PARLIAMENTARY DEBATE
Transgender Equality - 1 December 2016 (Commons/Commons Chamber)
Debate Detail
That this House notes the UK’s status as a pioneer in legislating for equality for LGBT people; welcomes the Government’s announcement of a new trans equality action plan; and calls on the Government to review its response to the recommendations of the Women and Equalities Committee’s report on Transgender Equality to ensure that the UK leads the world on trans equality rights, in particular by giving unequivocal commitments to changing the Gender Recognition Act 2004 in line with the principles of gender self-declaration and replacing confusing and inadequate language regarding trans people in the Equality Act 2010 by creating a new protected characteristic of gender identity.
The motion stands in my name, those of the hon. Members for Lanark and Hamilton East (Angela Crawley) and for Brentford and Isleworth (Ruth Cadbury) and many other hon. Members. I know many wanted to speak here today, but their other commitments in the House have precluded them from doing so. Their names are listed on the Order Paper.
The Backbench Business Committee has been most generous in allocating the time for this debate, which was inspired by the transgender report published by the Women and Equalities Select Committee in December 2015. I would like to thank, too, the hundreds of people and organisations who gave written and oral evidence to the Committee—evidence from more than 250 people and organisations. We were fortunate in having our specialist advisers, Stephen Whittle and Claire McCann to advise us. Indeed, we had an incredible Select Committee staff, particularly David Turner, Gosia McBride, Sharmini Selvarajah and Helena Ali. I also thank my fellow Select Committee members, particularly those in their places today to speak in the debate.
This is a first—the first ever debate on the Floor of the House on transgender issues. The report published by the Women and Equalities Select Committee was the first ever parliamentary inquiry into transgender issues. As you know, Mr Deputy Speaker, the Select Committee itself is the first ever such Committee charged with scrutinising the Government’s policies on equality issues. It was established by the House because of the pivotal role that these matters must play in creating a fairer society for us.
When we published our first report and chose to focus on transgender, a few people said to me, “Why are you choosing to focus on that above all other issues? Why use such an important platform to tackle the issues faced by such a small group? Surely there are issues that are higher on the list of priorities.” Others said that they had never met a trans person, and were not aware that they had any trans constituents. Well, it is estimated that more than 650,000 people in this country can identify with being trans: it equates to 1,000 people in every constituency, and that is probably a gross underestimate.
The evidence that the Select Committee received gave us an opportunity to gain some sort of insight into the prejudice, discrimination and ignorance that trans people endure every single day of their lives, but also the great joy that they experience when they are able to be recognised by the gender with which they identify. That is why this debate is important.
This debate is important because it is our job to stamp out prejudice wherever it lies, and to ensure that, as a nation, we are fair to everyone. I think we should judge our success as a Parliament by the way in which we treat the most marginalised and disadvantaged groups in society, and, given the issues with which transgender people must deal, they certainly fall into one of those groups. In striving for the recognition of equality rights that trans people need to enjoy, we reject prejudice, and by doing that, we improve the ability of all who are struggling to be treated equally to achieve their aim.
Attitudes are not static. I think it incumbent on us in Parliament to continually re-evaluate what equality means—what it means to have a free and fair society that gives everyone the opportunity to succeed. If attitudes towards equality were static I would not be standing here today, and the hon. Ladies on our green Benches would not be sitting here today; the civil rights movement in the US would not, in the year I was born, have outlawed segregation in schools and public places; Nelson Mandela would not have been democratically elected in South Africa; homosexuality would not have been decriminalised here in the UK in 1967; and we would not have equal marriage for same-sex couples. We need to continually challenge these norms and things that might be accepted, so we can be sure that equality evolves over time.
Trans people have not been dealt with fairly in this country—they have been marginalised. We know that is wrong, and the motion challenges us to consider what we can do better in the future.
The Select Committee report covered a huge range of issues, because that is what was required of us, making recommendations on hate crime, gender markings, prisoners and probation, media representation, schools and social care. I welcome the Government’s very positive responses to our report. Perhaps the Minister in her response today can indicate whether the Government have been able to look further at the issues on which the responses were perhaps a little less positive, because Committee members felt very strongly that every single one of the recommendations we put forward had merit and needed to be looked at, although there was a large number of recommendations—more than 70—so it was clearly difficult for the Departments to respond to them all in the time available.
Today is about looking at progress, so I will focus particularly on the strategic and legislative aspects of the Select Committee report, in the full knowledge that the great number of other Members here today will pick up on progress on the recommendations made for the NHS, child protection, offender management and schools.
The Government have committed to a new trans equality action plan to include a review of the Gender Recognition Act 2004 and a cross-Government review of removing unnecessary requests for gender information. All these steps are hugely welcome, but particularly the undertaking to look at training for specialist NHS staff to work in gender identity services, and tackling harassment and bullying of transgender people in education.
The other part of the Government’s response that I was heartened to read, as it is important for us in terms of planning for the future, was about the need to get the data right in this regard by better measuring the number of trans people in the UK, and also better monitoring people’s attitudes. If we are really going to tackle inequality in this area and really ensure trans people are able to enjoy the equality we all voted for in the Equality Act 2010, we need to make sure that we take the public with us and that there is the cultural change that is needed.
Perhaps today in her response, the Minister—who has been extremely generous with her time, thinking about these issues and talking to the Committee about them—will tell the House what issues in the 2011 action plan remain unaddressed, and what the status of the new plan is—when will it be published and how will the Government monitor its implementation? If we start to see this sort of certainty, trans people will have more confidence in the fact that not just the Government but public services are starting to get to grips with the issues they have to tackle on a daily basis.
The Gender Recognition Act was pioneering in its time. We criticised it slightly a few moments ago, but it was put on a pedestal as being pioneering—albeit a little late for the constituent of the hon. Member for Angus (Mike Weir). Now it needs updating, however. In particular, concern was voiced to us about the medicalised, quasi-judicial application process that is used. The Government have undertaken to conduct a review of the Act, and perhaps to de-medicalise the process and, as the previous Equalities Minister, my right hon. Friend the Member for Loughborough (Nicky Morgan), said, to
“overturn an outdated system and ensure the transgender person’s needs are at the heart of the process.”
Again, I was very heartened by that very positive response from the then Equalities Minister in July of this year.
Where is that review at the moment? Has the process been streamlined and de-medicalised, as indicated in the response to our report? Will the Government be considering again the Committee’s recommendations around the principle of self-declaration, which I believe would again put this country at the forefront of trans rights on the global stage, so that again we will be leading, as I believe we would like to as a country, on all LGBT rights?
Finally, I want to talk about primary legislation underpinning the rights of trans people. In our report, the Select Committee made the simple recommendation to change the terminology in the Equality Act by making the protected characteristic “gender identity” rather than “gender reassignment”. The Committee was concerned that, based on the evidence and on the legal advice that we took, the current wording does not adequately protect wider categories of people. It provides for trans people in the process of undergoing gender reassignment, but not the many people who may not have clear legal protection—those who do not live full-time in their preferred gender, non-binary or intersex people, or perhaps children whose gender identity is less well-developed than that of an adult.
The Equality and Human Rights Commission has recommended that a broader definition would be clearer and give more certainty. The current wording is outdated and confusing, and we believe that our proposed change would be in line with the Yogyakarta principles and with resolution 2048 of the Parliamentary Assembly of the Council of Europe. The Government have not yet accepted this recommendation, but the Minister has undertaken to keep it under review. Will she update the House today and look carefully at the Bill that I have just presented to the House with the support of other hon. Members?
To get things right, we need the right laws, the right strategy and the right culture. The report we published in December 2015 revealed serious shortcomings in legal protection for trans people and in the delivery of public services. We need to have a clear direction of travel. Our Committee has set out more than 70 recommendations, and the Government have undertaken a considerable body of work as a result of that. I hope that today’s debate will give a flavour of their direction of travel, in order to provide clear optimism for trans people in this country. I hope that it will also remind Ministers of the human cost of not taking the actions that are needed.
As an advocate for LGBTI equality, I am very proud that the first report from the Women and Equalities Committee focuses on the problems faced by the trans community. In the spirit of true equality, every sector of society should feel truly equal and it is our responsibility as members of the Committee and in life to ensure that that is the case. I believe that the Government’s response to our report is woefully inadequate. We need to ensure that the individuals who contributed to the inquiry and those who experience daily discrimination feel that the Government are heeding their calls for more equality. Trans equality must be the priority of every Government across the UK. I know that the Minister shares my passion for equality and I hope that today’s debate will give her an opportunity to respond, to hear the cross-party calls and to take action. I should also like to thank my friends and fellow Committee members, the right hon. Member for Basingstoke (Mrs Miller) and the hon. Member for Brentford and Isleworth (Ruth Cadbury), for securing this important debate and for their continued commitment to the cause of transgender equality.
We have only to look at the statistics from any mental health charity to understand why this debate is necessary. When one in four of the children in Scotland who identify as trans face bullying, discrimination and hate crime on a daily basis, we must do more. Statistics from Mind indicate that more than 40% of trans individuals have contemplated suicide and that, tragically, some of them have ended their own lives as a result of their experiences. This group of people is among the most marginalised in society. Trans individuals face disproportionately high levels of mental health problems and very high suicide rates. Discrimination against members of the trans community is an everyday aspect of their lives. Transphobia is endemic in the workplace, when accessing healthcare, in public services, in schools, in the media, in the criminal justice system and online. A sizeable percentage of individuals face this discrimination and prejudice on a daily basis.
The existing legislation provides some protections, and they are to be respected and admired. There was a time when the UK was a world leader in its approach to transgender equality. The Gender Recognition Act 2004 allows a trans person the right to a gender recognition certificate, should they wish their affirmed gender to be recorded as such on their birth certificate. This was applicable whether or not someone had undergone surgery or hormone therapy. However, this does not allow for people in the trans community who do not identify as either male or female to be recognised and protected within the law. During our inquiry, we heard from non-gendered and non-binary people who felt that they had been forgotten in the legislation. Additionally, we heard that the Act was rooted in clinical methods, requiring consent through a psychological diagnosis of gender dysphoria. The criticisms levelled at the legislation reinforce how outdated it has become. The Government must make changes to the Act to allow an approach of gender self-declaration.
Similarly, the once world-leading legislation for the trans community in the Equality Act 2010 is fast becoming outdated. It gave members of the trans community protection from discrimination, but we have heard that its provisions are routinely breached in relation to the trans community. The Act uses outdated terminology such as “gender reassignment” and “transsexual”; these are now considered inaccurate descriptors. Such terms have given rise to the misapprehension that the Act provides only for trans people who have undergone medical gender-reassignment treatment. To clarify, the protected characteristic should be amended to “gender identity”.
I am prone to mentioning the word “Scotland” often in debates, and I shall do so again now. In 2017, we will mark the year of trans equality and the progress that has been made on this issue. In Scotland, we have committed to reforming the Gender Recognition Act 2004 in line with international best practice in countries such as Malta and Ireland. In Scotland, we have committed to ensuring that all trans, non-binary and intersex individuals feel protected, because it is their human right to have their gender identity recognised in law and in life. I urge this Government to follow the example not only of Scotland but of the many other countries that are leading this best practice.
I call on the UK Government to match the Scottish Government’s commitment: 2017 marks the year of progress on transgender equality in Scotland, and the UK can continue that progress. This debate highlights the need to address transgender equality and the remaining challenges that trans and non-binary people face. Although Scotland has made huge progress towards achieving LGBTI equality in recent years and is now rated the best country in Europe for LGBTI rights, the SNP is not complacent. We are determined to tackle the unacceptable levels of prejudice and discrimination that trans and non-binary people continue to face. I hope that, as we move into 2017, we can make it a year of progress for transgender equality not just in Scotland but across the UK. In Scotland, the SNP has pledged an important step forward for transgender equality by reforming the gender recognition law to meet international best practice, so that all trans and non-binary people are fully recognised and can access their human right to a legal recognition of their gender identity.
Scotland is the best country for LGBTI equality, and the UK can continue to lead on this agenda, too. One of the distinctive parts of our equal marriage law is its more progressive approach to transgender recognition, and the UK could follow that example as well. I am not simply preaching to the choir; a multitude of countries across the world are leading on this agenda.
I wish to finish with the words of Reina, one of many trans women who wrote to me before this debate. She wanted to give testimony about what it is like to be trans in a rural community in Scotland. She said:
“Being trans is not a choice. It isn’t something where the person wakes up and just decides to be a particular way. Being this way is something that a person is born with, and which they have to try and struggle with throughout their lives, in a society that hates diversity and constantly attacks them”—
and their friends and family, and
“even kills them, for not conforming to the restrictive ideals of control freaks. Life is hard and usually short for someone who’s trans. There is a lack of respectful education and health care. There is a lack of support and understanding.”
Her words exemplify just why we need to take action: life is incredibly difficult for trans people, and the changes we can make in this place will make a huge difference to their lives. The Government must today commit to the recommendations of the “Transgender Equality” report, and offer the support and understanding that this community definitely needs. I urge the Minister to join me in making sure that 2017 is the year of transgender equality not just for Scotland, but for every transgender individual across the UK.
I say a massive thank you to the Backbench Business Committee. For the transgender community in the UK, this is the first time such a debate has been held on the Floor of the House of Commons, and it marks a very special day for the 650,000 transgender or non-gendered people in the UK. Just as we celebrated 50 years of Schools Out in the Speaker’s apartments yesterday, I hope that in 50 years’ time people will look back at this day and say that it marked a remarkable change in how people in the transgender community were considered in the UK. I am very pleased that this debate has been brought to the Floor of the House of Commons.
Although there is a lack of good data on the number of trans people in the UK, as my right hon. Friend stated, estimates currently suggest that 650,000 people in the UK are likely to be gender incongruent to some degree. This is an issue that has an impact on a significant number of our constituents. A number of constituents who came to see me as a result of our Select Committee’s inquiry suggested that this was the first time they could come out and say they were a member of the trans community. People often hide that and do not necessarily want to stand up and talk about it, but the inquiry has given them a huge opportunity to say that they are represented in this place and in the rest of the country.
As colleagues will know, I am a prominent supporter of LGBT rights. I have to say that the LGB part of the community has not always gone out and celebrated the T or the T+ parts of the community. This is also a huge opportunity for us to say that they are part of our friendship group. We must make a big apology for the fact that we have overlooked them as part of our community for a very long period. In her time as the new chief executive of Stonewall—she is not that new to the post—Ruth Hunt has been a huge advocate of the trans community. Following her apology to the trans community, the work she has done as chief executive has gone some way to repair the distrust and segregation within the LGBT community.
I have been a member of the Women and Equalities Committee since its creation in 2015. The report on transgender equality was its first report. The Committee received about 250 written evidence submissions, many from individual trans people who wanted to tell us about their own experiences, and there were five oral evidence sessions. I am not speaking on behalf of the Committee, but it is worth noting how it came to its conclusions. The Committee took evidence from a range of organisations conducting representative and advocacy work within the trans community, as well as from service providers of various kinds, academic experts and six Ministers in a variety of Departments. I want to take this opportunity to thank all those who gave evidence throughout the inquiry, particularly those from the trans community, which enabled the Committee to produce meaningful findings and recommendations.
The report states:
“A litmus test for any society that upholds those values”—
fairness and equality—
“is how far it protects even the most marginalised groups.”
I welcome the Government’s commitment to equality. I recognise that, as a country, we have led the way on lesbian, gay and bisexual equality. Despite the welcome progress, however, we are still failing that test for the trans community. We know that trans people face continuing transphobia, increased mental health issues, discrimination in the provision of public and private services, and bullying in our schools. The report made several recommendations for the Government to consider. I thank the Minister for the Government response, but I want to highlight a number of areas that need further consideration.
The report made it clear that the Gender Recognition Act 2004 and the Equality Act 2010 need to be amended. At the time, the GRA was a world-leading piece of legislation, but it is now outdated and in need of revision, as the hon. Member for Lanark and Hamilton East and my right hon. Friend the Member for Basingstoke have said, and we are falling behind many other countries. The process for applying for a gender recognition certificate is bureaucratic, expensive and even humiliating, and the burden of providing documentation can cause people significant distress. The process should be administrative, not a medicalised, quasi-judicial one. It should be underpinned by the principle of gender self-declaration, which would allow for a dignified approach that maintains the personal autonomy of applicants. After all, as Ashley Reed, who created a petition on this subject, has said of a person’s gender identity:
“You are the only person who can come to that realisation, not a panel.”
I welcome the Government’s commitment to review the GRA, but I urge them to commit to adopting the principle of gender self-declaration as well as to commit to changing the process.
As the Bill my right hon. Friend presented earlier today makes clear, the current wording of the Equality Act 2010 is fundamentally outdated and, ultimately, confusing. Terms such as “gender reassignment” and “transsexual” have resulted in significant confusion over whether trans people who have not undergone a medical intervention are entitled to the same protection. The report recommended that the protected characteristic should be changed to “gender identity”, bringing the wording in line with the Yogyakarta principles and resolution 2048 of the Parliamentary Assembly of the Council of Europe. The Government’s response to that recommendation was that they believe the current wording of the 2010 Act is adequate because people are protected through the provision on discrimination due to perception. However, that response is inadequate and I hope the Minister will clarify that statement. The 2010 Act bases the protection it provides for transgender people on the process of undergoing gender reassignment. Many trans people, such as non-binary, intersex people or young people whose gender identity is less well developed than that of an adult, may not have legal protection. I urge the Government to reconsider their rejection of the Committee’s recommendation. What steps have been taken to keep the matter under review, which the Government promised to do?
Away from the legislative changes, I now turn to some specific areas that need improvement, the first of which is the treatment of trans prisoners. Until recently there were no official statistics on the number of transgender prisoners in the UK. In November 2016, however, the Ministry of Justice published the results of a data collection exercise conducted in March and April of this year. It was reported that 70 transgender prisoners were held in 33 prisons in England and Wales at that time. The Committee argued that there was “clear risk or harm” when trans prisoners are not located in a prison
“appropriate to their acquired… gender”.
The report also said that holding trans prisoners in solitary confinement was not fair or appropriate, and I am sure that the whole House agrees.
Last year, there was the example of Tara Hudson, a transgender prisoner from Bath, who was born male but had lived her entire adult life as a woman. Tara was sent to an all-male prison. I thank the Under-Secretary of State for Women and Equalities, the hon. Member for Gosport (Caroline Dinenage), for supporting me in helping Tara to get into a prison appropriate to her gender, but lessons still need to be learned. Tara, who has lived as a woman her whole adult life, has undergone six years of gender reconstruction surgery and I, like many in the Chamber, would define her as a woman. Her detention in a male environment was not only physically damaging but dangerous from a security perspective.
In summary, we are a forward-thinking and progressive country and have led the way in ensuring that marginalised groups receive protection under the law. We have made huge strides over the decades in improving the rights of lesbian, gay and bisexual people. However, we must do more for the trans community. The Women and Equalities Committee report is groundbreaking and I hope its publication will be celebrated in 50 years’ time as a day of huge change for the trans community in the UK and around the world.
Many of us have been strong supporters of LGBT rights for many years, but until the Committee’s inquiry I knew relatively little of the extent of the issues facing transgender people. We heard moving accounts of people’s transitions and subsequent experiences and also from parents who have supported their children through the process of transition. It was also helpful to hear from service providers, academics and health specialists and from those providing representative and advocacy work within and for the trans community. I thank all of them for providing extensive evidence and for responding to our questions.
A cultural shift is going on in this country around issues of gender. There is greater acceptance of gender differences among young people. Our report identified the need for changes in the law and significant cultural, policy and process shifts in the fields of health, criminal justice, education and others. It also revealed that individuals experience high levels of harassment on a daily basis. That harassment can undermine careers, family life, incomes, living standards, access to services, quality of life and physical and mental health. It is no secret that a disproportionally high number of trans people have reported attempting suicide—an extremely sobering and distressing fact. The sooner we advance trans equality through legislative, policy and cultural change in our public institutions, the sooner there will be fewer trans people in the position of wanting to take their life because they are not getting the necessary care and support and the respect they deserve.
We have seen some progress in trans equality over the past few years. Trans and non-binary characters are actually being played by trans and non-binary actors.
If we look at America, however, any advances made in trans equality there have been threatened by state legislatures introducing bathroom Bills, which have been described as a solution in search of a problem. Such Bills are malicious, misinformed and directly threaten transgender people. The election of Donald Trump does not fill me with much joy for the future rights of transgender people in the US. A bathroom Bill would never be passed here in the UK, but we must keep an eye on the situation abroad and ensure that the British public are well informed so that harmful attitudes do not form here.
It is time for the law and our public services to catch up. On education, the Committee recommended:
“More needs to be done to ensure that gender-variant young people and their families get sufficient support at school. Schools must understand their responsibilities under the Equality Act.”
A survey this year in further and higher education found that bullying and harassment of trans students and staff appear to be commonplace. Furthermore, with nearly half of non-binary gendered respondents to the survey reporting that they are considering dropping out of their course and three quarters stating that they did not find their place of learning supportive, it is clear that we have to do more.
Will the Government assure the House that steps are being taken to create a more trans-inclusive environment in post-school education for trans students and staff? The Government’s response to the Women and Equalities Committee report on trans equality said that the Minister for further education would be writing to sector umbrella bodies highlighting the need for specific gender identity training and the need to ensure trans equality. Has that happened?
On health, we know that there has been a massive increase in the number of people, particularly young people, wanting/needing to transition, and many are identifying as non-binary, yet the delay they face in getting access to health and support services is far too long. Furthermore, GPs are too often acting as gatekeepers, preventing people from even entering the transition pathway. I was moved to hear of the experiences of trans young people who were denied support at the crucial time as they approached puberty. It has been clear from our inquiry that trans people encounter significant problems in using general NHS services that have nothing to do with their trans status due to the attitude of some clinicians and other staff when providing care for trans patients; we heard of the “trans cold”. That is attributable to a lack of knowledge and understanding, and in some cases even to out-and-out prejudice. It is therefore essential that there is sufficient training for GPs and a range of other clinicians to understand trans identities, so that people get the treatment that they want and need and that is appropriate.
Turning to criminal justice, with every news story that a transgender woman has been sent to a men’s prison, our frustration grows further. Our report made it clear that there is a clear risk of harm when trans prisoners are not located in a prison appropriate to their affirmed gender, and that they should get the right support there. It is unacceptable that in 2016 we have a criminal justice system that does not protect all groups on an equal basis, especially as this is costing lives.
In conclusion, I am proud to now be a Member of Parliament in the country that has gone further than most in recognising lesbian, gay and bisexual rights, but the UK is not the leading country in the world on the rights of trans, non-binary and intersex people. There has been progress, but not nearly enough. Time has not allowed me to cover all the issues raised in our report, but the Government’s delayed response—it took seven months—to our report raises concerns for us. The coalition Government’s 2011 advancing transgender equality action plan remains largely unimplemented. I repeat the Committee’s recommendation: the Government must take trans equality seriously and draw up a comprehensive strategy, with an action plan that addresses the full range of issues covered in our recommendations—and soon.
I want to focus on the health aspect of the excellent report by the Women and Equalities Committee: the services provided for transgender people by the NHS. Trans people experience worse health, both physical and mental, than the general population. The Equality and Human Rights Commission has found that a higher proportion of transgender people say that their physical health is “poor or very poor” compared with other LGBT communities and non-LGBT communities. Levels of poor mental health are also higher in the transgender population, with about half of young trans people and a third of trans adults reporting that they have attempted suicide. It is therefore imperative that transgender people have full access to general medical services—appropriate ones.
Transgender people also have specific health needs; untreated gender dysphoria, which, as Members will know, is medically defined as when a person experiences discomfort or distress because of a mismatch between their biological sex and gender identity, can and does take a real toll on someone’s mental health. Dr John Dean, the chair of the NHS national clinical reference group for gender identity services, has said that
“not treating people is not a neutral act—it will do harm.”
I could not agree more with Dr Dean. Some trans people’s health and wellbeing would be greatly improved by gender confirmation treatment through our specialist gender identity clinics. Trans people have to be able to access those treatments on our NHS if they need them.
“The NHS is letting down trans people”.
One of the first problems identified by the report was discrimination faced by trans people when they tried to access general medical services. Dr James Barrett, president of the British Association of Gender Identity Specialists, told the Committee:
“The casual, sometimes unthinking trans-phobia of primary care, accident and emergency services and inpatient surgical admissions continues to be striking.”
CliniQ, a specialist sexual health and wellbeing service provider for trans people, told the Committee that
“there is at best considerable ignorance and at worst some enduring and mistaken and highly offensive stereotypes about trans people among the public at large, amongst whom we must unfortunately number some health professionals.”
Sadly, this discrimination has real consequences. Terry Reed, of the excellent Gender Identity Research and Education Society, told the Committee that trans people were often nervous about accessing services because they were “not treated sympathetically” or even “politely” by doctors and staff. Brook, an organisation that provides sexual health and wellbeing services and advice for young people under 25, told the Committee that
“prejudice against trans people among medical staff”
was one of the reasons for poor health outcomes in trans people.
In addition, trans people report real difficulties in accessing specialist treatments and gender identity services. GPs have a legitimate role in acting as gatekeepers to NHS specialists, but I am afraid there is evidence that prejudice and ignorance among our GPs is preventing those who experience gender dysphoria from receiving the services they need. Dr James Barrett has said that there is a “persistent refusal” on behalf of some GPs to make referrals to gender identity clinics. The Beaumont Society has heard of one trans person being told by their GP at their first assessment—and let us think about how much courage someone needs to go to their first assessment:
“You’ll be taking money away from more deserving cancer patients.”
How wicked is that? It is a complete disgrace.
Where someone experiencing gender dysphoria is referred to a gender identity clinic it can take a very long time for them to receive specialist services such as hormone therapy or genital surgery. The process requires an independent assessment from two separate consultants, and a large amount of information needs to be gathered by the consultants about the individual before they can begin to proceed. That process typically takes months and spans several consultations. An additional precondition for genital surgery is that the patient must undergo at least a year of “real-life experience” of living “in the role” of their affirmed gender—it is an enforced pause. I have read the guidelines that explain the rationale behind this enforced pause, and I understand that the social aspect of changing one’s gender role is challenging and that clinicians do not want people to take on surgery until they are fully aware of those challenges, but that does not explain why the pause is often much longer than 12 months. The Government should assess the arguments made by some in the trans community that decisions over whether to go ahead with surgery should be based on the informed consent model. Under that model, doctors could immediately approve medical interventions if they are satisfied that a patient is fully aware of the implications of their decision. It is my understanding that the model is already used in parts of the United States of America. Given that it has already been tried and tested, the Government should be in a position carefully to assess its strengths and weaknesses, and bring that back to us.
It is important that the Government understand that delays in receiving treatment can, and do, cause real suffering. In the 2012 trans mental health study, one trans person said:
“Not having had my gender confirming yet has a constant effect on undermining my self-esteem and self-confidence as well as social transition—I hate every day that I have to live with ‘boy parts’ and I can’t wait to get rid of all recognisable ‘boy bits’.”
Another person told the same study:
“Permission for my chest surgery was delayed and I waited double the usual waiting time...This caused me to go into a deep depression. I had panic attacks when I left the house. I lost my job and then found I couldn’t leave the house.”
Such suffering could be prevented if we improved the speed at which our NHS works for trans people. Delays should not be any longer than is strictly necessary from a clinical point of view.
As a result of the problems that I have outlined, the Select Committee recommended that the Government conduct a root-and-branch review of how NHS services can be improved to better serve trans people and completely stamp out transphobia in our NHS. I am disappointed—I am sure that I speak for many Members here today—that the Government did not accept this clear recommendation. Instead they responded by stating that they will look into broadening the terms of reference of NHS England’s existing task and finish group for gender identity services. When such systematic failure has been identified, the Government should question the governance arrangements that are in place, rather than relying on them even more. I say that gently to the Minister and hope that she has had those conversations with her opposite numbers in the Health team. I invite the Government to give fresh consideration to a root-and-branch inquiry as part of their commitment to the cause of gender and transgender equality.
People who are in this position might be vulnerable by virtue of the fact that their path in life is very different from that of the majority. Given the proportionately high levels of mental ill health and suicide that we have heard about today, it is our responsibility to acknowledge that, and to recognise that we are all different—people are people—and that we need to make the path for transgender people as smooth and easy to negotiate as possible.
One of the things that I love most about my constituency is its diversity. I have no particular insight into the gender identity of our local people, but just as I absolutely value the huge variety of faith groups and our excellent community groups, such as East Renfrewshire Disability Action, which supports people with disabilities, it is vital that I stand up and be counted as someone who supports every effort to deliver protections and real equality for people of all gender identities. That is the least that they should expect.
Equality, community and standing up against prejudice are the responsibilities of all of us. Scotland is an open and tolerant country, and it is my job, and the job of my Scottish National party colleagues, to work every day to achieve those principles. We must continue to push towards being that better nation that is committed to delivering gender recognition laws to ensure that we have increased protections and equality for transgender people. I encourage the Minister to recognise the importance of the fact that people must have the ability to define their gender identity.
I am pleased that ILGA-Europe—the International Lesbian, Gay, Bisexual, Trans and Intersex Association—rates Scotland as the best country in Europe for LGBTI equality, but it is essential that we put in place practical steps to make the lives of transgender people better.
Before I came to this place, I was responsible for making sure that diversity, equality and inclusion were at the heart of every aspect of life in my workplace. It has been useful to reflect on that experience when considering how best to move forward in this area. I was focused on equality and employment law, and on how we could push on to do more and to make more things possible. The legal frameworks are vital in providing a roadmap for organisations and for Governments. We need to make the process easy and explicit so that there is a clear understanding of what is needed and expected. Legislation in this area should be aspirational and forward-looking. That is what we seek to put in place in Scotland as we reform gender recognition laws, and it is vital that we do so.
In my previous role, it was evident that providing an environment where young people could flourish and be whoever they were, with confidence, had a material impact on their lives. The fact that we had a very explicit, non-negotiable outlook on equality had a positive influence on how people behaved and on the discussions they had. That allowed young people of all gender identities to thrive and to succeed. We need that explicit framework from the Government, including clear terminology, so that confidence and understanding can continue to develop in all our communities.
The Scottish Government’s positive and unwavering stance of supporting LGBTI equality has been incredibly influential and has made a significant difference. That is a great starting point as we aspire, as we must, to go further and ensure that we do everything that we can to eradicate prejudice and enable everyone to achieve their potential.
The young people who thrive in situations where success and equality are at the fore are also influential. They take their outlook into the world—their peer groups, families and communities. Just like the young people whom I heard about on Radio Scotland earlier in the week, they will influence and inspire those with whom they come into contact. I was blown away by their stories, and by their mums, who were powerful and passionate advocates of their transgender children. Their voices and experiences shone through. No one could fail to be moved by their stories—stories of brave, strong people who are different and facing up to the world, and of all the worries and concerns that go with that.
I was pleased to hear one mother say that we have come a long way over the past few years. That is undoubtedly true, but there is more to do and it takes all of us here to stand up to be counted and to push further. We all have a responsibility to challenge those who treat people differently, or who marginalise them, because they do not fit into the boxes that society has traditionally tried to fit people into.
I was interested by the comments of my hon. Friend the Member for Glasgow North West (Carol Monaghan) about schools. The influence of education and supportive schools was key to the experience of the young women I talked about. Their support for the TIE—Time for Inclusive Education—campaign interested me. Inclusive education pays off hugely by advancing equality and making sure that all our children—and, by extension, all adults—have opportunities to achieve their potential. For far too long, transgender, non-binary and non-gendered people have experienced discrimination, disbelief and far, far worse. Young people are the key to transforming our society, and we need to support them fully to do that.
I end with some wise words from one of the ladies on the radio programme: no one size fits all. We do not expect that to apply to any other aspect of our identity, so why on earth should it apply to gender? That is what this comes down to. We are all a sum of our parts. All our identities are complex, but fundamentally people are just people. We are all different and our legislation must reflect that. Those principles are set out in Scotland’s national plan for human rights, which actively defends the right of everyone in society to be treated fairly, and with dignity and respect.
Transgender people make an enormous contribution to our society. As well as allowing us to discuss the difficulties that transgender people face each day, I hope that this debate can be used to celebrate transgender people across the UK. The hate and prejudice that lurks in our society is sickening, but what is remarkable is the positivity that shines in contrast to that. Ranging from the brilliant author and historian Jan Morris, to the late businesswoman and documentary star Stephanie Booth, some of our most remarkable people in Wales identify as transgender.
The obstacles standing between transgender people and equality, however, should be a cause of concern for all of us. In this House and in wider society, we often talk of working towards a more equal community, but in practice that is a distant future for transgender people. The lack of awareness and education about the issues that transgender people face is shocking, and the lack of action to tackle the problem is more so. In recent months and years, efforts have been made to increase awareness of the difficulties that transgender people face. Although there is still a long way to go, the contribution made by organisations ranging from news outlets to film production companies has been incredibly important.
Channel 4’s “Born in the Wrong Body” season raised awareness of how life is for transgender people before, during and after transition. The BBC has made similar productions, including “Just a Girl”, which tells the powerful story of young trans people. There have also been great initiatives by public bodies and institutions. I was proud to march at Pride Cymru this year and saw South Wales Police—my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty) mentioned this—marching with special shoulder patches to demonstrate their support for the LGBT+ community. Similarly, the British Army recently won the PinkNews public sector equality award for its work supporting LGBT personnel, including those who identify as transgender.
Such schemes are incredibly important to contrast with the discrimination and prejudice that is part of day-to-day life for transgender people in the UK, which at their worst can create unimaginable danger and put transgender people in immense harm. In 2015, 582 incidents of hate crime against transgender people were reported in the UK. This figure has trebled in the past five years, as was mentioned by the right hon. Member for Basingstoke (Mrs Miller), the Chair of the Select Committee. Those incidents included harassment, threatening behaviour, sexual assault and other violence, yet of the last year’s 582 incidents, only 19 led to prosecution. That cannot be acceptable.
Transphobic violence is a global problem. So far in 2016, it is estimated that at least 26 transgender people have been murdered in the United States, whereas in Brazil, it is estimated that around 60 were murdered in the first month of this year alone. Free & Equal, the UN campaign for LGBT equality, has claimed that such reported numbers account for only a fraction of the true figure as victims often do not feel safe enough to come forward.
The UK, like every other nation, has a long way to go to ensure that transgender people are safe from violent crime. A start would be to ensure that everybody feels safe and secure in reporting a crime of which they are the victim. Organisations such as Stonewall have been working relentlessly to encourage transgender people to report the violence that they face, but many victims say that they are concerned that they will not be taken seriously. Both the police and the Government must work harder to get the message across that if victims of violence report a crime, they will be taken seriously, and will be safe and secure.
For many transgender people, finding and maintaining work can be far more difficult than it is for others. A survey by the Gender Identity Research and Education Society in late 2000 found that, post-transition, two in three transgender people had left their job, either because they were forced to do so or because they felt there was no other choice. Although it is thought that conditions have improved since the date of that survey, there is still far more work to be done. More recently, to mark International Transgender Day of Visibility 2016, a less varied poll revealed that around 36% of transgender people left their job due to their transition.
The Equality Act 2010 states that people cannot be discriminated against in the workplace because of their gender reassignment, though far too often the Act is ignored. Thousands of transgender people each year in the UK are made to feel uncomfortable, intimidated and subjected to unwanted comments. The trade unions Unison and PCS have both been campaigning to make transgender people aware of their rights at work, and have worked alongside transgender people to fight cases of unlawful discrimination. Unfortunately, there is only so much that trade unions can do to protect people when discrimination can be so rife. In the same way as victims of transgender hate crime often do not come forward, many who are discriminated against in the workplace are afraid to report the fact, though this is unsurprising considering the lack of support they often receive. Unlike other forms of workplace discrimination, there is a lack of high-profile cases of transgender people being discriminated against, meaning that many are not fully aware of their rights or the procedures to make a claim.
Unfortunately, for many transgender people, discrimination does not begin only in the workplace. The education system in the UK is often woefully inept at accommodating transgender people. It is estimated that currently only 5% to 10% of transgender people begin transitioning under the age of 18, but those who do are often failed by their schools, colleges and sixth forms. A report earlier this year by Susie Green, chair of the Mermaids charity, claimed that transgender pupils are more likely to have poor attendance and attainment records, and are often seen as a problem for schools to overcome. Although schools often want to do their best to accommodate transgender pupils, most are not equipped with the right knowledge or resources to do so.
Addressing the difficulties that transgender people face in school often focuses on physical accommodation. Efforts may be made to provide gender-neutral facilities but, although that is incredibly important, there is often not enough focus on why transgender people fall behind academically. A number of local authorities now produce guidance for head teachers, but equally important are the NGOs and charities that deliver awareness training for school staff. In and around Bridgend county, which includes my constituency, the group A Brighter Future Altogether, Benefiting Bridgend provides crucial workshops to ensure that schools are better prepared to help transgender pupils to excel.
Those who begin transitioning at university can face similar issues. A 2014 report by the National Union of Students showed that 28,000 transgender students were studying in the UK, yet more than half had seriously considered dropping out. The same report also found that one in three transgender students had faced some form of bullying or discrimination. Student unions across the UK have been fighting to make campuses more welcoming for transgender students, and universities themselves have usually been willing to learn and adapt. I pay tribute to those universities that have adapted to support people who identify as transgender.
From school to university to the workplace, transgender people face discrimination at each turn in their life, and the persistent prejudice and danger can manifest itself in mental health issues. A recent study in the US journal Pediatrics claimed that these issues can arise if a trans person is not able to express their identity or if they do not feel accepted. PACE, the LGBT mental health charity, claims that 48% of transgender people under the age of 26 have attempted suicide, compared with only 6% of all adults under 26.
Similarly, as other Members mentioned, reports by Mind have claimed that LGBT people in general are more likely to suffer from depression and anxiety, with other studies demonstrating that transgender individuals are particularly at risk. That in turn can lead to people abusing alcohol and recreational drugs. Although there is little research into the prevalence of substance abuse among transgender people in the UK, the US national transgender discrimination surveys of 2008 and 2009 showed that over a quarter of participants had abused drugs or alcohol.
Unfortunately, the high rate of mental health issues in the transgender community is a problem that can be exacerbated by a lack of sufficient mental health facilities. The truth is that there is a serious lack of facilities for those with mental health issues in the UK. According to the King’s Fund, 40% of trusts saw a cut to their mental health budget in 2015-16, which has led to
“widespread evidence of poor-quality care”.
Mental health charities have voiced their concerns about these cuts, with Mind recently expressing concern that they fall squarely on patient care. Better mental health services would benefit everyone who finds themselves needing them, but considering the high proportion of transgender people needing help with their mental health, better services would specifically help those who are the focus of our debate.
The discrimination and prejudice that transgender people are met with for living their lives is a stain on our society. For these people, simple everyday tasks that we take for granted can be laborious and tiresome when they face unequal treatment at every turn. Our schools and workplaces are often woefully inept at accommodating transgender people, and the protection that they receive from harassment and violence is far from sufficient.
We owe it to the transgender people in each of our constituencies to come together to take concerted action to help to deliver equality for everyone, and we must start by recognising the scale of the problem. In this week alone, around 10 to 15 incidents of hate crime against transgender people will be reported to the police. Over the course of the month, more and more transgender people will leave their universities and places of work. We cannot claim to be working towards an equal society if we do not include transgender people in that vision. I sincerely hope that today’s debate will help to raise awareness of the issue and mark the start of a journey to make the UK inclusive for everybody.
According to the International Bar Association LGBTI law committee:
“Trans persons are arguably the most marginalised constituent within the Lesbian, Gay, Bisexual and Transgender…society. While considerable media attention has focused on the global debate for marriage equality, trans-specific issues are often largely not considered.”
That reinforces the importance of ensuring that gender identity is a protected characteristic under the Equality Act 2010.
The contributions on both sides of the House have been incredible. My hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) has been an incredible champion for equalities: she has worked tirelessly with other members of the Women and Equalities Committee, she hosts regular briefings for the SNP group and she sheds light on the various issues. We are all busy people, and it is very important that we work with our colleagues on both sides of the House to understand them, and she does an incredible job of helping us to do that.
The hon. Member for Brentford and Isleworth (Ruth Cadbury) talked about gender equality training, which is also important. My hon. Friend the Member for Glasgow North West (Carol Monaghan) mentioned that she was a teacher, and it is important that teachers, doctors and practitioners across society have the proper information so that they can support transgender people who come forward, in whatever context that may be.
My hon. Friend the Member for East Renfrewshire (Kirsten Oswald) spoke passionately about mental health, the diversity of her constituency and our being the sum of many parts. The hon. Member for Ogmore (Chris Elmore) spoke of the worrying figures in the US, and another Member spoke about President-elect Trump. The make-up of his Cabinet, and the views that he and they have expressed, should worry us all, and we should speak out against such views at every turn.
As a modern and allegedly forward-thinking democracy, we simply cannot afford to leave any section of our society forgotten or marginalised. The people of the nations of the UK—whatever their race, gender, religion or sexuality—must be able to play a full part and have a full life in our society.
As a relative newcomer to the LGBTI community, I have to say that one reason I am particularly glad we are having this debate is that it is of the utmost importance that we better familiarise ourselves with the language surrounding this topic. I will be honest: I was not wholly familiar with all the language and terminology. As someone who came out relatively recently, I felt there was almost an assumption that people would be totally familiar with all aspects of the LGBTI community and LGBTI life. However, like many, I am on a journey of discovery and learning, and I have to say that, after the research I did today, and having listened to the contributions from both sides of the Chamber, I feel more enlightened, and I hope others do, too.
When I was growing up, there were not enough LGBTI role models for me, and others have spoken about powerful role models, particularly in the trans community. We are now seeing actors and others coming forward—people such as Jack Monroe—and speaking so openly and passionately about their lives. There are also people taking on roles in various soap operas and normalising members of the LGBTI community and representations of them.
I read one of Jack Monroe’s interviews when I was preparing for the debate, and the passion about confusion and experimentation with identity came across. Fox Fisher has also been a fantastic role model, and has made some incredibly pioneering and powerful films about transgender issues and people’s journeys. We should take a moment to congratulate and commend all those in the transgender community who fight on a daily basis, as well as all the charities and other organisations, many of which my hon. Friend the Member for Lanark and Hamilton East mentioned, because they are at the forefront every day of the battle for equality.
Language is very important, because the truth is that correct language is not being normalised in our society and particularly, as has been said, in our media. We should be working towards a day when all our names can be preceded by Mx, because people should not have to choose their identity. For example, whether I, as a woman, am a Ms, a Miss or a Mrs defines my marriage status, which seems ridiculous. Why is it that, on the most mundane forms, we are still required to identify our gender and our marital status? I find it maddeningly unnecessary.
Beyond language, there is a huge amount of work to do, as many have said, on the Gender Recognition Act 2004. It is time to simplify the procedure for the self-declaration of gender and to put an end to the requirement for medical or psychiatric evidence. It is time that we allowed 16 and 17-year-olds access to the same process granted to 18-year-olds and up. It is time to fully and properly recognise trans, including non-binary, people in the Gender Recognition Act.
The LGBT Consortium provided some excellent briefing ahead of today’s debate and crystallised some of the really worrying challenges facing the trans community. It explained:
“When someone applies for a gender recognition certificate they are assessed by a panel…they never meet”.
Imagine someone who has perhaps spent years struggling to work out who they are, facing that panel process to be assigned. They do not meet the panel and, worst of all, there is no appeal. This is not like applying for a job; this is about people’s lives and identities. We must make sure that any process anyone has to go through is properly sensitive to their situation and to the challenges and battles they have had to go through.
The Scottish Government are publicly committed to all those changes to the Gender Recognition Act, and I hope the UK Government will now follow suit, because countries such as Australia, India, Denmark and Nepal are actually ahead of us on this front. They have the option on their passports to place an “X” next to the holder’s gender. Of course, no one’s gender makes them any less or more of a citizen of a country. As my hon. Friend the Member for Lanark and Hamilton East said, the UN’s International Civil Aviation Organisation has an internationally acceptable gender marker for passports.
I want to speak briefly about a recent encounter that I had with a local organisation called Glitter Cannons, a West Lothian LGBT group. I spoke to a young person who had gone through the process of coming out as trans in high school. She spoke movingly about the experience of PE and of which changing room she was going to go into and how that was managed at school. She said that, after some education, her teachers were able to give her good support, but the challenge was incredible.
Our First Minister, Nicola Sturgeon, has pledged to radically reform gender recognition law for transgender people and those of non-binary gender. I hope that if Scotland can do that, the UK can do it as well. At the end of the day, the UK has a long way to go before it treats transgender people properly, with the dignity and equality that they deserve. Mr Deputy Speaker, you and Mr Speaker, who is not in his place, have done a huge amount. I appeal to you and all of those in the House authorities to make this place, though it seems very much in the dark ages at times, as forward-thinking, progressive and open as possible for people across the LGBTI community and beyond. This is not just about dignity and equality, but about doing what is right for all our citizens, whoever they are, so that they can live their lives as they choose, freely and fairly.
I congratulate my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury), the hon. Member for Lanark and Hamilton East (Angela Crawley) and the right hon. Member for Basingstoke (Mrs Miller) on securing this debate. I want to put on the record my thanks and gratitude to all members of the Women and Equalities Committee for their continued sterling work, not only on transgender issues but on championing equality across the board. The quality and depth of the Committee’s inquiry are evidence of the very best work of this House.
The Committee’s report makes clear the extensive list of issues that must be addressed if we are to tackle existing discrimination and transphobia, and ensure that trans people can live fulfilling lives. I was shocked to hear the hon. Member for Bath (Ben Howlett) say that there are 650,000 transgender and transfluid people. Both he and the right hon. Member for Basingstoke are right to say that we need to get proper data so that we can have a properly resourced response.
The UK has come a long way on LGBT rights, and I am proud to be a member of a party that achieved the equal age of consent, repealed the vile section 28 of the Local Government Act 1988 and paved the way to equal marriage. I also thank the right hon. Lady for the incredible work that she did on that. We have further to go—there is always further to go—but I think that this House can be proud of the progress that we have made on LGB rights. However, to our collective shame, the same cannot be said about the rights of the transgender community.
Transgender people form a highly diverse community, with a number of different trans identities, including those who define as non-binary and non-gendered. Sadly, however, more often than not, what brings the trans community together is stark experience of inequality, discrimination, transphobia, abuse and violence. The consequences of that relentless hate are clear to see. I am grateful to my hon. Friend the Member for Brentford and Isleworth for giving concrete examples of the living hell that some people endure. Almost half of trans people in Britain have attempted suicide at least once, and 84% say that they have thought about it. Those, of course, are the people we know about.
I want to make a plea from the Dispatch Box: whatever you believe about the issue of trans and gender identity, however strongly held your beliefs and however much you may morally disagree, please recognise that there are people in this country who are facing daily abuse and who are dying, all because of their self-declaration. Please, just see them as people.
This House either leads in improving the lives of trans people, or it is responsible for standing by and allowing intolerance, hate, violence and vilification to continue. I am sure that that is not the House that we are part of. Challenging the discrimination and transphobia that have resulted in almost half of trans people attempting suicide is not just a moral imperative; it is fundamental if we are to really create a tolerant and equal society. I am grateful to my hon. Friend the Member for Ogmore (Chris Elmore) for outlining so passionately and emotionally the violence that trans people face on a daily basis.
The European Union Agency for Fundamental Rights LGBT survey found that two in five trans people have been attacked or threatened with violence in the past five years. The Women and Equalities Committee identified a significant issue of under-reporting of transphobic abuse and violence. It recommended that the Government focus on building trans people’s faith and trust in the police and the Crown Prosecution Service. I am grateful to my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty) for mentioning the good work that South Wales police are doing.
Fundamentally, if the perception persists that the police are biased against trans people—to be fair, that perception is largely because of the way in which they have been dealt with in the past—it will be impossible to build faith in those institutions. If a trans person is not heard or taken seriously when they report a crime, there can be no justice. If a trans person never even makes a report, for fear of the police response or of being exposed during the criminal justice process, we cannot punish the perpetrators.
The Government’s own hate crime strategy “Action Against Hate”, which was published in July, recognises the need to work closely with the transgender community to ensure that solutions are put in place to increase faith in the police and the CPS and that they meet the needs of the trans community. Will the Minister update us on that work? Which community organisations have the Government met, and what changes are they planning as a result?
The Government have also indicated that they will look to strengthen hate crime legislation. Will the Minister update us on the progress on that work and on the new guidance on how prison services are to treat trans people with regard to self-definition? I thank the hon. Member for Bath and my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith) for their work on that. Will the Minister confirm whether the new guidance also covers immigration and detention facilities?
As we have head, discrimination and transphobia start at a young age. According to the “Youth Chances” survey, more than four in five young trans people have experienced name-calling or verbal abuse, and three in five have experienced threats and intimidation. I echo the comments of my hon. Friend the Member for Ogmore, who said that we need to look at the underlying reasons that trans children are failing in school, rather than just at the logistical infrastructure issues. More than a third of young trans people have experienced physical assault.
The Women and Equalities Committee called on the Government to ensure that transgender issues should be taught as part of personal, social, health and economic education, and that teachers should be trained to feel confident in delivering it. That will go some way to ensuring that children grow up with a commitment to tolerance and an understanding that all people should be free to live with dignity and self-expression.
Labour and many campaign groups outside this Chamber have been calling on the Government to reintroduce a statutory, high-quality PSHE curriculum for all children in primary and secondary schools. I am pleased to say that, yesterday, the Chairs of five Select Committees did the same. To date, the Government have refused to do so. How long do they plan to go on ignoring the sheer weight of evidence that early intervention, through statutory PSHE, is a necessary tool in preventing hate crime and transphobia and in supporting children to grow up with respect for themselves and others? The Children and Social Work Bill will come to the Floor of the House on Monday, which presents the Government with the perfect opportunity to do the right thing and protect all children by tabling an amendment to that effect.
I now want to focus on the Gender Recognition Act 2004, and to reinforce what was said by the hon. Member for Lanark and Hamilton East. There remains a fundamental lack of understanding and awareness of the experiences and lives of trans people, and I echo the pleas that have been made—let us actually get some data on this. We need to understand the implicit and explicit discrimination that is happening against the trans community. That is compounded by the existing gaps in trans people’s legal rights and protections under the 2004 Act and the Equality Act 2010. The 2004 Act fails to provide an option for people who do not wish to undergo a formal process of gender reassignment, who do not conform to gender stereotypes and who do not wish to follow a different pathway from the one set out under the Act. The process of facing the gender recognition panel set out in the Act can cause distress and humiliation, and it is based on outdated medical concepts. The process is totally impersonal and unaccountable, and there is no right of appeal.
One campaigner spoke to me about her experiences. Sick of waiting for between five and seven years to receive treatment on the NHS and to follow the stipulated pathway, she went abroad for medical procedures. When she returned, the gender recognition panel insisted on gynaecological examinations and psychological tests, all at her own expense, in order for her to receive a gender recognition certificate. In the end, they refused her certificate—twice. Fundamentally, the process set out in the 2004 Act medicalises trans identities, strips individuals of personal autonomy and denies the trans community of the recognition that they can determine their own lives.
As part of the Government’s response to the Committee’s Report, they have committed to a review of the 2004 Act to de-medicalise the gender recognition process, and that is welcome. Will the Minister update the House on the Government’s progress with that review? Will she indicate whether the Government plan to take forward the Committee’s recommendation about self-declaration and self-determination?
The Equality Act 2010 is another fundamental piece of legislation that Labour is proud of, but that Act, too, needs updating. Terms used in the Act, such as “gender reassignment” and “transsexual”, are outdated and considered by some to be offensive and misleading, and they may not cover all members of the trans community. The Women and Equalities Committee report recommended that the Government amend the protected characteristic of gender reassignment to ensure that the largest possible number of people are afforded protection. The use of language such as “gender reassignment” and “transsexual” is both too vague and too specific, and it fails to provide clarity about who the public sector equality duty applies to. What plans do the Government have to update those terms?
The problems are compounded by the significant cuts that have been made to the Equality and Human Rights Commission, which upholds the public sector duty of equality. Recommendations in the report refer to the ability of the EHRC to look into complaints, but the Government imposed a 25% cut to the EHRC’s budget in the November 2015 autumn statement, having already imposed a 67% funding cut over the course of the coalition Government. That drastically reduces the impact that the EHRC can have in fulfilling its duty. Will the Government urgently halt further cuts to the EHRC, and will they produce an analysis of the impact of the cuts on the wellbeing of those with protected characteristics and on the commission’s ability to fulfil its roles properly?
I want to speak briefly about the NHS. To be honest, my hon. Friend the Member for West Ham (Lyn Brown) has spoken so powerfully about it that all I want to do is to ask a couple of questions. Gender identity clinics that provide specific healthcare for trans adults and young people are stretched far beyond capacity. That is leading to dangerous waiting times that regularly exceed the statutory 18-week limit and, in some cases, to poor quality of care. We have been told that all gender identity clinics are out to tender. Can the Minister confirm whether that is true, and can she tell us how many clinics are currently breaching the 18-week limit?
Fundamentally, this debate is not just about trans people; it is about the sort of open, tolerant, supportive country that we want to live in. This debate is an opportunity for the Government to set out their plans to help one of the most vulnerable and vilified communities, and I hope that the Minister will take this opportunity to do so.
The Prime Minister has made it clear that the Government’s mission is to make Britain a country that works for everyone. We want a society where everyone has a fair chance to go as far as their talent and their hard work will allow. That, of course, includes members of the trans population. We want them to be safe, healthy and free from discrimination, and we want a Britain that works for trans citizens.
I am proud of the UK’s strong legislative framework that protects trans people, but I am aware that progress in the acceptance and recognition of trans people has not kept pace in any way, shape or form with that of the lesbian, gay and bisexual community. I am also aware that transgender people suffer particularly high levels of inequality—from mental health to hate crime, and from bullying in schools to discrimination in employment—and we have heard many hon. Members speak passionately about all those things today. As the hon. Member for Lanark and Hamilton East (Angela Crawley) mentioned, mental health and suicide are big concerns. A young trans person in England today is nearly twice as likely to have attempted suicide, and nearly three times as likely to have self-harmed, as are their non-trans peers. That is utterly unacceptable. It has been said that trans issues are too difficult to tackle and too marginal to take notice of, and that it is too hard to implement change. We say that that is wrong. Trans people deserve dignity, respect and a life without discrimination.
I welcome the words of the hon. Member for Ogmore (Chris Elmore). As he says, we should take this opportunity to celebrate our trans community, especially the brave and inspiring individuals—from within the trans community and outside it—who do so much to fight against the prejudice, discrimination and disadvantage that we have heard about so movingly and passionately from so many hon. Members.
Tackling transgender inequality is a not a new initiative for us, and we continue to be recognised as one of the most progressive countries in Europe for LGBT rights by the International Lesbian, Gay, Bisexual, Trans and Intersex Association. In 2011 we issued the world’s first transgender action plan to address the real and everyday challenges faced by trans people, and the majority of the commitments in the action plan have been completed. We are in the process of collating progress updates, and we will publish a summary next year. Recently we invested £2.8 million to tackle homophobic, biphobic and transphobic bullying in schools that have no measures, or ineffective measures, in place to deal with it. We have also published practical and clear guidance for employers and service providers on how to deal fairly and sensitively with transgender employees and service users. We have absolutely no intention of ending our commitment to tackling transgender inequality.
In July we responded to the Women and Equalities Committee report and set out a further set of ambitious actions. One massive and key commitment was to review the Gender Recognition Act 2004. As my hon. Friend the Member for Bath (Ben Howlett) has said, it was a groundbreaking measure when it was introduced—I think we sometimes forget how groundbreaking it was—but the world has moved on incredibly since then, and it is right that we review how it is working now. We have begun a stakeholder engagement programme to look at how the gender recognition process can be improved, and at the legislative and non-legislative means that we would need to use to do that.
The Committee recommended that we move towards self-declaration of gender. We recognise that, as the hon. Member for Livingston (Hannah Bardell) rightly pointed out, the gender recognition process needs to be quicker, less bureaucratic and definitely less medicalised. However, we want to see more evidence on the case for change to a self-declaration model. A couple of other jurisdictions have just began to implement such a model. We will continue to monitor the implementation of the alternative gender recognition process in other countries, and we will analyse the very good evidence that the Committee published to inform our work.
My right hon. Friend the Member for Basingstoke presented her Bill today. We have not yet heard a convincing case for introducing gender identity as a protected characteristic. The Equality Act, and criminal, hate crime and employment legislation all offer protection for trans people. However, we will continue to keep an open mind, listen to testimony and monitor evidence to find ways to improve the lives of trans people.
My opposite number, the hon. Member for Rotherham (Sarah Champion), asked about hate crime. We have improved the recording of hate crimes against LGBT people to support more effective prevention and action. Police forces are now required to collect those data, and the first set of data was published as official statistics in 2013. We have committed to review legislation on hate crimes and we are currently considering the options. The Crown Prosecution Service also recently launched a consultation on draft guidance on prosecuting cases of offences involving transphobic hostility.
The hon. Member for Lanark and Hamilton East spoke about gender markings and gender X on passports. As she pointed out, UK passports currently recognise only male and female genders. Legal recognition is more broad than just changing passports and would need to be considered across Government. Introducing a third category, such as that denoted by an X in a passport, would require a change in UK primary legislation. However, on gender markings, as set out in the response to the Select Committee report, the UK has agreed with the International Civil Aviation Organisation to lead on a survey of member states on gender and passport markings. The gender questionnaire was circulated in October and member states had until the end of November to provide their views. We will review the responses, compile a report and submit it to the working group early in 2017.
Several hon. Members, not least my hon. Friend the Member for Bath, who has campaigned hard on the issue, talked about managing offenders. When I was a Justice Minister, my hon. Friend and I worked closely on a number of particular incidents that he raised. Managing transgender offenders has been a major concern and we have taken action. A number of events involving transgender prisoners in autumn 2015 highlighted the need for the policy on their treatment to be given a more fundamental reappraisal. When I was in the Ministry of Justice, I led on that work and last month the Government published their review and confirmed the position. That is why we will, from now on, manage anyone received into services run by the National Offender Management Service in the gender with which they identify rather than the sex assigned to them at birth.
Several hon. Members spoke passionately about health, particularly the hon. Member for West Ham (Lyn Brown). As she said, ensuring accessible and prompt health services for trans people is of continued concern. I am pleased that good, collaborative, progress is being made. Discrimination against trans people in the NHS is not allowed and is unacceptable. NHS England has convened a number of multi-agency symposiums to begin to address this issue. The hon. Member for Brentford and Isleworth (Ruth Cadbury) will be pleased to know that NHS England and the General Medical Council have acted on the Select Committee’s recommendations by publishing new guidance on GPs’ responsibilities in treating trans people. We are also tackling the very long waits to access gender identity services, and we are beginning to see results: the average waiting time for patients to receive reconstruction surgery at Imperial College Healthcare NHS Trust has dropped from 94 weeks to 61 weeks, and is getting better.
NHS England has increased financial investment in gender identity services from £26 million to £32 million this financial year. In addition to funding, we need to increase capacity in this specialism. That is why a joint initiative between NHS England and Health Education England was launched on 20 October to develop a programme of work to address national workforce and training constraints in that specialty. The planned outcomes will be recommendations for the future workforce, and will include curriculum development, continuing professional development and general awareness training among NHS staff.
The GMC and NHS England are also currently considering piloting a formal process for accrediting competencies in gender identity. To provide a better service nationwide, we will revolutionise service provision. We are seeking new providers to host gender identity clinics, and we will tender for them via national procurement in 2017. We will ensure that they can deliver the requirements of the updated service specifications for adult services. That means not only clinics offering better services, but ensuring better geographical spread.
NHS England’s new service specification will reflect the standards of care and will be out for consultation in the new year. NHS England has already published a new service specification for children, and a clinical commissioning policy for prescribing cross-sex hormones to gender-variant young people. The new policy is consistent with international guidelines and best practice.
Having a positive experience of childhood is vital, especially for trans children as they come to realise who they truly are. A number of Members, including the hon. Member for Brentford and Isleworth, said that schools have an important role to play in ensuring a positive experience.
My Department is commissioning research to understand whether social work training has sufficient coverage of gender variance. The initial research will be concluded by the end of March 2017, and we will use the findings to decide whether additional training materials should be made available. Outstanding and remarkable work goes on in some of our schools to support our trans students, which I have seen myself. I personally intervened to make changes after visiting a school where a headteacher raised the issue of recording pupils’ desired gender on school records. New guidance was subsequently issued in April—pupils can now sit their exams and receive certificates in their correct gender, which not only reflects who they are, but reduces the risk of their being outed in later life.
Other work that was not in the Select Committee report is under way. We are funding questions in the British social attitude survey on public attitudes towards trans people; issuing guidance on the provision of gender neutral toilets; and publishing guidance in the civil service on how to survey trans staff within Government Departments.
I hear the comments that the Government have not gone far enough or fast enough on trans equality. My response is to watch us as we deliver sustained and embedded change. We have shown that we can achieve major social reform—after all, we are the Government who introduced same-sex marriage, a defining milestone in equality. We will achieve the same milestone for our trans community by revising the Gender Recognition Act, and through other major initiatives.
I thank the Women and Equalities Committee for its report. We will continue to listen to all the voices on this important matter and deliver positive change for the trans community.
The debate has given the House and the whole country an opportunity to hear about the progress that the Government are making on the treatment of prisoners; on passport gender identification, on which Britain leads the way; and on reducing waiting times for NHS services. My hon. Friend the Minister, a fellow Hampshire Member of Parliament, is to be applauded for the energy, action and positive approach she brings. I look forward to continuing to watch her work unfold, but I also look forward to continuing to press her in the Select Committee on the recommendations.
Question put and agreed to.
Resolved,
That this House notes the UK’s status as a pioneer in legislating for equality for LGBT people; welcomes the Government’s announcement of a new trans equality action plan; and calls on the Government to review its response to the recommendations of the Women and Equalities Committee’s report on Transgender Equality to ensure that the UK leads the world on trans equality rights, in particular by giving unequivocal commitments to changing the Gender Recognition Act 2004 in line with the principles of gender self-declaration and replacing confusing and inadequate language regarding trans people in the Equality Act 2010 by creating a new protected characteristic of gender identity.
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