Everyday People

The voice from underneath the paper bag shakes with anger:

“Offended does not cover how I feel. I’m terrified. Too terrified to show you my face. And I’ve done nothing wrong.”

This brave individual is one of several trans masculine people and allies who, despite their fears, recently came forward to add their voice of experience to a video challenging discriminatory language in the media. Julie Burchill’s blisteringly transphobic and provocatively titled ‘Transsexuals should cut it out’ article - which was penned in defence of her friend and fellow columnist Suzanne Moore who had herself caused off ence in an article arguing that women today are expected to look like “Brazilian transsexuals” - sent shockwaves through the trans community when it was published earlier this year.

“How would you feel if you opened up a newspaper and were confronted with an article telling you that you were a terrible, worthless awful human being,” one of the video’s stars asked, while another expressed their “anger, resentment, disgust and fury” that Burchill’s article, which was later withdrawn by the Observer newspaper, had been deemed suitable for publication in the first place.

Jay McNeil co-founded TransBareAll, an organisation that works to support trans people with issues of health and wellbeing and was behind the right to reply video. He expressed his own frustration in the footage: “I spend every day fighting so people don’t have to hear that kind of abuse and deal with that kind of crap. And it makes me feel like, what is the point, if you feel you can just say that.”

McNeil, is an independent researcher with a specialism in transgender issues and health inequalities. While he was at university he started to look at his own gender identity and later came out as trans. He transitioned eight years ago and while on a personal level he says he feels “very privileged” to have “a great family, supportive partner, and a really good quality of life,” he was still deeply affected by the pejorative language deployed in the “vitriolic” article.

“I’m a very stable and robust person. I run three different organisations and I am an international search and rescue volunteer. You’ve got to be pretty mentally robust to go and pull people out of rubble or a collapsed building. But reading that article really hurt me. Because although it was very much aimed at trans women, those words are words that people use against us [trans men] too. And it made me feel like I didn’t want to engage with the rest of the world. It made me feel like I wanted to lock my door and stay inside. Because you are reading things which you’ve heard said to you, or have been used against you before. I can’t express how deeply that touches you. It is a gut-wrenching feeling.”

His main concern, however, was for how someone who isn’t in as good a place in their life would react to the article.

“Someone who is more vulnerable, who maybe isn’t having such a great time of it, who is maybe just coming out and is confused, or has been rejected; someone else is going to read that and it is going to do them so much damage.” According to a UK-wide study of trans mental health that was published last year, 51 per cent of trans people believe the way they are represented in the media had a negative eff ect on their emotional wellbeing. Led by McNeil, the study was the largest of its kind in Europe and provided groundbreaking data on trans people’s mental health needs and experiences. Funded by the Scottish Government via the Scottish Transgender Alliance (STA) and produced in partnership with Traverse Research, the Trans Resource and Empowerment Centre in Manchester, and Sheffield Hallam University, the study provided the data that McNeil says “confirmed everything we expected and everything we really feared finding as well”.

Some of the findings were “truly shocking”, he says, and make “a compelling case for the need for change”. The majority of participants, 84 per cent, had thought about ending their lives at some point. Of those, nearly half had attempted suicide, with a third making more than one attempt. Three per cent were planning to commit suicide in the near future. Additionally, more than half of the participants - 53 per cent - had self-harmed at some point, with 11 per cent currently self-harming.

McNeil says it is important to consider these figures in context, stressing that it is not the case that trans people are inherently mentally ill. The study also found that 81 per cent had experienced silent harassment for being trans, while nearly 40 per cent had experienced sexual harassment and physical intimidation. Additionally, a quarter had had to move away from family or friends because they are trans. It is these daily experiences and the sense of isolation and stress that they engender that can have a big impact on trans people’s mental health and wellbeing, he says.

However, with the Scottish Government due to begin consulting on a new suicide and self-harm strategy for Scotland shortly, McNeil argues it would be a mistake not to focus on the needs of trans people within the new strategy.

“From the data I’ve seen there is no other group that has suicide rates that high. No other group is killing themselves at the rate that trans people are and the idea that services currently aren’t looking at that and aren’t interested in addressing that is pretty shocking,” he states emphatically.

He also expresses concern that the barriers that prevent trans people from accessing healthcare services, and the “rife” prejudices that some are still met with when they do, are preventing some trans people from seeking the help they so desperately need. As a follow-on to the trans mental health study, the STA commissioned McNeil to conduct a small study of health and social care staff’s attitudes. While the vast majority of respondents came from England, McNeil argues negative attitudes that were revealed are “endemic” across the UK and are risking the lives of trans people.

“What it means is if they have significant health concerns they are not going to talk to doctors about it because they are too worried about how they are going to be perceived... People aren’t talking to mental health services when they are in crisis, even when they are feeling distressed. They are avoiding going to clinics and just talking to friends or not doing anything. And it is those sorts of things that are leading to this massive suicide rate.”

However, another survey conducted by LGBT Youth Scotland shows the roots of this issue go deeper still. At the end of 2012, LGBT Youth Scotland surveyed 350 lesbian, gay, bisexual and transgender young people aged 13-25 about their experiences of education.

“What it specifically showed was that education was the place that they faced the most discrimination and schools were the place they felt least protected,” explains Cara Spence, policy director, LGBT Youth Scotland.

“There was a slight improvement when they progressed to college and university. So some of the research, for example, showed that 69 per cent of respondents had experienced bullying and this reduced to 24 per cent at college and 13 per cent at university. However, for transgender young people they face an even harder time, with 79 per cent experiencing bullying. It reduced only slightly to 69 per cent when they went to college and 37 per cent at university. So it shows that, actually, they are having a much harder time in relation to school and when they go on to college and university things aren’t necessarily changing.”

The damage wrought by this homophobic and transphobic bullying can last a lifetime, Spence explains.

“I think many people don’t realise that bullying can ruin people’s lives. It is not character building or a normal part of growing up; it causes lasting damage.”

More than 88 per cent of those who had experienced transphobic bullying believed it had negatively impacted on their education and 42.3 per cent had left education as a result of their direct experience of transphobic bullying - demonstrating that in addition to impacting on an individual’s mental health and wellbeing, these early experiences are also potentially damaging their future chances of employment.

Such research is vital when pressing for change, explains Nathan Gale, Scottish Transgender Alliance (STA). The STA was formed to address issues of prejudice and the lack of information and support for transgender people in Scotland and as part of its work the Scottish Governmentfunded organisation provides best practice guidance, policy advice, and training to public sector organisations.

The STA has been working hard to raise political awareness of trans issues, Gale says and argues the proposals to equalise the marriage laws in Scotland present another opportunity for debate. The Scottish Government is currently consulting on legislation that will allow same-sex marriage. However, the draft legislation also includes a provision to remove the requirement on a married or civil partnered transgender person to divorce before obtaining full Gender Recognition.

It is an important recognition for transgender people in Scotland, explains Gale, who also transitioned eight years ago.

“I really hope that the equal marriage legislation will really be gender neutral and will provide truly equal partnership rights to trans and intersex people, it is really important that they are able to access legal recognition for their relationships just like anybody else. The requirement not to divorce or dissolve your civil partnership will be huge. But obviously there are people who have already had to do that and it would be really good if there could be some recognition of what they have lost.”

Another strand of the STA’s work is to improve public awareness of trans issues and support trans people to engage with public bodies and advocate for change, which led to them leading a historic first trans health conference in conjunction with NHS Health Scotland last year.

“That was fantastic, it went really well. It brought over 100 people from NHS staff, local authorities and the trans community together basically so the NHS staff could listen to what the priorities were of trans people,” Gale recalls.

Cath Denholm, NHS Health Scotland Director of Equality, People and Performance, said the special health board is “working closely with Scottish Transgender Alliance, the trans community and partners, including the Scottish Government, to assess and recommend how to better understand and meet the health needs of trans people so that NHSScotland is fully inclusive of them,” and it looks forward to the STA sharing learning from the conference in its forthcoming report.

“We already know that trans people experience higher rates of anxiety, stress and depression, lower levels of self-esteem and high levels of discrimination and harassment. These can have a negative impact on health including higher rates of smoking, alcohol and drug use. That is why this renewed focus and support should serve as a reminder not just to health and other public services, but society as a whole, about trans people’s rights; for NHSScotland, that is that trans people can expect and receive fairness of health outcomes through accessing the health services they need.”

This, she adds, includes working with local health boards to learn from the implementation of the Gender Reassignment Protocol following its publication last year by The Scottish Government. For the first time, the protocol clearly sets out the journey that a trans person should be able to follow, if that is their choice, as well as their rights relating to treatments and waiting times. The trans mental health study showed that one major source of harm to trans people’s mental health and wellbeing was the process they were required to go through to get the treatment some need, and so Gale calls the protocol a “huge step forward” for trans people and says ensuring its implementation will be a key priority for the STA in the year ahead. And in this, he insists, the evidence garnered from the recent mental health and education surveys demonstrating the importance of getting this right for trans people will have a crucial role to play.

“I think it is a good strategic time at the moment because the protocol has not long come out and they’ve got to do an audit of it within quite a short space of time about how it is being implemented,” he says hopefully.

“We can really say, here is the evidence that if people have a bad journey through the gender reassignment process, this is the impact it has and these are the services and resources they go on to use up because people with bad mental health are using loads of services. So if we can say this is what it will be like if they don’t have a good journey, then it is really good evidence for the protocol to get properly implemented.”