How Medicine Treats Disabled Trans People

In an article for SpoonieHacker, I talked about how medicine treats disabled trans people, and this conversation is something everyone can benefit from reading.

Podcast On Trans Issues

“Trans and non-binary activist, counsellor, trainer and writer Sam Hope is a founding member of Nottingham Trans Hub and the author of the book _Person-Centred Counselling for Trans and Gender Diverse People: A Practical Guide_ (2019). We speak to them about the dangers facing the trans community in Europe, and how best to offer meaningful support and solidarity.”

I gave this interview back in August, but it still feels relatively current, referencing GRA reforms, JK Rowling, and the situation for trans people across Europe. It took place prior to the Government’s decision not to reform the Gender Recognition Act in the UK. 

With thanks to Ibtisam Ahmed for giving me the platform to speak up for my community.

How Covid-19 Is Affecting The Transgender Community…

An extract from a talk I did for the University of Nottingham for Transgender Day of Visibility (31/3/20), detailing some of the extra complications that exist for the trans community around this pandemic.

Please note, I use certain language in this video that is ingrained but not ideal – It’s interesting how when we’re tired and stressed we use less skilful words, for example:

• Trans people being on a “journey” is an unhelpful cliché.
• Most trans people who were assigned female at birth would prefer to refer to their upper body with the word “chest”.
• Gender incongruence has superseded the term gender dysphoria, according to the World Health Organisation, and is generally preferred in-community, although not by everyone.

A critique of the hate crime agenda

The following is a transcript of my talk at the Five Leaves Bookshop event on LGBT Hate Crime. I would particularly like to thank Onni Gust for their assistance in my research and structuring of the talk, the US organisation Against Equality for their excellent resources on the subject, and Dee Fairchild for her proof-reading and encouragement.

 

This talk is going to be challenging, and I also want to give a content warning for discussions of various kinds of violence, including sexual violence. I spent a lot of time researching what I have to say today, and I hope to boost perspectives from parts of my community that have less of a voice.

I want to focus on the experiences of the trans community, but most of what I have to say is applicable to other minorities who experience hate crime.

When you are part of the trans community, hate crime becomes an everyday thing. Most of the trans women I know, and many of the trans men and non-binary people I know, have experienced hate-motivated violence – stabbing, beating, sexual assault, corrective rape, having their doors kicked in, vandalism and offensive graffiti on their homes, to name but a few. What is alarming is that most hate crime towards the trans community goes unreported. We know that reported hate crime against trans people is disproportionately high – government put it at 1% of crimes reported. That doesn’t sound much but when trans people represent more like only a quarter to a half percent of the population, that’s a lot. We also know from research by London LGBT charity Galop that as much as 80% of crimes against trans people go unreported.

My own personal experience of hate was of being driven close to suicide due to online harassment and defamation of character. This was from organised and socially powerful individuals who campaign tirelessly against the rights and recognition of transgender people. At one point things got so bad I did turn to the police out of desperation. They were kind but unhelpful and uneducated on trans issues. I learned that there is no such thing in law as hate speech against trans people, and no protection for us against incitement to hate crime.

Neil Chakraborti of the Leicester Centre for Hate Studies, who gave evidence to the recent Transgender Equality Inquiry has this to say:

“there are no incitement provisions around the stirring of hate towards trans people, but yet there are those provisions for other groups.  Interestingly there aren’t provisions for disabled people either, so it’s very much the trans community and people with physical and learning disabilities who are left out of the equation when it comes to the incitement of hate.”

He goes on to say:

“It’s frustrating that on the one hand we tell the trans community that we’re there for you, come and report your incidents and somebody will listen to you and that we want to learn from your experiences, but on the other hand we don’t have equivalent hate crime provisions as we do for the other monitored strands.”

So one of the barriers, then, is a lack of parity in law. But it gets more complicated still, because all the laws in the world will never put any but the most extreme and marginal figures before the courts. Trans people are currently in a position where most people are ill-informed about us, disrespectful reporting is standard, and academics and media representatives can say the most outrageous things about us without any loss of reputation, let alone other sanctions. In fact, it is becoming quite popular to take verbal pot-shots at our community in order to boost a waning academic career or increase ratings.

Our community’s surge in visibility and initial gaining of rights and recognition is double edged in this respect, as this shift in power we have experienced can be seen as threatening to some. That we have gone from utterly powerless to only slightly less so is not the point, the point for some is that we have shifted out of our place in society, and those people seek to put us back in our place.

It is this general climate of disrespect that is the background to hate crime against us, which can leave us sometimes feeling as if the general society message is that it’s socially acceptable to make fun of us, disrespect us, delegitimize us, look down on us, just so long as nobody steps over any lines.

Here’s Neil Chakraborti of the Leicester Centre for Hate Studies again:

“Those people we’ve spoken to through our research who’ve experienced transphobic hate crime have talked about there being a direct relationship between media representation and their experiences of hostility, discrimination and even violence.  I think that’s where real problems are when it comes to media reporting and can have some serious consequences for people.  I do definitely believe that there’s a correlation between representations through the media, and even political representations, the language we use, the normalisation of stereotypes, I think there’s a direct link between that and experiences of hostility.”

Neil Chakraborti giving oral evidence at the Transgender Equality Inquiry

 

 

 

Meanwhile, media representation of hate crime often also subtly manipulates our attention towards other vulnerable communities, pitting us against each other. Last year a friend of mine was in local news following a series of hate attacks. What’s wrong with the people of Mansfield? Was the question asked on local radio about her experiences. They problematised this poorer and more insular community. When in a related radio interview I tried to turn the tables on the media for their representation of trans people, they simply did not put my piece on air. But I feel the media hold structural power in this situation far more than the street-level folk of Mansfield, and it is their influence that perpetuates the problems we experience.

That great thinker and renaissance man Akala has something similar to say on the subject of race:

“all this nonsense about people being racist because they’re frustrated about their lives is totally classist, what we’re saying is only working class people are racist . . . racism was not invented by working class people, it was invented by elite academics . . . and perpetuated as part of political policy – from the top down, not the bottom up”

Akala confronting EDL leader

I think what he says is equally true of transphobia. It is academia, government and the media that support the structural inequalities that make hate crime possible.

Another concerning phenomenon to me is the way the media presents LGBT hate crime overseas. We often ignore the way our own culture has framed and intervened in the countries where homophobia, biphobia and transphobia are rife. We disregard the fact that war stirs up other kinds of violence, so that for instance we talk about oppressive crimes under ISIS or in Afghanistan in the context of Islam rather than the context of a war torn country. Meanwhile the media largely ignored the rounding up of trans people into camps in troubled but then right wing and Christian Greece in 2013. We talk about India and Uganda’s attitudes to LGBT people without mentioning it was the British Empire that exported those attitudes. In doing this, we reinforce our rights to intervene in these countries or judge them. Hate crime is exploited to reinforce Western dominance and superiority.

Is it possible that our focus on hate crime legislation also serves to pit the vulnerable against the vulnerable in a similar way?

I am reminded of my former work in domestic violence. I quickly learned that those brought before the court to answer for their attacks on women do not accurately reflect the structures of power that are in place against women. When I went to observe the domestic violence courts in action I was shocked to see a parade of vulnerable, generally young men, many with poor mental health, many of them black, almost all of them from deprived backgrounds. True power does not get itself caught up in the justice system. It knows what it can get away with and it also makes the laws and runs the structures that govern us.

We know that many marginalised minorities are over-represented in the prison population. For trans people this is no different, and the reasons are complex and multi-layered. Trans people suffer disproportionately from poor mental health which is directly related to lack of social support, discrimination, poor healthcare, poor housing, unemployment and psychological trauma. Trans people are less likely to be in employment, and more likely to be harassed or discriminated against at work. Trans people are even more likely than other LGBT people to become homeless or be poorly or vulnerably housed. Massive health inequality was recently flagged up in the Government’s Transgender Equality Inquiry as a major issue for the trans community. As with many oppressed communities, drug and alcohol abuse are issues within our community. Some of our medicines, if not prescribed to us, are considered class C drugs, and of course some of us in desperation turn to illegal markets for the drugs we need. Trans people are more likely to live in poverty. Trans people are more likely to find opportunities through sex work when there is a lack of other opportunity, and when we are sexualised and objectified. Trans people are more likely to experience sexual abuse and sexual exploitation. Trans people’s experience of domestic violence is disproportionately high. We are often, as with other LGBT people, considered the aggressors if we defend ourselves against attack, simply because people look on us with prejudice.

So, like most other minorities, we are thought to be over-represented in the prison system, and we might not always feel that prison is the answer in the way others who have never brushed with the law might feel. And we might not feel safe and trusting to approach the police. We might not expect a fair hearing. We don’t always act like the model minority and our sometimes messy lives may invite more judgement than sympathy.

Transgender woman Vikki Thompson, who committed suicide in a male prison in 2015

If we are people of colour, if we are from deprived areas, if we are sex workers, if we have poor mental health, if we are asylum seekers or immigrants, then we may be even less likely to feel the police are there to protect us.

We might also feel that sending hate criminals to prisons when many of us are in those prisons is not going to reduce harm to our community, and so we might feel ambivalent about enhanced sentences for hate crime. Particularly when we know that 75% of prisoners reoffend when they come out. Particularly when we know that non-custodial sentences can be better at reducing offending. Particularly when we know that the legislation is not actually reducing crimes against us.

When it comes to the police, many of us in the trans community are sincerely grateful for how much things have changed for the better. But there’s still a long way to go. Some of us are white and able and middle class and have never felt ourselves to have a complicated relationship with law enforcement. Those people often have the biggest voices, too. But we need to really work at understanding how different the experience is for those of us from even more marginalised communities. Those of us who have mental health difficulties or are neurodivergent, those from communities of colour, those who are sex workers, those who are vulnerably housed and homeless or live in poverty, those who are addicted to substances, those who have uncertain immigration status or are seeking asylum. We need, as a community, to protect and include those vulnerable people and that means putting their needs first and foremost, including showing understanding that they may not view the police as a protective presence.

The hard work has to come from the police and not from us, and the police need to be big and strong enough not to be upset and offended when we are critical. Or when we ask for them to do better for those most vulnerable, or listen to us more, or not put themselves into the middle of our social organising until we’re sure everyone feels safe about that.

Some, such as academic Wendy Brown, have argued that hate crime legislation creates an illusion of equality whilst in fact reinforcing structural power. It increases the power of the state over its citizens. It justifies the need for greater law enforcem
ent and increased incarceration. At the same time it devolves power away from the community and towards the state, asking the community to trust and look up to its protection, even as the state continues to perpetuate legislative inequalities.

This may be an extreme way of looking at things, but at a time when we seem to be questioning whether we can afford to look after our vulnerable citizens I find it somewhat puzzling that we still feel we can afford to incarcerate them.

Prison is expensive. The yearly cost of just one inmate could fund a full time school counsellor. The cost of incarcerating one person could fund two full-time workers raising awareness of trans issues in schools and colleges. As prisons become privatised, we start to suspect that our traumas are being exploited to create inventory for these businesses, while tackling the underlying issues that create our traumas is deemed unaffordable in these times of austerity.

At the same time, we do not seem to be able to provide adequate support to the victims of hate crime and their loved ones and communities. Many of my trans friends suffer from PTSD and access to therapy for this is extremely patchy.

“Against Equality”, an organisation in the US who gave me much to think about in my research, have this to say:

“Hate crimes don’t occur because there aren’t enough laws against them, and hate crimes won’t stop when those laws are in place. Hate crimes occur because, time and time again, our society demonstrates that certain people are worth less than others; that certain people are wrong, are perverse, are immoral in their very being.

“Creating more laws will not help our communities. Organizing for the passage of these kind of laws simply takes the time and energy out of communities that could instead spend the time creating alternative systems and building communities capable of starting transformative justice processes. Hate crimes bills are a distraction from the vital work necessary for community safety.”

So where does this leave us? On the one hand, of course, I want trans people to feel safe to report crimes against them and for those crimes to be taken seriously. Particularly as it is those most marginalised people I mentioned previously who are also most at risk of hate crime. I want to overcome the barriers – the fear of being outed, the fear of making it worse, the fear of not being taken seriously or not being understood or treated well. The lack of trans awareness within the police that reflects that of the general population and the media.

My own work has focussed on awareness raising and community building. I have found through experience that giving our community a voice and building relationships and understanding with the wider community is more powerful than any legislation.

I would like to quote Jess Bradley from the organisation Action for Trans Health:

 “We are unconvinced that hate crime legislation is an appropriate tool for combating transphobia due to its poor record as a deterrent and low engagement from the trans community. We believe a focus on education, awareness and combating medical neglect is more appropriate a response to transphobia”

The work I and others have done in Nottinghamshire to create a set of Safer Space Guidelines is I believe at the core of how we go forward. Instead of people who aren’t trans telling us what we need, it’s time, respectfully, that people began listening to this community. The guidelines, which can be found on the Notts Trans Hub Website, set out ways in which people can consult us and consider how they interact with us.

One of the repeating themes the trans community face is that everyone has the freedom to speak how they like about us, but when we respond with criticism our own free speech is deemed “too much” for people. I agree, it’s a big adjustment to even begin to adapt to our needs and treat us fairly. But society won’t be equal when everyone who hates us is locked up. Society will be equal when people see no reason to hate us.