Hide me!

Jai’s report

Attending the TGEU Council was an incredible experience, which brought home to me just how Matpic1important it is to be part of a large and diverse trans community. As a young trans person, I am primarily surrounded by other young trans people who (like me) are pre-transition, and thus struggling with significant dysphoria and/or mental health issues. This conference was full of trans people whose (medical) transitions began decades ago and who are now living wonderful, successful lives that are not characterised by dysphoria or adversity. Meeting older trans people who have survived into middle age or older and who have successful careers, relationships, and families is an important reminder that trans lives can be positive – a message that we don’t often hear in media-approved narratives of trans experiences.

I attended a number of workshops which also raised important points for me. During the “Methods to support and empower trans youth” workshop, the Swedish Youth Federation for LGBTQ Rights (RSFL Ungdom) presented two projects that they have run: Transformering.se and Pegusus.

Transforming.se is a website that aims to provide information on trans rights & healthcare, build community, and empower trans youth. It contains an email address that can be used to ask questions, as well as a a “news flow” section which is regularly updated with news, blogs, reviews, etc.. Pegasus is a project aiming to improve health and wellbeing in young LGBTQ people who have sex for compensation (i.e. those who have sex in exchange for money, goods, and/or services.)

Learning of these projects made me acutely aware of the lack of a single, reliable source of information for trans people in Scotland. While there are a number of charities and other organisations working with trans people in Scotland, there is no one place where someone can go to easily access accurate, up-to-date, fully inclusive information. This is one reason why online community groups (e.g. facebook) play such a large role in gathering information about healthcare options, legal rights, and the experience of being trans. While community organisation is important, this ad-hoc question and answer format is not a substitute for certified information collected in one place.

This difficulty accessing information in Scotland is compounded by our relationships to healthcare providers. The Federation feel that they are able to be a trusted confidante for young trans people in Sweden partially because they are not involved in the provision (and gatekeeping) of healthcare services. In Scotland, we have major problems in obtaining information about medical treatments, because it is widely believed that doctors will interpret questions as doubt or uncertainty and thus postpone medical interventions as a result of being asked questions. (This is not an unreasonable belief – this does indeed happen). Many Scottish trans people are thus embarking on medical treatments (e.g. hormone therapy) without a full understanding of what those treatments entail, but without anywhere to go for advice or information.

A neutral information source like transforming.se may address these problems, although it should not replace the community sharing element that is so strong in Scotland.

T-Action is a trans-run community group based in St Petersburg who do awareness raising, campaigning, community action, and projects to improve healthcare & prevent HIV transmission within the trans community. They hosted “The project ‘Trans people visiting doctors’: overcoming barriers in access to healthcare.”

The “Trans People Visiting Doctors” project involves trans people visiting doctors, coming out as trans, measuring how transphobic/trans-inclusive the doctor was, giving information to the doctor in the form of a book/pamphlet, and reporting back to T-Action. T-Action are thus compiling a list of good (and bad) doctors in St Petersburg.

This workshop hosted an interesting discussion on the differences between the situation for trans people in Russia and in Scotland. This in turn raised the question of what constitutes being an ally – how trans-inclusive does a doctor have to be in order to count as an ally? Although we all live in different countries, we face many similar or identical challenges and are pursuing the same end result – but what we count as a success varies because how far we’ve already come varies. Some count it as a victory if their doctor doesn’t say immediately refuse to treat them; others feel that their doctors ought to be proactively teaching themselves about trans healthcare in order to meet the needs of our community. Even in Scotland, I have been told by other trans people that I am asking too much if I expect my doctors to know how to use inclusive language without me having to explain it to them first – something I feel is part of their job.

This workshop also raised interesting questions relating to how to protect trans people while simultaneously working to fight transphobia. I would not run a project like this because I would not feel comfortable asking my trans volunteers to go and come out to doctors, and risk/face the subsequent transphobia. However, there are clear benefits to this project and T-Action do not see this as a concern. In fact, during volunteer training, T-Action had volunteers role play as transphobic doctors and patients dealing with transphobic doctors – something I would find very distressing as a trans person, and would not ask others to do. That said, I do feel that I would be better able to address transphobia in my real life if I did some training like this (as difficult as the training would be.)

These thoughts are both things I need to reflect on further, and which I am keen to discuss with other trans people.

“Thinking positHIVely – Empowering an HIV trans community response” was a complex workshop with a number of speakers presenting very different projects/information. Primarily, it highlighted the lack of information available about HIV/AIDS in transgender communities globally. There is very little data available, and that which is available is very specific – there are some studies on trans women in Asia, for example, but very little else. Another overarching theme was the importance of including sex workers and migrants within discussions about HIV and the trans community.

Primarily, this workshop highlighted for me the lack of integrated working between trans charities and HIV charities in the UK. I work closely with two HIV charities, and have never once seen trans people are one of the four main at-risk groups for HIV (although they are considered such globally). This partly reflects the specific situation in the UK relating to HIV transmission, but it also reflects the ongoing invisibility of trans people.

The workshop also raised some issues about how we classify risk groups. “MSM” is the at-risk group most prominent in the UK, but what is meant by MSM is often unclear – it is a category hovering somewhere between the biological category of people who regularly have penile anal sex, and the social category of people within gay/bisexual male culture. Trans people have changing and complicated relationships to both of these categories, so are medically and/or socially at risk in changing and complicated ways – but universal ignorance of trans existence means that there isn’t a conversation about measuring risk for trans populations. This has practical consequences – one charity that I work with runs clinics for MSM, which are certainly not equipped for trans people of any identity.

I am attending the AIDS 2016 conference in July in South Africa, so I am keen to further explore the connection between trans people and HIV/AIDS.

TGEU has been running a project on health for the last 6 months, and presented this in the “TGEU Healthcare Project” workshop. The project aims to increase knowledge within TGEU, healthcare providers, policy makers, and other organisations of barriers to healthcare that trans people encounter.

A preliminary survey received 36 responses, with 26 coming from EU countries. This survey found the following issues were highlighted in many/all countries: missing or inconsistently applied policies relating to trans healthcare provisions; gatekeeping; gaps in the knowledge of healthcare professionals; pathologisation of trans people; discriminatory treatment, including name/gender discrepancies; intrusive questions; misgendering; violation of confidentiality; refused screenings; placement in the wrong ward; delays in treatment; cost; lack of clinics or doctors; denial of treatment; forced mental health diagnoses; long waiting times; and difficulties relating to coverage of treatment by insurance providers.

The specific countries in which the project is being developed then presented on their situation, highlighting the following issues: a gap between the theoretical or legal situation and the actual experience of trans people; particular issues faced by those under 18; the power of individual clinicians to make a good or bad experience; the problem of being required to “prove” that you represent the right narrative; and regional/geographical barriers.

Almost all of the issues raised are also faced in Scotland, but differently or with additional complications (often related to cost). For example, many countries require trans people to “prove” themselves to a clinician who individually holds a lot of power over what it means to be “really trans;” in countries other than Scotland, clinicians are additionally able to decide which tests are necessary, and then demand that the trans individual cover the costs of those. In Poland, trans people are often forced to pay for their own chromosomal testing. Similarly, while pathologisation is a problem universally, it has different nuances in different places – in Serbia, you require a diagnosis of “transexualism” to access surgeries, but following surgery this diagnosis is removed as you are understood to be cured.

The above notwithstanding, this workshop did highlight many differences in health care across countries. In Scotland, I would describe trans healthcare as horrendously bad – but it is still significantly better than so many other places. As a Scot, I am unlikely to be forcibly detained for being trans and I am very likely to (eventually) get my hormones and other interventions, without having to pay. These are achievements that are still unrealistic goals for many trans activists across Europe. Despite this, I feel it is important to continue to demand more: our situation is better than many others, but we are still being treated unacceptably. The situation in Scotland should never be the example of “best practice” – even if it is far from the worst.

Overall, this workshop (and the conference as a whole) demonstrated for me that similarities between trans experience across Europe are far more prominent than differences. We are all in different stages of the fight for our equality, but we are all fighting the same things. This conference was important because Matpic3it changed the conversation (for me) on what it means to be transgender: trans people are showered from all sides with the message that we are broken versions of cisgender people – that we are essentially cisgender people who were “born in the wrong body” and now need to be medically corrected so that we are the same as everyone else. We are thus told by transphobic society and healthcare providers that the best we can possibly hope for is to be is as close to cisgender people (and bodies) as possible, although we will never quite be cis people. Community events like this bring home the truth: while our lives are filled with transphobia, adversity, and dysphoria, these are not the defining features of being trans. We are not broken cis people, and we should be proud of insisting on surviving as something else in a world that aggressively prioritises cisnormative experiences. Across Europe, trans people are having revolutionary conversations about gender, sexuality, equality, and freedom. While we are all fighting our own personal manifestation of transphobia, we are all fighting for the same thing: a world in which trans people can freely live as who we are – beautiful examples of the complex and wonderful diversity of human experience.