Transphobia in Social Work: The Need for Debate and Consideration of Wider Transgender Issues

Transphobia is a recent phenomenon in the forum of Social Work and inequalities; a term that's tagged on at the end of the line of inequalities faced by people from the differing community factions that don't fit into the mould of societal norms of traditionally white, patriarchal expectations. Despite the profusion of papers on wider transgender issues, there is a paucity of research discussing Social Worker and Mental Health practitioner interventions and their considered roles; this is given the emergence of trans issues in the UK thus highlighting the nascent need for debate.

Consideration has to be given to the conflicts that exist on the use of the transgender label, and specifically how it fits in with existence of the bi-polar binary gender system (Monro 2002); practitioners ought to consider a wider remit that includes not just the traditionally considered core elements of transsexual and transvestite people, but notably, the three different spheres of transgenderism which embraces those who are biologically, socially or morphologically transgendered (Laframbiose 2003), moreover, the realisation that the philosophies and politics behind the issues of transgenderism no longer belongs to a small community that practitioners will rarely come across in their careers, but instead on a daily basis to a whole range of individuals that do not adopt society's typically patriarchal expectations of male and female, including those that fit outside the bi-polar gender binary system but who do not adopt the trans label.

The new reality that practitioners face is that, daily, there is increasing potential of working with individuals who deviate from the traditional notion of gender binaries, including those people who arguably deviate to a trans role, but who don't adopt the label though non-the-less experience transphobia; a contradiction in terms requiring pause for constructive reflection.

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Initial stages of practitioner intervention

In order to ascertain practitioner roles, there is a need for full appreciation of the barriers in conforming to the norms of the wider society in general. Traditional psychological paradigms are starting to move with mental health providers working towards de-pathologising trans individuals as having 'normal' mental health (Cole and Meyer, 1998 in Raj, 2002); the inference here is that transgender is not a psychological problem, but more that the problem is handed over to individuals in society who fail to recognise the unconventional variations of gender roles and identity; a similar pattern follows with the social model of disability, which argues that it isn't the impairments that causes the problems of disability, but that the responsibility for disability is placed squarely on society (Oliver, 1990); I argue that this lateral notion is no different, perhaps pioneering a new definition and need for nascent debate for a 'Social Model of Transgenderism'.

Practitioners should adopt clear aims to apply the 'core values' of Social Work (Thompson, 2000), thus ensuring they work within an anti-oppressive framework which empowers trans individuals to access a range of services to which they are entitled. According to observations by Raj (2002), there is the requirement to express an attitude that is respectful, sensitive, accepting, validating, affirming, empathic, caring, compassionate, encouraging, supportive, and mutually trusting and trustworthy; the Social Model notion mentioned earlier would benefit the relationship between the 'service provider and customer';

Raj goes on to add that this approach ensures an honest negotiation for services that is informed by a mutual contract of respect and trust for each other; this is currently negated by the specific experiences of transsexual people in the UK who are subjected to various hoops to obtain the treatments they desire, as according to Eyre in her work for Charing Cross, she advises the need for gender identity clinics to become more client focused (1999), signifying that potential conflicts still exist between professionals and differing trans client groups who fear personally negative outcomes of practitioner interventions, an issue that should to be addressed to ensure that the needs of transgender people are being considered appropriately and respectfully.

Roles within practitioner intervention

The three main areas of work with which practitioners are concerned with are to work effectively and efficiently with trans individuals following standards of conduct laid down by the GSCC (2002), to work effectively with the agencies who can assist trans people and thirdly, to use a pertinent role enabling individuals to move forward with their lives, roles that are important to enable individuals contend with feelings of despair and a lack of self worth, some even attempt suicide; furthermore, according to Monro (2000), she broadly writes;

'Economic exclusion is one example of transphobia, unless gender ambiguous people are able to successfully 'pass' as male or female, are frequently victims of violence and abuse and like intersex people, are socially invisible with hardly any representation in the media, social policy and sexual minorities, and lack service provision in areas such as education, the family and the penal system.'

If trans people regularly experience these ranges of prejudices, the urgency becomes clear for practitioners to engage trans individuals in resolving these injustices, therefore facilitating their rightful integration as equal citizens; furthermore, the 'National Association of State Mental Health Program Directors' indicates that not all trans individuals are at the same stage of self-acceptance and identity development (1999); this suggests that there are issues to be addressed in terms of trans people's comfort levels in coming out and disclosing their minority status. Any practitioner's intervention should assess for individual's development in terms of their mental health, stress levels, self concept and access to social supports.

Recognising that discrimination against trans people is pervasive in this society (T.A.P. 1999), practitioners are faced with issues of prejudices experienced on a daily basis by individuals which includes being denied housing, employment, medical treatment, legal protection or some aspects of 'hate crime' in the community. During 1999, transsexual individuals met with key figures at a local health authority to look at patient's clinical needs as they would for any other group (PFC, 1999); this experience contributed to the development of initial recommendations to the Parliamentary Forum, which resulted in the 'Report of Interdepartmental Working Group Transsexual People' in April 2000 (Home Office).

This experience simply highlights how by acting in a significant 'activist' role and engaging individuals in small, localised issues of concern, can prove to be a stimulating and empowering experience and shows how such efforts by trans people can be used to good effect in proposals for a national governmental initiative thus helping to further break down the barriers of transphobia.

As 'advocates', it is essential to recognise the difficult positions that some trans individuals find themselves. Given that advocacy is something we approach others to take on board (Scottish Executive 2002) trans people become vulnerable as a result of the transphobic prejudices they face whether on a national scale via bad media experiences, or more directly from incidents within the local community. Some trans people do not have the close connections of friends and family to give the support that is required.

The practitioner's role in this case would be to ensure that trans individuals have a facility to speak out so that their views and feelings can be expressed in a safe environment without prejudice, and being an effective advocate that sees things from a trans persons perspective can empower individuals to make their own decisions, work a way forward and make some waves to resolve their difficulties. This has to be done on their terms and allows them to be in control of the whole process; for example, it is easy for advocates to do everything on an individual's behalf, though is it only true advocacy if the trans individual was given the power to decide whether the practitioner acts on their behalf, or acts as an influential professional enabling the individual to do things for themselves.

Practitioners effectively act as the link between individuals and the agencies and resources available to them. An example of the work of a 'broker' is perhaps that of the financial advisor, familiar with the availability of financial packages; in this respect, the practitioner needs to have a very clear knowledge of the agencies, services and packages available to the trans individual. Despite scant resources, there are important organisations including, but not limited to, the Gender Trust, Beaumont Society, GIRES and PFC, each offering specific roles to trans people. One of the aims of GIRES (2003), is to provide education on gender identity issues; they offer financial support for the educational work carried on at local level by trans people who are unemployed or on low incomes. Understanding the eligibility of these funding resources is just as important as realising the different target groups that each of the remaining organisations are aimed at.

In carrying out day to day work, the 'Trans-Yorks Project (2003) gives inspirational examples of work undertaken by trans people within Yorkshire and Humberside; Trans-Yorks is an organisation run for and by trans people, though needless to say, many lessons can be learnt from observing a project giving ideas for practitioners to take on board in other areas. The founding 'coordinator' also acted as the 'initiator' who was responsible for bringing together the components of the voluntary organisation in so many different ways, which ranged from providing a telephone support helpline, discussion e-mail list, resourceful website, newsletter, information library, fundraising and social events.

What resulted was the development of a constitution and a committee of trans people charged with the daily running of the groups' activities forging what is a forward thinking voluntary organisation which empowers local trans people to partake in the wider community and raise their own sense of identity, confidence and self esteem. Much can be learned here in developing the same resources elsewhere in the UK.

'Educating' others about the issues of transphobia and trans lifestyles requires practitioners to become fully informed; they need to be 'knowledgeable' in order to be effective, and can certainly provide a useful role in highlighting to trans individuals that the problems they have may well not be of their doing; certainly, being 'told' that they have been the subjects of 'victimisation', 'bullying' and 'harassment' can be empowering, and moreover, engages individuals to realise that there are acts, resources and agencies that can assist in overcoming the problems they face.

An example is that the Protection from Harassment Act (1997) can be a powerful tool in engaging the individual with their local police force to resolve issues of 'hate' crimes that have been made against them. Issues arise if the practitioner is not able to communicate this information effectively so that it is easily understood.

Practitioners are often engaged in an 'Enabler' role with individuals; enabling a trans individual to cope with 'transitional' stress from one gender to another, in being able to come to terms with, find and accept their own sense of gender identity, along with developing their place in the community is an important role to acknowledge. CCETSW (in Thompson 2000) explained the process of ensuring people have opportunities to explore their own strengths, and then break down the problems that they have into components so that they could be tackled more easily; this process will generally include establishing some aims and goals such as ascertaining access to education, obtaining and maintaining work, or simply finding new friends in the local community.

Issues arise in overcoming trans people's sense of poor self esteem and confidence, and so counselling skills formed from social work theories can be used in collaboration with other agencies and community projects, proving of benefit to the trans individual. It is worth noting that the majority of trans people, once they have settled their identity along the gender spectrum, often feel quite happy and contribute to society; however, there are some individuals who would benefit from being informed about the benefits of social work interventions at a level that best suits them, but which does not oppress them into an interventionists 'contract'.

A key task for practitioners is being involved with facilitating activities with local client groups, thus encouraging people to bring their ideas together either in brainstorming sessions, or opportunities that contribute to policy development or new initiatives to benefit the trans community and self defined by the group itself. As the 'facilitator' in these situations, the essential part of a regular role for practitioners. According to Iowa State University (1992), developing a partnership of trust and ensuring everyone is fully involved in unity to achieve an agreed objective is the most essential task.

This is a process that worked very well for Bockting et al (1999) who were charged with the task of getting together community representatives to develop an educational HIV prevention package for transgender people; the effective facilitation of this project resulted in increased partnership which led to a more effective campaign working towards promoting better health amongst transgender people.

As in any other community, conflicts and problems do arise, and one of the key practitioner roles in any case is that of 'mediation' in order to resolve conflicts and problems not just for the trans individuals, but also those closely related to them; one example specifically relates to a call in mediation in relation to trans parents, their partners and their children and often, Social Work practitioners are called in by the Children's a Families section to make an assessment in terms of The Children Act 1989 and the Family Law Act 1996.

According to Press for Change (2002) when a custody battle develops, the courts reluctantly award custody to the trans parent thus frequently place very severe restrictions on access, sometimes wholly forbidding access; this relates well with the fact that s.1 of The Children Act (1989) considers the interests of the child as being paramount and commonly, the trans birth parent will often feel oppressed and discriminated against; this is further compounded by the fact that the other parent and their social worker might assess that children could be disturbed by contact with a parent that has a trans identity. This therefore necessitates the role of mediation which enables the practitioner to educate and explain the situation to the close relations and friends to ensure contact is not lost and that access to their children is not prevented.

In much of this, the role of 'negotiator' is often called for, and is not dissimilar to that of the neutral mediator. Getting a consensus even between the different factions of the trans community, and the agencies charged with providing a service to them does involve fighting for a middle ground that all sides can settle down to in order to achieve a consensus between all sides; the question is, just what is there to negotiate? A look back on all the different roles that practitioners play will reveal the deep seated transphobia that trans people face in their lives, and in every aspect of intervention with trans people will mean coming to the bargaining table to achieve the one thing that trans people seek to achieve, a sense of fairness, justice and most all, the right to equality and respect.

Conclusion

Raj (2002) made some important recommendations in working towards an overall goal of providing a 'transpositive and therapeutic' approach that is 'trans affirmative' and which considers individual trans individuals using a 'best fit' approach; the suggestion here is that rather than perhaps working to a gender binary approach, that instead a reflexive role be taken on which accommodates and appreciates the needs of the specific gender that an individual feels to be, even if it doesn't fit in with societal norms thus eliminating any opportunities for transphobia to occur in the relationship with practitioner and the individual Indeed, the practitioner can apply their role appropriately depending on the practice setting, and that the needs, wishes and feelings of the individual trans person are taken into consideration first and foremost, and certainly before those of the practitioner;

Furthermore, the recommendations given by Raj are significant in that suggestions are given for ongoing professional development ensuring that practitioners are 'aware' of current trends and issues in transgenderism. Not only will such an approach ensure a more effective collaboration between practitioner and individual, but also assures the individual will not only receive the best quality professional response, but that the agency can report an increasingly value for money service which responds to, and is accepted by the trans community.

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