Talking Gender

Seems like I've been talking about gender with lots of people lately. A couple of pieces came out this week that I want to share.

First you can here me chatting with the lovely Dr. Lori-Beth Bisbey on her A-Z of sex podcast about transgender, and gender in general, here.

Second there's a nice long piece over on KQED about non-binary gender, which includes a quote from me. Here's the full interview that I did with them if you'd like to read more...

What are the findings of the little research there is on the topic of non-binary gender identities?

So far we know that around 1 in 250 people identify as non-binary when given a choice between male, female and another option, but in terms of experience over a third of people say that they are to some extent the 'other' gender, 'both genders' and/or 'neither gender'. Globally many cultures recognise more than two genders.

Those who identify as non-binary, and/or express themselves in ways that challenge binary gender, face similarly high levels of mental health difficulties to trans people generally due to the extent of transphobia in our culture. 40% of non-binary people have attempted suicide at some point, a third have experienced physical assault, and a sixth sexual assault based on their gender.

Like bisexual people, non-binary people often face erasure or invisibility in cultures that insist that gender and sexuality are binary (you are either male or female, straight or gay). Everyday misgendering and other microaggressions take a toll on non-binary people, as does discrimination from both straight and gay communities, and difficulties being recognised in their gender in the workplace, by medical professionals, and legally.

You mention your upcoming book, which will deal with this topic in-depth. Can you give us a little preview of what you discuss in relation to non-binary gender?

Absolutely. The book that Alex Iantaffi and I have written on gender focuses on the fact that all of us have a unique experience of gender. Whether we are binary or non-binary, trans or cisgender, we all have to navigate rigid social ideals about appropriate gender roles and behaviour, and these also have a negative impact on all of us. The book aims to help everyone to reflect on their own gender journey and how gender intersects with other aspects of their identities and backgrounds such as race, class, disability, age, etc.

So while the book contains lots of information about non-binary gender, including the words that people are currently using to describe themselves, and different options in terms of appearance and expression, it never suggests that those are unique to non-binary people. We all have a gender and we all express it and identify it in various ways.

Do you have any historical take on the genesis of non-binary gender as an accepted idea in the west? That seems to be mid to late 2000s, according to therapists, academics, etc.

Yes I agree. I think the internet has a lot to do with the fact that non-binary gender, and asexuality as well, have been recently far more recognised and understood. People have been more able to find other people with similar experiences, and it's also been easier to raise awareness in the wider world via social media. This has a knock-on effect that a lot of people who experienced themselves in non-binary ways in the past are now able to be more open about that, and identify in that way, because people have more awareness of non-binary experience, pronouns, etc.

Anything to say about non-binary gender in other cultures?

The important point is that there have always been non-binary genders across history and across the world. In the western world our understanding of gender used to be that there was one gender, with
women just being an inferior version of men. The current idea of two 'opposite' genders is a relatively new one. And there are cultures around the world which have three or five genders, or where gender just isn't considered to be as important an aspect of being a human as it is in western culture.

Is there any indication that there's a biological basis for those who feel neither male nor female? Actually for all of us gender is complexly biopsychosocial. That means that it's really impossible to completely tease apart which elements of our gender experience come from our genetic makeup, which from our life experiences, and which from the wider social forces around us.

All those things interact in complex ways. From research with intersex people we know that there is actually diversity (rather than a binary) across all aspects of sex: our chromosomal make-up, our levels of circulating hormones, the structures of our brains, and the ways our bodies express sexual characteristics. Anne Fausto-Sterling's work on this is very useful. From recent neuroscience we know that our bodies and brains are massively influenced by what we learn growing up, and the social messages around us. So even when something is 'biological' that doesn't necessarily mean we were 'born that way'. Cordelia Fine's work on this is very helpful.

It's best to view gender and sexuality (whether binary or non-binary) as a complex biopsychosocial thing. It's also useful to question why we're often so keen to find its roots in innate biological factors. Perhaps if we recognised that somebody's gender or sexuality shouldn't make a difference to the way we treat them, then we'd be less concerned with questions of causation.

Have you treated non-binary patients? If so, what are the biggest issues they face?

I certainly have worked with several non-binary clients - all adults in my case. I also looked at a survey done by the Beyond the Binary website on non-binary experience. The main issues faced by NB people
are:

• Inability to access education, work, housing, or healthcare without misgendering oneself
• Inability to have gender recorded correctly on medical, legal, educational, and other records
• Hospitals, prisons, care-homes and other institutions failing to recognise gender accurately
• Lack of accessible public facilities (toilets, changing rooms, sports facilities, etc.)
• Facing constant misgendering by others in relation to pronouns, titles, and everyday terms
• Everyday harassment, discrimination and hate-crime, leading to feeling very unsafe
• Inability to access many trans healthcare services due to lack of non-binary provision
• Feeling forced to present as male/female to be accepted, access work and make a living
• Intense school and/or workplace bullying due to gender expression
• Being labelled as 'difficult', 'dangerous' or 'unprofessional' when being open about gender, and the negative impact of this on employment, salary, childcare and/or accessing services
• Being forbidden in school or work settings from presenting as non-binary -no legal recourse

Anything else you want to say on this topic?

As well as the book with Alex, I have a recent book out which covers a lot of these ideas about gender - and sexuality - in comic form.

My clinical colleagues Christina Richards, Walter Bouman and I are also just finishing a book which covers everything about non-binary gender for psychologists, medics, surgeons, etc. We hope to ensure that non-binary people have as easy an experience with gender services in the future as trans men and women do. This paper gives an overview of some of that material.