en English

[CW: This episode contains a single mention of sexual violence from 30.00-30.30]

 

Marianne and Helen are joined by Van Levy (they/them), a nonbinary advocate, educator, and mental health therapist from San Diego. Van talks to us about how to deal with both external and internal transphobia, and how by improving the way we talk about trans people we can build a better world for everyone.

If you have been affected by any of the topics discussed in our podcast, and would like to get in touch, please contact us via the Help Centre. You can also contact us on social media where you will find us at @GenderGP on Twitter, Facebook and Instagram.

We are always happy to accept ideas for future shows, so if there is something in particular you would like us to discuss, or a specific guest you would love to hear from, let us know. Your feedback is really important to us. If you could take a minute or two to leave us a review and rating for the podcast on your favourite podcast app, it will help others to discover us.

 

Links:

Van’s book EXPLORING MY IDENTITY(IES) is a guide to addressing your internalised transphobia, and is available via Amazon.

 

The GenderGP Podcast

Why We Need To End Gatekeeping

 

Hello, this is Dr Helen Webberley. Welcome to our GenderGP Podcast, where we will be discussing some of the issues affecting the trans and non-binary community in the world today, together with my co-host Marianne Oakes, a trans woman herself, and our head of therapy.

 

Marianne Oakes:
Hi everyone, Helen Webberley and Marianne Oakes here again, [inaudible] podcast. And I’m very excited to welcome Van Levy from San Diego, who’s going to help us break the mold and as usual, I’m just going to hand straight over to Van to introduce themselves. Van, welcome.

Van Levy:
Well, thank you so much for having me. My name is Van, my pronouns are they/them, I am from San Diego and I do a lot of advocacy work for the trans and non-binary community. I’m a mental health therapist and educator and advocate and organizer. And I’m currently, one of the biggest projects that I’m working on right now is being able to identify mental health professionals who are willing to stop engaging in gatekeeping and provide letters to people who need them for affirming care, whether that’s for surgeries, hormones, gender marker changes, name changes after only one session, because it really only takes one session to do an assessment. It’s harmful that we even have to have that, but that’s where we’re at.

Helen Webberley:
I’ll let you into a little secret. And I’m hoping one day that, that the one session over here comprises of a 10 minute GP consultation, because that’s, that’s how much we get in a GP consultation, 10 minutes. And that’s how, how long we get to make an assessment, to make a diagnosis, to make a management plan, to share ideas with the patient, listen to concerns. So I’m hoping that one day, maybe, Van, we’ve got the same hope that one day trans healthcare will be as ordinary and boring as the rest of everybody’s healthcare. I don’t know whether that fits with, with you or around my aiming too high.

Van Levy:
I absolutely agree because the reality is, at least here in the US, if a cis person wants to have surgery or start hormones, they don’t have to go for a mental health evaluation and prove that they are who they are. And I, I believe that that care should be the same for anybody who is not cis. And so, like you said, that boring 10 minutes should be enough.

Helen Webberley:
And for all my patients out there who’ve ever had that boring 10 minutes with me, I was definitely not bored with you. Marianne,

Marianne Oakes:
Just to clarify there.

Helen Webberley:
Just to clarify. Marianne, do you think that your healthcare needs could have been met in one session? And also, what do you reckon about Van’s language there about the assessment kind of word?

Marianne Oakes:
Well, I think you, you already know that that really, I was forced to go through a diagnostic process. I never asked to go through a diagnostic process. Not only did I have to go through a diagnostic process, but they then set the criteria of my transness, that what I had to do to prove my transness. And I just thought it was really reductive and treated me like I had a mental health illness, which I clearly didn’t have. And what I’ve learned about the complexity of the treatment that I’ve got is, like Helen said, there’s no reason why my GP couldn’t have had the consultation with me and given me the same prescription, as I genuinely don’t believe we need to, I’m going to temper it. I think there are some people who have really complex mental health issues that need looking at, and I don’t want to mix them up, but your average trans person going into the doctor’s surgery, yeah, I think a 10 minute consultation would suffice. And at that assessment, what we, what are we assessing? Whether somebody knows who they are or whether we know them better than they know themselves, because I think that’s the, that’s the key here, isn’t it.

Helen Webberley:
So Van, that’s doctors in a nutshell, what about the the mental health practitioner? What about the role of counselling and psychotherapy and, and support because you can’t support someone on their journey in 10 minutes. I know that. So what about the other side of the, the professional?

Van Levy:
Yes, I do agree with that. I think that there’s a lot of different ways in which I want to approach that question. In terms of, so the mental health support is not about being trans, it’s about how to cope with the world that is not accepting of who you are. The reality is we live in an extremely transphobic world. It doesn’t matter where you are in the in the world. There is transphobia in all of us because we all have internalized transphobia because the societies we grow up in. So people seeking mental health, it’s not about us having to prove who we are and that we are trans. Nobody’s gonna know us better than we know ourselves, which I completely agree with. And another thing I want to touch on too, is that you can have a mental health illness or issue, and still be trans and still be eligible and have access to care there. Again, if we look at our cis counterparts, if you have a mental illness and you want to have breast implants, right, people will allow that to happen. It’s not synonymous that that should prevent you from being able to have access to what it is you want and need, and that should be the same thing with trans people. So the, the role of a mental health professional is to help support the person that they are working with in the way that that person wants and needs support, not from this hierarchical, I can’t say that word, position where I’m going to know what’s best for you, because I will never know what’s best for you because I’m coming from a position of privilege. And that privilege is only knowing myself, not knowing you and your own experiences and your own realities. So I think it’s, it’s really problematic when we’re approaching working with somebody who might be trans or non binary with this mentality, that first you have to prove who you are to me, and then I’m going to tell you what you need to do so that you can have the best life. That’s incredibly harmful. How can I help you? Where are you struggling? What do you need from me? Do you even want any help? And what help is it that I can assist in that support? Because at least for me, the way that I operate is, my role is to help you learn, to trust yourself, because at the end of the day, you know yourself better than anyone else, so, you know, what’s going to work for you, so how can I help support you trusting that and learning more to lean into that so that you can come up with the own with your own skills so that you’ll never need me. You become the, me, and by me, I just mean your own therapist. Not that I think I’m this wonderful therapist. Does that does that answer your question?

Helen Webberley:
Absolutely. Marianne, does that mirror your approach?

Marianne Oakes:
Exactly, really, I mean, the truth of the matter is when people come into my therapy room, rarely do we talk about gender, even though that is the starting point and the presenting issue, we then talk about the difficulties that they’re facing in being acknowledged, or the difficulties you’re having coming out or, you know, and internalized transphobia, how that’s affecting them. But rarely do we actually, in fact, I don’t think I ever have actually challenged somebody’s gender identity. I think I’m sometimes challenged when they come in and they really have lost trust in their own feelings, if that makes sense. And a lot of work, I don’t know about you, Van, but a lot of the work can be actually reconnecting them with their own feelings because the mistrust is, I can’t be trans because, and that, whatever it is, the feeling that they’ve just lost faith in, I find that can be quite challenging because they’ve already got that bias that it can’t be this.

Van Levy:
I absolutely agree. I think it, it goes to that. We have the world gaslighting, our realities, which then we internalize to now gaslight ourselves. “Am I really this, because I don’t meet the X, Y, and Z?”. And I think that’s why it’s super problematic, especially for us to be assessing if somebody is trans or not, because now we’re creating an identity that we’re communicating is a model with that. If you don’t meet these check marks, then you’re not really who you are. And that’s the same check marks that people are reading and learning about. Especially people who it impacts their own identity. So it’s like, oh, I don’t feel like this, so then I can’t be trans or am I really trans? Or am I mentally ill? And it gets so convoluted when the reality is again, if we, if we look at our cis counterparts, if you ask a hundred cis women, “what does it mean to be a woman?”, you’re going to get a hundred different answers because our identities are so unique to ourselves. So having this idea that in order for me to be trans, I have to meet all this criteria is super, super harmful. And I think that’s exactly what you were addressing.

Marianne Oakes:
I think that can come from within the community as well, Van, is because we’ve been made to be so defensive of our own identity that we then tend to believe our identities, the only way to go, I’ve come across that a lot within the community. You know, if you don’t go down the gatekeeping route, if you don’t prove your transness. So I think, you know, we’ve gotta be really careful you know, from within the community that we don’t perpetuate that hierarchy of transness.

Van Levy:
Yes, absolutely. And I think you’re, you’re absolutely correct because first we get lumped into this LGBTQPIA+ community, which is not the same, sexuality and identity and gender, then even within our own trans community and then within the non-binary community, and essentially all, all these different people have all these different identities within ourselves, whether it’s being black, trans, non binary, femme, like whatever marginalized identity that person holds is going to have its own experience. And we can’t just treat something again, like it’s a monolith. And so a lot of the violence comes from what I believe is called internal oppression. It’s, we’re being so oppressed from the world that the only way to get up or above anywhere in life is to now engage in that internal oppression of being better than the people within our own community. But it’s so violent. And it’s so harmful because where do we get to turn to for safety? Where do we get to be able to be our authentic selves without having to experience that violence?

Marianne Oakes:
You know, when they do come in the therapy room, that’s where that space becomes all about them. And sometimes it’s probably the first environment they’ve been in to be free, to be told to them without fear of judgment. And I think that’s something I know I work hard to create and it’s unique to every, every client.

Van Levy:
Yes. That at least for me, that is the hope and the goal. But what I do notice is that when they’re coming into that space, for them to be who they really are, they’re also bringing everyone else with them, with all the things that they’ve now have the thoughts about themselves. So it’s like you get to see this person and say, hey, be yourself and be safe. But part of that, being themselves and being that safe is all these harmful messages that keep them in line with what they feel they need to do in order to survive out there in the world. So it’s like holding both. If we really want you to lean into that discomfort, to find who you are while also we understand that you need to have these parts to you because they’ve always existed and your brain internalized them as ways to keep you safe and alive. And in many ways have.

Marianne Oakes:
What we’re talking about here is the role of the therapist, isn’t it? And it’s not aligning to what, certainly what I experienced of the gatekeeping model. They thought their role was to tell me how to be, not allow me be if that makes sense?

Van Levy:
Yeah. I’m not sure about how your assessments go, but I know that the many that I’ve done, a lot of the time people are in tears, that they got to just share a bit about their life and get access to what they wanted while not having to prove who they are. So they come in with so much like fear and anxiety of what, what do I have to say to get what I want? Where no matter how many times you say you don’t have to do that, just be yourself, until it actually integrates, like until the person actually feels it, and that’s when you just hear or see or witness it just melting away and the person finally being able to like breathe. And it’s almost like sometimes, is this the first time that you’ve ever been able to breathe? And that’s so sad. It’s so sad.

Marianne Oakes:
Well, I actually, Helen, did you want to ask something here, [inaudible]?

Helen Webberley:
You two have your peer support and carry on.

Marianne Oakes:
I, well, I was gonna say the model of gatekeeping over here is that you have to speak to one psychiatrist twice and a clinical psychologist once. And you just repeat your story three times. And if there’s consistency in your story, apparently you can get a diagnosis, provided you’re story’s consistent with what their diagnosis criteria is. I was really fortunate because as I was going through this process, I’d got a doctor who I’d recently met, who kind of kept saying, that’s rubbish. And she’s sat here with us today, but you don’t for somebody less informed. And I was, I, I was pretty strong and I kind of knew what to expect. The sub-part of all of this is the people going in to that environment, I’ve already learned the script. So any diagnosis that he’s got, he’s not [illegible] anyway. Cause they just told the people what they needed to know to get the prescription that they wanted. Whereas what we promote at GenderGP, for anybody listening, who’s been through our process, you know, is, is you don’t need to tell us anything other than the truth. What’s your truth? Because what we want to do is give you the best care to suit your needs. You know, the gatekeeping model doesn’t allow for that. It doesn’t allow to sit back and listen, and actually does this person need to go straight on to, you know, full dose hormones, would introducing it more slowly while they explore their gender, you know, in a bit more depth. I don’t know. But you know, that we listen and we learn about them and learn what their needs and expectations are and work with that, rather than what our, what the clinicians needs and expectations are.

Van Levy:
Yeah. it sounds like y’all have a very consistent process, out here in the United States, it’s so inconsistent. I’ve heard of people having to engage in therapy for well over a year, or being forced to take hormones for a year in order to have access to surgery. Cause a lot of people don’t want hormones. A lot of people don’t want surgery. We don’t need either to be who we are. And some people want both and some people want one or the other. I know in terms of like my process, like for me from the age of, I believe of 12 to 17, I was institutionalized all over the United States to all these different conversion camps, attempting to, to cure me of my identity all under the guise of mental health disorders of, you know, like borderline personality disorder, whatever it is that they might label the person in order to be able to engage in these harmful therapies without calling it, what it is, is that you’re trans and we’re going to try to, to change that. And so there’s just so much lack of consistency. And when I was 18, the, the process then was you had to live as the opposite gender, so a complete erasure of the non-binary and other identities, you had to live as the opposite gender for a year. Then you could have access to hormones where you have to take hormones for at least a year before you can have access to surgery. And even at that time to get your passport gender marker changed, you had to have some kind of genital surgery and not anything on your chest, like on your lower parts in order to have that gender marker change. And a lot of people don’t want to have surgery and so, which creates a lot of danger. If you’re traveling anywhere, you never know who you’re going to engage with, and they’re going to see your face and they’re going to see that gender marker and they might not match. And now you become a target for that violence. Another thing that I think is super important when we’re assessing, which it sounds like an approach that you might take is how we’re asking this question. So a lot of the times therapists might say, when did you know, you’re trans? Which, that’s super problematic in two ways, one, it’s putting the person having to like, again, prove who they are, but it’s also, you’re not going to get the most amount of information. If you ask somebody, when did you notice that things were a little different? When did you notice that maybe you weren’t showing up or being read by the world for who you are? And you don’t have to have access to the language. I didn’t know what the word trans was. I think until I was 13 or 14, but I’ve known that the way that the world read me around three or four years old, didn’t match who I was.

And so you’re going to get two very different answers. I knew I was trans maybe when I was 13 or 16, but I knew that I was who I was when I was about three or four years old. And so that’s another big thing that I think is problematic out here is the way that we’re asking questions. And it’s such a hyper-focus, so I call it sexual violence and sexual harassment, because one way or another, we’re always trying to find out about the person’s genitals. What were you born as? Are you biologically this? Are you having surgery? The whole focus is about our genitals. How has that not sexual harassment? How was that not sexual violence?

Marianne Oakes:
I think we spoke about this recently, Helen. I think it was all geared towards sex change originally that there, there was only really two things. You’re either a transvestite or transsexual in my day, and it was all geared around sex change. And I think what we’ve learned over the years is gender diversity, that, you know, there’s a whole array, there’s a whole spectrum of people who are gender diverse. But I think that certainly the model in the UK, which it doesn’t differ too much from what’s going on in the US, is geared towards sex change. And the thing when we talk about in, in the UK, we talk about the Gender Recognition Act, they’re really talking about the sex change recognition act because they want you to have had surgery. And so what you do get is this is a whole raft of people going for surgery, not because they wanted surgery, but they wanted the validation that they would get from having the surgery. I think that’s two different things,

Van Levy:
Which is super, super hurtful.

Helen Webberley:
I loved listening to both of you chatting away there and reshaping trans health care for the future. And it’s really exciting. I just, going to be really greedy and ask for a bit of professional help actually, because one, when I was practicing here years ago, I would see people of all ages come to see me. So I had young, very young people brought by their parents and the presentation will be, “this is my child, they’ve been telling me for years that they were trans and I didn’t believe them. Now, I believe them. Please, can you help?” And then I would have adults who would come in and say, “I’ve been struggling with this for years. And I just decided I can’t struggle anymore. Please, can you help?” So all this for me, because they had had that long period of struggle already. It was all, it was very, very easy to start within the first 30 seconds of complete and utter belief. If something that, like that is a lie, it doesn’t go on for all those years. But there was one bit that did bother me and that worried me from a professional point of view. I didn’t want to get sued basically. And they were the teenagers, the later teenagers and their story sounded different to me. Their stories sometimes sounded a little bit like I’ve recently met a group of LGBTQ+ people and I’ve realized who I am and now I want to take steps to change my gender. And that was the story that worried me. And actually now that the time has gone on, I’ve never seen any of those people not be trans. But those ones did worry me and I think that they would worry parents and I think that they would worry other providers who only had an hour or 10 minutes. And I just wondered whether either of you had any kind of professional hints and tips to help doctors, counselors, psychologists?

Marianne Oakes:
I don’t think there’s an easy answer to that is the, just, I think the way I experience them is that you don’t need to spend an hour talking about this, but if you dig a little deeper, you’ll find that something was going on beforehand. We gravitate to people naturally who we identify with. And if we gravitated to a group of people that helped us to find our identity, a bit like Van was saying earlier that the language that we use to get that information is really important. How long have they felt different? How long have they been aware that there’s not necessarily incongruence with their gender, but there was an incongruence with how they fit it in the world. Then I think you might open up a slightly different conversation. I don’t know what you would say to that, Van.

Van Levy:
So I think that it’s important to be aware, and it’s not much different that what you were saying is that when we have more awareness or visibility to somebody who is like me, then it validates that I am real, and that all these thoughts and feelings that I have in my head are making me, I am not crazy because they exist. So when you, I’ll speak for myself as a trans and nonbinary person navigating the world, so I was assigned female at birth, and I was told by the whole world that you’re a woman, you’re a girl and everything that went with that. I never felt that way, but I had no awareness of anything else until I read an article about a trans man. And so I thought, okay, I’m not a girl, but maybe I’m a trans man, because that’s my only option. So now I’ve been exposed to something that might feel right for me, even though I’m not a trans man, it wasn’t until I learned that there’s a, about being non binary that that is something that is a thing. And that, again, I’m not crazy because I’ve never felt how our, our society constructs, masculinity or femininity. I felt like I am me, whatever that looks like. And I don’t want to have to fit into a box of, of anything outside of just existing as I am. So it’s not the exposure to that article or to people within that community that made me trans or made me non binary. It’s those people that helped validate that what I feel is real and opened so much up for me. And I think that’s a big reason why a lot of us are advocating to have more awareness and visibility and representation of different communities in media or anywhere you go, so that we give people the freedom to potentially be validated in who they are, because if you take a cis person and you put them in an LGBT+ group, or with other trans people, non binary people, they’re still going to be cis, because our identity, just like, if, if you’re a heterosexual person you’re hanging out with somebody who’s not, it’s not going to turn you. If you’re somebody who shared that you were heterosexual and never been exposed to somebody who might be lesbian or, or, or a different identity and that feels more right for you, you’re going to get validity in that, but that doesn’t mean that it changed you. And so I think from a liability perspective, in order to avoid harming somebody it’s to trust them for who they are. At the end of the day, that’s it, that’s how we avoid imposing harm and avoid liability.

Helen Webberley:
I hope that’s helpful to anyone else who has the same fears that I once had. I’m interested that, you said, Van, that you were institutionalized for many years as an adolescent and I’m a) sorry that, that happened to you and b) I’m interested. And as you were telling me about it, I thought actually, that’s what we do to our young people over here. You know, the first thing that happens when they come forward and say they’re trans, they have to go through a period of, of difficulty within the home while mom and dad get used to the idea, which at the way that life is at the moment is understandable. I can understand that, how parents can find that really tricky, and then that can either be okay for the kid or it can cause harm. And that harm that we see it’s the stress and the anxiety and the depression. And as soon as that creeps in you, you end up in a situation where either it’s not needing to be diagnosed and you get sent off to the local mental health services to deal with those things. And it’s a very similar thing. They’re almost you’re being institutionalized in mental health services because you haven’t had that access to acceptance and belief and support that you really, really needed and Johanna Olson-Kennedy often talks about the overlap between people who struggle with gender dysphoria, fitting in society and the overlap between people with post traumatic stress disorder or borderline personality disorder or the autistic spectrum. And all of these things get confused. And I wonder how many trans people out there have those diagnoses and the one that that’s glaringly obvious is completely and utterly overlooked while they’re sorting out the others in that institution.

Van Levy:
I guess I got a little lost on what the question was?

Helen Webberley:
It wasn’t really a question. It was just an observation really. And I think if I was to lead with a question, the question is, you know, how can we stop harming young people in the way that you were harmed by forcing them through mental health services, when actually we’re causing them mental health issues by not starting at a position of belief, really?

Van Levy:
I think it just comes down to trusting the person who trusts you enough to share with you who they are like at the end of the day, that I think that’s all that it is. I know that an organization out here in the US near Memoirs, I had done some studies and found that if I’m remembering it correctly, that, so the QTBIPOC, so queer, trans, black, indigenous people of color had essentially two routes that existed for their youth, where they were institutionalized, whether it was the prison pipeline or the psychiatric pot pipeline. And I believe the study also showed that the darker your skin was, would increase the likelihood of the pipeline being prison over psychiatric hospitalizations, all again, like with these gaslighting diagnosis, that kind of similar to how you’re saying, how oftentimes, where is this post-traumatic stress disorder? Is there, is this somebody who’s neurodivergent is this mental illness? Is this a response to the way society is treating you? Which can look like mental illness, but it’s mental health, your mental health is being impacted. You are not mentally ill. Your mental health is being impacted. And I think that those are two very different things.

Marianne Oakes:
I just wanted to interject there because, I think the starting point, certainly with some medical centers is, “oh, you’re trans, oh, well, we’ll send you to the mental health services to make sure there’s nothing causing you to think this”. So straight away, we’re looking for a cause, because I think the medi- and Helen, you would know more about this than me, but I think the medical mindset is, “if we can find a cause, we can find a cure”. And I think once it’s a bit, I remember working in the workplace once and that, you know, if a problem, if a job came in, that was a problem, you’d pass it on to another department who would pass it on to another department, in fact, and then you’re back in your court. And I think that happened with trans patients that we go to the doctor. I can’t deal with that. I’m going to, I’m going to refer you to the, the mental health services who will then refer you to the gender identity clinic. But once you get in the mental health services, do you find that actually, oh, you’ve got something else wrong with you here. And a bit like Helen was saying somewhere, the gender dysphoria starts being at the bottom of the pile. It’s not seen as the presenting issue. We’ve got to find something because somebody said once, if you go to a psychiatrist, she will get a diagnosis, even if you were just at a delivery driver. And I think that kind of happened. And suddenly this, this child, or this adult is carrying these other diagnosis. And then when they get to the gender clinic, “oh, well, we better get these sorted, you know, so we can be sure that you are transgender”. And I think the reality is if we could just believe that transgender is a facet of a human character, then actually there would be no need for all them departments. I don’t know if that kind of fits with what you were saying there, [inaudible], it’s the belief right at the start.

Van Levy:
Yeah. It, it, it, it triggered a couple of things and I remembered what I did want to say, but a parallel to what you’re saying, that’d be the equivalent of having a mental illness diagnosis because you’re a woman, but then dealing with the mental health issues before they can validate that, are you really a woman? And I’m just talking about like, as a CIS person, right? Like that, that would be the same line of thinking. Can we really trust that you’re a woman or man, or like whatever the person’s identity is as a cis person, like, that’s exactly what they’re doing to trans people. I, what I wanted to say was that I think that it’s really important that we recognize, so we have this diagnosis of post-traumatic stress disorder, but that typically is for like one incident or multiple incidents where people don’t realize that for us as trans, non binary, anybody who isn’t cis or holds a marginalized identity is that that PTS does end now, and it will not end in our lifetime. We will have continuous stress disorder because the amount of micro, macro aggressions that we will experience, whether we’re watching a movie, listening to the radio, engaging in a conversation, meeting a new person, going to a doctor, having to be vetted if we’re trans enough to have access to the procedures we need, at least here in, in, in California, I’ve been rejected for many doctors for being trans. I’ve gone in, they found out I was trans. I’ve had the nurse come in and ask me to leave. I’ve experienced sexual violence, like all these things. And I don’t just mean sexual violence outside, like from an actual doctor, you go in for an ear infection. And the next thing you know, somebody’s putting, inserting their fingers into you, claiming that they’re checking for something when that has nothing to do with my ear. And so we will always experience an element of violence with our identities that isn’t just going to go away. So you can’t treat something that is always going to exist. And as a mental health provider, I think that we can assist in how to cope with it and validate that it’s real. So again, we don’t guess ourselves. And then you had mentioned is that, which is not different from the United States is ,we’ve identified this problem, now let’s try to find the cure. When we’re looking at our identities as a problem, and that there’s going to be a cure, we’re giving people and ourselves false hope, but we’re also communicating and we’re internalizing that something is wrong with me because if this is a problem and it’s part of me, that I’m the problem. So there’s something wrong with me that needs to, to be fixed.

Helen Webberley:
And I think then you speak with experience with passion, and it’s horrible to hear the things that you say sometimes. But when we started this, you obviously have a massive role in mental health, in advocacy and in education. And that’s why we’re all here today. Isn’t it? It is about teaching, about normalizing educating our world that we live in to make tomorrow’s world a better place. So one of the things also that you said, Van, at the beginning was that everybody has transphobia and trans people have their own internal transphobia and society has transphobia because we just don’t understand it. So is that true? I mean, what about advocates? Do, can you get to a position where actually you don’t have any transphobia, how do we get those people out there who really would love to help would really love to help us here and our mission of increasing awareness and understanding around these issues? How can your average person in the street become an advocate? What can they do? How can they put aside any transphobia that they may have been a grown-up to have?

Van Levy:
So to answer the first part, none of us will ever eradicate the internalized transphobia that we have all of, like, we’ll never eradicate all of it because it’s so deeply rooted in our systems that we’re not always aware of it, but how we continue to address it is accepting that we will engage in harmful ways, and cultivating an awareness and addressing it. So, for instance, if you say that you are going in for feminization surgery, right, even that is transphobic because it’s communicating that the only way to be feminine is to appear in this way or to have the surgery or whatever it might be, versus I’m going in to have a mastectomy, or I’m going in to take testosterone, right? I’m not going in for male hormones, I’m going in to get testosterone because it’s communicating that testosterone is only for men, or men, or only a certain way, or even when we talk about, you know, what were you biologically? The reality is most of us don’t know what our chromosomes are. Most of us don’t know all the different parts of our biology that makes us who we are. We only know what the doctors looked at, which was our genitals and decided that we are a certain gender and assigned it. And even that alone is transphobic because it’s equating that penises are for men and vaginas are for women. So the more that we unpack, what we’ve decided is a label for something, the more we can become aware of the internalized transphobia we have, and the more we can eradicate it. But again, it’s so deeply rooted that there’s no way for us to be a hundred percent rid of it. It’s about constantly being aware, constantly addressing it and trusting people when they bring it to our attention. So a big thing that I find problematic about a lot of allies, especially in the mental health field, is that the moment that you bring to their attention, that what they’re saying is problematic, their fragility shows up. There’s just fragility as in, they get defensive, especially if you say we all have transphobia, or you tell somebody that they’re engaging in a transphobic, microaggression, immediate responses, I’m not transphobic or I’m trans so I can’t be transphobic that right there is problematic in and of itself because you’re validating the person’s reality versus just saying, thank you. Asking, would you, would you mind educating me more? And if not, I will go do my own research, things like, people in the mental health field will do something called like trans 101. They don’t realize how problematic that is. Because for two reasons, one, it creates a model that you’re going to learn everything you need to know about an identity, but calling something trans 101. Imagine if I said women 101, everything you need to know about women, you can see how it’s problematic. Whereas if we’re saying trans 101, we’re not making those connections.

And so we’re, sorry, we will always engage in harm, but what makes us not problematic is being willing to always be able to check our privilege, to cultivate an awareness and to trust other people who are bringing it to our own attention. And any time you take trainings, try to take trainings that are by people who hold that identity. People with multiple marginalized identities, not just people within the binary who are able-bodied, who are, neuro-typical, really try to find trainings done by people who are often pushed out or erased or not listened to, or labeled as not good enough to educate.

Marianne Oakes:
We’re just conditioned with the binary, whichever way we look at it. And you know, it does start from the moment we’re born. Once they’ve seen whether we’ve got a vagina or a penis, then our journey is mapped out. And our parents and peers and guardians and teachers are all guiding us in a certain way. And because they all think the same way. And it just becomes part of our own thinking. I think that’s one of the toughest things about being trans and discovering your own identity. I think I’ve described it before. It’s like swimming against the current being brave enough to stop and, and try and swim the other way. And it does feel like you’re swimming against the current, but we can get stronger and we can keep swimming. And the more we swim, the more people see us, hopefully a few more people turn around and we’ll be in a pond rather than a river, eventually. I didn’t plan that metaphor.

Helen Webberley:
It was a lovely metaphor and a lovely image. So I know that one of us around the table had an exciting addition to their family yesterday, but I also happened to notice that that addition to the family has a gendered name and a gendered coloured hat and a gendered pronoun. So should we be rethinking that or is that going too far?

Marianne Oakes:
With the addition, Oscar, interestingly enough, he was gendered before in the womb basically. Or they wanted to know, was it girl or a boy, my other grandson, Billy, they came to me and said, we’re going to have, they didn’t, he didn’t have a name. We’re going to let our child go gender neutral. But Billy just, you know, he got, he got a male name, but the, you know, the reality is they tried but he’s just such a boy. And I think, you know, we’ve got to kind of accept that, you know, picking out the trans child is going to be nigh on impossible and what do you do, right. But I’d just like to think that they will grow up less binary in their thinking and they will just become the best that they can be as a person. And I think listening to Van today you know, I don’t think anybody could disagree, but if it’s going to change, it’s going to take a century to change, but we need more children like Billy and Oscar, you know, whether they are gendered by the parents in, in a particular way that if they reject that gender, that they are free to explore it, however they see fit. But yes, I’ll be raising that with it.

Van Levy:
Wasn’t a criticism.

Marianne Oakes:
No. Well, it just shows you how, how we sit here, comfortable with that. Even I don’t think of it. It just happens because we’re just conditioned that way. They even have gender reveal parties now don’t they, I was thinking of having that, one of them for myself, it’s almost like society is trying to really hold on to gender, to the gender binary.

Van Levy:
Yeah. And I think one way in that interim of gendered society, moving to a freeing society of allowing people to be who they are that interim stage could be even removing this idea that a name like Oscar is gendered, right? That’s part of our internalized transphobia. That’s part of our societal constructs. That Oscar is male, but there’s nothing about that name. If we break it down, that if you were to tell somebody in a whole other country who speaks a different language, who doesn’t know anything about our culture, Oscar, they’re not going to know, “oh, man”, they’re just going to hear a work because that’s all that it is. And so I think not associating or moving away from associating things as certain genders is going to help break those constructs and also having conversations as people get older. And I don’t mean like even in their teens, like three, four, adults make mistakes all the time. And sometimes we think somebody something, but then they have to teach us who they are and help us understand. So if I’m ever doing something that isn’t, doesn’t feel like it’s you, please share it with me, right? Giving kids the children, the ability to challenge adults, especially when it’s about themselves. And so I think those are different little ways that can help create more freedom so that they don’t have to sit there holding this by themselves. That something’s wrong with me. And then one of the things I forgot to mention earlier about challenging our internalized transphobia is I actually specifically wrote a book, it’s an interactive book. It’s only 69 pages of how to address our own internalized transphobia so that we can create safer places for ourselves, but also for others. So I did want to say that, and I know that this is auditorial. I wouldn’t say if I tell everybody what it’s called. So it’s called exploring my identity. And then in parentheses, ‘ies’ so like explore my identity or identities in case people have multiple ones and you can get it on Amazon in the UK as well.

Helen Webberley:
I’ll be able to put a link to that podcast as well. It’s going to tell you a tiny, tiny story. Cause you talked about if you went to abroad and no one would know that Oscar was historically a boy’s name. It’s not now, by the way, it is now a gender neutral name. And I was walking past a woman and her dog in the park yesterday, and she started she started, as I passed her she started speaking and she stopped, started talking to her dog in Polish. And I looked around and I almost said to my husband, oh my gosh, that dog understands Polish. And then I just realized what nonsense I was saying to myself because of course it’s just a noise, isn’t it. And that dog doesn’t understand English or Polish. But it did make me laugh. Van, we haven’t got long left. It’s been lovely talking to you, but I just wondered, I know you do some education materials about healthcare providers to be confident enough to provide care without hours and hours and hours of interrogation. Can you, can you, in a nutshell, tell us what to expect from those materials.

Van Levy:
It’s essentially create a safer place for somebody by letting them know that you’re going to be providing them a letter ahead of time. That what you’re looking for in, in this assessment is to just get some, some information for the document and that it’s less about them proving who they are versus just things that you need. And then really asking questions in trauma informed way. So again, when did you know that you didn’t feel right in yourself or that people weren’t seeing you for who you are? So that’s kind of more the like non gatekeeping trainings. I also have other trainings, which is about how to create a safer space for other people. And that is by how to build your own skills to address your own internalized transphobia. Because at the end of the day, to me, that’s the only way that education should be done around these different identities. Not an explanation of every single definition for every single word. Because again, we loop back to, if I ask a hundred women, what does it mean to be a woman you’re going to get a hundred different answers, it’s the same thing for trans people and non-binary people. So when you engage with your clients, don’t ask them what it means to be trans, ask them what it’s like for them to be trans. And you’re going to get a lot more information and potentially get a lot less defensiveness, but you’re also going to create safety and freedom because people want to share about themselves. They don’t want to have to educate you when they’re going in for mental health. But a lot of people, I can’t speak for everyone. A lot of people want to be heard, seen, validated for who they are, not for what you believe them to be.

Marianne Oakes:
I tell you what I found interesting there, Helen, is that we changed the name of our process from assessment to information gathering. Cause that’s all we’re doing is gathering information on that individual, not assessing them to a criteria set by somebody else, finding that information out, finding out how they experience themselves.

Helen Webberley:
I hope that over the years that we’ve been working Marianne, that the system has developed into a, a two way system. So you tell me about you and I’ll tell you as a doctor or a therapist, how I can help you with what you’re asking for help with. And so two ways, two specialists in the room, a specialist in themselves and in their identity, and a specialist in that health care profession who can come together and find the right and we’ll help the path for that person to make their life more easy. And I hope that that’s what we continually strive to achieve.

Van Levy:
That’s really beautiful.

Helen Webberley:
I mean, it’s a process, isn’t it. Every single day it’s, have we got this right? How can we make this better? And I hope that that’s,what podcasts like this will do to people listening to make this world a better place for every single identity and micro identity and dual identity and all of those things on QTPOC. I hadn’t heard of that before. I’m going to look that up. That’s going to be my learning of the day and join us. Thank you so much. You’ve been inspiring. And I really hope that people who have been listening will start to have confidence in helping people with, with a new approach, an approach that is there just to help not to challenge.

Van Levy:
Thank you. Yeah, me too. One last thing that I do want to say is that it doesn’t hurt you to validate somebody’s reality, but it can change somebody’s life to invalidate them. Think that that’s important for people to know who are opposing of who we are. How is it hurting you if we just exist? Very poignant. Thank you so much.

 

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