In January 2016, the report was published of the first ever enquiry into transgender discrimination by a UK parliamentary committee. In an interview with The Independent newspaper about the report, the chair of the Women and Equalities Select Committee, Maria Miller (MP), said, “Transgender people are today suffering the kind of discrimination that was faced by gays and lesbians decades ago… They are the last group of people in our society who endure overt and unchallenged prejudice and we need urgent root-and-branch reform of our public services to tackle it.” Maria Miller’s report covers many aspects of British social and institutional life, including marriage, sport, prisons, schools, the health-service, and the way gender is construed and defined by equalities legislation and in the information the UK government collects about its citizens. The report’s recommendations can be placed into sixteen general categories, and to implement them all will be a tall order. The existence of the political will to make this happen (and to commit public funds to it) will depend, I believe, on three connected factors. First: that the transgender community can convincingly portray itself as a significant minority (rather than as a crackpot clique of fetishists who aren’t quite sure which wardrobe to dress from in the morning). Second: that people can be educated to care about the systemic biases in law, employment, education and healthcare that disadvantage transgender people, and about the freedom key gatekeepers in those institutions have to enact their personal prejudices. Third: that the belief can be promulgated that real and avoidable damage is done to the lives of transgender people by these biases, and that the perpetuation of transphobia is detrimental to the moral and spiritual condition of the society in which it occurs.
The most radical aspect of the report on transgender discrimination by the Women and Equalities Select Committee is its foregrounding of the role played by language in shaping social attitudes. Too many eminent psychologists, sociologists and poets have described the link between language, thought and cultural practice as dialectic, interdependent and complementary for me to be able to claim that assertion as my own (Basil Bernstein and Pierre Bourdieu spring immediately to mind, along with Noam Chomsky, Émile Durkheim, Norman Fairclough, Michel Foucault, Martin Heidegger, Claude Lévi-Strauss, Alexander Luria, Stephen Pinker and Lev Vygotsky): the norms and values of a community are negotiated and crystallised through social interaction; these norms then influence the formation and application of the language used by members of that community; and continued use of that language embeds the community’s values and assumptions, and ensures they are passed on to subsequent generations.
To solve the problem of transgender discrimination, the Transgender Equality report does not offer gimmicky initiatives, or propose layers of bureaucratic monitoring and the establishment of focus-groups and think-tanks. Instead, the committee insists that the language with which legal and medical edifices in our society conceptualise and delineate gender needs to change in order to alter public perceptions of transgender people. This recognition that the pruriently physiological and diagnostic language used to define and describe transsexuals is responsible for the fear and confusion that underpins transphobia is hugely significant, and three of the report’s sixteen recommendations refer specifically to the transformative power of dragging the transgender lexicon into the twenty-first century:
- A more broadminded (and, therefore, non-binary) definition of ‘gender’ must be used in the collection of demographic information, and for the description of UK citizens on official documents (such as passports);
- The terminology used in the 2004 Gender Recognition Act must be up-dated, so that medicalised and anachronistic conceptions of transgenderism (which construe it as pathological, or related to mental-health) are replaced with language predicated on the assumption that transgender people have the right to autonomy of self-identification;
- Likewise, the terminology of the 2010 Equality Act must change to reduce the reliance for legal matters on labels derived from surgical procedures – like ‘gender reassignment’ and ‘transsexual’ – to determine gender nonconformity.
When the language we use to describe a phenomenon changes, it becomes possible for the way we think and behave in relation to that phenomenon to change as well. There are influential people in society who attempt to describe transgender people using language that assumes deficiency of character and deviation from collective norms. That language needs to change, and, when it does, and labels are abandoned that are rooted in surgical procedures (like ‘transsexual’), or redolent of sexual confusion (like ‘dysphoric’), three things can happen: people are able to discover that no two transgender individuals are alike; gender nonconformity can be understood as occurring on a rich and varied spectrum; and transgender people can be humanised and empowered to the extent necessary for society generally to care about – and empathise with – their plight.
Semantic and conceptual change, therefore, are necessary conditions for the implementation of the other recommendations contained in the report of the Women and Equalities Select Committee:
- Greater commitment from the UK government to delivering on the promises of its own 2011 action plan, ‘Advancing Transgender Equality’;
- Removal of the need for spousal consent for a legal change of gender when one person in a marriage seeks to undergo gender transition;
- Lowering of the legal age at which people can apply for gender recognition to 16;
- Protection for transgender people from having their gender history made public during court proceedings;
- Removal of unnecessary demands placed on transgender people to use separate facilities (such as toilets) in the workplace;
- The imposition of requirements on sporting organisations (such as university clubs) to reassess any gendered rules in their constitutions relating to participants’ access to non-competitive sporting activities;
- Strengthening of the existing hate-crime legislation to ensure it protects transgender people – and improved training for the people who enforce it;
- The provision of appropriate prison and probation for transgender offenders;
- Greater regulation of the way transgender people are portrayed in the media and on-line;
- The inclusion of transgender issues on the school curriculum; improved support for transgender pupils (and their parents) at school and by social workers; and improved gender-awareness training for further-education providers.
Maria Miller’s review of transgender equality reserves its severest criticism for the provision of healthcare for transgender people in the United Kingdom. Paragraph 25 of the committee’s conclusions states, “We have found that the NHS is letting down trans people, with too much evidence of an approach that can be said to be discriminatory and in breach of the Equality Act”. Accordingly, the report calls for:
- Greater regulation of doctors to reduce the biased treatment of transgender people (and to prevent doctors refusing to support transgender patients at all);
- An end to the association of transgenderism with psychological disorder that is encouraged by the inclusion of transgender services under the mental-health umbrella;
- General expansion of the capacity of the NHS for supporting transgender people, and wholesale improvement in the quality of treatment it provides (including at the Tavistock Clinic for gender-variant children and adolescents).
Why should anyone care about transphobic prejudice?
Exact statistics regarding the size of the transgender population are not easy to come by. A Home Office report in 2000 approximated that there were up to 2,000 male-to-female, and 400 female-to-male, transsexuals living in the UK. An estimate published by the transgender pressure group, Press for Change, said in 2014 that the total number was more likely to be nearer 5,000. In 2011, the Gender Identity Research and Education Society calculated that around 650,000 people in the UK (about 1% of the population) “experience some degree of gender nonconformity”.
In 2011, a paper published by the University of California’s Williams Institute estimated that 700,000 adults in the US identified as transgender (which constitutes around 0.3% of the population as a whole). Between 1936 (when the Social Security Administration was founded) and June 2015, 135,367 Americans were recorded as having changed their name for one of the gender they were not assigned at birth.
It seems petty and ridiculous to expect people to care about the plight of a minority group when precise data about the size of that group is not available (nor when it is not being systematically collected). In order to believe that the campaign for transgender equality is worthy of media attention, legislative time, and public funding, you have to agree that 1% of the UK population – or 700,000 people in the case of America – constitutes a significant minority. Additionally, you have to subscribe to the view that society has a duty to protect all its members, and think that a society that knowingly allows any group within it to suffer – no matter how small that group may be – is a society that is failing.
Perhaps the intellectual leap necessary for cisgender people to feel a measure of empathy with gender nonconformists can be made by considering the extent to which transgender people are statistically more likely than the general population to be the victims of unemployment, poverty and depression. In 2011, the US National Centre for Transgender Equality published the findings of its National Transgender Discrimination Survey, in a sobering document entitled ‘Injustice at Every Turn’. Researchers from the centre used questionnaires to survey over 7,500 transgender Americans, and were able to gather data from all fifty US states and its five permanently inhabited territories. The key findings of the research were that transgender people were nearly four times more likely to live in extreme poverty (that is, on less than $10,000 a year) than the general population, and that a heart-breaking 41% of respondents had attempted suicide – compared with 1.6% of Americans generally. The rate of attempted suicide, furthermore, was 51% for transgender people who reported having been bullied at school; 55% for those who had lost their jobs as a result of transitioning; and 61% and 64%, respectively, for those who had been the victims of violence or sexual assault.
Add to those statistics higher-than-average school-dropout rates for transgender people; double the rate of unemployment of cisgender Americans; a 90% affirmative response to questions about being mistreated or discriminated against at work; four times the rate of homelessness in comparison to the general population; and a one-in-five chance that a transgender person will be refused medical care on the grounds of their gender nonconforming status, and you will see that, when I use the word ‘plight’ to describe the consequences of transphobic prejudice on transgender people, I am not being flippant. The conclusion is inescapable: society is biased against transgender people being able to live happy, healthy and rewarding lives; and this bias is deep-rooted, endemic, and profoundly damaging.
The relative sizes of the UK and America makes statistical comparison an inexact science, but if similar demographic patterns pertain between the two countries (and there is no reason why, given their economic and political similarities, this would not be the case), the English health system is poorly equipped to cope with the responsibility of caring for transgender patients. Data about the number of gender reassignment operations being carried out by the Imperial College Healthcare NHS Trust is freely available on their website. At the end of January, 2016, 301 people were on the waiting list for an appointment at the Gender Identity Clinic; a further 130 were awaiting surgery, or approval for surgery. Since 2012, an average of 151 operations have been completed each year – meeting less than a third of demand. The average waiting time for patients at the clinic was the best part of 74 weeks in 2015, despite the waiting-time threshold for all surgical procedures in the UK having been set by the government at 18 weeks. It seems almost redundant to point out that, with suicide-rates amongst transgender people so disproportionately high, this punishing wait to take the last few all-important steps towards becoming the person you want to be, can literally mean the difference between life and death.
The primary reason for transphobic prejudice is, quite simply, that gender transition is assumed to be a choice. Compassion for transgender people cannot be achieved until the prevailing social attitude towards us ceases to be informed by disdain for a lifestyle decision made on a whim, and by the notion that our woes are self-inflicted. To anyone who is transgender, the belief that we elected to live this way – that we were anything other than compelled to take radical steps to cure ourselves of crippling depression and the inability to feel comfortable in our own skin – is baffling. You think gender transition is a choice; that we choose to be isolated or homeless, to live in poverty, or to be estranged from our spouses and children? You have got to be kidding.
The report by the UK parliamentary committee, ‘Transgender Equality’ (January 2016), can be viewed in full here…http://www.publications.parliament.uk/pa/cm201516/cmselect/cmwomeq/390/390.pdf
The comments of the committee chair, Maria Miller, to The Independent newspaper can be read here… http://www.independent.co.uk/news/uk/home-news/transgender-rights-mps-demand-end-to-institutional-transphobia-a6810881.html
You can blow the dust off the UK government’s 2011 document, ‘Advancing Transgender Equality: A Plan for Action’, here… https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/85498/transgender-action-plan.pdf
Estimates by The New York Ties about the number of transgender people living in the USA are collated here… http://www.nytimes.com/2015/06/09/upshot/the-search-for-the-best-estimate-of-the-transgender-population.html?_r=0
The report of the 2011 US National Transgender Discrimination Survey (‘Injustice at Every Turn’) can be studied here… http://endtransdiscrimination.org/PDFs/NTDS_Report.pdf#page=8
Up-to-date statistics regarding male-to-female gender reassignment surgery performed on the UK National Health Service are available here… https://www.imperial.nhs.uk/our-services/surgery/gender-surgery