Sunday, 29 June 2008

Countering the apologists…

One of the things you learn when you transition is that some people who are seemingly supportive are in reality nothing of the sort. I call them the smiling apologists and I think there may be at least one on the TUC LBGT committee.

There are several arguments that they believe are sincerely in your best interest to justify the continuation of the mental illness pathologization of transgender and transsexual people.

Their real interest is self-interest (often financial sometimes political).

Here are the more common ones, what they mean and how to counter the argument.

“You might regret it” (It meaning genital surgery.)

First point a transsexual never does by definition.

A transgender might if they are convinced by a psychiatrist to transition and “go all the way”!

This of course illustrates the person who makes the statement believes you are not capable of making the decision because you are mentally ill.

Fact:

The Mental Capacity Act of 2005 is ignored by NHS psychiatrists as regards transgender & transsexual people.

The Act makes a presumption of capacity - every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise.

Individuals must retain the right to make what might be seen as eccentric or unwise decisions.

“Some people have regretted the decision and sought to have the surgery reversed.”

Yes a tiny vocal minority have. These people’s stories appear time & time again as a justification for the need for multiple assessments over many years. The common factor is that someone else told them they were transsexual rather than transgender.

The reality of transsexualism is that it is a self-diagnosed condition. Only the individual can know the truth. There is a lot of evidence of transsexuals pooling knowledge to fit particular psychiatrists stereotypical views on what constitutes male or female. So you can con any psychiatrist if you want to.

Fact:

The single biggest cause of “regret” or rather dissatisfaction is poor surgical outcome.

For transsexual and transgender people the main symptom is a unique type of depression, Gender Dysphoria.


My team wins I’m euphoric. They lose I’m pissed off, fed up but never dysphoric. Ah but the psychiatrists say Dysphoria is usually experienced during depressive episodes, but in people with bipolar disorder it may also be experienced during manic or hypomanic episodes. Dysphoria in the context of a mood disorder indicates a heightened risk of suicide.

Yes well that’s clear then!

Fact:

Gender Dysphoria, if it did exist, is not caused by being transsexual or transgender. What is being pathologised is the reaction to abuse & rejection by society, friends, family and workmates.

It is the same as coming out if you are gay for transgender people making a temporary change. The difference for transsexual people is that they have no choice other than permanent change.

Transsexuals denied treatment could experience clinical depression and emotional problems, and an increased risk of suicide.

Transition takes years and must be medically supervised for a successful outcome.

It takes two years for legal recognition of a permanent change of gender presentation. Unless you are over 50 and go to Thailand it takes one-year post transition living to qualify for surgery. A psychiatrist’s report is needed but this can be obtained in a one-hour consultation.

Most GPs will not currently prescribe hormone therapy other than on a shared care with a gender specialist luckily not all gender specialists are psychiatrists.

Fact:

Scare stories about the dangers of hormones are not based on valid scientific data. Cross sex hormone therapy has as many benefits as disadvantages.

Charing Cross Gender Identity Clinic is the gold standard/global leader in the care of transgender and transsexual people.

This is untrue. They don’t even accept the NHS "Guidance for GPs, other clinicians and health professionals on the care of gender variant people".

No other comments here for fear of a libel/slander case but ask a small cross section of transsexuals and you will many who discharged themselves and went private.

Fact:

NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people can be downloaded from:

http://www.gires.org.uk/assets/doh-guidelines-for-clinicians.pdf

The transition process can be highly traumatic and may involve the person being off work for a long period of time.

Gender reassignment or rather gender affirmation surgery is not classed as major surgery but there are restrictions on lifting, bathing & sex for three months. After six months most people are fully recovered.

Fact:

Incapacity benefit can be claimed for any period off work.

The Real-Life Test minimises risk of a mistake.

There is no such thing as a test you might be living in male, female or androgynous role but you either alive or dead. The “test” is to ensure maximisation of psychiatrist’s fees.

Fact:

There is no valid statistical medical data to support this invention by psychiatrists.

It is important to demonstrate readiness for surgery.

Another meaningless psychiatric invention to justify delay and therefore more fees. NHS psychiatrists are known to use deliberate delay as a proof of determination to undergo surgery.

Fact:

Delay in surgery has been shown to have no medical benefit rather the reverse.

Transsexualism is a trait, disease, behaviour, desire, mental illness, perversion, paraphilia (sexual perversion), political identity, lifestyle or sin.

Yes please pick one to reveal your particular brand of bigotry. The selection of any of these will reveal your support for heterosexual Caucasian male supremacy.

Most psychiatrists are heterosexual Caucasian males so by definition they can’t understand or chose not to understand anyone other than another heterosexual Caucasian male.

Fact.

There are almost as many conflicting explanations of transsexualism as there are transsexuals. Surprisingly no one states the obvious that each individual is unique. Too dangerous that as it undermines social theory.

There are lots more ridiculous statements used to justify the mental illness pathologization but here are a selection of quotes that show the problems we face.

All these are from original letters in my possession so can be used without fear of libel or slander LOL

Quote Rosie Winterton Minister of State August 2006

The Department of Health is not responsible for deciding what is considered a mental disorder.

Surgeons are reluctant to commit to surgery in the absence of reassurance that the psychological impact of surgery will not be a negative one.

Quote Mrs S E Price Interim Chief Executive East Staffordshire Primary Care Trust September 2006

The recommendation of the Department of Health is that no gender dysphoria work is undertaken in the private sector because of the lack of certainty that standard protocols will be followed.

The NHS does not carryout cosmetic surgery. If this condition was not defined as a mental disorder, surgery would not be considered for funding by the NHS.

Evidence shows that there area large proportion of people who having had surgery regret the decision and some seek reversal.

Quote Rosie Winterton Minister of State October 2006

The majority of transgender people support the Benjamin Association’s Standards of Care.

The issues facing the Department for Constitutional Affairs and the Department for Health are rather different.

The Department for Constitutional Affairs had declared transsexualism is NOT a mental illness.

Quote Stuart Poyner Chief Executive South Staffordshire PCT December 2006

The inclusion of Dr Richard Curtis of the London Gender Clinic on a list of approved specialists issued by the Gender Recognition Panel does not make him an appropriate person for the PCT to refer your constituent to in respect of our clinical pathway.

Quote Rosie Winterton Minister of State January 2007

There is no specific exclusion in the Mental Health Bill for gender dysphoria and the position regarding gender identity disorders remains unchanged.

We acknowledge that gender dysphoria is clinically recognised as a mental disorder.

Quote Rosie Winterton Minister of State February 2007

We do acknowledge that those who have successfully made the transition from one gender to another may no longer have a mental health issue.


Quote Rosie Winterton Minister of State May 2007


It is not a matter for the Department of Health to define or differentiate between gender dysphoria & transsexualism.

The Department for Health does not see how transsexualism could reasonably be classed as sexual deviancy.

So there you have it.

The Department of Health is a law unto itself.

Psychiatrists will always support the mental illness classification.

The Human Rights issue of declaring someone mentally ill without any statistically valid scientific evidence is ignored.

We took HM Government to the European Court of Human Rights to get the Gender Recognition Act and now it is time to go back and rid ourselves of the curse of the mental illness classification.

Sunday, 22 June 2008

I know what faith is…

Last night I went to bed mentally & physically shattered. Emotionally whilst I’d resolved in my heart to fight on my head said I would lose. I’d deduced the arguments and tactics that my PCT plan to use against me and couldn’t see a counter.

As usual I said a little prayer and surprisingly fell into a very deep sleep.

Today I awoke with the solution and the tactics clear in my mind. My guardian angel (if you like) had planted it firmly in my mind.

I don’t remember any dreams (not like me that), which is why I’ve said guardian angel, but all I know is that I didn’t consciously think the solution through.

I now know that I can beat this evil PCT & Charing Cross who think they are so clever as people underestimate me time & time again.

I’m not going to spell things out at this stage but I have faith that I can win this battle both for myself and for all transsexual people.

Truth and justice are based on love and faith.

Saturday, 21 June 2008

Moving close to legal confrontation…

I’ve just received a letter from my PCT turning down my application for surgery with Mr Phil Thomas at the Sussex Nuffield.

Now I have to be careful what I say in this blog as the Chief Executive of the PCT has in the past accused me of being a bully by criticising NHS employees. To be specific it was a criticism of an NHS gender specialist that I could back up with evidence but then my PCT yet again likes to ignore or distort evidence.

As far as I can tell the PCT (maybe backed by the Department of Health) is determined not to let me establish the legal precedent that having obtained a gender recognition certificate I am entitled to be placed directly on the surgical waiting list without having to submit to the vagaries of Charing Cross psychiatrists.

This is my initial response to my GP before I prepare a report for her that if the Chief Executive of the PCT rejects will move us to a judicial review at the very least.

Happy days LOL


Dear Dr XXX,

Individual Treatment Panel Response for funding for surgery with Mr Phil Thomas at Sussex Nuffield

This is to advise you that I will require you to make a formal appeal.

I will be producing a full report for you to submit to the PCT.

However to be frank I am utterly staggered by both the ignorance of current best practice and the misinformation given to the people considering my case.

For example in the latest letter they acknowledge that Sussex Nuffield has zero rates of MRSA etc. but don’t state the Charing Cross rates. As they know that Charing Cross rates are not zero they know that I am at higher risk.

Most importantly the PCT alleges that as the Sussex Nuffield does not provide follow up for patients beyond three months then the cost of the five years of follow up provided by Charing Cross for any gender reassignment repair surgery must be topped up making the true cost of Sussex Nuffield considerably greater than that of Charing Cross. This is misinformation.

Any physical re-examinations of a patient’s surgery over five years can be conducted by any GP it does not require a visit to Charing Cross.

They are deliberately confusing five years of gender specialist follow up with physical examination. As I pay for this with my gender specialist the cost of top up in my case is zero.

I have a gender specialist recognised by HM Government and who is a co-author of the “NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people” a document that the PCT should be aware of. I have no intention of changing my specialist and I will bear the cost myself until such time as this PCT recognises his worth.

Additionally they ignore the most important exceptional circumstance in my case in that I have a female birth certificate having met the strict medical conditions for granting a gender recognition certificate. This is proof absolute of having met the globally recognised criteria for access to surgery.

The PCT is not offering me direct access to surgery it is asking me to get in an eighteen month to two year queue to see a Charing Cross Psychiatrist who will ignore the Gender Recognition Act & the Mental Capacity Act and insist on numerous appointments with himself and/or colleagues before on average a further two to three years later allowing me access to surgery providing I meet his stereotypical views of what being female entails.

My advice is that the PCT / Charing Cross policy could be shown to be illegal as regards people with gender recognition certificates.

Additionally the British Medical Association policy that states:

“Patients who are entitled to NHS funded treatment may opt into or out of NHS care at any stage. Patients who have had private consultation for investigations and diagnosis may transfer to the NHS for any subsequent treatment. They should be placed directly on the waiting list at the same position as if their original consultation had been within the NHS.”

My position is that as I am legally female, have completed consultations, investigations and diagnosis and therefore entitled to be placed directly on the waiting list for surgery something the PCT is refusing by the selective use of a single inflexible supplier and their letter is a poor attempt to hide their unreasonable refusal.

I will not give up on this battle with the PCT whatever the cost to myself.

I have been obstructed over the past three years by members/employees of the PCT such that any reasonable person would conclude this is prejudice.

I would however like to thank you personally for supporting my case.

Yours sincerely,

Maggie Fiona Fox

Copies to Janet Dean MP and Dr Richard Curtis http://www.transhealth.co.uk/

NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people can be downloaded from:

http://www.gires.org.uk/assets/doh-guidelines-for-clinicians.pdf

Watch this space!

Wednesday, 18 June 2008

Onwards to the LBGT Trades Union Conference

THE CASE FOR TUC UNITE AMENDMENT

Prospect motion:

Conference calls on the TUC to lobby the Government to introduce protections for trans people equal to those for persons protected on sexual orientation grounds.

Unite amendment

Delete full stop and add including:

I. Immediate exclusion of transsexual and transgender people from the Mental Health Act and abolishing the mental illness classification
II. Removal of the medical qualification from the Gender Recognition act and
III. Extending the new proposal to make incitement of homophobic hatred illegal to cover transgender and transsexual people

In February 2008 at the Unite LBGT conference I challenged Trevor Phillips Head of the UK Equality Human Rights Commission to respond to my question:

Can transsexual people count on the Equality Human Rights Commission (EHRC) to remove the mental illness classification?

Will EHRC see that “gender dysphoria” is confined to the dustbin of history and that laws are amended to bring transsexual people the same human rights as the rest of the LGB community?

His response was I don’t understand what gender dysphoria is and I have no intention of finding out! Being transgender is not a mental illness.

So this amendment from my Union is a continuation of the campaign.

The words transsexual and transgender are used, as whilst transsexual has an accepted medical & legal definition transgender doesn’t.

It is important that whatever label an individual chooses the law protects them.

THE ARGUMENT FOR IMMEDIATE EXCLUSION OF TRANSSEXUAL AND TRANSGENDER PEOPLE FROM THE MENTAL HEALTH ACT AND ABOLISHING THE MENTAL ILLNESS CLASSIFICATION

In 1973 the American Psychiatric Association under pressure & direct action from Gay activists removed homosexuality as a listed mental illness from their Diagnostic and Statistical Manual of Mental Disorders (DSM).

However a new diagnosis, "ego-dystonic homosexuality," was created for the DSM's third edition in 1980. This meant someone who had "distress" about their sexual orientation.

So this was a “slight of hand”!

In 1986, the diagnosis was removed from the DSM but the vestige of "ego-dystonic homosexuality" in the revised DSM-III reoccurred under "Sexual Disorders Not Otherwise Specified," which included persistent and marked distress about one's sexual orientation.

So it was still there!

The DSM 4th Edition (DSM-IV) was published in 1994, followed in 2000 by the DSM IV, Text Revision, or DSM-IV-TR. included "transvestic fetishism" and "gender identity disorder" (GID) as disorders.

So homosexuality was traded for transsexual and transgender!

Recent revisions of the DSM have made these diagnostic categories increasingly ambiguous, conflicted and over inclusive.

They reinforce false, negative stereotypes of gender variant people and at the same time fail to legitimize the medical necessity of sex reassignment surgeries (SRS) and procedures for transsexual women and men who urgently need them.

The result was that widening segments of gender non-conforming youth and adults being subject to diagnosis of psychosexual disorder, stigma and loss of civil liberty.

But it now gets worse!

Dr Kenneth Zucker will head the review of gender dysphoria at the American Psychiatric Association for DSM V.

Dr Ray Blanchard will help Dr Zucker.

This pair is famous for believing that transsexual women are gay men without penises (Blanchard) and that gender dysphoric children can be cured by conversion therapy (Zucker).

That translates as gender affirmation surgery is not justified and beat the shit out of children if they seem gender variant.

Zucker & Blanchard ignore the fact that there is no valid empirical evidence for their perverted theories. Their theories are based on selected feedback from selected subjects many of whom were desperate to gain access to medical treatment such they would say and feedback whatever their interrogator wanted to hear.

Professional norms simply do not support the idea that being “transgender or transsexual” is a form of mental illness or is inherently linked to psychopathology.

It is time for the medical professions to affirm that difference is not disease, nonconformity is not pathology, and uniqueness is not illness.


Scientists now accept the evidence that sexual orientation is set in the womb but dither about gender because of the influence of heterosexual male dominated organised religion’s powerful political lobby.

For the LBGT community there is now no option other than forcing psychiatrists by law to accept that the same set in the womb evidence that applies to homosexuality also applies to transsexual & transgender people.

The time for negotiation is long past!

The UK Mental Health Act of 2007 widened the application of the provisions of the 1983 Act to cover all mental disorders, not just those which fell within one of the four original categories.

The Act covers disorders that were forms of personality disorder which would not be considered legally to be "mental illness" and which do not fall within the current definition of psychopathic disorder because they do not result in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned.

That translates as anyone who has Gender Dysphoria or Gender Identity Disorder is subject to the Mental Health Act that could result in their sectioning, for example, by refusing to accept the mental illness classification!

This is the most appalling State intervention and denial of individual Human Rights and must not be allowed to continue.

This can only be achieved by the abolition of the mental illness classification for transsexual & transgender people.

THE ARGUMENT FOR REMOVAL OF THE MEDICAL QUALIFICATION FROM THE GENDER RECOGNITION ACT

The Gender Recognition Act sets out a procedure for applying to a Gender Recognition Panel for a Gender Recognition Certificate.

You can apply if:

You are at least 18 years of age

Have or have had gender dysphoria

Have fully lived in the acquired gender for at least two years

Intend to continue to live in your acquired gender for the rest of your life.


The Act is bad law as it confuses law and medicine enshrining the diagnosis of gender dysphoria and psychiatric treatment when all that is required is recognition of permanent change.

The medical questions include

Has your patient undergone surgical treatment for the purpose of modifying sexual characteristics?

Yes. If you are able to, please list the surgical procedures undergone.

No. Please explain why no surgery has been undertaken for this purpose!


Whilst these questions do not require primary surgical intervention to have taken place they indicate that it should be intended.

This of course is the same basis as the qualification for transsexual people to have employment protection under the Sex Discrimination Act.

Intention to undertake gender reassignment must be replaced with intention to live permanently in a gender different to that assigned at birth in that Act.

The existing act fails to recognise that diagnosis can only be determined by the individual concerned.

There are no tests that provide a definitive diagnosis and that surgery is a personal decision and has no bearing on identity.

THE ARGUMENT FOR EXTENDING THE NEW PROPOSAL TO MAKE INCITEMENT OF HOMOPHOBIC HATRED ILLEGAL TO COVER TRANSGENDER AND TRANSSEXUAL PEOPLE

Transsexualism is neither a ‘lifestyle’ choice nor a mental disorder, but a condition that is now widely recognised to be largely innate and somatic.

It has been shown that the condition cannot be cured by any conventional psychiatric interventions, psychoanalytic, eclectic, aversion treatment, or by any standard psychiatric drugs, it is not responsive to psychiatric treatments.

The diagnosis of this condition can only be derived from the self-reports of those experiencing it; and research indicates that neurodevelopment of the brain before birth is implicated in severe gender dissonance.

Transgenderism may or may not be a permanent change of gender and may even be no more than a temporary androgynous presentation.

Regrettably society contains elements that will unchecked by the rule of law take it that they have a divine right to abuse or punish anyone who fails to conform to what they consider their binary heterosexual norms.

Transsexual & transgender people live in constant fear of confrontation and physical attack based on bigotry and prejudice.

Whilst existing laws can be used to prosecute those that inflict physical injury or harassment the people that incite these actions are left immune from prosecution.

For example any transsexual who has transitioned in a shop floor environment can testify that it is not the bullies themselves that are the problem it is the people behind them inciting the hatred. Existing laws are inadequate in this area.

In Trevor Phillips address to the Unite LBGT Conference he stated that no religious group should be exempt from incitement to hatred and this must be made law in terms of transphobia.

Most transsexual people and some transgender people see their gender presentation in terms of expression of their core identity rather than their sexuality but the general public simply cannot grasp this distinction.

That means that primary legislation is required so that this lack of distinction is not exploited to exclude any transsexual or transgender people from the protection of the law.

These amendments aren’t about evolution they are about revolution.

The TUC must be a leader in the battle that replaces sin and disease with pride and strength, and these amendments are only the beginning.

You do not need anyone’s permission to change gender.

You do not need anyone’s approval to change gender.

Changing gender is NOT a mental illness.


Acknowledgements to:

http://www.tsroadmap.com/

http://www.gires.org.uk/assets/doh-guidelines-for-clinicians.pdf

Friday, 13 June 2008

The problem with Transgender is too many Mollies…

Now I’ve always been a person of many layers a bit like those Russian Dolls. I’ve always resisted the layers being completely peeled back as a sort of protection of the inner me. I let people get close but never that close probably fearing that while the four outer ones would be male the innermost one would be female – my terrible secret.

That is my definition of transsexual because it is your innermost and true identity that eventually will out. Then of course the issue becomes what do you do about it and the political debate starts...

One thing I know is that peeling back the layers of your mind can be a very emotional process but it’s not a mental illness. The realisation of the sex of your soul is a challenge no matter how strong your spirit.

In my case I resisted the inevitable too long & too hard though subsequent events have shown I had good reason. The euphoria of transition soon put to the test by society’s prejudice & intolerance. Sometimes I think the institutionalised prejudicial attitude displayed towards transsexual and transgender people illustrates the distance we still have to go to get equality between men & women.

Now in there lies the ethical dilemma as the politics of transgender raises huge fundamental questions of balance of human rights and even the definition of male & female. It can all get very complicated, if you want it, by labels and definitions but essentially the debate comes down to conflicting rights of those who make a permanent change and those who don’t.

Those who make a permanent changer of gender presentation mostly see this as a change of sex regardless of whether they undergo surgical changes to primary sexual characteristics. Permanent change of gender presentation equals rights to a new legal status, birth certificates and marriage. English Law allows this without a requirement for surgery though it does require you to admit to a bogus mental illness.

In the UK legal protection is given to those “who intend to undergo gender reassignment” and here in lies the crux of the transgender argument between those who say that means surgical changes to primary sexual characteristics and those who say no it doesn’t or that a third gender/sex or range of genders/sexes applies.

Confused? You should be!

Now pile into that the issue of sexuality and group together all Trans people within LBGT and the confusion is total for the general public especially the men who like their cyber Lady Boy fantasies.

So where do we go from here?

Well one thing for certain is that we must abolish the mental illness classification no matter what you call yourself as until we do we give the world an underlying excuse for their prejudice.

It is undoubtedly true that the worst examples of prejudice any Trans person In the UK will face is in the medical establishment and the way things are heading then gay & lesbian people will be dragged back into mental illness pathologization if they display the slightest non-binary gender presentation.

The problem is that LBGT appears to have adopted the transvestic fetishist agenda making demands for “equal rights” for men who temporarily change or modify their gender presentation. OK they’ll hate me for using transvestic fetishist, which is why they have grabbed and confused the transgender identity with their hierarchical pre-operative and post-operative transsexual approach.

But then what’s new there, these are men after all and they can’t cope with recognising women as equals so how can they understand those who make permanent change to primary sexual organs.

So why can’t the transvestites use the original name of Mollies then we can have LBGM so Transgender can separate, as M would indicate a sexual preference whereas T certainly doesn’t.

Far too simple!

That’s the problem with Transgender really it just contains too many Mollies…

http://en.wikipedia.org/wiki/Molly_house

http://en.wikipedia.org/wiki/Transgender

http://en.wikipedia.org/wiki/Transwomen

Friday, 6 June 2008

On the outside looking in…

I’ve just had a mini holiday at Gravesend; yes Gravesend I know that’s not everyone’s idea of a holiday destination. I suppose it’s a scaled up market town with a history of river Thames commerce and a famous death – Pocahontas. Still it was a nice break from Uttoxeter.

I stayed with “L” and yet again learnt a lot more about myself. “L” has a unique ability to get into the deepest recesses of my mind, the bit I keep the rest of the world out of. It can be scary and emotional but each time I emerge stronger and refreshed or is it purged?

So “L” and I shared some laughs and some tears but I wouldn’t have missed the experience for anything. I’m incredibly stressed at the moment and this mini break gave me the strength to fight on in terms of the important stuff but not be afraid to let go the rest.

There were lots of fun times, as well as the serious stuff. The highlights included seeing the new Harrison Ford film, a walk by the Thames and visits to the retail cathedral that is Bluewater.

The South East is now incredibly cosmopolitan but I worry about the social extremes the Caucasian haves in their retail temples whilst the Caucasian have-nots scurry about in their hoodies amongst an ethnically diverse underclass.

In my best dreams the haves and have-nots merge but in my nightmares the evil of capitalism destroys any hope of social cohesion denying a rebellion by the dumbing down of education. Never confuse quantity with quality a lesson our political masters ignore.

So I had a week observing society rather than participating but then that’s a holiday isn’t it regardless of whether it’s Torremolinos or Gravesend…