FTM Network response to the DfEE's consultation paper

February, 1998


Ms F A Martin
Department For Education and Employment
Caxton House
6-12 Tothill Street
London SW1H 9NF

February 25, 1998

Dear Ms Martin,

Re: CONSULTATION PAPER: LEGISLATION REGARDING DISCRIMINATION ON GROUNDS OF TRANSSEXUALISM IN EMPLOYMENT

Please find enclosed a response to the above, on behalf of the FTM Network.

The FTM Network is a self-help group providing help, advice, support and friendship to female to male transsexual and transgender people. The network was founded seven years ago and currently has 650 members in the UK. The membership ranges from those men who have been living in their new male gender for over 40 years to those who are considering whether a change of gender from female to male would be an appropriate solution to the issues and problems they are facing. The ages of the membership are from 16 to 80, and the areas of their employment are varied.

We have looked at the paper and the issues as they would particularly affect female to male transsexuals.

We look forward to hearing the outcome of this consultation process and hope that you will feel able to keep us informed.

Yours sincerely


Stephen Whittle
FTM Network Co-ordinator


FTM Network: Response to DfEE Consultation Paper on Legislation Regarding Discrimination On Grounds Of Transsexualism In Employment

Our primary point is that this proposal is unnecessary and should be withdrawn. The recent decisions in the ECJ, IT’s and the EAT, as we understand it, have held that ANY discrimination in employment on the grounds of an individual’s transsexualism, no matter what stage of treatment they are at, is illegal. As such transsexual people have the law’s protection in the workplace. The next stage surely must simply be to give guidelines to employer’s to ensure that both they and their employees are aware of the implications of these rulings, and that their equal opportunity policies are up to date.

Secondly: many of the problem areas envisaged in the paper could be immediately resolved if current scientific knowledge and best European practice was followed and transsexual people were able to be legally recognized in their new gender role for all purposes.

Thirdly: we consider many aspects of the consultation paper to be ill informed about the transsexual condition, its treatment and the processes undergone, and what can be achieved in individual cases. The paper does not take into account the many diverse ways in which individuals are affected by the condition and the lifestyle choices they are obliged to make because of the current social stigma attached to it. In particular it singularly fails to be aware of the treatment processes of gender reassignment (GR) and its particular limitations in relation to transsexual and transgender men (FTMs).

We will now address the specific points in the consultation paper, albeit that we consider that our primary point should be paramount.

Para 9 : It seems appropriate, for the purposes of employment protection, to regard difficulties faced as a result of GR to be comparable to another individual undergoing lengthy medical treatment.

Para 10 : It is unrealistic to mark the start of protection as being at the point of time when individuals seek medical intervention. Many FTMs have no choice, because of family or social difficulties, to try other than to accommodate their trans lifestyle without seeking treatment. Further current NHS funding policies mean that many FTMs find it impossible to obtain medical treatment. Area Health Authorities are refusing even an initial consultation for assessment on the basis that if that assessment means that the individual is diagnosed as transsexual this would commit them to the funding obligations required to provide treatment. This means, for example, that many attend work in an androgynous or ’butch’ mode of dress prior to any treatment - surely they should also be afforded full protection in the workplace from harassment and dismissal, so long as they work within the workplace rules. However practice guidelines, to ensure such rules are not excessively onerous in terms of gender conformity except where absolutely necessary, would, we consider, be a good idea.

Para 11 : It is often difficult to define a distinguishing moment when a person might be considered to be transsexual (see above). They might be said to be so from birth to death, and so should warrant appropriate protection from inappropriate discrimination throughout their lives - just as the law provides so for women and black people.

Also, as previously pointed out, because of NHS funding policies many FTMs resort to seeking private treatment on an ad hoc basis. There are also many FTMs who underwent GR many years ago, should they now be forced to seek medical confirmation of what has become a fact? Further, there are doctor’s who refuse to acknowledge that an individual is transsexual. One network member who had been living, and working, as a bearded and successful man for several years was consistently refused any form of surgical treatment on the NHS, because, as it turned out, one particular psychiatrist had refused to recognize him as being transsexual. The FTM ultimately obtained a mastectomy privately, having had to save for it. He is now a successful university lecturer.

Para 12 : There should be no circumstances in which disclosure is necessary. The particular circumstances proposed are ludicrous. Should a FTM not be allowed to play a man in a drama because he is not a ’real’ man? He certainly would not be able to play a woman - unless of course he did it in drag. As regards private households, surely to refuse to employ somebody because they are a transsexual man would do nothing more than justify prejudice.

Para 13 : With regard to FTMs - the question illustrated above is: "How is it possible to identify what is the period of gender reassignment?"

The treatment process for FTMs is:

Hormone therapy
must be pursued for life, the voice will break after approx. 6 months, beard growth will appear after 9 - 12 months.
Bilateral mastectomy
will be performed at the earliest 1 years after commencing living in role. Current NHS waiting times are around 3 years, during which the FTM has to bind their breasts in order to hide them. For some who are very large breasted this is very difficulty and painful, and it will be difficult, during that period, to disguise their status as FTM.
Hysterectomy
this is no longer recommended as a compulsory treatment, until the FTM is of post menopausal age. Some FTMs have a hysterectomy at an earlier age because testosterone treatment can cause erosions of the cervix. However for the majority, as menstruation and fertility will have ceased within 2 months of starting hormone therapy, it is recommended that they avoid this serious and invasive surgery until they are of an age when they become liable to an increased risk of cervical cancer.
Phalloplasty or Metadioaplasty
this is surgery to create a phallus, or in the case of metadioaplasty; a micro penis from the release of the clitoral hood. Currently such surgery is rarely available on the NHS, and even if pursued at great cost privately (between £40,000 and £100,000), is rarely successful. The failure of such surgery is not limited to sexual inability, but often leads to major disability for the FTM concerned. Of those few network members who have pursued such surgery, nearly all are now disabled for life and will never work again. As a result, such surgery is not recommended by any of the leading physicians in the field, other than a last ditch attempt to save an individual from taking their own life.

Of the network members, less than 3% have undergone genital surgery, and we see one of our main functions as educating FTMs to learn how to live life to the full as a "man without a penis".

The implications are that if any time period were to be designated the time when someone was during reassignment, we would have to recommend that, for FTMs, it was that period leading up to the point when they were placed on the waiting list for a bilateral mastectomy. To extend it beyond this would place them in a legal limbo for the purposes of employment for an indefinite period.

To answer the specifics of this section:

a. Toilets have doors which are designed to give individuals privacy. FTMs always have to use a cubicle rather than a urinal. Hormone treatment very quickly allows the FTM’s voice to break and beard growth to develop, for them to use the lady’s loo would, we are sure, be extremely threatening to the women who used them. It is FTM’s who are likely to feel fearful in public toilet areas, many find the fear of discovery very debilitating. To be forced to use an inappropriate toilet or a disabled toilet would be cruel, and would lead to a fundamental failure of the requirements of the "real life test" imposed by the medical profession, which is required before any surgical treatment will be provided.
The notion of the proposed "reasonable person" test assumes that all people in society fit in neat little boxes. Many people would fail such a test - on that basis should employers insist that a polycystic woman with facial hair or a Kleinfeldter’s syndrome man with breast growth use the disabled toilet.
b. If FTMs are to be excluded, at any time, in their employment from close personal contact with others, it would exclude (and in the past, have excluded) many from their jobs. There are amongst the FTM network members; trainee doctors, masseurs, chiropodists, physiotherapists, occupational therapists, nurses, security guards etc. Surely the public in these circumstances are only seeking the treatment provided by these people, patients with flu really don’t care whether they are seen by a male or female doctor, similarly both male and female chiropractors treat both men and women. Would you be arguing that transsexual men and women could complain if they were to be treated by non-transsexual men and women?
c. The notion of a period of reassignment in which treatment is concluded is fundamentally flawed as regards FTMs. The problem, as we have said earlier, lies with the limitations of treatment. Albeit that many FTMs can achieve quite masculine features through hormone therapy and a bilateral mastectomy, current best medical practice recommends that they do not undergo genital surgery. As such most FTMs learn to live their lives as men with female genitalia, the alternative is horrendous scarring, a useless and painful phallus incapable of urinating or of being used for sexual intercourse. As well as those we have already cited who work in close contact with members of the public, amongst our members we also have a leisure centre manager, a swimming pool attendant, several who work in clothing retail, many who work as home helps or social workers in the community. To specify a completion point for GR would bar those people from their jobs for life.

Para 15 : This begs the question as discussed above - when would GR be completed in the case of the FTM ? As we understand current case law, FTMs already have complete protection under the SDA 1975, and we would argue that that position should not changed.

Para 16 : Such exceptions would bar many of our members from the jobs they are already undertaking successfully. As regards religious exceptions, this seems to do nothing more than enable organized prejudice. If an organization would employ men and women then it should also employ transsexual men and women.
One member did, in fact, work as a church community worker and was dismissed when his past was disclosed. However the church congregation walked out, en masse, in protest when they learnt the truth of the dismissal (it had previously been implied by the church wardens that the dismissal was due to sexual improprieties with children!).

Any religion should be endeavouring to maintain even higher standards than the rest of us, if they don’t then they should lose their charitable status.

As regards vulnerable people: many network members are ’out’ about their gender status and we know of no instance where ’vulnerable’ people have felt threatened in any way by the transsexuality of their carer. In fact, it has been stated by several public and private sector employers that their FTM employees bring a great understanding of their clients’ difficulties to these posts, and several of our members work with patients with mental health difficulties both in hospitals and in the community.

Para 17 : This would only be acceptable if full legal recognition were to follow GR. The Government simply cannot have its cake and eat it in this case. Employer’s would be able to dismiss, or refuse to employ, an FTM for a male post because they were legally a ’woman’ and they could refuse to employ them in a female post because they looked like a man. One network member who worked as a legal advisor for a Lesbian Law group, has continued to work for the group after his transition to the male role, and there have been no problems in the workplace, or with clients.

Para 18 : Many of our members work with children both professionally and as volunteers. Whether scout masters or teachers, such posts are not barred to either men or women, to bar FTMs would be to exclude them from posts they are already bringing expertise, enthusiasm and skills to.

The notion that FTMs are a danger or a threat to children in any way is confusing sexuality with gender. FTMs are like other men only perhaps even less of a threat because, to our knowledge, there has never been a charge or a conviction of an FTM for molesting children.

As to whether children find their own gender identity threatened or damaged by knowing an FTM, in reality most children would never know. Of those who do, such children have shown a greater understanding than most adults. Further many FTMs are parents, whether biological or not, and bring up children very successfully.

Para 19 : This is unacceptable. There is no reason why an FTM should not be afforded the support of the EOC to claim the protection they have under the SDA, and not just in the workplace. To remove this potential support would be in itself contrary to the SDA and the spirit of it, discriminatory and a legalization of bigotry. It would drive far more FTMs into the dreadful spiral of secrecy which has ruined enough lives already.

We, as an organization, condemn these proposals as 

1. Ill-informed as regards the issues faced, the medical treatment undergone and the relationships between gender, sex and sexuality in trans people’s lives.
2. Short sighted as regards the legal implications of attempting to remove protection already afforded to transsexual people by the courts both here and in Europe.
3. Legitimizing discrimination on the grounds of gender behaviour which is seen as ’different’. We feel they will endanger many FTMs positions in the workplace, particular through the emphasis on the "completion of treatment".

We feel further that they are a continuation of the social stigmatization processes which drive FTMs, and their loved ones, into a life of secrecy wherein they are driven to feeling ashamed of themselves and their status.

We feel as an organization that the consultation process should be extended so that we can inform government as to our real needs in the workplace and as to how we can help contribute as good citizens to the welfare of the society that belongs to us all.

Stephen Whittle, FTM Network Coordinator
Sam Wong, FTM Network Secretary

On behalf of the FTM Network, BM Network, London WC1N 3XX