Knowledge is Power: Our Non-binary Voices Finding Support

Knowledge is Power: Our Non-binary Voices The Knowledge is Power workshop (October 2014) for non-binary people featured 10 young non-binary people talking about their experiences in different areas of their lives for 3 hours and sharing their knowledge to other group members. They travelled from as far as Canterbury and Leeds to attend, and had a range of ethnicities, ages, gender identities, stages of their transitions and backgrounds. The workshop consisted of four key questions that were answered: 1) How do nonbinary people in the UK find support? 2) How do you feel included in society? 3) What do you want to see in your futures? And 4) What's your experience of healthcare as a non-binary person? The following write-up is an anonymous summary of the stories, points and quotes shared.

Finding Support

“More college groups.”

There were many ways the people in the room said they found support as nonbinary people. Some notable points of community gathering and information sourcing included:      

GI (and wider-spread groups) Social media: tumblr, twitter, Facebook (though these were felt to be not UKfocused enough) Online discussion forums Non-binary meet-up groups (such as one that's held at the Royal Festival Hall) College and university groups ('more of these' were said to be needed and beneficial) Underground media/events

People who spoke about this question felt that they wanted a comprehensive list of all UK trans support groups, both online and physical, making sure that it's publicised when and where trans groups are non-binary inclusive. One of the feelings that came out of the group was that there was sometimes an anxiousness as to whether a trans space was safe enough/inclusive enough for non-binary people, and whether or not they would feel or be welcomed into a space. They also wanted non-binary people to feel like they weren't an add-on to a space, and with more support groups nationally rather than lots of London-centric groups. In rural areas, non-binary people felt disconnected. There was a feeling that a lot of spaces where non-binary people could gather and focus on non-binary identity was limited to 'support', and that music, poetry, and social events spread out across the UK would create a sense of community feeling and inspiration.

Inclusion in society

Media

“When do we get represented?”

One of the things that we all looked forward to in our futures was the mainstream media producing positive images of non-binary people. But alongside that, the chance to create our own discussions focused around non-binary people, such as talks, conferences and consultations. The media and 'TV culture' was also a source of support cited for some of the group – it was a point where people could identify and relate to people, for an identity to 'click' with them. Support could also come in the form of breaking down common stereotyping and misconceptions, such as representing non-binary people accurately – as people. Stories in the media that have been covered well recently include Stephanie Hirst, a trans woman and radio personality, who was portrayed positively. Other people felt that non-binary people can get lost in between the cracks of the media, through 'not being interesting enough' to write a story on, or not understandable enough. There was a feeling that non-binary people could be affected by media sensationalisation if they present in a feminine way. In a culture where masculinity is favoured, it was noted that feminity is degraded, which contributes to the offensive way many stories featuring trans women are written. In some ways, one

of the group members felt, we have gone backward in how we speak about transition: some papers in the 1950s were more civil in talking about transition than now! Though we couldn't come up with a lot of out non-binary people visible in the media, some of the groups' inspirations from the UK included: 

La Roux, a singer who identifies as non-binary

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Eddie Izzard (something the group got excited about!) who many people latched onto as children identifying with the language he used (“it's not a woman's dress; it's my dress!”) as well as the switching between boy and girl mode.

It was said in the larger group discussion that any portrayal of the (few) non-binary characters in popular culture weren't human; for example, Bmo from Adventure Time is a robot who is 'genderless'. Non-binary is portrayed close to the concept of 'third sex', and conflated with intersex – as one person said, a 'magical sex from the future' rather than what's happening right now. Research Some people felt that the current trans studies done in the UK didn't reflect them or made them feel left out; non-binary people should be explicitly included in trans research in order to make it 'less binary'. Legal and social recognition

“Some people were shocked that many titles are not legally binding.” Birth certificates can be changed via Gender Recognition Certificates, though for people who don't want a sex on their birth certificate or want something other than male or female, there's no option. Changing a birth certificate is already difficult, and for non-binary people it can be hard to 'prove' they are living as male or female if they do want to change to a binary gender marker. Some non-binary people do want to get married, and one barrier to this is a difficulty faced in obtaining correct legal documentation. Marriage as a person's true identity, without a GRC should be recognised and worked towards. Public services are lagging behind in non-binary awareness, and a need for schools, universities and businesses to receive education and training about non-binary genders was discussed; even when inclusive policy was in place, such as a neutral

Mx title on a bank card, non-binary people were being asked if a 'typo had been made'. Through sharing our stories, it was suggested that while employees of businesses and services were happy to change gender markers and titles, the systems in place forced them to change back – an example of this was given as the NHS. A link to the work of MxActivist is included at the end of this, who has been doing work with the Non-binary Gender Inclusion Project around business' and organisations' inclusion of non-binary people and their equality policies, something that many of the group were excited to hear happening. There were also concerns around the clarity of the procedures necessary to create a Deed Poll (some people were shocked that it could be done for free) and obtaining a new title (some people were shocked that many titles are not legally binding). Sports was mentioned as an area where non-binary people are denied access to – a very gender-segregated space. People in the groups felt that sports could be made more accessible for non-binary people through mixed sports becoming normalised at school and further education, such as in universities (Quidditch teams were given as an example where this is happening). Many people in the group felt that nonbinary awareness in society, and therefore public services, could be spread through education started at school. One comment was:

“Gender should be explored from an early age to challenge stereotyping.”

At work, non-binary people had complex and different journeys. A positive light was shone on Transport for London, who had been receptive to ideas of Mx as a title and options to not choose a gender on certain forms. When the first group talked about inclusion in society, they decided that many nonbinary people often 'did what needed to be done' to fit in, picking and choosing battles when it came to explaining their identities or engaging with educating people. Often, we said that we just went with how we are read, as that can be easiest. So rather than expressing the complexities of our identities truthfully, w e choose what might be understood best by the other person. One member of the group said that they felt conscious of their presence in trans spaces; they were anxious that trans people would ask themselves “why is a cisgender (non-trans) person here?” when looking at them or hearing how they identified. The concept of 'not trans enough' was brought up, something that

everyone was tired of hearing in relation to non-binary genders and perception in trans spaces.

“How do I explain myself to everyone?” Some people expressed an awkwardness associated with outing themselves, especially when trying to make new friendships and build relationships when not wanting to be seen as 'threatening'. Key questions were raised: 'can I or should I explain my gender to everyone?', and 'how do I work with people choosing how I am read?' Gender exploration amongst trans people is where non-binary and binary trans people can meet; gender presentation in trans people can be fluid to the point of crossdressing, and that you can cross-dress and be trans. Language

“Make queer 'underground' language 'overground'.”

The language of non-binary communities is fluctuating and evolving. While this has happened over the years in trans discourse, non-binary people can feel left behind and not included in definitions and ways of talking about trans experiences. LGBT and trans spaces should make an effort to make sure language is as accessible and inclusive as possible. The use and spread of language was also mentioned in support systems. Many people found that inclusive language and education on its importance would help create welcoming social spaces generally. We brought up one positive example of a country including non-binary people in discourse: Sweden, and the abundance of the gender neutral pronoun 'hen'. This is rolled out from reception. Perhaps it's time to do something similar in the UK with the already existing gender neutral pronoun 'they', which is thought by many to be grammatically incorrect? If this was taught as an explicitly gender neutral pronoun, similar to the Swedish model, it might make it more legitimate to use by more people in everyday situations. But breaking language binaries can also help cis people. A story was told in the space of the title Mx being used positively by a cisgender person who was told what it meant by one non-binary person, as a title for people who didn't want to reveal their gender or make it a part of how they were addressed. The question of 'can everyone use Mx?' was asked, but also 'why do we need titles anyway?'

What do we want to see in our futures?

Having a relatable community is important. The lack of understanding and education in society means non-binary people feel cut off from different communities and social groups. Automatic assumptions of gender and perceptions feed into this due to gendered social education. Almost every area of society is gendered and thus can be misgendering to the majority of non-binary people, including vital pieces of documentation – such as titles like Mr and Ms, and passport genders, as well as toilets. Finding gender neutral toilets/changing facilities is difficult, yet their need is difficult to understand for many people, cis and binary identified trans people, who think they're a luxury or unnecessary. Non-binary access needs to be global. As trans people travel from country to country, issues in the UK are affected by issues on an international level. How do non-binary people access different countries with different laws and restrictions, especially regarding name and gender changes. If a gender marker were available as neutral or 'other' in the UK, how would it be viewed abroad? Hopefully as nonbinary discussions grow from grassroots levels worldwide, we might see increasing inclusion of gender variance in many places where there was none or little before.

Our Health

“NOT TAKEN SERIOUSLY.”

One of the overarching feelings that came from the emotional talks about nonbinary people's healthcare was that we don't feel taken seriously, in most areas of care. Personal examples and stories were shared about having difficulty accessing birth control because of gender perceptions or non-understanding, and a difficulty accessing and staying on hormone replacement therapy. Mental health There was a significant number in the group who reported that healthcare professionals they saw about their gender were keen to diagnose or 'suggest' a range of mental health conditions instead, such as one person being misdiagnosed with BPD (borderline personality disorder), because they said they are genderfluid. Autism is another condition that came up that people were diagnosed with, or having to face doctors that their non-binary gender manifested itself as a result of childhood trauma. Some of the group experienced their learning disabilities were being linked to their gender identity. However, when it came to gender specific services provided by GICs (gender identity clinics), it was felt by some that the psychologists at these services could

sometimes more knowledgeable than the doctors who spoke to non-binary patients more frequently, and that there was a learning gap.

“Can I admit to being genderfluid and be taken seriously, and not 'unstable sense of identity?'”

Some of those who were diagnosed with mental health disorders felt they were being diagnosed in a very gendered way; they said the feeling of dismissal or that the assumption that they were 'unstable' felt like they were being 'treated like women', in a misogynistic manner based on their gender assigned at birth. Many of those who did have mental health conditions explained they were w alking the line of either being treated as unstable or somehow 'wrong' because of their mental health condition or because of their gender identity. Because of their treatment once they disclosed their non-binary identity, some found that vitally needed services in many cases were hard to access

“Damned if you do, damned if you don't”.

Conflicting information For non-binary people seeking mental health services at CAMHS, age was considered to be a factor, with some healthcare professionals saying that a person was either 'too young' or 'too old' to know that they were non-binary. There is also conflicting information regarding transition pathways in general, with one person being told by a healthcare professional at CAMHS that they 'weren't allowed' to change name and gender marker. Gender Identity Clinics

“Four opinions... three years...”

Almost all of the people undergoing treatment at Gender Identity Clinics (GICs) said that they had either experienced poor treatment because of being non-binary or feared poor treatment. Many felt that they were pressured into or felt expected to follow a 'set path' of transition. For many non-binary people in the group, there was

a feeling that they would rather do one thing before or instead of another, but that taking things in an order that felt most comfortable and natural might hinder their transition. For example, some didn't want hormone therapy, but did want surgery. Some in the group saw no other options for treatment, and ended up paying to get treated privately, after having to wait for a fourth opinion after three years of consultation. This 'gatekeeping' was something feared by people in the group who hadn't yet accessed medical services. There was a worry in the group around gender expression at GICs, with some experiencing discrimination or dismissal because of the clothes they wore or how they presented themselves when they went for appointments. One word which came up was inconsistency: it was felt that there is an inconsistency throughout the different GICs in the UK regarding things such as criteria that people felt they had to 'tick' to get seen, the sorts of psychiatric checks that had to be done for non-binary people, and the quality of care. What is Real Life Experience? One point that came up during the end discussions on Real Life Experience was that it was unclear what it meant for non-binary people. It was felt that there needed to be clarity about this, but at the same time some critiques of the existing model of RLE were brought up. For some people, RLE was too long, it only validated your gender identity for somebody else, and it was felt that if, at the end of the transition process, you didn't feel you were trans, it was OK – a journey rather than a 'mistake'. A few of the group had experienced a lack of care and attention when undergoing transition-related treatment at the GIC. This included not being told what invasive and emotionally draining physical health check-ups were for, which left them distressed, or a complete lack of follow-up care after gender related hormone treatment. The lack of communication was highlighted as a stumbling block for both doctors and patients: non-binary patients didn't know why their medical or gender history was being looked into (such as when sexual or personal questions were brought up, i.e. 'do you sit down to pee?'), and non-binary patients were less likely to speak truthfully about how they were feeling to doctors for fear of rebuttal or discrimination. Empathy and community integration was something touched on briefly – how could cisgender medical professionals looking after trans people feel part of the trans community when they had to maintain professional boundaries, and would

trans/non-binary people want to see their doctors attending events, such as Transgender Day of Remembrance services? Lack of GP and doctor training There was a fear that doctors who may do initial treatment or referrals might think 'what if...?' in relation to non-binary people. As funds are being cut in the NHS, there's a worry that doctors who think they can't 'reliably' treat a person won't in the first place, and that GPs who are unsure of the correct way to treat non-binary trans people (or the current guidance around non-binary gender treatment) may stall treatment out of fear and ignorance. One of the group, who works in the NHS, commented that funding was an issue; there are stretched resources and doctors could be scared of facing a backlash if a person they've treated 'detransitions', and could be decried for wasting public money at a time where the NHS has to justify what it uses its public funds for. We asked if a non-binary person transitioning to a binary gender then and coming out as non-binary would be considered 'detransitioning', and whether this would be viewed as problematic treatment on behalf of the doctor. General health

“Are you sure it's not because you're transgender?”

Non-binary people, like trans people, mentioned the 'trans broken leg' syndrome: going for general health treatment and their gender being questioned or brought up. These can be in inappropriate times and places where non-binary people feel the most vulnerable; one example given was during a place where a non-binary person might feel uncomfortable due to the very 'gendered' nature of the space: a breast tissue exam. One group member expressed that sexual health was an area where gender is misunderstood and confused, with experiences of doctors and nurses asking inappropriate questions during unrelated treatment. Many non-binary people have had the experience of educating healthcare providers on their own treatment. Speaking to uneducated or unaware pharmacists about medication or treatment options was one example. Some people have had unnecessary questioning when picking up hormone drugs from pharmacists. (“Mind your business!”)

Some non-binary people expressed an anxiousness around gendered spaces in hospitals, such as hospital wards, which they said has made or would make them feel worse on top of surgery. Disclosure during medical treatment is a worry, like it is for many trans people regardless of gender and gender history. Two questions came up when we talked about this: 'should I mention I'm non-binary?' and 'is it beneficial to mention it'? Again, the worry about not being taken seriously came up as a barrier to being honest when talking to healthcare professionals. Medical reformation was mentioned as something that is an important and clear goal for the future of non-binary activism and furthering of rights in the UK: that there has to be a commitment to create a better system of trans healthcare that is fully inclusive of non-binary people; that pathways of treatment have to be flexible and at the patient's design; that there has to be a focus on educating healthcare providers to promote understanding and acceptance; that healthcare pathways have to be accessible by people of all genders. It was suggested that a way this could be changed is through providing better education to medical students in universities and medical schools, not only in primary and secondary educatio n. It was put forward that any education had to be reputable and internal, otherwise it might not be taken seriously, and that non-binary people should talk to key doctors at the GIC who can be allies and forthcoming to teach other doctors about nonbinary identities. The service provided by PALS was highlighted as somewhere where conversations could start, but that any consultation groups or patient-doctor feedback sessions had to be planned and structured carefully so that doctors didn't feel threatened or shut down to any form of criticism. It should be based on open invitation, and there should be an emphasis on building relationships and working together.

A non-binary event We discussed, as a larger group, a future event for non-binary people and around non-binary issues we could develop in the new year. Some ideas from it were:    

London: it's a hub and has travel routes across the country Held in a large space such as a university campus Healthcare professionals invited Get people who 'don't get it' to come – especially trans/LGBT groups to create a discussion

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Big it up and push it out – get as many people to come to it as possible, but also make sure groups and sessions are integrated where appropriate so learning spreads Get educators to come: they can educate people themselves (such as the Department of Education!) Creative digital content, such as videos. Learning to create action in workshops, as well as spaces exploring different non-binary identities, with key messages saying that people can look like anything and that non-binary is a spectrum. Breaking down language and using Plain English – if more people knew about genders other than the binary, more people could identify as non-binary potentially, and it's all about explanation. Panel ideas: “Am I Non-binary?”; what non-binary actually means and how it manifests itself in different people. A space to answer and ask uncomfortable questions Explaining and de-constructing the binary. Non-binary social safe spaces and specific support on the day. Medical professionals having a chance to sit in and listen to non-binary talk about their experiences of treatment. A panel of representatives from workshops throughout the day to feed back what has been discussed in all areas. A social event at the end of the day to relax. Thinking about different age groups and intersections who might have specific experiences relating to being non-binary.

At the end of the day, here were some of the words that were used to describe the session:       

Social Starting Point Community Informative Interesting Mind Boggling Progressive

Further Reading Non-binary Inclusion Project: The Non-binary Inclusion Project is a UK group focused on spreading awareness of non-binary issues to services. Most recently, they worked with UCAS to ensure changes would be put in place to make their application forms more trans and non-binary friendly. This is their new tumblr, but you can also find them active on Twitter and Facebook. Non-binary wiki: This is a relatively recent wiki page collecting non-binary information. Free Deed-Poll: Here's a template to help create a free Deed Poll for name change. Letters to services about non-binary inclusion: Mxactivist, who works with the Nonbinary Inclusion Project, does some great work in sending out letters to businesses and services that could include non-binary options or 'Mx' as a title option. They have a section on their blog about their successes. Here's their discussion with the NHS Blood and Tansplant services, asking them for clarification about the classification of trans people. Beyond the Binary: A new website that will be up at the end of this year/beginning of the next. Beyond the Binary is a UK-focused magazine for non-binary people in the UK which will accept submitted content on a regular basis.