Trans Rights, Medicine, and Law @ The Leicester Human Rights Arts and Film Festival

The doctors and psychiatrists treating trans people in primary care through to transitioning health services in Gender Clinics are often influenced by a pervasive trans narrative of moving from one gender to another as if this is representative of all trans people and understood equally by all concerned. This narrative is of course how some trans people feel and how they often express their transitioning experiences. The narrative articulated by many transpeople in Western contexts consist mainly of the ways in which the original body through the trope of the ‘wrong body,’ distresses them for many years, and which prior to transition they are compelled to live a gender that is not truly them. Following, often many years of ‘living a lie’ the body is sometimes refashioned to align better with their gender identities. What this simplistic narrative may imply to different healthcare, and other professionals, providing care and services to transpeople, is that trans people all desire the same things in relation to their bodies, that they experience their transition equally, and that the transitioning technologies required are the same. Transitioning technologies here refers to hormone therapies and surgical interventions…….

https://www.facebook.com/HRAFFL/

 

Keynote: Research assemblages and epistemological commitments

education-word-cloud-concept-blackboard-22887919

I provided a keynote address at University of Strathclyde: TransForming Research Practice: Towards ‘Best Practice’ in Transgender and Non-binary Inclusive Social Research.

My paper started with a practical recognition that is required of researchers is to be able to choose the best form of methodology for the job at hand. Or for researchers to understand by choosing one methodology over another will inevitable produce different results. I want to draw on Fox and Alldred’s recent paper by paraphrasing their understanding of ‘doing and producing research.’ I think their concept of research machines as part of a ‘research-assemblage’ allows us to begin to recognize research as a process of territorialization. Research territorialization is the often momentary settling of all the research’s constituent parts into a whole that shapes knowledge production. The knowledge that research produces manifests according to the particular flows of affect produced by any researcher’s methodology and methods, analysis and write-up and the people involved. This materialist analysis of research-as assemblage is pivotal to my more recent understanding of research integrity, and will form the basis for a critical framework for this talk around qualitative and indeed it’s often quoted nemesis quantitative social inquiry surrounding trans and non-binary people.

to see PowerPoint click Trans and Non-binary

Davy, Z. (2015). Trans Intelligentsia: A Western Pictorial? TSQ: Transgender Studies Quarterly, 2(4), 676-678.

KatieHerzog-Transtextuality-(LACMAsInstallation2013)acquisition

Katie Herzog’s Transtextuality (Senate Bill 48), an installation “depicting 48 portraits of transgender men and women of letters,” took on the mammoth task of displaying portraits of trans pioneers who represent transgender intelligentsia. The celebration of her Western “sitters” is an impressive display, and their academic work has no doubt contributed vast and wide-reaching insights into mine and the lives of some of my trans sisters, brothers, and others. However, her wall of fame, while potentially innocent in its creation, neglects the class, ethnicity/race, sexuality, and other situational aspects of trans writers’ lives that may have impacted the performative aspects of knowledge production about (trans) gender beyond the Western imaginary. Although this trans celebration may feel subversive because it challenges the status quo of those whose knowledge counts vis-à-vis cisgender people, we must be constantly drawn to ask, does the subversion suppress others?

Davy, Z. (2015). The DSM-5 and the Politics of Diagnosing Transpeople. Archives Of Sexual Behavior, 44(5), 1165-1176.

th9VY71WQ6Springer Science+Business Media New York 2015

Abstract

In the DSM-5 there has been  a change in the diagnosis for transpeople of all ages from Gender Identity Disorder (GID) to Gender Dysphoria (GD), in part to better indicate the distress that transpeople may experience when their gender identity feels incongruent. The Workgroup for Sexual and Gender Identity Disorders, chaired by Kenneth J. Zucker, was employed by theAmericanPsychiatricAssociation (APA) to update the DSM-5’s GID diagnosis reflecting contemporary scientific knowledge. Additionally, in a pre-publication report to the APA, members of the Workgroup suggested that they would also be concerned with the destigmatization of transpeople while preserving a diagnosis that medical insurance companies would accept for issuing payments for transitioning treatments (Drescher, 2013). The aims of this article are, firstly, to question whether changing the diagnosis lessens the stigmatization of transpeople. I will suggest that the semantic change from GID to GD marks ‘‘inverted’’ gendered expressions as pathological and, thus, continues to stigmatize transpeople. Secondly, the article explores the development of the GD diagnosis, and illustrates how the scientific data this were founded on are contentious. The article then demonstrates how the trans anti-pathologization movement has challenged the perceived pathologizing effects of the DSM-5 classification of GD. The article examines a selection of Western transgender community advocates’ websites, forums, and blogs. From these sources, the article then explores the different narratives of transpeople and political groupswho offer details of their praxis, and evidences how the trans anti-pathologization advocates use the available science and human rights discourses to contest the role of psychiatry in the treatment of transpeople.

http://link.springer.com/article/10.1007/s10508-015-0573-6

Davy, Z., Amsler, S., and Duncombe, K. (2015) Facilitating LGBT Medical, Health and Social Care Content in Higher Education Teaching. Qualitative Research in Education, 4 (2) pp. 134-163

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Increasingly, Lesbian, Gay, Bisexual, and Transgender (LGBT) health care is becoming an important quality assurance feature of primary, secondary and tertiary healthcare in Britain. While acknowledging these very positive developments, teaching LGBT curricula content is contingent upon having educators understand the complexity of LGBT lives. The study adopted a qualitative mixed method approach. The study investigated how and in what ways barriers and facilitators of providing LGBT medical, health and social care curricula content figure in the accreditation policies and within undergraduate and postgraduate medical and healthcare teaching. This paper illustrates opposing views about curricula inclusion. The evidence presented suggests that LGBT content teaching is often challenged at various points in its delivery. In this respect, we will focus on a number of resistances that sometimes prevents teachers from engaging with and providing the complexities of LGBT curricula content. These include the lack of collegiate, colleague and student cooperation. By investing some time on these often neglected areas of resistance, the difficulties and good practice met by educators will be explored. This focus will make visible how to support medical, health and social care students become aware and confident in tackling contemporaneous health issues for LGBT patients

A new commentary on my (and colleagues) latest research about LGBT curricula content for medical, health and social care students is available at

http://www.nationalelfservice.net/social-care/equality-and-diversity/fit-to-practice-lgbt-inclusion-in-health-and-social-care-education-and-accreditation/

For open access of the full article please go to

http://hipatiapress.info/hpjournals/index.php/qre/article/view/1210

Davy, Z & Siriwardena, A. N (2012) ‘To be or not to be LGBT in primary health care: health care for lesbian, gay, bisexual, and transgender people.’ British Journal of General Practice. 62(602),

Niro Siriwardena and I will be publishing a Analysis and Comment piece in the British Journal of General Practice concerning LGBT health care.

Lesbian, Gay, Bisexual and Transgender (LGBT) primary healthcare will become a feature of the primary care repertoire.1 Pride in Practice, which is supported by the RCGP,provides a rating system that judges primary care surgeries on a welcoming environment, access, the general practitioner (GP) – patient consultation, staff awareness and training and health promotion for LGB people. For those surgeries signed-up to the initiative, action plans to address shortfalls in GP surgeries or any area of healthcare in need of improvement will be developed in consultation with the Lesbian and Gay Foundation. Another initiative, Transgender Awareness, is attempting to address a number of issues that are important to a phenomenologically diverse group of transgender patients.2 While acknowledging this very positive development, it is important to understand what we mean by ‘LGBT primary healthcare’. In what follows, we will draw on the concept of LGBT healthcare to explore the benefits and potential harms that this term can engender; we will draw on the different ways that the relatively sparse LGBT health literature has addressed and accounted for the different foci of LGBT healthcare over the years; in doing so we will argue for a more nuanced approach to LGBT primary healthcare.

 

Siriwardena, A. N., Middlemass, J., Davy, Z., Cavanagh, K., Linehan, C., Lawson, S. and Morgan, K. (2012) ‘Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study.’ British Journal of General Practice.

some members of the ENACT project have will soon be published in the British Journal of general Practice. 

Abstract

Background: Insomnia is the most commonly reported psychological complaint in Britain. Cognitive behavioural therapy for insomnia (CBT-I) has been shown to be effective, but is not widely used because of lack of trained providers. Computerised Cognitive Behavioural Therapies (CCBT) for insomnia may be a solution to this access shortfall.

 Aim: We explored patient and health professional perspectives to inform the development of a novel computerised cognitive behavioural therapy programme for insomnia (CCBT-I) that includes social networking.

Design: We used a qualitative approach underpinned by the Theory of Planned Behaviour.

Setting: Primary care in Lincolnshire and Nottinghamshire

Method: Interviews and focus groups with health professionals and adults with insomnia were used to elicit attitudes, beliefs and behavioural intentions about online interventions for insomnia.

Results: We interviewed 23 health professionals and 28 patients. Features designed to increase confidence in CCBT-I; engender trust in professional relationships; provide online support and improve programme functionality were perceived to increase the successful uptake and adherence. User interactions via integrated social networking would provide mutual support but concerns included apprehension about online ‘strangers’ and information security. Patients wanted mobile applications; access in short periods; self-assessment; more interactive, personalised information on sleep and moderated contact with other users.

Conclusion: Uptake and adherence to online programmes for insomnia requires design features to focus on trust and functionality. Although computerised therapies for insomnia would allow more people to access treatment, patients’ control over CCBT-I and interactions with other users and professionals may stimulate a more positive experience of online therapy.

Book Review of Recognizing Transsexuals

5.0 out of 5 stars Giving transgender proper analysis: an essential read., 25 Feb 2012
By
A. Drummond “grrlAlex” (Wales, UK) – See all my reviews
(REAL NAME)
This review is from: Recognizing Transsexuals (Hardcover)

Recognising Transsexuals: Personal, Political and Medico-Legal Embodiment.

For anyone working in the field of transsexualism and indeed the broader domain of transgender I would suggest this book is a key text to have on the reading list. It takes a detailed and broad scoping look at the interface of transsexualism as a phenomenon within the individual, society, the medical profession, and law. A real strength of this book is that it is highly relevant to the UK position and more importantly that the author is showing how the definition of transsexualism has moved on, illustrating in the narrative the broad scoping possibilities offered by the more fluid and dynamic definition implicit in ‘transgender’.

This is an informative book then, with its research and focus based predominantly in the UK but with direct relevance to Europe and other Western cultures. The author leads us through an exploration of the phenomenon of transsexualism, highlighting the way traditional medical and legal conceptualisations of gender were caught up in ‘hegemonic and stereotypical cultural ascriptions of masculinity and femininity’. Diagnostic psychiatric manuals have themselves previously been framed from within the essentialist hetero-normative assumptions of the past, and thus historically, atypical gender identifiers were seen as some form of sexual inversion. However, new scientific knowledge and contemporary philosophical understandings are offering new ways of conceptualising the phenomenon, and, as an emerging generation of transgender and gender-queer individuals challenging the status quo we find the old medical models are simply no longer fit for purpose.

The book considers the interplay of political, legal and medical systems of sexual and gender regulation, and looks at the ways that transpeople themselves have been interactive (and increasingly proactive) in shaping specific pathways and potentials. The book gives careful consideration to the social currency of the physical body – as humans within a social society we are all subject to visual-aesthetic judgement by others and it is naive to dismiss the importance (in terms of its impact on our social relations) of the physicality we present to others. This is of course particularly significant for a transperson in terms of how one is read and or understood by others. I felt a particular strength of this book is that it devoted a decent amount of space to drawing some distinctions between the relative importance of specific body surgeries between transman and transwoman. Another strength is that it also draws attention to the recent emergence of genderqueering – the deliberate deconstruction and troubling of gender norms by a new generation of predominantly younger transgender individuals who refuse to be constrained by old school definitions of how they should express their gender identity. These are exciting times.

This book comes at a time when new knowledge and information about transgender and gender-queering is increasingly shared over the internet as gender-queer individuals find connections with others who can validate their unique experiences and create new ways of knowing and defining their experiences. Outdated medical models no longer reflect the new diversity of this group as finally we escape the legacy of the early gatekeepers of transsexual realisation. In the past it is acknowledged that one needed to become a ‘proper’ or convincing ‘man or woman’ post surgery and to offer an a priori ‘unambiguous developmental story’. Variously referred to as ‘learning the script’ these carefully rehearsed narratives reflected an anxiety about failing to convince the gatekeepers and therefore losing access to treatment: but this undoubtedly led to the distortion and indeed corruption of data, and increasingly now we are recognising that different developmental stories exist- each valid in their own ways. And equally significant, in terms of desired outcomes, there is increasing acknowledgement that there are differing stopping points with regard to transition.

In summary then, within the pages of this book, we find a well researched and neatly presented discourse on the phenomenology of queer genders that considers not only the historical contexts from which diagnosis such as transsexualism and transvestism were derived, but moves on to give the reader a more balanced and informed position of contemporary understandings of gender queering. It highlights the way in which the conceptualisation of these identities is continually evolving as a result of a complex interplay of scientific breakthrough, social activism within the queer community, and political evolution in legal systems (for example the Gender Recognition Act and Single Equality Act ). These factors are all influential in the way in which people may inhabit and embody gendered identities that are at variance with one denoted at birth.

If I had a criticism of the book, (asides from the cost which sadly will put it outside the reach of many who would benefit from reading it) it is that like so many in this field, the language structure is in places somewhat complex and the writing style leans heavily towards the academic genre, performing and reiterating an academic elitism that may afford it respect in that milieu, but then runs the risk of leaving it less accessible to others who would really benefit from the insights and observations. That said, I’d not wish to put potential readers off – even if you have to re-read the odd paragraph a couple of times, the effort really is worth it.

In conclusion then, I’d say this is an intelligently written, well researched and thoughtfully considered text that I believe will add very usefully to current understandings and thinking in this fascinating field. It would be fair to say that this book certainly has the potential to achieve its aim of affording a better recognition to the broad diversity of transsexual experiences and can therefore enhance the understanding within the psychiatric and psychology professions of this particular client group – a minority who have been so seldom properly researched in such depth or with such careful consideration.

Recognizing Transsexuals: Personal, Political and Medicolegal Embodiment (Update)

Following a wonderful British Sociological Conference at the University of Leeds, that consisted of a Gender Study Group Roundtable, featuring Prof. Sasha Roseneil, Prof. Ruth Holliday, Dr Surya Monro, prof Stevi Jackson and Prof Yvette Taylor (disguised as me) that considered the future of gender studies, research, gender and the REF, and activism, I then presented my paper entitled

Bodily aesthetic affects in trans erotica: towards a wider ‘spectra of desire.’

Abstract:

The sexualisation of trans people is a thorny issue due to the pathologizing undertones within sexological literature. After many years of being on the one hand, silenced about sexuality or on the other hyper-sexualized, for fear of being pigeon-holed as unworthy recipients of medical interventions by the medical teams providing healthcare, both transsexual and transgender people have started to explore and produce their “sexual bodies” and represent them in novel ways through prose, poetry and pornographic film. ’The political move to illustrate the wider ‘spectra of desire’ (Stryker, 2006) and experiences of trans-sexuality was announced to be politically important as a way of shifting stereotypical associations surrounding trans embodiment and sexuality generally. These projects of sexual representation rely on transforming spaces and discourses within cultural mediums in which transpeople explore their sexuality. Using trans erotica texts, I will illustrate that ‘transsexualism’ and ‘transgenderism’ are not solely about gender, as a core characteristic, and suggest that sexuality is part of trans subjectivity too. I will suggest further that new representations of trans-sexuality within the erotic representations pose challenges to the medical policy and practices surrounding trans medicalization and the sedated ideas surrounding transpeople as either non-sexual or hyper-sexual. This focus on erotica allows for new analyses and conceptualizations of trans-sexuality that incorporate bodily aesthetic affects of the transitioned and transitioning body. Simultaneously, understanding trans bodily aesthetic affects helps us move away from territorialized identitarian markers, such as gay, lesbian and bi and explore a wider spectra of trans desire.

I was then awarded the prestigious BSA Philip Abram’s Memorial Prize 2012 for best first, sole-authored book in Sociology published in the UK for Recognizing Transsexuals. I received this award as Joint winner alongside Michael Rey.

A truly momentous day and conference.

 

My Short CV

I have included a CV on my blog to encourage contact with those working with Transgender Embodiment in the Medicolegal system of any country, who may wish to collaborate on research projects.

https://docs.google.com/document/d/1_YGy6Q5JRTrjSGJSbykxPvhqqBEn4F8JczJ–AePg7E/pub