Zorg is van belang, niet “gender dysforie”

Genderzorg hoeft niet gebonden te zijn aan ontrechte psychiatrische diagnoses. De meeste mensen hebben die ook niet nodig. Daarin lopenmedische processen en de WPATH Standards of Carre 7 achter. Dat blijkt ook uit een inteview dat Mare Van Hove had in het Belgische holebitijdschrift Zizo met de Gentse endocrinoloog Guy T’Sjoen. Continue reading

Praktische oplossingen voor patiëntenstop VUmc

Sinds januari neemt het VUmc geen nieuwe trans*-patiënten meer aan, want daar hebben ze geen geld voor. De regering heeft de Nederlandse Zorgautoriteit (NZa) ingeschakeld voor een analyse van de situatie. Continue reading

Gatekeeping

Informed consent is the only way to go with people who are legally and factually able to decide for themselves how their life, their body, their gender should be. that does not say those who are somehow not able to express themselves (in this area) should be excluded for not voicing their need. They are just mostly not understood. Each and every psycho/medical intervention needs to be for the benefit of the one who needs it. Using medicine differently equals cruel, unusual treatment or even torture. Like forced sterilisation of women because they are of the wrong class and ethnicity.

Nor do we call for the abolition of any and all social, psychological or even psychiatric involvement in the decision process towards social and physical gender transitions. However the respective professionals just not have a decisive nor obligatory and coercing role. They must be there if we need them, when we need them, as we need them.

Yes, this is a first attempt to sketch an ideal situation and it is of course a situated one, from a situation where there is in principle a well organised health care system. Without this being available and accessible other practices will develop that may be just as valid. In all cases the free will of the applicant (better than client or patient) is leading. Not a medical or state requirement.

idahot

Medical requirements are only acceptable in so far as they area a technical requirement. Like blood works before starting transitional hormone treatment. Classically called sound grounds for a certain order are not merely technical but often also moral. Like testosterone use before chest reconstruction. Professionals have to get used to a multiplicity of body images and gender identities.

Trans* and gender variant people may have mental health problems – like so many others. In that case these issues need to be attended – as with everyone – but they are not be default a game breaker for medical assistance in gender transition. Not even for scrutiny – other than with everyone. Trans* and gender variant people demand equal and just treatment to all others (ought to have). So away with required psycho screening before entering medically assisted physical gender transition.

The question that leads me to writing this article is why the hell do they (the legal and medical professionals) still wish to treat us differently? Why the hell don’t they listen to our strong wishes and our pain of living the ‘wrong’ life, our stories how our lives so often are prevented full bloom by restricting, refusing norms and values in society that we call cisgenderism and transphobia.

All over the world doctors and psychologists have learned to be the expert. But expertise does not come from applying text book knowledge but from listening to real people with an open ear and an open heart. Stand next to your “patients” instead of hovering over them with an attitude of superiority.

Politicians and lawyers need to stop legislating what does not need legislation. Only in a conservative model that refuses the basic equality of people often codified in constitutions and for sure in human rights treaties, there is a reason not to.

The world is changing, dear doctors and lawyers and politicians. And the world has always influenced lives so don’t be so surprised that we suffer from injustice. Instead become a bit more modern and realise the ivory tower is crumbling down, being permeated by the real world. You can try to contain all variation, but you can not extinguish it. Reason why legislation and practices like in Uganda, Nigeria, Russia, Lithuania, attempts by the Catholic Church and narrow-minded US religious ‘leaders’ are not only unjust, inhuman and discriminating, but in the end also futile. Just: to the cost how many lives? How many people will it take until those powers that be realise they better modernise? Or didn’t we grow over slavery and patriarchy? Don’t we have human rights discourse and legislation that all oppressed take as their tool of preference, their common discourse for change?

 

Gender dysphoria

When someone is diagnosed with gender dysphoria you are already ‘too late’. Damage is already done then, the person developed “gender stress”. Now the job is relieve the stress without imposing roles or assuming identities. This is the more true where it concerns minors.

Gender teams have a morbid focus on an imposed psychiatric disorder. Transsexuality or no transsexuality is go or no go. Unhappy but not transsexual? Sorry you are too light. All is focused towards gender reassignment.

If cisphobia was real ..

Quite some people who do not understand the concept of trans discrimination think that trans people are exaggerating when they complain how they are seen, treated in society. To counter that or at least enlighten through putting trans* experience as the norm. Then cis people (non-trans people) would be the ones being discriminated.

Continue reading

Niet meer geld maar andere zorg

Daags na de aanname van de wijzigingen voor artikel 1:28 BW, de wet op de geslachtsregistratie, kwam het VUmc met de melding: “We hebben miljoenen extra nodig want we kunnen de zorg niet financieren”. En vandaag kwam de pers met een update. Het ligt uiteraard weer heel anders. Hier in het kort de problemen en de doodsimpele oplossing.
Continue reading

Transzorg zonder diagnose. Wanneer?

Voorlopig niet. Want de meest nabije progressieve wijziging in classificatiesystemen – staat het er niet in, dan wordt het niet erkend – geven ons nog altijd het label “gender incongruentie” of “genderdsyforie”. En omdat het gender betreft dat met geslacht te maken heeft, krijgt het een speciale lading. Tegelijk zijn er mogelijkheden tot een andere benadering van zorg die her en der al werkelijkheid zijn. Dit artikel gaat daar nader op in.

Continue reading

Mensenrechtenrapportage 2013

Er is weer een jaar voorbij en het College voor de rechten van de Mens in Nederland vraagt  weer om input voor de jaarlijkse rapportage. Hier is de onze.

Geacht College,

Evenals vorig jaar willen wij u deelgenoot maken van onze zorgen op het gebied van de naleving van mensenrechten in Nederland. Continue reading

Training in trans* and intersex rights

From the beginning of 2014 Vreerwerk will offer a training in human rights with a focus on transgender and intersex issues. This course aims at staff of government and inter-governmental and non-governmental organisations, students and activists interested in trans* and intersex issues that need a basis in human rights for their work, but are not looking for an expensive academic course. Continue reading

Trans in the head

Earlier I argued that trans* is not a disorder and that the problem is more likely with transphobia than with gender variation. I showed how much we are stuck in binary thinking that needs to get rid of its expectations of universality. A way out may lie in the concept of “fuzzy sets”. In the future, trans is in the head.

Who enters into combat against the idea that trans people would have a mental disorder, would best give perspectives for another way/outcome/solution. That is why we look amongst others to Ecuador.

In the end the battle for trans rights is not about identities, One should be able to freely live the gender identity one feels comfortable with. Since we have a basic right to identity, this should not lead to so many issues, we should be able to continue building a lovely en just world. Alas the struggle for identity (instead living and celebrating identity) is being used in a power struggle to privilege a particular conservative morality. The fight for identity is only a small and bloated (inflated) part of a broader struggle for justice. Though not everyone makes that step from acknowledgment to further action.

Only a small group of the trans* population enters (medical) transition. Some 12,5% in the Netherlands. Many do not because they do not want to, do not  dare or just cannot. Some love comfortably in two genders or fluctuate between two genders, others again just don’t take gender as a reference point anyway. Gender queers who throw the system over board  in that sense don’t have much with identity struggle either. Except that you must be able to be or to become whoever you feel to be. Afterwards: shall we now continue to change/improve the world?

Ec-psi-2

Some good developments in the direction of autonomy and respect come from the Spanish speaking world. More and more you encounter the term “trans en la cabeza” there, “trans in the head”. That idea leads to a totally different, not by default male or female, gender expression. oftentimes no medical intervention either which in turn has to do with archaic and arrogant treatment y psychiatrists, that mostly check if you are “trans enough”. Partially this (trans in the head) is rather sub-cultural, partially it is mainstream.

In Ecuador mostly trans people so seek medical assistance, be it official or not. Apart from the ID card that needs to be adapted to the gender one lives in. For that a campaign is waged these days, titled “Si es mi cédulo, tien que ser mi género”, “My ID must read my gender”by the organization “Cuerpos distintos, derechos iguales” (Different bodies, same rights). They warn for colonial concepts when the psychiatrist presses forward western ideas of how masculinity and femininity. In this sense the struggle for trans rights fits well in current anti colonial struggle.

This leads to a multitude of bodies and identities and thus to an explosion of what we understand by “men” and “women”. A revolutionary development: less than ever identity will relate to being born in a certain body and more to a certain conviction. Also it is a revolutionary appeal to the human right of autonomy of the body. So revolutionary alas that frequent and fierce resistance of the gender powers that be is to be expected. Nevertheless this is the way forward and we are on our way.