Friday, 2 February 2024

An activism email on the introduction of a “positive duty” to prevent sexual harassment [Note: Content Warning - discusses discrimination and effects, including self harm. Reader discretion is advised]

Note: CONTENT WARNING - some of this content is about upsetting, disturbing or triggering events & attitudes. Seek competent help - including professional - if you need it. Aboriginal and Torres Strait Islander readers are advised that linked articles may contains names and/or images of deceased people. READER CAUTION IS RECOMMENDED! For anyone distressed by anything in this post, or for any other reason considering seeking support, resources are available in Australia here, here, and here. In other nations, you will have to do an Internet search using terms such as “mental health support - <your nation>” (which, for instance, may lead to this, this, and this, in the USA, or this, this, and this, in France [biased towards English-language - my apologies]), or perhaps try https://www.befrienders.org/. 

Further to my post earlier this week on this topic (here), I have now written an activism email, which is copied below in a lightly edited version - mainly for privacy reasons, but I have also edited some clumsy wording that I wish I had recognised before sending the email off. Sigh.

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Dear Member for _,

Further to previous emails and discussions, I am writing to you about the existence of a certain amount of ongoing transphobia in institutions - namely, medical centres including hospitals and their agents in light of the new "positive duty" under the national Sex Discrimination Act (SDA), which became active on 12th December, 2023.

Information on that new duty can be found at:



Firstly, I wish to point out that my working career (I am now retired) included:
  • advising the company I worked for in the 1980s on ways to respond to the new OHS Act;
  • playing a role in enabling formal QAQC registration when that was introduced in the 1990s;
  • having a role as an Employee's Representative when the Equal Employment Opportunity for Women Act was introduced;
  • an ongoing role in workplace diversity, equity, and inclusion (DEI) committees; and
  • a role as a Board Director, for around a year.



I also note that activism by others has led to other significant actions to protect and enable trans+ people to survive and maybe even thrive, including the changes to the Sex Discrimination Act in 2013, and many beneficial changes in the State of Victoria, with some further actions currently being underway (notably, consideration of extending anti-vilification protection to include LGBTQIASB+ people [note: the inclusion of S and B is for Indigenous people - see “Aboriginal and Torres Strait Islander people must be at the centre, not the margins, of LGBTQIA+ plans and policies”   https://theconversation.com/aboriginal-and-torres-strait-islander-people-must-be-at-the-centre-not-the-margins-of-lgbtqia-plans-and-policies-209221   Madi Day, Lecturer, Department of Indigenous Studies, Macquarie University; Dameyon Bonson, Suicide Prevention, Macquarie University   26th July, 2023). 

For reference, information on the changes to the SDA introduced in 2013 can be found at:


It is my opinion, after having attended an AHRC online training event on the new positive duty and on the basis of my lived experience, that the likely impact of the new "positive duty" aspect of the Sex Discrimination Act is being underestimated - especially the requirement to accept the responsibility (liability) of third parties, which is the specific reason that referring implementation to existing DEI committees, which in my experience are limited to matters within organisations, may not work.

I consider that what is now required (as a result of the new duty) in the DEI field, generally considered part of human resources aka "people and culture" sector, is akin to the past introduction of requirements to ensure subcontractors and other third parties comply with OHS and QAQC requirements.



Next, I wish to turn to the problem of transphobia - particularly misgendering.

This is a problem I have experienced, with a third party taking my details over the phone deliberately changing my details (specifically, inserting the wrong courtesy title [the correct title is shown in my signature block]). I may have included this in past emails to you. 

More recently, I am aware of a nurse deciding that someone (not me) having had gender affirmation surgery could be misgendered - i.e., referred to INCORRECTLY by assigned-at-birth-sex pronouns.

In the case of my experience, I objected and the malicious error was corrected, and I received an immediate verbal apology ... however, nothing was done, as far as I am aware, to prevent a recurrence of the problem - which has contributed to my profound reluctance to use hospitals again. I have experienced three decades of trauma, ranging  from microaggressions (see “What are microaggressions? And how can they affect our health?”   https://theconversation.com/what-are-microaggressions-and-how-can-they-affect-our-health-193309   4th April, 2023   Mahima Kalla, Digital Health Transformation Research Fellow, The University of Melbourne) through emotional & verbal abuse to physical assaults, and that makes me wary when I see indications of transphobic problems still occurring - anywhere. 

That is also the case for many other trans+ people.

(I use trans+ as a shorthand for trans, gender diverse and non-binary.)

I have provided links below to research which shows:
  • other trans+ people have had similar experiences, and have similar reluctance to use some medical services;
  • transphobia is a health threatening act.

Now, those who do not accept the reality of trans+ people in the political arena are possibly "just" expressing their point of view; in the medical field, they are being, in my opinion, unprofessional and actively harming the health and wellbeing of trans+ people - which leads to my concern that receiving treatment for any particular health issue is of questionable, and possibly no or even a negative, benefit, if the psychological conditions endured while doing so compromises my wellbeing.

Many of us (trans+ people) have been pointing out the life threatening aspects of transphobia for decades   ...   the threats to our wellbeing or even survival needs to be taken seriously.

There is also the problem of the so-called "gender critical" ideology, which the Lemkin Institute, named after Raphael  Lemkin, who invented the word genocide, considers genocidal. See: 

“Statement on the Genocidal Nature of the Gender Critical Movement’s Ideology and Practice”   https://www.lemkininstitute.com/statements-new-page/statement-on-the-genocidal-nature-of-the-gender-critical-movement%E2%80%99s-ideology-and-practice    (Issued on 29th November 2022)  

In addition, there have been for a few years now groups aiming to assist trans+ people leave the USA and UK because of the extreme and growing transphobia in those nations. 

In fact, the growing adoption and use of transphobia by right wing extremists as a tool to incite hate (as shown by the phone calls, including death threats to children, threatening LGBTQIASB+ events in this State, which I have written about to you before) is cause for increasing alarm (and such groups have been noted as a point for concerns - for instance, in the Legal and Social Issues' Committee's August 2022 report "Inquiry into extremism in Victoria", by agencies - and ASIO's threat assessment - e.g., see “ASIO chief highlights evolving terror threat to Australia”   https://www.aspistrategist.org.au/asio-chief-highlights-evolving-terror-threat-to-australia/   by John Coyne, on The ASPI Strategist website   22nd February, 2023   “Social media has created the kind of anonymity that has emboldened the expression of extremist views and perspectives that would never be publicly shared in the real world. Some have used it to legitimise hate speech as simply personal expression”).

Those medical practitioners - including nurses - who express any doubt or anti-trans sentiment in a professional setting could, in my opinion, be reasonably considered to be expressing a professional opinion in an area outside their area of practice, which is potentially of significant professional concern and (as a former Board Director) could also be viewed as dangerous from a liability point of view.

From the point of view of trans+ people, such transphobic people/actions (and that is how they are from our point of view - especially our lived experience) are also contributing to an atmosphere that is psychologically abusive - or at least psychologically hostile - particularly in light of the even more traumatic experiences that trans+ people are undergoing more generally as transphobic hate is spread.

I am aware of some limited (and morally questionable, in my religious opinion) exemptions for religious beliefs on schools (see https://www.justice.vic.gov.au/equal-opportunity-act-religious-exceptions), but not for hospitals. Anyone who wishes to claim religious obligations is, in my opinion (and, it would seen, from the preceding link, the Victorian law's perspective), not protected. Furthermore, as a Minister in two Pagan religions who has interacted with many other religions, I am aware that those who claim religiously-based discrimination are often not supported by all versions of their religions.

Although there have been major improvements over the last two decades, perhaps best exemplified by the changes in dictionary definitions (see https://www.merriam-webster.com/wordplay/merriam-websters-short-list-of-gender-and-identity-terms) and the inclusion of management of transphobia in some online health forums – e.g., https://www.healthline.com/health/transphobia, the recent deterioration of social attitudes in response to right wing actions is a concerning problem - as an example, apart from the mental health impacts, avoidance of using toilets will lead to kidney problems for trans+ people.

I have provided links to articles from The Conversation website, which is a collaboration between academics and journalists below. In addition, I wish to draw your attention to the following:
  • “Majority of transgender patients report negative experiences in emergency departments”   University of Western Ontario news release 12th March, 2014   https://www.eurekalert.org/news-releases/788400   “A new study out of Western University (London, Canada) has found the majority of transgender patients have had a negative experience when it comes to receiving emergency department (ED) care. The findings, by first author Greta Bauer, PhD, is in press at the Annals of Emergency Medicine, the official publication of the American College of Emergency Physicians, and is now posted online.   The study used respondent-driven sampling, a methodology developed to specifically address the challenge of studying hard-to-reach populations.”  
  • “Prevalence of Diverse Genders and Sexualities in Australia and Associations With Five Forms of Child Maltreatment and Multi-type Maltreatment”   https://journals.sagepub.com/doi/10.1177/10775595231226331   Daryl J. Higgins, Institute of Child Protection Studies, Australian Catholic University; David Lawrence, School of Population Health, Curtin University; Divna M. Haslam, School of Law, Queensland University of Technology; et al   12th January, 2024   “... for all five maltreatment types, the prevalence for the diverse gender category was significantly higher than for women, which in turn was significantly higher than for men. The pattern was evident for physical abuse and neglect, but was strongest for sexual abuse: 51.9% of participants with diverse genders having experienced sexual abuse, compared to 37.3% of women and 18.8% of men.”   This paper also includes estimates of the prevalence of gender diverse people as 1% overall and 2.3% of youth. My opinion is that the increase in numbers for younger people is as a direct result of the reduction of discrimination  
Under such circumstances, I consider it vital for the leadership of our health institutions set an example of best practice inclusion, and ensure that the same is implemented at all levels. From the response to my complaint a year or so ago, mentioned above, I consider the basis of an adequate system already exists, but it needs to be adapted to the wider requirements of the new "positive duty" of the Sex Discrimination Act, which emphasises increased prevention of reasonably foreseeable problems - including third parties.

It may be that our medical systems [have] to adopt the best practice approach, which is seeing [a] growing and now, IMO, widespread use, of including the option of identifying pronouns (if so desired by the patient) on medical forms - and I would argue that any opinion as to the medical necessity of same [should] be made ONLY by experts in gender identity, not those who mistakenly think everything has been OK to date.


In conclusion, what I am seeking is for a credible and genuine assurance that a proper response to the positive duty is being implemented, and, if possible, some way of knowing when that has been done (I would anticipate at least six to twelve months as a realistic estimate of the required time frame). I request that you forward this, or write using this material, to the Minister for Health and the Minister for Equality on my behalf, as one of your constituents, to seek such genuine and credible assurances within a reasonable time.


Thank you for your time and consideration.


Following are some articles from The Conversation website (see https://theconversation.com/au), which is a collaboration between academics and journalists. Links to evidence is included in the articles:
  • “Backlash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times”   https://theconversation.com/backlash-to-transgender-health-care-isnt-new-but-the-faulty-science-used-to-justify-it-has-changed-to-meet-the-times-220831   G. Samantha Rosenthal, Associate Professor of History, Roanoke College   31st January, 2024   “In the past century, there have been three waves of opposition to transgender health care.   In 1933, when the Nazis rose to power, they cracked down on transgender medical research and clinical practice in Europe. In 1979, a research report critical of transgender medicine led to the closure of the most well-respected clinics in the United States. And since 2021, when Arkansas became the first U.S. state among now at least 21 other states banning gender-affirming care for minors, we have been living in a third wave.   ...   the archives of transgender medicine demonstrate that backlash against these practices has historically been rooted in pseudoscience. And today, an anti-science movement that aims to discredit science altogether is fuelling the fire of the current wave of anti-trans panic.”    
  • “Transgender regret? Research challenges narratives about gender-affirming surgeries”   https://theconversation.com/transgender-regret-research-challenges-narratives-about-gender-affirming-surgeries-220642   Harry Barbee, Assistant Professor of Health, Behaviour and Society, Johns Hopkins University; Bashar Hassan, Postdoctoral Research Fellow in Plastic and Reconstructive Surgery, Johns Hopkins University; Fan Liang, Assistant Professor of Plastic and Reconstructive Surgery, Johns Hopkins University   23rd January, 2024   “Evidence suggests that less than 1% of transgender people who undergo gender-affirming surgery report regret. That proportion is even more striking when compared to the fact that 14.4% of the broader population reports regret after similar surgeries.”   
  • “Women’s police stations in Australia: would they work for ‘all’ women?”   https://theconversation.com/womens-police-stations-in-australia-would-they-work-for-all-women-165873   Amanda Porter, Senior Fellow (Indigenous Programs), The University of Melbourne; Ann Louise Deslandes, Independent journalist, writer and researcher, University of Sydney; Crystal McKinnon, Indigenous Research Fellow, RMIT University; Marlene Longbottom, Aboriginal Postdoctoral Research Fellow, University of Wollongong   17th September, 2021   “Evaluations of women’s police stations have had mixed results. For example, one recent evidence summary in India found “all-women police stations did not improve services for gender violence victims”. It found no improvement in reporting or accountability with respect to women’s police stations in India.   And there is evidence to suggest women’s police stations are not free from discrimination and violence, such as reports of transphobia.”   
  • “No, you can’t identify as ‘transracial’. But you can affirm your gender”   https://theconversation.com/no-you-cant-identify-as-transracial-but-you-can-affirm-your-gender-163729   Braden Hill, Pro-Vice Chancellor, Edith Cowan University; Stevie Lane, Equity Projects Officer, Edith Cowan University   2nd July, 2021   “... trans and gender diverse people’s decision to transition (whether that be social, medical and/or legal) is almost always involuntary and out of necessity to live their lives authentically.   Almost 50% of trans young people in Australia have attempted suicide at least once in their lives. Trans and gender diverse young people experience higher levels of psychological distress than their cisgender peers.”   My lived experience, and that of other trans+ people I have spoken to (which involved well over a hundred when I was a co-convenor of TransGender Victoria), supports this   
  • “Supporting trans people: 3 simple things teachers and researchers can do”   https://theconversation.com/supporting-trans-people-3-simple-things-teachers-and-researchers-can-do-149832   Katherine (Kate) Power, Lecturer in Management, School of Business, The University of Queensland   13th November, 2020   “Globally, trans people are confronted by discrimination and violence, and young trans people experience depression at four times the rate of their peers.   However, while many universities have support services for lesbian, gay and bisexual (LGB) students, trans students often lack tailored support. Comparable data for universities aren’t available, but one Australian study found trans high school students lacking support from teachers are almost four times more likely to drop out than students receiving support.”   
  • “Transgender kids get their own health-care guidelines”   https://theconversation.com/transgender-kids-get-their-own-health-care-guidelines-98308   Carmen Pace, Clinical Psychologist and Research Fellow, Murdoch Children's Research Institute; Ken Pang, Clinician Scientist Fellow and Paediatrician, Murdoch Children's Research Institute; Michelle Tollit, Research Officer, Murdoch Children's Research Institute   18th June, 2018   “Being transgender or gender diverse is now largely viewed as part of the natural spectrum of human diversity. For some people, this is just part of who they are, and it’s not a cause of concern. Others experience gender dysphoria – the distress related to the mismatch between one’s sex and gender. It’s the reason many seek help from health-care professionals.”   
  • “Homophobia is harmful to workers and businesses”   https://theconversation.com/homophobia-is-harmful-to-workers-and-businesses-74825   Raymond Trau, Lecturer, RMIT University   21st March, 2017   “Homophobia is costly to workers and the businesses that employ them, research shows. Unfortunately, it’s still prevalent in Australia and the latest lobbying from 34 business leaders for marriage equality emphasises the need for it to be addressed both within and outside the workplace.”   I note that many modern medical facilities are businesses   
  • “Explainer: what treatment do young children receive for gender dysphoria and is it irreversible?”   https://theconversation.com/explainer-what-treatment-do-young-children-receive-for-gender-dysphoria-and-is-it-irreversible-64759   Fiona Kelly, Associate Professor, Law School, La Trobe University   2nd September, 2016   “... the fact is that no four-year-olds in Australia are undergoing any irreversible treatment. At that age, treatment for gender dysphoria consists mainly of counselling. No other medical treatment will occur until the child nears puberty.   For young adolescents entering puberty with profound and persisting gender dysphoria, the possibility of delaying progression of puberty may be discussed. This treatment is often referred to as Stage 1 treatment and is fully reversible.”   My lived experience, and that of other trans+ people I have spoken to, is that irreversible biological changes of puberty set us up for discrimination, and the massive problems that come with that. Puberty blockers would have made my life much, much, much better   
  • “Being transgender is not a mental illness, and the WHO should acknowledge this”   https://theconversation.com/being-transgender-is-not-a-mental-illness-and-the-who-should-acknowledge-this-63182   Damien Riggs, Associate Professor in Social Work, Australian Research Council Future Fellow, Flinders University   29th July, 2016   “A study published this week in the Lancet medical journal has lent support to this move. Echoing previous research, the study found poor mental health among transgender people is primarily the product of social stigma and violence. This counters the view that being transgender is itself pathological.”   
  • “FactCheck Q&A: was Lyle Shelton right about transgender people and a higher suicide risk after surgery?”   https://theconversation.com/factcheck-qanda-was-lyle-shelton-right-about-transgender-people-and-a-higher-suicide-risk-after-surgery-55573   Author:  Kairi Kõlves, Senior Research Fellow, Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, Griffith University;   Interviewees:  Cecilia Dhejne, Clinical sexologist, Gender team Stockholm, Centre for Andrology and Sexual Medicine, Karolinska Institutet; Mikael Landén, Professor of Clinical Neuroscience, University of Gothenburg;   Reviewer:  Karolina Krysinska, Research Fellow, Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, UNSW Sydney   4th March, 2016   “... it is also possible some viewers may have been left with the impression that the study showed sex reassignment surgery causes a higher risk of suicide later in life. That is not what the Swedish study showed. In fact, the researchers wrote that things might have been even worse without sex reassignment.”   Based on my lived experience, I am firmly of the view that (1) I would NOT have survived had I not had gender affirmation surgery, (2) the overwhelmingly predominant problem since having had surgery is discrimination, (3) it has been a struggle for many decades to get researchers to listen to us on this point, and (4) other trans+ people I have spoken to share these views   
  • “How media reports affect trans people, and what should be done”   https://theconversation.com/how-media-reports-affect-trans-people-and-what-should-be-done-32604   Eloise Brook, Lecturer in Media Writing and Public Relations, Victoria University   8th October, 2014   “Yesterday, the Courier-Mail put the gruesome murder of Indonesian transwoman Mayang Prasetyo, killed by her partner Marcus Volker, on its front page. The article is breathtaking in its prurience and voyeurism. Even though Prasetyo was murdered and dismembered, the Courier-Mail deemed it appropriate to include a succession of photos of a seductively-posed Prasetyo in a bikini.   The article manages to imply both Prasetyo’s culpability in her own death – repeatedly pointing out both her transsexuality and sex work – and to sexualise her: though only after playing that old Fleet Street trick of flagging readers to her pre-operative status.”   The concern about such abysmal treatment of trans+ people in the media is that it may influence medical staff if they are not familiar with the work of medical experts in this area   
  • “Anti-homophobia campaigns are linking being gay with misery”   https://theconversation.com/anti-homophobia-campaigns-are-linking-being-gay-with-misery-10061   Roz Ward, GLBTI Health Researcher and Co-founder of Safe Schools Coalition Victoria, La Trobe University   18th January, 2013   “Being gay, lesbian, bisexual, transgender or intersex is joyous! Make no mistake, it’s the experience of homophobia and transphobia that can destroy lives and often leads to depression, anxiety and poor mental health.   The evidence for this is as clear and conclusive as it gets. Discrimination can have a worse effect on your health and well-being than smoking, drinking, or what you eat.” 

Yours faithfully

 

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Assumptions / basis 

In writing this, I have assumed / started from the following: 

  • this blog states quite clearly that it is about political and human rights matters, including lived experience of problems, and thus I will assume readers are reasonable people who have noted the content warning in the post header;

Possible flaws 

Where I can, I will try to highlight possible flaws / issues you should consider:

  • there may be flawed logical arguments in the above: to find out more about such flaws and thinking generally, I recommend Brendan  Myers’ free online course “Clear and Present Thinking”; 
  • I could be wrong - so keep your thinking caps on, and make up your own minds for yourself.

 

If they are of any use of interest, the activism information links from my former news posts are available in this post. 

 

If you appreciated this post, please consider promoting it - there are some links below.

Remember: we need to be more human being rather than human doing, and all misgendering is an act of active transphobia/transmisia that puts trans+ lives at risk & accept that all insistence on the use of “trans” as a descriptor comes with commensurate use of “cis” as a descriptor to prevent “othering”.

Copyright © Kayleen White 2016-2024     NO AI   I do not consent to any machine learning aka Artificial Intelligence (AI), generative AI, large language model, machine learning, chatbot, or other automated analysis, generative process, or replication program to reproduce, mimic, remix, summarise, or otherwise  replicate any part of this post or other posts on this blog via any means. Typo’s may be inserrted deliberately to demonstrate this is not an AI product.     Otherwise, fair and reasonable use is accepted under Creative Commons 4.0 on an Attribution-NonCommercial-ShareAlike basis   https://creativecommons.org/licenses/by-nc-sa/4.0/  

 

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