I’m coming a couple of days late to this as the Daily Mail thoughtlessly published their piece whilst I was offline at the weekend, but it’s still worth a blog post to clarify the issues. According to an article they’ve run, (Caution: Daily Mail Link) Doctors are being “forced to carry out sex change ops” under “new guidelines” by the General Medical Council. (GMC)

(Edited to add: The GMC guidance is available on their web site. (PDF Link). The relevant piece is the footnote to paragraph 5 on page 3)

Firstly, these are very specialised surgeries and you can’t just rock up to an operating theatre and carry one out without quite a bit of training and it’s not an area one accidentally stumbles into. I only know the surgeons practising vaginoplasty (I.e. for transwomen) but there are perhaps two or three who do any significant number in the whole of the UK – Phil Thomas, James Bellringer and possibly if he’s still practising, Tim Terry.

The idea of being “forced” to carry out such an operation is ludicrous. The guidelines are there simply to prevent GPs from blocking patients who want to access these services, not push people into specialisations they don’t want to pursue.

Secondly, this is not new but just clarifying the GMC’s existing view. The GMC made it clear at a meeting in January that they regard this as bad practice already. (I do not entire agree with this stance, as getting care for Trans people often requires a GP willing to fight on the behalf of their patients and go that extra mile)

Oh, there’s some random bleating about how the marginalises Christian medics. They need to get over that obsession that followers of one particular incarnation of the gods are being persecuted, as Christianity doesn’t have a monopoly on being transphobic. You don’t even need to be religious to be prejudiced.

So pretty much the usual level of accuracy we’d expect from a Daily Mail post on Trans issues, really.

For those not aware, or who are not Liberal Democrat party members, the thorny topic of accreditation (vetting) of LibDem conference attendees has cropped up again. This time round, Federal Conference Committee (FCC) is well aware of the sensitivities and has been asking for views from the wider party on the topic.

I won’t go into the civil liberties issues, as that’s been covered elsewhere. I have however been involved in another aspect of the process, that of accrediting transgender party members and by extension, to some extent also anyone else with an inconsistent or secret previous identity such as victims of domestic violence.

The chair of FCC, Andrew Wiseman, was kind enough to come and visit myself and Sarah Brown in Cambridge in Friday for a chat and to catch up on the current situation as a precursor to us both, along with Adrian Trett (LGBT+LibDems Chair) meeting with full FCC earlier tonight.

Sarah spoke first, and has blogged her take on it after which I filled in a few gaps myself. I mentioned that CRB check rates using the Trans process are half what we would expect, suggesting that Trans folk are put off by CRB-like processes and mentioned that special application processes with organisations like the CRB tend to go wrong. Even for those of us who are out, old names are like knowing the real names of daemons from mythology of old, as they give people emotional power over us we would rather they did not have.

Also, anyone with an inconsistent past faces requests for more information, which is off-putting and creates extra work as well as possibly causing people to run out of time before conference. (I know this happened to at least two non-Trans people)

We had a few questions from FCC members. Two stick in my mind – first discussion on the CRB process. This is not guaranteed to keep anonymity even if they get it right, as unaltered records of any previous offence can be sent to a potential employer, complete with old names on. Secondly, “How to Labour handle this”. The answer is simple – pretty much every Labour supporter I know, even if still a supporter of the party, quit their actual membership after the passage of the Gender Recognition Act 2004. It appears there are very few active and out Trans folk in the Labour party these days. They are also of course the party of ID Cards, so unsympathetic to privacy concerns even among their own members (FCC thought it unlikely the Tories had many Trans members – my experience suggests this may be incorrect, presumably because they haven’t had the chance to annoy the Trans community for most of the the last decade and a half)

Members of the FCC seemed surprised by the strength of what we’d said, based on tweets I’ve seen since. I guess one gets used to pointing out that many of us risk a violent death if we’re outed to the point that is loses its impact to us and just becomes a fact of life. To your average white, straight, cis (i.e. Non-trans) person of a non-military background, a breach of confidentiality means messing around sorting out unauthorised bank transactions, not dodging bricks through the window whilst sorting out new accommodation in another city. In that respect, I’m glad we live in Cambridge and not elsewhere, where life would not be so easy.

Things are heading in the right direction, but FCC do not have the final say given the involvement of the police. After tonight’s meeting they have put conference registration on hold to give them more time to sort things out with the police, so for now we wait…

I am somewhat saddened to see the reaction if US authorities to someone having a mental health issue is to charge them with a criminal offence.

Saddened, but not surprised because that seems to be the way mental health issues are handled in the US. Luckily, the Judge has at least asked for a report into his mental health to see if he’s fit to stand trial, but it’s not looking good.

What is the point of the criminal justice system after all? Firstly, it is a deterrent. If people know or fear they will be caught and punished, it will hopefully make them less likely to commit crimes.

Would the threat of punishment have made any difference here? No, because he was not thinking straight. I would imagine very few people have sat around thinking “I’d better not have a mental health incident today, because I’m doing something important. Better put it off until tomorrow instead.”

And the justice system can be used to try to stop someone who has already committed a crime from doing so again, by either keeping them away from potential victims (i.e. lock them up in prison, bail conditions/ASBOs) or by some sort of remedial work such as dealing with an underlying drug or alcohol problem. Will that make any difference here? Not likely. Unless there was some underlying cause, such as a bizarre and unexpected prescription drug interaction, I can’t imagine he’ll be cleared bit to fly by the FAA again unless they’re really sure whatever triggered this has been fixed.

Threatening to prosecute someone for having a breakdown, whatever their job, just smacks of unproductive vigilanteism.

Blog posts relating to Tuesday night’s conference call: (In no particular order)

A few prior to that call, or not related to it:

Later additions to this list:

Mainstream press, firstly prior to the call:

And a couple from after: (Note the difference in tone!)

Last night there was a conference call between policy advisors within the LibDem party and the more vocal grass-roots, such as myself, on current proposals to extent interception powers. It was more than a little enlightening and certainly heated at times. It included the Senior Policy Advisors, (SPAds) special advisors and policy unit staff who are Liberal Democrats, but work alongside the Civil Service. Much of the job of a SPAd for example is to tell a Civil Servant that they’re proposing something the minister won’t stand for, without having to worry the minister too much about it. It’s also confidential so the minister doesn’t have to worry about negative press coverage because a Bernard Woolley civil servant has had a dumb idea.

That system has broken down here. The Civil Service have resurrected their nice plans from under the Labour Government, tweaked them a bit and put them under the noses of the new crop of advisors. But the Civil Servants don’t understand this either, so the briefings they have been giving are rather one-sided. (That’s not me being charitable by the way – they are not being all Sir Humphrey. I’ve met some of these people and they really don’t understand it.)

Miss S B has also written about the call on her blog and that’s worth a read too, along with the comments, for more on the political rather than technical/policy side.

Here is what the policy bods think is being proposed

The current situation is that the security services and police can request information from service providers that they already hold. I’ll skip the detail, but depending on the service provider they can get some idea about some phone calls made or received and emails from at least the last few days, potentially up to two years worth.

They can’t do this in all cases, for example Skype, World of Warcraft chat (Apparently this has been used by drug dealers) or similar. Even Disney’s Club Penguin for young kids could be used in this way, as the Three Lions film demonstrated.

So they want to “normalise” the situation and catch up with technology with the new programme so they retain the ability they already have.

On the call, someone from the policy/SPAd side actually used the phrase “terrorists and paedophiles” to justify increasing powers. This is the 21st Century equivalent of Godwin – any law not involving actual abuse of kids that requires “OMG PAEDOPHILES!” to justify probably should never be enacted or even ever discussed again.

Here is what is actually being proposed

The briefings have been one-sided, as I’ve noted. As a result, claims of “scaremongering” by Nick Clegg and that the coverage is “complete nonsense” by Lynne Featherstone is probably in line with what they are being told by the Civil Service and what they genuinely believe they are discussing.

It is also wrong.

We had to explain it several times, but it was clear that the policy folks did not understand they were shifting the balance between retaining and obtaining. At the moment, service providers can hand over information they already retain in the course of normal business and require an interception warrant from the Secretary of State to obtain anything more than this.

The new proposals would oblige service providers to obtain information that they currently don’t – basically, to dive into the contents of the traffic we’re carrying to figure out not only that you’re sending traffic to a Google mail server or World of Warcraft, but what that traffic really does.

One analogy that has been used is asking Royal Mail to record all mail, with details of who sends mail to whom, which is already pretty bad from a civil liberties perspective. But it is actually worse than that, because we are being asked to open all the mail and check to see if the envelope actually contains another letter inside to be forwarded on to someone else. Or not just record that you rang a voicemail service, but listen in on the call to see who left you messages.

And they think we can create a system to open these letters and listen in on these calls without risking also creating a system that might be able to read or listen to the content. And that we’re able to guarantee keeping the data secure – on a system that by necessity has to be connected to the internet – once collected.

To give them credit, the policy folk did say that this was a red line they were not willing to cross. However, they do not yet accept (Because Civil Servants tell them otherwise) that this is what is actually being proposed. If we can can convince them of this, by convincing them that the party grass roots does know what it is talking about on technological issues, I would expect the plans would get dropped pretty quick.

The situation now

There has been a degree of back-tracking from the top in response to a level of grass-roots reaction that has surprised them. Initially, it seems there were plans to announce legislation (Without consultation?) in the Queen’s speech. That’s now been watered down to “draft legislation” and vague noises about “consultation”, but it is not clear what the form of that draft legislation or consultation would be.

So it’s not hopeless. But we do still need to keep the pressure on those at the top to make sure they can’t change surveillance powers without being held properly accountable not to the civil service, but to the wider party.

Sadly, I don’t have time to write at length (again) about the leaked plans to keep a database of everyone’s communications. Ironically this is becase I’m busy today running the very thing the spooks want to snoop on, the internet. My own views are on record anyway, as my first speech at LibDem conference was in favour of this amendment on the topic and I’ve blogged about it before.

Here’s a quick summary of the plans: They’re ill-conceived and illiberal. I have yet to see one good argument for the proposals as they all seem to boil down to TERRORISTS EXIST or once this morning PEDOPHILES EXIST. There is little evidence that these plans will help, as my personal experience has shown – plod came to me asking for communications information under existing legislation several months after kicking in the doors of some terrorists. No snooping, no interception warrants under existing powers, just “good old fashioned policing”.

I didn’t have the data after that long, unsurprisingly. Perhaps we could spend some of the money on currently leaked plans to train police better in dealing with online crime instead?

But I am worried, even if Mark Pack isn’t. Yet.

Not that worried, as I’m always skeptical as every time plans like these come up, it’s always “confidential briefings” and assurances from journalists that they have a “reliable source”, so we don’t really know what’s going on.

But it’s pretty obvious someone wants more power than they currently have. Did someone on “our side” leak the plans to try to kill them as Jennie suggests? If so, good on them. I don’t even mind if the LibDems take some flack for it if it means we kill it.

But they didn’t tell the rest of us and caught many off guard, which might explain the rabbit-in-headlights response from the top of the Liberal Democrat party.

Or did someone on “the other side” leak it test the waters and soften us up for what is to come in advance of the Queen’s speech? I would hope that the reaction has made them see the error of their ways, but I know that is a misplaced hope.

I’ll close with a message to anyone at or near the top of the LibDem party reading this: We’re a broad church, with people from both the left and right, so topics like the economy are bound to cause splits.

But this one shouldn’t be difficult. To make it easy, we put the clue in the name of the party: Liberal Democrats. Please let’s not go all “People’s Democratic Republic”, a code phrase for a communist dictatorship, where we dispose of ideas we like least in the title.

There have been a couple more answers from Leeds GIC in response to Freedom of Information requests. The first is the “Information for Referrers” leaflet (PDF Link) which details what steps GPs should take before passing someone on to the service. We already suspected the most interesting part of this, specifically: “The GP would need to provide an up to date physical examination report…In addition to the physical examination an examination of the sexual characteristics would be highly desirable.“. I struggle to see how a physical examination of “sexual characteristics” at this stage can be justified, particularly when by a GP who is not going to have the experience to do this sensitively. The only time I had any form of physical examinations were by the surgeon and electrologist, which despite being rather necessary was still, in the case of the surgeon’s visit, rather upsetting.

Most likely the main effect of this is just going to end up being unnecessarily upsetting people trying to access the service. Luckily, I’ve heard of several people that have refused the physical exam and they’ve still been able to get a referral, so this aspect appears not always to be adhered to. It’s inclusion in the referrers leaflet means people that don’t need it or want it may still end up having it however, because they feel bullied into it to access essential medical care.

One sensible aspect is getting the GP to carry out the blood tests before referral. This would hopefully cut down on delays at the GIC due to needing to go away and come back for a test, although I do not know if this is routine practice at other GICs too.

Slightly worrying is the assertion that this is a “a time-limited Pathway of Care for the maximum of three-year duration“. [sic] Having not heard of anyone being discharged from the clinic after three years while still mid-transition, I assume this is not actually enforced.

The other response was asking who had been involved in an FoI response and some rather inaccurate content on their web site, which has since been updated. In it, they start getting defensive about their policies, something I have not seen before in an FoI response. Here’s what they said:

Specifically, our Care Pathway follows the stages laid down within The Harry Benjamin International Standards of Care (this differs from the WPATH guidance), as we believe that hormone treatment is best undertaken after real life experience has begun to ensure that, possibly irreversible hormone treatment is not undertaken without there being a completely coordinated comprehensive care approach which has the ability to meet the changing needs of our service users flexibly and safely. This is paramount to a positive outcome.

Interestingly, they are explicitly rejecting the latest version of the WPATH Standards of Care with this response and reinforcing their view that hormones should only be prescribed after going “full time”. I have no idea if Leeds doctors have ever actually tried anything like talking to their patients, but going full-time is far more irreversible than hormones. Just because it’s social and not chemical/biological does not lessen it’s impact if you are treating the person as a whole.

I have not seen any studies of this, but I also suspect that those going full time before hormones are hugely more at risk of social impacts such as job loss and violence due to not “passing”.

A few weeks ago, an article appeared in New Statesman highlighting how the Met Police buried a critical 2005 report by Brian Paddick into their handling of rape cases. Having asked for a copy of the report, you will probably not be surprised to learn the Met have conveniently lost it. Here’s their reply:

Searches have been made within Sapphire Command, (who are responsible for investigating rape and other serious sexual offences), Territorial Policing Headquarters, Records Management, MPS Press Office and the National Police Library.

The requested document has not been traced.

If truthful, not only have they buried the document so that the public can’t see it, but they’ve buried it so deep that even Sapphire Command don’t have it. Given those are the folks who currently investigate rape and might be best in a position to implement the original recommendation to adopt a “consistent, victim-centered approach”, that’s worrying.

I don’t know who found this first – it was all over twitter yesterday. It seems Urban Outfitters have joined the ranks of retailers using casual transphobia in their products with this greetings card, described by them as “charming”. (Update at 1130, 19th March: The card appears to have been pulled. The link now shows just that the product has “sold out”.)

In case it gets pulled down – I hope it does – here’s the text:

Jack and Jill,
Went up the hill,
So Jack could see Jill’s fanny,
But Jack got a shock,
And an eyeful of cock,
Because Jill was a closet tranny.

Their twitter account, @uoeurope has had a large number of (Polite so far, I’m pleased to say) messages asking for an explanation. No response as yet.

Yvette Cooper, shadow Secretary of state for the Home Office and shadow minister for Women and Equalities made a bit of a faux pas yesterday. She wrote an opinion piece for Pink News – which I agree with the ideas behind, even if I’m suspicious of the motives – calling on the government to introduce more marriage equality by allowing same-sex religious marriage.

Unfortunately, it seems she’s not that well-informed on LGBT issues and neither are whichever Labour HQ staff proofread the piece. Badly informed enough not to know what the T in LGBT stands for in fact.

Here’s what one paragraph near the end initially included…

We know there are other prejudices many who are lesbian, gay, bisexual or transvestite still face from homophobic bullying in school, to discrimination at work.

Oops.

The line was rapidly corrected to say “transgender”, with Pink News blaming the error on a “typo in the original copy”. But this is Labour’s second error in a week, the first Ken’s London mayoral manifesto making errors on healthcare comissioning.

I do not regard this development as a good thing. Effective government requires effective opposition and it’s harder to push a topic when the opposition are floundering.