Thursday, October 29, 2009

A Statement of Support for the Liverpool Homophobic Hate Crime Vigil

On Monday 26th October this year a large gang of youths surrounded and attacked a 22 year old gay man, James Parkes, as he left a bar in Liverpool City Centre. He was left with serious head injuries.

The attack is being treated by Police as a homophobic hate crime and some arrests have already been made.

This was not the first attack of its' kind. Recently another gay man was beaten to death in Trafalgar Square London. Going back further there have been many other such atrocities, including the murder in Liverpool of Michael Causer last year.

Liverpool's Lesbian and Gay community is holding a vigil in the city on Sunday November 1st as the nation increasingly wakes up to the reality of homophobic violence.

In my official capacity as Chair of the North West Region's Equality and Diversity Group I agreed with my associates that I would make this statement of support to the organisers of the vigil.

A statement of support from the Chair of the North West Equality and Diversity Group, Christine Burns MBE, on the occasion of the vigil against homophobia in Liverpool, Sunday 1st November

The North West Equality and Diversity Group (NWEDG) – a network of more than a hundred public private and third sector organisations from all parts of North West England – deplores the senseless and hate motivated attack on James Parkes last Monday, 26th October.

The North West's public agencies have a strong record of promoting the equality and safety of all our 6.9 million citizens, and recognising the value that their immense diversity brings to the character and success of our region.

That includes the estimated 612,000 people who are Lesbian, Gay, Bisexual or Trans.

Regional Equality and Diversity Strategy

As Chair of NWEDG, and as a lesbian woman with an open and proud trans history of my own, I am doubly glad (and conscious) of the commitment I see all the time from my colleagues in the Regional Leaders Board (4NW); the Regional Development Agency (NWDA); Government Office North West (GONW); our strategic health authority NHS North West; and the Equality and Human Rights Commission.

That public commitment is reflected in the Regional Equality and Diversity Strategy, which clearly identifies the goal of reducing all hate crime as one of our three key priorities for strategic action.

No place for hate

Hate crimes – whether against ethnic minorities, disabled people or those who are gay lesbian bisexual or transgender – are the extreme expression of senseless intolerance and discrimination.

These heinous acts can have no place in a modern, plural society – a. society which is fast becoming even more diverse.

There will be more old people, more short term economic migration, more ethnic minorities and mixed marriages, and more openness and confidence about people's sexuality and gender identity.

It's not always that the population itself is changing. It's that people like myself can now be open and honest about who we are and share our experiences of life with our friends, neighbours and colleagues.

We say to those who are uncomfortable with these shifts "get over it!"

In fact I would go further and say that as a region we must embrace and capitalise on our diversity.

There is considerable evidence that if we are positive about diversity and at the same time move towards greater equality, then the North West – its communities and individuals – will be more prosperous and have a better quality of life.

The causes

But we also need to understand why hate crimes still exist.

It's 40 years since homosexuality was decriminalised. Many centuries have passed since England first became a multicultural country – a country of Romans, Angles, Normans, freed slaves and protestant refugees. And all that was even before the industrial revolution!

Hate crime and discrimination begins – like all intolerance – with fear of difference and our own insecurities.

That fear is fanned by ignorance and frequently, but not always, poverty.

It gains strength from a culture where bullying is all too common, and where the majority are sometimes too ready to sit on their hands and stay silent.

Not isolated cases

This week's attack on James Parkes is unfortunately just one of many. I'm conscious that this same weekend there will be another vigil taking place in London because of the recent murder of Ian Baynham. In Liverpool we also remember the murder of Michael Causer. And, later this coming month, there will be vigils all around the country (and the world) marking the annual Transgender Day of Remembrance.

The attacks on James (and Michael) are perhaps most poignant because they happened in our own back yard – in a region where we like to think we have a particular grasp of tolerance and welcoming difference.

The public shock should mark a turning point here in the North West - away from being silent on this issue and towards "equality activism".

Schools have a duty

Schools have a major role in ending the bullying culture and educating children and young people about difference. That must include teaching our children about all types of difference – LGBT included.

The excuse offered by the notorious Section 28 is no longer there. Teachers have a duty to no longer ignore homophobic attitudes, but to deal with them.

Promoting a positive message

The annual celebr8 (don't discrimin8) initiative, which is now in its third year, promotes positive messages about equality and diversity.

Just this week, in fact, we've agreed to support 12 community projects promoting community cohesion, respect and understanding.

That includes one in merseyside. And our second major annual Equality and Diversity conference is to be held this year in Liverpool, on November 11th.

It's not impossible

It's easy, on occasions like this week, to feel helpless and disempowered by the sheer horror of events. The idea that a gang of youths could pour such hate upon a young man like James is beyond comprehension for many of us.

Some might therefore wonder whether the kinds of strategic actions I've talked about can ever bring about the required change of attitudes and behaviour.

As someone who has campaigned in the past for changes that were once considered impossible, I believe that we can change our society to bring an end to senseless hate crime.

But the change starts when we recognise that it's not someone else's job. We all have a part to play. So let's all collectively send a message to the bigots, the bullies, the racists, the homophobes. We say "No to hate crimes in the northwest"

Christine Burns MBE
Chair, North West Equality and Diversity Group
29th October, 2009

Thursday, October 08, 2009

Just a change of name...

For some reason or other the simple act of changing a trans person's name and title on medical records seems to be a subject that puts some GP practices and hospital records clerks into an awful tizzy.

This recent example is typical of the kind of question I'm often asked. In this case a gender clinic was being asked for guidance by the patient's GP practice:

We have a patient who is presently registered and was born as female. They have undergone a legal name change of forename to something more masculine. In the letter that you have sent to the practice you refer to the patient as male. You are assessing the suitability for cross-sex hormone therapy; I assume this indicates the patient has not had surgery.

In order for our practise to have this patient registered as male the Family Health Services Authority re-register the patient with a new NHS number and disregard the previous document as archived.

Could you please tell me at what point this patient should be registered as male?

This kind of question is covered in the Department of Health's guide, "Trans: A Practical Guide for the NHS". A common problem is that officials sometimes assume that they ought not to make any changes until the patient obtains a Gender Recognition Certificate. In a footnote on page 30 it says,

"Note that the purpose of a GRC is merely to facilitate the creation of a new entry in the register of births, from which a new birth certificate can be issued. The GRC as a document has no other legal standing. It is not appropriate to operate a policy of requiring sight of a GRC in order to change an individual's name in patient or employee records. A statutory declaration or deed poll is the most that should be required for changes of name and title, just as for anyone else, and regardless of the individual's state of transition."

In case that's not enough, the guide then touches on the topic again and again. There are passages about medical records on page 43, on record keeping on page 55 and a best practice fact box on page 35.

Yet still these questions are asked. For these reasons I thought it would be worthwhile to feature the rest of my answer to the above query. Essentially it comes in two parts:

Firstly, the appropriate time for changing records is when the patient commences living permanently in the new gender role. It is not appropriate to insist that they have had any particular endocrine or surgical treatment – or to insist they have a GRC.

Changing name and title is no big deal. Tens of thousands of such changes are accommodated every year when women marry, so the mechanisms already exist.

The most important day to day change for a trans person is that the records contain the appropriate form of title (Mr, Miss, Mrs, Ms) and the name they have taken. UK law does not require any specific process for that. You and I can change our names at any time just by telling everyone that henceforth we will be known as 'x'.

It's not technically necessary to have a piece of paper (deep poll, statutory declaration or marriage certificate), but banks and other agencies prefer something to put on file, so trans people are recommended to complete a statutory declaration of their name change. As this is a legal document, NHS Trusts should take account of it. To refuse to change records on this basis would be unlawful discrimination.

The second consideration is how records work for the purposes of sex-specific screening (e.g. inviting women over 50 for breast screening or people with prostate glands for checks). The Trans Guide again explains very clearly (top of p43) that screening should be on the basis of physiological need. Thus, depending on the way their systems work, GP practices and hospitals must make appropriate arrangements.

I'm not familiar with the precise operating details of these systems, but if it's possible to make a distinction between title (Mr / Miss / Mrs etc) and sex, there is a decision to make over whether the sex indicator should be changed or not.

A balance needs to be struck between calling the patient for the right kinds of screening and fulfilling the requirements of the Gender Recognition Act when they have a GRC. (i.e. A flag that says a trans man is female could be visible to people who should not see it and the practice would break the law in terms of unauthorised disclosure of protected information).

The best way in my view is to change the flag (as it should be) to reflect the transitioned gender and simply make alternative arrangements to screen the patient. E.g. diary events could be set up on the patient's personal record.

This is preferable in any case as a trans man would need to be seen for gynaecological examinations in a setting which preserves his privacy and dignity. I.e. You wouldn't just let the computer send him along to sit in a clinic full of women.

The same goes for a trans woman needing BOTH prostate exams and breast exams but not gynaecological tests.

Issuing a new NHS number is OK – and some trans people specifically request this. I'm not clear whether there's a gender indicator buried in the number or not. Conflicting answers have been given on this.

However, issuing a new NHS number is separate to the question of whether the patient's medical record should be replaced. Clearly that would not be in the interests of the patient.

The best thing, however, is not to try and make these decisions on a blanket policy basis but to sit down with the patient and discuss the options and the implications so they can decide what's best for them in an imperfect system.

For instance, if one option would mean that doctors couldn't access their previous medical history then patients may well decide that that isn't in their interests.

Remember that all people want is an appropriate sense of privacy, protection from disclosures that could make them vulnerable in their wrong hands, and respect for their dignity.

Sunday, October 04, 2009

Dear Sir or Madam – The New Edition

Dear Sir or Madam; ISBN 978-0-9562734-0-6; £13.99; Published by Mark Rees; Order enquiries markrees (at)

Just under eighteen years ago, on Thursday 27th February 1992, the organisation called Press for Change came into existence in a tea shop.

The tea shop is gone now. There is no blue plaque.

Instead, on the site, stands Portcullis House – the imposing steel, concrete and glass building full of committee rooms and the offices for many MPs.

There is no official history of Press for Change (PFC). The tiny organisation was too busy making history to fuss too much about writing it down.

Obscurity to success

In the ten years between 1995 and 2005, in particular, the campaign went from obscurity to a point where its' primary mission had been achieved. It had seen a succession of ground breaking legal cases alter the way in which transsexual people were viewed.

Employment discrimination was outlawed. It became unlawful to operate any kind of systematic bar to NHS treatment for gender Dysphoria. Hundreds of people obtained practical legal advice. A process was created for transsexual people to obtain birth certificates supporting their lived reality. They could marry someone of the opposite gender or have a civil partnership with a same sex partner. Later on, in 2008, discrimination in the provision of goods facilities and services was also outlawed.

It's a remarkable achievement for a few volunteers working in their bedrooms, and of course I'm proud of the small part I played in that, along with others.

Some of the solutions weren't perfect, but that's politics. A job still exists for people to build on those achievements – particularly to rectify the inequities and embed true change in the country's institutions and hearts. I hope another generation will work on that and forgive us for not fixing everything perfectly at the first attempt.

Maybe, one day too, someone will write about the amazing things that went on inside that tiny little organisation with such grand ambitions. In the meantime the organisation's online web archives stand as a record of the events, day by day.

The man who started it

Whatever anyone finally writes about the PFC phenomenon though, we must never forget the story of the man who – more than any other – caused the events which led to it being founded.

Mark Rees is an incredibly polite and self-effacing man considering his achievements. He's really not the kind of character you'd expect to take his country to the European Court of Rights and make the kind of history which would start a movement.

And quiet mens' achievements can so easily be missed and forgotten when history comes to be written. This is why I'm so keen for people to know Mark's story

First edition

Mark published the first edition of his autobiography, "Dear Sir or Madam" in 1996, just as PFC's campaigning in the UK was beginning to pay off.

Sir Alex (now Lord) Carlile QC described it at the time as "A brave and honest plea for justice .. a story of suffering and success". The New Law journal described it as "Not only moving but required reading for anyone legally and medically concerned". It is a remarkable book.

The first edition, promoted by Cassell, told the personal story of Mark's own life from birth in December 1942, through childhood, going to sea, transitioning to male in 1971, taking his case to Europe in the 1980's and making the vital connections that gave birth to a campaign in the early 90's.

All the way through this very personal account, it's clear that Mark was never in doubt about his gender – and neither was anyone who met him.

But the first edition went to press at a time when the legal and social status quo remained implacably unaltered. The book recorded the genesis of Press for Change but, for Mark, the prognosis in late 1995 remained really rather bleak and daunting.

Cassell finally ceased publication of Dear Sir or Madam in 2003 and, oddly, I never got to read it because I was always too busy.

Rewriting the end

Shortly after Cassell deleted Mark's book, Parliament passed the Gender Recognition Act in July 2004. Thousands of people's lives changed as a result.

With bitter irony, however, Mark was in a unique position which meant he couldn't benefit without losing his small state pension.

Eventually, when he was old enough for his pension to be unaffected, Mark thought again about applying for the legal recognition he had sought all along – the quest that laid the historical foundations for eventual success.

Again, with cruel irony, the delay meant that Mark could no longer use the simplified application procedure for legal recognition. He would have to go through the full process. He explains the complexities of all this in an interview I recorded with him back in 2007 and rebroadcast in 2008.

A little administrative matter

Mark describes it as "a little administrative matter" and pays touching credit to the little part I had in finally overcoming the obstacles for him to receive his very own Gender Recognition Certificate and new birth certificate in 2008, thus bringing his story to a new and rather more satisfying place after 66 years.

So it was entirely fitting that Mark should decide to update his autobiography to include the amazing things that had happened in 13 years since the last, and his own altogether happier ending.

Cassell, the original publisher, thought that by now the life story of a trans man wasn't interesting enough to publish themselves. Fortunately, these days, people can publish their own books quite easily though ... which is what Mark has done.

So if you're at all interested in the history of how Press for Change came to be formed, or what it's like to live through nearly seven decades of life as a trans man, this is your book.

Order from the man himself

You'll need to order the book from the man himself. You can email him at markrees (at) At 67 you'll need to be prepared to deal in old technology. Mark relies on a computer at the local library and old style ways of commerce like cheques and snail mail. In return, however, I'm sure he'll agree to inscribe your book personally. It's a delightfully olde-worlde process.

And if you'd like to help him then I'm sure he'd be happy to discuss how you can buy a handful of copies to sell on to friends.

Above all though, do make sure you read it. Mark has a lovely style of telling his personal story. He describes terrible obstacles but is never bitter. For, in truth, he really has always been a gentleman.