Читать книгу Living in Love and Faith - Bishops of the Church of England - Страница 50

The third place where things get complicated is precisely in the distinction between sex and gender – because the two are tangled together. One connection between sex and gender is obvious. The way in which a baby is categorized at birth is typically a response to that baby’s visible genitals – though we will see in the next chapter that the picture is not always so straightforward. There are other connections between gender and the body, however. It has been argued, for instance, that someone’s sense of their own gender, whether or not it is the one assigned to them at birth, might emerge in part from the way their body has developed. It might, for instance, emerge from the ways their brains and nervous systems have developed. That might have to do with development that took place while they were still in the womb, but it can go beyond that. There are, in other words, complex two-way flows between sex and gender, some aspects of which are not yet well understood. Some now therefore refer to ‘gender/sex’ as a single complex reality, rather than try to sustain a neat distinction between biology and culture.¹¹⁸

History of trans identities

What we understand as trans (in all its different forms) has been understood very differently in different cultural settings and periods of history. Many societies have had ways of categorising gender that don’t divide everyone up into ‘male’ and ‘female’. In some societies people who we might today identify as trans have had a special status as shamans or priests. For example, North American tribal cultures often recognized ‘Two-Spirit’ people – a term which overlaps with what we are calling trans, as well as with lesbian, gay, bisexual, and intersex. In different ways, in different contexts, such people have been treated with reverence and sometimes have a role as leaders of the community.¹¹⁹ The word ‘transsexual’ was first used in German in 1923 and in English in 1949, framing as a medical issue the experience of those who don’t identify with the gender that they were assigned to at birth.

The word ‘transgender’ is more recent, and was coined in part to avoid this medical framing. It can be traced back to the 1970s, when it was popularised by an American activist, Virginia Prince. She used it to describe the way in which she lived full-time in a gender role different from the gender to which she had been assigned at birth, but without surgical intervention. Since then, usage of the term has evolved to cover all those who don’t identify with their assigned gender.

The adjective ‘trans’ (or ‘transgender’) can be used to refer to any individual whose sense of their own gender identity does not match the gender that they were assigned to at birth. The adjective ‘cis’ (or ‘cisgender’) can be used to refer to any individual whose sense of their own gender identity does match the gender that they were assigned to at birth. (‘Cis’ is a Latin prefix, often contrasted with the prefix ‘trans’. It has been used, for instance, in geographical contexts: ‘cisalpine’ meaning ‘on this side of the Alps’ and ‘transalpine’ ‘on the other side of the Alps’. It was adopted in discussions of gender in the 1990s, simply in order to have words to use for people on both sides of the distinction we are discussing.)

The adjective ‘trans’ is increasingly used to name a wide range of different kinds of identity. It is perhaps most commonly used for someone who was assigned female at birth but who identifies as male, or vice versa. It can also be used of someone who was assigned female or male at birth but who does not identify as either. Amongst various other possibilities, someone may identify as ‘non-binary’ if they don’t identify either as fully male or fully female; they may identify as ‘gender-fluid’ if they experience their gender identity as fluctuating or as context-specific; they may identify as ‘agender’ if they don’t identify at all as either male or female.

Gender identity can change with time. Gender fluidity is a term which is used in different ways. Often it describes non-binary gender identity, or a person’s understanding of themselves as gender fluid, having transitioned from one (binary) gender to another. It may also refer to change in gender identity across time, or to the recognition of a multiplicity or continuum of gender categories. Discussions about sex, gender and gender identity are ongoing and there is still much to learn about these matters.¹²⁰

Some people who identify as trans (but not all) experience gender dysphoria. Dysphoria is a deeply rooted discomfort or distress. A person can experience it towards bodily features that are not typically regarded as matching their identified gender (‘physical dysphoria’). It can also be experienced towards the ways in which other people respond to and categorize those bodily features (‘social dysphoria’). Identifying as trans does not necessarily bring with it these kinds of visceral discomfort, but many trans people do experience them with differing levels of severity. This experience can lead to anxiety, depression, and an increased risk of suicide.¹²¹ (‘Gender incongruence’ is the term now suggested by the World Health Organization for ‘a marked and persistent incongruence between an individual’s experienced gender and the assigned sex’, which need not manifest as dysphoria.¹²²)

Some trans people transition. That is, either temporarily or permanently, they express a different gender identity from the one they have previously expressed. Such transitioning can be social: changing some or all of one’s name, the pronouns one uses, one’s clothing, make-up, hairstyle, voice, deportment, and social roles. It can be legal: seeking recognition of one’s gender identity on legal documents such as passports, as allowed under the 2004 Gender Recognition Act (though relatively few people take advantage of this¹²³). It can also be medical: pursuing various different kinds of hormonal or surgical treatments designed to align some aspects of the body more closely with a person’s identified gender.

Transitioning is normally understood as a way for someone to do justice to a gender identity that they have been aware of for a long time (perhaps for as long as they can remember), or that they have slowly discovered – though some also experience their gender identity as changing over time.

Transgender: statistics

It is very difficult to know how many trans people there are in the UK. The Government Equalities Office tentatively estimated in 2018 that there are currently between 200,000 and 500,000 trans people in the UK. Recent studies in the United States suggested that trans people make up between 0.5 and 2.7% of the population – with this very wide variation reflecting significant differences in the definition used.¹²⁴

The situation is changing rapidly, however, and these numbers may turn out to be too low. The growth in public awareness of trans people, the prevalence of social media sites and online trans forums, the spread of new vocabularies for naming trans experience, seem to be leading to increased numbers of people identifying as trans.

These increases are reflected in referrals reported by gender clinics in a number of countries. In the UK, referrals of young people to the Gender Identity and Development Service (GIDS), part of the Tavistock-Portman NHS Trust, have been rising steadily, growing from 678 in 2014–15 to 2,590 in 2018–2019. The average age at time of referral has also dropped over the last decade. The treatment of children and young people continues to be a source of significant controversy.¹²⁵ In 2018/19, 1,740 of the referrals were for young people assigned female at birth, and 624 for those assigned male at birth, though this may simply be a matter of a correction to an earlier under-diagnosis of people in the former category.

It is important to remember, however, that not all trans people seek this kind of medical treatment, and only some of those who do are referred to clinics like this. The number of referrals is only one indication of the number of people identifying as trans in the population more widely.¹²⁶