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. 

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 know. 

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.

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”.

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?

Gender Fatigue – Andrej Pejic & the trend for the ‘bend

Edit 22/04/15 – In the time since I wrote this piece I’m aware that that Adreja Pejic has “come out” and transitioned. In light of this I’ve considered whether this piece comes across as mean-spirited. My intention was to criticise the idea that the only kind of acceptable gender non-conforming body was one that conformed to idealised standards of (female) beauty, and that this was not as ground-breaking and empowering as some media sources had made it out to be. I have no issue with Pejic herself and however she chooses to express herself, more the way the media paraded her.

Barnes & Nobel censored this cover, worrying that customers might mistake him for a topless woman

Here comes an unpopular opinion. I am bored of Andrej Pejic. There, I said it.

Yes, he’s pretty, I don’t deny that. I’m not bored of looking at him,  he’s gorgeous and has created some stunning images. What I’m bored of is the way he’s being continually lauded as the patron saint of gender diversity as if he’s the first bloke to ever wear a dress.

You’ve probably heard of the Serbian-born male model, famous for, well, looking like a girl. And not just any girl, a beautiful girl, with the high-fashion look designers crave. Andrei shot to fame following a Marc Jacobs editorial which showed the blond, elfin model in a short dress, showing off his slender, well-oiled legs. A sensation was born and Pejic became one of the first male models to take part in female catwalk shows and fronting many campaigns for men’s and women’s wear. Controversy and world-wide fame insued after he gained a place in FHM’s ‘hottest women’ list, generating some rather ugly transphobic abuse, and when he starred in a push-up bra advert.

Pejic, who does not identify as transgender, has been quoted saying that he enjoys dressing in both masculine and feminine styles and has been mistaken for a girl since he was a child, suffering no hostility for it “I can’t really say that it was ever a bad thing. All I’ll say is … a lot of free drinks!”. Journalists and media have applauded his bravery and defiance in the face of gender-norms, his innovation and his status as an icon of gender-fluidity, someone judged on their ‘merits’ rather than their gender. So does the acceptance of Pejic into the mainstream media and fashion world mean that society is becoming more accepting of variation in gender and individuals whose identity differs from their biological sex? I’m not so sure.