The clock is ticking

Methinks the window of opportunity for the Royal College of Psychiatrists to do anything to dig themselves out of the hole they’ve so cleverly constructed for themselves is closing. Fast.

Like a rabbit paralysed in the headlights of an oncoming vehicle, their response is too slow, too little, too late.

Because, as those brought up in the subtleties of politics will tell you, its not just what someone does that counts, but how they do it, when they do it. A government Minister caught out for some minor indiscretion by the press, who comes clean instantly, apologises and promises not to do it again, will probably survive. One that blusters, denies, twists and weasels: they probably won’t, because over the evolution of the story, it is not the initial impulse to shick! Horror! but their reaction that eventually becomes the story.

And the story so far with the Royal College of Psychiatrists is roughly thus.

The Gathering Storm

Their Gay and Lesbian (but NOT Trans) Special Interest Group decided to hold a conference on trans issues. So far, so clumsy – but that’s all it was. This could well have been a positive event, leading to greater rapprochement between psychiatry and the trans community, who already view that profession with deep suspicion.

Unfortunately, they didn’t talk to the trans community and opted, either through incompetence or a desire for cheap publicity, to go for two serious transphobe speakers: the inimitable Ms Bindel, and preening media tart, Dr Az Hakeem.

(OK: there’s nowt wrong with being a media tart. I’m one, too…but then its my day job and I don’t also claim to be a serious therapist).

This has excited some comment, of which a selection below:

Psychiatrists plan transphobic conference

Message to the RCPsych folks about their conference

falsely shouting fire in a crowded theatre with debate on this thread

cis people telling trans people how they should think, feel, be, act

Bindel again involved in deciding trans people’s future

RCPsych, Julie Bindel and Witchcraft with debate on Yahoo

Psychiatrists plan transphobic conference in london

Of course, it isn’t all bad news for the RCPsych, given that they have received fulsome praise from GenderTrender. Though maybe the fact that that blog is one of the most bigoted, irrational collations of hate in respect of trans issues out there ought, perhaps to give the RCPsych pause for thought.

Peace or War?

At base, however, the response from the trans world has been universally hostile, universally disgusted, as this conference seems to prove all the worst that we believed about psychiatrists.

So, a few weeks back, dialogue began, with management over at the RCPsych. It would definitely have been nice if the organizers of the conference would deign to speak directly to us po’ trannies: but it was not to be. Not one individual from the GL SIG could stir themselves to pick up the phone or write an e-mail.

Instead, platitudes were exchanged through a third party. There are “regrets” at how the conference is being perceived, and no intention to cause “alarm and distress”. The trouble is, this is not honest engagement or response: this is news and crisis management. The simple, sensible route forward is to talk to us.

Apparently psychiatrists don’t like to do that: or rather, its ok so long as we are on the couch, power lines clearly drawn. But treat trannies as equals? Perish the thought!!!

And now, unless action by the RCPsych is radical and a good deal more inclusive than it has been so far, the end-game looms. Some trans men and women will picket and/or demonstrate when the delegates turn up. I understand that support is growing amongst students and student unions, so this is likely to be a not insignificant event.

Others are muttering quietly, off the record, about simply ensuring this conference does not go ahead. Given the recent example of UK Uncut, I do hope that the RCPsych has the budget to pay for the security this conference is likely to need.

“The lights are going out…”

Otherwise, this feels a bit like 1 August 1914. (Ah yes: I remember it well. : ) )

Huh? What is she blethering about? Well, after the Austrian Archduke got shot at the end of June that year, the various European powers went into a huddle in a last ditch attempt to avoid war. On July 31, Russia mobilized. The next day, so did Germany.

Late on 1 August, the German leader, Kaiser Wilhelm had second thoughts and tried to rescind the mobilization. It was, his generals informed him, too late. If he had wanted peace, then the time to achieve that was in the days before mobilization started – but once started, it couldn’t be stopped.

Which takes us neatly back to the start. The window for the RCPsych to avoid an ultimately damaging confrontation is closing. Its not shut yet – but it will soon, and if they are not careful, they are likely to end up with the worst of both worlds: no conference, and an enduring rift between their members and the trans community.

And psychiatrists are supposed to be intelligent people?

Jane
xx

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About janefae

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15 Responses to The clock is ticking

  1. Historical note. This wouldn’t be the first time the RCPsych’s actions have given rise to a trans street protest — except that the last time it happened to take place outside the Royal Society of Medicine, where they were staging a joint conference.

    The reason on that occasion was the attempt by a Nottingham Psychiatrist, Dr Brian Ferguson, to impose a deeply regressive set of ‘Standards of Care’ for gender patients over the whole of Britain.

    Initially Ferguson’s proposals were casually endorsed by his peers (such as Richard Green) because they hadn’t actually troubled to read them. When Claire McNab of Press for Change forced them to do so, they hastily withdrew their signatures.

    Not to be deterred, Ferguson pressed on and insisted on presenting his proposals to a very mixed reception inside the RSM (April 2002), whilst the largest trans picket of the age held a peaceful vigil outside.

    The result of this car crash was the creation of a joint RSM/RCPSych committee, chaired by Prof Kevan Wylie, to develop new UK ‘guidelines’ for treatment.

    The committee featured trans stakeholders as well as clinical members. I wasn’t directly involved; however the text was such a mess after a couple of years that I stepped in and (with the aid of Tracy Dean) substantially rewrote them .. retaining the clinical material, but adding essential context that was missing.

    The process rumbled on but ended in a standoff, as there were parts (such as the number of clinical opinions for FtM chest reconstruction) that the clinicians stubbornly wouldn’t give way on. Press for Change warned of legal challenges. The RCPsych got a Barrister’s opinion .. and the Barrister essentially agreed with PFC.

    As a result of that, nine years after they began work, the guidelines for treatment still haven’t been published. The college would rather sit on them and have no formally endorsed guidelines for care than tackle the clinical sacred cows that wouldn’t stand up to equality and human rights law scrutiny.

    Frankly, the latest mess therefore comes as no surprise to me at all.

  2. Emily says:

    What a train wreck this is. Unfortunately, the arrogance of a lot of the medical community will continue to result in such messes and it’s only by shouting about it that we have a hope to change that.

    I do hope I’ll be able to make it to the UK to join that protest.

  3. A thought…

    Those who have no interest in our history are quite content to carry on repeating theirs

  4. Pingback: The angry post… « Jane Fae's Blog

  5. Psychiatrists are intelligent people. Well, some of us are.

    This “debate” has been on the cards for a while. It’s probably fair to say that, as a clinic, we’ve been divided in terms of how to respond to an event already set up with non-clinician Julie Bindel and Dr Az Hakeem providing stances based on anecdote but limited evidence. To some extent, it could be argued that even the act of engaging with an ostensibly absurd/obscene topic to point out its absurdity/obscenity lends that topic a spurious pseudo-legitimacy it does not deserve. This is a valid viewpoint and one with which we have wrestled.

    Those of us taking part do so because we felt, after much discussion, that it was important to inject some actual clinical evidence/experience into what might otherwise be a display of largely uninformed opinion.

    Please do not tar all psychs with the same brush.

  6. Stuart makes an important point. If anyway doubts his genuineness you could do worse than to listen through this in-depth interview which I recorded with him a couple of years ago

    Half and hour with Stuart Lorimer

    • janefae says:

      Agreed, Christine…and no desire to “tar all with the same brush”. I think, as i think about this more, that my issues boil down to two or three.

      First is the way in which some bods sort of self-appoint themselves to know other peoples’ minds better than they themselves. That’s a difficult one, since, as you and i both have past experience of politics, its also an accusation thrown at anyone who is an activist.

      That said, i always (i hope) tend to approach political issues with a degree of self-doubt: I might always be wrong. Its when people lose that awareness of their own fallibility that they become dangerous.

      Second, i have a long-standing beef with psychiatry, which long predates any trans awareness at all. Its around the way in which psychiatry is represented as “science”, when in many, many cases, it is little more than collated anecdote.

      And whilst i’m not simplistic enough to demand “aut Popper aut nihil” of my science (translated: “either it agrees with Popper or it sucks!”), and i’ve read critiques of complex science such as those put forward by Quine et al, I am still outraged by the epistemology of it all. Basically, psychiatry, in far oo many places, lays claim to a status for its insights when the evidence base is about as good as that for astrology or homeopathy.

      That doesn’t mean i think all psychiatrists are evil. Nor that they do no good whatsoever, since i am a firm believer in the power of (self-)analysis to bring about change.

      Rather, i think its the claim of an “expert” to be able to frame and understand better than the subject the import of their remarks. That is the point at which Psychology parted company from Freud, with the way lighted by pioneers such as John Watson (the founder of modern behaviourism).

      In that sense, perhaps my real target is psychoanalytic theory. Dunno…i’d be interested in anyone who came back at me with a reasoned explanation of “what psychiatry has ever done for us”, in a way that neither medical nor psychological models of mind and behaviour could have.

      jane
      xx

  7. I was very disappointed when I say the programme as it really didn’t seem to offer anything new and the fact that they hadn’t found a trans speaker for the ‘personal perspective’, that this was TBC and that they placed it as the last presentation implied they were an after thought and that their biography wasn’t put alongside the ’eminent experts.’ It was evidently tokenistic.

    We’ve been running trans affirmative training for therapists for some years now and it’s lamentable but perhaps unsurprising that the UK has NO openly psychiatrists who are trans.

    This event perhaps could benefit from the kind of mutiply focussed political action that the American Psychiatric Association had to undergo in the late 70’s to remove homosexuality as an mental illness. There is a fascinating podcast detailing that story here: http://www.pinktherapy.com/downloadables/DSMHx.mp3

    • janefae says:

      I understand they are trying to find a psychiatrist/psychologist who is also trans…which might go some way towards satisfying demands. All the same, the fact that they are going off on their own to find such an individual and not being prepared to talk to some of the most active trans groups around speaks volumes in terms of “good” faith.

    • I know of several medics and psychologists who are trans. The majority are “stealth” and, frankly, I could never bring myself to blame them for this. There is a tendency, sometimes, within this field, to prioritise identity over training/experience. Almost all of the individuals I know are concerned that they would become known for being trans rather than being respected for their clinical or academic expertise.

  8. I know Professor Mike King, the chair and I have a great deal of respect for him. He’s done an amazing amount of brilliant research into LGB mental health issues.

    I don’t know the extent to which he’s been involved in programming the event, and I imagine he has been involved. I just can’t figure out why the lack of consultation and dialogue with the trans community.

    I hope this DOES lead to dialogue and ACTION! It’s sorely needed 🙂

    • janefae says:

      If you’ve not already, you should warn him of choppy waters ahead on this. If the RCPsych were principled, they would have done that already, but i am not so sure they have.

      Whatever the original motivation, what i am seeing here is not simple transphobia, but the sort of corporate inertia that seizes poor and mediocre organisations when a crisis hits. What was needed was swift action and instant engagement. However, partly because that is seen as “weakness”, partly because the inner bureaucracy makes that difficult to impossible, you get this sort of dog in manger foot-dragging response, which almost always makes things worse.

      Ah, well….

      jane
      xx

  9. Josephine Dunn says:

    “Psychiatrists are supposed to be intelligent people”. Ah Jane – what we would hope for is that they are intelligent people. What they are is over academic badly confused people who want to put things into buckets (see intro to Human Behavioural Biology with Stanford professor Robert Sapolsky – a very sound chap). They become ‘upset’ with things they can’t put into a bucket. As Terry Pratchet would say – you make wine out of things you can put in a bucket and eat things that crawl out of one. Putting people into a bucket is problematic as – no matter how large the bucket is – they will keep trying to get out. And then the psychiatrist becomes ‘upset’. If anyone needs ‘fixing’ , it is the psychiatrists who have failed to evolve to the level of thinking properly. Why do you need to find a psychiatrist who is ‘trans’ ? Surely you just need EVERYONE to be open, sensible, decent human beings who can communicate properly and not make judgements based on whether others fit into a particular bucket? Why not start by throwing away the buckets?

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