United Kingdom

The first major UK wide survey conducted of trans people was the Engendered Penalties 2007 report conducted by the transgender activist group Press for Change, which claimed to be, ‘the most comprehensive study ever undertaken of trans people and their lives’ (Whittle et al, 2007:17); and with 872 survey respondents, ‘the largest sample to date of any sociological study conducted on trans people globally’ (2007:26).

This study has provided a baseline for other research and the results are still pertinent today cited in the literature, and was clearly a major influence on the STA study 2008.

The Engendered Penalties 2007 report was commissioned by the Equalities Review in the UK in preparation for the passing of the Equality Act (UK Gov, 2010). Findings were based on empirical data gathered from: ‘a qualitative review of 86,000 emails to Press for Change and 16,000 online postings to the FTM UK email list’; in addition to

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‘A quantitative analysis of responses from 872 self-identified trans people to an online survey’ (Whittle et al, 2007:14). The gender ratio of survey respondents was 646 MtF and 197 FtM or 74% to 23% or an approximately 3:1 ratio. Of interest is that in this 2007 report. in contrast with the ILGA 2008 report for which Whittle was also the lead researcher (discussed below) Whittle et al argue that a ratio of Mtf:FtM 4:1 or 3:1 corresponds with the norm for other surveys in Europe and the USA (Whittle et al, 2007:28).

The UK Engendered Penalties report acknowledge that the survey cannot claim to be representative of the trans population as a whole: ‘Rather, we would suggest that given the number of respondents and the correlations with previous research we can claim that it is significant enough to draw some conclusions’ (Whittle et al, 2007:30). The report highlighted issues of inequalities and discrimination in preparation for the UK Equalities Framework 2010 legislation. Significant findings were: ‘73% of trans people surveyed experienced some form of public harassment including violence with 10%

being victims of threatening behaviour when out in public spaces’ (Whittle et al, 2007:16); and ‘35% (over 1 in 3) of trans people have attempted suicide at least once in their lives’ (Whittle et al, 2007: 78). The report argued that: ‘There has been little evidence-based research on the nature of inequality and discrimination experienced by trans people, but the available evidence suggests that discrimination and prejudice are pervasive’ - particularly in the areas of employment, health care and housing (Whittle et al 2007: 21). Whittle has argued elsewhere that in the UK there is ‘an ongoing paucity of empirical analysis of gender diversity’, particularly in-depth sociological studies, and thus ‘gender issues are still viewed as minority interests rather than as a matter of concern to us all’ (Stryker & Whittle, 2006: xiv). It is this paucity that the current study aims to address with an in-depth sociological study into transgender practices in Scotland.

The UK wide NHS Audit of Patient Satisfaction with Transgender Services (NHS, 2008) aimed ‘to capture the patient experience of transgender services to assess positive and negative aspects and to inform future development of the service’ (NHS, 2008:2). Results were based on 647 responses received to an online plus paper based survey that ran for 6 months and was not restricted to UK respondents (possibly

Constructing identities, reclaiming subjectivities, reconstructing selves: an interpretative study of transgender practices Scotland

47 because the survey designers knew this would have been too difficult to control with an anonymous online survey). The gender ratio of respondents MtF: FtM was 4:1, with the mean and median age of total respondents being 44, the average age for MtF being 46 and younger for FtM being 36 (2008:3). The report confessed puzzlement at these gender discrepancies but like other studies, could not provide an explanation for the phenomenon. The findings of this NHS Audit are discussed in more detail in the Medical Practices chapter with reference to data gathered from interviews in the current study.

GIRES (the Gender Identity Research and Education Society) published a report on Gender Variance in the UK: Prevalence, Incidence, Growth and Geographic Distribution 2009. This survey of previous research studies into transgender populations was funded by the UK Government Home Office in order to fill an

‘information gap’ and develop ‘reliable estimates of the size, growth and geographic distribution of this vulnerable community’ (Reed et al, 2009:2). The objectives of the study were to improve the evidence base regarding ‘transphobic crime’ and growing transsexual needs for ‘specialised medical services’ (Reed et al, 2009: 6). The report indicated that there was a predominance in the United Kingdom of medical research, followed by crime reports on the subject of transgender, and argued for ‘a clear and present need to support and protect a significant number of gender dysphoric people in the community’ (Reed et al, 2009:5).

The significance of the GIRES report is that it was the first attempt to collate and evaluate data from different studies in an endeavour to define the demographics and prevalence of gender variant people in the UK: ‘to estimate reasonably the size, growth and geographic dispersion of the trans community using data from a variety of sources’: surveys, academic and government reports; as well as NHS and private gender identity clinics. The report makes the point that: ‘transgender people are difficult to count’ (Reed et al, 2009:7).

GIRES updated the 2009 report in 2011, and again in 2015 Monitoring Gender Non Conformity -A Quick Guide, intended as a policy guide for public service employers compliance with the Equality Duty (UK Gov, 2010). The updated GIRES reports

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48 estimate that 1% of the UK population is ‘gender non-conforming to some degree’, and 0.2 % are ‘likely to seek medical treatment for their condition at some stage’(GIRES, 2015: Para 4). However information presented elsewhere on the GIRES website defines these percentages quite differently:‘1% of the population has the protected characteristic of gender reassignment (Equality Act 2010), and approximately 0.2 of the population is likely to change the gender (social) role permanently - roughly 140,000 in the UK’ (GIRES, 2015b). Accuracy of category definition is one of the problems when it comes to enumerating the prevalence of gender variance: ‘gender non-conforming’ is not the same issue as the permanent gender change required to ensure ‘the protected characteristic of gender reassignment’, and ‘likely to seek medical treatment’ is not the same issue as ‘to change the gender (social) role permanently’. To conflate these categories causes confusion rather than clarification.

The calculations in the GIRES gender prevalence report updates (2011, 2015) are based on the assumption that there has to be a symmetry to the MtF: FtM gender ratio balance for gender variance, therefore there will be larger numbers of people who ‘experience some degree of gender variance’ than have actually been empirically counted. Given the numbers of MtF transwomen, GIRES argues there must actually be equal numbers of FtM transmen to provide a symmetrical gender balance:

They may number 300,000, a prevalence of 600 per 100,000, of whom 80% were assigned as boys at birth. However, the number would be nearly 500,000, a prevalence of 1,000 per 100,000 (1%), if the gender balance among gender variant people is equal, as seems increasingly likely (GIRES, 2011:Para 4).

However this balancing out of the gender ratio is not substantiated by empirical evidence. In the 2009 GIRES report, the figures indicated that ‘80% were assigned as boys at birth (now trans women) and 20% as girls (now trans men)’ (Reed et al, 2009) which is the usual skewed Mtf: FtM 4:1 gender ratio evident in the samples of most transgender studies. But then the 2011 GIRES report update confidently anticipates:

‘that the gender balance may eventually become more equal’ (GIRES, 2011:Para1).

Then the further 2015 GIRES report update estimates: ‘there may be nearly equal numbers of people transitioning from male to female (trans women) and from female to male (trans men)’ (GIRES, 2015: Para 4). This illustrates the development of a discourse, the origin of which can be traced to the ILGA Trans Euro Study (Whittle et al, 2008) discussed below in the section on Europe, after which UK transgender

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49 research discourse began to shift to arguing the MtF:FtM gender ratio 1:1 together with a concomitant projection of the transgender population being 1% of the general population. However empirical research has yet to corroborate as being applicable to the UK this 1:1 gender ratio estimate based on findings in other European countries.

The GIRES reports (2009, 2011, 2015) predict a rapidly growing UK transgender population. The 2015 GIRES report estimates that people seeking medical treatment for gender non-conformity is likely to grow at 20% per annum or faster (GIRES, 2015:

Para 4 ), and confirms the need for more ‘Qualitative rather than quantitative evidence’

(GIRES, 2015: Para 3). The current research is hoping to fill the need for more nuanced qualitative information about transgender people than statistics can offer.

The Equality and Human Rights Commission (EHRC) Trans Research Review 2009 was a comprehensive appraisal of relevant UK wide academic and non-published quantitative and qualitative research , and policy documentation, in relation to trans people, in order to establish an evidence model on equality and discrimination that would ‘inform future policy development and strategy in Britain’ (EHRC, 2009:iv).

The report included the following findings:

The review reveals that there is a case for UK-wide quantitative and qualitative study on the economic position, experiences and needs of the trans population.

The absence of such evidence means that the correct support, funding, services and policies, are not in place for trans people (EHRC, 2009:74)

The EHRC study Monitoring Equality: Developing a Gender Identity Question 2012 was in response to the Equality Act’s introduction of the Equality Duty (UK Gov, 2010), conferring additional responsibilities upon the public sector to publish information to demonstrate compliance and embed equality (EHRC, 2012:6). This study reviewed and developed gender identity questions to be used in equality monitoring which were then tested on focus groups consisting of trans and non-trans participants (EHRC, 2012:7). The resulting EHRC study approved questions asked in a specific order are now used for Public Sector Equality Duty monitoring, and these recommendations were adapted and incorporated into the questionnaire design for the current study. Of interest is that the EHRC (2012) report states: ‘Testing found that the terms “male” and “female” are less problematic than “man” and “woman” because the former are seen as biological facts and not socially constructed like the latter terms’

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50 (EHRC, 2012:129). This could be considered revealing of an underlying biological essentialism revealed in the responses of participants in that study, an assumption seemingly unquestioned by the report’s authors.

The UK wide Trans Mental Health Study stated that 11% of its 889 responses came from Scotland (McNeil et al, 2012:5-9). This would suggest that it gathered 98 transgender participants from Scotland, a larger sample than had responded to any previous research in this region. The study was sponsored by the STA and recruitment methods were similar to that of previous STA surveys - mainly snowballing and self-selection convenience sampling. The findings of the Trans Mental Health Study (2012) are discussed in the Medical Practices chapter of the current study.