tag:theconversation.com,2011:/ca-fr/topics/transgender-1693/articlesTransgender – La Conversation2024-03-13T20:59:46Ztag:theconversation.com,2011:article/2234122024-03-13T20:59:46Z2024-03-13T20:59:46ZWhat is gender-affirming care? A social worker and therapist working with trans people explains<figure><img src="https://images.theconversation.com/files/581460/original/file-20240313-20-z1u6um.jpg?ixlib=rb-1.1.0&rect=26%2C0%2C4466%2C2991&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although medical doctors may be the first point of contact for children exploring their gender identity, many other professions can provide gender-affirming care, such as psychologists, social workers, teachers, counsellors and recreational coaches.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>In late January, Alberta Premier Danielle Smith unveiled <a href="https://globalnews.ca/video/10264944/danielle-smith-unveils-albertas-proposed-guidelines-on-parental-consent-gender-affirming-care-rules">policies on gender-affirming care and parental rights</a>. These policies want to change access to medical treatments, participation in athletics, and whether transgender children can use preferred pronouns and names in school.</p>
<p>Meanwhile, <a href="https://www.nytimes.com/2024/02/02/opinion/transgender-children-gender-dysphoria.html?smid=nytcore-ios-share&referringSource=articleShare">op-eds in newspapers</a> have brought attention to how professionals are supporting transgender children and the long-term effects of medical interventions. <a href="https://edmontonjournal.com/opinion/columnists/david-staples-alberta-danielle-smith-europe-gender-transition-policy">And suggested</a> that “adults can live with the consequences, but inexperienced children can’t”. </p>
<p>This suggests medical professionals are not assessing maturity and readiness in transgender children, and also that children should not be transitioning prior to adulthood. </p>
<p>As a registered clinical social worker and registered marriage and family therapist who works primarily with the 2SLGBTQIA+ population, I want to explain gender-affirming care and how professionals use it. I also want to discuss detransition, because too many people misunderstand and misuse the term. </p>
<p>There are several important assessments that must be considered prior to addressing maturity. For gender-affirming care, a child has to be assessed as a mature minor, which is a rigorous assessment completed by a professional such as a <a href="https://www.cap.ab.ca/Portals/0/pdfs/CAPPA-MatureMinors.pdf">psychologist</a> or <a href="https://acsw.in1touch.org/document/2024/SUM_MinorsAndConsentIssues_20150326.pdf">social worker</a>.</p>
<h2>Gender-affirming care</h2>
<p>According to the <a href="https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth">Canadian Paediatric Society</a>, gender-affirming care assesses psychological, social, medical and surgical options for gender-diverse people. These assessments explore an individual’s personal, familial and environmental histories, as well as their mental health and physical health. Practitioners use this knowledge to best understand one’s functioning and strengths, and to give people the kind of support they need. </p>
<p>Although medical doctors may be the first point of contact for children exploring their gender identity, many other professions can provide gender-affirming care, such as psychologists, social workers, teachers, counsellors and recreational coaches. </p>
<p>Allowing children to express gender creatively is one of the first steps explored by mental health experts when working with transgender children, youth and their families. <a href="https://www.psychologytoday.com/ca/blog/lifetime-connections/202311/gender-creative-parenting-lets-kids-be-kids#:%7E:text=Gender%2Dcreative%20parenting%20is%20a,the%20world%20and%20varied%20interests.">Gender creativity</a> is a term used to identify the fluidity of gender; how one’s identity is not set in stone and can change as we learn more about ourselves. </p>
<p>Allowing a child to express independent thought and creativity with gender expression will not lead children to assume they are in need of medical interventions. On the contrary, as a professional, these interventions are used to support a child’s understanding of their options through improving self confidence and self-esteem. </p>
<p><a href="https://jeunesidentitescreatives.com/upload/ressources/files/Barbies_and_Beer.pdf">Methods</a> can include social play, such as learning more about their own likes, forms of expression and ultimately exploring what makes them happy. The intention behind this is to help children build confidence and self worth, allowing them to engage in social settings authentically without fearing social consequence. </p>
<h2>Importance of support</h2>
<p>It is normal for us to compare ourselves to others, or to what we understand of social customs and rules. These social customs suggest our assigned sex at birth must match socially regulated forms of gender expression. </p>
<p><a href="https://www.plannedparenthood.org/learn/gender-identity/transgender/what-do-i-need-know-about-transitioning">Transitioning</a> begins the moment one confirms to themselves that their identity is different from these social rules. This doesn’t mean everyone who feels this way will go on to socially or medically transition. </p>
<p>Once a child can identify that they feel a certain way, it is vital for them to receive support from parents, caregivers, teachers and their broader community. Gender non-conforming young people are at risk for <a href="https://doi.org/10.1016%2Fj.jadohealth.2016.09.014">mental health struggles</a> such as anxiety, depression, self-harm and attempted suicide.</p>
<p>One possible explanation for this could be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846479/#:%7E:text=Minority%20stress%20theory%20posits%20that,physical%20and%20mental%20health%20outcomes.">minority stress</a>, which is the distinct, chronic stressors minorities experience related to their identity, including victimization, prejudice and discrimination. </p>
<p>It is important to think critically about the social and political contexts that limit gender expression, because it impacts everyone, and can directly harm gender-diverse children. Considering this and minority stress, this is why it is important to allow children the space and freedom to freely express themselves, so that they can understand gender expression has more than two options: conform to social expectations or medically transition. </p>
<p>When children are provided gender-affirming care, mental health professionals support them in better understanding their emotions. This involves identifying feelings and learning how to emotionally regulate. This also includes addressing negative beliefs about their feelings, normalizing emotional responses and supporting children to become more self-compassionate. </p>
<p>Some believe mental health professionals focus on <a href="https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=abs2270">gender dysphoria</a> when providing such care to children and youth. This is the feeling of uneasiness or distress because your gender identity does not match your assigned sex at birth. </p>
<p>However, children and youth are provided with various forms of support prior to medical interventions being used. Medical interventions are oftentimes the last method a child is provided, and when it is provided, <a href="https://doi.org/10.1080%2F26895269.2021.1915223">some have described it as life-saving</a>.</p>
<p>Practitioners use gender-affirming care to promote <a href="https://www.healthline.com/health/transgender/gender-euphoria">gender euphoria</a> — the joy of aligning gender identity with gender expression. This is done by supporting children in finding confidence and self-worth by promoting their social and psychological well-being.</p>
<h2>What is detransitioning?</h2>
<p>Some gender-diverse children will need medical interventions but that doesn’t mean they have to persist for a lifetime. By providing children and youth access to medical interventions, professionals are addressing the <a href="http://www.phsa.ca/transcarebc/child-youth/affirmation-transition/medical-affirmation-transition/puberty-blockers-for-youth#:%7E:text=The%20changes%20to%20your%20body,that%20can't%20be%20reversed.">severity of dysfunction caused by gender dysphoria</a> </p>
<p>“Detransition” is a term used to describe those who have undergone medical and/or surgical interventions, and then reverted back. There is <a href="https://fenwayhealth.org/new-study-shows-discrimination-stigma-and-family-pressure-drive-detransition-among-transgender-people/">evidence</a> showing people undergo corrective approaches after medical or surgical interventions due to <a href="https://doi.org/10.1089%2Flgbt.2020.0437">discrimination, stigma and family pressure</a>. </p>
<p>It is crucial to understand that transgender individuals who use medical and surgical means for a period of time and stop, may not be detransitioning.</p>
<p>There are individuals who identify as <a href="https://doi.org/10.3390/jcm9061609">non-binary</a> who begin medical interventions, at a limited dose or for a duration of time, instead of committing life long. In my practice, I have seen many individuals begin hormone treatment and with the support of their doctor change the dosage as they continue to explore their gender identity. </p>
<p>There is a need for further research exploring detransition, especially in terms of how therapists can best support individuals who decide to stop or change their medical intervention plans with their doctors. </p>
<p>Ultimately, gender-affirming care is about providing people with the support they need. To help them see themselves in ways that promote joy, confidence and happiness. It is not about pathologizing gender expression. </p>
<p>Gender transition is not about fitting into preset ideals, but rather, finding joy in day to day experiences that is cultivated by our happiness, confidence and sense of belonging.</p><img src="https://counter.theconversation.com/content/223412/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gio Dolcecore 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>Gender-affirming care assesses psychological, social, medical and surgical options for gender-diverse people.Gio Dolcecore, Assistant Professor, Social Work, Mount Royal UniversityLicensed as Creative Commons – attribution, no derivatives.tag: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/2248882024-03-01T18:33:43Z2024-03-01T18:33:43ZGhana’s new anti-homosexuality bill violates everyone’s rights, not just LGBTIQ+ people - expert<p>Ghana’s new <a href="https://edition.cnn.com/2024/02/28/africa/ghana-passes-anti-homosexuality-bill-intl/index.html">anti-homosexuality bill</a> infringes several rights and freedoms, not only of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) people but of heterosexuals too. The bill has been in the works since 2021 when it was tabled in parliament as a <a href="https://www.graphic.com.gh/features/opinion/private-member-s-bill-key-to-parliamentary-effectiveness.html">private member’s bill</a>.</p>
<p>The objective of the <a href="https://cdn.modernghana.com/files/722202192224-0h830n4ayt-lgbt-bill.pdf">Human Sexual Rights and Family Values Bill</a> is</p>
<blockquote>
<p>to provide for human sexual rights and family values and for related matters.</p>
</blockquote>
<p>At the heart of the contention about the proposed law is the question of discrimination, its purpose and its effect of nullifying or impairing the recognition, enjoyment or exercise by all persons, on an equal footing, of all rights and freedoms.</p>
<p>The title of the bill, obviously, is ironic because the law rather sets out to deny the right to sexuality and related rights to LGBTIQ+ people and to criminalise their actions. The key action which is criminalised is consensual sexual relations between two homosexual adults.</p>
<p>The bill defines such practices, linking them to similar provisions in the <a href="https://ir.parliament.gh/bitstream/handle/123456789/2433/ACT%2030.pdf?sequence=1&isAllowed=y">Criminal and Other Offences Act of Ghana</a>. Interestingly, it also criminalises and denies other acts, such as oral sex, which heterosexual couples also do to homosexuals and lesbians. The LGBTIQ+ community is also prohibited from marriage and from adopting or fostering.</p>
<p>If the president signs the legislation, Ghana will join <a href="http://www.globalequality.org/component/content/article/166">36 African countries</a> where homosexuality is illegal. It’s punishable by death in <a href="https://www.fairplanet.org/story/death-penalty-homosexualty-illegal/">some countries </a>, including Nigeria and Mauritania. So, Africa remains a tough place for LGBTIQ+ people. But there has been some progress in countries like South Africa and <a href="https://healthpolicy-watch.news/mauritius-supreme-court-throws-out-colonial-anti-gay-law/">Mauritius </a> where colonial era laws have been repealed.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mauritius-is-the-latest-nation-to-decriminalise-same-sex-relations-in-a-divided-continent-215270">Mauritius is the latest nation to decriminalise same-sex relations in a divided continent</a>
</strong>
</em>
</p>
<hr>
<p>As a scholar of international human rights law, I believe this bill will infringe the right to privacy, right to health, freedom of association and expression, and press freedom. It will also impinge on the rights of teachers, lecturers, civil society activists and citizens who share content on social media platforms that the bill deems illegal. </p>
<h2>Compromising key freedoms</h2>
<p>The bill’s criminalisation of consensual sexual relations between two homosexual adults and imposition of sentence of three years on violators of that provision of the law is prohibitive and disproportionate. The practice should not be criminalised, but if at all, violation should at best attract a non-custodial sentence, for example a fine or community work. The LGBTIQ+ community has the right to be treated with dignity. The fact that someone is gay should not lead to a loss of his/her humanity.</p>
<p>Moreover, since the only way the criminalisation of consensual sex can be enforced is by “peeking through the window”, this will infringe on the right to privacy.</p>
<p>There has been many instances where members of the LGBTIQ+ community, and even those who the society consider as such but are not, have been <a href="https://www.theguardian.com/global-development/2021/jul/13/arrested-abused-and-accused-wave-of-repression-targets-lgbt-ghanaians">arrested </a>and subjected to acts of molestation, abuse, torture and <a href="https://www.hrw.org/news/2021/09/20/ghana-lgbt-activists-face-hardships-after-detention">other forms of violence</a> and <a href="https://www.losangelesblade.com/2024/02/05/man-in-ghana-assaulted-for-being-gay/">extrajudicial measures</a> which constitute a violation of their right to dignity. Some are even killed. The vigilante groups that effect these arrests also have the habit of extorting money from the alleged perpetrators of LGBTIQ+ practices. Where the “suspects” end up at the police station, the police have also resorted to extortion of large sums of money from the suspects before letting them go. </p>
<p>The law seeks to avert such occurrences by imposing a term of imprisonment of between six months to three years for anyone who harasses someone accused of being LGBTIQ+. However, this is a feeble attempt by the sponsors of the bill to appease or assure the LGBTIQ+ community. </p>
<p>The forced disbandment of LGBTIQ+ associations in Ghana, will constitute a violation of the right to freedom of association and freedom of expression, among others. It has been abused in a number of instances and is likely to be further abused even more. The provision that seeks to make owners of digital platforms or physical premises in which LGBTIQ+ groups organise guilty of promoting LGBTIQ+ activities violates the right to freedom of association and expression, among others. </p>
<p>Also, the provision on imposing harsh sentences on teachers and other educators who talk about LGBTIQ+ in the classroom is likely to infringe on the right to academic freedom and the right to education. Further, the imposition of six to 10 years of imprisonment for anyone who produces, procures, or distributes material deemed to be promoting LGBTIQ+ activities is likely to lead to the abuse of the right to freedom of expression, information and education and even press freedom. The same goes with the provision on criminalising the “public show of romantic relations” between people of the same sex, even including cross-dressing.</p>
<p>What is important to also note is that the law is not made to restrict or violate the rights of the LGBTIQ+ community only. Teachers, lecturers, media personnel and civil society activists, people who share content over social media platforms, or broadcast content on LGBTIQ+ are also going to be held criminally responsible.</p>
<h2>Presidential or constitutional challenge</h2>
<p>I propose that President Nana Akufo-Addo should not assent to the law as it is, relying on <a href="https://lawsghana.com/constitution/Republic/constitution_content/113">article 108</a> of the 1992 Constitution since, being a private members bill, it has likely financial implications for the state. Thus, relying on <a href="https://www.hrw.org/news/2021/09/20/ghana-lgbt-activists-face-hardships-after-detention">article 106</a>, he can refer the bill to his highest advisory body (<a href="https://cos.gov.gh/">Council of State</a>) for its advice. Otherwise, he has the power to state in a memo to the Speaker of Parliament any specific provisions of the bill which in his opinion should be reconsidered by Parliament. </p>
<p>If he does not, the matter can be taken to a Human Rights Court by a citizen, relying on <a href="https://lawsghana.com/constitution/Republic/constitution_content/38#:%7E:text=(5)%20The%20rights%2C%20duties,freedom%20and%20dignity%20of%20man.">article 33(5)</a>of the Constitution, which provides that “the rights, duties, declarations and guarantees relating to the fundamental human rights and freedoms specifically mentioned in this Chapter shall not be regarded as excluding others not specifically mentioned which are considered to be inherent in a democracy and intended to secure the freedom and dignity of man.” </p>
<p>The other option is to go straight to the Supreme Court to challenge the constitutionality of the bill.</p><img src="https://counter.theconversation.com/content/224888/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kwadwo Appiagyei-Atua 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>Ghana’s anti-gay bill will affect heterosexual’s tooKwadwo Appiagyei-Atua, Associate Professor of Law, University of GhanaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2238592024-02-22T19:20:31Z2024-02-22T19:20:31Z‘Why can’t I wear a dress?’ What schools can learn from preschools about supporting trans children<figure><img src="https://images.theconversation.com/files/576943/original/file-20240221-22-vpe08q.jpg?ixlib=rb-1.1.0&rect=58%2C109%2C5515%2C3480&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/red-white-and-green-color-pencils-O2u6gA2esAI"> Alexander Grey/ Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>A new group of young children has just started school for the first time, with many excited about new friends, uniforms and being at “big school”. </p>
<p>But for trans kids, starting school can be a much more daunting process. </p>
<p>They have likely gone from preschools and daycare where they had the freedom to wear what they want and play what they want, whether that was dinosaurs, dolls or dress ups. The boy who likes to be Rapunzel was probably viewed as “cute” and the girl always playing pirates was encouraged to do so. </p>
<p>But school culture is much more <a href="https://doi.org/10.1111/bjep.12540">cisnormative</a>. This means schools tend to assume children can be sorted into boys and girls and everyone is comfortable in what category they are in. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-does-it-mean-to-be-cisgender-103159">Explainer: what does it mean to be 'cisgender'?</a>
</strong>
</em>
</p>
<hr>
<p>You can see this in formal ways, with boys’ and girls’ uniforms and toilets and in informal ways, with boys and girls making different friendship groups and playing different games at lunch.</p>
<p>This makes it difficult for trans children to feel as <a href="https://doi.org/10.1177/01614681221121710">though they belong</a> at school. Trans students often have <a href="https://doi.org/10.1016/j.jadohealth.2013.11.008">lower levels of wellbeing</a> and <a href="https://doi.org/10.1080/15388220.2012.732546">lower educational outcomes</a> than non-trans students.</p>
<p>My research looks at what schools can learn from preschools and other early learning settings such as daycare centres about how to support trans students.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/4-out-of-5-parents-support-teaching-gender-and-sexuality-diversity-in-australian-schools-176787">4 out of 5 parents support teaching gender and sexuality diversity in Australian schools</a>
</strong>
</em>
</p>
<hr>
<h2>My research</h2>
<p>In 2023 I partnered with P-TYE, an advocacy network for parents of trans children. The study, which is currently in peer review, looked at how we can integrate support for trans children across a range of services including education, medical and mental health. </p>
<p>Through P-TYE and wider networks, we recruited 12 families with trans children. The children had an average age of 13 and had been recognised as trans between two and ten years. </p>
<p>Though interviews, I spoke to them about their experiences of childcare and school. Three themes emerged.</p>
<h2>1. The importance of being ‘child-centred’</h2>
<p>Early education services are “child-centred”. This means educators are trained to place a child’s “belonging, becoming and being” at the centre of their curriculum (as per the <a href="https://www.acecqa.gov.au/nqf/national-law-regulations/approved-learning-frameworks">Early Years Learning Framework</a>). This includes freely exploring gender and their identity. </p>
<p>As one parent told us their trans girl “had an incredible teacher” for preschool</p>
<blockquote>
<p>who’d take old curtains and make things […] these three-tiered skirts that were heavy and they made beautiful sounds and they caressed you when you wore them and [my child] found such joy in these creations.</p>
</blockquote>
<p>Another child showed her foster parents a photo of herself at daycare </p>
<blockquote>
<p>in a dress up pushing a pram around with a baby in it. And she’s got a handbag on, jewellery and everything. She’s about three years old in the picture. And she says, this is the first time I knew I was a girl.</p>
</blockquote>
<p>In contrast, trans identity in schools often means “breaking the rules”. Parents in the study described examples of schools not letting trans students express their identity.</p>
<blockquote>
<p>every day she was asking, ‘why can’t I wear a dress to school’? Why do I have to go to the boys’ toilets? They’re mean to me when I’m in there.</p>
</blockquote>
<figure class="align-center ">
<img alt="A dress up box with clothes and jewellery spilling out the top." src="https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576944/original/file-20240221-20-4h4iye.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">In daycare centres children are free to experiment with identity in their play.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/child-toddlers-dress-clothes-jewellery-creative-1905733132">Klem Mitch/Shutterstock</a></span>
</figcaption>
</figure>
<h2>2. Not categorising kids by gender</h2>
<p>Parents in the study also reported how children weren’t categorised into genders by pre-school routines. As one interviewee said: </p>
<blockquote>
<p>all the kids use the same toilet […] they [were called the] ‘cockatoos’ and the ‘koalas’ or whatever […] they weren’t ever separated by gender.</p>
</blockquote>
<p>But at school, children faced daily choices about whether they are a boy or a girl. One parent described how a class had segregated lunch crates for boys and girls. Their trans child stood out with “this pink drink bottle with unicorns on in a sea of dinosaurs”. </p>
<p>Children also have to wear the correct uniform, be in the right line for sport and use the assigned toilet and can be <a href="https://doi.org/10.1080/1550428X.2019.1647810">bullied</a> by other students when they try.</p>
<p>One child “survived kindergarten by walking”. She told her parent </p>
<blockquote>
<p>I just realised that if I wasn’t still, I was less of a target so I just made sure in kindergarten to keep moving and I never stopped moving.</p>
</blockquote>
<p>For non-binary children – who don’t feel like a boy or a girl – school brings a more complex set of difficulties.</p>
<p>One parent talked about a lucky dip at the school fete with boy or girl gifts. They said this signals to their child “I have to be one of these things or the other” and “tells my kid that they don’t fit in the world”.</p>
<h2>3. Support for educators</h2>
<p>Research shows having <a href="https://doi.org/10.1080/14681811.2016.1273104">teachers who are positive about gender diversity</a> is crucial for the wellbeing of trans students. </p>
<p>My interviews also suggested responses to trans kids often depend on individual educators and schools. Many preschool educators were supportive and “totally fine to change pronouns, like immediately”. But as one parent told the study, one educator reportedly said: “I’m not going to play this name game” and refused to use a child’s new name. </p>
<p>Some school teachers did make a difference. One wellbeing officer “put out all the uniforms and said, ‘which one would you like to wear?’”</p>
<p>At a schools sports day one trans boy was allowed to compete with the boys. As his parent said:</p>
<blockquote>
<p>he’s never been a sporty kid. He came last and everything, but it made him really happy to to be in with the boys.</p>
</blockquote>
<p>Another teacher was “fantastic” but “a bit old school” saying “I’ve got no idea what to do, what to call her, what to say. I’m really out to sea here.”</p>
<p>This suggests both early education and school teachers need access to <a href="https://westernsydney.edu.au/gsds/educator_resources">education and resources</a>, so whether students get support isn’t left up to chance.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-kind-of-suffocating-queer-young-australians-speak-about-how-they-feel-at-school-and-what-they-think-of-politicians-187010">'It's kind of suffocating': queer young Australians speak about how they feel at school and what they think of politicians</a>
</strong>
</em>
</p>
<hr>
<h2>What should schools do differently?</h2>
<p>Schools should take the lead from early learning environments and stop “sorting” students based on gender. </p>
<p>This could mean:</p>
<ul>
<li><p>having a range of uniform items children can select from as some schools already do</p></li>
<li><p>more all-gender toilet facilities, where privacy is protected for all students</p></li>
<li><p>preferred names and pronouns should be easy to change in school systems and teachers should use these.</p></li>
</ul>
<p>Teachers also need access to resources and information so they can confidently have conversations about gender. This needs to be part of a <a href="https://doi.org/10.1080/15532739.2017.1355648">whole-of-school approach</a> to supporting trans students and their families.</p><img src="https://counter.theconversation.com/content/223859/count.gif" alt="The Conversation" width="1" height="1" />
<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>Children are often allowed to freely explore their identities in early childhood services. But when they get to school, they are categorised as ‘boys’ or ‘girls’.Cris Townley, Postdoctoral research fellow, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2218662024-02-19T19:04:04Z2024-02-19T19:04:04Z‘I was who I wasn’t’: McKenzie Wark’s memoir of late transition envisions a less gender-restrictive world<figure><img src="https://images.theconversation.com/files/576367/original/file-20240219-24-miu7bl.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C2404%2C1193&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">McKenzie Wark.</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:MackenzieWark1.jpg">BaixaCultura, via Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>McKenzie Wark is a cultural and social critic who teaches at the New School in New York. Her new memoir, <a href="https://www.versobooks.com/en-gb/products/3113-love-and-money-sex-and-death">Love and Money, Sex and Death</a>, is structured as a series of letters to people she has known: her younger self, her mother and sister, her ex-wife of 20 years, more recent lovers, some fictional people – even a god. </p>
<p>In this series of letters, Wark speaks to her past and imagines possible futures. She muses about how her life has changed since coming out as transgender in 2017 at the age of 56, but she also writes evocatively and fiercely about the loss of her mother as a child, her life and relationships in New York, and her visions for a less gender-restrictive world. </p>
<hr>
<p><em>Love and Money, Sex and Death: A Memoir – McKenzie Wark (Verso)</em></p>
<hr>
<p>This is a book which has a lot to say about being trans, but it deliberately avoids becoming a linear story of discovery of a “true” self. Instead, Wark shows us how a “self” is made from its relationships, through “fights and feuds”, through “covens of care”. There is a continual sense of her reconstructing herself through and with others. </p>
<p>This is conveyed in the style and form of the book. Part of the beauty of an epistolary memoir is that Wark gets to write throughout in the second person, giving the book a feeling of intimacy. The concept of “writing to a younger self” in the first and last chapters allows Wark to reconstruct a life in hindsight, retro-engineering the story to fit her late change of identity. </p>
<p>This is done with a light touch. Wark writes to her younger self as to another, someone she knows well, but who has their own problems, perspectives and choices. Stories of the past are as much “about” the present self as the facts of what actually happened. Wark writes: </p>
<blockquote>
<p>When one transitions to another sex, the past comes back as if in a different medium. Memories tell not of who one was but who one wasn’t. I was who I wasn’t for the longest time. Transition brings rushes of the past back. Shots for an incomplete home movie. I had to edit memory as I edited flesh.</p>
</blockquote>
<p>These “edited memories” are told in ways that foreshadow, without reducing to, any story of “I was always a woman”. Wark complains that trans people are always pushed to tell essentialist stories about their gender. She presents her life as a series of encounters and experiments, which happened to turn out this way, but might have gone another. “I’m writing this to your own future, or a possible one at least,” she writes on the first page, addressing a young McKenzie.</p>
<blockquote>
<p>I’m not going to say you are a girl, or that you always were. You’ve been reading transsexual memoirs on the sly already and not finding yourself in that ‘born in the wrong body’ story. You feel like your body is already a girl’s body. […]
Maybe some sorts of transsexual people ‘always knew’, but you didn’t. You’re always swerving, blindly falling through gender.</p>
</blockquote>
<p>Wark’s vulnerability and openness about failures, letting people down, not knowing the plot, is part of the book’s aesthetic. But this does not make it a sad story, even as it canvasses death and failed love. As Jack Halberstam argues in <a href="https://www.dukeupress.edu/the-queer-art-of-failure">The Queer Art of Failure</a>, failure can open up alternate possibilities for life and love. </p>
<p>Wark is often cynical about the future: “There’s no past, no arcadia. But no future either.” All the same, the book carries the strong themes of care and desire for revolution or utopia, which make it a deeply optimistic work.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/zkRlHKTvsqQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/judith-butler-their-philosophy-of-gender-explained-192166">Judith Butler: their philosophy of gender explained</a>
</strong>
</em>
</p>
<hr>
<h2>Vulnerability and receptivity</h2>
<p>While not sure she was always a woman, Wark writes that she “need[s] to feel feminine”. This does not just mean that she needs to paint her nails (although that, too). It is an overtly sexual “femme” desire: to be exposed, penetrated, made to feel her own vulnerability, openness and receptivity. </p>
<p>One of the things the book does is to enact the queer understanding that this “femme” does not need to be the property of people of any particular gender. Even though she has transitioned into womanhood, Wark maintains a deliberate blurriness about what gender means. Ultimately, she suggests, there can be more revolutionary potential in failing to live up to a single gendered identity than in trying to achieve authenticity. </p>
<blockquote>
<p>I wouldn’t say that being trans now is living my truth. I’d say it’s a better fiction.</p>
</blockquote>
<p>In the first chapter of part three, McKenzie and “Veronica”, an elegant trans woman friend, talk over lunch in an expensive New York restaurant. Amid cocktails, disagreements and speculations about the other guests’ sexuality, McKenzie presents a full-fledged theory of trans women as utopian avant-garde. </p>
<blockquote>
<p>The trans woman bears the burden of the absurdity of gender. She is the scapegoat for what everyone imagines they’re denied. </p>
</blockquote>
<p>Precisely because trans women are accused of being deceptive, Wark suggests, they can lead towards a world where people are not constantly in thrall to unattainable “true” models of gender, but instead “make our being together with reference only to each other”.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=676&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=676&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=676&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=850&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=850&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576411/original/file-20240219-22-andlwy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=850&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">McKenzie Wark.</span>
<span class="attribution"><a class="source" href="https://www.goodreads.com/photo/author/60623.McKenzie_Wark">Goodreads</a></span>
</figcaption>
</figure>
<p>The “Venus” chapter is addressed to a Black trans woman friend who committed suicide during COVID lockdown. It reports on the Brooklyn Liberation for Trans Lives protests for Black trans women. Here, Wark reflects that she has given up her status as a man, but become a middle-class white woman, a “Karen” (a name she had previously chosen for herself). </p>
<p>Following from the scenes in expensive New York restaurants, this (inevitably) feels a bit tokenistic at first. It finishes, though, in such a blaze of anger and ragged grief, of political will for revolution, connection and shared fate that we can glimpse a form of alliance that might be possible when the privileged are prepared to let themselves be undone. </p>
<p>The “hindsight” structure of the memoir means that the reader is always aware of time. Wark counts the years between herself and her past, herself and her future. “Your life as a woman will be brief,” she says to her younger self. “She’ll die young.”</p>
<p>In many ways this is a book about growing older. It addresses the themes of maturing and how priorities in relationships change over time: the gaining of a warmer, less anxious perspective. </p>
<p>Time was necessary for Wark to become her (if that is what she has done) self. The “trade-off with late transition” is ever-present, for better and worse. There is an insistent sense of time shortening ahead of her. But as with her sense of gender, Wark’s sense of time is fluid, often felt through music – jazz when she was younger, rave and ambient later. Time is felt in Wark’s writing, more than measured. It has a music of its own.</p>
<blockquote>
<p>How long have we been here? How long are we dancing? […] We are in a pocket in time where there’s more time […] We go into weightless days, seconds, millennia. On the other side of the measure of beats is a time without measure.</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/576336/original/file-20240218-22-cja5ia.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">McKenzie Wark’s new memoir is fast moving and kaleidoscopic.</span>
<span class="attribution"><span class="source">Nito/Shutterstock</span></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-is-essentialism-and-how-does-it-shape-attitudes-to-transgender-people-and-sexual-diversity-203577">What is essentialism? And how does it shape attitudes to transgender people and sexual diversity?</a>
</strong>
</em>
</p>
<hr>
<h2>Freedom and joy</h2>
<p>Wark often assumes an educated reader. Phrases like “This was postmodern aesthetics as Oedipal break-up” will make sense to some readers, but not others. Wark draws on her career as a media theorist, but is also happy to laugh at her “weird brain labour”. There are many funny (although still sometimes painful) moments. Of the dating app Tinder, she writes:</p>
<blockquote>
<p>when I say I’m trans, they say it’s OK because they’re into kink. (Then ghost me.) They say they have several selves, only one of them female. (They all need a bath.)</p>
</blockquote>
<p>One of the delicious things in this book is the sense of freedom that it invokes. Wark has lived a life of experimentation, following impulses, paying little heed to social conventions. She acknowledges that, at times, this has made her unreliable or even cruel. She does not shy away from responsibility and regret. But overall there is a sense of joy: a “capacity for delight”, as she says of a lover. At heart, these letters are love letters. </p>
<p>There is always more in a book than you can convey in a review, especially a book as fast-moving and kaleidoscopic as this one. But it could perhaps be summarised as a book written from the other side of multiple processes of undoing – loss of loved ones, restructuring of the body and identity, confrontations with violence and prejudice. </p>
<p>Love and Money, Sex and Death ricochets between sparkling defiance, unravelled grief, and furious hope. It always seeks connection with the others it addresses. It combines the personal and political through a philosophy of intimate coalition, in the name of a world where all can find a home and freedom. It’s a fun, wild, devastating ride. Read it.</p><img src="https://counter.theconversation.com/content/221866/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>Love and Money, Sex and Death ricochets between sparkling defiance, unravelled grief, and furious hope.Anna Szorenyi, Lecturer in Gender Studies, University of AdelaideCambrey Payne, PhD candidate, University of AdelaideLicensed 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/2208312024-01-30T13:35:29Z2024-01-30T13:35:29ZBacklash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times<figure><img src="https://images.theconversation.com/files/571543/original/file-20240125-15-cirbso.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5778%2C3252&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anti-trans legislation adjudicates the bodily autonomy of those who do not conform to gender norms.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/TransgenderRights/5105bf799bb64a7b88d180c1a410463a">Carolyn Kaster/AP Photo</a></span></figcaption></figure><p>In the past century, there have been three waves of opposition to transgender health care. </p>
<p>In 1933, when the Nazis rose to power, they <a href="https://daily.jstor.org/90-years-on-the-destruction-of-the-institute-of-sexual-science/">cracked down on</a> transgender medical research and clinical practice in Europe. In 1979, a research report critical of transgender medicine <a href="https://doi.org/10.7326/M22-1480">led to the closure</a> of the most well-respected clinics in the United States. And since 2021, when <a href="https://www.npr.org/2023/06/20/1183344228/arkansas-2021-gender-affirming-care-ban-transgender-blocked">Arkansas became the first U.S. state</a> among now <a href="https://www.lgbtmap.org/equality-maps/healthcare_youth_medical_care_bans">at least 21 other states</a> banning gender-affirming care for minors, we have been living in a third wave.</p>
<p>In my work as a <a href="https://gsrosenthal.com">scholar of transgender history</a>, I study the <a href="https://theconversation.com/gender-affirming-care-has-a-long-history-in-the-us-and-not-just-for-transgender-people-201752">long history of gender-affirming care</a> in the U.S., which has been practiced since at least the 1940s. Puberty blockers, hormone therapies and anatomical surgeries are <a href="https://www.latimes.com/opinion/story/2023-03-28/opinion-gender-affirming-care-is-not-new-or-experimental">neither experimental nor untested</a> and have been safely administered to cisgender, transgender and intersex adults and children for decades.</p>
<p>On the other hand, the archives of transgender medicine demonstrate that backlash against these practices has historically been rooted in pseudoscience. And today, an anti-science movement that aims to <a href="https://www.scientificamerican.com/article/the-antiscience-movement-is-escalating-going-global-and-killing-thousands/">discredit science altogether</a> is fueling the fire of the current wave of anti-trans panic.</p>
<h2>The 1930s − eugenics and sexology collide</h2>
<p>In the 1920s, the new science of hormones was just reaching maturation and <a href="https://uncpress.org/book/9781469674858/wondrous-transformations/">entering mainstream consciousness</a>. In the field of sexology – the study of human sexuality, founded in 19th century Europe – scientists were excited about research on animals demonstrating that removing or transplanting gonads could effectively change an organism’s sex.</p>
<p>In 1919, the German sexologist <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> founded the <a href="https://www.scientificamerican.com/article/the-forgotten-history-of-the-worlds-first-trans-clinic/">Institut für Sexualwissenschaft</a> in Berlin, which became the world’s leading center for queer and transgender research and clinical practice. Hirschfeld worked closely with trans women as co-researchers throughout the 1920s. Several trans women also received care at the institute, including <a href="https://doi.org/10.1080%2F26895269.2020.1749921">orchiectomies</a> that halted the production of testosterone in their bodies.</p>
<p>Within months of Hitler’s rise to power in early 1933, a <a href="https://www.hmd.org.uk/resource/6-may-1933-looting-of-the-institute-of-sexology/">mob of far-right students</a> broke into and shuttered the institute for being “<a href="https://daily.jstor.org/90-years-on-the-destruction-of-the-institute-of-sexual-science/">un-German</a>.” Some of the <a href="https://collections.ushmm.org/search/catalog/pa26364">most famous images</a> of Nazi book burning show the institute’s library set ablaze in an outdoor plaza.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Black and white photo of person in uniform throwing books into a bonfire" src="https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=600&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=600&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571540/original/file-20240125-21-rigby5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=600&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Members of the Nazi party confiscated and burned ‘un-German’ books, including those from the Institut für Sexualwissenschaft.</span>
<span class="attribution"><a class="source" href="https://collections.ushmm.org/search/catalog/pa26364">United States Holocaust Memorial Museum, courtesy of National Archives and Records Administration, College Park</a></span>
</figcaption>
</figure>
<p>Nazi ideology was based on another prominent field of science of that time: <a href="https://www.genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism">eugenics</a>, the belief that certain superior populations should survive while inferior populations must be exterminated. In fact, Hirschfeld’s sexology and Nazi race science had common roots in the Enlightenment-era effort to <a href="https://doi.org/10.1080/17496977.2020.1794161">classify and categorize</a> the world’s life forms. </p>
<p>But in the late 19th century, many scientists went a step further and <a href="https://theconversation.com/proposed-1920s-orphanage-study-just-one-example-in-history-of-scientific-racism-37015">developed a hierarchy of human types</a> based on race, gender and sexuality. They were inspired by <a href="https://www.britannica.com/topic/social-Darwinism">social Darwinism</a>, a set of pseudoscientific beliefs applying the theory of survival of the fittest to human differences. As race scientists imagined a fixed number of human races of varying intelligence, sexologists simultaneously sought to classify sexual behaviors as innate, inherited states of being: <a href="https://www.beacon.org/A-Queer-History-of-the-United-States-P1426.aspx">the “homosexual”</a> in the 1860s and <a href="https://www.digitaltransgenderarchive.net/news/2016-08-die-transvestiten-sexology-and-pivotal-moments-in-trans-history">the “transvestite,”</a> a term coined by Hirschfeld himself, in 1910.</p>
<p>But where Hirschfeld and other sexologists saw the classification of queer and trans people as justifications for legal emancipation, eugenicists of the early 20th century <a href="https://encyclopediavirginia.org/entries/eugenic-sterilization-in-virginia/">in the U.S.</a> and <a href="https://encyclopedia.ushmm.org/content/en/article/eugenics">Europe</a> believed sexually transgressive people <a href="https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144">should be sterilized</a> and ultimately eradicated.</p>
<p>Based on this premise, the Nazis <a href="https://www.cornellpress.cornell.edu/book/9781501765155/pink-triangle-legacies/">murdered thousands of LGBTQ people</a> in the Holocaust.</p>
<h2>The 1970s − making model citizens</h2>
<p>In the 1950s and 1960s, transgender medicine bounced back in the U.S. Scientists and clinicians at several universities began experimenting with new <a href="https://press.uchicago.edu/ucp/books/book/chicago/H/bo156724705.html">hormonal and surgical interventions</a>. In 1966, Johns Hopkins became the <a href="https://soundcloud.com/hopkins-medical-archives/gender-identity-clinic-press-conference-1966">first university hospital in the world</a> to offer trans health care. </p>
<p>By the 1970s, trans medicine went mainstream. <a href="https://www.hup.harvard.edu/books/9780674013797">Nearly two dozen university hospitals</a> were operating gender identity clinics and treating thousands of transgender Americans. Several trans women and men wrote <a href="https://www.theparisreview.org/blog/2021/01/29/the-conundrum-of-conundrum/">popular autobiographical accounts</a> of their transitions. Trans people were even <a href="https://americanarchive.org/catalog/cpb-aacip_507-cc0tq5s22t">on television</a>, talking about their bodies and fighting for their rights. </p>
<p>Yet trouble was brewing behind the scenes. Jon Meyer, a psychiatrist at Johns Hopkins, was skeptical of whether medical interventions really helped transgender people. In 1979, Meyer, along with his secretary Donna Reter, published a <a href="https://doi.org/10.1001/archpsyc.1979.01780090096010">short academic paper</a> that ushered in the second wave of historic backlash to trans medicine.</p>
<p>In their study, Meyer and Reter contacted previous patients of the Johns Hopkins Gender Identity Clinic. To understand whether surgery had improved patients’ lives, the authors developed an “adjustment scoring system.” They assigned points to patients who were in heterosexual marriages and had achieved economic security since their operations, while deducting points from those who continued to engage in gender nonconformity, homosexuality, criminality, or sought mental health care.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Black and white image of transgender artist Coccinelle smiling beside her husband Francis Paul Bonnet" src="https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571547/original/file-20240125-31-t8e03l.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">Some researchers defined a successful medical transition as one that resulted in visible conformity to gender norms and heterosexuality.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/artiste-transgenre-coccinelle-et-son-mari-francis-paul-news-photo/1505597233">Reporters Associes/Gamma-Rapho via Getty Images</a></span>
</figcaption>
</figure>
<p>Meyer and Reter believed that gender-affirming surgeries were successful only if they made model citizens out of transgender people: straight, married and law-abiding.</p>
<p>In their results, the authors found no negative effects from surgery, and no patients expressed regret. They concluded that “sex reassignment surgery confers no objective advantage in terms of social rehabilitation,” but it is “subjectively satisfying” to the patients themselves. This was not a damning conclusion. </p>
<p>Yet, within two months, Johns Hopkins had <a href="https://doi.org/10.7326/M22-1480">shuttered its clinic</a>. <a href="https://www.nytimes.com/1979/10/02/archives/benefits-of-transsexual-surgery-disputed-as-leading-hospital-halts.html">The New York Times</a> reported that universities would feel pressure to similarly “curtail their operations and discourage others from starting to do them.” Indeed, only a <a href="https://doi.org/10.7326/M22-1480">handful of clinics remained</a> by the 1990s. Transgender medicine did not return to Johns Hopkins <a href="https://www.washingtonpost.com/national/health-science/long-shadow-cast-by-psychiatrist-on-transgender-issues-finally-recedes-at-johns-hopkins/2017/04/05/e851e56e-0d85-11e7-ab07-07d9f521f6b5_story.html">until 2017</a>.</p>
<p>In requiring trans patients to enter straight marriages and hold gender-appropriate jobs to be considered successful, Meyer and Reter’s study was <a href="https://doi.org/10.1007/BF02115944">homophobic and classist in design</a>. The study exemplified the <a href="https://nyupress.org/9781479899371/trans-medicine/">pseudoscientific beliefs</a> at the heart of transgender medicine in the 1960s through the 1980s, that patients had to conform to societal norms – including heterosexuality, gender conformity, domesticity and marriage – in order to receive care. This was not an ideology rooted in science but in bigotry.</p>
<h2>The 2020s − distrust in science</h2>
<p>As in the 1930s, opposition to trans medicine today is part of a broad reactionary movement against what some far-right groups consider the “<a href="https://www.theguardian.com/world/2023/sep/15/project-2025-policy-manifesto-lgbtq-rights">toxic normalization</a>” of LGBTQ people. </p>
<p>Legislators have <a href="https://theconversation.com/penguin-random-house-pen-america-authors-and-parents-sue-florida-county-for-removing-books-on-race-and-lgbtq-themes-205945">removed books with LGBTQ content</a> from libraries and <a href="https://www.newsobserver.com/news/politics-government/article254903187.html">disparaged them as “filth</a>.” A recent law in Florida <a href="https://www.them.us/story/florida-trans-bathroom-law">threatens trans people with arrest</a> for using public restrooms. Both Florida and Texas have pursued efforts to <a href="https://www.them.us/story/texas-attorney-general-ken-paxton-state-data-on-trans-texans">compile data on their trans citizens</a>. Donald Trump’s <a href="https://www.theatlantic.com/magazine/archive/2024/01/trump-lgbtq-transgender-community-protections/676139/">campaign platform</a> calls for a nationwide ban on trans health care for minors and severe restrictions for adults.</p>
<p>And similar to the 1970s, opponents of trans medicine today frame gender-affirming care as a “debate,” even though <a href="https://glaad.org/medical-association-statements-supporting-trans-youth-healthcare-and-against-discriminatory/">all major U.S. medical associations</a> support these practices <a href="https://www.ama-assn.org/press-center/press-releases/ama-states-stop-interfering-health-care-transgender-children">as medically necessary</a> and lifesaving. </p>
<p>But widespread <a href="https://www.bostonreview.net/articles/andrew-jewett-science-under-fire/">distrust in science and medicine</a> in the <a href="https://www.thenation.com/article/society/anti-science-is-a-systematic-issueand-its-not-going-away/">wake of the COVID-19 pandemic</a> has affected how Americans perceive trans health care. Prohibitions on gender-affirming care have occurred simultaneously with the relaxing of pandemic restrictions, and some scholars argue that the movement against trans health care is part of a <a href="https://blogs.lse.ac.uk/gender/2022/04/11/what-anti-gender-and-anti-vaccines-politics-have-in-common-the-construction-of-gender-and-the-covid-19-pandemic-in-right-wing-discourses/">broader movement</a> aimed at discrediting scientific consensus.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Back of person wearing trans flag at the back of a legislative hearing room with a rotunda" src="https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571550/original/file-20240125-28-zetkg0.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">A rash of legislation restricting access to gender-affirming care claims to protect the health of children, despite lack of support from major U.S. medical associations.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/TransgenderHealthMissouri/442b19097c7f44a0a0864c4046aa5acb">Charlie Riedel/AP Photo</a></span>
</figcaption>
</figure>
<p>Yet the adage “<a href="https://www.nsta.org/journal-college-science-teaching/journal-college-science-teaching-mayjune-2022/why-do-people-say-i">believe in science</a>” is not an effective rejoinder to these anti-trans policies. Instead, many trans activists today call for diminishing the role of medical authority altogether in <a href="https://www.americanscientist.org/blog/macroscope/its-time-to-stop-gatekeeping-medical-transition">gatekeeping access to trans health care</a>. Medical gatekeeping occurs <a href="https://doi.org/10.1080/26895269.2022.2100644">through stringent guidelines</a> that govern access to trans health care, including mandated psychiatric evaluations and extended waiting periods that limit and control patient choice. </p>
<p>Trans activists have <a href="https://filtermag.org/wpath-trans-nonbinary-health-care/">fought with the World Professional Association for Transgender Health</a>, the organization that maintains these standards of care, by demanding greater bodily autonomy and depathologizing transsexuality. This includes pivoting to an <a href="https://doi.org/10.1093/jsxmed/qdad019">informed consent model</a> where patients make decisions about their own bodies after discussing the pros and cons with their doctors. Trans activists have been rallying against medical authority since the early 1970s, including calling for <a href="https://www.digitaltransgenderarchive.net/downloads/th83kz57z">access to hormones and surgeries on demand</a>.</p>
<p>It is not clear how the current third wave of backlash to transgender medicine will end. For now, trans health care remains a question dominated by medical experts on one hand and people who question science on the other.</p><img src="https://counter.theconversation.com/content/220831/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>G. Samantha Rosenthal 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>For as long as trans medicine has been around, so has its opposition. The tactics of prior waves of anti-trans policies are still in play today.G. Samantha Rosenthal, Associate Professor of History, Roanoke CollegeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2206132024-01-25T12:21:02Z2024-01-25T12:21:02ZHow the tide turned on transgender support charity Mermaids<figure><img src="https://images.theconversation.com/files/568172/original/file-20240108-20-cwznj1.jpg?ixlib=rb-1.1.0&rect=35%2C26%2C5955%2C3961&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/lgbt-pride-flag-symbol-lesbian-gay-1722901423">BlurryMe/Shutterstock</a></span></figcaption></figure><p>The charity Mermaids, which offers support services to transgender young people and their caregivers in the UK, was once portrayed in the media as a respected source of advice and information. But by 2022, this had changed. </p>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/17405904.2023.2291136?src=exp-la">Our recent study</a> showed that negative attention to the charity peaked in 2022, a year that saw British newspapers regularly publishing stories that helped establish an image of Mermaids as a danger to young people. Similar complaints and concerns from members of the public led the Charity Commission to open a regulatory compliance case on Mermaids, in <a href="https://www.bbc.co.uk/news/uk-63081644">late September 2022</a>.</p>
<p>Our findings show how some media outlets have used negative representations of Mermaids to imply that those who support trans young people are untrustworthy. Such representations have threatened to turn the organisation into a weapon against the very people it is trying to help. </p>
<p>In the past decade, there has been a significant increase in media attention on transgender people and the issues that affect them, something that has been noted <a href="https://mermaidsuk.org.uk/news/exclusive-mermaids-research-into-newspaper-coverage-on-trans-issues/">in research</a> commissioned by Mermaids and carried out by linguistics professor Paul Baker.</p>
<p>Studies have also shown how these media representations of transgender people <a href="https://www.tandfonline.com/doi/full/10.1080/14680777.2022.2097727">often dehumanise</a> them, <a href="https://journals.sagepub.com/doi/10.1177/1363460717740259">ignore and disregard</a> their identities, and characterise them as either <a href="https://glaad.org/publications/victims-or-villains-examining-ten-years-transgender-images-television">victims or villains</a>. </p>
<p><a href="https://mermaidsuk.org.uk/news/exclusive-mermaids-research-into-newspaper-coverage-on-trans-issues/">Representations of young transgender people</a> have tended to be more positive, or at least neutral. Yet news stories often suggest that their efforts to transition, for example through the adoption of a new name or clothing choices, should not be supported. </p>
<h2>Increasing interest</h2>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/17405904.2023.2291136?src=exp-la">Our study</a> showed that Mermaids became the subject of particularly intense media scrutiny in late 2022. At this time, news articles and opinion pieces were calling into question the charity’s legitimacy and authority, with particular attention to their support of young people’s decisions and preferences around clothing and names. The Times and Telegraph published numerous reports in the autumn of 2022 that called Mermaids’ practices a “danger” to young people. </p>
<p>For example, in October 2022 the Daily Telegraph published an article titled “Trans charity helping 16-year-olds legally change names in secret”, which also states that Mermaids “gave potentially dangerous chest-flattening devices to 14-year-olds against their parents’ wishes”.</p>
<p>Chest binders were a particular focus in many articles. Our research shows that the frequency of the word “binder” dramatically increased in 2022 articles about Mermaids. Binders are tight-fitting items of clothing that some trans and gender questioning young people wear in order to minimise <a href="https://www.nhs.uk/conditions/gender-dysphoria/#:%7E:text=Gender%20dysphoria%20is%20a%20term,harmful%20impact%20on%20daily%20life">gender dysphoria</a> and affirm their gender identities. </p>
<p>Many of the articles describe binders as destructive, powerful mechanisms that are dangerous to young people. They focus on physical health problems, such as musculoskeletal and breathing issues, which can result from unsafe or unregulated binding.</p>
<p>The articles do not tend to acknowledge the harm that can be caused by gender dysphoria, or by attempting to bind the chest without adult supervision. <a href="https://www.liebertpub.com/doi/full/10.1089/trgh.2018.0017">Research has shown</a> that the potential for health risks may be worsened if young people try to hide their use of a binder from adults, instead of discussing how to use one safely. </p>
<figure class="align-center ">
<img alt="Happy young people dancing at an outdoor event." src="https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568174/original/file-20240108-156527-ff2c23.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">New guidance to schools takes a restrictive approach to gender transitions.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-young-people-dancing-outdoor-festival-2192448719">Tint Media/Shutterstock</a></span>
</figcaption>
</figure>
<p>Mermaids <a href="https://mermaidsuk.org.uk/news/statement-in-response-to-a-telegraph-article-published-sunday-25-september/">responded to the Telegraph</a> article by clarifying that they are working to reduce harm for young people. They note that providing “comprehensive safety guidelines from an experienced member of staff is preferable to the likely alternative”. Mermaids’ guidance says it is important to follow safety tips such as limiting use as much as possible in warm weather, even if you’re struggling with gender dysphoria.</p>
<h2>Changing perspectives</h2>
<p>The services offered by Mermaids have remained largely unchanged over the years. However, when we <a href="https://www.tandfonline.com/doi/full/10.1080/17405904.2023.2291136?src=exp-la">investigated the representation</a> of Mermaids in British newspapers, we found there hadn’t always been such high levels of negative attention. </p>
<p>Between 2015 and 2016, during their first year operating as a charity, there was hardly any interest in Mermaids’ activities. Where it was mentioned, the organisation was usually represented as a valuable support service. </p>
<p>In 2018, media interest increased significantly after the release of Butterfly, an ITV drama about a trans young person and their family. In the same year, the National Lottery announced they would be awarding a grant of £500,000 to support Mermaids’ work through the Big Lottery Fund. </p>
<p>While newspapers were still signposting Mermaids as a source of information and support at this time, there was also resistance to the charity’s growing recognition and positive reputation. For example, the Sunday Times reported “an outcry” following the Big Lottery announcement, calling into question the value of Mermaids’ work as a public service.</p>
<p>Between 2019 and 2022, the frequency of articles grew again. 2022 saw the most significant peak in interest, with four times as many articles being published than in the previous year. </p>
<p>In late November 2022, the Charity Commission opened a <a href="https://www.gov.uk/government/news/regulator-announces-statutory-inquiry-into-mermaids">statutory inquiry</a> that focused on “newly identified issues about the charity’s governance and management”, including internal issues of equality and diversity amongst staff. The charity’s CEO, Susie Green, resigned in November 2022. </p>
<p>These events further contributed to negative interest in the charity. They were frequently labelled a “<a href="https://www.telegraph.co.uk/news/2022/12/02/mermaids-transgender-charity-formal-investigation/">scandal-hit</a>” organisation whose experience with trans young people could not be trusted. The commission has yet to report its findings. </p>
<p>These changing representations of Mermaids are in line with wider shifts in the climate for trans young people in Britain. Just before Christmas, the UK government’s Department for Education released its <a href="https://consult.education.gov.uk/equalities-political-impartiality-anti-bullying-team/gender-questioning-children-proposed-guidance/supporting_documents/Gender%20Questioning%20Children%20%20nonstatutory%20guidance.pdf">long-awaited guidance</a> on gender questioning children for schools and colleges in England.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/trans-guidance-for-schools-the-voices-of-young-people-are-missing-207663">Trans guidance for schools: the voices of young people are missing</a>
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</em>
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<p>The guidance, which is undergoing public consultation and is not legally enforceable, advises educators to take a restrictive approach to transgender pupils’ social transition at school. The LGBTQ+ charity <a href="https://stonewall.org.uk/about-us/news/not-fit-purpose-stonewalls-response-draft-trans-guidance-schools-england">Stonewall said</a> the guidance has “the potential to have a very chilling effect” akin to section 28, which banned the discussion of same-sex relationships in English schools between 1988 and 2003. </p>
<p>Recent years have seen more awareness of trans identities among the general public, and a <a href="https://gids.nhs.uk/about-us/number-of-referrals/">significant increase</a> in referrals to gender identity services. Much of the <a href="https://www.dailymail.co.uk/news/article-12366421/The-trans-lobby-pushed-double-masectomy-bitterly-regret-Thats-Costas-advert-dangerous-writes-SINEAD-WATSON-detransitioned-woman-double-mastectomy.html">media coverage</a> around trans young people alludes to the potential for regret. </p>
<p>However, the <a href="https://www.sciencedirect.com/science/article/pii/S1054139X22005031?via%3Dihub">vast majority</a> of young people who socially transition maintain a stable gender identity into adulthood and a 2021 US study found rates of <a href="https://atm.amegroups.org/article/view/64719/html">post-surgery regret</a> are 0.3%. </p>
<p><a href="https://mermaidsuk.org.uk/news/exclusive-mermaids-research-into-newspaper-coverage-on-trans-issues/">Paul Baker’s research</a> suggested that organisations like Mermaids may be targeted because they can more easily be named and critiqued than trans young people themselves. We would agree. </p>
<p>Discrediting the organisation, not the people, allows journalists to question and oppose young people’s gender identities without breaking media <a href="https://www.ipso.co.uk/media/1275/guidance_transgender-reporting.pdf">guidelines</a> for reporting about trans people and children. </p>
<p>The dominant image of Mermaids as a dangerous and controversial organisation has probably contributed to a growing culture of fear and suspicion around trans young people and those who support them. </p>
<p>Hardly a negative word has been directed towards transgender young people, yet the seeds of mistrust, in anyone who upholds their identities and choices, have been firmly planted by the British media. </p>
<p><em>This article has been updated to add details of the Charity Commission’s ongoing regulatory compliance case and statutory inquiry into Mermaids.</em></p><img src="https://counter.theconversation.com/content/220613/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>Research shows how the group once portrayed as a respected source of advice began to be seen by some outlets as a danger to young people.Aimee Bailey, Lecturer in English Language, De Montfort UniversityJai Mackenzie, Senior Lecturer in Applied Writing and Humanities, Newman UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2206422024-01-22T13:30:00Z2024-01-22T13:30:00ZTransgender regret? Research challenges narratives about gender-affirming surgeries<figure><img src="https://images.theconversation.com/files/569390/original/file-20240115-19-obyz75.jpg?ixlib=rb-1.1.0&rect=135%2C23%2C5179%2C3519&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Gender-affirming surgeries give transgender people the opportunity to align their bodies with their gender identity.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/transgender-woman-prepares-another-womans-makeup-prior-to-news-photo/1484588805?adppopup=true">Luke Dray/Getty Images</a></span></figcaption></figure><figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=255&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=255&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=255&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=321&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=321&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570225/original/file-20240118-21-ts9rff.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=321&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="attribution"><a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>You’ll often hear <a href="https://www.nytimes.com/2023/05/16/us/politics/transgender-care-detransitioners.html">lawmakers</a>, <a href="https://www.youtube.com/watch?v=dJMMqREtQJc">activists</a> and <a href="https://www.cbsnews.com/news/60-minutes-transgender-health-care-issues-2021-05-23/">pundits</a> argue that many transgender people regret their decision to have gender-affirming surgeries – a belief that’s been fueling a <a href="https://www.lgbtmap.org/equality-maps/healthcare_youth_medical_care_bans">wave of legislation</a> that restricts access to gender-affirming health care.</p>
<p>Gender-affirming care can include surgical procedures such as facial reconstruction, <a href="https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/top-surgery">chest or “top” surgery</a>, and <a href="https://transcare.ucsf.edu/guidelines/vaginoplasty">genital or “bottom” surgery</a>.</p>
<p>But in <a href="https://jamanetwork.com/journals/jamasurgery/article-abstract/2813212">an article</a> we recently published in JAMA Surgery, we challenge the notion that transgender people often regret gender-affirming surgeries. </p>
<p>Evidence suggests that less than 1% of transgender people who undergo gender-affirming surgery report regret. That proportion is even more striking when compared to the fact that 14.4% of the broader population reports regret after similar surgeries. </p>
<p>For example, studies have found that between <a href="https://doi.org/10.1016/j.pec.2017.06.032">5% and 14%</a> of all women who receive mastectomies to reduce the risk of developing breast cancer say they regretted doing so. However, less than 1% of transgender men who receive the same procedure report regret.</p>
<p>These statistics are based on reviews of <a href="https://journals.lww.com/prsgo/fulltext/2021/03000/regret_after_gender_affirmation_surgery__a.22.aspx">existing studies</a> that investigated regret among 7,928 transgender individuals who received gender-affirming surgeries. Although some of this prior research <a href="https://journals.lww.com/prsgo/fulltext/2021/11000/letter_to_the_editor__regret_after.29.aspx">has been criticized</a> for overlooking the fact that regret can sometimes take years to develop, it aligns with the growing body of studies that show positive health outcomes among transgender people who receive gender-affirming care. </p>
<h2>Why access to gender-affirming surgery matters</h2>
<p>About <a href="https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/">1.6 million people</a> in the U.S. identify as transgender. While only <a href="https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf">about 25%</a> of these individuals have obtained gender-affirming surgeries, <a href="https://www.doi.org/10.1001/jamanetworkopen.2023.30348">these procedures have become more commonplace</a>. From 2016 to 2020, roughly 48,000 trans people in the U.S. received gender-affirming surgeries.</p>
<p>These procedures provide transgender people with the opportunity to align their physical bodies with their gender identity, which could positively impact mental health. <a href="https://doi.org/10.1080/19359705.2021.2016537">Research shows</a> that access to gender-affirming surgeries may reduce levels of depression, anxiety and suicidal ideation among transgender people. </p>
<p>The mental health benefits may explain the low levels of regret. Transgender people have <a href="https://doi.org/10.1080/09540261.2022.2093629">far higher rates</a> of mental health concerns than cisgender people, or people whose gender identity aligns with their sex at birth. This is largely because transgender people have a more difficult time <a href="https://theconversation.com/what-the-new-science-of-authenticity-says-about-discovering-your-true-self-175314">living authentically</a> without experiencing <a href="https://www.cdc.gov/mmwr/volumes/68/wr/mm6803a3.htm?s_cid=mm6803a3_w">discrimination, harassment and violence</a>.</p>
<p>Gender-affirming surgery often involves <a href="https://doi.org/10.1080/26895269.2022.2100644">going through a number of hoops</a>: waiting periods, hormone therapy and learning about the potential risks and benefits of the procedures. Although most surgeries are reserved for adults, the <a href="https://www.wpath.org/">leading guidelines</a> recommend that patients be at least 15 years old.</p>
<p>This thorough process that trans people go through before receiving surgery may also explain the lower levels of regret. </p>
<p>In addition, many cisgender people get surgeries that, in their ideal world, they wouldn’t receive. But they go through with the surgery in order to prevent a health problem. </p>
<p>For instance, a cisgender woman who receives a mastectomy to avoid breast cancer may ultimately regret the decision if she dislikes her new appearance. Meanwhile, a transgender man who receives the same procedure is more likely to be pleased with a masculine-looking chest.</p>
<h2>Improving research and public policy</h2>
<p>It’s important to note that this research is not conclusive. Views of surgeries <a href="https://doi.org/10.1007/s00268-017-3895-9">can change over time</a>, and patients can feel quite differently about their outcomes eight years <a href="https://doi.org/10.1007/s10508-014-0300-8">after their surgery</a> as opposed to one year after their surgery.</p>
<p>Nonetheless, the consensus among experts, including at the <a href="https://www.ama-assn.org/press-center/press-releases/ama-reinforces-opposition-restrictions-transgender-medical-care">American Medical Association</a>, is that gender-affirming surgery can improve transgender people’s health and should not be banned. </p>
<p><a href="https://www.lgbtmap.org/equality-maps/healthcare_youth_medical_care_bans">U.S. states</a> such as Oklahoma and North Dakota have ignored this consensus and have restricted access to these procedures. In response, 12 states have designated themselves “<a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2812422">sanctuaries</a>” for gender-affirming care.</p>
<p>Although our statistics on surgical regret may change as researchers learn more, they are the best data that health care providers have. And public policies that are based on the best available evidence have the most potential to improve people’s lives.</p><img src="https://counter.theconversation.com/content/220642/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Harry Barbee has received funding from the National Institute on Aging for their past work. </span></em></p><p class="fine-print"><em><span>Bashar Hassan and Fan Liang 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>The findings push back against the notion that many transgender people end up wishing they hadn’t gone through with gender-affirming surgeries.Harry Barbee, Assistant Professor of Health, Behavior and Society, Johns Hopkins UniversityBashar Hassan, Postdoctoral Research Fellow in Plastic and Reconstructive Surgery, Johns Hopkins UniversityFan Liang, Assistant Professor of Plastic and Reconstructive Surgery, Johns Hopkins UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2169772024-01-03T13:43:29Z2024-01-03T13:43:29ZThe Lotus Sutra − an ancient Buddhist scripture from the 3rd century − continues to have relevance today<figure><img src="https://images.theconversation.com/files/566359/original/file-20231218-23-ldln3o.jpeg?ixlib=rb-1.1.0&rect=1%2C0%2C1189%2C601&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A Lotus Sutra scroll praising the manifold mercies of the bodhisattva Avalokiteshvara.</span> <span class="attribution"><a class="source" href="https://www.metmuseum.org/art/collection/search/44849">Universal Gateway chapter of the Lotus Sutra/Calligrapher: Sugawara Mitsushige/The Metropolitan Museum of Art Collection</a></span></figcaption></figure><p>State legislatures across the United States have introduced <a href="https://www.equalityfederation.org/tracker/cumulative-anti-transgender">over 400 bills to limit transgender Americans’ rights</a>. Many of these bills’ sponsors, such as the Christian nonprofit Alliance Defending Freedom, cite Christian values as well as the values of the other <a href="https://brill.com/view/journals/rag/11/1/article-p67_5.xml">Abrahamic faiths</a> – Judaism and Islam – to justify their anti-trans positions. </p>
<p>The Alliance Defending Freedom claims that Christians, Jews and Muslims view gender as binary and defined only by biology, though these religions’ <a href="https://therevealer.org/beloved-transgender-children-and-holy-resistance/">diverse followers</a> actually hold a <a href="https://theconversation.com/muslims-protesting-against-lgbtq-pride-are-ignoring-islams-tradition-of-inclusion-209949">range of views</a> on <a href="https://therevealer.org/turning-to-the-talmud-to-find-gender-diversity-that-speaks-to-today/">LGBTQ+ issues</a>. Historically, these religions were often more accepting of varied gender identities before <a href="https://publicseminar.org/2018/07/gender-as-colonial-object/">colonialism imposed binary gender</a> as a universal concept. </p>
<p>Religious <a href="https://www.ihs.gov/lgbt/health/twospirit/">values from multiple</a> <a href="https://theconversation.com/for-indonesias-transgender-community-faith-can-be-a-source-of-discrimination-but-also-tolerance-and-solace-193063">traditions</a> have supported <a href="https://therevealer.org/many-paths-to-freedom-transgender-buddhism-in-the-united-states/">transgender identity</a>. <a href="https://cup.columbia.edu/book/buddhist-masculinities/9780231210478">As a scholar of Buddhism and gender</a>, I know that several Buddhist texts treat gender as fluid. One such text is the Lotus Sutra, one of the most popular Buddhist scriptures in East Asia. Its core message is that everyone, no matter their gender or status, has the potential to become a Buddha. </p>
<p>The Lotus Sutra conveys its <a href="https://tricycle.org/magazine/greater-awakening/">message of universal Buddhahood</a> in several stories that depict transformations between male and female bodies. For example, a dragon girl instantly transforms into the masculine body of a Buddha, proving that female bodies are not barriers to awakening.</p>
<p>Elsewhere, the Lotus Sutra describes how the <a href="https://doi.org/10.1093/acrefore/9780199340378.013.167">bodhisattva Avalokiteshvara</a>, known as Guanyin in Mandarin and Kannon in Japanese, takes on male or female forms depending on the needs of the audience. </p>
<h2>The dragon girl’s gender transformation</h2>
<p>To understand the story of the dragon girl, it is important to understand how Buddhas’ bodies were defined as masculine in early Buddhism. Most people are familiar with the historical figure Siddhartha Gautama as “the Buddha,” but Buddhists believe that <a href="https://tricycle.org/beginners/buddhism/why-do-buddhists-talk-about-many-buddhas/">several “Buddhas,”</a> or enlightened teachers, have been born throughout history. All of these Buddhas are said to possess 32 marks that distinguished their bodies from regular bodies. </p>
<p>One of these marks was a sheathed penis, which meant that Buddha bodies were male by definition. In addition, Buddhist texts identified five roles, including Buddha, that were off-limits to women. </p>
<p>In the <a href="https://cup.columbia.edu/book/the-lotus-sutra/9780231081610">Lotus Sutra</a>, the Buddha’s disciple, Shariputra, refers to these limitations when he rejects the idea that the dragon girl could quickly attain Buddhahood: </p>
<blockquote>
<p>“You suppose that in this short time you have been able to attain the unsurpassed way. But this is difficult to believe. Why? Because the female body is soiled and defiled, not a vessel for the Law. How could you attain the unsurpassed bodhi? … Moreover, a woman is subject to the five obstacles. First, she cannot become a Brahma heavenly king. Second, she cannot become the king Shakra. Third, she cannot become a Mara demon king. Fourth, she cannot become a wheel-turning sage king. Fifth, she cannot become a Buddha. How then could your female body attain Buddhahood so quickly?”</p>
</blockquote>
<p>However, the dragon girl proves Shariputra wrong by instantly attaining Buddhahood, transforming her young, female, nonhuman body into the male body of a Buddha. Women in premodern East Asia <a href="https://compass.onlinelibrary.wiley.com/doi/10.1111/rec3.12270">found inspiration</a> in the dragon girl’s story because it showed that their own female bodies were not barriers to enlightenment. </p>
<figure class="align-center ">
<img alt="A scroll with golden etching on a black background depicting a scene from the life of the Buddha." src="https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=655&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=655&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=655&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=824&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=824&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557848/original/file-20231106-21-qgdfq9.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=824&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This scroll from the ‘Devadatta’ chapter of the Lotus Sutra depicts the 8-year-old daughter of the Dragon King emerging from her palace beneath the sea to offer a precious, radiant jewel to the Buddha on Eagle Peak.</span>
<span class="attribution"><a class="source" href="https://www.metmuseum.org/art/collection/search/44851">The Metropolitan Museum of Art</a></span>
</figcaption>
</figure>
<h2>The bodhisattva’s gender fluidity</h2>
<p>Another inspiration from the Lotus Sutra can be found in the Chapter of Universal Salvation, which focuses on the <a href="https://south.npm.gov.tw/english/ExhibitionsDetailE003110.aspx?Cond=c176e479-7c87-462c-9b58-9b3900ca851e&appname=Exhibition3112EN">bodhisattva of compassion, Avalokiteshvara</a>. A bodhisattva is an advanced spiritual being who postpones enlightenment to help people in the world. </p>
<p>According to this chapter, Avalokiteshvara will adopt any form to save people. Avalokiteshvara can become a monk, nun, layman, laywoman, rich man, rich man’s wife, young boy, young girl, human or nonhuman, depending on the audience’s needs. </p>
<p>In China, this passage provided scriptural support for Avalokiteshvara’s perceived <a href="https://cup.columbia.edu/book/kuan-yin/9780231120296">transformation from a male to female figure</a>. Indian Buddhist texts described Avalokiteshvara as male, but in China people came to see Avalokiteshvara as female. </p>
<p>Though scholars have not found one single explanation for this transformation, the Lotus Sutra passage offers justification for Avalokiteshvara’s gender fluidity. Images of Avalokiteshvara from China, Japan and Korea can depict the bodhisattva as masculine, feminine or androgynous.</p>
<h2>The Lotus Sutra and transgender inspiration</h2>
<p>Due to the Lotus Sutra, Avalokiteshvara has become an inspiration and icon for transgender, gender-fluid and nonbinary people in and beyond East Asia. At Japan’s <a href="https://matcha-jp.com/en/9828">Shozenji Temple</a>, head nun Soshuku Shibatani, who underwent gender reassignment surgery, has said, “The Kannon Bodhisattva has no gender identity,” using Avalokiteshvara’s Japanese name. </p>
<p>A <a href="https://blog.stheadline.com/article/detail/1116787/%E9%9D%9E%E7%94%B7%E9%9D%9E%E5%A5%B3">blog post</a> from Taiwan quotes from the Lotus Sutra in describing Avalokiteshvara as a nonbinary figure who transcends any single gender identity. </p>
<p>However, Avalokiteshvara’s role as a transgender icon is not universally accepted. Another <a href="https://n.yam.com/Article/20130509462739">Taiwanese blogger</a> reported that a friend of theirs argued with their description of the bodhisattva as transgender. In April 2022, an Avalokiteshvara statue in The Burrell Collection in Glasgow, Scotland, labeled as a transgender icon, <a href="https://www.museumsassociation.org/museums-journal/news/2022/04/glasgow-life-defends-trans-label-in-burrell-collection-after-politicisation-row/">resulted in protests</a>. The anti-trans group For Women Scotland argued that the label unnecessarily politicized the statue. </p>
<p>Despite these objections, more and more people have found inspiration in Avalokiteshvara as a transgender, nonbinary or gender-fluid figure. Just as the Lotus Sutra’s story of the dragon girl inspired Buddhist women in premodern East Asia, Avalokiteshvara’s gender fluidity offers inspiration to people today. </p>
<p><em><a href="https://www.linkedin.com/authwall?trk=bf&trkInfo=AQHFNdxAPOLqfAAAAYyDQhP4XlW43CSxFWDpq9-1rWWyWub3I-5Wq7BJL_wg5vkC0-EEWdyTHjmNbcHqNfYuNJ4krmD_PiPpjOatEpoVecRRhBp70u5VgTWb2HOF7POqNQMpnmg=&original_referer=&sessionRedirect=https%3A%2F%2Fwww.linkedin.com%2Fin%2Fmarissa-posani-8473432a6%2F">MJ Posani</a>, an undergraduate student at the University of Tennessee, contributed to the research for this article.</em></p><img src="https://counter.theconversation.com/content/216977/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Megan Bryson 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>For many Buddhists today, both in East Asia and across the world, the Lotus Sutra offers religious support for various gender identities.Megan Bryson, Associate Professor of Religious Studies, University of TennesseeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2201262023-12-19T13:17:40Z2023-12-19T13:17:40ZPope Francis’ approval of blessings for LGBTQ+ couples is a historic gesture, according to a Catholic theologian<figure><img src="https://images.theconversation.com/files/566409/original/file-20231218-20-apod48.jpg?ixlib=rb-1.1.0&rect=37%2C3%2C2141%2C1329&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pope Francis speaks during his weekly general audience in St. Peter's Square at the Vatican on Oct. 18, 2023.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/VaticanLGBTQ/8556ca299dda4df394f5e8864e86a1c1/photo?Query=pope%20francis%20same%20sex&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=46&currentItemNo=1">AP Photo/Alessandra Tarantino</a></span></figcaption></figure><p>Pope Francis’ <a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=in%20lingua%20inglese-,Declaration,Presentation,-This%20Declaration%20considers">Dec. 18, 2023, announcement</a> that Catholic priests may bless LGBTQ+ couples and others in “irregular” situations marks a definitive shift in the Roman Catholic Church’s posture toward many types of loving relationships. It may also mark a definitive turning point within the Roman Catholic Church.</p>
<p>Across the last few years, Francis has <a href="https://theconversation.com/pope-francis-support-for-civil-unions-is-a-call-to-justice-and-nothing-new-148607">made gesture</a> <a href="https://theconversation.com/it-shouldnt-seem-so-surprising-when-the-pope-says-being-gay-isnt-a-crime-a-catholic-theologian-explains-198566">after gesture</a> indicating his desire to find a way for the Catholic Church to accompany and welcome people whose loving relationships do not fit into the church’s sacramental understanding of marriage as between a man and a woman, ordered toward procreation and ended only by death.</p>
<p>He has telegraphed <a href="https://apnews.com/general-news-7b465b60945f40deb3a68b3de742f84a">for a long time</a> his desire to come to some new arrangement that would welcome loving relationships in the church without transforming the church’s doctrine on marriage and sexuality all at once – the Dec. 18 declaration seems to do exactly that. </p>
<h2>Pastoral emphasis</h2>
<p>First, let’s be clear about what this new declaration is not. The declaration does not permit the marriage of LGBTQ+ couples, or couples where parties are divorced without annulment of the marriage. Neither does the declaration permit any recognition of a civil marriage.</p>
<p>The declaration is specific that the blessing of relationships outside marriage must not be done in any way that might be confused with a marriage ceremony. In fact, the declaration encourages priests to be <a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=prayer%20preceding%20this-,spontaneous,-blessing%2C%20the%20ordained">responsive to “spontaneous</a>” requests for a blessing, and it forbids the creation of “<a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=The%20popular%20understanding%20of%20blessings%2C%20however%2C%20also%20values%20the%20importance%20of%20descending%20blessings.%20While%20%E2%80%9Cit%20is%20not%20appropriate%20for%20a%20Diocese%2C%20a%20Bishops%E2%80%99%20Conference%2C%20or%20any%20other%20ecclesial%20structure%20to%20constantly%20and%20officially%20establish%20procedures%20or%20rituals%20for%20all%20kinds%20of%20matters">procedures or rituals</a>” that would provide anything like a script for a blessing ceremony.</p>
<figure class="align-center ">
<img alt="Two people stand in front of a cathedral while another man in white priestly garments blesses them." src="https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566410/original/file-20231218-19-qx13c9.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">Same-sex couples take part in a Catholic public blessing ceremony in Cologne, Germany, on Sept. 20, 2023.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/VaticanLGBTQExplainer/fd76861aa59c4f43ab97ac397e74b082/photo?Query=pope%20francis%20same%20sex&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=46&currentItemNo=13">AP Photo/Martin Meissner</a></span>
</figcaption>
</figure>
<p>Still, the declaration is remarkable for what it does do. Sidestepping difficult doctrinal questions that <a href="https://www.catholicnewsagency.com/news/255544/the-5-cardinals-behind-the-latest-dubia-issued-to-pope-francis">divide Catholics</a>, the document’s emphasis is pastoral – it is oriented toward caring for and ministering to people rather than teaching doctrine.<br>
The word “pastoral” appears 20 times in the declaration. Francis’ emphasis is unmistakable: The subject of the declaration is not marriage or sexual morality; the declaration is about something else.</p>
<h2>What ‘blessings’ mean in the church</h2>
<p>In fact, the declaration is about blessings and what they mean in the Catholic Church.</p>
<p>A long stretch of the document is devoted to defining and clarifying what the Roman Catholic Church means by the word “blessing.” <a href="https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_risposta-dubia-2023_en.html#:%7E:text=For%2C%20when%20one%20asks%20for%20a%20blessing%2C%20one%20is%20expressing%20a%20petition%20for%20God%E2%80%99s%20assistance%2C%20a%20plea%20to%20live%20better%2C%20and%20confidence%20in%20a%20Father%20who%20can%20help%20us%20live%20better">Francis has said that</a> “when one asks for a blessing, one is expressing a petition for God’s assistance, a plea to live better, and a confidence in a Father who can help us live better.” A blessing is an “<a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=a%20superabundant%20and-,unconditional%20gift,-.">unconditional gift</a>” that “<a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=divine%20gift%20that%20%E2%80%9C-,descends,-%2C%E2%80%9D%20the%20human%20thanksgiving">descends</a>,” while our human thanksgiving “ascends” to God. </p>
<p>Blessings, in this pastoral sense, are events when our human dependence on God’s mercy is expressed as a desire for closeness with God. God, in Catholic belief, responds through the church. “<a href="https://www.vatican.va/content/francesco/en/audiences/2020/documents/papa-francesco_20201202_udienza-generale.html#:%7E:text=It%20is%20God%20who%20blesses">It is God who blesses</a>” in these situations, Francis has written. God’s blessing manifests through priests and ministers.</p>
<p>A <a href="https://b2c-cbp-assets.s3.amazonaws.com/pdfs/9780899425603.pdf">Book of Blessings</a> provides formulas for everything from blessing a new home or a safe voyage to blessings for elderly people and seeds at planting time. Yet often enough in Catholic life, blessing is requested for an object like a rosary or Bible. </p>
<p>When these desires for blessing arise spontaneously, the church’s ministers always accommodate them. The church’s doctrine says blessing is abundant and inexhaustible. “Such blessings are meant for everyone; no one is to be excluded from them,” <a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=Such%20blessings%20are%20meant%20for%20everyone%3B%20no%20one%20is%20to%20be%20excluded%20from%20them">the Dec. 18 declaration says</a>.</p>
<h2>Sidestepping difficult issues</h2>
<p>These meanings of “blessing” are distinct from the blessing in the Rite of the Sacrament of Marriage, which is specific to the “union of a man and a woman, who establish an exclusive and indissoluble covenant.” </p>
<p>Yet, within the scope of that much more broad, pastoral understanding of blessing, Francis has said with this declaration that blessing should not be withheld from LGBTQ+ couples or anyone else.</p>
<p>In this way, the pope has sidestepped the more difficult doctrinal questions while still inviting all couples to present themselves for the blessings they desire. </p>
<p>But the pope has not sidestepped the controversy. In recent decades, the <a href="https://apnews.com/article/anglican-church-lgbtq-issues-4f635708fdb24df166ac8237f9473f00">Anglican Communion</a> and the <a href="https://www.mprnews.org/story/2010/08/27/lutheran-split">Lutheran Church</a> have been roiled by controversy over LGBTQ+ acceptance. More recently, the <a href="https://apnews.com/article/congregations-leaving-united-methodist-church-lgbtq-bans-70b8c89ea49174597f4548c249bab24f">Methodist Church</a> in the United States has split over the issue. </p>
<p>Catholics are divided in a similar way, and this declaration is not likely to cool down divisions. In fact, I believe, those divisions will likely deepen – especially in the United States, where Catholic bishops <a href="https://www.usccb.org/news/2023/statement-usccb-vaticans-document-addressing-pastoral-blessings">have been tepid</a> in their response to the declaration and <a href="https://www.americamagazine.org/faith/2023/11/02/cardinal-christoph-pierre-interview-246416">Francis has not been embraced enthusiastically</a>. </p>
<p>Yet for now, the Roman Catholic Church has made a historic gesture of welcome that invites all people to experience the love of God in a community of believers devoted toward building up a more just and equitable world. “The Church is … the sacrament of God’s infinite love,” <a href="https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2023/12/18/0901/01963.html#en:%7E:text=The%20Church%20is%20thus%20the%20sacrament%20of%20God%E2%80%99s%20infinite%20love">the declaration says</a>. </p>
<p>Pope Francis has been constant in that loving, pastoral emphasis. For as much as the Dec. 18 declaration has changed, it has not changed that.</p><img src="https://counter.theconversation.com/content/220126/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven P. Millies 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>In emphasizing the church’s love for all, including people in LGBTQ+ relationships, the pope has sidestepped thorny doctrinal issues.Steven P. Millies, Professor of Public Theology and Director of The Bernardin Center, Catholic Theological UnionLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2167242023-12-07T21:08:46Z2023-12-07T21:08:46ZWhen ‘rights’ divide: Trans kids need supportive families<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/when-rights-divide-trans-kids-need-supportive-families" width="100%" height="400"></iframe>
<p>Protests in support of “parental rights” have taken place across Canada in recent months. Many taking part in these demonstrations have railed against “gender ideology” in school curricula and <a href="https://canadians.org/analysis/what-you-need-to-know-about-the-parental-rights-protests/#">mixed bathrooms</a>. </p>
<p>Much of this rhetoric is based upon the transphobic fallacy that age-appropriate inclusive health education will somehow manufacture queer and trans children all over the place. </p>
<p>The rights of young people to determine their identities are being stripped away, beginning in <a href="https://theconversation.com/new-brunswicks-lgbtq-safe-schools-debate-makes-false-opponents-of-parents-and-teachers-207600">New Brunswick</a> and <a href="https://theconversation.com/saskatchewan-naming-and-pronoun-policy-the-best-interests-of-children-must-guide-provincial-parental-consent-rules-212431">Saskatchewan</a>. The rights of a trans and non-binary child or youth to be referred to by their name, and to be treated with respect by having their gender affirmed, are being eroded across Canada. </p>
<p>These policies put children and youth at risk, and they reinforce a false opposition between “parents’ rights” and children’s rights. </p>
<h2>Pitting parents against their kids</h2>
<p>Lacking support from family is one of the strongest predictors of trans and non-binary youth <a href="https://transpulsecanada.ca/results/report-health-and-well-being-among-trans-and-non-binary-youth/">attempting suicide</a>. Let that sink in. A trans kid’s family — their support, acceptance, dismissal or rejection — are the most important factor in whether a young person considers ending their life. </p>
<p>More than 10 years ago, researchers had already made strong connections between the support that trans youth received within their families and self-esteem, depression, suicidality, satisfaction with life and long-term overall <a href="http://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf">mental health</a>.</p>
<p>The term “dead name” is used to denote the pre-transition name of a trans or non-binary person. This term exists for a reason, because forcing a child to deny their gender identity can cause their mental health to suffer.</p>
<p>If parents, educators, schools and provincial governments really care about the health and well-being of our youth, we must oppose enacting policies that create a false dichotomy between the “rights” of parents and the rights of children and youth. We must instead help families of trans and non-binary youth to come together instead of be torn apart.</p>
<p>Respondents in <a href="https://doi.org/10.1080/00224499.2014.886321">research focused on minority stress and trans youth</a> reported daily bullying in school and higher levels of sexual and physical assault, with poorer mental and physical health overall compared to non-trans participants.</p>
<p>Data indicates 59 per cent of transgender and non-binary people in Canada <a href="https://doi.org/10.1080/26895269.2023.2278064">have reported being misgendered daily</a>, an experience that can be devastating to a young person <a href="https://transpulsecanada.ca/results/report-health-and-well-being-among-non-binary-people/">coming out into themselves</a>. </p>
<h2>Dangerous silencing</h2>
<p>Silences can be dangerous. I didn’t even hear the word “lesbian” growing up in 1980s, conservative Canadian suburbs. In this shiny, white, middle-class Protestant world, silence about all forms of difference was a constant. But when I moved into the world I realized how our lives were veiled in layers of embedded racism, homophobia and <a href="https://www.jstor.org/stable/3173834">compulsory heterosexuality</a>.</p>
<p>To be clear, the silence and invisibility of lesbians, and even the invisibility of the word “lesbian” did not stop me from becoming a great big, card-carrying queer. </p>
<p>However, hearing the word at the right time might have stopped me from marrying a gay man at 19 and embarking upon a lavender marriage that was doomed from its inception. Silently and unconsciously we did what we “knew” to be the only road we could travel: we bought a house, we had babies, we spun through the tidal force of sanctioned heterosexuality and we still came out the other side flaming like rockets in the night, queers. </p>
<p>The invisibility we experienced and faced only made the road to authentic living and loving, much longer and harder, and it created so much more collateral damage. I tell this story because the way trans and non-binary youth are being repressed and made invisible today reminds me of the abyss of invisibility I faced. </p>
<p>So, when we pit the “rights” of parents against the rights of children and youth to have a safe, accepting and affirming family and school environment, we are assuming that these are in opposition. </p>
<p>Instead, we need to explore these questions through a systems lens. That is, we need to consider the whole: parents, siblings, the trans/non-binary youth, the school system, all of the systems in which the children or youth are swimming. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A person holding another person's hand consolingly" src="https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/563473/original/file-20231204-17-96yucz.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">We must help families of trans and non-binary youth to come together instead of be torn apart.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Overcoming transphobia with family support</h2>
<p>There are situations where parents, teachers or others in a child’s life are irreconcilably transphobic, and this is not going to shift. However, in my extensive experience as a queer, gender non-conforming clinical psychologist, I have seen parents come around and find a way to affirm their child’s gender. </p>
<p>This was achieved through persistence, education and empathy. I had to make space for a parent’s fears, and even space for the transphobic comments and the concerns they produced (while shielding their children from those conversations).</p>
<p><a href="https://theconversation.com/family-support-protects-trans-young-people-but-their-families-need-support-too-202743">The family must continue to show up</a>, trying to find their way to their child. My job was to protect their child from their parents’ fear and transphobia while holding the parents as they tried to find their way. When this hard work by all parties was successful, the well-being of that child or youth was vastly improved and they finally had the support they needed to find their way through a frequently transphobic world. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-parents-can-support-a-child-who-comes-out-as-trans-by-conquering-their-own-fears-following-their-childs-lead-and-tolerating-ambiguity-158275">How parents can support a child who comes out as trans – by conquering their own fears, following their child's lead and tolerating ambiguity</a>
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<p>I have also worked with families who could not overcome their views. A father who simply could not let go of rigid Catholic theological interpretations that cast his child as damaged, a mother who had experienced her own traumas in ways that made it very hard for her to be flexible, leaving her child out in the cold. </p>
<p>I have worked with many, many families over decades and most of the time, they can find their way to accepting and affirming their trans and non-binary child. For the few who can’t, what do we do in those situations? We certainly must not enact <a href="https://www.cbc.ca/news/canada/new-brunswick-trans-lgbtq-higgs-1.6889957">laws and policies</a> to “protect” their “rights.” </p>
<p>Instead, we need find ways to support those young people whose parents deny their existence, experience and identity. So many just need to hear that they exist and learn that they are okay, just as they are.</p>
<p><em>Miles Cooke and Jamie Zarn, research assistants on Heather MacIntosh’s research team at McGill University, also contributed to this article.</em></p><img src="https://counter.theconversation.com/content/216724/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather B MacIntosh receives funding from SSHRC</span></em></p>In the wake of transphobic protests, the ‘rights’ of parents are being falsely positioned in opposition to the rights of transgender and non-binary children rather than focusing on supporting families.Heather B MacIntosh, Associate Professor, Director, MScA Couple and Family Therapy, School of Social Work, McGill UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2149322023-10-24T21:07:06Z2023-10-24T21:07:06ZQueerphobic hate is on the rise, and LGBTQ+ communities in Canada need more support<p>In the past few years, people who identify as LGBTQ+ have been facing increasing harm and discrimination. Canada is not insulated from growing anti-queer and anti-trans sentiment.</p>
<p>The Saskatchewan government recently passed <a href="https://www.cbc.ca/news/canada/saskatchewan/sask-parental-rights-law-1.7002088">a controversial bill</a> that requires students to get their parents’ permission to change their pronouns in school. Critics have called the bill a “humiliation” for the province and experts have warned that it could further endanger at-risk youth.</p>
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Read more:
<a href="https://theconversation.com/saskatchewan-naming-and-pronoun-policy-the-best-interests-of-children-must-guide-provincial-parental-consent-rules-212431">Saskatchewan naming and pronoun policy: The best interests of children must guide provincial parental consent rules</a>
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<p>The bill is part of a wave of reactionary anti-LGBTQ+ sentiment that has been on display in legislatures and on the streets. In September, marches were held <a href="https://globalnews.ca/news/9972437/anti-lgbtq2-rallies-canada-counter-protests/">across the country</a> to <a href="https://theconversation.com/how-the-parental-rights-movement-gave-rise-to-the-1-million-march-4-children-213842">protest inclusive public education</a>.</p>
<p>Drag queen story hours across Canada <a href="https://globalnews.ca/news/9220283/drag-story-time-cafe-protest/">have been targets</a> of <a href="https://www.theglobeandmail.com/canada/article-anti-gay-activists-target-childrens-libraries-and-drag-queen-story/">coordinated attacks</a>, with one in Québec being forced to <a href="https://www.cbc.ca/news/canada/montreal/drag-story-hour-secret-location-1.6799385">move to an undisclosed location</a> because of safety concerns.</p>
<p>In the United States, the number of anti-LGBTQ+ bills introduced in state legislatures <a href="https://www.aclu.org/legislative-attacks-on-lgbtq-rights">has surpassed 500</a>, and the rate of online harassment against LGBTQ+ people <a href="https://www.adl.org/resources/report/online-hate-and-harassment-american-experience-2023">has been increasing</a>.</p>
<p>Discrimination against LGBTQ+ people is also taking place online. Sexual minority Canadians are <a href="https://www150.statcan.gc.ca/n1/pub/85-002-x/2020001/article/00009-eng.htm">twice as likely to experience inappropriate behaviours online</a>, and LGBTQ+ youth in Canada are <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00003-eng.htm">significantly more likely to be cyberbullied</a> than their straight, cisgender counterparts.</p>
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Read more:
<a href="https://theconversation.com/5-things-to-know-about-drag-queen-story-time-206547">5 things to know about Drag Queen Story Time</a>
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<p>We at the <a href="https://odlan.ca/">Ontario Digital Literacy and Access Network (ODLAN)</a> use the term “queerphobic online hate” to refer to all forms of online discrimination and hatred directed at LGBTQ+ people. ODLAN is a volunteer-led non-profit organization with a mission to enhance digital literacy, remove access barriers and support marginalized communities who experience challenges, including digital harms.</p>
<p>Some examples of digital harms include cyberbullying, online harassment and non-consensual image sharing. Queerphobic online hate can also start online and continue in person. For example, an LGBTQ+ gym in Edmonton was <a href="https://www.cbc.ca/news/canada/edmonton/queerflex-lgbtq-gym-edmonton-doxing-1.5460939">forced to close</a> because of doxing. </p>
<h2>Queerphobic online hate</h2>
<p>Our goal at ODLAN is to develop digital strategies that mitigate problems LGBTQ+ communities face online. We recently partnered with <a href="https://www.wisdom2action.org/">Wisdom2Action</a>, a consulting firm that works to facilitate positive change related to gender justice and LGBTQ+ inclusion, to conduct a <a href="https://odlan.ca/research-report-2023/">research project</a> on how LGBTQ+ individuals and organizations in Canada have experienced queerphobic online hate. </p>
<p><a href="https://odlan.ca/wp-content/uploads/2023/08/Mitigating-Online-Hate-ODLAN-Full-Report-Digital.pdf">For this project</a>, we conducted six focus groups with a total of 17 participants, including one focus group for racialized participants; one for trans, non-binary, Two-Spirit, genderqueer, agender, and gender non-confirming people; one for people with disabilities, two for any LGBTQ+ anglophones; and one for any LGBTQ+ francophones.</p>
<p>Our research found that LGBTQ+ people and organizations experience queerphobic online hate in many ways. This hate can happen <a href="https://glaad.org/smsi/lgbtq-social-media-safety-program/">on social media</a>, including in the form of public comments or private messages. Participants also reported receiving anti-LGBTQ+ comments in emails directed at them or their organization. Queerphobic online hate was expressed through text, images, videos and emojis, and many spoke about being victims of trolling and anti-trans rhetoric. </p>
<p>Queerphobic online hate can be perpetuated through virtual events. One participant said their organization frequently saw high levels of hateful activity during publicly live-streamed webinars.</p>
<p>Unfortunately, queerphobic online hate can sometimes come from LGBTQ+ people. Our research found that cisgender, gay, white men, including those from older generations, may speak out against trans, queer and non-binary people. Aphobia (<a href="https://www.asexuals.net/aphobia/">prejudice against asexual and aromantic people</a>) was identified as another form of <a href="https://doi.org/10.1080/00918369.2021.2020543">lateral hate</a> (when members of a marginalized group perpetuate harm against members of their own group). Other participants stated that transphobia is not uncommon in LGBTQ+ spaces and that <a href="https://www.cbc.ca/news/canada/saskatoon/people-of-colour-say-racism-exclusion-fetishization-rampant-in-lgbtq-communities-1.6471430">those spaces are often unwelcoming to racialized people</a>. </p>
<h2>Misinformation and disinformation</h2>
<p>The roots of misinformation and disinformation about LGBTQ+ communities are diverse and rooted in <a href="https://juliaserano.medium.com/all-the-evidence-against-transgender-social-contagion-f82fbda9c5d4">pseudo-science</a> and <a href="https://static1.squarespace.com/static/5c40e14112b13fb574c1214b/t/62cc7d667829b27c76818f6b/1657568631861/Mapping%2Bthe%2BLandscape%2Bof%2BFaith-Based%2BHeterosexism%2Band%2BTransphobia_2021.pdf">religion</a>. While this is not new, today’s digital world means that anti-LGBTQ+ beliefs can easily be spread far and wide online.</p>
<p>Sometimes, information is misinterpreted and misappropriated to justify anti-LGBTQ+ hate. Misinformation like this may not be shared intentionally, but it still causes harm. Disinformation about LGBTQ+ people, such as them <a href="https://www.npr.org/2022/05/11/1096623939/accusations-grooming-political-attack-homophobic-origins">being “groomers,”</a> is both intentional and harmful, having severe real-world impacts. </p>
<p>As trans people have gained visibility, the trans identity has been framed as a <a href="https://www.technologyreview.com/2022/08/18/1057135/transgender-contagion-gender-dysphoria/">contagion that is rapidly spreading, particularly among young people</a>. Information about rates of de-transition (when someone in the process of transitioning stops or returns to their gender assigned at birth) is often <a href="https://juliaserano.medium.com/spotting-anti-trans-media-bias-on-detransition-a9a782a46894">misinterpreted, taken out of context and posted to social media</a>. Disinformation like this aims to discredit trans people and justify discrimination against them.</p>
<h2>Discriminatory and conspiratorial beliefs</h2>
<p>Our research found that anti-LGBTQ+ ideologies were often combined with other bigoted and discriminatory beliefs and <a href="https://www.the-independent.com/news/world/americas/us-politics/transgender-far-right-qanon-violence-b2108235.html">far-right politics</a>. One racialized participant reported that they had seen anti-immigration sentiment tied to claims that queer and trans people were immigrating to Canada.</p>
<p>Queerphobic online hate has been justified by pseudo-scientific beliefs or arguments about <a href="https://www.adl.org/resources/blog/what-grooming-truth-behind-dangerous-bigoted-lie-targeting-lgbtq-community">protecting children from perceived threats</a>. With an apparently <a href="https://www.cbc.ca/news/world/parental-rights-movement-us-canada-1.6796070">growing parental rights movement</a> and <a href="https://egale.ca/wp-content/uploads/2023/05/Egale_Pride_Unravelled_Government_Package_May23.pdf">escalating anti-LGBTQ+ hate in Canada</a>, more research on queerphobic online hate is urgently needed. LGBTQ+ organizations, staff and volunteers also need solidarity and support. </p>
<p>We recommend creating and providing targeted resources that help people deal with queerphobic online hate and develop digital literacy skills. This should be done at multiple levels, including the local level with community organizations, as well as the provincial and federal level with government agencies. It also means filling existing deficits among LGBTQ+ organizations by improving resources, offering mutual aid and sharing resources. </p>
<p>Queerphobic online hate must also be countered with systemic solutions like enhancing the resources and services available to LGBTQ+ organizations, including better and more accessible mental health support. We at ODLAN are invested in these goals by, for example, developing and launching training modules to help organizations develop strategies to address queerphobic online hate and protect themselves from such harms.</p>
<p>Until we have a society that is inclusive and safe for all LGBTQ+ people, individuals and organizations need to keep fighting against queerphobic online hate across Canada.</p><img src="https://counter.theconversation.com/content/214932/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher Dietzel receives funding from the Fonds de Recherche du Québec - Société et Culture (FRQSC) and serves as the Community Research Advisor for the Ontario Digital Literacy and Access Network (ODLAN).</span></em></p><p class="fine-print"><em><span>Hannah Maitland is the co-founder of the Ontario Digital Literacy and Access Network (ODLAN) which authored the report that forms the basis of this article. This report was funded by the Digital Citizen Contribution Program of the Department of Canadian Heritage. </span></em></p><p class="fine-print"><em><span>Stephanie Jonsson is the co-founder and Executive Director of the Ontario Digital Literacy and Access Network (ODLAN) which authored the report, that forms the basis of this article. This report was funded by the Digital Citizen Contribution Program of the Department of Canadian Heritage.</span></em></p>LGBTQ+ people face significant harms from online hate.Christopher Dietzel, Postdoctoral fellow, Gender and Sexuality, McGill UniversityHannah Maitland, PhD Candidate in the Department of Gender, Feminist, and Women's Studies, York University, CanadaStephanie Jonsson, PhD candidate, Gender, Feminist and Women's Studies, York University, CanadaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2146902023-10-23T12:25:17Z2023-10-23T12:25:17ZBiological sex is far from binary − this college course examines the science of sex diversity in people, fungi and across the animal kingdom<figure><img src="https://images.theconversation.com/files/554094/original/file-20231016-21-1wrv5k.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2169%2C1382&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Biological sex comes in many more forms than just male or female.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/watercolour-illustration-of-male-and-female-symbols-royalty-free-image/1209433697">Yifei Fang/Moment via Getty Images</a></span></figcaption></figure><figure class="align-right ">
<img alt="Text saying: Uncommon Courses, from The Conversation" src="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/topics/uncommon-courses-130908">Uncommon Courses</a> is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.</em> </p>
<h2>Title of course:</h2>
<p>Diversity of Biological Sex Characteristics</p>
<h2>What prompted the idea for the course?</h2>
<p>Most people view biological sex, or the physical features related to reproduction, as <a href="https://www.pewresearch.org/social-trends/2022/06/28/americans-complex-views-on-gender-identity-and-transgender-issues/">simple and binary</a> – either male or female. Even those who recognize that gender – referring to cultural norms around biological sex, or a person’s internal feeling of being masculine, feminine or both – can be complex and nuanced don’t see biological sex in the same way. Many also regard variability in sex and gender as exclusive to people – not found in nonhuman animals.</p>
<p>I am a <a href="https://scholar.google.com/citations?user=OaEmJXAAAAAJ&hl=en">behavioral neurobiologist</a> who has been teaching human physiology since 1998. Over the past several years, I have <a href="https://theconversation.com/brain-scientists-havent-been-able-to-find-major-differences-between-womens-and-mens-brains-despite-over-a-century-of-searching-143516">focused my reading and writing</a> <a href="https://www.psychologytoday.com/us/blog/governing-behavior">on the biology of sex</a>. It struck me that many of my students had misguided assumptions about sex characteristics, including that all people are physically either 100% male or 100% female. </p>
<p>A <a href="https://ari.oucreate.com/4873-5873_syllabus.pdf">course on biological sexual diversity</a> in both nonhuman animals and people could challenge these assumptions.</p>
<h2>What does the course explore?</h2>
<p>First, we examine <a href="https://doi.org/10.1002/dvg.1020150303">why sexual reproduction evolved</a> in any species. This question is <a href="https://theconversation.com/why-did-sex-evolve-researchers-edge-closer-to-solving-longstanding-mystery-55407">still hotly debated among biologists</a> because sex is inefficient. It requires time and energy to find a suitable mate and unite your sex cells, plus it allows you to pass on only half your genes to your offspring.</p>
<p>In comparison, <a href="https://openstax.org/books/biology-2e/pages/32-3-asexual-reproduction">asexual reproduction</a> – essentially cloning yourself – is much more efficient. You don’t have to find a mate, and everyone can produce offspring themselves because there are no males. In biology, “male” refers to an individual that makes small sex cells like sperm, and “female” refers to an individual that makes large sex cells like eggs.</p>
<p>Next, we explore <a href="https://www.ucpress.edu/book/9780520280458/evolutions-rainbow">nonhuman sexual diversity</a>, including fungi that have <a href="https://doi.org/10.1016/j.fbr.2015.08.002">thousands of sexes</a> and aphids that <a href="https://doi.org/10.1016/S0169-5347(01)02331-X">reproduce asexually most of the year</a> but sexually once each fall. Among many others, we also learn about fish that are male or female at <a href="https://doi.org/10.1016/B978-0-12-800049-6.00160-8">different times of their lives</a>; <a href="https://doi.org/10.1016/j.isci.2020.101652">intersex crayfish</a>; and <a href="https://doi.org/10.1016/j.yhbeh.2005.07.013">female spotted hyenas</a> that have a penis.</p>
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<figcaption><span class="caption">Sex characteristics manifest in different ways across the animal kingdom.</span></figcaption>
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<p>We then transition from nonhuman animals to people, via the brain. We learn about <a href="https://doi.org/10.1177/1073858419867298">a few small</a> <a href="https://doi.org/10.1007/s00359-019-01376-8">brain structures in vertebrates</a> that likely have reproductive functions and are differently sized in females versus males on average. We also learn that most people have some brain structures that are more typically male, others that are more typically female and still others that are intermediate – in other words, <a href="https://doi.org/10.1073/pnas.1509654112">most people are mosaics</a> of female-typical and male-typical brain sex characteristics.</p>
<p>Finally, we focus on the biological sex characteristics of <a href="https://doi.org/10.1038/518288a">intersex people</a>. The <a href="https://doi.org/10.1038/nrendo.2014.130">chromosomes and reproductive organs</a> of intersex people have <a href="https://www.ted.com/talks/emily_quinn_the_way_we_think_about_biological_sex_is_wrong#t-781094">some typically female and some typically male characteristics</a> or are intermediate between them.</p>
<p>Students then build on their knowledge of the diversity of biological sex characteristics to discuss whether intersex infants should have <a href="https://aeon.co/essays/people-born-intersex-have-a-right-to-genital-integrity">surgery to “correct” their genitals</a>, as well as <a href="https://www.nytimes.com/2016/07/03/magazine/the-humiliating-practice-of-sex-testing-female-athletes.html">who should be allowed</a> <a href="https://doi.org/10.1080/15265161.2012.680533">to compete in</a> <a href="https://theconversation.com/striking-a-balance-between-fairness-in-competition-and-the-rights-of-transgender-athletes-159685">girls and women’s athletics</a>.</p>
<h2>Why is this course relevant now?</h2>
<p>Perhaps more than ever, there is a debate about how to treat people who do not fit neatly into a female or a male box. Many assume that biological sex is binary and regard transgender and nonbinary people as mistaken or confused. In addition, for many decades, <a href="https://theconversation.com/gender-affirming-care-has-a-long-history-in-the-us-and-not-just-for-transgender-people-201752">intersex infants</a> have undergone surgical procedures to make them appear more typically male or female. Even those who support transgender, nonbinary and intersex people often assume that biological sex is binary. But this assumption is not anchored in evidence.</p>
<h2>What will the course prepare students to do?</h2>
<p>Students often say that before they took this course, they had no idea biological sex characteristics could be so diverse, despite having taken several biology courses. </p>
<p>An improved awareness of the complexity of biological sex may help shape the research and teaching of future biologists. This will help them design experiments that take account of the diversity of their subjects and be more <a href="https://theconversation.com/trans-students-benefit-from-gender-inclusive-classrooms-research-shows-and-so-do-the-other-students-and-science-itself-204777">inclusive in their teaching</a>. It may also help all students ask better questions and make better judgments about social and political issues related to sex and gender.</p><img src="https://counter.theconversation.com/content/214690/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ari Berkowitz receives funding from the Oklahoma Center for the Advancement of Science and Technology and has received funding from the National Science Foundation and the National Institutes of Health.</span></em></p>Spanning evolutionary biology, genetics, development, neurobiology, endocrinology and psychology, as well as current events and sports, students explore the complexities of the biology of sex.Ari Berkowitz, Presidential Professor and Director of Graduate Studies, Biology; Director, Cellular & Behavioral Neurobiology Graduate Program, University of OklahomaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2149342023-10-10T21:30:23Z2023-10-10T21:30:23ZAnti-trans protests: The Conservative party could use ideological polarization to win voters<p>The polarizing debates in Canada over issues of gender and sexuality recently led to heated demonstrations and counter-demonstrations in cities across the country. </p>
<p>The <a href="https://millionmarch4children.squarespace.com/educational-material">One Million March 4 Children</a> coalition that was behind the protests has its sights aimed at a range of issues related to sexual education in schools, <a href="https://link.springer.com/referenceworkentry/10.1007/978-94-007-0753-5_1137">including the teaching of gender theory</a>. The coalition <a href="https://millionmarch4children.squarespace.com/supporters">includes truckers’ organizations and members of the radical right as well as religious organizations</a>. </p>
<p>Since the demonstrations were mainly driven by different conservative movements, it was not surprising to note the presence of <a href="https://theconversation.com/from-america-to-ontario-the-political-impact-of-the-christian-right-107400">Christian groups</a> at the rallies. But the strong presence of immigrant communities, particularly Muslims, came as a surprise to many. During that week, both a Muslim association and a conservative nationalist Québec columnist, <a href="https://www.wsws.org/en/articles/2023/09/03/nvld-s03.html">Mathieu Bock-Côté</a>, each from opposite ideological spectrums, denounced <a href="https://nationalpost.com/opinion/with-omar-alghabras-departure-trudeaus-losing-his-point-man-in-the-muslim-community">Prime Minister Justin Trudeau’s call for a tolerant attitude</a> in almost identical terms. </p>
<p>Libertarian fiscal policies and highly conservative social policies have wind in their sails at the moment, and there’s no reason why they shouldn’t appeal to religious groups among different minority groups in Canada. </p>
<p>While Maxime Bernier’s People’s Party of Canada (PPC) has made gender issues its hobbyhorse, Pierre Poilievre’s Conservative Party of Canada (CPC) has been more cautious about jumping into the fray and has asked his MPs to exercise restraint. Yet his party could benefit from the polarization that the gender question is creating. Three elements seem to point in this direction. </p>
<p>Firstly, the CPC largely holds the evangelical Christian vote on moral values and could bolster the mobilization of this part of its base. Secondly, unlike many European populist right-wing parties, when it comes to anti-immigration rhetoric the CPC doesn’t have much room to manoeuvre. A party that wants to win federal elections in Canada cannot alienate immigrant communities. And finally, the search for a fault line within immigrant communities along the conservative/liberal axis over the question of sexuality and gender may alter the balance of political forces in the long term. Gender issues could be that fault line.</p>
<p>Respectively a professor of sociology at the Université du Québec à Montréal and a doctoral student in political science at Université de Montréal, our research focuses on nationalism, populism and political conflicts in Québec and Canada. </p>
<h2>The politicization of trans issues by the conservative right</h2>
<p>While there is nothing new about the religious right politicizing issues around sexuality, debates on gender and the inclusion of trans people have recently taken on greater importance. </p>
<p>The American right has been making these issues part of its general critique of liberalism for years. <a href="https://www.hilltimes.com/story/2023/07/17/how-the-political-right-are-contesting-pride-month-in-canada/392313/">The appropriation of these issues in Canada is more recent</a>. Bernier’s PPC has made opposing “gender ideology” an important part of its program. </p>
<p>More recently, bills proposed by the Conservative governments of New Brunswick and <a href="https://theconversation.com/saskatchewan-naming-and-pronoun-policy-the-best-interests-of-children-must-guide-provincial-parental-consent-rules-212431">Saskatchewan</a>, which would require school principals to notify parents of a child’s request to change their first name or pronouns, <a href="https://www.theglobeandmail.com/opinion/article-parents-should-be-defending-childrens-rights-rather-than-rushing-to/">have also sparked heated debates</a>. These debates pit “parental rights” against the rights of trans children to live in safety. In Québec, the use of gender-neutral first names and the <a href="https://montrealgazette.com/news/blainville-rejects-gender-neutral-washrooms-in-schools">question of gender-neutral washrooms</a> have been added to the list of issues fuelling this polarization.</p>
<h2>The conservative values of cultural minorities: a road to victory?</h2>
<p>CPC results in the last three elections fell short of its expectations. However, slipping support for the Liberals, inflation, and the issue of home ownership being out of reach have all helped the CPC make inroads among young voters, particularly young men. </p>
<p>In the last election, the CPC’s challenge was to reconcile the social conservatism of its base with a platform that would be acceptable to centrist voters. Andrew Scheer and Erin O'Toole stumbled over this problem. </p>
<p>Stephen Harper’s Conservative majority in 2011 owed its success to wins in ridings with a high proportion of immigrants in the Toronto area, notably in Mississauga, Brampton, Richmond Hill and Vaughan. While these ridings were not part of <a href="https://policyoptions.irpp.org/magazines/the-winner/the-emerging-conservative-coalition/">Harper’s initial strategy</a>, the difficulty of rallying Québec nationalists forced him to change tack, so Harper turned his attention to the cultural minorities in Toronto’s suburbs. In addition to conservative values, these communities shared the Conservatives’ attachment to religion and to business friendly free-market policies. Harper also introduced <a href="https://www.cbc.ca/news/politics/income-splitting-what-it-is-and-who-benefits-1.2818396">tax measures that favoured a traditional model of the family, often a patriarchal family structure</a>, which values the work of a single parent and where one spouse has a much higher income than the other. </p>
<p>Currently ahead in the polls, the CPC could make gains at the expense of the Liberals in Markham, Vaughan, Richmond Hill, Whitby and Pickering-Uxbridge, in some Toronto ridings, in Oakville and as far as the Hamilton suburbs. The CPC could also regain ridings in Greater Vancouver that it lost to the Liberals in the last election. </p>
<h2>PCC’s likely strategy</h2>
<p>Poilievre probably sees the politicization of gender and sexuality issues as an opportunity to bolster support for the CPC in the run-up to the next election. To achieve this, it is unlikely that he will follow the example of the People’s Party, which promised to limit the rights of transgender children, and choose not to interfere in provincial jurisdictions. </p>
<p>The CPC will probably stick to using dog whistles to call out “wokeism” and to support provincial governments and religious communities that denounce sex education programs. </p>
<p>That is exactly what Poilievre did at a gathering of Toronto’s Pakistani community in August. In a <a href="https://www.cbc.ca/news/politics/poilievre-lgbtq-pronouns-schools-1.6950029">speech delivered as part of Pakistan’s Independence Day celebrations</a>, he defended religious freedom as well as the right of parents to “pass on their traditional teachings to their children,” and to “bring them up with their own values.” Earlier in the summer, he <a href="https://www.cbc.ca/news/politics/poilievre-new-brunswick-lgbtq-students-1.6889770">opposed federal government interference in New Brunswick’s policy requiring parental consent for LGBTQ students wishing to change their name or pronouns</a>. </p>
<p>The CPC could benefit from public <a href="https://angusreid.org/canada-culture-wars-gender-and-trans-issues/">support</a> on these issues. Although practices related to gender transitions <a href="https://www.cbc.ca/news/health/gender-affirming-care-canada-1.6967503">are rare in Canada</a>, they do spark the ire of conservative circles. </p>
<p>Other conservative positions, such as <a href="https://nationalpost.com/news/local-news/poilievre-blames-wave-of-violence-in-alberta-on-prime-minister-justin-trudeau-and-ndp/wcm/d6805980-8a25-43ba-93be-fe44bd2d5b89">criticizing drug decriminalization in British Columbia and Liberal “wokeism” in response to crime</a>, could also strike a chord with religious voters. So a strategy based on fiscal conservatism, law and order, the traditional family and conservative sexual values could be very advantageous for the CPC in many ridings. </p>
<h2>What dilemmas for the opposition parties?</h2>
<p>The CCP’s strategy also calls into question those of the Liberal Party and the NDP. As defenders of ethnic communities and religious, sexual and gender minorities, but also as critics of Québec’s Bill 21 on secularism, these parties have been nurturing voters at opposite sides of this ideological polarization. </p>
<p>This development was predictable. The significant presence of certain cultural communities in anti-LGBTQ+ mobilizations shatters the simplistic idea promoted by the identitarian left that “diversity,” because it is often in a minority position, is necessarily liberal and progressive. </p>
<p>Immigrant communities are heterogeneous and their views on <a href="https://angusreid.org/canada-religion-interfaith-holy-week/">issues of freedom of conscience and expression</a> vary widely. But their community institutions, which are sometimes religious and patriarchal, don’t always fit with the Liberal and NDP orientation towards citizenship and sexual diversity.</p>
<p>Reactions from Québec’s nationalist milieu have been equivocal on these issues. On the one hand, the Bloc Québécois (BQ) says it <a href="https://www.cbc.ca/news/politics/canada-federal-election-lgbtq-1.5306119">supports LGBTQ rights</a> and will continue to do so, but on the other says it is <a href="https://www.ledevoir.com/societe/798447/opposants-defenseurs-droits-personnes-lgbtq-affrontent-rues-pays">incapable of taking a position at the moment and wants to listen to both sides of the divide</a>. The issue is also far from consensual among its provincial nationalist allies. Both the governing Coalition Avenir Québec (CAQ) and the Parti Québécois (PQ) <a href="https://montrealgazette.com/news/blainville-rejects-gender-neutral-washrooms-in-schools">raised concerns</a> around gender theory in schools. The PQ leader, Paul St-Pierre Plamondon, went as far as speaking of a risk of seeing the “radical left” impose gender ideology on children. By refusing to take a clear position, the Bloc Québécois missed an opportunity to take a stand in favour of the rights of sexual minorities over those of outraged parents. By defending the right of provinces to use the notwithstanding clause, it chose to defend provincial autonomy over a defence of Quebec’s National Assembly’s stances on academic freedom and secularism. From the point of view of its constitutional strategy the BQ’s strategy is coherent, but it opens the way to criticisms that its defence of LGBTQ rights and secularism is asymmetrical. </p>
<p>The CPC could, however, be faced with the possibility of a province using the notwithstanding clause to pass legislation protecting “parental rights,” <a href="https://www.cbc.ca/news/canada/saskatchewan/moe-parental-rights-christian-pronoun-1.6961432">a use recently confirmed by Premier Scott Moe in Saskatchewan</a>. It would be tricky for Poilievre to, on one hand, defend conservative provinces using the notwithstanding clause, and on the other, oppose Québec using the clause to defend its laws on secularism and the French language. Both the BQ and the CPC could therefore face catch-22 decision-making situations. </p>
<p>So a window could be opening up for Poilievre and the CPC. Wear and tear on Liberal power along with repeated Liberal blunders and economic challenges are all contributing to this. That said, the growing support of young people from different social and political trajectories for conservatism is part of a series of broader social and demographic changes that could shake up the political landscape for years to come.</p><img src="https://counter.theconversation.com/content/214934/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Les auteurs ne travaillent pas, ne conseillent pas, ne possèdent pas de parts, ne reçoivent pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'ont déclaré aucune autre affiliation que leur organisme de recherche.</span></em></p>Pierre Poilievre’s Conservative party could make gains by rallying the libertarian right, evangelical Christians and immigrant communities, especially Muslims, on issues of sexuality.Frédérick Guillaume Dufour, Professeur en sociologie politique, Université du Québec à Montréal (UQAM)François Tanguay, Doctorant en science politique, Université de MontréalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2091632023-10-03T11:25:52Z2023-10-03T11:25:52ZThe burials that could challenge historians’ ideas about Anglo-Saxon gender<figure><img src="https://images.theconversation.com/files/540153/original/file-20230731-29-viqvo1.jpg?ixlib=rb-1.1.0&rect=27%2C27%2C4573%2C2559&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Saxon burial mound in Taplow, England.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/saxon-burial-mound-taplow-england-1778768042">mbarredo/Shutterstock</a></span></figcaption></figure><p>There are a significant number of <a href="https://www.cambridge.org/core/journals/antiquity/article/viking-warrior-women-reassessing-birka-chamber-grave-bj581/7CC691F69FAE51DDE905D27E049FADCD">Anglo-Saxon burials</a> where the estimated anatomical sex of the skeleton does not align with the gender implied by the items they were buried with. Some bodies identified as male have been buried with feminine clothing, and some bodies identified as female have been found in the sorts of “warrior graves” typically associated with men. </p>
<p>In the <a href="https://www.barpublishing.com/the-spindle-and-the-spear-a-critical-enquiry-into-the-construction-and-meaning-of-gender-in-the-early-anglo-saxon-burial-rite.html">archaeology of early Anglo-Saxon England</a>, weaponry, horse-riding equipment and tools are thought to signal masculinity, while jewellery, sewing equipment and beads signal femininity. And, for the most part, this pattern fits. </p>
<p>So far though, no convincing explanation has been put forward for the burials which appear to invert the pattern. My PhD research asks whether looking at these atypically gendered burials through the lens of trans theory and the 21st-century language of “transness” has the <a href="https://www.jstor.org/stable/27111445">potential to improve historians’ understanding</a> of early Anglo-Saxon gender.</p>
<p>Atypically gendered burials <a href="https://www.cambridge.org/core/books/trans-and-genderqueer-subjects-in-medieval-hagiography/E094ABC7CD4B64802F4AC1E54588705E">are generally excluded as “outliers”</a> in excavation reports and subsequent research. This relies on the anachronistic idea that historical societies followed a system of sex, gender and sexuality aligning with 19th-century western standards.</p>
<p>This idea is so common that <a href="https://bradscholars.brad.ac.uk/handle/10454/9906">many people believe</a> these three aspects of humanity have remained unchanged throughout history. But such an approach may mean that there are aspects of how gender was understood in early Anglo-Saxon England (circa AD450 to 750) that are going unrecognised today. </p>
<p>Using <a href="https://www.jstor.org/stable/43967044">approaches from trans studies</a> – which acknowledge the potential for genders beyond a male-female binary in historical cultures – allows researchers to approach these burials more critically. It also brings these graves – and the lives of the people buried in them – into meaningful historical research, rather than leaving them to be discarded from studies as outliers. </p>
<figure class="align-center ">
<img alt="An ornate golden belt buckle" src="https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/535813/original/file-20230705-7861-ajdex1.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">
<figcaption>
<span class="caption">The golden belt buckle discovered in the Sutton Hoo burial hoard.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Sutton_Hoo_(3).JPG">Jononmac46/Wiki Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Eleven burials from the fifth to eighth century found in the <a href="https://archaeologydataservice.ac.uk/library/browse/issue.xhtml?recordId=1087779">pre-Christian cemetery of Buckland, Dover</a> were designated as “discrepancies” in their cemetery excavation reports. This was due to a perceived misalignment in the sex of the skeleton and the gender associations of the items they were buried with. </p>
<p>This makes them a good place to begin exploring an interpretation of these burials through the lens of transness, as a possible explanation for this “discrepancy”. A closer look at two of these burials, “Grave 30” and “Grave 93”, offers insight into the complexities of gender in this period.</p>
<h2>Inside Grave 30</h2>
<p>The <a href="https://archaeologydataservice.ac.uk/library/browse/issue.xhtml?recordId=1087779">occupant of “Grave 30”</a> was between 35 and 40 years old, buried around AD600, and was designated “definitely male” in the excavation report, based on their skeletal features. </p>
<p>At a depth of 0.61 metres, Grave 30 is especially deep for this period. This suggests they were a person of high status, as the energy expended digging a person’s grave reflects the regard in which they were held by their community. </p>
<p>This is further suggested by the person having suffered from five cavities – the result of a high-sugar diet. The absence of enamel hypoplasia (horizontal lines which appear on the teeth during periods of malnutrition) also demonstrates that their access to food was reliable. </p>
<p>In the grave was a bone comb, a silver-gilt brooch, a silver pin, 84 beads, a silver pendant, a buckle, a knife and a set of iron keys – a rich collection which emphasises their high status.</p>
<p>All of these items are associated with femininity and are anticipated finds in cisgender female graves (burials where a female skeleton is accompanied by artefacts considered feminine). The brooch and pin, for example, were both parts of seventh century feminine clothing. </p>
<p>We will never know exactly who this person was, or how they fit into their community. But taking a trans studies approach to the burial evidence, I can theorise that this could be interpreted as the grave of a wealthy trans woman, who wore fine silver jewellery, ate as well as any of her contemporaries and on her buckled belt proudly bore the large iron keys of the home she managed.</p>
<h2>Inside Grave 93</h2>
<p>The person in “Grave 93” was also estimated to have died aged between 35 and 40. They were designated “possibly female” in the excavation report, poor preservation not allowing for complete certainty.</p>
<p>Grave 93 is not as deep a grave as 30, but is still large. There is evidence of tooth cavities known as “occlusal fissures”, often caused or exacerbated by feminising hormones, particularly during pregnancy. This evidence supports the
designation of the skeleton as female, but doesn’t preclude transness as an explanation for this burial in the light of the accompanying artefacts. </p>
<p>This person was buried alongside a sword, a spearhead, fragments of a decorated shield, one glass bead (likely attached to the sword), an iron rod, a bronze band, iron fragments of a buckle and a bronze ring.</p>
<p>The sword makes this one of only 17 graves excavated in the cemetery to contain such a high-status weapon. The combination of weapons is the archetypal assemblage of an Anglo-Saxon “<a href="https://www.jstor.org/stable/650808">warrior grave</a>”. </p>
<p>Again, we will never be able to know for sure who this person was in life. Such a burial does not necessarily signify that the person was a warrior. However, it does indicate that they were of high status and operated in a masculine sphere. </p>
<p>A trans studies reading of the burial evidence suggests this could be interpreted as the grave of a trans man who enjoyed a position of respect in his community, displaying his wealth, masculinity – and perhaps warrior status – through his shield, sword and spear. </p>
<p>There are other possible explanations for these burials. Perhaps the weapons in Grave 93 were family heirlooms, buried with a woman who was the last of that family line, or were the possessions of a “warrior woman” along the lines of Lagertha in the TV series Vikings. </p>
<p>As there are so many variable factors and we can’t speak with the people in these burials, any historical theory on gender in this period can only ever be speculative. A trans-exclusionary interpretation of the burial evidence is no less selective – it operates through as modern a lens as a trans-inclusive interpretation and requires just as many assumptions. </p>
<p>While trans-inclusive approaches can’t offer a definite explanation for burials which sit outside of a traditional understanding of Anglo-Saxon gender, the insights they offer are equally evidence-based. Bringing these “anomalous” burials out of the footnotes and into mainstream scholarship offers new perspectives into the earliest iteration of the English-speaking world.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?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">
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<p><em>Looking for something good? Cut through the noise with a carefully curated selection of the latest releases, live events and exhibitions, straight to your inbox every fortnight, on Fridays. <a href="https://theconversation.com/uk/newsletters/something-good-156">Sign up here</a>.</em></p>
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<p class="fine-print"><em><span>James Davison 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>Skeletons found with items that don’t align with their estimated sex are usually excluded from research – but that assumes a 19th century view of gender.James Davison, PhD Candidate in Medieval History, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2127752023-09-28T19:59:36Z2023-09-28T19:59:36ZFriday essay: ‘I hope eventually to become a woman’ – trans life in Australia from the 1940s to 1970s<figure><img src="https://images.theconversation.com/files/547985/original/file-20230913-29-fzq1ow.png?ixlib=rb-1.1.0&rect=5%2C11%2C3982%2C1976&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Trove</span></span></figcaption></figure><p><em>Readers are advised that this essay contains historical terms which are now generally considered outdated and offensive.</em></p>
<p>In December 1952, former American GI Christine Jorgensen made global news after undergoing gender affirmation surgery in Copenhagen. Australian newspapers showed great interest, with headlines like “Man Converted to Woman by Danish Doctors”, “Man Becomes Woman and ‘She Is Glad’”, and “‘Converted’ Girl Hopes to Marry”. </p>
<p>Jorgensen’s story even had an Australian angle: she intended to tour the country in late 1954 and appear in a series of fashion parades featuring Australian swimsuits, summer frocks and gowns. She also planned a cabaret-like performance at Sydney’s Palladium Theatre and in Melbourne. </p>
<p>Local models protested, with one modelling agent saying, </p>
<blockquote>
<p>A fashion parade featuring Miss Jorgensen would reek of the sort of sensationalism that’s popular in America, but isn’t suitable in Australia. For local girls to parade with him – I mean her – would lower our professional dignity. </p>
</blockquote>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=757&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=757&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=757&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=952&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=952&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547971/original/file-20230913-29-1hkx7e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=952&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Christine Jorgensen in 1954.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Christine_Jorgensen">Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The manager of the Palladium cancelled Jorgensen’s show and she called off her tour – though she did eventually visit Australia in 1961.</p>
<p>The media presented Jorgensen’s gender affirmation as a marvel of modern medicine and the embodiment of white, middle-class femininity. Jorgensen put a face and a name to emerging medical discourse about “transsexualism”, which American endocrinologist and sexologist Dr Harry Benjamin <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9780203955055-6/transsexualism-transvestism-psycho-somatic-somato-psychic-syndromes-harry-benjamin?context=ubx&refId=c366fede-0331-41f2-951b-a4669a4b8676">distinguished from “transvestism” in 1954</a>: </p>
<blockquote>
<p>It [transsexualism] denotes the intense and often obsessive desire to change the entire sexual status including the anatomical structure. While the male transvestite, enacts the role of a woman, the transsexualist wants to be one and function as one, wishing to assume as many of her characteristics as possible, physical, mental and sexual.</p>
</blockquote>
<p>Jorgensen’s gender affirmation also presented Australians who were questioning their gender with new possibilities. Her endocrinologist received letters from 465 people around the world inquiring about the possibility of a “change of sex”. Thirteen such letters came from Australia: nine from assigned male at birth (AMAB) people and four from assigned female at birth (AFAB) people (there were also eight letters from Aotearoa New Zealand). </p>
<p>The changing language and possibilities as embodied in Christine Jorgensen are but one example of evolving understandings and lived experiences of trans people in the postwar period. </p>
<p>The rise of medical discourse about “transsexualism” and surgical options in Melbourne and Sydney offered new explanations and opportunities, particularly for those trans people who adhered to stereotypical ideas of white, middle-class respectability. The postwar era also saw the consolidation of camp cultures in the capital cities, bringing together a variety of sexually diverse and gender-diverse people. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/witch-hunts-and-surveillance-the-hidden-lives-of-queer-people-in-the-military-76156">Witch-hunts and surveillance: the hidden lives of queer people in the military</a>
</strong>
</em>
</p>
<hr>
<h2>World War II and its aftermath</h2>
<p>Within World War II armed forces, there were surprising gender-crossing opportunities and trans possibilities. Drag performances were common as a form of entertainment, and were socially acceptable contexts in which AMAB people – be they gay or trans – could <a href="https://acuresearchbank.acu.edu.au/download/20b2aea6d26d10b7d444d74269e4cbeea499a2759b9646674a4f10de5ae154ac/27611576/Riseman_2018_Serving_in_silence_Australian_LGBTI_military.pdf">experiment with gender expression</a>. There is also more concrete evidence of trans service members in accounts published after the war. </p>
<p>The Chameleon Society of Western Australia published a newsletter that told the tale of a member who served in the Australian Army and was seconded to a British regiment on the Rhine:</p>
<blockquote>
<p>Well one day during a routine inspection, the RSM [regimental sergeant major] was going through the members kits and came across a whole heap of ladies apparel. The RSM grunted and said “You are Australian aren’t you?”, “Yes Sir” said our member. The RSM grunted and moved on leaving our member wondering what in the hell was going to happen. Well what did happen was rather remarkable. A few days later the RSM came across our member and pressed a card into his hand and said “I can recommend this club.” On it was a[n] address of a cross-dressing club in Hamburg.</p>
</blockquote>
<p>During and after the war, a few new patterns emerged in media reports that shed light on trends around trans people. Coverage still primarily focused on cases with a salacious element, but one change was that more stories presented perspectives from the dressers themselves. </p>
<p>One such example was Patrick John Cowther, arrested in Melbourne in 1944 dressed in women’s clothes, a pearl necklace and a gold bangle and wearing lipstick, rouge, powder and eyeliner. Cowther admitted to wearing a pink nightdress to bed and, when their family was not around, dressing as a woman at home. They reportedly said to the police: </p>
<blockquote>
<p>You gentlemen wouldn’t understand. It’s quite normal. Something inside me makes me want to do it. I’ve done it all my life. There are hundreds in England like me.</p>
</blockquote>
<p>The tabloid Truth included more detailed coverage of this case, even publishing an image of Cowther dressed in women’s clothes. Their lawyer argued that there was nothing offensive about how Cowther dressed, and that Cowther dressed in women’s clothing as “an emotional relief … and to me it is perfectly natural”. </p>
<p>The magistrate disagreed: Cowther was convicted and fined £2.10. It is interesting that their solicitor was making arguments that aligned with contemporaneous understandings of “transvestism” yet did not use the word. The way Cowther expressed themself and invoked the existence of others was a sign of growing awareness about others “like them”.</p>
<p>As time went on, medical discourse gradually crept into press reports about dressing – particularly after the publicity surrounding Christine Jorgensen. For instance, police in Adelaide arrested John Martin Vernon Rounsevell while Rounsevell was dressed in women’s clothing, a wig and high heels and carrying a handbag. </p>
<p>Rounsevell admitted to dressing frequently as a woman and took police to a garage containing several boxes and a wardrobe full of women’s clothing. They said to police, </p>
<blockquote>
<p>I cannot help myself. I am not telling lies. I have been to doctors and hope eventually to become a woman. </p>
</blockquote>
<p>A psychiatrist testified that Rounsevell had been experiencing “transvestism” for at least 12 years and this compelled them to dress in women’s clothing. The judge accepted that Rounsevell suffered from a neurosis and released them on a £100 bond with the understanding that they would seek medical treatment.</p>
<p>Examples of AMAB defendants invoking medical defences, and magistrates accepting them, became more common in the 1960s. Coverage of AFAB people caught living as men tended to follow the prewar patterns of assuming it was for economic benefits, to seek adventure or to escape from an unhappy marriage. Yet there was the occasional AFAB person who invoked a desire to transition to being a man. </p>
<p>In October 1950 Truth reported about Bill Armitt, a 22-year-old AFAB person who said that over his lifetime he had gradually developed masculine characteristics. </p>
<p>Armitt had been wearing men’s clothes and had short hair since age 14; in 1949 he had changed his name and lived as a man with his father, working as a bushman. Armitt booked an appointment with a doctor to investigate if he were “one of those rare cases of a woman who is really a man” – the article implying that the specialist was referring to intersex variations. </p>
<p>A few weeks later, Truth reported that Armitt had undergone a gynaecological exam and the specialist had conclusively determined that he was a woman. Armitt did not accept this, remarking, </p>
<blockquote>
<p>I don’t care what the doctors say. I know in my heart that I am a man and that I will always be a man. I don’t know what to do now. What can I do? […] If I can’t live as a man, I don’t want to live at all. </p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=509&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=509&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547995/original/file-20230913-29-j0pj21.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=509&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A 1947 Truth article about Bill Armitt.</span>
<span class="attribution"><span class="source">Trove/NLA</span></span>
</figcaption>
</figure>
<p>Armitt was referred to a psychologist but declined the consultation. He returned to Goulburn and his fate is not known.</p>
<p>The other emerging trend during this period was linking gender-crossing cases with the female impersonator scene. Theatre had always been a socially acceptable site for men to dress as women. By World War II, female impersonation represented an extension of this practice, combining dress, acting and singing and with impersonators appealing to audiences because of how convincing they were as women. </p>
<p>In the early 1940s <a href="https://dictionaryofsydney.org/person/oreilly_benjamin">Lea Sonia</a> was perhaps Australia’s most famous female impersonator, described in one Truth article as “pos[ing] so convincingly as a woman fan dancer as to leave most of the audience still doubtful when the wig is removed at the end of the performances”. </p>
<p>Sonia died during a brownout in 1941 when she was hit by a tram while running for a taxi.</p>
<p>One person who cited the spectre of female impersonation was Neville McQuade, alias Colin Carson. McQuade appeared in the press on several occasions in the 1940s when arrested for vagrancy or offensive behaviour. In an interview with Truth, they expressed a desire to be famous like Lea Sonia, and regaled readers with descriptions of outfits and hair and desires to be a famous stage performer. McQuade was arrested a second time in 1943 for behaving in an offensive manner, being dressed as a woman and dancing with men. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=603&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=603&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=603&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=758&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=758&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547988/original/file-20230913-19-9uynd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=758&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A Truth report on Neville McQuade.</span>
<span class="attribution"><span class="source">Trove/NLA</span></span>
</figcaption>
</figure>
<p>Their third arrest was just after midnight on New Year’s Day 1944, for being dressed as a woman and dancing with a man on the streets of Newtown. On that occasion Dr Norman Haire testified for the defence and said McQuade was a “transvestist type” under his care. The magistrate fined McQuade £3 and released them on a 12-month good behaviour bond.</p>
<p>McQuade made one more appearance in the Australian media: in 1949 police arrested them, then living as Colin Carson, for having insufficient lawful means of support. Police also accused them of performing sex work with men, but McQuade vehemently denied this. They were quite open about continuing to dress in women’s attire and spoke about various social parties and balls that “were mostly frequented by perverts and their associates”.</p>
<p>McQuade’s appearances in the media across the 1940s collectively highlight the continuity and change when it came to gender crossing. Police were still arresting AMAB people dressed as women and laying charges such as offensive behaviour. There were also two emerging patterns that summarised the dominant trans subcultures and discourses until the 1980s: medicalisation and the camp scene. There was overlap between these two sites of trans visibility, but broadly speaking what separated them were the politics of respectability.</p>
<h2>Medicalising transgender</h2>
<p>In 1951, psychiatrist Dr Herbert Bower saw a patient at Melbourne’s Royal Park Mental Hospital who was AMAB but identified as a woman. Bower initially thought the patient was psychotic, but as he came to know them he realised the individual was <a href="https://auspath.org.au/2022/05/26/australian-trans-health-history-report/">well adjusted except for the gender identification</a>. He had no clear diagnosis or treatment for them and subsequently continued to see patients with a different gender identity from their sex assigned at birth.</p>
<p>Bower’s early encounters with these individuals were around the same time that international medical discourse was concretising a pathology and language that built on the prewar sexology and new developments in surgery. </p>
<p>In 1949 Dr David Caldwell used the word “transsexual” to describe a person whose gender identification was different from their sex assigned at birth. </p>
<p>Dr Harry Benjamin’s aforementioned 1954 article Transsexualism and Transvestism as Psycho-Somatic and Somato-Psychic Syndromes explicitly distinguished “transvestism” from “transsexualism”. In 1966 Benjamin published The Transsexual Phenomenon, which became a global textbook for the <a href="https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.2164-0947.1967.tb02273.x">medical treatment of “transvestites” and “transsexuals”</a>.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1013&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1013&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1013&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1274&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1274&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549235/original/file-20230920-21-dn8dih.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1274&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p>Australians were conscious of these overseas developments because of the worldwide press they generated. Still, it was only Bower and a small number of psychiatrists who would treat local trans patients. Much of their work in the 1960s–70s centred on searching for a cause for people’s transness, as well as distinguishing between “transvestites”, “transsexuals” and effeminate homosexuals. </p>
<p>Richard Ball was one such psychiatrist associated with what are believed to be Melbourne’s first gender affirmation surgeries. The Victorian Health Department ran a Transsexualism Consultative Clinic from 1969. When Ball diagnosed people as “transsexuals”, he referred them to a surgeon who operated at Royal Melbourne Hospital, usually early on Saturday or Sunday mornings to keep away from conservative “prying eyes” in the general hospital system.</p>
<p>In 1975 Ball was appointed as professor of psychiatry at St Vincent’s Hospital, though the Transsexualism Consultative Clinic continued to run until 1987. Over its 18 years, according to later media reports, the clinic saw approximately 700 people and referred about 100 of them for gender affirmation surgery. </p>
<p>All cases had to go through a review panel before being accepted as a surgical candidate. The clinic’s approach represented an early example of a pattern that would echo across the country, as around the world. </p>
<p>First, psychiatrists made a distinction between “transvestites” and “true transsexuals”. To fit the criteria of a “true transsexual”, a person had to present as seeing themselves as the opposite gender trapped in the wrong body (this is known as “wrong body discourse”). What constituted the opposite gender reflected dominant social constructs framed around white, middle-class respectability. </p>
<p>The big distinction between “transvestites” and “transsexuals” was that the latter had to desire gender affirmation surgery and then to live indistinguishably, quietly, in their affirmed gender. Those individuals who did not meet the criteria would be denied treatment.</p>
<p>Sydney’s history of trans health care in the 1960s–70s has points of commonality with Melbourne’s, particularly around the role of psychiatrists and the need for a panel of specialists to approve surgery. Unverified newspaper reports and an oral history interview suggest Sydney was the site of Australia’s first gender affirmation surgery, in 1968. There were actually two gender clinics running in Sydney by the early 1970s, both directed by psychiatrists. One was at the Prince Alfred Hospital, but it closed in 1975 when the director accepted a position in Newcastle.</p>
<p>The most prominent personality behind trans psychiatry in 1970s Sydney was Neil McConaghy. McConaghy is a controversial figure in Australia’s history of sexuality and medicine because he was a practitioner of gay aversion therapy. When it came to trans people, though, he did not practise aversion therapy; indeed, his research and consultations at the Prince Henry Hospital were more in line with contemporaneous international ideas around “transvestism” and “transsexualism”. </p>
<p>McConaghy and psychiatrist Ron Barr also regularly deployed a “penile volume response test” – a mechanism that measured erectile responses to imagery – as part of their assessment process. They believed that “true transsexuals” were only attracted to men, which of course was a false supposition because sexuality is not the same as gender identity. </p>
<p>Justifying this belief, Barr <a href="https://link.springer.com/article/10.1007/BF01541372">wrote in 1976</a>: “Patients who show a heterosexual pattern of response may live to regret the loss of the penis following surgery.” </p>
<p>Former patients do not speak fondly of the penile volume response test, which they found not only degrading but also absurd. “Sascha” (a pseudonym) recalls:</p>
<blockquote>
<p>They would take us and they would connect our bits to a machine and then you’d be watching a film that would be flitting through the zoo and a baboon’s arse would flash up, and then you’d go a little bit further and there’d be this large, languid sort of Spanish-looking woman with huge, hairy tits, then she would be sort of lying there going like this and then you’d be flitting through the zoo again and there’d be a man’s penis and it was supposedly designed to measure your sexual responses when you came to any of these diversions.</p>
</blockquote>
<p>Carlotta similarly <a href="https://catalogue.nla.gov.au/catalog/1017655">writes in her autobiography</a>: </p>
<blockquote>
<p>they wired my penis and brain up and showed me photos of people in Kama Sutra positions, vaginas, penises and animals fucking, to see what my reactions would be. I was so angry and offended that I ripped off all the wires and stormed out.</p>
</blockquote>
<p>Although Barr’s specific test did not continue after the 1970s, physical examinations including measuring of genitals certainly did – and this was not unique to Sydney.</p>
<p>When Sydney specialists approved trans people for surgery, the operations were performed at Prince of Wales Hospital. Those surgeries stopped in 1978. When questioned in a 1981 interview why, Barr gave the following explanation:</p>
<blockquote>
<p>Well, several of us felt that, and the surgeon felt, he wasn’t entirely convinced it was helping […] I think being a transsexual is primarily an identity problem, not a sexual problem, because transsexuals are willing to take large doses of Oestrogens which greatly reduce/knock out sex drive and anybody who is primarily interested in sex would not take anything to know [sic] out their sex drive, they are more concerned with identity.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/thanking-carlotta-a-pioneer-for-sex-and-gender-diversity-28191">Thanking Carlotta – a pioneer for sex and gender diversity</a>
</strong>
</em>
</p>
<hr>
<p>Transgender people have a different recollection about surgeries and why they ceased. Trans people sometimes spoke about surgeons who botched the procedures, with dire consequences. In an article in Cleo magazine sometime in the mid-1970s, performer <a href="https://www.gayinthe80s.com/2013/10/1987-transgenders-hit-australian-day-time-television/">Trixie Laumonte</a> stated:</p>
<blockquote>
<p>I wouldn’t have the operation in Sydney. I’ve seen too many botched up jobs here and it is a real tragedy […] Lots of surgeons are in sex change work for the money and I’ve seen some disgusting jobs. They can make a real mess of you and that’s when you get someone who is unhappy afterwards.</p>
</blockquote>
<p>A few years earlier, the press reported about a stripper, Tiffany Jones, who died following complications from breast augmentation surgery in a private hospital.</p>
<p>“Sascha” very bluntly said in her oral history interview: </p>
<blockquote>
<p>They [surgeons] mutilated so many people, and so many people just died from stuff that they did. They didn’t know what they were doing and it was awful, horrible. </p>
</blockquote>
<p>She believes the Sydney surgeons were not properly trained to perform gender affirmation surgeries and that the trans women they operated on were like guinea pigs. She recollects one friend whom she describes as having been “butchered” by the surgeons. Eventually, that person died by suicide, which Sascha attributes in part to the surgery complications. Sascha believes the many complications from surgeries led Sydney surgeons to cease operating. </p>
<p>Although there are conflicting accounts as to why gender affirmation surgeries terminated in Sydney in 1978, by then viable alternatives had emerged in Melbourne and Adelaide. </p>
<h2>Trans people navigating health care</h2>
<p>Before the 1970s there were no trans organisations, no publicly advertised gender clinics and no internet to find doctors with knowledge or referral pathways. Some trans people desperately wrote to the media seeking advice. A letter to a Truth advice column published in 1966 read:</p>
<blockquote>
<p>I am a male, and I want very badly to become a female. But I understand this operation is against the law in Australia. I have become very feminine in outlook and even my handwriting has changed. When I walk I roll my hips like a woman. I try not to walk like this, but I can’t help it. Can you help me get female hormones? – A.G. (South Australia)</p>
</blockquote>
<p>The response was that the person might have a glandular problem and should seek referral to an endocrinologist.</p>
<p>Those trans people who approached psychiatrists had mixed results depending on the psychiatrist’s specialist knowledge and the resources available where the person lived. </p>
<p>The protocols that psychiatrists developed from the 1960s and 1970s were very rigid: they would assess if a person were a “true transsexual” and judge whether the person could, if given hormone treatment and gender affirmation surgery, blend indistinguishably with cis women. This was of course quite subjective, but it meant psychiatrists wielded significant power over trans people’s bodies and health care.</p>
<p>The psychiatrists expected trans women to wear dresses and apply stereotypical standards of white femininity (during this era it was almost always trans women, but in later periods psychiatrists would similarly expect trans men to dress and present like stereotypical men).</p>
<p>Psychiatrists by their own admission would deny treatment to those whom they considered not feminine enough or those who did not live sufficiently respectable lives, such as strippers and sex workers. </p>
<p>Those whom psychiatrists diagnosed as “true transsexuals” would be prescribed hormones by an endocrinologist and must live full time as women for two years – the “real-life test”, as it was called – before the psychiatrists would approve them for gender affirmation surgery. Trans people had to navigate these rigid boundaries and over time came to refer to psychiatrists as gatekeepers.</p>
<p>Trans people who did not meet psychiatrists’ approval were, to an extent, able to exercise agency and find other ways to secure hormones. One interview participant, Jazmin Theodora, remembers that as far back as the 1960s, “Someone started taking the hormones to get breasts, and then we all started taking them.” </p>
<p>She recalls a Dr Roger Gray who prescribed them without questions – exercising what is now known as <a href="https://onlinelibrary.wiley.com/doi/10.5694/j.1326-5377.1976.tb130424.x">the informed consent model</a>. In Melbourne, Dr Harry Imber joined a St Kilda GP clinic in 1972 and by the late 1970s was known in trans circles for his willingness to prescribe hormones with informed consent – he even wrote about it in the Medical Journal of Australia in 1976. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=929&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=929&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=929&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1167&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1167&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549232/original/file-20230920-21-vrsi49.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1167&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p>Other trans people sourced hormones through the black market. In some instances this meant trans women who had legitimate prescriptions shared hormones with their friends.</p>
<p>In other circumstances it meant finding a chemist who was willing to sell them off-book, though always for higher than the normal retail price. When it came to gender affirmation surgeries, trans people had fewer options. Surgeries were limited to a small number of specialists in Melbourne and Sydney – not to mention the rigid gatekeeping expectations just to be eligible. </p>
<p>In extreme examples of desperation, people tried to perform gender affirmation surgery on themselves. A case from 1968 made the cover of Truth; the person had been taking feminising hormones and said they just could not live as a man. They were rushed to hospital, where they were reported as saying, “I did it myself with razor blades in the kitchen while my wife was in bed asleep.” </p>
<p>Trans people with some means could travel overseas for gender affirmation surgery. From the 1960s–70s the most common destinations were London (where those with British citizenship could have it done through the public system at Charing Cross Hospital), Hong Kong, Morocco and Egypt. </p>
<p>In 1962, PIX magazine ran a three-part firsthand account by a trans woman. In part one she described her lifetime struggle with gender. Part two detailed her numerous psychiatric assessments and meetings with surgeons in Melbourne who ultimately declined to perform the operation. </p>
<p>She managed to source feminising hormones from a chemist and tried other doctors in Sydney who also declined to refer her for surgery. Eventually, doctors in London approved her for gender affirmation surgery and even waived the costs. </p>
<p>The author explained that she was narrating her transition journey because:</p>
<blockquote>
<p>It is the fervent hope that I will instil courage into those who, like me, have been condemned to twilight existence as neuters. Every scorn, every hostility that is heaped upon these poor people is an unnecessary scar. And I would beg of you who have cast the first stone in this direction to stay your hands.</p>
</blockquote>
<hr>
<p><em>This is an edited extract from <a href="https://www.mup.com.au/books/transgender-australia-paperback-softback">Transgender Australia: A History Since 1910</a> by Noah Riseman (MUP).</em></p>
<hr><img src="https://counter.theconversation.com/content/212775/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Noah Riseman receives funding from the Australian Research Council, project DP180100322. </span></em></p>Before the 1970s, there were no trans organisations or publicly advertised gender clinics. But camp cultures brought together a variety of sexually- and gender-diverse people.Noah Riseman, Professor in History, Australian Catholic UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2130852023-09-24T12:02:25Z2023-09-24T12:02:25ZYoung people with sexual or gender diversity are at higher risk of stopping their HIV treatment because of stigma and harsh laws<p>Ending the AIDS pandemic – particularly in eastern and southern Africa – cannot be achieved unless more resources are channelled to meet the needs of key vulnerable populations.</p>
<p>This is one of the themes that emerged during an <a href="https://www.samrc.ac.za/event/11th-sa-aids-conference-2023-20-23-june-2023-durban">AIDS conference in June</a> in South Africa. Prejudice against particular groups – such as men who have sex with men (MSM) and transgender communities – interferes with treatment regimes and people’s adherence to treatment. These groups are also at higher risk from HIV due to increased levels of stigma, discrimination, violence and criminalisation. </p>
<p>Our research is part of a three-year <a href="https://www.heard.org.za/wp-content/uploads/2023/06/SADC-Symposium-Report_final.pdf">project</a> on HIV-related stigma linked to young people with sexual or gender diversity. The research, conducted in Malawi, Zimbabwe and Zambia, involved 156 participants.</p>
<p>The research identified three main findings:</p>
<ul>
<li><p>Criminal laws and strongly negative socio-cultural and religious beliefs produced deeply rooted intolerance around sexual or gender diversity. </p></li>
<li><p>Participants spoke about repeated experiences of verbal harassment, being gossiped about and physical violence.</p></li>
<li><p>Other population groups with HIV said their lives had become more tolerable as social awareness and acceptance of HIV had increased over time. However HIV-related stigma regained its potency when linked to sexual or gender diversity, with adverse effects for adherence to antiretroviral treatment. </p></li>
</ul>
<p>Our research provided novel evidence on the deeply rooted fears and anxieties around multiple forms of stigma among young MSM and transgender women in southern Africa. </p>
<h2>Criminalising sex</h2>
<p>Across 13 countries in east and southern Africa, laws and policies criminalise same-sex sexual relations and facilitate the process of stigmatising gay and transgender individuals.</p>
<p>Recently, Uganda passed the Anti-Homosexuality Act of 2023, which punishes same-sex conduct with life imprisonment. Several acts considered as “aggravated homosexuality” are liable to the death penalty. </p>
<p>Our study also noted that young people had developed various strategies to manage their lives. For example choosing when to disclose or identify as a person living with HIV or as a member of the sexual minority community in others, but rarely being both at once. </p>
<p>The constant worry and stress of living with HIV, and the fear of being stigmatised, could have a significant impact on health and wellbeing. </p>
<p>The burden of concealing their identities resulted in a range of mental, emotional and physical vulnerabilities. Signs of depression as well as frequent alcohol use were evident.</p>
<p>Overall 42% of participants had contemplated suicide at least once. According to one participant, an 18-year-old:</p>
<blockquote>
<p>I feel like I am nothing, I am useless. In the community, looking at HIV, I am a gay, people they isolate me. So, I don’t feel comfortable, even failing to go to work and finding some money, whatever. And, sometimes, I decide if I can die today, I can rest. So, a lot of things come into my mind when I am disturbed … Sometimes my parents try to comfort me but, internally, I am really disturbed.</p>
</blockquote>
<p>As well as signs of depression, frequent alcohol use was evident. </p>
<p>There were few services available to assist in coping with these multiple stigmas, with those that came closest being provided by “sexual minority friendly” organisations or led by sexual minority peers themselves.</p>
<h2>Fear of being found out</h2>
<p>Being seen taking antiretroviral therapy or having it found in one’s possession signalled that one was living with HIV. Some individuals preferred to miss doses, occasionally or over more prolonged periods, rather than endure actual or feared stigma linked to being “found out” as someone living with HIV.</p>
<p>A 24-year-old told us:</p>
<blockquote>
<p>What made me to delay taking medication is when my partner wants me to visit his home because he stays in Zomba, and I haven’t disclosed my HIV status to my partner yet, and I can’t take the ARVs with me there. As a result, I go there without the ARVs.</p>
</blockquote>
<p>A 19-year-old said:</p>
<blockquote>
<p>It affects me sometimes because, if people reject you, you feel like stopping to take the medication. ‘Maybe am just wasting my time, let me just die.’ It affects me a lot.</p>
</blockquote>
<p>Other findings we made were that:</p>
<ul>
<li><p>Many participants had had their status disclosed by LGBTIQ+ peers without their consent. HIV-related stigma is still highly prevalent within the LGBTIQ+ community and has many negative impacts. </p></li>
<li><p>Participants continued to experience or fear stigma related to their sexual orientation at health facilities, which also affected their access to healthcare and retention in care.</p></li>
<li><p>Tailored HIV services for key populations, including young MSM and transgender women, were not reaching everyone; rural areas were the least included.</p></li>
<li><p>Through their experiences, gay young men and transgender women were familiar with the harmful consequences of stigma and yet they were often ostracised from planning and decision-making roles. </p></li>
</ul>
<h2>The way forward</h2>
<p>Key populations in our study faced inequalities in three main areas: access to HIV services; justice and human rights; and investments in programmes geared towards them.</p>
<p>There were few services available to assist in coping with these multiple stigmas. Those that came closest were provided by “sexual minority friendly” organisations or led by sexual minority peers themselves.</p>
<p>There need to be more community-based organisations that are run by members of these key populations. In Cameroon, for example, the <a href="https://www.usaid.gov/cameroon/health/hiv-aids">CHAMP</a> programme supports grassroots advocacy to mitigate stigma and violence and trains peers to offer counselling, </p>
<p>We can only achieve progress if we treat everyone as equal partners in fighting this pandemic.</p><img src="https://counter.theconversation.com/content/213085/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kaymarlin Govender receives funding from the National Research Foundation and Sida</span></em></p><p class="fine-print"><em><span>Patrick Nyamaruze receives funding from HIV/AIDS Special Fund Round III initiative of the Southern African Development Community. </span></em></p>Stigmatised people living with HIV often suffer from fear, depression and abuse. It’s sometimes easier to stop a treatment regime than risk being ostracised or assaulted by the community.Kaymarlin Govender, Research Director at The Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-NatalPatrick Nyamaruze, Post-doctoral research fellow, University of KwaZulu-NatalLicensed 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/2124312023-08-30T23:24:23Z2023-08-30T23:24:23ZSaskatchewan naming and pronoun policy: The best interests of children must guide provincial parental consent rules<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/saskatchewan-naming-and-pronoun-policy-the-best-interests-of-children-must-guide-provincial-parental-consent-rules" width="100%" height="400"></iframe>
<p>Saskatchewan’s Premier Scott Moe <a href="https://www.cbc.ca/news/canada/saskatchewan/sask-cabinet-shuffle-august-2023-1.6950764">recently shuffled his cabinet</a>. Among the ministers changing portfolios is Dustin Duncan, who is being moved from education to overseeing the province’s Public Service Commission.</p>
<p>The changes came shortly after Duncan <a href="https://www.saskatchewan.ca/-/media/news-release-backgrounders/2023/aug/policy---use-of-preferred-first-name-and-pronouns-by-students.pdf">introduced new policies</a> that require parental consent for students to participate in sexual health classes and to make name or pronoun changes if they are under the age of 16. </p>
<p>Duncan <a href="https://www.cbc.ca/news/canada/saskatchewan/sask-opposition-gender-school-policy-1.6945452">has not provided information</a> regarding what research or legal precedent was used in formulating this policy. Several groups have spoken against the policy, including the <a href="https://thestarphoenix.com/news/local-news/i-think-theres-going-to-be-an-army-there-advocates-to-rally-in-saskatoon-against-new-sask-education-policies">trans community</a>, <a href="https://www.stf.sk.ca/about-stf/news/dangerous-saskatchewan-government-policy-harmful-to-students/">Saskatchewan Teachers’ Federation</a> and <a href="https://thestarphoenix.com/news/local-news/saskatchewan-school-boards-association-calls-for-pause-on-new-education-policies">Saskatchewan School Boards Association</a>. </p>
<p>The Federation of Sovereign Indigenous Nations (FSIN) has <a href="https://twitter.com/fsinations/status/1696619095385362900">called for the policy to be repealed</a> and the ministerial directive is currently under review by the <a href="https://www.saskadvocate.ca/advocate-to-review-new-ministry-of-education-policy-on-use-of-preferred-names-and-pronouns-by-students/">Saskatchewan Advocate for Children and Youth</a>, who has indicated concern that the rights of children were not sufficiently considered.</p>
<p><a href="https://www.cbc.ca/news/canada/new-brunswick/policy-713-education-changes-1.6944879">A similar policy</a> was also introduced in New Brunswick and similar policies are being considered in <a href="https://toronto.ctvnews.ca/parents-must-be-fully-involved-in-student-s-decision-to-change-pronouns-ontario-education-minister-says-1.6537959">Ontario</a> and <a href="https://nationalpost.com/opinion/canadian-politicians-transitions-policy">Manitoba</a>, sparking a contentious debate about the rights of children, the rights of parents and the role of schools and government in society. </p>
<p>While elected officials play a crucial role in shaping policies that align with the values of their constituents, they must also consider relevant research and legal context for a balanced approach. Otherwise, they risk destabilising classrooms and harming students.</p>
<h2>Importance of inclusion in schools</h2>
<p>It has been widely acknowledged that gender-variant children, including those who identify as trans or non-binary, are more likely to experience <a href="https://doi.org/10.1007/s00787-019-01319-3">anxiety</a>, <a href="https://doi.org/10.1016/j.jadohealth.2016.06.012">depression</a>, <a href="https://doi.org/10.1007/s10567-021-00344-6">social isolation</a> and even <a href="https://doi.org/10.1016/j.jadohealth.2016.09.014">suicide</a>. Creating supportive environments that acknowledge their chosen names and pronouns <a href="https://doi.org/10.1016%2Fj.jadohealth.2018.02.003">has been shown to mitigate these risks</a>. </p>
<p>Many schools across Canada have implemented policies to address gender identity issues among students, aiming for a <a href="https://journals.sagepub.com/doi/full/10.1177/01614681221121513">more inclusive educational environment</a>. Parents and families are most often involved in the care of gender-variant youth in schools. </p>
<p>However, in some cases parents are not involved when it has been identified that informing parents presents real risks to the child, including <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344346/">abuse</a> or <a href="https://doi.org/10.1080/0145935X.2016.1151781">abandonment</a>. There is a necessity of policy to address this reality that places children in danger.</p>
<h2>Parental rights</h2>
<p>Parental rights, often advocated by the <a href="https://www.cbc.ca/news/politics/fundamentalist-christian-movement-1.6793677">religious right in North America</a>, historically influenced areas like <a href="https://heinonline.org/HOL/LandingPage?handle=hein.journals/arz62&div=5&id=&page=">homeschooling</a>. The parental rights movement is based on the concept that <a href="https://elibrary.law.psu.edu/cgi/viewcontent.cgi?article=1221&context=fac_works">children are property</a> of the parents with limited rights. The movement has found resurgence in the United States and has <a href="https://www.cbc.ca/news/world/parental-rights-movement-us-canada-1.6796070">started to become more influential in Canada</a>. </p>
<p>Historically, groups who oppose social progress have used parental rights as a guise, whether it was about <a href="https://www.jstor.org/stable/1410311">segregated schools</a>, <a href="https://brill.com/view/journals/chil/19/4/article-p661_4.xml">sexual health education</a> or <a href="https://www.utexaspressjournals.org/doi/abs/10.7560/JHS22106?journalCode=jhs">gay rights</a>. They would often suggest that schools exclude parents and harm children. In truth, schools and school policy promote parent engagement for <a href="https://psycnet.apa.org/record/2006-02288-003">improved child outcomes</a>.</p>
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Read more:
<a href="https://theconversation.com/parental-rights-lobby-puts-trans-and-queer-kids-at-risk-184804">'Parental rights' lobby puts trans and queer kids at risk</a>
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<p>Saskatchewan has a strong tradition of parent-school co-operation in education. Small school districts were a feature of the province. They <a href="https://books.google.ca/books/about/The_Evolution_of_Professionalism.html?id=YpaPIAAACAAJ&source=kp_book_description&redir_esc=y">kept decision-making local</a> and thus more accessible to parents.</p>
<p>Nevertheless, parent councils have been a more recent legal entity in Saskatchewan when they were legislated in the 1990s. Parents in these councils often <a href="https://www.islandscholar.ca/islandora/object/ir:5108">serve the role as community liaison</a>. Given the strong collaboration between schools and parents, we question the necessity of provincial parental consent policy. Parent involvement is already promoted at the community, local school division, school and classroom levels.</p>
<h2>Rights of children</h2>
<p>Recently, the rights of children have gained prominence, particularly in the context of disputes between <a href="https://assets.cureus.com/uploads/review_article/pdf/13250/1612427982-1612427978-20210204-18204-1h246tl.pdf">parents and mandatory vaccinations in schools</a>. In Canada, children are protected by the Charter of Rights and Freedoms and the country is a signatory to the <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child">United Nations Convention on the Rights of the Child</a>. </p>
<p>Several <a href="https://www.scyofbc.org/wp-content/uploads/2016/02/Child-Rights-in-Canadas-Legal-System-Complete.pdf">key articles</a> from the convention are relevant to this discussion, including rights for non-discrimination, rights for life, survival and development, rights to express their views, rights to identity, nationality and family relations and the best interests of the child principle.</p>
<p>It’s important to note that Article 5 of the convention — which stipulates that the state should respect parents’ responsibilities, rights and duties — should also be considered. The convention does not confer sole determination of a child’s best interests on parents, nor does it exclude them from being seen as discriminatory actors. Rather, it places the onus on the state to safeguard these rights. </p>
<p>The state bears the responsibility of protecting children from discrimination and ensuring their well-being, opinions and growth. Notably, even though specific terms like “trans” may not be explicitly mentioned, <a href="https://www.canada.ca/en/public-health/services/national-child-day/united-nations-convention-rights-of-the-child.html">Canada does include gender within the scope of non-discrimination</a>. The convention underscores that a child has the right to preserve their identity and name, <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child">distinct from the parent’s authority</a>.</p>
<p>In Saskatchewan, parents have roles in decision-making through directly electing school trustees, participating on school community councils and by having the right to homeschool their children. The state has responsibilities for child welfare. </p>
<p>Policies concerning legal names in schools must be scrutinized to avoid violating individuals’ rights to non-discrimination as outlined in the Charter of Rights and Freedoms and multiple articles in the UN’s Convention on the Rights of the Child. </p>
<p>We advise <a href="https://leaderpost.com/news/local-news/sask-politics/moe-new-sask-education-minister-defend-pronoun-consent-policy">Saskatchewan’s Education Minister Jeremy Cockrill</a> to be guided by the best interests of children in the review of this policy. Provincial policies must support Saskatchewan schools that respect children’s rights, protect children from harm and engage parents on their role and responsibilities within public education.</p><img src="https://counter.theconversation.com/content/212431/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Conor Barker receives funding from Social Sciences and Humanities Research Council of Canada. </span></em></p><p class="fine-print"><em><span>Patrick Richards 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>Elected officials must consider relevant research and legal context when shaping education policies. Otherwise, they risk destabilizing classrooms and harming students.Conor Barker, Assistant Professor, Department of Psychology & Faculty of Education, Mount Saint Vincent UniversityPatrick Richards, PhD Candidate, College of Education, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2075832023-08-02T17:13:56Z2023-08-02T17:13:56ZFive must-read summer non-fiction books – reviewed by our experts<figure><img src="https://images.theconversation.com/files/537339/original/file-20230713-21-e1od0c.jpg?ixlib=rb-1.1.0&rect=871%2C0%2C5119%2C3000&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-vector/young-girl-reading-magazine-on-picnic-1653591187">PayPau/Shutterstock</a></span></figcaption></figure><p><em>Looking to expand your horizons this summer? We’ve asked our experts to review some of the biggest non-fiction books released this year so far. There are books to expand your knowledge of environmental collapse, others that will give you an insight into the work and lives of creatives like artist Leonora Carrington and actor Elliot Page, and books that offer advice on living better.</em></p>
<h2>1. <a href="https://thamesandhudson.com/surreal-spaces-the-life-and-art-of-leonora-carrington-9780500025512">Surreal Spaces: The Life and Art of Leonora Carrington</a> by Joanna Moorhead</h2>
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<img alt="Book cover featuring black and white photo of a woman sitting on the floor." src="https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=879&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=879&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=879&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1104&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1104&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534037/original/file-20230626-15-dc7lhu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1104&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="attribution"><span class="source">Thames and Hudson</span></span>
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<p>Joanna Moorhead’s study of the pioneering surrealist painter and writer Leonora Carrington (1917–2011) captures a wave of fascination for surrealist women artists. Carrington’s zest, her intellectual curiosity and her defiant pursuit of personal autonomy and uncompromising artistic authenticity dazzle at every turn in this evocative, deeply-felt study of the spaces and places of the artist’s life and work. </p>
<p>An exquisite contribution to art history and visual culture studies, this cultural geography of the life and the work of the artist and author complements the work of Whitney Chadwick’s book (<a href="https://thamesandhudson.com/women-artists-and-the-surrealist-movement-9780500296165">Women Artists and the Surrealist Movement</a>), positioning Carrington as a seminal surrealist and celebrating a remarkable life in art and ideas. </p>
<p><em>Reviewed by Susan Harrow</em></p>
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Read more:
<a href="https://theconversation.com/six-must-read-summer-fiction-books-reviewed-by-our-experts-207690">Six must-read summer fiction books – reviewed by our experts</a>
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</em>
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<h2>2. <a href="https://www.hachettebookgroup.com/titles/hal-hershfield/your-future-self/9781668626856/">Your Future Self: How to Make Tomorrow Better Today</a> by Hal Hershfield</h2>
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<img alt="Book featuring a bird escaping an egg." src="https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=930&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=930&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=930&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1169&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1169&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537325/original/file-20230713-17-stl6ue.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1169&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="attribution"><span class="source">Hachette</span></span>
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<p>Hal Hershfield’s well-researched and fascinating book has strong echoes of the practice of “<a href="https://www.gov.uk/government/news/horizon-scanning-programme-a-new-approach-for-policy-making">horizon scanning</a>”. Particularly, that it is important to avoid transplanting who and what we are now into the future, but instead to consider the context of the future. Hershfield suggests not just thinking of ourselves as wrinkly, older versions of who we are now, but as people who have taken a full journey of time and experience.</p>
<p>Hershfield explains that we often view our future selves as strangers and are consequently prone to making decisions against our own long-term interests. He gives excellent examples of how we can improve our decision-making through visualisation and by writing to and from our future selves to refine our choices. </p>
<p>Hershfield recommends that we instead attend to the needs and wants of our contemporary selves, so we are not mortgaging ourselves to our futures. Your Future Self includes curated highlights at the end of each chapter to drive home the key lessons. A well-balanced and thought-provoking book.</p>
<p><em>Reviewed by Robert Dover</em> </p>
<h2>3. <a href="https://www.penguin.co.uk/books/453797/pageboy-by-page-elliot/9780857529282">Pageboy</a> by Elliot Page</h2>
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<img alt="A book featuring a man in jeans and white vest on cover." src="https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=923&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=923&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=923&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1160&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1160&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537326/original/file-20230713-21-p04z0u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1160&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="attribution"><a class="source" href="https://www.penguin.co.uk/books/453797/pageboy-by-page-elliot/9780857529282">Penguin</a></span>
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<p>The new memoir from actor Elliot Page’s (best known for <a href="https://www.imdb.com/title/tt0467406/">Juno</a> and <a href="https://www.imdb.com/title/tt1312171/">The Umbrella Academy</a>) explores his experiences of queerness, gender and stardom. Page’s honest and vulnerable text includes insights into his complicated childhood in Nova Scotia, his early closeted queerness and his recent gender transition. </p>
<p>The book is poignantly raw, but Page also offers gentle levity through his encounters with love and sex. In places, Page links his difficulties to the broader transphobic narratives that are harming trans people across the world. In contextualising his stories as part of a wider social current, Page’s work becomes doubly compelling. </p>
<p>Page is reflexive in acknowledging some of his privileges as a white celebrity with greater access to financial security. Alongside this, he is mindful in quietly recognising ongoing and historical LGBTQ+ activism, making this a remarkable memoir – honest, engaging, melancholic, yet heartening. </p>
<p><em>Reviewed by Rosie Nelson</em> </p>
<h2>4. <a href="https://www.bloomsbury.com/uk/earth-transformed-9781526622587/">The Earth Transformed</a> by Peter Frankopan</h2>
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<img alt="Book cover featuring two sides of a globe." src="https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=913&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=913&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=913&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1147&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1147&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536841/original/file-20230711-29-exw7up.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1147&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="attribution"><a class="source" href="https://www.bloomsbury.com/uk/earth-transformed-9781526622587/">Bloomsbury Publishing</a></span>
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<p>The Earth Transformed traces humanity’s relationship with the environment from the planet’s earliest life to the present day. The focus is on societies that build cities and support them with intensive agriculture, modifying their environments in the process. Through this lens, the book charts how responses to environmental challenges are generally shaped by political factors.</p>
<p>Human progress, it seems, is largely a scaling up of the same flawed approaches of governments, while, over millennia, voices speak against the exploitation of nature, but never achieve a lasting victory. </p>
<p>Frankopan synthesises a large, interesting body of research to tell a story of crucial importance for today’s world. What’s missing is a penetrating analysis of the forces that have held (some) humans to this course and how to escape them. His discomfort with environmental factors as historical agents means that the book sometimes undersells the potential of these approaches to rewrite the story of past and future.</p>
<p>However, the book will give readers plenty to think about and many new insights into how we’ve got to where we are. </p>
<p><em>Reviewed by Amanda Power</em></p>
<h2>5. <a href="https://www.heathbooks.co.uk/product/the-human-mind-a-brief-tour-of-everything-we-know/paul-bloom/9781847926951/">The Human Mind: A Brief Tour of Everything We Know</a> by Paul Bloom</h2>
<figure class="align-right ">
<img alt="Book cover with writing and coloured squares." src="https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=924&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=924&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=924&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1162&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1162&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536838/original/file-20230711-21-kqk57d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1162&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="attribution"><span class="source">Bodley Head</span></span>
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<p>This book is a flashback to my undergraduate psychology classes, where we learned about B.F. Skinner’s <a href="https://braintour.harvard.edu/archives/portfolio-items/skinner-and-behaviorism">behaviourism</a>, Jean Piaget’s <a href="https://www.simplypsychology.org/piaget.html">stages of development</a> and Sigmund Freud’s <a href="https://www.bps.org.uk/psychologist/freud-and-unconscious">unconscious mind</a>. It is an excellent book for anyone who wants a brief tour, as the title suggest, of these important basic concepts in psychology.</p>
<p>The book offers readers examples of these psychological concepts set in the contemporary world. Bloom uses Pokemon to describe parents’ influence on their children, discusses biases through eBay and gives an example of living in a penthouse in Manhattan as a metaphor for a cognitive map. His stories are sometimes surprising and made me laugh out loud, which made this book enjoyable to read.</p>
<p>At the same time, I would have liked to see more up-to-date research in the book, especially in the context of positive psychology, which is my specialism. In a happiness chapter, we get a reductionist perspective on wellbeing, which can be misleading to readers. Overall, however, a very enjoyable read.</p>
<p><em>Reviewed by Jolanta Burke</em></p>
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<img alt="" src="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?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">
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<p><em>Looking for something good? Cut through the noise with a carefully curated selection of the latest releases, live events and exhibitions, straight to your inbox every fortnight, on Fridays. <a href="https://theconversation.com/uk/newsletters/something-good-156">Sign up here</a>.</em></p>
<hr><img src="https://counter.theconversation.com/content/207583/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>From new writing on art to books on how the world got to where is politically and environmentally.Susan Harrow, Professor of French Language and Literature, University of BristolAmanda Power, Associate Professor of Medieval History, University of OxfordJolanta Burke, Senior Lecturer, Centre for Positive Health Sciences, RCSI University of Medicine and Health SciencesRobert M. Dover, Professor of Intelligence and National Security, University of HullRosie Nelson, Lecturer in Gender, University of BristolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2075922023-07-31T12:22:14Z2023-07-31T12:22:14ZTrans youth are significantly more likely to attempt suicide when gender dysphoria is met with conversion therapy than with hormone treatment<figure><img src="https://images.theconversation.com/files/539103/original/file-20230724-15-9fs65h.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Trans teens living in a supportive family environment have a lower risk of attempting suicide or running away from home.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/gender-symbols-royalty-free-image/1314046616">Eoneren/E+ via Getty Images</a></span></figcaption></figure><p>As states continue to <a href="https://translegislation.com/">introduce laws</a> that restrict access to gender-affirming care or limit protections against conversion therapy, questions have arisen about the effectiveness of interventions intended to help transgender youth. In this political climate, gold-standard evidence is more important than ever.</p>
<p>Prior research has been unable to tease out cause and effect between health outcomes and gender-affirming care like hormone therapy or gender-denying interventions like conversion therapy, largely because of a lack of longitudinal data or an appropriate control group. To establish whether something causes an outcome, researchers typically rely on <a href="https://doi.org/10.1111%2F1471-0528.15199">randomized control trials</a> – experiments that randomly assign people to a treatment or a placebo. Random assignment is a trusted way to create two equal groups to compare. However, because it is unethical to withhold treatment or administer potential harmful interventions, randomized controls trials are off the table in this case.</p>
<p>In lieu of randomized control trials, researchers often retrospectively compare people who have received an intervention with those who did not. Studies using this approach have linked hormone therapy with <a href="https://doi.org/10.1371/journal.pone.0261039">positive mental health outcomes</a> for trans teens. However, because this treatment requires parental approval, teens who receive hormone therapy may have more supportive families than those who do not. The mental health improvement they experienced may partially be due to <a href="https://doi.org/10.1089/trgh.2020.0094">living in a gender-affirming family environment</a> rather than the effects of hormone therapy alone.</p>
<p>Our research team was able to address these study design issues directly. Along with our colleagues <a href="https://www.umass.edu/economics/graduate/current-graduate-student/nguyen">Duc Hien Nguyen</a> and <a href="https://scholar.google.com/citations?user=6VtcuWMAAAAJ&hl=en">Yana Rodgers</a>, <a href="https://www.researchgate.net/profile/Travis_Campbell3">we are</a> <a href="https://scholar.google.co.uk/citations?user=7qADvu8AAAAJ&hl=en">economics and</a> <a href="https://scholar.google.com/citations?user=Di1AiloAAAAJ&hl=en">health policy</a> researchers who study the health and economic outcomes of marginalized populations, including LGBTQ+ communities. To assess cause and effect, we used a method commonly used in economics, policy analysis and health policy research called an <a href="https://doi.org/10.1146/annurev-publhealth-040617-013507">event study</a>. We analyzed data from the 2015 <a href="https://www.ustranssurvey.org/reports">U.S. Transgender Survey</a>, which includes responses from over 27,000 trans adults across the nation. We compare people who initiate an intervention with those who initiate the same intervention one year later. The group that has not yet started treatment acts as a control group, providing credible estimates of the effect of treatment.</p>
<p>We found that supportive family environments and <a href="http://dx.doi.org/10.1257/pandp.20231057">hormone replacement therapy</a> that affirms a transgender child’s gender identity decrease their risk of suicide or running away from home, whereas unsupportive family environments and <a href="https://doi.org/10.1016/j.jhealeco.2023.102750">conversion therapy</a> that denies their gender identity increase these risks.</p>
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<figcaption><span class="caption">Trans youths and their parents struggle to navigate the wave of anti-trans bills in the U.S.</span></figcaption>
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<h2>Treating gender dysphoria</h2>
<p>Many transgender people experience <a href="https://www.psychiatry.org/psychiatrists/diversity/education/transgender-and-gender-nonconforming-patients/gender-dysphoria-diagnosis">gender dysphoria</a>, which is psychological distress arising from a mismatch between how a person expresses their gender identity and the social norms of their sex assigned at birth. To treat gender dysphoria, health professionals typically use gender-affirming interventions such as hormone therapy to align gender expression with identity. Some, however, use gender-denying interventions such as conversion therapy to align gender identity with sex. </p>
<p>Gender affirmation includes processes that help a person feel socially and physically aligned with their gender identity. Affirmation could include social changes, such as going by a gender-affirming name and pronouns, using gender-aligned bathrooms, or wearing gender-affirming clothing. Affirmation could also include medical interventions, such as medications to delay the onset of puberty, hormones that help align physical characteristics with gender identity, or, for trans adults, gender-affirming surgeries. Some trans adults also legally change their names and gender markers on their ID. Research has shown that these forms of gender affirmation may <a href="https://doi.org/10.1089/trgh.2020.0038">alleviate gender dysphoria</a>.</p>
<p>Conversely, <a href="https://doi.org/10.1002/hast.365">gender-denying interventions</a> like conversion therapy attempt to change the sexual orientation or gender identity of youth. These interventions assume that gender identity is malleable before puberty. Although it is presumably intended to alleviate gender dysphoria and social stigma of being trans, studies have found that it can prolong and intensify those issues and lead to <a href="https://doi.org/10.1001/jamapsychiatry.2019.2285">psychological distress in adulthood</a>. </p>
<p>Because there is <a href="https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-whether-conversion-therapy-can-alter-sexual-orientation-without-causing-harm/">no credible evidence</a> supporting the efficacy of conversion therapy, <a href="https://doi.org/10.1542/peds.2018-2162">many professional</a> <a href="https://www.psychiatry.org/about-apa/policy-finder/position-statement-on-treatment-of-transgender-%28tr">health organizations</a> <a href="https://www.apa.org/news/press/op-eds/science-gender-affirmation">have recommended</a> <a href="https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence">gender-affirming care</a> to alleviate gender dysphoria in trans people. </p>
<p>There has been limited evidence, however, on the health effects of both hormone therapy and conversion therapy for trans people, which is why the Centers for Medicare and Medicaid Services has not provided a <a href="https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=368">national coverage determination regarding hormone replacement therapy</a>. This means HRT isn’t uniformly covered by state or federal health insurance.</p>
<h2>Effects of gender affirmation or denial</h2>
<p>So what are the effects of affirming or denying a child’s gender identity? </p>
<p>First, we found that <a href="https://dx.doi.org/10.2139/ssrn.4503648">over 40% of trans adolescents</a> living in family environments that are unsupportive of their gender identity attempted suicide by the age of 18, a rate approximately eight times as high as that of cisgender adolescents.</p>
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<p>We also found that <a href="http://dx.doi.org/10.1257/pandp.20231057">hormone replacement therapy significantly improves</a> the mental health of trans youths. In comparing differences in suicide attempts between trans youths who started HRT a year apart from each other, we found that both groups experienced similar increases in suicide attempts over the five years before initiating treatment but experience a significant drop the year they start treatment. Overall, initiating hormone therapy led to a 14.4% reduction in attempting suicide for trans youths.</p>
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<p>Our research on the effects of <a href="https://doi.org/10.1016/j.jhealeco.2023.102750">conversion therapy</a> on the mental health of transgender youths had dismal findings. We found a 13.8% increase in attempted suicide within the first year of conversation therapy, and a 47.5% increase in running away from home.</p>
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<p>We also analyzed the effects of social transitions on risk of attempting suicide or running away from home. These social transitions include realizing their gender differed from their sex assigned at birth, self-identification as trans, starting to tell others they are trans, and living full time as their gender identity.</p>
<p>We found that for trans youths living with unsupportive families, social transitions <a href="https://dx.doi.org/10.2139/ssrn.4503648">increase their risk of attempting suicide and running away from home</a>. For those living in supportive family environments, that risk is reduced and in some cases virtually eliminated. Some of the increased risk of suicide and running away from home for trans youths living in unsupportive family environments can likely be attributed to higher incidences of conversion therapy and limited access to hormone therapy.</p>
<h2>Public policy and transgender well-being</h2>
<p>Transgender people face <a href="https://theconversation.com/health-rights-for-trans-people-vary-widely-around-the-globe-achieving-trans-bliss-and-joy-will-require-equity-social-respect-and-legal-protections-194237">widespread stigma, discrimination and violence</a>. In June 2023, the Human Rights Campaign declared a <a href="https://www.hrc.org/press-releases/for-the-first-time-ever-human-rights-campaign-officially-declares-state-of-emergency-for-lgbtq-americans-issues-national-warning-and-guidebook-to-ensure-safety-for-lgbtq-residents-and-travelers">national state of emergency for LGBTQ+ Americans</a>, the first in the LGBTQ civil rights organization’s over 40-year history. This was prompted by the <a href="https://translegislation.com/">more than 560 anti-transgender bills</a> that have been introduced in the U.S. through July 2023, 80 of which have passed.</p>
<p>More anti-trans bills have been on the docket in 2023 than any prior year in U.S. history. Our research suggests that policies restricting access to gender-affirming care and limiting protections against conversion therapy will have significant negative effects on the lives of transgender youths.</p>
<p>As newer and larger data sets on the health, economic and social outcomes of trans people <a href="https://www.ustranssurvey.org/">become available</a>, researchers will be able to quantify the effects of anti-trans policies and provide richer insights into the lives of transgender Americans. Whether these findings will help change the tide of restrictive policies on trans health care and protections in the U.S. remains to be seen, but for now, our research suggests that family support will be key.</p>
<p><em>If you are struggling or having suicidal thoughts, help is available. Call or text the 988 Suicide & Crisis Lifeline or chat at <a href="https://988lifeline.org/chat/">988lifeline.org</a>. The Trans Lifeline (1-877-565-8860) and The Trevor Project (phone 1-866-488-7386, text 678-678, or chat <a href="https://www.thetrevorproject.org/get-help/">thetrevorproject.org</a>) also offer crisis support.</em></p><img src="https://counter.theconversation.com/content/207592/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nathaniel Tran receives funding from the National Institute on Aging. </span></em></p><p class="fine-print"><em><span>Samuel Mann receives funding from the Nuffield Foundation. </span></em></p><p class="fine-print"><em><span>Travis Campbell 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>Because of ethical considerations, there are no clinical trials comparing the effects of hormone therapy to conversion therapy on trans youths. But a set of recent studies tease out cause and effect.Travis Campbell, Assistant Professor of Economics, Southern Oregon UniversityNathaniel Tran, Ph.D. Candidate in Health Policy, Vanderbilt UniversitySamuel Mann, Postdoctoral fellow, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2095222023-07-12T07:18:53Z2023-07-12T07:18:53ZHealth research must be ethical – we can do more to make sure that’s the case for young trans people and their families<figure><img src="https://images.theconversation.com/files/536990/original/file-20230712-19-dj3dfr.jpg?ixlib=rb-1.1.0&rect=42%2C25%2C5565%2C3707&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>Monday’s <a href="https://www.abc.net.au/news/2023-07-11/blocked:-the-battle-over-youth-gender-care/102587506">Four Corners</a> program on gender affirming care highlighted <a href="https://www.abc.net.au/news/2023-07-10/transgender-children-westmead-hospital-research-four-corners/102568570">concerns about research</a> undertaken with 79 young trans people and their families who sought help at the Children’s Hospital Westmead. </p>
<p>Since the Four Corners episode, the New South Wales health minister has announced a <a href="https://www.theguardian.com/world/2023/jul/11/sydney-childrens-hospital-gender-research">review</a> of the scientific evidence related to health care for young trans people. </p>
<p>One family who took part in the research featured in the ABC program expressed shock and distress at how they and others in their community were represented and how the study was framed when it was published. The research suggested links to <a href="https://www.abc.net.au/news/2023-07-10/transgender-children-westmead-hospital-research-four-corners/102568570">family trauma and dysfunction</a> and high rates of “desistance” (defined in the research as the resolution or disappearance of gender-related distress). </p>
<p>The program raised important questions about ethical research. What are the obligations of researchers and ethics committees to ensure the best outcomes? How can we ensure ethical principles for young trans people and their families are met – especially when they might see research as one of few avenues for accessing care? How do young trans people and their families know when they should or shouldn’t sign up?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/family-support-protects-trans-young-people-but-their-families-need-support-too-202743">Family support protects trans young people – but their families need support too</a>
</strong>
</em>
</p>
<hr>
<h2>Obligations and oversight</h2>
<p>In Australia, a <a href="https://www.nhmrc.gov.au/research-policy/ethics/human-research-ethics-committees">human research ethics committee</a> must assess research conducted with people before it’s given the go-ahead. These committees are often located in universities, government departments and hospitals. They include a chairperson, members of the public and people with expert knowledge and current experience in research. </p>
<p>Ethics committees aim to ensure research proposals meet <a href="https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018">ethical principles and guidelines</a>. These say research should be respectful, <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">culturally safe</a> and undertaken in the best interest of the individuals and communities. </p>
<p>Marginalised communities, in particular, need culturally safe research. This includes trans young people, many of whom <a href="https://theconversation.com/yes-words-can-harm-young-trans-people-heres-what-we-can-do-to-help-176788">experience</a> anxiety and depression as a result of stigma and discrimination. </p>
<p>Ensuring research participants are culturally safe means they feel accepted and are socially, emotionally and physically protected from harm when participating in health research. <a href="https://connect.springerpub.com/content/book/978-0-8261-6921-1/part/part01/chapter/ch01#:%7E:text=Cultural%20safety%20emphasizes%20patient%2Dcentered,day%20%E2%80%93%20especially%20people%20of%20color.">Cultural safety</a> includes recognising research participants may have more than one marginalised identity, such as young Aboriginal trans people or young trans people with a disability. </p>
<p>Researchers and ethics committees also must ensure research <a href="https://www.nhmrc.gov.au/about-us/publications/australian-code-responsible-conduct-research-2018">is conducted ethically</a>. Doing research responsibly includes being open and honest in developing, undertaking and accurately reporting research findings. </p>
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<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>What about young trans people and their families?</h2>
<p>“Do good”, “do no harm”, and “nothing about us without us” are fundamental ethical principles. Accordingly, it is expected research with young trans people and their families is undertaken ethically, responsibly and with integrity. </p>
<p>Young trans people and their families need to be involved throughout the research process. Partnerships must be established before research proposals are submitted to ethics committees for approval. Working in partnerships with trans children, young people, their families, and communities builds mutual trust, respect, and accountability.</p>
<p>When young trans people and their families are not meaningfully included as research partners, research findings can be misinterpreted. This can cause harm to young people and their families. </p>
<p>The <a href="https://www.why.org.au/">Wellbeing, Health & Youth</a> <a href="https://www.why.org.au/index.php/why-research/ethics-of-engagement/WHY-engagement-framework">engagement framework</a> co-produced with young people from different marginalised groups presents a set of values and practical questions for researchers that promote ethical engagement with young people. These include looking at how co-design can create an approach that is youth-centred, strengths-based and focused on
maximising opportunities for health and wellbeing. </p>
<p>When engagement includes mutual trust and accountability, diversity and inclusion, and equity and responsiveness, participants and their loved ones are unlikely to feel shock at how their experiences are presented. </p>
<h2>How can young trans people and their families assess research ethics?</h2>
<p>Participants should be presented with clear information about what the study will involve and the implications of participation. Before deciding on whether to participate in research, young trans people and their families should know their <a href="https://www.transhub.org.au/respect#your-rights-in-a-research-setting">rights in research settings</a> including the right to complain and what happens to their personal data if they withdraw. </p>
<p>Helpful questions to ask before consenting to participate in research include: </p>
<ul>
<li>do the researchers have expertise in trans children and young people’s health?</li>
<li>what organisations do they work for?<br></li>
<li>why are they doing the research? </li>
<li>how connected are they to the communities they are researching? </li>
</ul>
<p>Participation in research should be a choice. It should not involve any kind of coercion, such as feeling that not participating in the research would mean a person would not get the same access to gender-affirming health care. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&rect=7%2C10%2C1723%2C1136&q=45&auto=format&w=1000&fit=clip"><img alt="Young person wearing makeup" src="https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&rect=7%2C10%2C1723%2C1136&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536988/original/file-20230712-29-abu8rn.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Young person Brock was interviewed by Four Corners and is receiving gender-affirming care.</span>
<span class="attribution"><a class="source" href="https://www.abc.net.au/news/2023-07-10/transgender-children-westmead-hospital-research-four-corners/102568570">ABC Four Corners: Mat Marsic</a></span>
</figcaption>
</figure>
<h2>Robust research is needed</h2>
<p><a href="https://theconversation.com/yes-words-can-harm-young-trans-people-heres-what-we-can-do-to-help-176788">Young trans people</a> and <a href="https://theconversation.com/family-support-protects-trans-young-people-but-their-families-need-support-too-202743">their families</a> experience <a href="https://www.telethonkids.org.au/projects/past/trans-pathways/">significant marginalisation and health inequity</a>. </p>
<p>Robust research is vital to reducing this health inequity and improving the health and wellbeing of young trans people. </p>
<p>To ensure this research is of the highest standard, ethics committees must have the expertise to uphold ethical principles in research involving trans children and adolescents. They may need more training and should seek independent guidance from subject experts, including from people with lived experience. </p>
<p>As the Four Corners program shows, high-quality guidelines specifically for research with trans people, including children and adolescents, are urgently needed.</p><img src="https://counter.theconversation.com/content/209522/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>Rachel Skinner is affiliated with the NSW Ministry of Health, Sydney Children's Hospitals Network, Australian Association of Adolescent Health, Society of Adolescent Health and Medicine, Australian Professional Association of Transgender Health</span></em></p><p class="fine-print"><em><span>Sav Zwickl works for the Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne and is affiliated with the Australian Professional Association for Trans 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>How can we ensure ethical research principles for young trans people and their families are met – especially when they might see research as one of few avenues for accessing care?Cristyn Davies, Research Fellow in Child and Adolescent Health, Faculty of Medicine and Health, University of SydneyKerry H. Robinson, Professor in Sociology, School of Social Sciences, Western Sydney UniversityRachel Skinner, Professor in Paediatrics, University of SydneySav Zwickl, Trans Health Research Fellow, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2076002023-06-20T21:22:38Z2023-06-20T21:22:38ZNew Brunswick’s LGBTQ+ safe schools debate makes false opponents of parents and teachers<figure><img src="https://images.theconversation.com/files/533024/original/file-20230620-20-hawh29.jpg?ixlib=rb-1.1.0&rect=52%2C8%2C5817%2C3822&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New Brunswick's contentious updated Policy 713 on sexual orientation and gender identity in schools will take effect July 1.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Across Canada, we are witnessing a surge of unrest surrounding 2SLGBTQIA+ policy changes and cultural shifts in education, <a href="https://globalnews.ca/news/9758359/nb-blaine-higgs-lgbtq-policy-713-backlash/">sparking heated debates</a> and rallies across the country. </p>
<p><a href="https://www.theglobeandmail.com/canada/article-schools-become-targets-for-backlash-against-lgbtq-rights/">Ontario</a>, <a href="https://www.cbc.ca/news/canada/manitoba/heather-stefanson-book-bans-lgbtq-1.6848704?cmp=rss">Manitoba</a> and <a href="https://globalnews.ca/news/9703502/jennifer-johnson-transphobic-alberta-election/">Alberta</a> have all recently made the news regarding 2SLGBTQIA+ educational issues. </p>
<p>In New Brunswick, the premier and education minister sparked backlash and contentious debate after a recent call to review policy that sets minimum standards for <a href="https://atlantic.ctvnews.ca/n-b-government-expands-review-of-province-s-policy-on-sexual-orientation-in-schools-1.6414635">establishing safe, welcoming, inclusive and affirming learning environments for students, families and allies who identify as 2SLGBTQIA+
</a><a href="https://www2.gnb.ca/content/gnb/en/news/news_release.2023.06.0297.html">(Policy 713)</a>. </p>
<p>Recently announced changes to <a href="https://www2.gnb.ca/content/dam/gnb/Departments/ed/pdf/K12/policies-politiques/e/713.pdf">the 2020 policy</a> have sparked a volatile debate reflecting polarizing arguments that make false opponents out of parents and teachers.</p>
<figure class="align-center ">
<img alt="People seen standing holidng pride flags outside a school bus." src="https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532775/original/file-20230619-23-kntsbm.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">Across Canada, we are witnessing a surge of unrest surrounding 2SLGBTQIA+ policy changes. Supporters wave flags to show support for students at East Wiltshire School in Cornwall, P.E.I., in June 2021.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/John Morris</span></span>
</figcaption>
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<h2>Students’ rights to choose pronoun/name</h2>
<p>Policy 713 had clearly set guidelines related to supportive school environments, alliances, self-identification and “universal spaces,” referring to all schools having at least one universal washroom accessible at all times. </p>
<p>Under <a href="https://www2.gnb.ca/content/dam/gnb/Departments/ed/pdf/K12/policies-politiques/e/713.pdf">the original policy</a>, school staff would consult with a transgender or non-binary student to determine their preferred first name and pronouns. Only if a student under age 16 wished to change their name for official record keeping (such as on a report card), the student was required to get parental consent. The policy also said that when contacting a parent to discuss a students’ preferred name, the principal must have the student’s informed consent.</p>
<p>Changes to the policy say if students under 16 disagree to get parental consent to change the name used in school record keeping, they would be referred to a social worker or school psychologist “<a href="https://www2.gnb.ca/content/dam/gnb/Departments/ed/pdf/K12/policies-politiques/e/713-2023-07-01.pdf">to work with them in the development of a plan</a> to speak with their parents if and when they are ready to do so.” </p>
<p>However, CBC reported that when asked whether the changes mean teachers can use a child’s preferred name or pronoun informally in the classroom without parental consent, <a href="https://www.cbc.ca/news/canada/new-brunswick/nb-policy-713-review-hogan-1.6863231">Bill Hogan, New Brunswick’s minister of education and early childhood development, said, “According to the policy, they will use the name of the student given at birth</a>.”</p>
<p>Members and allies <a href="https://www.change.org/p/save-policy-713-and-the-rights-of-2slgbtqia-students-in-new-brunswick-schools?redirect=false">of the 2SLGBTQIA+ community advocate for Policy 713 remaining as written</a>. The Canadian Civil Liberties Association <a href="https://www.cbc.ca/news/canada/new-brunswick/new-brunswick-lgbtq-policy-rights-protections-1.6868375">said the changes “violate the rights and dignity” of LGBTQ youth</a>. In a statement, the New Brunswick Association of School Psychologists said the <a href="https://www.cbc.ca/news/canada/new-brunswick/school-psychologist-social-worker-trans-students-pronouns-1.6879422">new policy will hurt students</a> and that “misgendering transgender and gender diverse people increases risk of self-harm, suicidal ideation and other mental health concerns.”</p>
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<h2>Precedent across the country</h2>
<p>People who support changes to the policy express concerns about <a href="https://www.theglobeandmail.com/canada/article-nb-premier-blaine-higgs-faces-caucus-revolt-over-education-policy-on">parental rights</a> and traditional values. <a href="https://www.cbc.ca/news/canada/new-brunswick/policy-713-nationwide-attention-1.6876528">CBC reports that a conservative Christian group based in British Columbia has encouraged supporters</a> to lobby New Brunswick MLAs because what happens in the province could set a precedent across the country.</p>
<p>While the public was assured that stakeholders were being consulted throughout the Department of Education and Early Childhood Development’s review process, some <a href="https://www.cbc.ca/news/canada/new-brunswick/new-brunswick-policy-713-consultation-review-process-1.6861948">students</a> and <a href="https://globalnews.ca/news/9725559/nb-parent-used-lgbtq2-inclusion-policy/">parents who</a> were consulted did not feel their voices were truly being heard. </p>
<h2>Polarized arguments</h2>
<p>Recently, there have been outrageous allegations that schools or teachers are <a href="https://www.pafe.ca/why_are_without_parental_consent">“grooming”</a> children for gender transition, or that schools are “<a href="https://nationalpost.com/opinion/the-state-has-no-right-keeping-childrens-gender-identity-secret-from-parents">keeping children’s gender identity secret</a>.” </p>
<p>Teachers <a href="https://globalnews.ca/news/9727632/nbta-consultation-policy-713-review/">are caught in the crossfire</a>. Teachers aim to foster students’ <a href="https://selfdeterminationtheory.org/">self-determination (which requires meeting the needs of being one’s authentic self in relationships with others, having autonomy and a sense of competence)</a>, self-advocacy and safe and inclusive learning environments, but now face being ordered to disregard children’s voices. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/AHA9pC_tm0s?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">CBC News video about Policy 713.</span></figcaption>
</figure>
<p>It is important to understand that parents/guardians and families were not excluded by the original policy. The aim was to ensure “all members of the school environment have the right to self-identify and express themselves without fear of consequences…” </p>
<p>Being positioned as the enemy of parents and children’s welfare, at the same time as they are being ordered to refrain from inclusive practices for
specific groups, has increased the strain on already drained educators.</p>
<h2>Duty of care</h2>
<p>To speak of schools or teachers keeping secrets is misleading. Teachers are mandatory reporters. They are legally bound to keep the youth in their care safe from neglect and abuse. There are policies and procedures for this <a href="https://asdeast.nbed.ca/wp-content/uploads/sites/2/2022/01/725n.pdf">in school boards and in the Education Act</a>.</p>
<p>Teachers also have a duty of care for the safety, well-being and education of all students during school hours. Teachers set the learning environment, but students whether age four, 14 or 17 have agency in the way they engage with the conditions teachers establish.</p>
<p>An educator’s ability to support students’ thriving is grounded in the relationships built with students, their families and their communities. Collaboration and co-operative planning with the child or young person are essential, and involving their guardians and community however possible, is ideal. </p>
<p>A team approach hopefully results in young people positively constructing their identities, discovering their interests and passions and exploring possibilities through academic and social aspects of school life.</p>
<p>However, for some this journey is <a href="https://www.cbc.ca/news/canada/nova-scotia/lgtbq-bullying-cape-breton-1.6818760">harder than for others</a>.</p>
<h2>Supporting students’ self-advocacy</h2>
<p>Outside of mandatory reporting, teachers make professional judgements grounded in a firm framework of ethical practice, policy guidelines, knowledge of students and consultation when required.</p>
<p>If a student shares something with a trusted person like a teacher and there is no cause for concern, teachers maintain neutrality and confidentiality. Teachers strive to affirm (not <a href="https://genderreport.ca/gender-transition-at-school/">encourage</a>) what the student is telling them. Teachers offer a non-judgemental space, and support young people to self-advocate or co-advocate to <a href="https://www.studentscommission.ca/assets/pdf/en/publications/Adults_Allies_in_Action.pdf">build relationships with adults</a> and community members in their lives. </p>
<figure class="align-center ">
<img alt="Pieces of paper showing different pronouns." src="https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532848/original/file-20230620-56698-dljgrz.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">A sense of trust could be diminished for students if their school community won’t use their preferred pronouns.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p><a href="https://www.cbc.ca/news/canada/kitchener-waterloo/twitter-drops-policy-against-deadnaming-local-organizations-consider-leaving-platform-1.6816906">Refusing to honour a student’s request to be called by a name or pronoun</a> they prefer, or insisting they see a counsellor or psychologist, could <a href="https://www.cbc.ca/news/politics/new-brunswick-blaine-higgs-policy-713-1.6880751">diminish trust</a> between a student and their teachers and families. </p>
<p>This would isolate the student, with neither families nor teachers as <a href="https://www.minus18.org.au/articles/how-to-be-a-trans-ally">allies</a>, potentially putting the student at <a href="https://nbmediacoop.org/2023/06/16/commentary-from-rainbows-to-storm-clouds-unraveling-the-hidden-harms-of-new-brunswickes-changes-to-policy-713/">greater risk</a>.</p>
<h2>Reducing stigma</h2>
<p>It is crucial to address the source of marginalization, which is discrimination. </p>
<p>We need to provide support to children and youth on a case-by-case basis. Education plays a vital role in reducing stigma, dismantling prejudice and discrimination, <a href="https://gpseducation.oecd.org/revieweducationpolicies/#!node=41746&filter=all">promoting acceptance and nurturing a diverse and vibrant society</a>.</p>
<p>Schools must continue to be inclusive and foster cultures of equity, acceptance and compassion where each student is valued and honoured for who they are.</p><img src="https://counter.theconversation.com/content/207600/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>Guided by policy, practice and relationships with students, families and communities, teachers are charged with helping all students thrive. To suggest otherwise is disturbing.Andrea Garner, Assistant Professor, Faculty of Education, University of New BrunswickMelissa Dockrill Garrett, Assistant Professor, Faculty of Education, University of New BrunswickLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2071402023-06-14T12:28:41Z2023-06-14T12:28:41ZTrans and gender-diverse people in Saskatchewan need better access to primary care<figure><img src="https://images.theconversation.com/files/531890/original/file-20230614-17-ritl1a.jpg?ixlib=rb-1.1.0&rect=1116%2C41%2C5030%2C3016&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Trans and gender-diverse people in Saskatchewan face challenges accessing primary care.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Research has demonstrated time and again that the social marginalization and exclusion experienced by many people who are trans and gender diverse are <a href="https://doi.org/10.1001%2Fjamanetworkopen.2020.15036">closely tied to having poorer health, including higher rates of chronic illness</a>. </p>
<p>This may be because many trans and gender-diverse people have had negative experiences with health-care providers, or feel that the health-care system is ill-equipped to handle their needs, or are on long waiting lists for care.</p>
<p>In a <a href="https://www.schoolofpublicpolicy.sk.ca/research-ideas/publications-and-policy-insight/policy-brief/access-to-quality-healthcare-for-people-who-are-trans-and-gender-diverse-in-saskatchewan.php">new policy brief</a>, we outline our concerns about access to health care for people who are trans and gender diverse in Saskatchewan. </p>
<p>This work is part of a broader initiative — <a href="https://research-groups.usask.ca/transnavigator/the-project.php">the Trans Research and Navigation Saskatchewan</a> (TRANS) project — that explores the effectiveness of peer navigation for improving the health-care experiences of trans and gender-diverse people in the province. </p>
<figure class="align-center ">
<img alt="A person in a purple T-shirt outdoors, looking at the camera," src="https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531891/original/file-20230614-22-aaakle.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">The challenges facing people who are trans and gender-diverse begin from the moment they enter their doctor’s office.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Peer navigators are members of a community — in this case, trans and gender-diverse people — who draw on their own experiences with the medical system to help others overcome barriers to care. </p>
<p>The brief draws on the preliminary research from the project as well as existing research on the experiences of people who are trans and gender diverse in Saskatchewan and elsewhere. It focuses on barriers to primary care, barriers to specialist care and other socio-legal concerns. </p>
<h2>Challenges for trans, gender-diverse patients</h2>
<p>The challenges facing people who are trans and gender diverse begin from the moment they enter their doctor’s office. </p>
<p>In addition to concerns about the use of the right name and pronouns, some people who participated in the focus groups and interviews held by the TRANS project shared accounts of physicians refusing to provide any type of care to trans and gender-diverse people and/or refusing to refer them to another physician. </p>
<p>Given the <a href="https://globalnews.ca/news/9175996/saskatoon-clinics-close-patients/">lack of family physicians with openings for new patients in Saskatchewan</a>, this leaves some trans and gender-diverse people without a doctor. Furthermore, people whose doctors aren’t willing to provide hormone therapy may feel that the same doctor is unlikely to provide supportive knowledgeable care in other areas.</p>
<figure class="align-center ">
<img alt="stock photo of a transgender person looking at camera with blurred light background" src="https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531892/original/file-20230614-20-bb9fjr.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">People who are trans and gender diverse may face long wait lists for appointments with doctors who are comfortable providing gender-affirming care.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>In other instances, people who are trans and gender diverse reported that their family doctors are generally supportive, but not comfortable — at least not yet — with providing gender-affirming care including prescribing hormone therapy. </p>
<p>Yet hormone therapies are relatively straightforward prescriptions, <a href="https://theconversation.com/gender-affirming-care-has-a-long-history-in-the-us-and-not-just-for-transgender-people-201752">and similar medications</a> are often prescribed for cis-gender men with low testosterone or cis-gender women experiencing menopause. But many family doctors do not feel comfortable providing them to people who are trans and gender diverse, though the reasons for this are unclear.</p>
<p>This leaves people who are trans and gender diverse hoping that their family doctor will refer them to someone else who is comfortable providing hormone therapy. For people in rural areas — <a href="https://saisia.ca/wp-content/uploads/2022/07/Final-version-EN-Benefits-of-living-in-Rural-SK-with-crop-marks.pdf">35 per cent of the people in Saskatchewan</a> — these challenges can be compounded by the need to travel for care. </p>
<p>Given that there are very <a href="https://doi.org/10.1089/trgh.2020.0181">few family doctors who report that they <em>are</em> comfortable providing hormone therapy in Saskatchewan</a>, there are long wait lists for appointments, and people who are trans and gender diverse are left in the lurch. </p>
<h2>Solutions for improving care</h2>
<p>The solution to this problem is relatively simple: ensuring that more and more family doctors in Saskatchewan are comfortable providing gender-affirming care, including hormone therapy. </p>
<figure class="align-center ">
<img alt="A person with a beard and glasses wearing a striped shirt smiling and a second person out of focus" src="https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531893/original/file-20230614-31-dbn8gn.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">Reducing bottlenecks in primary care is a critical part of improving the health of people who are trans and gender-diverse.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>There are many ways to make this happen. The simplest and most cost-effective approach is for willing family doctors to educate themselves <a href="https://www.rainbowhealthontario.ca/TransHealthGuide/">using relevant guidelines</a> carefully developed in other provinces (or <a href="https://bmc1.utm.utoronto.ca/%7Ekelly/transprimarycare/resources.html">other training resources</a>). </p>
<p>Other options, as we outline in the policy brief, could involve family doctors connecting with others who are more experienced in providing gender-affirming care, or receiving support from the peer navigation program initially established by the TRANS research team. </p>
<p>Those involved in medical education — at the University of Saskatchewan and elsewhere — could continue to support <a href="https://www.sma.sk.ca/?tribe_events=trans-inclusive-healthcare-series">medical education opportunities</a> for family doctors and other primary-care providers to become more comfortable in providing gender-affirming care. </p>
<p>There are other straightforward and important interventions that could improve access to care. These include, among others: </p>
<ul>
<li>Continued support for the peer navigation program, </li>
<li>Changing requirements for access to surgical care, </li>
<li>Increasing the availability of mental health supports, </li>
<li>Making it easier to make changes to legal documents and identification, and </li>
<li>Establishing a multidisciplinary network or health centre dedicated to care for people who are trans and gender diverse. </li>
</ul>
<p>Improving access to family doctors who are <a href="https://doi.org/10.3390/healthcare9080967">supportive, competent and confident</a> in providing access to hormone therapy — reducing bottlenecks in primary care — is a critical part of improving the health of people who are trans and gender diverse.</p><img src="https://counter.theconversation.com/content/207140/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alana Cattapan receives funding from the Social Sciences and Humanities Research Council of Canada and the Canadian Institutes of Health Research.</span></em></p><p class="fine-print"><em><span>Gwen Rose 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>Improving the health of people who are trans and gender diverse means improving access to family doctors who are supportive, competent and confident in providing access to gender-affirming care.Alana Cattapan, Assistant Professor, Department of Political Science, University of WaterlooGwen Rose, PhD candidate in English and research assistant with the Trans Research and Navigation Saskatchewan (TRANS) project, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.