On this week’s episode of What the Trans!? Flint and Alyx spend talk about:
- Trans people contributing to the legal case on whether GRCs should do what they were designed to do.
- A new paper on the effects of puberty blocker bans.
- Our regular trip to Loser’s Corner with the LGBA!
- Third party security at an event at Putlins assaulting trans people
- We speak to Trans Actual about GPs refusing to prescribe HRT, and exclusive information on the progress of the review into Adult Gender Services
References
The LGBA vs. TKDB!
Youth Activists Release Thousands of Live Crickets at Anti-Trans Conference in London | Them
Suspected trans rights activists disrupt LGBA conference with live crickets | The Independent (“Suspected”? Lmfao)
Court Case
Natacha Kennedy’s Paper
https://www.academia.edu/124722434/Children_of_Omelas_Effects_of_the_UK_Puberty_Blocker_Ban
Butlins
Security assault trans people in Butlins bathroom while ravers chant “Let Her Pee”
TransActual
NHS England » Collective action by GPs: supporting guidance
x.com/boymoderology/status/1843761352034402374?t=0POaQHoLCXMYGxWIzDNOJg&s=19
x.com/TransActualCIC/status/1844062477786747014?t=4vIG-e0BBK1vy-MbeizULg&s=19
Transcript
Flint: Ooh, slow down. Slow down.
Alyx: [laughs] Alshleigh’s not here to say it this time.
[Intro music plays]Alyx: Hello everybody and welcome to another episode of What the Trans?!
Flint: What the Trans?!
Alyx: Ah, so another day. How are you doing, Flint?
Flint: I have been doing pretty good. I’ve mainly just been… honestly I got really into a TV show and then it got cancelled really quickly so I’m like “Oh that was really fun. Oh I’m really bummed”. You know that kind of weird headspace?
Alyx: Oh no definitely. Was it Netflix by any chance?
Flint: Yeah yeah, it was [laughs]. It was Kaos, it was that one that’s like a modern retelling of Greek mythology. It’s actually really really fun. It’s honestly the most like mythologically accurate that I’ve felt at least from what I know about Greek mythology, which by no means am I any fucking expert but like it’s nice seeing Zeus be kind of, you know petulant and insecure because that’s kind of what to me has always read far more actually how he kind of seemed to come across in the tales and like… like the, one of the things I really like, this is a really good way to show how, like they have it as like weirdly accurate but also it works in the modern sense is that like um, the guard dog to the underworld, right? Cerberus is still the guard dog to the underworld but in this scenario it’s more like there’s many Cerberuses. And they’re like the sniffer dogs in an airport, as you’re going through the security that is getting into the underworld. So they’re still the guard dogs of the underworld, but it’s like, in that kind of, um, you know, guard dog sense that we have today. It was really cool, it just, I guess it just didn’t do Stranger Things numbers; it didn’t immediately become their biggest, biggest hit. Annoying. Shame. Ridiculous. Bad money model, um…
Alyx; Boo!
Flint: Whatever. Keep creating bad art, I guess. Whatever . Um… Because you keep letting the good ideas just die before they even get to become anything. Fine! Fine.
Alyx; I know. I was, that was my disappointment with like, Willow or something. When the Willow TV show on Disney Plus I was absolutely devastated to see go.
Flint; Yeah. We should, we should probably address the elephant in the room which is that unfortunately there is no Ashleigh this week.
Alyx: Yeah, it’s sort of, um, whenever it comes to, um Pride season we’re always the busiest we can be. We’re not… It’s actually the most intense working period. But like, a little bit after the time of, um, Pride season in October/November time we start to have some time to sort of decompress, slow down and start to do our own holidays. I’ve got my own holiday in Croatia coming up next week. I’m not going to be, eh, doing an episode next week. Ash has taken the first episode off.
Flint: First ever?
Alyx: First ever in five years.
Flint: Aw, Jeez! No, that’s definitely deserved. God damn.
Alyx: She’s been in every single episode. She’s dealt with many hosts. Uh, she’s probably got more to come after us knowing her luck. [laughs]
Flint: Yeah. So I mean it’s… It’s just us devilish duo this week instead of our normal troublesome trio. But you know, I say “normal troublesome trio” as if I’ve been here for years. I have not, but you get what I’m saying. Um… [laughs]
Alyx: It feels like you’ve been here for years. It’s… [laughs]
Flint: [laughs] I don’t know whether to take that as a compliment or not.
Alyx: Oh shit, that’s a good point.
[laughter]Alyx: It’s been a pleasure! Um…
[singing] Losers’ Corner [laughter]Flint: Yeah. That’s it, bae’s, it’s time for Losers’ Corner. And this week is a real tasty treat for you all. It’s another interview. No doubt you’ll have heard of the latest action undertaken by our winners this week: tackling transphobia with equal heroism and hilarity. We’ve spoken to them during their first big stunt at NHS England, and been lucky enough to cover their action at the Department of Education firsthand too. They’ve got a real skill for getting transphobes to bug out. And they’ve done it again. That’s right, folks. Strap in, because it’s time to hear from Trans Kids Deserve Better, as the losers this week are the entire LGB Alliance conference.
Alyx: Roll the clip!
[laughter]Flint: Okay hello.
Rens: Hi.
Alyx: Hello.
Flint: You wanna, uh, let us know, like your pseudonym and things like that? Let us know who you are out of the group?
Rens: Yeah [inaudible] My name is Rens. My pronouns are they/them. Yeah. I’m a member of TDB.
Zeds: My name is Zeds. Um, my pronouns are they/them.
Flint: So what message did you want to send by unleashing 6,000 crickets into the LGBA conference?
Rens: We wanted to show that we aren’t going to let them take away our identities and [inaudible] wanted them to feel a fraction of the fear that they’ve given to us on an everyday basis. Just the fact that, we’re going to show them that we aren’t going to stay quiet and just take all the abuse and let them have a platform for them to spew their hate. Um, we’re going to take it back.
Flint: The biggest question is how the hell did you pull this off?
[laughter]Zeds: Well honestly I’m not quite sure.
[laughter]Rens: To be fair at the moment I’m not quite sure how much of it was criminal. And I know that we have been talking about most of it. But the bare bones of it is we went to various [inaudible] We bought as many crickets as they had and sold [inaudible] so we bought those. And we put a thousand of them into bags and we went into the park and we hid them under our skirts. And then… so I had like three under my skirt [inaudible] rubbing quite a bit. So I had to hold my friend’s hand and like, pretend I’d injured my leg. Actually what we said was that I had a stoma bag and so we had to go into the accessible toilet and change it together. And so what we were actually doing in the accessible toilet was putting them into our handbags.
[laughter]Alyx: Oh my God.
Flint: The gender neutral toilets saving.
Rens: Yeah. Still we were surprised that we got away with it. I mean, they had an airport security thing. Like we had to put our bags into a scanner. But the thing was, after we’d got in and out once they just didn’t check it again. We went through a metal detector but they didn’t check our bags again. Um, which for something you would believe would have such high security, I mean they’ve probably changed their security now. But, um, for a place that’s supposed to have such tight security and, like airport controls, they just let us through.
Flint: So all of that… all of that fancy tech and it didn’t get used properly.
Zeds: All, all that fancy tech and they didn’t put it in. We just went, we just put them in our handbags, went upstairs, sat in the room,
Alyx: Aw, that is absolutely crazy. I mean, there must have been some close calls there, right?
Rens: Yeah. I mean, we really thought they were going to suspect something, because one of the security guards walked us to the accessible bathroom and was like, chatting to us the entire time so I really thought something was going to slip but then nothing/
Alyx: Aw yeah, I mean, you’d think they would–
Rens: We were terrified obviously, because you just, you notice the sound that, the crickets making noises. They chirp quite a bit. And so we just had chirping handbags, um, but we sat in a far corner to wait for the right time. Um, and yeah, terrifying. I’m really surprised that we actually managed to get to the point of taking them out, but I’m glad that we did.
Alyx: No, exactly. ‘Cause I mean, given the demographics of the LGB Alliance, a large number of young trans– young… Because as well as that a large number of young people in the, uh conference area and they were like “Oh, there’s a lot of young folk in here today”. Was there some sort of, um, things for that?
Rens: Um, they were quite excited by it actually. So we all had disguises and things. We purposefully, like one of us wore a wig. We did terrible makeup. And we went to charity shops and found, like, different clothes we thought they would wear. Um, and then we all came up with fake identities, so we gave fake names. Um, and then when it came to actually– they had a lot of stalls in their lobby area, so when it came to talking to people at the stalls we said we were uni students and we made up things about our course and researched which classes do that course so that we could talk about it, and they were just really really delighted to have young people there, so that should, that should tell you something about their demographic in terms of who’s actually buying into it.
But yeah, overjoyed that [inaudible] quite a lengthy conversation about the supposed course my friend was on. Um… and another one like, we got invited to a party. Um, and like, got given– and it seemed to be a really close-knit party as well. Like, there weren’t very many people invited and they were just delighted, I expect, to see random strangers because we were the first young people that they found.
Flint: How old were the people that invited you to this party? Is this LGB Alliance people?
Rens: I think they were part of it because they were running one of the stalls there.
Flint: Right.
Rens: Obviously because they were there I assume it was a part of it. This was people for, I’m not sure, have you heard of battle of ideas?
Flint: Of who?
Rens: It’s the battle of ideas. It’s like, uh, um, a debate conference that happens every year. They debate and such. One of their taglines is that “We have real free speech”. So that will tell you something. And for this year, they have multiple panels, and each of their panels has something to do with “Gender wars: where does it end?”, and those sorts of titles.
Flint: Joyous.
Rens: That’s happening this weekend, and we actually got invited to a party tonight. Um, like we got added to a WhatsApp group chat. Um, and told to come to, seemingly a party for close friends tonight.
Alyx: Funny to see that they got their hopes up, thinking “Oh, young people in the room. How about that?”.
Rens: Yeah. There was one stall that was particularly related to surrogacy, um, and like egg donations and things. And so we were treated to quite a graphic talk about the horrors of that and how they prey on young women. Um, and like, force them into egg donating and surrogacy and using our bodies for money and all that sort of thing. And she got really quite passionate about it and then when we told her that we were at uni that seemed to get her even more passionate and, like… yeah. Really, really concerned with it. She believed it so fervently, um… so it was almost scary, like the way that she was describing it.
Flint: Was there any particular speaker or moment that you were waiting for before you decided to release them? Um–
Alyx: Release the crickets!
Rens: I mean, so when we were planning– we decided to go before Jamie Reed’s speech. Jamie Reed is someone who whistle-blew a trans healthcare clinic for kids in the US. Um, got it shut down. And we wanted to–
Alyx: Oh no.
Zeds: Obviously we were targeting the whole conference, but we wanted to shut down that one specificly because, like, we are kids being denied healthcare and it is because of people like her and it’s, it’s just despicable
Rens: And, like to have her up there being glorified for doing that in front of a room full of people, um [inaudible]
Flint: Did you, out of interest, um, did you choose crickets as, like a nod to a previous historic action? Because in 1995 some lesbians I think in America, um, did a similar thing. They went in undercover to a, I think a conversion practice, um, event, um, of like quote unquote ex-gays and they released loads of crickets. Did you pick crickets intentionally as a nod to that or not?
Zeds: I mean honestly I wish, um, we found out about it after.
Rens: [inaudible] be compared to them.
Zeds : Um, there was a lot of discussion beforehand, before the action, about the Biblical plagues, though. Um..
Rens: Uh huh. Yeah.
Zeds: Of which crickets was, of locusts I guess was one. Sorry Rens, you were saying something.
Rens: So even though that, that we weren’t intentionally trying to mimic them it is really cool to, like, one, be compared to them. I think we had a message from one of them. And just to like, know that we were carrying it on, even if we didn’t realise it.
Alyx: Aw.
Flint: Oh my God. That’s so cool.
Rens: Yeah.
Flint: Aw. I mean, you know, every time that we hear about you you do seem to be making history. So I mean it makes sense. Um, how… Out of that, how have you been finding the… the reaction to your protest?
Zeds: It’s… it’s been interesting. Um, like, there’s been so many lovely responses. But also, on the other hand there’s been a lot of like, horrific hate and people trying to doxx us and stuff like that. Um, which has been less fun, but honestly it’s really heartening to see people motivated and put into action by this protest. And people, I dunno, feeling like there’s been a revival of trans direct action has been really hopeful for like, what the future is going to be like.
Rens: I’ve been trying to stay off social media as much as I can, like just because I know reading [inaudible] because I know reading some of the stuff on there isn’t going to be great for me. But it’s been lovely, so the people who have been looking at social media have been like seeing screenshots of [inaudible] lovely things. People are saying and knowing that we [inaudible]
Flint: Hmm.
Alyx: Oh definitely. I mean, our audience has been absolutely loving seeing all the stuff you’ve been doing and uh, with all those reactions, all positive and negative, I mean, I remember seeing the one where you’re on the roof of the NHS building and the Department of Education and a lot of it was surrounding, trying to get the attention of, um, outlets like the Daily Mail, BBC, all these sort of things. And in this particular action you’ve, we’ve managed to get some, em, reactions from more mainstream news outlets. And we were wondering what your thoughts, eh, were on that.
Rens: We’ve been joking a lot that we’ve finally made it because we got an article in the Daily Mail.
Flint: Yeah.
Zeds: Um, I mean, for me personally it’s been… it’s been really nice. There’s been a few outlets calling LGB Alliance anti-trans. And while a lot of them are calling it a gay rights conference, it’s been really nice seeing like, people starting to recognise that actually [inaudible] isn’t feminist and it’s not a gay rights thing, it’s just transphobia. And also it’s just kind of nice to get mainstream coverage for once, because they really like to ignore us.
Alyx: It’s great to see them say anti-trans as well, instead of the usual crap as well.
Flint: Yeah, yeah. Trying to pitch this as infighting when it’s not. You’re rightfully standing up against some really violently detached from reality people. Are there any other, um, things that you wanna say, that you wanna share with the audience of What The Trans?!, any kind of places to direct any support if people wanna give it? Because I know a lot of people wanna help out.
Zeds: I mean… I guess it’s great seeing all the support we have and hearing everyone saying, like, that we’re so cool and saying that they’re hopeful because of us. That’s been really amazing. But also we want other people to take action. It shouldn’t have to be just us and like we’ve proved, I think with this that actually TERFs and transphobes can be stopped. And we don’t just have to let them spout their horrifying hatred. We don’t just have to let that happen. We can stop it. And it’s gonna be difficult but it’s necessary and I feel like we’ve spent so long, like feeling really helpless. And it doesn’t have to be that way, but it’s gonna take community effort. It can’t just be kids.
Alyx: It’s been an absolute pleasure chatting with you all and, look… well as I said, about this fantastic protest. I mean…
Flint: Yeah, truly, truly it’s… it’s actually really amazing just to be able to, like have a chat with you, ‘cause as I said, I feel this is stuff that deserves to be in history books, and in time will be, like…
Alyx: Also I’m three for three on Trans Kids Deserve Better interviews.
[laughter]Zeds: You’re welcome.
Flint: Icons. Legends.
[laughter]Alyx: Brilliant! I feel proud of them every single time. All the pride. Every single person in the community goes “fuck yes” every time. Fucking crazy and brilliant.
Flint: They’ve got the gumption for it, and they’re, they’re–
Alyx: That’s the word.
Flint: It’s really… it’s just very admirable. And it’s needed. This is the kind of shit that needs to be in history books. You hear me? It needs to be in fucking history books. And I mean, speaking interviews that we’ve managed to get with some really important people in the trans community, uh, we got an opportunity to speak to doctor Natacha Kennedy.
Alyx: Natacha has released a preliminary analysis on the puberty blocker ban. She spoke about some of what was found on her Twitter, which we have linked. But we wanted to give her the opportunity to explain in full what the current findings indicate. Where this research may be headed and this is some really important work that we need. And it’s not surprising at all that this is being led by someone in our community who cares.
Natacha: I’m exhausted, actually. Um, it’s taken a lot out of me to get that publication done in time. ‘Cause, you know, there was an eighth of October deadline to have it in for the government NHS inquiry. So I had to get it done in double quick time, really. That’s why it’s not peer reviewed yet, ‘cause it takes a while to go through that sort of thing.
Flint: Can you walk us through what kind of study this is, and its aims?
Natacha: Okay, I’m trying to get at the experience of young trans people since the imposition of the puberty blocker ban. To talk to young trans people themselves I have to go through research ethics. If they’re under 18, definitely. If they’re under 16, definitely, definitely, threfinitely. So I have to get ethics approval for that. That can take quite a long time. Goldsmith’s are pretty hot on ethics, which is good. So I wouldn’t have got that done in time for the eighth of October. So the next best thing is to look at what parents are saying about their children. The mother of a trans child put up a questionnaire, entirely independently of me, actually, in a forum of parents of young trans people and got 97 responses. Which is not that far off the number of patients per year at the NHS GIC.
Flint: Hmm.
Natacha: I checked the questionnaire and it was fine. One bit was a bit funny so I left that out. But the rest of it I looked at, and she sent me the CSV file with all the answers. And it was quite clear- actually one of the things we talk about in polititive research is what we call saturation.
Flint: Hmm.
Natacha: Now that’s when we have data coming in, once we get to the stage where there’s nothing new coming from the data, and then we kind of do a couple more if you like, and if there’s still nothing new then we’ve got saturation. There’s no new information from that particular group.
Flint: Hmm.
Natacha: Now this easily fits the requirements of saturation. Half that number could’ve been that. So I’m confident that the data I got is good quality and it covers the experience of young trans people to date after the ban. Obviously I want to have the inclusion of young trans people in that data, so I’m going through ethics at the moment and I’m going to make sure I can do some interviews with them. But it probably won’t be until January now. Which then means I can publish it as a peer reviewed paper sometime next year. I was working to a government deadline, so I had to do what I could in terms of this analysis.
Flint: What’s the overall findings of the study with regards to, like children’s quality of life, um, and the quality of life of the family?
Natacha: Okay, well in essence there’s two ways to look at it. There are those children who have been denied puberty blockers and there are also those children who have just evaded the ban. The contrast between the two is enormous. The ones who have been caught up in the ban, who can’t get puberty blockers, that sort of thing, have severely damaged their mental health. Anxiety, depression, withdrawal, self-harm, suicidal ideation, depression. All sorts of things. Very, very sharp decline in mental health. Compared with the children who evaded the ban, they’re talking about how it’s like a weight being lifted off their shoulders. That they are thriving. They’re enjoying life. They’re able to sleep on their own. You know, they’re going to school again, they’re socialising, things like that. So it really is like chalk and cheese. There’s this enormous difference really. And it’s very, very clear from that, that the puberty blocker ban is really harming trans children.
Flint: What conclusions can we make about the puberty blocker ban in lieu of this research?
Natacha: The Cass Report really didn’t cover what would happen after a puberty blocker ban, so this is quite new. But it’s very, very clear that there is an enormous amount of harm going on by withdrawing this medication. The justification for the puberty blocker ban was that there’s a possibility that puberty blockers might cause harm. Puberty blockers I think they started publishing, started prescribing them in 2000, maybe a little bit before that. So we’ve got 24 years.
Flint: Hmm. That’s quite a good chunk of time.
Natacha: There are people in their late thirties who have been prescribed puberty blockers. If there was going to be any major problem with puberty blockers we would know by now. On top of the data from puberty blockers being prescribed for precocious puberty, which is… goes back probably forty years, more than that now. So far there is no evidence, no observational evidence that there’s any problem. So they’re setting a very, very small possibility of what is likely to be a really, really tiny negative effect, if at all, from puberty blockers on trans children’s health against the actual very, very significant damage to children’s mental health which is evident and is obviously being affecting these children now. There is plenty of psychological research out there which says if you suffer from adverse mental health experiences as a child, that will stay with you. We’re not talking about something that’s going to go away. It’s going to stay with, and… and also the evidence from this study in the United States which was just published recently, Lee et al, basically came, came out with some qualitative data that suicide attempts have increased in states where they had anti-trans legislation, including puberty blocker bans.
Flint: Right.
Natacha: Now, the interesting thing about that is that the… the level of, ah, suicide ideation in these states actually increased over time.
Flint: Right.
Natacha: So it didn’t, there wasn’t a big hit of, you know, of… of mental health issues and then it went down. Quite the opposite. It’s gone up over time. So I think we can expect that the mental health issues we’re seeing now will get worse.
Flint: Right. Yeah. ‘Cause it’ll spill over. Yeah.
Natacha: Yeah. The rationale for the puberty blocker ban in the Cass Review was based on one publication which is a, uh, a speculative paper with no data, referring to another paper that says there may have been some cognitive effect of puberty blockers when given to mice.
Flint: Right.
Natacha: And therefore we need to think about this with trans kids. Mice, children. Hmm.
Flint: Hmm, yeah.
Natacha: Now actually, the Cass Review completely omitted the largest study into puberty blockers, the effects of puberty blockers on trans children, which was published in 2022, Arnoldusson et al, 2022. Basically that concluded that there was no cognitive decline in trans children. They measured that in all sorts of ways but largely in educational outcomes. The entire rationale for this puberty blocker ban has literally gone. The only reason that the government has claimed for implementing it is to protect children. Well they’re not protecting children, they’re harming children.
Flint: There’s also this, um, this narrative that often, I think I’ve seen paired with the notion of protecting children, which is soft of, as if these, these measures of the Cass review, the blocker ban, are to empower parents. And I was going to ask how has the blocker ban changed parents attitudes towards the new gender services? Were the parents that responded to the questionnaire feeling confident in the services that were being set up for them in the future?
Natacha: Okay, I mean, no. I think–
Flint: No.
Natacha: For the ones who had experienced it, the data was very, very negative. There had been a lot of problems. One of them said it sounded like the… the service they had been to was basically operated by a closet transphobe. This is, it’s difficult to find data on, because there have been so few yet who have been through this. So it’s going to take a while.
Flint: Of course.
Natacha: But when you think about it, who is going to go and work in those places?
Flint: Hmm. Yeah.
Natacha: You’re not… no one who wants to retain any kind of credibility is going to work in those places because they’re basically conversion centres.
Flint: Yeah.
Natacha: So probably most of the people who work there, as psychologists and things like that, are going to be transphobes. I can’t see any other demographic that would apply for a job there. And I think that’s been borne out in the small amount of data that I’m seeing so far. I don’t think there is any great deal of confidence. I mean, there’s no point in going to these centres. What can people offer? Potentially the only thing they can offer is psychological counseling. You know, it’s like saying, uh, somebody sort of beating you up and hitting you and kicking you and punching you and, you know, all sorts of violent things, and then stopping and saying “Are you okay? You shouldn’t really feel bad about this”.
Flint: [laughs] Yeah. Yeah I know, it’s–
Natacha: That’s literally what it is. One of the things that was very noticeable about the way these children were feeling harmed, was that it was constant. It was always with them, day or night. They couldn’t get through a day without thinking about it. The parents were reporting them talking about it all the time. So it’s a constant worry. Now you can’t deal with that with psychological counseling or even psychological drugs. There is no way you can deal with that. Particularly if the people who are supposed to be psychologically counseling are the people who’ve taken away what you want. So I don’t think there is going to be any point in going to see one of these centres. And indeed I think from some of the responses I’ve got, parents are worried that they might be referred to social services and potentially threatened with having their child taken away. So I’m not confident at all and I don’t think a lot of parents are.
Flint: On the point of, like, ‘cause it does make sense that it would be people who at best have no idea how dire the situation is, and at worst are supportive of it that would be in these spaces. But thinking, um, along that more general line, from that data that you’ve got, how has the blocker ban affected these families and the children’s experience of transphobia in general?
Natacha: They all seem to report an increase in transphobia. I’m not sure whether that comes from the Cass Report or from the puberty blocker ban. I suspect most people don’t understand what the Cass Review is, so they haven’t really understood it. But a ban on puberty blockers is… is almost like saying we don’t trust trans kids.
Flint: Yeah.
Natacha: We don’t trust who you say you are. Especially when, I mean the publication that Kemi Badenoch came out with about all of this was “gender questioning”, and that’s in the school guidance still, and, you know, Cass multiple times talked about, uh, what was it? “Gender distressed” children.
Flint: Yeah.
Natacha: I mean, these children are not distressed. They’re distressed by transphobia, not by their gender. I think the use of language and the fact that there has been, for the first time, some government anti-trans legislation is almost like painting a target on the back of trans kids. And I suspect, I don’t know, but this is what I’m seeing them reporting as well, an increase in transphobia at school.
Flint: Hmm.
Natacha: So I think it’s… when you do something like that there are always going to be other effects. When you introduce some sort of legislation against trans people, especially trans kids, you are basically encouraging transphobia. There’s no other– it’s not gonna not happen when you do something like that.
Flint: What can trans children and their families do in the current climate to help get through it, do you think?
[unclear]Natacha: There’s obviously, they could go to this Anne [Trans] Health, if they’ve got the money. And I’m told they can legitimately prescribe blockers; it would mean having to, I think go to Spain to get them. A couple of times a year. So it’s quite expensive. I don’t think there’s any other solution, to be honest. I know some people may be self-med. I can’t really speak about that. I don’t really know-
Flint: Yeah, no. Fair.
Natacha: I don’t know much about it. And, yeah, probably not as many risks as people think. But it’s… not ideal, and it’s being forced on them, you know?
Flint: Yeah. It’s having to take the risk of it not being in a setting where there’s kind of, like clinical support that’s really vital as the main risk there. This is obviously a preliminary analysis, you’ve mentioned getting to peer review, why it’s had to be released right now as a preliminary analysis. But what the next steps are after this date and going forward, is a longitudinal study what you’re sort of aiming for with this, or…?
Natacha: Yeah I mean it’s what I would aim for. I would need to, there’d need to be several people onboard, even if we’re not doing a lot at any one time, just in case people drop out and move on and things like that.
Flint: Yeah.
Natacha: So I think it’s doable and I think it’s important to do.
Flint: Mmm.
Natacha: Um, and, um, I’m told that Hillary Cass actually said oh we should, um, we should monitor what’s going on and we should, you know, I don’t think she, I don’t think she expected this.
Flint: Yeah. I don’t think she expected someone to go okay. There. Let’s look at it. Let’s test your mettle and find that it’s, you know, tin. [laughs]
Natacha: I think, to be honest, that actually the most, the biggest emotion is anger of the deal, and that Cass has been allowed to get away with this horrible misinformation.
Flint: It’s a complete injustice.
Natacha: Yeah, and Wes Streeting is swallowing it whole.
Flint: Yeah. Yeah.
Natacha: Um, and the media and a lot of MPs are doing that as well and it’s basically, it’s a recipe for conversion therapy for kids. And that’s not acceptable, and I’m not gonna let that go.
Flint: I mean, that was some really really insightful stuff like, obviously as you’ve heard, like, there’s a lot of time constraints as to why this is in the form that it is. But I’m really- excited feels like the wrong word, but I really wanna see what comes next from this. And what the further steps that they take will be because this is the kind of really important stuff that is, I think is really key to helping show how absolutely detrimentally harmful this is to children just full stop. And how that impacts the trans community as a whole. Parents, you know, entire communities. It’s a whole thing. Fuckin’…. [laughs]
Alyx: Definitely and we need all the academics we can to continue doing these studies to make sure that everything, as well, that everything’s documented and the reason that the Nazis burned the papers at Hirschfeld was, em, because they couldn’t deal with all this research and all the documentation on trans, LGBT and queer people existing. So we’ve got to keep going with this. Natacha’s work’s, em, quite important there. Next up is Claire Prosho from Claire Trans Talks, who has spent the last 18 months analysing transphobic hate crimes. And following the recent release of data for this last year she now has a dataset from 2011 through to March of this year, and was kind enough to write up her findings for us into an article. We’ve published that on our site and linked it in our resources for this episode. But we also wanted to take you, listeners, through her findings as well. What follows is from the article itself. Dates from the last year shows that more than half of police services have seen a drop in hate crime reported by transgender people, which averaged at a drop of 18% for each service that saw a decline. Essex police saw the biggest decline at -36.5% and Leicestershire the smallest at -1.6%. However, the vast majority of hate crime against transgender people goes completely unreported. In 2018 in their LGBT in Britain trans report, Stonewall estimated for unreported rates to be around 76%. And in 2020 or 2021 Gallup indicated that this had increased to 86% in their transphobic hate crime report in 2020. According to [inaudible] at the time of the original Home Office release for 2022 and 2023 it had been noted that this had been increased again to 9 out of 10 or 90%. But this appears to have been edited out of the release shortly after publication. In effect, hate crime against transgender people in England and Wales is at epidemic proportions, and reporting of hate crimes in police service has collapsed across the country. It is that collapse in reporting that has led to data plateauing out, as shown in a graph, above and over the last couple of years, not an actual decrease in hate crime. What else can we learn from the data we have? Well, adjusting for population we now know that only 1 in 744 trans people reported a hate crime in 2011 to 2012 but in 2022 to 2023 this has increased to 1 in 55, compared to sexual orientation based hate crimes, which had decreased to 1 in 67. But if we factor unreported rates, the number of trans people experiencing a hate crime in England and Wales is 1 in 5. 20% of the trans population likely experienced a hate crime at some point over the last year. Based on extrapolated data on reported hate crime, we honestly suspect that figure is much higher, given that TransActual reported that 99% of trans people experienced online transphobia in their Trans Lives Survey in 2021.
Flint: And it’s easy to work out what has caused this collapse in hate crime reporting. Historical mistrust with the police and the massively increased politicization of police services by the previous Tory government as part of their phony culture war, coupled with a complete lack of action by police services, who are hampered by a lack of interest and training, fear of upsetting the freedom of speech brigade and UK press have all led to this sorry state of affairs. From talking to friends in the community, the vast majority of trans people can no longer justify the waste of time and effort to report hate crime, especially online hate, for no return or action. Hate crime against trans people is simply not taken seriously in any capacity by police or UK government, and it is far too often written off by police services and politicians as freedom of speech. But all this data shows empirically that trans people continue to face substantially increased risks of personal violence and abuse in public, and are being subjected to increased more violent attacks and in and on their own homes across England and Wales. That has to change. But does Labour have the courage to do anything? Personally, I very much doubt it, but only time will tell. And that was Claire’s writing, but I very much agree [laughs]
Alyx: Yeah, Claire’s done some fantastic writing. I remember when we were chatting in the WhatsApp and her analysis on so many of these stories and all the data has just been invaluable and we really need more people analysing data like this. And hell, if you’ve seen other bits of data and want to analyse and show off these kinds of stories, we’re always happy to give our platform out to those who might want to help with analysis like this in the future.
Flint: Please, if you are a data nerd, if you are a spreadsheet nerd, do your thing. Please, like, do your thing. We’re always looking for good, genuine, actual analysis of this data of, of much of the data surrounding trans people to better show the actual reality. I mean, I’ve found that this analysis that Claire had done has actually pretty, like, accurately sort of, it validated my own experience. It’s fucked. It’s fucked and it’s not functioning anywhere near how they want to tell you that it does.
Alyx: No definitely. And thank you Claire so much for doing that work for us.
Flint: Yes, thank you so much. Now that we have thoroughly covered all of these… I say, like, normally it’s smaller stories before the meat, but we’ve had quite a few that are like, pretty big.
Alyx: Often… gosh, the hate crime one was the meat in itself, if we didn’t have this one.
Flint: Yeah, the… why don’t you take us through the meat, as it is now?
Alyx: Yes. The the burger in this horrid news bun, which we’ve tried to sprinkle in a bit of seasoning with nice news. But this one is very much a horrid, disgusting, overcooked beef. Which is some really horrid news about the recent stuff that’s come out on Twitter. So this story is a bit of a two-parter. The first part you’ve probably heard about already, particularly if you’re in the UK, which is that many trans people have received letters last week from their GP advising them that they would no longer be provided with their hormone prescriptions. This is a completely separate issue from the puberty blockers ban and affects adult trans people who have been seen a few times at their gender clinic and have also been given their estrogen or testosterone by their clinic. It seems strange to us that so many people in different parts of the country had received some surprisingly similar-looking letters around the same time. And as you might have guessed, we’ve sort of been looking around, and it seems to be a coordinated effort. From what we can gather, from some of the sources, which we believe has happened here, or is one of the things that has affected it is the primary care networks across the country have been doing collective industrial actions where some of their demands are to not take prescriptions from secondary care institutions like gender clinics. Then hostile GPs then ask other GPs to specifically target gender identity clinics. And because of the collective action agreement they have to join in. But this is from some of our anonymous sources so far, we’re still gathering evidence but if you’ve seen anything that helps corroborate this, please get in touch. But the big picture is that trans people are being denied the healthcare they need, and those affected have been contacting TransActual, who have been looking into this. We spoke to their CEO Chay, who gave us his thoughts on the issue. But what’s the second part of this story, you may ask? Well, dear listener, while we were sat down with him, we took the opportunity to ask about where things are with the adult gender services review, as TransActual is part of a trans healthcare coalition that’s aiming to help stop this new review being Cass mark II. Ring that bell.
[sound effect: bell]Alyx: And we’ve got some exclusive updates for you all. Alright, so we’ve Chay from TransActual. His pronouns are he/him. Uh, welcome to the pod.
Chay: Thanks for having me.
Flinty: Yeah. Um, I mean, I feel like I should just start off by just asking how are things at TransActual at the minute, where are things up to and whatnot with, like, what’s been going on?
[unclear]Chay: We’re very busy. As we, you know, as we speak, sort of, um, preparing to publish a report on patterns with GPs refusing to prescribe HRT. We’ve got a Meet Us, Hear Us campaign. If you don’t know about that, it’s an initiative to encourage people to go and meet their MP or other elected representative because, you know, they’re making decisions about our lives and a lot of MPs and others have not knowingly met a trans person. Em, so it’s important that they hear about trans people’s experiences. So we’re really encouraging people to get involved in that. There’s info on the TransActual website and we’re going to have a day of action. As many people getting a meeting with an MP in parliament on the 13th of November to start off Trans Awareness week. So there’s all the exciting things and, and important things there. There’s also things like the work that we’re doing within the Trans Healthcare coalition around the review into adult services and we’ve also just responded to the stakeholder consultation on the puberty blocker ban as well. There’s other stuff going on, too, the book that we’ve got out, Transitions: The Unheard Stories. And so much. It’s a very busy time for TransActual, and it’s nice that not all of it is having to react to awful things happening. But yes, we are having to also react to awful things happening and it’s a busy time.
Flint: So out of the people who have reached out to you about the GP HRT situation, what have you learned so far from those that have gotten in contact?
Chay: Yeah, so we’ve got an online form for people to fill in, so if anyone listening has been refused HRT by their GP, within the past year or past couple of years, please go and go to the TransActual website and fill in the form but we’ve been tracking the data since May, which was when we first noticed more people mentioning that they were refused prescription. But when we had a look at the data for people who have been seen or are being seen by an NHS gender clinic and who have got a letter or a report that is asking their GP or other previous GP to prescribe, we’re finding that there’s been a definite increase of people and the the majority of the people that responded to our survey at least are people that… they’re not new on starting HRT, they’re already on it. And I think it was around half, it was a GP that had previously been prescribing for them who’d changed their mind on it. And a third of the people being refused care, including myself actually, were people that have been discharged from their GIC. So it’s not necessarily what I might have expected with with GPs with it being GPs that never prescribed HRT before. That’s happening as well, and with new prescriptions, but the common reasons that are coming out are GPs saying they don’t feel competent to prescribe which is strange because it’s the same medication that cis people have for menopausal cis women or for cis men with low testosterone and also for some intersex people, it’s the same medication. You just have to look at, is it in the normal range, you know. But they don’t feel competent to prescribe. A lot of people saying about our Integrated Care Board or our Primary Care Network or our practice we we don’t have a policy to prescribe HRT to trans people or variations on that theme. In my personal case it was my integrated care boards, say that GPs should only prescribe HRT under shared care with a gender clinic. And I said to them well where does that leave me? I was discharged years ago and also I’ve got no ovaries, so you know, and actually I managed to get my HRT after a bit of a conversation, but I don’t know what’s happening next time. And there’s been a lot of this but also GP attitudes towards it generally have come out, we’ve had one GP stop prescribing for someone because they were worried that it might impact their career. You know, and a lot of things around pay as well. We’re not paid to do this. This is not in the GP contract. But funnily enough we’re at the Royal College of GPs conference. We had a exhibition stand, em, a couple of weeks ago and and of the GP’s we were speaking to, some of them said, oh it’s not in the general GP contract but do it– but I prescribe anyway, even though we’re not really funded for it, and then other GPs said to us: no it is covered under the general sort of clause of the GP contract. Because it can’t possibly list out everything that they need to support patients with, because that would be an incredibly long… Imagine initially all the pages on a contract that long if they had to list out everything that they were funded to treat. So some GPs with the understanding that they are funded and it’s part of their core work, so a lot of, you know, they’re unclear on what the policy is. And then meanwhile we have the the national policy for the service specification for NHS gender clinics says that gender clinics aren’t commissioned to prescribe. And it’s different for some of the pilot clinics but on the whole the clinics aren’t commissioned to prescribe and the expectation is the GPs will prescribe, and it says it really clearly. So there’s a few things going on, because of course GPs are under a lot of pressure. They’re taking, they’re working to rule at the moment which is the type of industrial action short of going on strike. And definitely at TransActual we support trade unions and we support workers’ rights. However, your union action has… it’s got to not have a significant risk to people’s lives or wellbeing. You know, it’s tough. But then also we’ve got just the general climate around this… the way we’re talked about and transition related care is talked about by politicians, in the press, you know. There’s a general… for some GPs that will be making them nervous. For other GPs it’ll be empowering them. So there’s a whole mish mash of reasons that it could be and realistically there’s a combination and of course the Royal College of GPs guidance.
Alyx: They recently did an update, didn’t they? A clarification.
Chay: They did.
Flint: Yeah. I was just about to ask what your understanding of it is
Chay: We’re glad that they offered clarification, of course. It takes the guidance on what they were saying about prescribing HRT for trans adults, it takes it back to what it originally said, around about just before they changed it in the spring. Late spring/early summer they changed it after the Cass Report was published. I wish it would be a bit clearer and a bit more to the point, because it kind of still says: well, we encourage, you know, you can prescribe but there’s still a bit of a “you don’t have to” in there. As opposed to the guidance for the GMC which is a lot clearer and a lot more straightforward. So I kind of wish the RCGP would just signpost people to the GMC guidance and that’s the guidance that we- And of course there’s still a lot in there around trans children and young people that is an issue. And we are seeking to speak to the Royal College of GPs on that to see where they’re up to with things and and what’s led to different changes and all of that business, really.
Flint: What do you feel is driving these actions of the HRT withdrawal stuff? Do you feel it’s more intentional or…?
Alyx: And why it’s so sudden and such as well. It feels so sudden, doesn’t it?
Flint: Yeah. Yeah, it feels like it’s been a sudden ramp-up.
Chay: It feels like it, but it’s hard to know how sudden because the block might just have been a couple of people happened to place their letters online and they went viral. Em, because this has been going on since, you know… We wrote a resource for trans people about what to do if your GP refuses your prescription back in May and launched the tool, because we’d seen an increasing pattern. But it really is, I think, is a combination. So because there’s so much misinformation about detransition, and because there’s been high profile court cases to do with people who are very much in the minority and regretted their transition and took legal action. So GPs are, some will be afraid of court cases. And it’s a bit like – the coverage of these court cases is a bit like coverage of airplane crashes, right? Because the reason they get coverage is because it doesn’t happen very often. Whereas actually, car travel is far more dangerous than traveling on aeroplane, but because road accidents are fairly common, you know, the occasional bump on traffic lights or something doesn’t get reported on. So there’s probably a perception among some GPs that detransition is more common than it actually is. And they fear that they may be prosecuted or some action might be taken against them. Again for those that hold hostile views, we’re seeing people feel more able to express trans hostile views these days because of the ongoing media, social media campaign, behaviors of some politicians. It acts to sort of embolden people as well. Confusion because of the blocker ban then and I don’t know what I can prescribe, so I’m just not going to prescribe anything. Like I said, the action short of a strike and the working to rule may well be part of it. We support trade unions at TransActual. We support workers rights, but we would rather it wasn’t impacting trans people, one of the groups that are known to face many, many healthcare barriers.
Flint: So do you, do you feel that action short of strike is a contributing factor?
Chay: It could be. It’s hard to know. I think it’s a combination. And also I wonder… this is not based on anything I’ve seen, but just more of a question in my mind that someone may well investigate at some point. But I wonder whether any of the insurers that provide GPs with their professional insurance and their legal indemnity type insurance. I do wonder whether one of the big ones has changed how it – the policy or put something out that says we won’t cover you for this. Because the wording in the letters that I’ve seen is very similar. Duplicated. It could be that too. So in reality it’s probably all of those things. It’s not one thing.
Flint: When you talk about being across the NHS, just to pull it back to the HRT situation. How far widespread across the UK is that, in your data? Is it outside of England and Wales?
Chay: So in England it is in every NHS region. Not every indicated care board. But examples in… of the people that reported to us, there will be more examples of course. But it is 22 of the 42 integrated care boards. We’ve got instances of refusal reported in those. And then across all of the regions of England. In Scotland we had six people report. And in Wales, three. And we’ve not had any reports from Northern Ireland, but that might be as well because in Northern Ireland the the gender clinic is not really functioning at all. So the issues there are different. But yes it is largely England. With that geographical data you’ve got to think, you know, if someone in a local support group has shared it within the group. Sometimes the geographical spikes might be more to do with that and less to do with it being especially an issue in that area. It might just be more people in that area have seen that we’re tracking it, and have a form to fill in. You know. So with certain things with that to just so be mindful of not joining too many conclusions. But definitely, we know it’s every single region in England.
Alyx: Definitely. It definitely all seems very widespread and, eh I think it too, as mentioned you’ll probably want as much data as you can get in terms of the other regions like Scotland and Wales and Ireland. So if any of our listeners are out there, we’ll make sure to attach this in our description. But for those who are also listening who are thinking “what if I’m next?”, how reasonable is it right now for the average trans person to fear that their HRT could be next?
Chay: That’s a really tricky one to answer. So I’ll say a couple of things that I hope will reassure people. So the first one is that if you’re refused you don’t need to just leave it there and go “Oh that’s it”. TransActual has a resource on our website and I mentioned that you can use. It takes you through, there’s a two-sided PDF that you can send to your GP or print out and take in, or show them on your phone, that tells them what the GMC says. It tells them what’s in the service specification, and it tells them where they can get guidance on prescribing HRT as well and it covers a lot of the things that if someone might be concerned about in terms of being allowed to prescribe or knowing how to monitor, because this guidance out there for people. And the resource talks people through who to complain to first and then who to escalate it to, and we’d always encourage people to complain if you’ve got the emotional energy, because it’s not just you that this issue’s affecting and if we find the integrated care boards or individual practices aren’t dealing with a complaints appropriately and resolving them, people have the right to complain to the Parliamentary and Health Services Ombudsman. And they keep track of patterns of complaints and if they spot any particular patterns they report on them and make recommendations around some of the issues. So when you complain it’s not just for yourself but it helps other people potentially as well. The other thing to say is, it is important to caveat this by saying trans people should have access to hormone therapy on the NHS. They should have access to blood testing and should never have to look for alternative solutions. But what I will say is that trans people, even before the NHS provided HRT, we got access to HRT. We will always have access in one form or another but the point is we should have safe, free access to HRT because we are entitled to it from the NHS. But it’s just because I know people are scared. It’s just something I was talking about with a friend the other day, that is we have our moments of community, but on the whole we pull together; we look out for each other. And that’s not something that’s going to change. And in the meantime there’s people that are working on it. We know a lot of people are anxious, and you know we are too, to be honest. But we’re working on it. So that’s why, you know, we’ve got the report that we’re going to be releasing later in the week. The draft report is already gone to NHS England. It’s already, um, gone to a few people that need to see it. Um, and indeed with one of the letters, um, we’ve– we have, um, been sent, we’ve raised over that integrated care board already. Um, so that,you know, TransActual and others and, you know, there are people within the NHS that are working to get it sorted. Just know that there are people that do care and are… are doing something. And yeah, I think it’s important for people to know that, because the world can feel a bit scary sometimes.
Flint: Where– where do you see this situation sort of headed in… in the future do you think?
Chay: If it comes down to integrated care boards having discriminatory policies, they could head to court, you know, and trans people’s rights – transition related care was won in the courts in the first place. So there could be a court case. In court cases against GPs or disciplinary action against GPs. Especially if they’re refused care to someone that’s had their ovaries or testes removed, you know? Because there’s extra health risks with that.
Alyx: I know the gender criticals are going to have fun with lawyers.
Chay: No, no. And we know some very, we know lots of very supportive lawyers as well, and it shouldn’t have to happen, but I think it’s a potential. On a policy basis what my view of what needs to happen is, is that it needs to be really clear in the service specification for NHS gender services, that what the expectations are of GPs and how that fits in with the GP contract is for a commissioner to work out, not me. But it should have been made to fit with the GP contract. You know, GPs need to be properly funded. So if that’s funding for enhanced services that’s probably a good thing because actually, you know, enhanced service funding often funds GPs to do regular health checks on certain groups of patients. And given that trans people face a great number of health inequalities that would be quite good too. And you know, I’m hoping that perhaps the training may well be a bit, you know… It’s very clear in our data GPs are saying “I don’t feel competent”, we’ll deliver training to them then, you know? And whether that’s training from – I know some of the GICs deliver training within their regions or whether it’s the Royal College of GPs providing training centrally, you know. If they were GPs in every area trained and able to develop confidence that would go a long way too. And actually that does an important thing that needs to happen for transformation of transition-related care and moving to a system that works for us anyway. But we’re quite far away from that system that we’d like to see at the moment which is sort of illustrated by this with GPs refusing to prescribe.
Alyx: Yeah exactly. I think as you mentioned there’s a lot of stuff about the service specification and with some of the information about the new review on the service specification and all the work of gender – and a review into gender identity clinics for adult health care, of the Levy Review, TransActual have been doing some work with the trans healthcare coalition as you said, on the Levy Review. And I suppose with the stuff about the GPs in the near future, how’s things looking at the Levy Review at the moment? Because our listeners would be curious to see how –
Chay: Yeah, yeah. And we’re conscious that we as a coalition, we need to tell people where things are up to. So yeah, this great question and great opportunity to sort of say. So we’re avoiding calling it the Levy Review because we don’t want it… especially if it turns out to be awful, we don’t want it to be used as this really as a throwaway phrase that is very easy to then refer to as… in the way that the Cass Review is in policy making. It’s a sort of convoluted way to explain it.
Flint: I think I get what you’re saying is it’s sort of the way that Cass has been able to become a prominent figure. And it’s been able to all be centered around this one person, and that’s been advantageous for her career at our detriment. And preventing that happening again-
Chay: Yeah, that’s part of it. That’s part of it. And it sets up – when this code name like the name of the review it sets it up on a pedestal and, you know, in the case of the Cass Review it’s a pedestal it does not deserve. But anyway so we’re sort of saying it’s the independent review into the NHS England adult gender clinics. Doesn’t quite trip off the tongue as well. We know the review visits have started. We are starting to get information from one or two visits, but I’m not gonna say anything more until we’ve heard how more of the visits have been. We did have concerns that whilst trans people weren’t explicitly excluded from being part of the teams going into review (the gender clinics), that there was no explicit inclusion so it was like, well if a clinician happens to be trans then there’ll be a trans person on the team doing the review for that particular clinic. And other members of the Coalition and other LGBTQ+ orgs of stressed quite plainly that you need to be including some patient voice representation on the teams. Unfortunately not heard back about whether that’s happened. So like I said we’ll have to see once we hear some more reports of how the visits going. These review visits are a bit like… for people that are familiar with education-y stuff, I think of them a bit like Ofsted inspections to see what clinics are doing well, where they need to improve, what they’re doing in terms of are they following the current service specification, things like that. How many patients are they seeing? What’s the patient experience like? But without the pass or fail mark. But anyway they’re reviewing all the traditional gender clinics plus Transplus and Indigo and there’s going to be reports about each of them into each of the reviews and then it’s all going to come together in one report of all the clinics. That is only part of the review into adult services. So it’s going to inform the review of the non-surgical service specification. That covers things like how many assessment appointments you had, what types of clinician work in a gender clinic, what services the gender clinic offers in… ‘Cause there’s a little bit about hair removal as well. And then stuff to do with surgery is a separate one. So what the NHS are doing at the moment is on Monday, anyone registered as a stakeholder in NHS gender services got sent the details of a stakeholder consultation into the existing service specification, and NHS England have told us the reason they’re doing that is because they want to hear from people what we think should be kept. What we think needs to change. What we think needs adding and what we think needs removing. And also from the findings of the review visits led by Doctor Levy, that from that they will then draft an updated service specification and then there’ll be public consultation on that and and all of these things. So that’s kind of where we’re up to with things. So there’s a couple of things going on. There’s also going to be a policy on hormone replacement therapies for trans people, because that isn’t the moment and again that’s potentially an opportunity for trans people…
Alyx: This is part of the Levy Review, isn’t it?
Chay: Yeah it’s all part of the review, so this is what I was saying. The visits by Doctor Levy are only part of it. So yeah, and because there’s not previously been a HRT policy for trans people. So it could be useful because it might be able to include something about GPs and their responsibilities, you know?
Alyx: There’s also been concerns about the puberty blockers where, would it be like a possibility of a delay to try and use that kind of consultation to try and make it harder to get HRT?
Chay: With the puberty blockers, my sense is that was that was coming from government, or the previous government. Or not that… we’ve had many different messages from the new government. We’re due to publish a letter to Wes Streeting about that tomorrow. An open letter signed by 144 people.
Alyx: Yeah I think I saw a pre-press release
Chay: Yes you’ll have seen the pre-press release. Yes, yeah. So that… yeah that’s going out tomorrow. But in a meeting that I and other representatives from LGBTQ+ and trans organizations were in, NHS England said to us there’s no plan to remove access to HRT. There’s no plan to close any gender clinics. I do not have that in writing. I’ve just had it verbally. I’ve asked for it in writing because I think actually NHS England should be communicating to trans people about what’s going on.
Flint: Definitely.
Alyx: It’d be more reassuring.
Chay: And to be reassuring. And we’ve been saying this as the trans healthcare coalition and individual organizations, we’ve been saying this for months, em, repeatedly, every time we speak to them. It’s “will you communicate with trans people, because people are scared” because rightly… So they’ve seen what’s happened with Cass Review, and trans people are worried about adult care. In terms of the Coalition, we are very mindful of where the issues came about with Cass Review and we’re looking very closely. All the stages and we’ll be ready to – if we think that anything untoward is happening or we’re seeing flaws in what’s going on, we’ll be raising the issues straight away and publicly. But also we’re not just – we’re not working on the assumption that all care is going to be taken away. We’re working in the knowledge that we have to be aware that there are people in the world that would like that to happen. But actually we’re focusing on making sure that we see improvements to what is, let’s face it, is a broken system. It’s a broken system. Something needs to happen to improve it. And so we’ll be, as a coalition, and again, as the organizations within the Coalition, we might have all slightly different nuances to our views on things. But alternately we want improvements to transition related care, so this review as a whole, you can see why it’s worrying people. But it could lead to improvements.
Flint: When you’re asking them to change certain things or you’re critiquing the way in which things can be done to better the trans community, are you feeling listened to?
Chay: Just towards the start of the review process, or the part of the process being led by Doctor Levy, quite a few LGBTQ+ orgs and trans organizations did have a meeting with him. And he’s sent through the key lines of inquiry. And we had an opportunity to feed back to him on those, and to the team on those and we had a discussion around it. We had opportunities to raise some things that were a bit problematic and they invited us to follow up with email. We’ve now had an email back to say “We’ve made the changes” but it felt like they wouldn’t have had the meeting if they didn’t want the feedback. However – and again I’m not sure we really pushed on it – the importance of having trans people as part of the review team, by design, not just by accident. And we’re not sure and gonna need to see and find out what’s going on a few more of the review visits before I can say whether that’s happened or not.
Alyx: Not to bring it back to bringing doubts on review again. We have seen some folk– there was like a freedom in the information request a while back about the Cass Review appointments and how Cass was appointed because she was like, only person interviewed and short listed and it seemed to be a lot of the same cases.
Chay: Yes. Yeah, so Doctor Levy was, there was a FOI came out, that Doctor Levy was the only candidate. And I’m in two minds what I think about it, you know. Because on the one hand he’s not worked in gender medicine and isn’t trans either, but on the other hand it was him that led some complaint major national reviews so, you know. Reviews into, when there was a particular group of hospitals that were failing and needed turning around it was him that led that review. So he’s certainly experienced in reviewing healthcare providers and provisions and looking at systematic change. What he isn’t is an expert on trans people’s lived experience and on trans people’s healthcare. And something that we were keen again when we met with him, so we were keen to stress that transition related care is different to other healthcare because we’re not ill. It’s different to a lot of other care because we’re not ill and that makes it different when you’re looking at assessment processes and things like that.
Alyx: We did see a job he was doing at the LSC ISB.
Flint: It’s the Integrated Care Board of Lancashire and South Cumbria, I believe.
Alyx: Yes. And they sort of had, like, a ban on prescribing HRT and doing blood tests.
Chay: Yeah. It was on… I think that was around shared care with private providers which obviously we disagree with an ICB banning GPs from offering shared care with private providers for HRT. The thing that’s difficult though is a lot of ICBs have that, so it’s hard to know without asking him directly about it or reading his mind, it’s hard to know what the motivation was. But yes of course I can see why that would worry people. And it does raise questions, you know, and something again that’s… working around this are mindful of. And watching.
Alyx: Oh definitely. And, I mean, the work at the Trans Healthcare Coalition will definitely be – we’re definitely behind you and I hope it goes absolutely brilliantly. You’ve answered those questions on the Levy Review. We’ve absolutely rinsed you for answers and all that sort of stuff. And I suppose to move to a more positive thing, you’ve had some fantastic work at TransActual, not only with the Levy Review but also as you mentioned earlier, you’re working on the speaking to MPs in Parliament and get – what I can see is making sure there’s a torrent of trans people coming into parliament speaking to MPs. Do you want to walk us through some of that?
Chay: Yeah so the Meet Us, Hear Us campaign is on the basis that, look, MPs making decisions about our lives, or decisions that impact our lives, and it might be sometimes it’s trans-specific decisions, other times it’s not. They’re just decisions that impact us as humans, and more broadly. They’re making decisions about our lives without having met us and without having heard from us about their experiences. And a lot of them will be getting their information from the media, from the press, from social media. And indeed from transphobic campaigners that are in Parliament on a regular basis. It’s time for it to change. We need that to change. And everyone has a part that they can play if, you know, if they feel able to. Everyone has as a little bit that they can do, to be part of that change. So we’re having a day of action on the 13th of November. It’s a Wednesday and it’s the first day of Trans Awareness Week and what better to start Trans Awareness Week than encouraging trans people to meet their MPs in Parliament. You know, some people have managed to book an appointment with their MP already in parliament and we’ll be going along and we’ve got support for people on the day. And we have a travel bursary if people are on no income or allowing when they fill out their form to say that they’ve booked their appointments with their MP and they’re coming to Parliament, they can let us know and then be like to be they’d like to be considered for the travel bursary. And we cover the cost if someone needs to travel with a carer or cover the carer’s travel as well. And we’re gonna have a drop in for MPs so any MP that’s not fortunate enough to have an appointment with one of their trans constituents or any of their trans constituents on that day, we’re going to have a drop in where they can come along and talk to members of the TransActual team. Talk to other trans people that we’re inviting to be part of the drop in as well. And really, really get those conversations going and get MPs listening. But is actually not limited to just talking to MPs. Talk to your senate member, talk to your MSP, talk to your Northern Ireland Assembly member, talk to your local councilors. Just talk to anyone that’s making decisions about our lives. There’s lots of information on the TransActual website. If you go to transactual.org.uk/meetushearus that is the home for all of that information. So we’ve got the resources on how to arrange a meeting with your MP, what to expect from it, how to prepare for it, how to follow up afterwards. Lots of top tips. We’ve run some workshops for trans people as well on meeting elected representatives and there’s lots of information there. And like I said it’s not just limited to going to meet your MP. It’s not just limited to coming down to London on the 13th of November. It’s good to have a national day of action but actually what’s really important is just go and meet them. Or have an online meeting if you can’t get out of the house or something like that. Have an online meeting. But it’s just important that we’re heard, you know, and listened to.
Alyx: Oh my gosh, that was such a good interview.
Flint: It really was, it really was. It was really good to be able to like, get needed important info on something that is very very concerning, and to be able to then also get information on this other really big important stuff that we’ve not really seen much about. Really needed. Very glad that Chay was really willing to sit down and have a word with us about it. And yeah.
Alyx: As a journalist I fucking love a good exclusive. And this was so many exclusives wrapped up in a big bundle. And being– we were like, aside from TransActual probably doing their own bits but being able to be the first to put it out there, that’s always exciting. I love those kinds of things. I’m always– I’m always running to try and get as many of those as I can grab, and it’s so good. That’s just my selfish part of it that’s coming in there. [laughter] But some very important information there about where things are at and some things that the community really need to know, because when you’re seeing these reviews and all this worrying news you feel left out, being let into the fold with some of this information that we’ve managed to give you, em, we’re hoping that helps with nervous wait as the review takes place and to know but there are trans people who are, whether welcomed or not are elbowing their way into the room regardless of whether they like it or not.
Flint: And of course any more updates that we get, any more information that we can share and spread to the rest of all of youse out there at home then obviously we will do. But we’ve at least got something for now and that’s pretty good scoop. Pretty good scoop. [laughs]
Alyx: I love scooping. So good.
Flint: And speaking of scoops, I know that everyone listening may be quite full on all of the news and the meat that we’ve given them. But how about a little bit of dessert?
Alyx: Yeah, it’s just like when you’ve had a really big dinner and all of a sudden you then think “Oh, I might have enough room for a bit of dessert”.
Flint: Yeah. Or someone’s like “Little but of ice cream?” and you’re like oh suddenly… suddenly actually there’s space there; I can move things around. We’ve got this. [laughs] [sample plays] Maybe a little bit of pud then. Bloody surprise mate, you got room for pud.
Flint: Because this episode was such a particularly difficult one, with a lot of heavy news in it, we kind of wanted to provide some nice joy and just chill good times to end things out on. So we’re doing dessert now. This is not just going to be a thing about big newses. The way that I think we’d figured out is basically it’s a more community-led thing so if anyone has really cool, like, if there’s any interesting cool good news that you get, send it in to us. If there’s any kind of icons in the community, any more local artists or people that are in your local queer communities and you want a spotlight on them, let us know about them.
If you want to, if there’s big milestones then send them in. It’s that vibe. We want to make sure that we aren’t just sitting down and talking about transphobes and transphobia as opposed to talking about our community.
Alyx: Yeah, uplifting everyone.
Flint: Yeah, yeah. I mean obviously we’re still gonna report on the big news. That still has to happen. I don’t know about you, but I think it’s been nicer having little things that are nice in between the big stuff.
Alyx: It just allows – just most of the time, most of the ending of the news I’m going [sighs]. The early end of the nice news I’m going [satisfied sigh]. I’m afraid, dear listener, with all these interviews and all this queer joy and all the news, I think we better, em…
Flint: We better let you go.
Alyx: I’m sorry. You’re going to get more of this next episode and if you want to have us talk about nerd culture more you can check us out on Patreon as well. We’ve got What The Flux coming up, we’ve got Trek The Trans, Who The Trans. If it’s mixed, some kind of who, what, why, where with a bit of trans or something at the end of it, we’ve got it.
Flint: Some form question connected to some form of art and that’s going to be…
Alyx: Trans.
[laughter]Alyx: Oh exactly and you can also check us out on our website at whatthetrans.com, at… well we’re on the nearly dying Twitter at twitter.com/whatthetrans. We’re also on Threads or BlueSky if you want to not be part of that dodgy situation. We’re on Facebook and of course, as we mentioned, Patreon. But with that, thank you very much and [falsetto] goodbye!
Flint: Byeee.
[outro music]Flint: This episode of What The Trans was written, presented and produced by Flint, Ashleigh Talbot, and Alyx Bedwell. Edited by Amber Devereux, Oli Morris and Larianne Davis. And with music composed by Waritsara Yui Karlberg. Thumbnail by Uppoa Peirs, and transcription performed by Sam Wyman, Rowan B, Rachel Aldred and Georgia Griffiths. And we’d also like to send out a massive thank you to our wonderful Patreon producers, starting with:
[unclear]Alyx & Flint: Tim Rufo, Maestrum, Danny Gould, Lex Phoenix, Sebastian Sings Soprano, Joe the low-quality enby, Andrea Brooks, Jack Edwards, Emily Roberts, Dulcie, Stefan Blakemore, [unclear], [reverb] CRAZZEE RICHARD, needles and threads, Flaming Dathne, Dr McGee, Genevieve Dickson, Rachel Harris, Katie Reynolds, Georgia Holden Burnett, Grabilicious, Mx Aphen, Rootminusone, Grey, Elisabeth Anderson, Bernice Roust, Ellen Mellor, Jay Hoskins, Trowan, Ashley, Matty B, Setcab, Jane, Roberto de Prunk, Rose Absolute, Sarah, Sinna, Kiki T, Dee, Skye Kilaen, Eric Widman, Bee, Jude, [French accordian plays] monsieur squirrel, Fergus Evans, anubisajackal, Camina, Brandon Craig, braykthasistim, Sian Phillips, Heidi Rearden, Ezra, Lentil, clara vulliamy, Amelia, Samantha Raven, Corvina Ravenheart the trans metal DJ from Twitch and VR chat will play St Lucifer for props, Tabitha Jo Cox aka Candy, Fiona Macdonell, Murgatroid, ontologicallyunjust, Stella, Cyndergosa, Rebecca Prentice, [reverb] CRAZZEE RICHARD, danoblivion, Florence Stanley, Helen_, Elle Hollingsworth, Nick Ross, Melody Nix, Fiona Punchard, John, a mysterious, anonymous patron (ooooh!) [X-Flies theme plays], CB Bailey, Gordon Cameron, Ted Delphos, Kai Luren, Vic Parsons, Patreon User, Vic Kelly, Katherine, Sabrina McVeigh, Cassius Adair, Melissa Brooks, Karaken12, April Heller, Sofie Lewis, Alexandra Lilly, Claire Scott, Ariadne Pena, Lauren O’Nions, Bernard’s Pink Jellybean, Lenos, and Chris Hubley.
Flint: Thank you.
Alyx: Thank you all for listening. Bye!
Flint: Cheers. Till next time.
[outro music ends]Flint: Fucking hell, that was so long. Oh no!
