Asking about gender – inclusivity and trying to get it “right”

The young person sat in front of me is noticeably androgynous in a loose tunic, with elfin features, the sharp cheekbones of a male-model, and an overgrown pixie-cut. My assessment form demands a tick in the box, are they male or female? I wonder if they fall somewhere outside of this binary, if maybe they define themselves as genderqueer, or somewhere else on the gender spectrum. Maybe they don’t use any label for how they see themselves. I’d like think of myself as reasonably open-minded and something of an ally for LGBT rights and gender diversity, so I want to make an effort, to get it “right”. But I’m also conscious of causing offence – what if they do identify as male, will they be insulted by my asking? Maybe they’ve had a lifetime of being mislabelled as feminine. Will this break down our relationship before it’s even begun?

“What would you like me to put down for gender?”

(pause, confused expression) “Um…male”

“Okay… I only ask because some people identify as genders different from “male” or “female””

“Oh yeah… I know some people like that”

“Okay, what shall I put for your ethnicity?”

And so we move on.

This encounter made me think about how I ask questions about demographics and diversity. In healthcare often the forms we use as restricted – used to generate statistics and leaving little room for greyer areas. But there are many aspects of personhood that aren’t immediately obvious. I have no difficulty asking someone their age, but somehow checking in with someone about issues such as gender and sexual orientation feels more difficult – my concern is that others will think I have made assumptions about them, “What makes you think I’m gay?”.

One way of making diversity questions less personal is to ask them routinely, even when the answer may appear “obvious”. Guesses at ethnicity and sexual orientation are also open to error without checking in (for example: someone who appears caucasian but is actually of mixed heritage). It is time-consuming to run through these kinds of questions but when I have the chance I do find it helpful. Most of the clients I work with have “majority” characteristics but they are rarely offended when I ask anyway. Often the form can be a starting point for these conversations “It’s something we ask everyone” and can reveal difference that isn’t immediately obvious in a relatively safe manner. Giving people assessment forms to complete themselves may also be another route, and including “other” boxes alongside diversity checklists. I also wonder, for those who sit in the majority groups, whether being asked the question provokes some thinking about diversity and brings a degree of normalisation.

NB – I don’t consider myself an expert on these topics, this is merely a reflection on my own experience. I recommend anyone interested in informing themselves about being sensitive and inclusive towards gender diverse individuals do some research – e.g. BPS, genderbread  , Christine Richards

“Just a phase”? Freedom to be a little sexually flexible

Queer women’s sexuality appears to be having something of a media ‘moment’. The new series of Orange is the New Black has got many heterosexual women claiming they’d “go gay” for genderfluid star Ruby Rose and supermodel face-of-everywhere Cara Delevigne is on the cover of Vogue describing her loving relationship with singer Annie Clarke. A comment from journalist Rob Haskell has drawn particular anger “Her parents seem to think girls are just a phase for Cara, and they may be correct.” Having their same-sex attraction written-off as “experimentation” is an experience many queer people can relate to. Photos of Kirsten Stewart sharing intimate moments with her partner Alicia are often naively captioned as “Kirsten and friend”. Bisexuality is often treated as invisible when the individual is in an opposite-sex relationship, as though their past relationships, attractions, preferences and sexual experiences are no longer a part of their identity. People of non-heterosexual identity are keen to stand up and proclaim that their sexuality is not a “phase”, that it’s who they are and it’s here to stay.

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But what’s wrong with having a “phase”? Tastes and preferences vary throughout our lives and experimentation is a way in which we can work out what we like, what we want. The phrase has become imbued with negativity – connotations of inauthenticity. Ideas that sexual experimentation is motivated by ideas of what is “cool”, what is expected at a certain age, being a part of a peer group where such a thing is “expected”. Sexuality is treated as a trend, a fashion. Implicit is the notion that the experience, and any feelings attached to it, is not genuine. In cold hindsight it is rewritten as meaningless.

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Trans Visiblity: Rallying, allying and minding your own business

NB – I am open to suggestions and making edits to this piece if anyone feels the language used is inappropriate or inaccurate. Please drop me a message and let me know556cd6644ae56e586e4588d8_caitlyn-jenner-bruce-jenner-july-2015-vf

Here is an extract from a recent conversation I had:

“But the first Matrix is definitely the best Wachowski Brothers’ film”

“They’re actually not called the Wachowski Brothers anymore, as one of them has since transitioned”

“Ah okay, didn’t know that! Good pub quiz knowledge!”

And then the conversation moved on. Transgender people are arguably more visible now than ever before, and words and phrases such as “transition”, “non-binary”, “female-to-male” and “gender identity” are far more commonplace in general vocabulary and seem to not need the level of explanation that they once did. That isn’t to say that it’s fully entrenched in common knowledge, and many people still don’t know the difference between terms such as “transgender”, “transvestite” and “hermaphrodite” (and think “cis” is some kind of infection), (the BBC published a helpful glossary this week). Awareness is rising, and that’s never been more true than this week, with Caitlyn Jenner’s Vanity Fair cover, quickly becoming the most visible trans person in the world.

Transvisibility has certainly increased in the last couple of years. Openly trans actress and activist Laverne Cox rose to prominence in Orange is the New Black, later gracing the cover of Time magazine and posing nude for Allure. Trans models such as Lea T and Andeja Pejic have been very visible in fashion and beauty campaigns. Popular television shows such as Transparent and Louis Theroux’s “Transgender Kids” have been educational to audiences. Journalist and presenter Paris Lees, once voted top of the “pink list” of influential UK LGBT people, has brought a lot of attention to trans issues. Trans men continue to be less visible, although statistics suggest that they are similar in number.

Prior to this week I was only vaguely aware of Ms Jenner (I’ve never watched her reality shows) but lately my social media has been awash with images of her, celebrating her bravery, openness and the inspiration she gives. But you only need to read the comments posted on this article (or indeed from some celebrities) to see how far we have to go in terms to increasing awareness, acceptance and equality for the transgender and minority gender identity community.

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Trans people experience significant discrimination and abuse. Many trans people, particularly women of colour, are murdered each year. They are rejected by their families, bullyied and the list of those who turn to suicide increases. The stories of Leelah Alcorn and Lucy Meadows are two recent tragic examples that have been publicised. Trans rights were largely ignored in the equal marriage debates, and the issue of “spousal veto” remains – in which a married person applying for a gender recognition certificate must have the approval of their spouse. The UK’s most prominent gay rights charity Stonewall has only recently begun to represent trans people, after lengthy lobbying. Transphobia is pervasive and often slips under the radar, as though seem as a fair topic for fun rather than an undercurrent of prejudice that impacts on the lives of trans people continually. Trans people are often the subject of jokes in the media and derogatory terms such as “tr*nny” are used without thought. If you look out for it you might be surprised the level of offensive language commonly used that refers negatively to trans communities, often slipping in subtly. Trans people are overrepresented in mental health populations, and with a lifetime of discrimination and high incidences of trauma it’s little wonder why. In order to access gender identity services people must jump through considerable hoops that include extensive psychiatric evaluation. The past hashtag #transdocfail exhibited just how uninformed health professionals are about trans issues. Any one of these instances is shocking, but together it’s a pretty horrifying picture of how we treat human beings we see as “different”.

TDFSamples

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Strong & Beautiful Style at MAC

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I’m currently loving the current MAC ‘Strength’ campaign, featuring fitness model and female body-builder, Jelena Abbou. I’m a long-term fan of MAC make-up and they’re known for employing eye-catching concepts and styling for their photo-shoots, but it’s really refreshing to see a mainstream advertisement that celebrates some diversity in female beauty. Other than rather tokenistic (and often insulting) ‘real women have curves’ shots, a particular standard of young, waifish (and usually white) beauty is very much the published norm. Though being fit and exercising has never exactly been unfashionable, often it seems to be marketed only as a means to losing weight and becoming a particular shape. See this rather depressing article about a New York-based trainer who helps agency models get down to sample size with a very particular exercise regime “Push-ups are out — developing the chest is bad news — as are squats and lunges, which make the derrière too round to fit into the clothes”. When muscular women have featured in ad campaigns and editorials, they’re often portrayed as something of a freak-show attraction, or in a rather masculine manner. It’s nice so see that this campaign celebrates Abbou as a feminine woman as well as an athlete, whose body is a testament to her power and dedication. Strength indeed.

Shop the collection here.

Vaginas are revolting

And they refuse to do it quietly.

I was recently involved in a research study about women’s perceptions of their labia. Seven-plus pages of questions about my opinion of my labia majora. Do I think they’re too big? Too small? Too droopy? Too hairy? Do they bother me? Do I avoid swimming or sex to prevent others from noticing them? Would I like to pay to get someone to nip and tuck them to a more acceptable standard? The questionnaire was definitely something of an eye-opener and did leave me feeling somewhat depressed. Although I was often ticking at the ‘never’ or ‘rarely’ end of the scale, there were some questions where I did have to admit that sometimes I do have less-than-positive opinions about my body. Also I was fully aware that there would be some women out there who would be ticking ‘very much’ and ‘always’ to many of the given statements. There are many people out there who truly hate their labia, or other parts and aspects of their genitalia. That makes me really sad.

I’ve been umming and erring over what language to use in this piece. It’s about female genitalia, vaginas, vulvas and everything that comes attached to them. Often the word ‘vagina’ is used in a non-anatomically-correct (oh, this makes me seethe!) to mean the entire internal and external genitalia. I like ‘cunt’, though I know a lot of people find it offensive. It’s a short strong word that I think holds a similar impact to words used for male anatomy. Plus it’s an old English word, it has the history. Don’t like ‘pussy’, it’s become a little too America-porno and I’m not a fan of cutesy euphemisms, as if there’s something rude or shameful about calling it what it is. I do find myself using phrases like ‘lady-garden’ (mostly because I find this one quite funny, as is the equivalent ‘gentleman-forest’!) and girl-parts, which probably contradicts my previous statement, but it works for me. And you’d probably use different words in different contexts; though anatomical terms are the most accurate, you might not want to throw them into an intimate moment. The Vagina Monologues does a great piece all about this. But we’re talking about the same thing, whatever we call it.

I’m not a historian, but I don’t think this level of dissatisfaction with genitalia was always around. Female body-dissatisfaction is obviously not something new, though it seems to be ever-growing. Operations to ‘trim’ labia into a ‘neat’ shape have not always existed. Whereas much plastic surgery focuses on parts of the body that are immediately obvious to others – bigger breasts, straighter noses, slimmer buttocks. If you wanted to appear more attractive to others, perhaps this makes sense. But your labia aren’t (usually) on show, they’re actually hidden most of the time. Yet woman may feel this pervasive need to change this part of their body that may only be seen by themselves, their gynae and their partner.

I imagine plastic surgeons would say they are responding to a demand, they may well be right. Though I wonder what effect it has even knowing that such an operation exists. A standard is set for the ‘correct’ and ‘appealing’ labia, and the question is posed ‘Is yours attractive? Is it normal? Would you like to change it?’ Health and beauty companies thrive off the fears and insecurities of the masses. Once the customer has been made aware of their need, a product can be sold to them to ‘fill’ this need. Wrinkles, a natural part of aging, are demonised, and a magical cure is sold. Women didn’t use to buy razors. Now the sight of a woman with hairy arm-pits is often treated with disgust. Yet there is no particular hygiene benefit to shaving arm-pits (after all, the majority of men don’t), yet now for women it is considered the norm. As is shaving leg-hair. A new market is created. Special razors for women are marketed, in pretty baby-pinks and blues. A generation of girls are born into a culture where this is completely normal and grooming of body-hair is just something you do.

Looking at older pornography can be quite enlightening (all in the name of research!). I think if you showed a bunch of teenage boys Playboy images from the 70s, with their full-bushes, tan-lines and natural breast, they’d probably laugh and show signs of disgust. Yet this was the height of sexiness not too long ago. For many people, porn is the first time they get to have a really good look at the genitalia of another person. A heterosexual woman may not have many opportunities to have a close to look at another’s parts, being only able to see her own and these images in the media. Even if you do have sex with women, I don’t imagine everyone really gets an opportunity to have a really long, well-lit, inspection of another person’s genitals (doing so may unnerve your partner, so please approach this with caution!). Porn is now very easily accessible. So for many women (and men), they’ve only ever seen their own goods, and the neat and tidy presentations on screen.

Labia show as much variation as human faces, they vary in their colouring, amount of hair, relative sizes and lengths, symmetry…they’re wonderfully diverse. Yet if you’ve only ever seen one particular type and your own, a negative comparison is easily made. (I think this is probably true for men to some extend too, and insecurities around penis size relating to the well-hung men who are sought out for porn. Although culturally men do tend to see other men naked more often – think showering and urinals, than women see other women). Hungry Beast created this fantastic mini-documentary about labia in the media, particularly relating to censorship and photo-editing. As someone who has worked in nude photography I can relate to this. A photograph that displays more labia is often considered more explicit than one that does not. Yet for a model with larger labia, the same pose may show off more than that of another model. Is this in itself inherently offensive? The result is fewer and fewer images that show the true variation of labia, leading those who don’t fit this model to believe that there’s something strange and ugly about themselves.

I once over-heard a conversation given by someone I know about a ‘scary vagina’. A ‘scary vagina’ apparently has hair on the outer labia, and the inner labia and larger than the outer. This isn’t a ‘scary vagina’, it’s a totally normal one! And it’s this kind of attitude that perpetuates shame and body-loathing.

The recent back-lash over the latest Fem-Fresh campaign has pulled this campaign for cunts of the world into the more mainstream attention. The team behind the adverts for vag-wipes probably thought they were empowering women, with their adverts of a jubilant woman saying ‘Woohoo for my froo-froo!’ and ‘Whatever you call it, love it’. It isn’t all bad, we should be able to have information about women’s body parts out there. Recently a women’s group were reprimanded for leaving ‘sexually explicit’ material around where children could see them. The material in question was a poster advertising support services and awareness of female genital mutilation and featured an image of a young woman of Africa-heritage. I have looked at the material several times and all I can come up with is that the school did not wish for children to see the word or references to ‘genital’. What message does this send, to sufferers of these atrocities, but also to young people in general? That we can’t talk about what’s between our legs?

Anyway, back to Fem-Fresh. It seems we can only talk about vaginas under cutsey euphemisms. And this is the razor story all over again. Create insecurity and need: your vagina smells bad. Sell product to fix need: here is a wipe to make your vagina smell lovely. Provided you wash regularly and don’t have an infection, your vagina smells completely normal. It isn’t supposed to smell like a flower. Vaginas are moist, it’s how they clean themselves. They have their own, natural smell. I don’t think it would be a big leap to say that many people like this smell, it’s erotic. I’m reminded of Pamela Des Barres 70s groupie memoir when she talks about using chocolate and strawberry douches (now out of favour mainly due to being particularly unhealthy and actually promoting infection). Vaginas aren’t supposed to taste like ice-cream.

It goes without saying that it is absolutely a woman’s choice to do exactly what she wishes with her own genitalia. And if that means that she wishes to have her labia surgically cut and trimmed, all the hair waxed off and for her vulva to be lightly fragranced, so be it. It’s her choice. But it should be because that’s what she wants, rather than out of a fear that her vagina is shameful and disgusting as it is and needs to reach a certain standard before it can be unleashed on others. Unless you work in the sex industry, your genitalia are probably only seen by yourself and the people you choose to have sex with. It’s something personal and private, not on show to the world in the same way that other parts of the body are. There are women around the world who are having their genitals savagely mutilated and disfigured, having their right to a natural body and sex-life taken from them, yet we’re inflicting our own private battle on our lady-parts. Owners of vaginas: Your genitals aren’t an identikit flesh-light, they’re a diverse and wonderful piece of human anatomy. You weren’t born believing there was something wrong with your body, yet somehow the idea became more and more acceptable to the point where it’s completely accepted. An entire industry thrives on making you hate what you have and buy a piece of altered perfection. It doesn’t have to be that way.

And for everyone else who loves vaginas: Show them some appreciation! Each is different and they’re not strange or scary. Go and tell your favourite vagina how much you like her, just as she is.

It’s not really in the flavour of this article, but as some of you may be at work, images below the cut.

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New guidelines for working therapeutically with Sexual & Gender Minority Clients

It’s already shaping up to be a good year for gender and sexual diversity in mental health. Last month the BPS (British Psychological Society, the organisation that oversees all practising psychologists in the UK) released the document ‘Guidelines and Literature Review for Psychologists Working Therapeutically with Sexual and Gender Minority Clients‘, which can be viewed for free online here. Although aimed particularly at those delivering therapy in sexuality/gender-focused settings, this advice has relevance for health professionals working in all areas. The report states its aims: ‘These guidelines have been developed in recognition of the importance of guiding and supporting applied psychologists around their work with sexual and gender minority clients in order to enable their inclusion in clinical practice at a high standard. They also aspire to engender better understanding of clients who may have suffered social exclusion and stigmatisation in order to reduce the possibility of this in the clinical arena.’ Attention is given to the harm caused in the past by perspectives in mental health about sexuality, which began to be put right the the removal of the diagnosis of homosexuality from the DSM in 1973. However, there is still a long way to go before services truly are inclusive and sensitive to the needs their clients, regardless of their sexual or gender identity. High levels of mental health problems have been reported in this client group, but they often experience difficulty accessing services, and may experience discrimination (unintentional or otherwise) from uninformed professionals.

It’s a large document that I’m still in the process of digesting, but so far I’ve been struck by how inclusive and wide-ranging it is. The report discusses ‘less-visible’ sexualities and identities, such as the spectrum that gender identities can take, forms of bisexuality and more fluid identities. Controversial and often-overlooked topics such as non-monogamous relationships/orientation, BDSM and sex-work are also tackled. It is worded sensitively, with effort to use quotes from service-users and use current phrases and slang, to bring professionals closer to the world inhabited by the clients they may meet.  The report encourages professionals to consider their own understandings of gender and sexuality, the context we live in and how this has shaped our own and others’ perceptions of.There is also a focus on doing away with myths that perpetuate throughout the system about certain identities, and a strong opposition to attempts to ‘cure’ a sexual or gender identity. It seems to be a really positive and well-researched report that would be beneficial to individuals working in a wide range of sectors, to inform and advise on a range of issues with working with this client group. If you’ve seen the document, what were your thoughts?