Trans, non-binary need better support
Over the past few years, I have been hugely privileged to work alongside many people who identify as trans or nonbinary. It has been some of the most rewarding work I have ever done.
For those who find the terminology confusing, the umbrella phrase ‘‘trans or non-binary’’ is used for someone whose gender identity differs from the sex they were assigned at birth.
For example, a person who is assigned female at birth based on genital organs, may feel very strongly that he is a man – the usual word for this is a ‘‘trans man’’. Someone else assigned female at birth might identify as ‘‘non-binary’’, which means they see themselves as neither entirely a man or a woman, but somewhere on the spectrum between these two genders.
There are many other terms used to describe gender identity and, if you’re interested in learning about them, look at the resources at the end of this column – there is a wealth of information that will help demystify some of the language. But for this column, we will simply use ‘‘trans or non-binary’’ and I hope that anyone who identifies using other terms will feel included.
Shamefully, we don’t know enough about this community. We don’t have accurate statistics to know even how many people identify as trans or non-binary in New Zealand.
We have a rough idea when it comes to young people – the Youth 2012 study estimated that around 1.2 per cent of all young New Zealanders identify as trans or non-binary.
A further 2.5 per cent report questioning their gender identity, but we have no local data for our adult population.
Despite the lack of accurate figures, we can say that this community is made up of tens of thousands of New Zealanders, and the time to understand and address their needs, especially when it comes to health and wellbeing, is long overdue.
A local survey called Counting Ourselves is doing just that. This comprehensive groundbreaking study, led by Dr Jaimie Veale of the University of Waikato, is the first of its kind in Aotearoa. Veale and her team asked 1178 trans and non-binary people aged between 14 and 83 about their school, family and work life, physical and mental health, including access to genderaffirming healthcare, experiences of discrimination and violence, and the support they received in their life.
The first results were published last month. The findings are shocking, but hopefully will be the catalyst for rapid change to the systems that provide support (or, in many situations, don’t).
Here is a summary of its findings:
■ High levels of participants wanted, but were not able to access, gender-affirming healthcare. Gender-affirming healthcare includes non-medical care (such as hair removal and counselling support), as well as medical care (such as hormones and surgeries). Barriers to accessing services included cost (many aren’t available in the public system), and also a lack of clear pathways as, in many districts, service provision is patchy, or even non-existent.
■ More than one-third (36 per cent) of participants had avoided seeing a doctor because they were worried about disrespect or mistreatment as a trans or non-binary person. A total of 20 per cent reported this in the past 12 months.
■ More than one-in-six of all participants (17 per cent) reported that a professional, such as a psychiatrist, psychologist or counsellor, had tried to stop them from being trans or non-binary.
■ Five out of every seven participants aged 15 and older (71 per cent) reported high or very high psychological distress, compared with only 8 per cent of the general population.
Horrifyingly, the study also showed that more than half of the participants (56 per cent) had seriously thought about attempting suicide in the past 12 months. Two in five (37 per cent) had attempted suicide at some point.
■ More than two-thirds of participants (67 per cent) had experienced discrimination at some point –
44 per cent in the past 12 months – a rate much higher than the general population (17 per cent in the past 12 months). Fifty-seven per cent of participants did not disclose at work they are trans
or non-binary because they feared discrimination.
■ Almost one-third of participants (32 per cent) reported someone had sex with them against their will since they were 13 – and half said someone had attempted to do this.
This is a much higher rate of sexual violence than for women or for men in the general population. Participants who reported this were twice as likely to have attempted suicide in the past year (18 per cent) than participants who did not report this (9 per cent).
■ Compared to the general population, participants were almost three times more likely to have put up with feeling cold (64 per cent) and to have gone without fresh fruit or vegetables (51 per cent) to reduce costs.
■ Many trans and non-binary people have a lot of support within their family/wha¯ nau. Among participants whose family/wha¯ nau knew they were trans or non-binary, more than half (57 per cent) reported that most or all their family supported them.
People who were supported by at least half of their family/wha¯ nau were almost half as likely (9 per cent vs 17 per cent) to have attempted suicide in the past 12 months.
I felt a deep sense of sadness when I read this report – and to a degree a sense of shame. As a member of the wider Aotearoa community and the medical community, I would like to think we are doing a lot better than this. I have always hoped that New Zealand is accepting and inclusive, but it would appear that this community, and I am sure other stigmatised minority communities as well, can’t take that for granted.
Despite the alarming nature of some of these findings, there were positives to come out of this study too, particularly around the sense of belonging and connectedness.
Jack Byrne, co-investigator on the study and human rights researcher, confirms this, saying, ‘‘Our study suggests that when trans and nonbinary people are supported by their families, teachers, classmates, workmates or community, it could save lives. The rate of suicide attempts in the past year was almost half for those participants whose gender was supported by at least half of their family or wha¯ nau.
‘‘Non-European participants, who felt a strong sense of belonging to their ethnic group, were also much less likely to have seriously considered suicide in the past 12 months.’’
The report calls for measures to improve the wellbeing of trans and non-binary people.
It suggests the approach should include creating better laws, policies and training to protect trans and non-binary people from discrimination and violence; providing clear pathways for genderaffirming healthcare in each district health board; naming trans and non-binary people as a priority in mental health policies; and supporting schools to be safe and inclusive for trans and non-binary students.
I could not agree more strongly and the louder we can make it the more likely it is to be heard. This wonderful community deserves better and, I hope the next time a study such as this is conducted, we can look at the results and feel proud of how much we have learned and how far we have come.
For more information on trans and non-binary resources, supports and information, visit Gender Minorities Aotearoa (genderminorities.com) or InsideOUT (insideout.org.nz).