birth. At his Institute for Sexual Science, Hirschfeld offered people hormone therapy and performed the first documented genital transformation surgery. Adolf Hitler deemed Hirschfeld “<a href="https://www.sealpress.com/titles/susan-stryker/transgender-history-second-edition/9781580056908/">the most dangerous Jew in Germany</a>,” and the Nazis burned his research center after he fled for his life. </p>
<p>Despite this violence toward trans medicine, endocrinology in the U.S. and Europe advanced in the 1930s with the use of synthetic testosterone and estrogen for medical transitioning. <a href="https://doi.org/10.1210/en.2018-00529">Estrogen</a> was first purified in 1923 and used for hot flashes, bone loss prevention and other reproductive health issues. <a href="https://www.jstor.org/stable/24980239">Testosterone</a> was isolated and synthesized in 1935 and first used to treat <a href="https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881">hypogonadism</a> in men as well as tumor growth in women. </p>
<p>Puberty blockers, or gonadotropin-releasing hormone agonists, were <a href="https://www.ohsu.edu/sites/default/files/2020-12/Gender-Clinic-Puberty-Blockers-Handout.pdf">first approved by the U.S. FDA in 1993</a> for children undergoing puberty too early. For trans adolescents experiencing <a href="https://doi.org/10.1080/26895269.2022.2100644">gender dysphoria</a>, or distress from a mismatch between their gender identity and sex assigned at birth, these medications can be <a href="https://doi.org/10.1177/07435584221100591">critically important</a> for their well-being. Far from being experimental, the medications have <a href="https://doi.org/10.1080/26895269.2020.1747768">strong evidence</a> for their overall beneficial effects for trans youths.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/KomI-XiiJw0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">There is debate about whether trans youths are able to determine whether they are ready for gender-affirming care.</span></figcaption>
</figure>
<p>Christine Jorgensen was the first American to undergo what was then called “sex change” surgery, in Denmark in 1952, <a href="https://www.sealpress.com/titles/susan-stryker/transgender-history-second-edition/9781580056908/">making headline news</a>. Doctors in other parts of the world also started to gain clinical expertise in <a href="https://transcare.ucsf.edu/guidelines/vaginoplasty">vaginoplasty</a>, sparking global networks of transgender health care. For instance, <a href="https://doi.org/10.1155/2014/182981">surgeons in Thailand</a> developed their own techniques in the 1970s for Thai trans women. </p>
<p>Soon, trans people from other countries learned of Thai surgical techniques and began to travel to Thailand for care. With strong government support, Thailand has become a <a href="https://www.dukeupress.edu/mobile-subjects">global hub for gender-affirming services</a>. Subsequently, foreign travelers “<a href="https://doi.org/10.1016/j.socscimed.2022.114950">crowded out</a>” some Thai trans people from quality care as the market shifted to accommodate medical tourists.</p>
<p>For some health travelers, <a href="http://doi.org/10.1017/S1745855207005765">services are more affordable</a> in Thailand than in their home country. Traveling for health services can also <a href="https://www.oecd.org/health/health-systems/48723982.pdf">provide greater anonymity</a>. For those in the U.K. seeking gender-affirming care, traveling abroad is an alternative to <a href="https://cass.independent-review.uk/publications/interim-report/">long wait times</a>.</p>
<p>Medical tourism is more dire for those living in countries where <a href="https://ilga.org/trans-legal-mapping-report">trans people face criminalization</a>, such as Brunei, Lebanon and Malawi, or where gender-affirming surgeries are <a href="https://pubmed.ncbi.nlm.nih.gov/34194279/">religiously prohibited</a>, such as Saudi Arabia.</p>
<h2>What does global health equity mean?</h2>
<p>Globally, trans people experience issues accessing <a href="http://doi.org/10.1016/S0140-6736(16)30653-5">culturally competent and equitable health care services</a>, both <a href="https://theconversation.com/doctors-often-arent-trained-on-the-preventive-health-care-needs-of-gender-diverse-people-as-a-result-many-patients-dont-get-the-care-they-need-191933">generally</a> and for gender-affirming services. Trans and gender-diverse people experience greater mental distress and <a href="https://doi.org/10.1016/S0140-6736(16)00684-X">everyday violence and discrimination</a> than their cisgender peers. </p>
<p>A <a href="http://doi.org/10.1089/trgh.2020.0026">2019 report</a> of nearly 200 health organizations around the world found that 93% do not recognize trans people in their work on gender equality, and 92% do not mention trans health in their programmatic services. <a href="http://doi.org/10.1136/bmjgh-2020-003394">Decolonizing global health</a> means including marginalized people in decisions and knowledge production around global health. It also includes and addresses the needs of trans and gender-diverse people worldwide.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Patient and doctor in exam room" src="https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/495182/original/file-20221114-19-pmhw1p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Including trans people in health care policies and practices can help reduce disparities.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/doctor-talking-to-patient-at-hospital-room-with-royalty-free-image/1236342725">FG Trade/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>Global trans health equity means providing resources to <a href="http://doi.org/10.1089/trgh.2020.0026">target the root causes</a> of gender-based health disparities. <a href="http://doi.org/10.1016/S0140-6736(16)30653-5">This involves</a> legal gender recognition, government support and anti-discrimination laws. While medical and public health support is necessary for trans women, who are <a href="https://www.aidsmap.com/news/mar-2022/trans-women-66-times-more-likely-have-hiv-trans-men-nearly-7-times-more-likely-global">disproportionately affected by HIV</a> worldwide, global trans health equity also means addressing other areas that contribute to this disparity, such as <a href="https://doi.org/10.1080/14461242.2020.1868899">poverty</a>, economic exclusion and <a href="https://www.undp.org/asia-pacific/publications/denied-work-%E2%80%93-audit-employment-discrimination-basis-gender-identity-south-east-asia">workplace discrimination</a>. </p>
<p>For countries with universal health coverage, medical and public health researchers recommend that gender-affirming services be included as <a href="https://doi.org/10.1016/S0140-6736(16)00684-X">essential services</a>. They are not cosmetic, but are necessary for those who want them. </p>
<h2>Better alternatives for all</h2>
<p>Amid everyday injustices, violence and <a href="https://doi.org/10.1016/S0140-6736(16)00684-X">vulnerabilities</a> are countless forms of trans <a href="https://doi.org/10.1080/17441692.2020.1856397">resilience and resistance</a>, <a href="https://doi.org/10.1016/j.socscimed.2020.112808">activism</a>, <a href="https://doi.org/10.1215/01642472-7971139">collective care</a> and <a href="https://doi.org/10.1332/policypress/9781447342335.001.0001">knowledge sharing</a>. There are even some “<a href="https://doi.org/10.1080/14461242.2020.1855999">bubble[s] of utopia</a>,” or clinics and health care settings where trans people can access services with reduced delay. These alternatives open the possibility for <a href="https://doi.org/10.4324/9781003034063-9">transgender bliss</a>, or liberation from restrictive colonial gender constructs, and <a href="https://doi.org/10.1093/socpro/spac034">transgender joy</a>, or improving one’s quality of life and forming meaningful connections by embracing a marginalized identity. </p>
<p>How can policies, institutions and society cultivate trans bliss and joy worldwide?</p>
<p>All human bodies are “<a href="https://doi.org/10.4324/9780203976531">sociocultural artifacts</a>.” How they are expressed and lived in is determined by social contexts and shaped by available resources. Sex and gender are points in a vast “<a href="http://doi.org/10.1002/j.2326-1951.2000.tb03504.x">multi-dimensional space</a>” of anatomy, hormones, chromosomes, environment and culture. Global health equity for trans people holds accountable the institutions and decision-makers responsible for the health and safety of all human beings. It is oriented toward the freedom to flourish in a world that celebrates sex and gender diversity as a <a href="https://blogs.scientificamerican.com/voices/stop-using-phony-science-to-justify-transphobia/">natural fact of life</a>.</p><img src="https://counter.theconversation.com/content/194237/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Reya Farber received funding from a National Science Foundation Graduate Research Fellowship under Grant No. DGE-1247312, Boston University Graduate School, Boston University Sociology Department Morris Funds, and William & Mary Summer Research Grant.</span></em></p>While gender-affirming health care is essential to the well-being of trans people, access to quality services varies significantly by geographic region and social context.Reya Farber, Assistant Professor of Sociology, William & MaryLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1919332022-11-14T13:26:01Z2022-11-14T13:26:01ZDoctors often aren’t trained on the preventive health care needs of gender-diverse people – as a result, many patients don’t get the care they need<figure><img src="https://images.theconversation.com/files/492839/original/file-20221101-14-z2rkvm.jpg?ixlib=rb-1.1.0&rect=43%2C58%2C4830%2C3593&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Gender-diverse adults have a harder time getting effective primary and preventive health care than their nontransgender counterparts.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/doctors-pockets-with-medical-instruments-royalty-free-image/91540120?phrase=stethoscope&adppopup=true">Peter Dazeley/The Image Bank via Getty Images</a></span></figcaption></figure><p>Preventive health care – such as cancer screening – is <a href="https://www.cdc.gov/cancer/dcpc/prevention/screening.htm">a critical tool</a> in the early detection of disease. Missed screening can result in a missed diagnosis, delayed treatment and <a href="https://doi.org/10.1093%2Fjnci%2Fdjab028">reduced chances of survival</a>. </p>
<p>But the medical system is poorly equipped to meet the needs of gender-diverse patients.</p>
<p>Around <a href="https://www.reuters.com/world/us/new-study-estimates-16-million-us-identify-transgender-2022-06-10/">1.64 million people in the U.S.</a> identify as transgender, nonbinary or gender diverse – people whose gender identity differs from the sex they were assigned at birth.</p>
<p>This adds up to 1.3 million or 0.5% of U.S. adults, all of whom are more likely to <a href="https://pubmed.ncbi.nlm.nih.gov/35308990/">encounter implicit, or unconscious, biases</a> when they seek medical care compared with their cisgender counterparts – those whose gender identity aligns with the sex they were assigned at birth. </p>
<p>I am a <a href="https://directory.hsc.wvu.edu/Profile/40295">primary care doctor in Appalachia</a>, as well as a <a href="https://doi.org/10.15766/mep_2374-8265.11111">medical educator</a> who studies <a href="https://doi.org/10.7189%2Fjogh.10.020387">how to improve the instruction</a> of future health care providers. I work hard every day to improve the health of the underserved. </p>
<p>Primary care doctors devote much of their lives to preventive medicine – the art of stopping disease before it starts. Cancer screening consumes much of my life. </p>
<p>So I’m concerned about the barriers to preventive care for patients who are transgender, including consistent access to <a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/03/health-care-for-transgender-and-gender-diverse-individuals">adequate cancer screening</a>. </p>
<h2>The problems with the binary model</h2>
<p>Health care spaces and providers often focus on “men’s health” or “women’s health” specifically. Intake forms may have no option for declaring a gender identity separate from the <a href="https://theconversation.com/not-everyone-is-male-or-female-the-growing-controversy-over-sex-designation-172293?notice=Article+has+been+updated.">sex assigned at birth</a>. Health screening and insurance policies for diseases like cancer tend to remain geared to a flawed binary male-female model.</p>
<p>Gender-diverse patients often find themselves <a href="http://dx.doi.org/10.1136/fmch-2019-000130">teaching their primary care doctors</a> how to provide them with competent care, because many medical students <a href="https://doi.org/10.22454/FamMed.2021.509974">get little training</a> on providing gender-affirming care.</p>
<p>As a result, 1 out of 3 gender-diverse adults <a href="https://www.aafp.org/pubs/afp/issues/2018/1201/p645.html">do not seek preventive care</a>, according to a report by the <a href="https://transequality.org/sites/default/files/docs/resources/NTDS_Report.pdf">National Center for Transgender Equality</a> – or they are not offered these services at all – when they see a health care provider. Even more alarming, 19% of transgender folks report that <a href="https://doi.org/10.21037%2Ftau-20-954">they’ve been refused care</a> altogether.</p>
<p>This may contribute to higher rates of <a href="https://transequality.org/sites/default/files/docs/resources/NTDS_Report.pdf">tobacco use, obesity, alcohol use</a> and other cancer risk factors <a href="https://doi.org/10.1186/s12909-019-1727-3">in gender-diverse people</a>.</p>
<h2>Cancer care challenges</h2>
<p>Research to date shows that transgender adults over age 45 are screened for colon cancer <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347308/">at a lower rate</a> than cisgender patients. They are also more likely to be <a href="https://doi.org/10.1093/jnci/djab028">diagnosed at later stages</a> of lung cancer. This can be devastating, because <a href="https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.html">finding lung cancer</a> before it spreads can literally mean the difference between life and death.</p>
<p>The University of California, San Francisco, one of the few places that has protocols for the care of transgender patients, recommends that transgender women who are older than 50 and have been <a href="https://transcare.ucsf.edu/guidelines/breast-cancer-women">taking a feminizing hormone</a> for five years begin getting <a href="https://transcare.ucsf.edu/guidelines/breast-cancer-women">screened for breast cancer</a>. However, according to a recent Canadian study, only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347308/">about 1 in 3 transgender women</a> who are eligible for breast cancer screening receive mammograms, compared with 2 in 3 eligible cisgender women.</p>
<p>In a 2021 study, researchers found that transgender patients with <a href="https://doi.org/10.1093/jnci/djab028">non-Hodgkin lymphoma, prostate cancer or bladder cancer</a> had roughly twice the death rate of their cisgender counterparts. Since the researchers were able to firmly identify only 589 transgender individuals out of nearly 11.8 million records, they could not accurately compare rates for other types of cancer.</p>
<p>Since 2017, the American Society of Clinical Oncology has recommended including <a href="https://doi.org/10.1200/jco.2016.72.0441">data about patients’ sexual and gender minority</a> status in cancer registries and clinical trials. However, in 2022 the society found that <a href="https://ascopubs.org/doi/full/10.1200/OP.22.00084">only half of oncology care providers</a> are routinely collecting gender identity information. So it’s clear that there’s still a lot to learn about the barriers to inclusive cancer care.</p>
<p>Lack of training in both medical school and residencies – intensive training stints where new doctors hone their skills – perpetuates these disparities.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Ee4fyqk997s?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">In a 2019 TEDx talk, educator Jo Codde discussed the importance of compassion, dignity and respect as a means to improving transgender health care.</span></figcaption>
</figure>
<h2>Bias in medical school</h2>
<p>Medical education is <a href="https://doi.org/10.1016/S0140-6736(20)30846-1">plagued by biases</a> that reflect society’s stereotypes and prejudices. Further, researchers have found that students can <a href="https://doi.org/10.1007/s11606-007-0160-1">unconsciously absorb</a> biases or stereotypes encountered in their medical education. </p>
<p>And just 26% of doctors directing family medicine clerkships – courses in which medical students start working and interacting with real patients – say they <a href="https://doi.org/10.22454/FamMed.2021.509974">feel comfortable teaching transgender health care</a>.</p>
<p>So the Association of American Medical Colleges has called for emphasizing at all levels of training the health of people who are lesbian, gay, bisexual, transgender, queer or questioning and other identities – <a href="https://www.aamc.org/news-insights/insights/keeping-our-promise-lgbtq-patients">known as LGBTQ+</a>. The association <a href="https://store.aamc.org/downloadable/download/sample/sample_id/129/">recommends that schools</a> take a “<a href="https://doi.org/10.1097/acm.0000000000003581">layered” approach</a> that integrates education on gender-affirming health care across their curricula. This can include incorporating LGTBQ+ health in early coursework, <a href="https://health.wvu.edu/news/story?headline=wv-steps-features-diverse-manikins-standardized-patients-for-students-to-gain-experience-working-wit">using practice patients in simulation</a>, and creating opportunities to care for patients with lived experience.</p>
<p>Many medical schools still fail to integrate gender-affirming care throughout the curriculum, though. Instead, <a href="https://doi.org/10.1007/s11930-018-0185-y">medical schools often append</a> it to the existing curriculum – offering dedicated lectures or small-group activities that address LGBTQ+ health. Medical schools overall are providing a median of only five hours of instruction <a href="https://doi.org/10.22454/FamMed.2021.509974">on gender-affirming health care practices</a>. </p>
<h2>Health insurance obstacles</h2>
<p>In 2015, the Centers for Medicare and Medicaid Services clarified that preventive care services are available under the Affordable Care Act, <a href="https://transcare.ucsf.edu/guidelines/insurance">regardless of gender identity</a>. </p>
<p>However, the main organizations guiding providers and insurance coverage regarding breast, cervical and prostate cancer screening <a href="https://doi.org/10.21037%2Ftau-20-954">continue to use</a> an approach based on the ingrained binary male-female model approach. </p>
<p>For example, the U.S. Preventive Services Task Force still gears its <a href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening">recommendations for breast and cervical cancer screenings</a> toward cisgender women, with <a href="https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/jama-tf-approach-addressing-sex-gender-issues-bulletin.pdf">little guidance</a> on how to apply them to transgender patients.</p>
<p>This is driven in part by <a href="https://doi.org/10.21037%2Ftau-20-954">a lack of data</a> on how to best screen transgender patients for cancer. </p>
<p>Insurance coverage and companies also create hurdles. Gender-diverse patients are more likely to be <a href="https://doi.org/10.1093/jnci/djab028">uninsured or underinsured</a> – making it <a href="https://doi.org/10.1097/mlr.0000000000001693">much harder for them to access</a> preventive medical care. A gender identity mismatch in an <a href="https://doi.org/10.1093/jamia/ocab136">electronic medical record</a> can <a href="https://transcare.ucsf.edu/guidelines/insurance">trigger a denial</a> for a cancer screening. </p>
<h2>Momentum for change</h2>
<p>Fortunately, the medical field is recognizing that gender-diverse patients have unique health care needs.</p>
<p>Since 2017, the <a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/03/health-care-for-transgender-and-gender-diverse-individuals">American College of Obstetricians and Gynecologists</a> has published recommendations
for health care providers on making their practices open and inclusive for all individuals. Training all staff and creating an open office space without a gendered approach is a key recommendation.</p>
<p>Now over <a href="https://transhealthproject.org/resources/medical-organization-statements/">20 medical organizations</a> give similar guidance, with hopes of increasing inclusion through the health care system.</p>
<p>Another encouraging sign is that some medical schools are integrating gender-affirming care into their coursework. The University of Louisville in Kentucky reports that it now offers <a href="https://louisville.edu/medicine/ume/ume-office/equality/curriculum">50 hours of LGBTQ+-specific topics</a>. And a faculty-student team at the Boston University School of Medicine has developed a tool to help medical schools assess and improve <a href="https://doi.org/10.1097/acm.0000000000004203">how they educate students</a> to provide sexual and gender-minority health care.</p>
<p>I’m hopeful that <a href="https://doi.org/10.4158/EP171758.OR">the next generation</a> of health care providers will be a <a href="https://www.mededportal.org/doi/10.15766/mep_2374-8265.10536">force for change</a> at their institutions; in my experience, <a href="https://www.npr.org/sections/health-shots/2019/01/20/683216767/medical-students-push-for-more-lgbt-health-training-to-address-disparities">incoming medical students</a> are more aware of health disparities than their older generations of educators.</p><img src="https://counter.theconversation.com/content/191933/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jenna Sizemore does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>From primary care to cancer screening and insurance coverage, gender-diverse people still face many hurdles to getting good medical care.Jenna Sizemore, Assistant Professor of Medicine, West Virginia UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1909932022-10-31T17:12:52Z2022-10-31T17:12:52ZGender diversity reforms have helped UK company boards, but they are failing in other countries - new research explains why<figure><img src="https://images.theconversation.com/files/492103/original/file-20221027-20183-1md3al.jpg?ixlib=rb-1.1.0&rect=0%2C10%2C6706%2C4457&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/busy-working-day-top-view-young-1290799462">G-Stock Studio / Shutterstock</a></span></figcaption></figure><p>It may take close to 300 years to achieve gender equality and the empowerment of all women and girls, according to a UN progress report on its sustainable development goals (SDG), <a href="https://www.unwomen.org/en/digital-library/publications/2022/09/progress-on-the-sustainable-development-goals-the-gender-snapshot-2022">Gender Snapshot 2022</a>. This is way off the 2030 deadline set when the SDGs were adopted by UN member states in 2015.</p>
<p>Closing the gender gap in the corporate world will contribute to meeting these goals. This means not only boosting women’s participation in the workforce, but ensuring that women are represented equally in positions of power and leadership within companies. However, global progress has advanced at different rates, with some countries lagging far behind. </p>
<p>Worldwide corporate governance reforms have <a href="https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---act_emp/documents/briefingnote/wcms_754631.pdf">encouraged changes</a> in the composition of boards of directors for the last two decades. While they vary in scale and severity, gender diversity regulations generally aim to increase the pool of female talent at companies and to make boards more independent in terms of how their members are chosen and appointed. </p>
<p>And for good reason. A gender diverse and independent board can help a company in several ways. Research shows that boards which are gender diverse can <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1467-8683.00011">boost company performance</a> and lower the probability of <a href="https://livrepository.liverpool.ac.uk/3150784/">corporate fraud</a>, for example. </p>
<p>Independent directors – those with no attachments to the corporation – contribute more effectively toward decision making. They tend to have fewer potential conflicts of interest, as well as different <a href="https://journals.sagepub.com/doi/10.1177/014920630202800603">expertise and social networks</a> to board members with existing links to the company.</p>
<p>Gender diversity regulations that apply to companies’ boards of directors are either voluntary – that is, entirely at a company’s discretion – or enforced through legal quotas. But <a href="https://doi.org/10.1111/1467-8551.12660">research</a> I recently published with my colleagues shows that voluntary gender diversity regulations often don’t work.</p>
<h2>Progress on gender reforms</h2>
<p>Norway was the first country to introduce a <a href="https://www.elgaronline.com/view/edcoll/9781782547921/9781782547921.00027.xml">proportional gender quota</a> for listed and state-owned companies in 2003. Other countries followed suit in trying to boost gender equality, either by also establishing board-level gender quotas or by making recommendations of a voluntary nature in codes of good corporate practice.</p>
<p>Since investors are likely to appreciate companies following good corporate governance practice, voluntary gender regulation can be an incentive to appoint more women to corporate boards. These recommendations are non-binding, however, and tend to be vague in setting a target for board diversity. This might promote a “one and done” approach, where compliance is achieved with the appointment of a single female director. </p>
<p>Our research also shows such one-off appointments tend to be internal or based on existing relationships – that is, a director that is not independent. This can be because finding qualified women externally is more costly. </p>
<p>By contrast, gender quotas set at 30%-40% of board composition achieve higher female board representation faster. Certainly, many countries – including European states such as France, Germany, Italy, the Netherlands and Spain – have dropped voluntary regulations altogether, in favour of legislative quotas. Gender quotas may also force companies to look externally in search of more talent to fulfil the required targets, creating a more independent board. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/492104/original/file-20221027-36500-3r2eme.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Company boards of directors should aim to be more diverse and independent.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/diverse-business-partners-arguing-about-bad-1022439889">fizkes / Shutterstock</a></span>
</figcaption>
</figure>
<h2>Ineffective voluntary regulations</h2>
<p>Our research also found that voluntary gender diversity regulations are particularly ineffective in countries with a strong familial culture, such as Mexico. This kind of culture is associated with societal attitudes and expectations that establish the role of women as carers and men as breadwinners. In such countries, women might have to overcome barriers to reach a board appointment because of stereotyped perceptions about their advisory and leadership abilities.</p>
<p>In countries with a strong familial culture, we found that female director appointments are likely to be <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/1467-8551.12208">symbolic</a> and are predominantly based on relationships. To publicly demonstrate commitment towards the voluntary reform, companies don’t tend to draw from the pool of externally available talent, which means they don’t get the corporate benefits of board gender diversity. </p>
<p>Because voluntary gender reforms are ineffective in incorporating female directors who are independent to the board, they reduce overall board independence. Only gender quotas are successful in increasing the proportion of independent female directors on boards in such cultures. </p>
<p>Mexico introduced a voluntary gender quota regulation for company boards in 2018, making the basic recommendation of “incorporating women on the board of directors”. After two years, the proportion of women on company boards of directors had <a href="https://5050wob.com/wp-content/uploads/2021/11/Reporte-2021-11.10-v5-Diversidad-Geenero-Consejos-MX12.pdf">increased from 7.3% to 9%</a>. </p>
<p>This is an improvement, but at a much slower pace than, for example, the UK, which saw female directors on boards increase from 9.5% to 17.4% two years after establishing a similar voluntary regulation in 2011. And by 2020, the UK had no more “one and done” boards – women now make up around 40% of non-executive directors on the boards of <a href="https://ftsewomenleaders.com/wp-content/uploads/2022/05/2021_FTSE-Women-Leaders-Review_Final-Reportv1_WA.pdf">FTSE 350 companies</a>. </p>
<p>In this way, the UK <a href="https://www2.deloitte.com/content/dam/Deloitte/global/Documents/gx-women-in-the-boardroom-seventh-edition.pdf">performed as well</a> as other countries that have quotas, such as Norway and France, where seats held by women on boards in 2021 were about 42% and 43%, respectively. </p>
<p>The independence element has been particularly difficult to achieve in Mexico’s familial culture, with the percentage of female directors with no previous ties to a company <a href="https://5050wob.com/wp-content/uploads/2021/11/Reporte-2021-11.10-v5-Diversidad-Geenero-Consejos-MX12.pdf">growing from</a> 0.9% of all directors in 2018 to only 1.9% in 2020.</p>
<p>This research shows the benefits of legal gender quotas over voluntary regulations. But as a first step towards addressing this gender diversity issue, particularly in countries with a strong familial culture, voluntary regulations could be made more specific. </p>
<p>In the case of Mexico, even a tweak to current recommendations to specify the appointment of women who are independent to boards of directors could go a little way towards increasing board gender diversity. For more significant progress towards global gender equality goals, however, legal quotas seem to be the best way forward.</p><img src="https://counter.theconversation.com/content/190993/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jannine Poletti-Hughes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Voluntary regulation has helped company boards become more diverse but has been more successful in certain countries.Jannine Poletti-Hughes, Senior Lecturer in Accounting and Finance, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1884302022-08-10T20:11:15Z2022-08-10T20:11:15ZMore than 80% of people we asked said they’ve experienced violence in junior sport – and women and gender-diverse people cop it most<figure><img src="https://images.theconversation.com/files/478451/original/file-20220810-26-v3dilp.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2713%2C2034&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Lars Bo Nielsen/Unsplash</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Every week millions of Australian children play community sport. Participating in community sport can improve children’s mental, physical and social wellbeing, but only if the sport environment is <a href="https://pubmed.ncbi.nlm.nih.gov/23945179/">physically and emotionally safe</a>.</p>
<p>Our <a href="https://journals.sagepub.com/doi/10.1177/08862605221114155">new research</a> shows community sport spaces aren’t safe for everyone. We found 82% of 886 survey respondents said they experienced violence while playing community sport as a child in Australia.</p>
<p>Our study was one of the first in Australia to include the experiences of non-gender-binary individuals. We found gender-diverse people reported particularly high rates of violence while playing sport as children. Some 81% reported experiencing psychological violence from a coach, compared to 55% and 50% for women and men respectively.</p>
<p>Women also had high rates compared to men of psychological (82% vs 74%) and sexual (40% vs 33%) violence.</p>
<p>So how can we change this? </p>
<h2>Violence in community sport</h2>
<p>In recent years, cases of violence against children in elite sport in Australia have garnered national media attention. <a href="https://www.abc.net.au/news/2022-01-21/swimming-australia-response-misogynistic-culture-report/100772476">Swimming</a> and <a href="https://www.abc.net.au/news/2022-04-20/wais-gymnast-abuse-final-report-lands/101001344">gymnastics</a> are perhaps the most visible examples of the widespread nature of violence against children in sport, but they aren’t alone.</p>
<p>The media often focus on single sports and the abuse experienced by elite athletes, which can lead to a false sense of security in other sports and in sport at the community level.</p>
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Read more:
<a href="https://theconversation.com/whether-teams-win-or-lose-sporting-events-lead-to-spikes-in-violence-against-women-and-children-99686">Whether teams win or lose, sporting events lead to spikes in violence against women and children</a>
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<p>The short- and long-term <a href="https://www.childabuseroyalcommission.gov.au/final-report">consequences of violence</a> are profound and include anxiety, depression, mistrust, impaired relationship dynamics and more. </p>
<p>Understanding how often children experience violence playing sport is critical to monitoring this violence and keeping children safe.</p>
<h2>What we studied</h2>
<p>Our team at Victoria University completed the <a href="https://journals.sagepub.com/doi/10.1177/08862605221114155">largest study to date</a> in Australia exploring how often children experience violence in community sport.</p>
<p>We surveyed 886 Australian adults who had played organised community sport when they were younger than 18, asking them about their experiences of violence in sport. Specifically, they were asked about unsanctioned violence, that is, violence occurring outside the specified rules of the game. This could have occurred in diverse environments such as on the field, in the locker rooms, or during travel for sport.</p>
<p>It’s important to note that because the study didn’t use a nationally representative sample, the data can’t be extrapolated out to represent the whole of community sport in Australia.</p>
<p>Respondents were mostly women (63%), but came from all states and territories in Australia and had participated in 68 different sports. Around 18% of respondents were between 18 and 25 years old, which highlights how recent some of the reported experiences are. </p>
<figure class="align-center ">
<img alt="Coach yelling at his players through a megaphone" src="https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/478469/original/file-20220810-4746-9clt4s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">81% of gender-diverse people said they experienced violence from a sports coach when they were kids.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<h2>Psychological, physical, sexual</h2>
<p>We found 82% of respondents experienced violence while participating in sport as children in Australia.</p>
<p>Psychological violence was the most frequent form (76% of respondents), but rates of physical violence (66%) and sexual violence (38%) were also high.</p>
<p>The survey also distinguished between different types of perpetrators – peers, coaches and parents. Our respondents reported high rates of psychological violence by peers (68%), and high rates (>50%) of physical and psychological violence perpetrated by a coach.</p>
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Read more:
<a href="https://theconversation.com/the-long-history-of-gender-violence-in-australia-and-why-it-matters-today-119927">The long history of gender violence in Australia, and why it matters today</a>
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<p>We found non-gender-binary people experienced higher rates of several types of violence than both women and men combined. Peer-perpetrated sexual harassment was particularly high for these individuals (59%), as was peer physical violence (53%).</p>
<p>Women experienced more psychological and sexual violence, whereas men experienced more physical violence by their peers when playing sport as a child.</p>
<p>While our sample wasn’t representative of the Australian population, our findings echo international research findings. A <a href="https://journals.sagepub.com/doi/full/10.1177/0193723520973571">Canadian study from 2020</a>, which used the same survey in 14-17 year olds, also found high rates of psychological (79%), physical (40%) and sexual violence (28%).</p>
<h2>How we can change things</h2>
<p>These data can be quite confronting, especially for those of us (ourselves included) who are so passionate about sport.</p>
<p>The aim of this article and study isn’t to demonise sport. Instead, it’s to acknowledge we need to understand the depth and breadth of violence against children in sport, in order to make sport safer.</p>
<p>In the long-term, a national study with a representative sample is needed to establish how often violence against children in community sport occurs. It’s the only way to measure whether our policies and practices are preventing violence against children in sport. Such studies take time, expertise and funding, but they are achievable with the right support.</p>
<p>National <a href="https://www.sportintegrity.gov.au/what-we-do/national-integrity-framework">frameworks</a> <a href="https://www.childsafestandards.org.au/">and policies</a> are essential to ensuring sporting clubs are complying with safeguarding standards.</p>
<p>However, national policies and campaigns take time to have impact at the grassroots level. This is complicated by a context where many community sport clubs are surviving on the capacity of very few, <a href="https://www.sportaus.gov.au/__data/assets/pdf_file/0020/1017443/Sport-Australia-The-Future-of-Sport-Volunteering-Insights-Report-2021.pdf">burnt-out volunteers</a>.</p>
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Read more:
<a href="https://theconversation.com/how-sport-can-tackle-violence-against-women-and-girls-107886">How sport can tackle violence against women and girls</a>
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<p>A top-down approach to behaviour change isn’t our only option. There’s an opportunity to start creating change with and within community sport. This can help identify the most effective strategies for preventing violence against children in community sport. </p>
<p>Community sport can and should be a welcoming, inclusive and safe environment. We can only achieve this through a whole-of-community effort.</p>
<p>Awareness that violence in community sport exists is a first step. </p>
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<p><em>If this article has raised issues for you or if you’re concerned about someone you know, call Lifeline on 13 11 14, Beyond Blue on 1300 22 4636, or Kids Helpline on 1800 55 1800.</em></p><img src="https://counter.theconversation.com/content/188430/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We found 81% of gender-diverse people reported experiencing violence from a coach.Mary Woessner, Lecturer in Clinical Exercise and Research Fellow, Institute for Health and Sport (iHeS), Victoria University, Victoria UniversityAurélie Pankowiak, Research Fellow, Institute for Health and Sport, Victoria UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1738022022-02-23T13:36:07Z2022-02-23T13:36:07ZUS counties with more civic engagement tend to have more women on local company boards of directors<figure><img src="https://images.theconversation.com/files/445793/original/file-20220210-18404-1jb33e0.jpg?ixlib=rb-1.1.0&rect=242%2C1085%2C5150%2C3531&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women still have a long way to go to reach parity in the boardroom.
</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/black-chairwoman-concept-vector-illustration-royalty-free-illustration/1299804743">Wanlee Prachyapanaprai/iStock via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em> </p>
<h2>The big idea</h2>
<p>U.S. counties where people are more likely to vote and engage in professional and social associations tend to have more women on the boards of local corporations, according to <a href="https://doi.org/10.1111/corg.12418">our new peer-reviewed study</a>. Moreover, we found that women in these communities are more likely to be appointed as chairs of influential board committees.</p>
<p>To reach these conclusions, we studied nearly 3,000 publicly listed U.S. companies, representing more than 90% of stock market equity. For each company, we collected financial data from 2000 to 2018 on company size, growth, risk and performance, as well as details on the composition of their board of directors, such as their size and the percentage of female members. </p>
<p>Our data showed that while the overall share of women on corporate boards is very low, there is considerable variation across the U.S. In 2018, a quarter of companies in our database didn’t have a single female board member, and just under 100 had at least as many women as men on boards.</p>
<p>Prior studies have suggested that <a href="https://doi.org/10.1016/j.jbusres.2018.01.043">regional policies</a> or <a href="http://dx.doi.org/10.2139/ssrn.2192918">barriers</a> might explain the differences. We hypothesized that a concept sociologists call “<a href="https://www.investopedia.com/terms/s/socialcapital.asp">social capital</a>” might be a factor. Broadly speaking, <a href="https://www.investopedia.com/terms/s/socialcapital.asp">social capital</a> refers to how people in a society work together to achieve common goals, which in turn <a href="https://doi.org/10.1016/B978-0-444-53187-2.00010-3">can build trust</a>, <a href="https://doi.org/10.1111/1468-0297.00077">improve local governance</a> and <a href="https://doi.org/10.1596/0-8213-3561-8">address social problems</a> like poverty.</p>
<p>So for each company in our database, we also pinpointed the U.S. county in which it has a headquarters. Then, for each county, we collected data on population growth, percentage of women in the workforce, median household income and age, and religiosity and average level of education of local residents.</p>
<p>To measure social capital, we collected <a href="https://aese.psu.edu/nercrd/community/social-capital-resources">county-level data</a> on voter turnout, U.S. census response rates and a gauge of how many residents are likely members of nonprofit and social organizations such as churches, business associations and even bowling teams. Counties with greater turnout and membership levels got higher social capital scores.</p>
<p>Consistent with our predictions, we found that companies located in counties with more social capital also tended to have more women on corporate boards. Moreover, businesses in counties that scored among the top 20% in terms of social capital were 1.5 times more likely to have at least one woman on their boards than those in the bottom fifth. </p>
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<p>We also found that companies in high-capital counties were more likely to put women in charge of key decision-making committees, such as ones that oversee audits, compensation and executive and board nominations.</p>
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<h2>Why it matters</h2>
<p>Female participation in labor markets saw tremendous growth in the 20th century. </p>
<p>In the U.S., for example, the percentage of women in the workforce <a href="https://ourworldindata.org/female-labor-supply#female-participation-in-labor-markets-grew-remarkably-in-the-20th-century">went from 20%</a> at the start of the century to over 60% toward the end. It’s a <a href="https://www.bloomberg.com/quicktake/women-boards?sref=Hjm5biAW">little lower today</a>.</p>
<p>At the same time, women experienced growing representation on corporate boards, from <a href="https://www.bloomberg.com/quicktake/women-boards?sref=Hjm5biAW">virtually none</a> in the early 1900s to about 17% in 2018, according to our data. Still, there’s clearly a long way to go to achieve gender parity in corporate boardrooms – a <a href="https://doi-org.proxy.shh.fi/10.1016/bs.hecg.2017.11.007">key pillar of power and influence</a> in America. </p>
<p>While some countries – and U.S. states – have introduced <a href="https://theconversation.com/targets-and-quotas-a-two-pronged-approach-to-increase-board-diversity-12553">gender diversity targets or quotas</a> to increase the share of women on corporate boards, our findings suggest there may be other ways to achieve the same result. That is, policymakers and others keen to put more women in corporate board seats might consider focusing some of their efforts on encouraging more civic participation at the local level. </p>
<h2>What still isn’t known</h2>
<p>Social capital helps explain some of the variation in the share of women who sit on corporate boards, but there’s still much researchers do not know about why one company has more women than another – within a county, for example.</p>
<p>In addition, more research could be done on social capital and how it affects other corporate governance mechanisms, such as CEO compensation.</p><img src="https://counter.theconversation.com/content/173802/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A study of 3,000 companies found a correlation between local ‘social capital’ – which measures such variables as voter turnout and census response rates – and more women on corporate boards.Siri Terjesen, Associate Dean, Research and External Relations; Executive Director, Madden Center for Value Creation; Phil Smith Professor of Entrepreneurship, Florida Atlantic UniversityHanna Silvola, Associate Professor of Accounting, Hanken School of EconomicsMansoor Afzali, Assistant Professor of Accounting, Hanken School of EconomicsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1767872022-02-14T18:45:41Z2022-02-14T18:45:41Z4 out of 5 parents support teaching gender and sexuality diversity in Australian schools<figure><img src="https://images.theconversation.com/files/446156/original/file-20220214-21-1qew7ah.jpg?ixlib=rb-1.1.0&rect=0%2C6%2C4500%2C2984&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Debates about how schools acknowledge gender and sexuality diversity have been ongoing in Australia. It’s often claimed parents oppose the inclusion of gender and sexuality diversity content in the teaching of their children. But <a href="https://www.tandfonline.com/doi/full/10.1080/14681811.2021.1949975">our research</a> shows four out of five parents support such content being included in the relationships and sexual health curriculum.</p>
<p>Debate about these issues has been revived by the federal <a href="https://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/Bills_Search_Results/Result?bId=r6821">Religious Discrimination Bill</a> and the NSW One Nation’s <a href="https://www.parliament.nsw.gov.au/bill/files/3776/First%20Print.pdf">Education Legislation Amendment (Parental Rights) Bill</a>. The <a href="https://theconversation.com/grattan-on-friday-morrisons-religious-discrimination-package-couldnt-fly-on-a-wing-and-a-prayer-176892">now-shelved</a> federal bill would have allowed religious schools to expel transgender and gender-diverse students. The NSW bill seeks to revoke the accreditation of educators who discuss gender and sexuality diversity in a public school. </p>
<p>Both bills would have the same effect: the erasure of gender and sexuality diversity from schools.</p>
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Read more:
<a href="https://theconversation.com/nsw-inquiry-rejects-expert-advice-on-parental-rights-bill-and-it-will-cause-students-to-suffer-167539">NSW inquiry rejects expert advice on Parental Rights Bill, and it will cause students to suffer</a>
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<p>Until now there has been no comprehensive research in Australia that examines what parents actually want in relation to such topics in their child’s education. This lack of research-based evidence has meant even <a href="https://www.sciencedirect.com/science/article/abs/pii/S0742051X18305407">teachers are unsure</a> about whether or not they are allowed to discuss gender and sexuality diversity. </p>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/14681811.2021.1949975">Our landmark study</a>, published in the journal Sex Education, sheds light on this issue. Our findings challenge the idea that most parents oppose the inclusion of gender and sexuality diversity-related content in school. </p>
<h2>What did the study find?</h2>
<p>We surveyed 2,093 parents of students attending government schools across the nation. To ensure results could be considered nationally representative, data were weighted using a <a href="https://www.srcentre.com.au/our-research#life-in-aus">probability panel of Australian adults</a>. Both demographic markers (including gender, location and languages spoken at home) and attitudes to education that’s inclusive of gender and sexuality diversity were used to weight the final data set. </p>
<p>The survey asked fundamental questions about parents’ views on the “who, what, when” of relationships and sexuality education. There was a specific focus on how parents felt about including gender and sexuality diversity in the curriculum.</p>
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<p>The findings show 94% of parents want relationships and sexuality education in schools, in keeping with the <a href="https://www.australiancurriculum.edu.au/f-10-curriculum/health-and-physical-education/">current Australian Curriculum</a>. When asked about gender and sexuality diversity across six different topic areas, on average, 82% of parent respondents support their inclusion as part of the relationships and sexual health curriculum from kindergarten through to year 12.</p>
<p>In terms of understandings of gender diversity by students at different ages, two-thirds of parents (68%) want this topic introduced in the curriculum by the end of stage 4 of schooling (years 7 and 8). In keeping with other areas, over 80% of parents support its inclusion by the end of year 12. </p>
<p>Parents’ reasons for supporting inclusion were apparent in their views on the purpose of relationships and sexual health education. Given a choice of four central purpose statements, the largest group of parents (nearly 50%) felt this curriculum area should focus on student “empowerment, choice, consent, and acceptance of diversity”. </p>
<h2>It’s about fairness, inclusion and safety</h2>
<p>These findings reflect the culture of fairness and inclusion that most Australians believe in. The results point to parents’ understanding of the importance of inclusion. They object to the <a href="https://apo.org.au/sites/default/files/resource-files/2021-04/apo-nid311780_1.pdf">school-based harassment of gender and sexuality diverse students</a> in this country. </p>
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Read more:
<a href="https://theconversation.com/9-in-10-lgbtq-students-say-they-hear-homophobic-language-at-school-and-1-in-3-hear-it-almost-every-day-160356">9 in 10 LGBTQ+ students say they hear homophobic language at school, and 1 in 3 hear it almost every day</a>
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<p>These young people are rarely represented in curriculums. They are not only invisible, but also experience discrimination by omission. </p>
<p>Parents are likely to know Australia has one of the <a href="https://www.aihw.gov.au/suicide-self-harm-monitoring/data/populations-age-groups/suicide-among-young-people">highest rates of youth suicide</a> in the world. Tragically, <a href="https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdab383/6444311">the rate is even higher</a> for gender and sexuality diverse young people. Their experiences at school are undoubtedly linked to this outcome. </p>
<p>In our study, nearly 90% of parents wanted to see the curriculum address discrimination and bullying of gender and sexuality diverse people. This finding speaks to their desire to create safe and welcoming schools for all students.</p>
<h2>What does this mean for teachers?</h2>
<p>This research has important implications for teachers of relationships and sexual health education. <a href="https://opal.latrobe.edu.au/articles/report/2nd_National_Survey_of_Australian_Teachers_of_Sexuality_Education_2018_pdf/13207265">Many report</a> they avoid gender and sexuality diversity and fear community backlash. </p>
<p>Teachers’ unease prevails despite <a href="https://www.dese.gov.au/student-resilience-and-wellbeing/australian-student-wellbeing-framework">federal government guidance</a> that promotes the well-being of students. The guidelines encourage schools to create positive learning environments that foster diversity and respectful relationships and support students to feel safe, connected and included.</p>
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Read more:
<a href="https://theconversation.com/free-schools-guide-about-inclusiveness-and-climate-science-is-not-ideological-its-based-on-evidence-162423">Free schools guide about inclusiveness and climate science is not ideological — it's based on evidence</a>
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<p>The <a href="https://www.abc.net.au/news/2022-02-11/religious-discrimination-bill-transgender-students-teachers-/100821338">public response</a> to the Religious Discrimination Bill and its subsequent shelving highlights how it is inherently anathema to punish and exclude children and young people from school based on their identity. Australian teachers need to be supported to create a school culture where these students can feel safe, welcome and informed about their relationships and sexual health. </p>
<p>Educators across the country would benefit from additional guidance and support to feel confident that discussing these topics is in line with the views of the majority of their students’ parents.</p><img src="https://counter.theconversation.com/content/176787/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tania Ferfolja has received funding for this research from the Australian Research Council. </span></em></p><p class="fine-print"><em><span>Jacqueline Ullman received funding from the Australian Research Council for the research discussed in this article.</span></em></p>Those who oppose inclusive teaching content often claim to be representing parents’ views. The evidence from a large national survey of parents shows those claims are very wrong.Tania Ferfolja, Associate Professor, School of Education, Western Sydney UniversityJacqueline Ullman, Associate Professor in Adolescent Development, Behaviour and Wellbeing, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1722932022-02-04T13:09:35Z2022-02-04T13:09:35ZNot everyone is male or female – the growing controversy over sex designation<figure><img src="https://images.theconversation.com/files/441210/original/file-20220118-13-l32vzy.jpg?ixlib=rb-1.1.0&rect=0%2C26%2C5906%2C3904&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although the medical establishment is now recognizing that sex is not binary, society as a whole has been slow to embrace the concept.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/small-beautiful-child-lies-on-the-bed-on-his-royalty-free-image/1300384940?adppopup=true">Vera Livchak/Moment via Getty Images</a></span></figcaption></figure><p>Check out your birth certificate and surely you’ll see a designation for sex. When you were born, a doctor or clinician assigned you the “male” or “female” label based on a look at your genitalia. In the U.S., this has been <a href="https://doi.org/10.1056/nejmp2025974">standard practice for more than a century</a>. </p>
<p>But sex designation is not as simple as a glance and then a check of one box or another. Instead, the overwhelming evidence shows that <a href="https://doi.org/10.1002/ase.2002">sex is not binary</a>. To put it another way, the terms “male” and “female” don’t fully capture the complex biological, anatomical and chromosomal variations that occur in the human body. </p>
<p>That’s why calls are growing to remove sex designation from birth certificates, including <a href="https://thehill.com/changing-america/respect/equality/566767-ama-doctors-experts-recommend-removing-sex-designation-from">a recent recommendation</a> from the American Medical Association. </p>
<p>I am a <a href="https://www.bumc.bu.edu/busm/profile/carl-streed/">professor of medicine</a> who has worked extensively <a href="https://scholar.google.com.au/citations?user=Rv-dZJ4AAAAJ&hl=en">on lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) issues</a>. My co-author is a <a href="https://www.childrenshospital.org/directory/physicians/g/frances-grimstad">professor of gynecology</a> who is deeply involved in the health of people who are trans and intersex. </p>
<p>Our research and clinical experience show that sex designation is not something to take for granted. For those who don’t fit neatly into one of two categories – <a href="https://doi.org/10.1002/(sici)1520-6300(200003/04)12:2%3C151::aid-ajhb1%3E3.0.co;2-f">and there are millions</a> – an inappropriate classification on a birth certificate can have consequences that last a lifetime.</p>
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<figcaption><span class="caption">What does intersex mean?</span></figcaption>
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<h2>The problems with sex designation</h2>
<p>Variations in genital anatomy happen more frequently than you might think; <a href="https://doi.org/10.1002/(sici)1520-6300(200003/04)12:2%3C151::aid-ajhb1%3E3.0.co;2-f">they occur in 0.1 to 0.2% of births annually</a>. In the U.S., that’s about 4,000 to 8,000 babies each year. </p>
<p>Other sex traits don’t necessarily help either. Doctors examining the reproductive organs <a href="https://doi.org/10.1038/518288a">can find people</a> born with both a vagina and testes, and also those born without any gonads. And when evaluating an individual’s estrogen and testosterone hormone levels, long defined as key determinants of female and male bodies, doctors find some people with vaginas still produce <a href="https://doi.org/10.1016/S0140-6736(12)60071-3">significant amounts of testosterone</a>. Because of this, testosterone is not a great indicator for defining sex; higher amounts of testosterone do not necessarily make someone male. </p>
<p>Even karyotyping – a laboratory procedure used since the 1950s to evaluate an individual’s number and type of chromosomes – doesn’t tell the whole story. While we typically expect people to either have XX or XY pairs of sex chromosomes, <a href="https://doi.org/10.1038/518288a">many people have variations</a> that <a href="https://dx.doi.org/10.1159%2F000499274">do not fit either category</a>. These include <a href="https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782#">Turner syndrome</a>, in which a person is born with a single X chromosome, and <a href="https://www.mayoclinic.org/diseases-conditions/klinefelter-syndrome/symptoms-causes/syc-20353949#">Kleinfelter syndrome</a>, which occurs when a person is born with a combination of XXY chromosomes. </p>
<p>In short, human diversity has demonstrated that the binary categories of male and female are incomplete and inaccurate. Sex designation, rather than “two sizes fit all,” <a href="https://doi.org/10.1089/lgbt.2021.0018">is on a spectrum</a>. Up to 1.7% of the U.S. population – that’s more than 5 million Americans – have an anatomy and physiology that present intersex traits.</p>
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<figcaption><span class="caption">What it’s like to be intersex.</span></figcaption>
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<h2>Binary designations can be damaging</h2>
<p>Those with intersex traits who <a href="https://doi.org/10.1371/journal.pone.0240088">are assigned at birth</a> to be female or male can <a href="https://www.amnesty.org/en/latest/campaigns/2017/05/intersex-rights/">experience medical care that harms them</a>, both physically and psychologically. </p>
<p>Sometimes physicians perform surgeries to align bodies into binary categories. For example, those born with a larger than typical clitoris <a href="https://doi.org/10.1089/lgbt.2021.0018">may have it reduced in size</a>. But some who have this childhood surgery suffer as adults from pain and difficulty having sex.</p>
<p>[<em><a href="https://memberservices.theconversation.com/newsletters?nl=science&source=inline-science-corona-important">Get The Conversation’s most important coronavirus headlines, weekly in a science newsletter</a></em>]</p>
<p>Additionally, governments sometimes limit those with intersex traits from fully participating in society. For instance, in Australia, <a href="https://ihra.org.au/16808/annulment-marriage-due-intersex-marriage-falsely-called/">marriages have been annulled</a> because governments have previously ruled that an intersex person – someone not seen to be “100% man” or “100% woman” – cannot be legally married.</p>
<p><a href="https://stillmed.olympics.com/media/Documents/News/2021/11/IOC-Framework-Fairness-Inclusion-Non-discrimination-2021.pdf">Private entities</a> often do the same. The International Olympics Committee uses <a href="https://www.wired.com/story/caster-semenya-and-the-twisted-politics-of-testosterone/">cutoffs of hormone levels</a> to determine who plays in women’s sports. As a result, some athletes have been barred from participation. </p>
<p>And for those with a gender identity that differs from the sex designation on a government document, <a href="https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf">discrimination, harassment or violence</a> can result. </p>
<p>State governments have begun to acknowledge sex diversity. Some let gender-diverse people change their designation on birth certificates, <a href="https://www.lgbtmap.org/equality-maps/identity_document_laws/birth_certificate">although there are restrictions</a>. Medicine too <a href="https://doi.org/10.1089/lgbt.2021.0018">is changing</a>. For example, some pediatric centers have stopped performing surgeries on newborns with <a href="https://protect-us.mimecast.com/s/jNAuCVOrlMC8Dq3vuQEnoR?domain=them.us">differences in sex development</a>. Still, society at large <a href="https://www.cnn.com/2017/09/20/health/geas-gender-stereotypes-study/index.html">has been much slower to move beyond</a> the use of strictly binary categories. </p>
<p>As clinicians, we strive to be accurate. The evidence shows that using male and female as the only options on birth certificates is not consistent with scientific reality. Evidence shows that removing this designation will tell new parents that it’s not sex assignment that’s most important at birth but rather the celebration of a healthy and happy baby.</p><img src="https://counter.theconversation.com/content/172293/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carl Streed receives funding from the National Heart, Lung, and Blood Institute and the American Heart Association. He is affiliated with the US Professional Association for Transgender Health and the American Medical Association. </span></em></p><p class="fine-print"><em><span>Frances Grimstad does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Millions of people do not fit neatly into male or female sex designations at birth, and wrong identification can set them up for a lifetime of physical and mental harm.Carl Streed Jr, Assistant Professor of Medicine, Boston UniversityFrances Grimstad, Assistant Professor of Gynecology, Harvard UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1709922021-11-12T13:36:57Z2021-11-12T13:36:57ZTransgender and gender diverse teens: How to talk to and support them<figure><img src="https://images.theconversation.com/files/429858/original/file-20211103-13-1rnekug.jpg?ixlib=rb-1.1.0&rect=34%2C58%2C3224%2C2912&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The webinar speakers, Jules Gill-Peterson (left) and Kacie Kidd.</span> <span class="attribution"><span class="source">courtesy of the scholars</span></span></figcaption></figure><p>Transgender youth have been around long before the word transgender has. Yet today, transgender teens are increasingly visible in society. For parents and caregivers, knowing how to talk to their children about gender can present a steep learning curve.</p>
<p>The Conversation U.S. on Oct. 21, 2021, hosted contributors <a href="https://history.jhu.edu/directory/jules-gill-peterson/">Jules Gill-Peterson</a>, an associate professor of history at Johns Hopkins University, and <a href="https://www.pediatrics.pitt.edu/people/kacie-m-kidd-md">Dr. Kacie Kidd</a>, medical director of the pediatric Gender and Sexual Development Clinic at West Virginia University Medicine Children’s Hospital, in a webinar titled “Transgender and gender-diverse teens more visible than ever: Who they are, what they need and how to talk about sensitive issues.”</p>
<p>The speakers, who have both <a href="https://theconversation.com/trans-kids-in-the-us-were-seeking-treatment-decades-before-todays-political-battles-over-access-to-health-care-157481">written</a> <a href="https://theconversation.com/nearly-10-of-youth-in-one-urban-school-district-identify-as-gender-diverse-new-study-finds-161640">articles</a> for The Conversation, shared their expertise on gender diversity in teens and answered commonly asked questions.</p>
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<p><em>Below are some highlights from the discussion. Please note that answers have been edited for brevity and clarity.</em></p>
<p><strong>Transgender and gender diverse youth have become <a href="https://theconversation.com/nearly-10-of-youth-in-one-urban-school-district-identify-as-gender-diverse-new-study-finds-161640">more visible than ever</a>. How does transgender history inform us about where society is at in the United States?</strong></p>
<p><strong>Jules Gill-Peterson</strong>: A lot of the rhetoric around [trans] kids frames them as totally new – most people are getting to know that there are trans youth for the first time. The visibility that we’re dealing with today is pretty unprecedented. But that doesn’t mean [transgender] people themselves <a href="https://theconversation.com/trans-kids-in-the-us-were-seeking-treatment-decades-before-todays-political-battles-over-access-to-health-care-157481">haven’t existed before</a>. </p>
<p>One of the challenges that anyone who’s trans faces is coming to an understanding of yourself in a culture that fundamentally doesn’t recognize that you exist. One of the most remarkable things about trans youth is that they’re able to stand up in this world that we’ve created, that gives them no reason to know who they are, and say, “Hey, actually, I know something about myself that none of the adults in my life know.”</p>
<p>I think history can be a really powerful grounding force to give young people a sense of lineage. It’s not like you look back in time and you see yourself reflected, by any means. But I think it can be profoundly reassuring, in a moment of not just political backlash but the general isolation that trans people face in a cis-normative society, to be able to [see] that you’re not the first person to ever go through this. [I think] that is just kind of a powerful message and one that I certainly subscribe to as an adult too, but I can imagine it’s especially important for young people.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Parent sitting next to and comforting youth" src="https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/429860/original/file-20211103-13-172mbor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Listening and believing your child about their identity is key to supporting them, Jules Gill-Peterson said.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mother-sitting-by-teenage-son-studying-at-home-royalty-free-image/1321465605?adppopup=true">Maskot/Getty Images</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p><strong>What does “cis” mean and where does it come from?</strong></p>
<p><strong>Jules Gill-Peterson</strong>: This is actually a term from chemistry. It’s a prefix that you can put in front of words. So is the word “trans.” Trans as a prefix means across – it’s the spatial metaphor moving across something. <a href="https://www.historians.org/publications-and-directories/perspectives-on-history/may-2017/tracing-terminology-researching-early-uses-of-cisgender#:%7E:text=As%20a%20term%2C%20cisgender%20combines,the%20addition%20as%20reflecting%20the">Cis</a> means on the same side of. At some point on the internet, people started using that word; they were looking for a word to distinguish between people who are trans and people who are not. Cisgendered came to mean that your gender identity matches what was assigned at birth. That being said, it’s not a totally kind of innocent or uncomplicated term. I’m not sure how helpful it is to think of cisgender as something that people need to own up to, for example, in a pronoun circle (when people introduce themselves by name and by the pronouns they prefer). </p>
<p>I think often the pressure for people to [identify] as cis doesn’t make any sense, either. It’s like, well, what makes you cisgender? Did you really go through that long process of deciding if your gender matched what’s on your birth certificate, like trans people have to deal with? I tend to use the word cis in my work to describe large historical structures that created that very obligation in the first place. </p>
<p><strong>Kacie Kidd</strong>: To build off that, we as a people have a tendency to put people in boxes. And I’m sure that many of us have had the experience of not neatly fitting into a box that society ascribed to us. And I think that’s something that we all can connect to, and relate to, and understand that our job of putting people in boxes is not helpful, right? And there is no binary for most things, if not all things, and I think our realization of that helps to understand the broader [situation].</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&rect=17%2C0%2C5973%2C3970&q=45&auto=format&w=1000&fit=clip"><img alt="A group of people hold up LGBT and trans pride flags" src="https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&rect=17%2C0%2C5973%2C3970&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/429831/original/file-20211102-17-ztnf52.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Learning how to talk to your teen about gender identity might be new, but it doesn’t have to be difficult, according to experts on transgender youth.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/pride-protest-royalty-free-image/1297981846?adppopup=true">Vladimir Vladimirov/Getty Images</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p><strong>What are binders and gender-affirming procedures, and is there a right age for them?</strong></p>
<p><strong>Kacie Kidd</strong>: A binder is a garment that constricts chest tissue and has a variety of uses; elite athletes often use similar kinds of products. But [binders] can help make someone feel more in line with who they are and can help them kind of navigate the world. But the answer to your question is no, there isn’t a perfect age. But these are long, thoughtful conversations and considerations. </p>
<p><strong>Jules Gill-Peterson</strong>: As a historian of medicine, one of the really interesting stories that I pulled in my book, <a href="https://history.jhu.edu/2021/07/20/histories-of-the-transgender-child/">Histories of the Transgender Child</a>, for example, is that <a href="https://theconversation.com/transgender-medicine-what-care-looks-like-who-seeks-it-out-and-whats-still-unknown-3-essential-reads-159984">gender affirming medicine</a> originated long before it was seen as gender affirming. The medical techniques used now came out of studying trans and intersex people and under really horrific, barbaric, torturous conditions. But the goal of that research was actually not to help intersex and trans people – it was to force them to appear more “normal,” but actually developed means to medically intervene into human sex and gender.</p>
<p>One of the interesting truths here is that there really isn’t that much of a meaningful difference. The only difference between trans medicine and non-trans medicine is who gets stigmatized for it. Who has to go get a psychiatric letter of evaluation, who has trouble getting insurance compensation? [For example,] who uses the most hormones in this country? Cisgender women and cisgender men. They just don’t have to ask for it as much. Other kinds of surgeries that are exactly the same as gender affirming surgeries are called cosmetic surgeries. </p>
<p><strong>I worry about my trans daughter having regrets in the future, when going back won’t be an option.</strong></p>
<p><strong>Jules Gill-Peterson</strong>: I understand the anxiety, but I want to make the case that [regret] is a red herring that’s been planted in our mind. I think the concept of regret is often tied to this idea of “de-transitioning,” the idea that you can transition and then un-transition, which is not a very good way of thinking about it. When people do choose to de-transition, especially trans women, it is due to <a href="https://fenwayhealth.org/new-study-shows-discrimination-stigma-and-family-pressure-drive-detransition-among-transgender-people/">overwhelming social pressure discrimination</a> and loss of social support people.</p>
<p>People de-transition when they lose their jobs, when their partners abandon them, when their families won’t speak to them, when they’re in dire financial straits, when they’re experiencing street harassment and criminalization, and when they don’t have the material resources they need to live. Those are the most concerning regrets. </p>
<p>Our children’s genders aren’t something that belong to us, right? And so our job is to support them in life and try to avoid those regrets, or to avoid the regret of going through puberty you didn’t want to go through, or having to, you know, spend years pretending to be someone you [are not]. I think those are things we should feel regretful for in society.</p>
<p></p><hr><p></p>
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<a href="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=343&fit=crop&dpr=1 600w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=343&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=343&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=431&fit=crop&dpr=1 754w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=431&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/404379/original/file-20210603-15-bb4qy1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=431&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<p><em>Read our in-depth series on <a href="https://theconversation.com/us/topics/trans-youth-2021-102529">issues facing transgender children and their families</a>. You can also sign up for a <a href="https://theconversation.com/us/newsletters/transgender-youth-77/">four-email newsletter “course”</a> with stories delivered over a week to learn about the latest research on trans youth.</em></p><img src="https://counter.theconversation.com/content/170992/count.gif" alt="The Conversation" width="1" height="1" />
Two experts on transgender youth share how to talk about gender and support trans youth.Thalia Plata, EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1690252021-10-15T01:05:24Z2021-10-15T01:05:24ZWhat are gender pronouns and why is it important to use the right ones?<figure><img src="https://images.theconversation.com/files/426140/original/file-20211013-19-ktbdtf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/non-binary-hispanic-transgender-mid-tomboy-2007442631">Shutterstock</a></span></figcaption></figure><p>Gender pronouns are the terms people choose to refer to themselves that reflect their gender identity. These might be he/him, she/her or gender-neutral pronouns such as they/them. </p>
<p>Knowing and using a person’s <a href="https://apo.org.au/node/41426">correct pronouns</a> fosters inclusion, makes people feel respected and valued, and affirms their gender identity.</p>
<h2>The difference between sex and gender</h2>
<p>While people may use the terms sex and gender interchangeably, they mean different things. </p>
<p>Sex refers to the physical differences between people who are female, male, or intersex. A person typically has their sex assigned at birth based on <a href="https://www.medicalnewstoday.com/articles/232363">physiological characteristics</a>, including their genitalia and chromosome composition. </p>
<p>This is distinct from gender, which is a social construct and reflects the social and cultural role of sex within a given community. People often develop their gender identity and gender expression in response to their environment. </p>
<p>While gender has been defined as binary in Western culture, gender is on a broad spectrum; a person may identify at any point within this spectrum or outside of it entirely. Gender is <a href="https://www.medicalnewstoday.com/articles/232363">not neatly divided</a> along the binary lines of “man” and “woman”.</p>
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Read more:
<a href="https://theconversation.com/the-difference-between-sex-and-gender-and-why-both-matter-in-health-research-162746">The difference between sex and gender, and why both matter in health research</a>
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<p>People may identify with genders that are different from sex assigned at birth, some people do not identify with any gender, while others identify with multiple genders. These identities may include transgender, nonbinary, or gender-neutral. </p>
<p>Only the person themself can determine what their gender identity is, and this can change over time. </p>
<h2>Gender neutral pronouns</h2>
<p>People who identify outside of a gender binary most often use non-gendered or nonbinary pronouns that are not gender specific. These include they/them/their used in the singular, ze (pronounced “zee”) in place of she/he, and hir (pronounced “here”) in place of his/him/her. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1394913215994155009"}"></div></p>
<p>Everyone has the right to use the gender pronouns that match their personal identity. These pronouns <a href="https://www.medicalnewstoday.com/articles/232363">may or may not</a> match their gender expression, such as how the person dresses, looks, behaves or what their name is. </p>
<h2>Why the right pronouns matter</h2>
<p>It’s important people, workplaces and organisations support people’s use of self-identified first names, in place of legal names given at birth, and self-identified pronouns, in place of assumed pronouns based on sex assigned at birth or other’s perceptions of physical appearance.</p>
<p>Being misgendered and/or misnamed <a href="https://apo.org.au/node/41426">may leave the person feeling</a> disrespected, invalidated and dismissed. This can be distressing and threaten the person’s mental health. </p>
<p>Transgender and non binary people are <a href="https://cns.utexas.edu/news/victimization-of-transgender-youths-linked-to-suicidal-thoughts-substance-abuse">twice as likely</a> to have suicidal thoughts than the general population, and are up to four times as likely to engage in risky substance use.</p>
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Read more:
<a href="https://theconversation.com/almost-half-of-trans-young-people-try-to-end-their-lives-how-can-we-reduce-this-alarming-statistic-83221">Almost half of trans young people try to end their lives. How can we reduce this alarming statistic?</a>
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<p>Conversely, using correct pronouns and names reduces depression and <a href="https://news.utexas.edu/2018/03/30/name-use-matters-for-transgender-youths-mental-health/">suicide risks</a>. </p>
<p>Studies have found that when compared with peers who could not use their chosen name and pronoun, young people who could <a href="https://www.sciencedirect.com/science/article/abs/pii/S1054139X18300855">experienced</a> 71% fewer symptoms of severe depression, a 34% decrease in reported thoughts of suicide and a 65% decrease in suicide attempts.</p>
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<h2>7 tips for getting pronouns right</h2>
<p>The following tips might help you better understand gender pronouns and how you can affirm someone’s gender identity: </p>
<p><strong>1. Don’t assume another person’s gender or gender pronouns</strong></p>
<p>You can’t always know what someone’s gender pronouns are by looking at them, by their name, or by how they dress or behave. </p>
<p><strong>2. Ask a person’s gender pronoun</strong></p>
<p>Asking about and correctly using someone’s gender pronouns is an easy way to show your respect for their identity. Ask a person respectfully and privately what pronoun they use. A simple “Can I ask what pronoun you use?” will usually suffice. </p>
<p><strong>3. Share your own gender pronoun</strong> </p>
<p>Normalise the sharing of gender pronouns by actively sharing your own. You can include them after your name in your signature, on your social media accounts or when you introduce yourself in meetings. Normalising the sharing of gender pronouns can be particularly helpful to people who use pronouns outside of the binary. </p>
<p><strong>4. Apologise if you call someone by the wrong pronoun</strong></p>
<p>Mistakes happen and it can be difficult to adjust to using someone’s correct pronouns. If you accidentally misgender someone, apologise and continue the conversation using the correct pronoun. </p>
<p><strong>5. Avoid binary-gendered language</strong></p>
<p>Avoid addressing groups as “ladies and gentleman” or “boys and girls” and address groups of people as “everyone”, “colleagues”, “friends” or “students”. Employers should use gender-neutral language in formal and informal communications. </p>
<p><strong>6. Help others</strong></p>
<p>Help others use a person’s correct pronouns. If a colleague, employer or friend uses an incorrect pronoun, correct them.</p>
<p><strong>7. Practise!</strong></p>
<p>If you’ve not used gender-neutral pronouns such as “they” and “ze” before, give yourself time to practise and get used to them. </p>
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Read more:
<a href="https://theconversation.com/lgbt-history-month-forgotten-figures-who-challenged-gender-expression-and-identity-centuries-ago-153815">LGBT+ history month: forgotten figures who challenged gender expression and identity centuries ago</a>
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<img src="https://counter.theconversation.com/content/169025/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Glen Hosking (he/him) does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It only takes a few seconds to ask ‘what pronouns do you use’, but knowing and using a person’s correct pronouns can have a big impact on their mental health.Glen Hosking, Senior Lecturer in Psychology. Clinical Psychologist, Victoria UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1686472021-10-04T21:16:05Z2021-10-04T21:16:05ZNew data shows that homelessness is a women’s rights issue<figure><img src="https://images.theconversation.com/files/424531/original/file-20211004-13-1q6fgia.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5415%2C3745&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A new Canada-wide survey shows 28 per cent of women-led households struggle with the affordability, suitability or adequacy of their housing. This is almost double the rate of households led by men.
</span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Paul Chiasson </span></span></figcaption></figure><p>Visible homelessness during the COVID-19 pandemic has highlighted the housing crisis across Canada. <a href="https://doi.org/10.3167/ghs.2020.130311">For women, girls and gender-diverse people, homelessness is often hidden,</a> meaning that they are more likely to avoid shelters, couch surf or remain in abusive relationships than end up on the streets. Because of this, we know less about their experiences. </p>
<p>New data from <a href="https://womenshomelessness.ca/wp-content/uploads/EN-Pan-Canadian-Womens-Housing-Homelessness-Survey-FINAL-28-Sept-2021.pdf">the Pan-Canadian Women’s Housing and Homelessness Survey</a>, the largest gender-specific data collection of its kind in Canada, tells us a clear story. </p>
<p>Lack of access to housing has gendered causes and effects, and gender equality in Canada depends on fair access to adequate housing. This survey, completed by 500 women and gender-diverse people in 12 provinces and territories, shows us <a href="https://www.youtube.com/watch?v=r2gIsXsQDQA">why housing is a women’s rights issue</a>.</p>
<h2>Housing affordability and low incomes</h2>
<p><a href="https://www.cmhc-schl.gc.ca/en/professionals/housing-markets-data-and-research/housing-research/core-housing-need/core-housing-need-data-by-the-numbers">Twenty-eight per cent of women-led households</a> struggle with the affordability, suitability or adequacy of their housing. This is almost double the rate of households led by men. </p>
<p>The Pan-Canadian Survey found that many women and gender diverse people who have experiences of homelessness have no money after paying for housing. Only 14.2 per cent can make ends meet after paying rent. </p>
<figure class="align-center ">
<img alt="A graph show strategies used to afford basic necessities." src="https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/424227/original/file-20211001-16-1xtrrgz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Strategies used to afford basic necessities, according to the Pan-Canadian Women’s Housing & Homelessness Survey.</span>
<span class="attribution"><span class="source">(Schwan, K., Vaccaro, M., Reid, L., Ali, N., & Baig, K. (2021). The Pan-Canadian Women’s Housing & Homelessness Survey, Canadian Observatory on Homelessness)</span></span>
</figcaption>
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<p>We know that women and gender-diverse people still <a href="https://www150.statcan.gc.ca/n1/pub/75-004-m/75-004-m2019004-eng.htm">earn less than men</a>, limiting access to an increasingly <a href="https://www.nbc.ca/content/dam/bnc/en/rates-and-analysis/economic-analysis/housing-affordability.pdf">unaffordable housing market</a>. Women are also <a href="https://www150.statcan.gc.ca/n1/pub/89-503-x/2015001/article/54931-eng.htm">more likely to have minimum wage</a> or part-time employment, meaning housing is even more unaffordable for them. </p>
<p>In the Pan-Canadian Survey, 60.2 per cent of participants reported not being able to afford a place to live, and 46.5 per cent reported not being able to afford a damage deposit, moving expenses and/or utility hookups. </p>
<p>Participants also noted that the available affordable housing was inadequate for children (15.2 per cent), in bad condition (40.8 per cent), unsafe (32.8 per cent) or inaccessible to people with disabilities (more than 70 per cent). </p>
<p>More than one-third of participants had also been forced to leave their most recent housing because they couldn’t afford it anymore (34.8 per cent). Gender pay inequities have a real impact on women’s right to housing.</p>
<figure class="align-center ">
<img alt="a graph shows reasons why it's difficult to find affordable housing" src="https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=512&fit=crop&dpr=1 600w, https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=512&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=512&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=643&fit=crop&dpr=1 754w, https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=643&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/424231/original/file-20211001-20-6rbqa9.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=643&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Reasons why it’s difficult to find affordable housing.</span>
<span class="attribution"><span class="source">(Schwan, K., Vaccaro, M., Reid, L., Ali, N., & Baig, K. (2021). The Pan-Canadian Women’s Housing & Homelessness Survey, Canadian Observatory on Homelessness)</span></span>
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<h2>Housing often dependent on a romantic partner</h2>
<p>Homeless counts of the general population, without a gendered lens, report that the top reason people lose their housing is because of <a href="https://www.canada.ca/en/employment-social-development/programs/homelessness/publications-bulletins/report-addiction.html#h2.07">addiction and substance use</a>. </p>
<p>In contrast, the Pan-Canadian Survey reported 47 per cent of participants said a breakup was the main reason they lost their most recent housing. This means that many women and gender-diverse people are forced to choose between staying in a personal or romantic relationship or becoming homeless. </p>
<figure class="align-center ">
<img alt="A woman looks out a window at a city street." src="https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/424585/original/file-20211004-15-1dczo0o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Many reported they couldn’t afford a new place or moving expenses, forcing them to stay where they are.</span>
<span class="attribution"><span class="source">(JD Mason/Unsplash)</span></span>
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</figure>
<p><a href="https://undocs.org/en/A/HRC/43/43">Under human rights standards</a>, women and gender-diverse peoples’ housing should not depend on their relationship status.</p>
<p>Advancing gender equity in Canada means protecting independent housing for women and increasing access to home ownership for low-income women and gender-diverse people.</p>
<figure class="align-center ">
<img alt="a graph shows reasons why survey participants had to move out" src="https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=383&fit=crop&dpr=1 600w, https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=383&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=383&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=482&fit=crop&dpr=1 754w, https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=482&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/424228/original/file-20211001-22-1rqpje9.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=482&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Reasons why survey participants had to move out of their homes.</span>
<span class="attribution"><span class="source">(Schwan, K., Vaccaro, M., Reid, L., Ali, N., & Baig, K. (2021). The Pan-Canadian Women’s Housing & Homelessness Survey. Canadian Observatory on Homelessness)</span></span>
</figcaption>
</figure>
<h2>Struggles to find access to emergency shelters</h2>
<p>Women-specific homelessness services in Canada <a href="https://womenshomelessness.ca/wp-content/uploads/State-of-Womens-Homelessness-Literature-Review.pdf">are overcrowded and underfunded</a>. Participants reported major barriers to accessing emergency shelters, with almost a third (32.6 per cent) being unable to access a bed when they needed one. </p>
<p>This problem is even worse in rural, remote and Northern communities, where there’s a lack of shelter beds for women, Indigenous, racialized and 2SLGBTQIA+ people, as well as people with disabilities. This 32.6 per cent shared that the main reason they were unable to access shelter was because services were too full when they arrived. </p>
<p>Additional barriers are caused by shelters with extra rules for entry. Participants shared examples of being refused service for reasons that included pregnancy, not meeting domestic abuse criteria, shelters unsuited to their physical needs or for being too <a href="https://www.wepridefest.com/index.php?option=com_aglossary&view=term&id=34&catid=14&Itemid=834">masculine-presenting.</a> </p>
<p>When they were unable to access shelter, many participants turned to rough sleeping, survival sex, returning to abusive situations, and begging friends or acquaintances to take them in. Addressing the housing gender gap means ensuring equitable access to emergency shelter and services for women and gender-diverse people.</p>
<figure class="align-center ">
<img alt="a graph shows the top problems at drop-ins and shelters" src="https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=272&fit=crop&dpr=1 600w, https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=272&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=272&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=342&fit=crop&dpr=1 754w, https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=342&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/424232/original/file-20211001-21-1d61fiz.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=342&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The top seven problems at shelters.</span>
<span class="attribution"><span class="source">(Schwan, K., Vaccaro, M., Reid, L., Ali, N., & Baig, K. (2021). The Pan-Canadian Women’s Housing & Homelessness Survey. Canadian Observatory on Homelessness)</span></span>
</figcaption>
</figure>
<p>If policy, programming and practice do not explicitly include gendered lived realities, women, girls and gender-diverse people will continue to be left behind.</p>
<p>What was previously known only through stories and small-scale studies emerges as a clear message in the Pan-Canadian Survey. Realities of housing costs, relying on personal or romantic relationships to stay housed and limited access to shelters are made worse by how little we know and see of women and gender-diverse homelessness. </p>
<p>The hidden nature of gendered homelessness means that many women and gender-diverse people are not included in homeless counts, so their needs are under-served and unrecognized. </p>
<p>To achieve equality for women and gender-diverse people in Canada, we need to <a href="https://womenshomelessness.ca/wp-content/uploads/EN-Rights-Based-GBA-Analysis-of-NHS-28-Sept-2021.pdf">hold governments accountable and demand they tackle the issue of gender inequality in housing</a>.</p><img src="https://counter.theconversation.com/content/168647/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hannah Brais is a doctoral student at McGill University. She receives funding from the Social Sciences and Humanities Research Council. She is affiliated with the Old Brewery Mission and the Women's National Housing and Homelessness Network. </span></em></p><p class="fine-print"><em><span>Alex Nelson receives funding from the Social Sciences and Humanities Research Council. They are affiliated with the Women's National Housing and Homelessness Network, the Canadian Lived Experience Leadership Network, and the Vote Housing Campaign.</span></em></p><p class="fine-print"><em><span>Jesse Jenkinson receives funding from Canadian Institutes of Health Research and Canada Mortgage and Housing Corporation. She is affiliated with the Women's National Housing and Homelessness Network.</span></em></p><p class="fine-print"><em><span>Kaitlin J. Schwan has received funding from the Canada Mortgage and Housing Corporation (CMHC) to support her research on homelessness. She is affiliated with the Women's National Housing and Homelessness Network.</span></em></p>Women, girls and gender-diverse people have unique experiences of housing and housing loss.Hannah Brais, PhD Student, Geography, McGill UniversityAlex Nelson, PhD Candidate, Anthropology, Western UniversityJesse Jenkinson, Postdoctoral Fellow, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of TorontoKaitlin J. Schwan, Senior Researcher, Canadian Observatory on Homelessness, York University, CanadaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1675392021-09-14T02:59:37Z2021-09-14T02:59:37ZNSW inquiry rejects expert advice on Parental Rights Bill, and it will cause students to suffer<figure><img src="https://images.theconversation.com/files/420702/original/file-20210913-15-qocqi8.jpg?ixlib=rb-1.1.0&rect=359%2C17%2C5200%2C3431&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>A newly released <a href="https://www.parliament.nsw.gov.au/lcdocs/inquiries/2610/Report%20No%2044%20-%20PC%203%20-%20Education%20Legislation%20Amendment%20(Parental%20Rights)%20Bill%202020.pdf">report</a> by a NSW parliamentary inquiry ignores scientific research in supporting changes to the Education Act. These changes are likely to add to the risks of harm that transgender and gender-diverse young people face. </p>
<p>Schools need to provide appropriate care to all students. The <a href="https://www.parliament.nsw.gov.au/bills/Pages/bill-details.aspx?pk=3776">proposed changes</a> to the law will prevent staff from doing that for transgender and gender-diverse young people. By further marginalising them, the changes could increase their already high rates of <a href="https://pubmed.ncbi.nlm.nih.gov/31280740">bullying, mental illness and suicide</a>.</p>
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<strong>
Read more:
<a href="https://theconversation.com/supporting-trans-people-3-simple-things-teachers-and-researchers-can-do-149832">Supporting trans people: 3 simple things teachers and researchers can do</a>
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<p>The Education Committee’s report ignored scientific research findings and recommendations presented in submissions to its inquiry into the <a href="https://www.parliament.nsw.gov.au/bills/Pages/bill-details.aspx?pk=3776">Parental Rights Bill</a>. One Nation MP Mark Latham, who <a href="https://www.smh.com.au/politics/nsw/latham-s-education-bill-stirs-debate-about-transgender-issues-in-schools-20201022-p567oi.html">introduced</a> the bill to parliament last year, chaired the committee. Its report endorsed proposed amendments to the <a href="https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-1990-008">Education Act 1990</a> and <a href="https://education.nsw.gov.au/about-us/rights-and-accountability/legal-issues-bulletins/transgender-students-in-schools">Bulletin 55: Transgender Students in Schools</a> that will prevent schools from teaching that gender and sex are distinct concepts. </p>
<p>The amendments may also prevent school staff from affirming and supporting their transgender students until consent has been gained from potentially unsupportive parents, and lengthy, <a href="https://www.mdpi.com/1660-4601/16/24/5088">expensive</a> medical procedures have been completed. By preventing appropriate care for all students, such changes will further alienate and marginalise transgender and gender-diverse young people. </p>
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<h2>What does the science say about sex and gender?</h2>
<p><a href="https://doi.org/10.1146/annurev.ps.36.020185.000405">Scientific research</a> has for many decades regarded sex and gender as distinct, but related. <strong>Sex</strong> refers to the biological and anatomical characteristics attributed to males and females. <strong>Gender</strong> encompasses the social and cultural characteristics of men and women – for example, personality, stereotypical interests, and behaviour. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/25772652/">Researchers recognise</a> that sex and gender can be more related for some individuals and less related for others.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/30024214">Scientific research</a> also acknowledges that neither gender nor sex is binary. The physiological characteristics used to define sex, such as chromosomes and external genitalia, can display <a href="https://onlinelibrary.wiley.com/doi/10.1002/ajhb.23623">variation</a> outside a clear division of male and female. </p>
<p>Moreover, both cisgender (sex and gender are in alignment) and transgender (sex and gender do not align) people may engage in <a href="https://psycnet.apa.org/record/1993-25426-001">gender nonconformity</a> through their styles of dress, interests and behaviours. <a href="https://srcd.onlinelibrary.wiley.com/doi/full/10.1111/cdep.12366">Nonbinary individuals</a> can also have characteristics of both men and women, change between the categories, and/or see themselves as being outside the binary of male and female. </p>
<h2>What are the risks of harm?</h2>
<p>Rates of mental health problems are much higher in gender-nonconforming youths. In Australia, <a href="https://pubmed.ncbi.nlm.nih.gov/31280740">up to three in every four</a> of these youths have been diagnosed with depression and/or anxiety. Much of this is due to school experiences such as peer rejection and bullying. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/bullying-linked-to-gender-and-sexuality-often-goes-unchecked-in-schools-55639">Bullying linked to gender and sexuality often goes unchecked in schools</a>
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<p>Alarmingly, <a href="https://pubmed.ncbi.nlm.nih.gov/31280740">one in two</a> transgender and gender-nonconforming youths have attempted suicide. And <a href="https://pubmed.ncbi.nlm.nih.gov/31280740">about four in five</a> report self-harm or suicidal thoughts. Those who experience victimisation in school are <a href="https://psycnet.apa.org/record/2012-27680-006">four times more likely</a> to attempt suicide than those who are not victimised.</p>
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<p>Schools have a vital role to play. Support and acceptance from teachers and peers are important protective factors in reducing rates of mental health concerns and suicidality. Support for gender-nonconforming young people significantly <a href="https://pubmed.ncbi.nlm.nih.gov/30344037">reduces their risks</a> of depression and suicidality. </p>
<p>A <a href="https://www.sciencedirect.com/science/article/pii/S0273229720300186?casa_token=0yQeeHmBRFsAAAAA:dWB89JWyQJZFuG07RxZknb3eHLKEhzzDb0lqSka9HExw2aQnyWvr425VIcDPuWWYK8EC8dm1">positive classroom climate</a> increases the academic success as well as the safety of these students. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/why-education-about-gender-and-sexuality-does-belong-in-the-classroom-102902">Why education about gender and sexuality does belong in the classroom</a>
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<h2>Report ignores science</h2>
<p>According to the committee <a href="https://www.parliament.nsw.gov.au/lcdocs/inquiries/2610/Report%20No%2044%20-%20PC%203%20-%20Education%20Legislation%20Amendment%20(Parental%20Rights)%20Bill%202020.pdf">report</a>, teaching about gender diversity should be avoided due to concerns of a “social contagion” effect. In 2018, a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330">research paper</a> examining gender dysphoria (the experience of distress due to incongruence of gender and sex) suggested social contagion might explain why some parents surveyed reported that more than one young person within their child’s friendship group began identifying as transgender at a similar time, despite the overall low prevalence of transgender children in the population. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/31011991">Criticism</a> of this paper and its methodology led to it being <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214157">corrected</a>. The paper was republished alongside additional text that noted the significant weaknesses of the study design and the limitations of the findings. </p>
<p>An earlier <a href="https://www.ncbi.nlm.nih.gov/pubmed/28913950">study</a> showed siblings of transgender children displayed flexibility in their gender stereotype knowledge while retaining their sense of gender as cisgender. Thus, we currently have no strong scientific reason to believe that learning about gender diversity leads to people misattributing their gender. </p>
<p>Some parents may be concerned their children may incorrectly claim a transgender identity. However, comprehensive education about gender will ensure students are well equipped to understand and determine their gender. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/crossroads-program-should-we-teach-children-that-gender-identity-is-fluid-heres-what-the-research-says-65223">Crossroads program: should we teach children that gender identity is fluid? Here's what the research says</a>
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<p>This education also will provide a supportive environment for all students to explore their interests without fear of judgement by peers or punishment by schools. Students will be inspired to take part in activities that were once stereotypically gendered. For example, more girls may pursue science and technology while more boys may consider teaching. </p>
<h2>What should schools be able to do?</h2>
<p>Rather than prohibit the accurate teaching of gender and sex and restrict the support available to transgender students, the law should empower schools to employ strategies that support the safety and well-being of all students. Such strategies should include:</p>
<ul>
<li><p>teaching about gender in a <a href="https://www.publish.csiro.au/sh/pdf/SH17001">scientifically informed, inclusive manner</a></p></li>
<li><p>using <a href="https://www.tandfonline.com/doi/pdf/10.1080/14681811.2015.1080678">correct pronouns</a></p></li>
<li><p><a href="https://www.tandfonline.com/doi/pdf/10.1080/14681366.2021.1912158">training</a> teachers in how to support gender-nonconforming students. </p></li>
</ul>
<p><a href="https://www.tandfonline.com/doi/pdf/10.1080/14681811.2015.1080678">School staff</a> require training in how to:</p>
<ul>
<li><p>combat transphobic language and behaviour</p></li>
<li><p>provide inclusive and accurate sex education</p></li>
<li><p>advocate for inclusive and protective policies for gender-nonconforming students. </p></li>
</ul>
<p>Every child deserves a supportive, quality education based on science. Equality Australia has made it easy for you to <a href="https://equalityaustralia.org.au/ignoranceineducationbill/?link_id=0&can_id=7507e5d31c36e50c06325c5db01e8af4&source=email-theres-no-room-for-ignorance-in-our-education-system-5&email_referrer=email_1282924___subject_1695868&email_subject=nsw-leaders-need-to-hear-from-you">convey this sentiment</a> to your political leaders.</p>
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<p><em>If this article has raised issues for you or if you’re concerned about someone you know, call Lifeline on 13 11 14 or beyondblue on 1300 22 46 36</em>.</p><img src="https://counter.theconversation.com/content/167539/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma F. Jackson is affiliated with the Academic Senate of Macquarie University. </span></em></p><p class="fine-print"><em><span>Jonathan David is an employee of Twenty10 inc GLCS NSW and President of Dayenu - Sydney's Jewish LGBTQ+ Community.</span></em></p><p class="fine-print"><em><span>Melissa Norberg is the Deputy Director for the Centre for Emotional Health (CEH) and the National President for the Australian Association for Cognitive and Behaviour Therapy (AACBT).</span></em></p><p class="fine-print"><em><span>Veronica Sheanoda is a Consumer Advisory Committee member for her local Primary Health Network.</span></em></p>Proposed changes to the law will prevent schools from providing appropriate support for transgender and gender-diverse young people. These changes could increase their already high risks of harm.Emma F. Jackson, PhD Candidate, Department of Psychology, Macquarie UniversityJonathan David, PhD Candidate, Centre for Emotional Health, Macquarie UniversityMelissa Norberg, Associate Professor in Psychology, Macquarie UniversityVeronica Sheanoda, PhD Candidate, Department of Psychology, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1650372021-08-17T19:29:55Z2021-08-17T19:29:55ZHow to avoid gender bias in job postings<figure><img src="https://images.theconversation.com/files/414432/original/file-20210803-27-hihrfi.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5217%2C3475&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research shows women job-seekers are turned off by job postings that use the type of language that appeals more to men.</span> <span class="attribution"><span class="source">(Piqsels)</span></span></figcaption></figure><p>Women remain underrepresented in a number of high-profile fields <a href="https://www.investopedia.com/articles/investing/092315/why-are-so-few-women-finance-its-complicated.asp">like finance</a> <a href="https://www.forbes.com/sites/biancabarratt/2021/05/04/how-to-break-down-the-barriers-young-women-still-face-in-stem/">and STEM</a> (science, technology, engineering and mathematics). </p>
<p>Experts say there’s a number of reasons for these imbalances, including an overly <a href="https://hbr.org/2018/12/what-will-it-take-to-make-finance-more-gender-balanced">masculine culture</a>, <a href="https://doi.org/10.1057/s41599-020-00654-0">gender stereotypes</a>, <a href="https://doi.org/10.2469/faj.v74.n2.3">scarcity of role models for women</a> and <a href="https://www.forbes.com/sites/peggyannesalz/2021/05/18/inspiration-from-a-rising-female-leader-on-solving-the-stem-gender-gap/">perceptions of poor work-life balance</a> across various male-dominated industries. </p>
<p>Whether organizations are doing so because they’ve recognized the <a href="https://hbr.org/2019/02/research-when-gender-diversity-makes-firms-more-productive">practical benefits</a> of gender diversity or they’re responding to external pressures — including <a href="https://corpgov.law.harvard.edu/2017/04/26/institutional-investors-lead-push-for-gender-diverse-boards/">investors</a> pushing for gender representation — companies around the world have responded by investing <a href="https://www.theglobeandmail.com/report-on-business/small-business/talent/with-tech-giants-like-google-going-after-female-talent-how-can-startups-compete/article28073328/">substantial resources</a> into recruiting and retaining women.</p>
<p>These efforts have resulted in a range of diversity and inclusion initiatives, including offers of a wide range of benefits and mentorship opportunities for recently hired employees. Regardless of these changes, however, progress on achieving <a href="https://www.catalyst.org/research/women-in-science-technology-engineering-and-mathematics-stem/">gender parity</a> continues to move slowly.</p>
<h2>Appealing directly to women</h2>
<p>These continued gender parity challenges reinforce the need to rebrand corporate communications to signal the explicit recruitment of women. There’s also a pressing need to demonstrate that working in these fields will allow women to pursue and achieve their career goals.</p>
<p>In this move towards rebranding, recruitment strategies around paid internships, particularly job postings, are a critical first step. </p>
<p>That’s because internships offer candidates a relatively low-stakes opportunity to gain experience in a particular industry. They also provide organizations with critical access to job candidates who have completed internships and who want to continue working with the organization. Those employees have already had a <a href="https://www.linkedin.com/pulse/why-internships-so-important-college-students-suchi-musaddi">realistic preview</a> of the work they’ll be doing as well as the organizational culture, a benefit to both employer and employee. </p>
<h2>The power of words</h2>
<p>Job postings also provide an opportunity for organizations to advertise for an open position and highlight the benefits of working for the company in a way that <a href="https://doi.org/10.1080/09585192.2021.1891112">attracts potential applicants</a>. But we’re well aware of the <a href="https://business.linkedin.com/content/dam/me/business/en-us/talent-solutions-lodestone/body/pdf/Linkedin-Language-Matters-Report-FINAL2.pdf">power of words</a>, and the language used in job postings may play a role in <a href="https://doi.org/10.1037/a0022530">discouraging or dissuading</a> women from applying for positions. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man and woman talk in an office setting, the woman with her back to the camera." src="https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/414433/original/file-20210803-23-1v95cy6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Men and women respond differently to different types of language in job posts.</span>
<span class="attribution"><span class="source">(Charles Deluvio/Unsplash)</span></span>
</figcaption>
</figure>
<p><a href="https://doi.org/10.1037/0022-3514.93.5.751">Previous research</a> suggests that men and women respond differently to <em>agentic</em> language (which is self-oriented and focuses on power and achievement) and <em>communal</em> language (which focuses on harmony and collaboration) language, with men identifying more with agentic and women with communal goals.</p>
<p>Using an <a href="https://doi.org/10.1002/ejsp.2561">established dictionary</a> of agentic and communal words, <a href="https://doi.org/10.1016/j.jbef.2021.100544">we assessed</a> the language of internship job postings in a male-dominated industry. We find that agentic language continued to permeate internship job postings across the financial services industry, even those nationally recognized for their diversity and inclusion initiatives. </p>
<p>This creates a significant mismatch, since women feel a stronger sense of fit with the position and are more interested in applying when job postings include higher levels of communal language. </p>
<p>The main takeaway from our study is that excessive agentic language in job postings discourages female applicants by diminishing the appeal of the position, consequently slowing down any progress towards gender diversity in male-dominated industries.</p>
<h2>Curb subtle gender bias</h2>
<p>Our research shows that aspiring female applicants are highly attuned to the ways in which job postings describe the available positions and the company’s organizational culture. We’ve found that gendered language in job postings plays a role in the systemic gender imbalance in male-dominated industries.</p>
<p>Companies interested in recruiting more women should pay closer attention to language in job postings as a first step to reducing this subtle form of gender bias. That means organizations should prioritize communal <a href="https://doi.org/10.1007/s11199-019-01104-1">rather than agentic language and goals</a>. </p>
<figure class="align-center ">
<img alt="Two women sit talking at a table in an office setting." src="https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/414434/original/file-20210803-23-o00o22.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Business leaders should pay close attention to the language they use in job postings if they want to build a more gender-diverse workplace.</span>
<span class="attribution"><span class="source">(Unsplash)</span></span>
</figcaption>
</figure>
<p>We encourage organizations to extend this concept beyond job postings to other areas where potential applicants seek out information about the company, like websites and annual reports.</p>
<p>So instead of this kind of agentic phrasing: </p>
<p>• Benefit from an <em>independent</em> and <em>goal-oriented</em> culture that provides the foundation for your <em>success</em>.</p>
<p>• Company X is looking for <em>keen</em>, <em>responsible</em> and <em>capable</em> <em>individuals</em> <em>eager</em> to <em>succeed</em>.</p>
<p>• <em>You</em> will <em>capably</em> contribute to the company’s hard-<em>won</em> <em>reputation</em>. </p>
<p>Consider this kind of communal phrasing:</p>
<p>• Benefit from <em>our</em> <em>inclusive</em> culture that supports the group while also <em>respecting</em> <em>conversation</em> and debate.</p>
<p>• <em>We</em> <em>appreciate</em> self-learners with strong <em>interpersonal</em> skills.</p>
<p>• As a valued <em>member</em> of <em>our</em> <em>team</em>, <em>we</em> will work <em>together</em> to develop a shared culture of <em>inclusivity</em>, <em>loyalty</em> and <em>trust</em>. </p>
<h2>The bottom line</h2>
<p>Effective communications for the recruitment of a diverse workforce demands careful attention to the language used in job postings.</p>
<p>Otherwise, our research shows that organizations may unknowingly alienate a significant portion of the workforce. </p>
<p>By recognizing and removing subtle forms of biased language that deter women from applying, organizations can take an important first step to attract a more gender-diverse workforce and improve their competitiveness in the job market.</p><img src="https://counter.theconversation.com/content/165037/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erin Oldford receives funding from Social Sciences and Humanities Research Council. </span></em></p><p class="fine-print"><em><span>John Fiset receives funding from the Social Sciences and Humanities Research Council of Canada</span></em></p>The language in job postings may be hampering the efforts of organizations in male-dominated industries to create more gender-diverse workforces.Erin Oldford, Assistant Professor of Finance, Memorial University of NewfoundlandJohn Fiset, Assistant Professor, Management, Saint Mary’s UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1558402021-07-21T00:28:08Z2021-07-21T00:28:08ZGender-specific health programs address important issues, but risk creating new biases<figure><img src="https://images.theconversation.com/files/411475/original/file-20210715-32735-vwup70.jpg?ixlib=rb-1.1.0&rect=103%2C111%2C4498%2C2399&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock/elenavolf</span></span></figcaption></figure><p>Gone are the days when health programmes were designed to simply punish or reward people to encourage behaviour change. We now know lasting behaviour change is more complex and nuanced, and this has prompted a proliferation of programmes that attend to factors like motivation, confidence, social support and social determinants of health. </p>
<p>Among such programmes, we’ve observed a trend towards gender-targeted interventions. Examples include programmes for men focusing on <a href="https://nihi.auckland.ac.nz/node/606">rugby fandom</a> as a route to getting them to look after their health, and those for women that concentrate on <a href="https://mro.massey.ac.nz/handle/10179/14951">small, holistic health changes</a> to limit the impact of damaging body ideals. </p>
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<img alt="Person doing strength training" src="https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&rect=72%2C99%2C5934%2C3908&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/411471/original/file-20210715-25-gzbab9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Health programmes are often tailored for either men or women.</span>
<span class="attribution"><span class="source">Shutterstock/Nataliia Martseniuk</span></span>
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<p>While biological sex is based on our anatomy and physiology, gender is a <a href="https://www.youtube.com/watch?v=DW5YctpK7pM">socialised identity</a>. Our gendered identities accompany societal expectations of how we should or should not act. </p>
<p>There is no doubt gender shapes how we “do” health — the way we eat, sleep, exercise, connect with others and manage stress. While gender-specific needs are important, a gendered approach may ignore people who identify as neither and it runs the risk of creating new biases.</p>
<h2>A case for women-focused health programmes</h2>
<p>Women-focused health programmes were arguably developed as an antidote to an overwhelmingly patriarchal society. </p>
<p>The most obvious bias in health research is that much of the data on women’s health has been <a href="https://theconversation.com/research-into-pregnancy-birth-and-infant-care-is-historically-underfunded-and-women-are-paying-the-price-126629">collected by and from men</a>. </p>
<p>Gendered <a href="https://www.who.int/social_determinants/resources/csdh_media/wgekn_final_report_07.pdf?ua=1">disadvantages or inequities</a> for women also result from poor representation in leadership positions and unfair norms that place greater expectations on them. </p>
<p>For example, women spend more time than men doing unpaid <a href="https://womenshealthvic.com.au/resources/WHV_Publications/Issues-Paper_2017.10.03_Serving-up-inequality-Women-and-food_Version-2_(Fulltext-PDF).pdf">household work</a> and taking on <a href="http://www.oecd.org/dev/development-gender/Unpaid_care_work.pdf">caring responsibilities</a>. These imbalances trickle down to shape how women spend their time and care for their health.</p>
<p>In response, women-specific research centres have been established in <a href="https://www.wgtn.ac.nz/health/centres/centre-for-womens-health-research">New Zealand</a> and <a href="https://whri.org/">internationally</a> to help close the gap in knowledge regarding women’s health. </p>
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Read more:
<a href="https://theconversation.com/research-into-pregnancy-birth-and-infant-care-is-historically-underfunded-and-women-are-paying-the-price-126629">Research into pregnancy, birth and infant care is historically underfunded – and women are paying the price</a>
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<p>Similarly, organisations like <a href="https://www.ywca.org.nz/about-us-national/">YWCA</a> and <a href="https://www.whv.org.au/">Women’s Health Victoria</a> position gendered inequities at the centre of their work and help create a better understanding of how health programmes can effectively support women’s long-term outcomes for behaviour change.</p>
<p>In New Zealand, <a href="https://www.shiftnz.org/about">Shift</a> supports young women to be physically active through a focus on collaboration, fun, building community and leadership. <a href="https://mro.massey.ac.nz/handle/10179/14951">Next Level Health</a> empowers women by using a holistic and weight-neutral approach to behaviour change. This moves the focus away from body weight and defines health more broadly, emphasising well-being, connection to people and place and other behaviours. </p>
<p>As a result, sleep, self-care and stress management become as important as physical activity and nutrition. Such programmes create a more inclusive and relevant vision of health and counteract the <a href="https://www.ywca.org.nz/media/2417/bi-report-final-compressed.pdf">body image concerns</a> women often experience due to socialised pressures to attain an “ideal” body.</p>
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<img alt="Man in doctor's room." src="https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/411479/original/file-20210715-32849-17ckagz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Men are less likely to seek medical help.</span>
<span class="attribution"><span class="source">Shutterstock/Chinnapong</span></span>
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<h2>‘Tough’ approach to men’s health</h2>
<p>Despite a male-dominated health system, men continue to have a higher risk of various health conditions, including <a href="https://gh.bmj.com/content/2/2/e000298">coronary heart disease</a> and being <a href="https://minhealthnz.shinyapps.io/nz-health-survey-2017-18-annual-data-explorer">overweight</a>. </p>
<p>When it comes to health behaviour programmes, men are notoriously difficult to recruit. This may be due to the fact <a href="https://pubmed.ncbi.nlm.nih.gov/15737222/">men are less likely to seek help</a>. </p>
<p>There have been urgent calls for <a href="https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-4038-4">male-specific healthy lifestyle programmes</a> that often use “masculine” male-dominated sports (<a href="https://nihi.auckland.ac.nz/node/606">rugby</a>, <a href="https://www.ed.ac.uk/education/rke/making-a-difference/football-fans-in-training">football</a>) to entice men to join. </p>
<p>Some, such as <a href="https://www.toughtalk.nz/">Tough Talk</a>, play with stereotypical male traits to encourage men to discuss their health. In parallel with women’s health research, <a href="https://www.otago.ac.nz/mens-health/research/">male health research centres</a> are fast becoming commonplace. </p>
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Read more:
<a href="https://theconversation.com/men-are-buying-potentially-risky-steroid-substitutes-online-to-get-the-ideal-body-144249">Men are buying potentially risky steroid substitutes online to get the 'ideal body'</a>
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<p>Considering these gender differences, a gendered approach can be justified. Gender equality and <a href="https://www.health.govt.nz/about-ministry/what-we-do/work-programme-2019-20/achieving-equity">health equity</a> are <a href="https://sdgs.un.org/goals/goal5">global priorities</a> and such programmes have potential to address them. Playing to peoples’ gendered identities may work for recruitment and effectiveness, too. </p>
<h2>Slipping through the cracks</h2>
<p>While gendered interventions aim to fill certain gaps, they may actually create new ones, particularly when we consider that many health programmes are funded by nationally competitive grants that often favour projects with potential for greater impact (the biggest slice of the population). </p>
<p>People who identify with the wider group of LGBTQI+ are vulnerable in terms of <a href="https://mentalhealth.inquiry.govt.nz/inquiry-report/he-ara-oranga/">mental health</a>. This disparity exists because of the greater inequities this community faces. </p>
<p>Some solutions may come from <a href="https://insights.digitalmediasolutions.com/articles/gender-diversity-marketing">gender-diverse marketing</a> that emphasise gender responsiveness, rather than placing a specific gender at the centre of campaigns. </p>
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Read more:
<a href="https://theconversation.com/why-the-way-we-approach-transgender-and-non-binary-healthcare-needs-to-change-149816">Why the way we approach transgender and non-binary healthcare needs to change</a>
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<p>Perhaps non-gendered health programmes could create open discussion about how people identify their gender, rather than repeating an inherited gendered story. Admittedly, that might be idealistic for a lifestyle programme. </p>
<p>We’re not arguing against gender-specific programmes. <a href="https://theconversation.com/gender-bias-in-medicine-and-medical-research-is-still-putting-womens-health-at-risk-156495">Gender bias in health research</a> is an ongoing issue, among others, that requires <a href="https://pubmed.ncbi.nlm.nih.gov/25231058/">targeted action</a> to eliminate harmful inequities. </p>
<p>But we suggest gender responsiveness as a compatible approach for lifestyle programmes, in which gender is embraced but does not drive the programme. A choose-your-own-path approach that allows for diverse identities and autonomy, regardless of gender. Otherwise, the gaps we aim to fill might become gaping holes elsewhere.</p><img src="https://counter.theconversation.com/content/155840/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Gender bias in health research is an ongoing issue, but health interventions that target women or men ignore gender-diverse people and create new areas of discrimination.Matthew Jenkins, Research Fellow, University of OtagoVictoria Chinn, Lecturer in Health, Te Herenga Waka — Victoria University of WellingtonLicensed as Creative Commons – attribution, no derivatives.