Understanding Trans Health Dr Ruth Pearce r pearce

Understanding Trans Health Dr Ruth Pearce r. pearce 1@leeds. ac. uk School of Sociology and Social Policy University of Leeds http: //ruthpearce. net

OUTLINE 1. Background 2. Trans health issues 3. Tackling mistrust

1) BACKGROUND

TRANS PEOPLE ARE… …people whose gender identity differs from the gender they were assigned at birth CIS PEOPLE ARE… …people whose gender identity aligns with the gender they were assigned at birth

• Transgender • Trans woman • Trans man • Non-binary • Genderqueer • Transsexual • Transvestite • Cross-dresser

PRONOUNS How to refer to trans patients? • Trans women and girls: she/her • Trans men and boys: he/him • Non-binary people: they/them If you’re not sure what pronoun a patient uses… …just ask!

TRANSPHOBIA and CISGENDERISM Transphobia • Prejudice towards trans people Cisgenderism • Structuring society around the assumption that everyone is cis

TRANSITION A person’s journey from their assigned gender to another gender • Social transition • Physical transition Not every trans person will transition

2) Trans health issues

TRANS PEOPLE ARE MORE LIKELY TO… • …experience mental health issues • 88% depression, 53% self harm • …attempt suicide • 48% lifetime prevalence • …experience harassment or violence • • 41% experienced hate crime in last year 28% faced domestic abuse in last year • …be HIV positive • …experience substance abuse • …be on the autistic spectrum (maybe!)

GENDER IDENTITY SERVICES • Gender clinics (GICs) • Assessment • Diagnosis • Care management • Referrals • Primary care • Hormone prescriptions • Testosterone injections • Blood tests • Surgery

3) Mistrust (and misunderstanding)

“The NHS is letting down trans people: it is failing in its legal duty under the Equality Act. Trans people encounter significant problems in using general NHS services, due to the attitude of some clinicians and other staff who lack knowledge and understanding—and in some cases are prejudiced. The NHS is failing to ensure zero tolerance of transphobic behaviour. ” House of Commons Women and Equalities Committee (2016)

Misunderstanding 1: MISGENDERING “[M]y wife kept correcting nurse from him to her, husband to wife. Nurse still continued to misgender [me] each time” Research participant: Judith “She was assigned to a male ward with a male name on her ward file when she was last in hospital, in spite of transitioning 25 years ago and having a Gender Recognition Certificate. ” Fieldwork diary

Misunderstanding 2: TRANS AS TRANSITION

Misunderstanding 3: TRANS BROKEN ARM “Trans Broken Arm Syndrome. It’s when healthcare providers assume that all medical issues are a result of a person being trans. Everything – from mental health problems to, yes, broken arms Naith Payton (writing for Pink News, 2015) “Secondary care refuse to treat my mental health problems because I'm attending a GIC. The GIC won't treat them either. ” Trans. Doc. Fail. Anon

“She's been wonderful to me and very supportive and understanding from the very beginning of my transition - though she immediately told me that she had not supported a transperson before and as far as she was aware had never even met one. ” Research participant: Ellie “She was very welcoming and friendly, and I got on with her really well. I was made to feel at ease and she listened closely to everything I said” Research participant: Warren “Nurse calling in referral to urologist: ‘Yes. Yes, female is correct. Yes, her penis’” Twitter user

TO FIND OUT MORE… • Fox Fisher and crew – My Genderation – (Youtube Channel) https: //www. youtube. com/user/My. Genderation • Royal College of Nursing (2017) – Fair care for trans patients https: //www. rcn. org. uk/professional-development/publications/pub-005575 • Stonewall (2018) – Trans Report https: //www. stonewall. org. uk/lgbt-britain-trans-report • Scottish Transgender Alliance (2012) – Trans Mental Health Study https: //www. gires. org. uk/assets/Medpro-Assets/trans_mh_study. pdf • CN Lester (2017) – Trans Like Me – Virago • Ruth Pearce (2018) – Understanding Trans Health – Policy Press