The Difference Between Health & Politics

by Linda Darling

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

It could be argued that everything in life is political. It seems to me however, that there is a world of difference between the implicit assumptions of a holistic health discourse which struggles to accommodate diversity and be responsive to client needs, and on the other hand the conscious politicization of health from a minority sectional perspective for a specific political goal. The kind of language, behaviour, and practices of the two are, I believe, mutually exclusive.

What happens when one group attempts to impose it's own agenda and views on health and welfare issues is a subject that urgently needs addressing. It's time to talk about the abuse that's been going on in the gender community, in our family. Time to show the bruises and reveal the scars, for denial, silence and misinformation, has created a great deal of confusion, anger and fear for some of us. My point of view is that a health service consumer, the person in whose name things are done, but who seldom actually gets the chance to speak. I am not interested in factional politics, and have no view on the merits or demerits of trany political groups in so far as they effect the health and welfare service that I rely on. When they come into conflict with that then I feel they open themselves to legitimate examination.

Hegemony by Default

Is there such a thing as hegemony by default, I wonder? One reason the Gender Centre attracts attention among the gender community is that it is respected and looked up to for it's professional standards. It has a certain status and prestige, it has a budget an the organisational capacity to implement service directives. The trany community, on the other hand, is fragmented, divided and in disarray with few groups having a public presence at all. It means that by default, in the absence of a political or cohesive social community, The Gender Centre is perceived in some quarters as leading the trany community, as hegemonic. From this, it is a short step, for those with political aspirations to misrecognise the role of the Gender Centre [perhaps deliberately], and see the Gender Centre not as a health service provider but as an authority wielding power and influence. Seen from this angle, what it does in health can be "misinterpreted" for the purposes of political power, and an effort made to convert it's actions to the field of political discourse; to recode one discourse can be mounted. In fact, of course, the Gender Centre has no leadership role, nor does it aspire to any. It would be contrary to it's constitution and values. It looms large because the organisation and resources of the wider gender community are small - a matter of perspective. It is simply there and others are not.

At the Centre

The Gender Centre cannot become a prize to be fought over by conflicting factional interests. By it's very nature it must attempt to address the needs of many diverse groups. This is achieved by a constitution, a statement of operating principles, an A.G.M. and an elected management committee. I have lived in Gender Centre refuge accommodation and have also visited the centre many times and met others there. It is an oasis of calm and acceptance in an otherwise hostile world where people with serious issues in their lives can find a safe welcoming atmosphere and meet others in a friendly supportive environment with only basic courtesy expected from them. Many find, as I did, that this supportive environment can diminish fear and insecurity.

If the centre is threatened by outside political forces and it's every activity becomes in the eyes of some a subject of contention, then it's power to help and heal is thereby diminished. The words:

• client centered approach;
• self-acceptance;
• expressing oneself;
• non-judgmental;
• respecting cultural issues and values;
• religious principles and beliefs;
• racial and ethnic issues;
• the social and political values held by some presenting for service; and
• the self-determination of the individual regarding medical and therapeutic treatments,

are all words and concepts that are found in health and welfare and are designed to promote equality of service and be inclusive.

Two Vocabularies

What happens when the inclusive values of health and welfare are threatened by politicization? One group have provided a graphic example. That group of course is the Transgender Liberation Coalition, or T.L.C. By attempting to have the Gender Centre Staff dismissed and take control of the centre this group has, I believe, to be examined in great detail, since their actions follow a pattern and that pattern is determined by the nature of the organisation and the ideology. They have no publicly available literature to consult on their principles, constitution and so on, so I can only give some idea from my own personal experience. It is ironic that a small group of individuals that advocate removing the word "identity" as a psychological statement about a transgender person because it cannot accurately describe them, then immediately replace that with a very narrow and fixed political construction of identity. What exactly is this identity you may ask? Their view appears to be that there is a hierarchy, "realℜ trannies with real issues who live in the inner city suburbs, and who do not follow the medical intervention model - therefore surgical/hormonal options are not favoured. A certain T.L.C. member privately stated "anyone who has surgery must be a fool". They want someone who in their terms is "out" and "proud" as a highly visible public symbol. They want someone who challenges and confronts the gender order assumptions of the world at every turn. They see themselves as radical, challenging the world and deconstructing a whole society. They claim to have a social base among inner city and William Street trannies, and regularly speak for them on their behalf. I wonder if the people concerned are aware of that? They have little concrete to offer in terms of resources however, although they did gain some prestige because of the work they put in on the Transgender Anti-Discrimination Bill. The privileging of one identity (of people very much like themselves) they wish could be hegemonic, in the absence of any broad support, could only be effected by an infusion of resources, money and organisational capacity to gain that support. Unfortunately, for reasons mentioned earlier, the Gender Centre loomed large as the entity most likely to be able to supply these.

Funding

Funding is supplied for the Gender Centre by the N.S.W. Health Department through the AIDS and Infectious Diseases branch and supported by the Department of Community Services under the S.A.A.P. Program. It is tied to implementing fixed programs and health strategies. It is not a budget that can be appropriated for political purposes. If it was, then the funding would be withdrawn and the Gender Centre closed down. What am I to make of this? A member of the management committee received a telephone call at home from a T.L.C. member threatening that if she didn't toe the line then "we can pull half your funding".

T.L.C. Slogans

Before I talk about the campaign to destabilise the Gender Centre, politicise it's activities and draw it into political discourse, I'd like to examine a few T.L.C. assumptions and slogans. "Out and Proud", what does it mean to be "out", for some who identify as trany and are not invisible in the gender they perceive as theirs - there is no choice but to be out. "Why advertise an unavoidable fact of life" may be the reaction of many people. For some there is a choice, and that is the key word - choice. Some people have taken a great deal of time and trouble not to attract attention so they can have a relaxed private existence in the suburbs and this must be respected. From a health perspective of course it is. When a group of individuals substitutes themselves for the majority and makes being "out" a condition of authenticity, pride or value, then they quickly distance themselves from the others who feel diminished and offended by it. It is no longer the whole individual in or out that matters but simply the political value that lies in them being under the correct label.

What does "pride" mean for a transgender person I wonder? If it means self-confidence and self-esteem then this is positive and to be welcomed. If it means "trany pride" in the Mardi Gras or as a temporary compensation for perceived lack of status and esteem in the community then this too is positive. If an organisation or an individual is always "proud", always telling others they are proud to be who they are or proud to be a trany, I have to wonder why. On what basis does this pride rest? Most people are proud of specific things or achievements in their lives. A pride always carried around on display looks to others like arrogance. If someone is always "proud" and demands others accept this and tries to project it so others acknowledge them as proud, are they not in fact in a state of denial? In fact suffering from an inferiority complex which when "pride" disguises the unresolved problems of a persons life, distorts the ego and creates need, constant need for recognition and more opportunities for "pride" as a way of avoiding painful unresolved inner conflicts.

A health service cannot afford to be so strident. It has many different types of clients to consider. The political solution is of course to exclude some of them to make the group more homogenous and this indeed is what T.L.C. advocate with their notion of "prioritisation" of health resources targeted at their group.

T.L.C. Beliefs

T.L.C. appears to believe that it's campaigning around the trany bill has given it a privileged position to stake it's claim to speak for the whole community on a variety of other issues. They believe themselves to be the embodiment of a social movement (of five people) that is similar to the way the gay movement started by questioning medical pathology models of homosexuality. The problem with this is that the centre is eclectic by it's very nature there is no one model; quite sane and healthy individuals can weigh up the options and still decide that surgery is for them. They created the fiction that the Gender Centre operates under an "illness model" and says trannies are sick! as a way of mobilising fear. resentment and division so they could ride to "power" on the wave of hatred they created.

The campaign to destabilise the Gender Centre

The Gender Centre could not possibly accept the politics of T.L.C., who are a tiny minority of the overall service users. Because of this a long political campaign has been waged to destabilise the Gender Centre. The idea seems to have been to tie the staff up in refuting endless allegations, to plant stories in the press, to go to the Health Department itself and claim irregularities at the Gender Centre. Staff time seems to have been diverted to unproductive uses by this and staff morale reduced. This would be one way of getting the staff to leave since calls for resignations have failed. The more the queer press printed T.L.C. views, which was the only way they could communicate, then the more it seemed they were important. "Influential people in the community" as they describe themselves. The Sydney Star Observer and capital Q papers made no attempt to report the views of ordinary Gender Centre service users and instead chose to follow the direction of T.L.C.. They had decided that the Gender Centre was to be "won over" politically to their concept of "Queer Culture". What about the views of Gender Centre Association members or service users? These would only get in the way so they were ignored! Don't they realise that culture develops from below? It cannot be imposed from the top. They will have a difficult task to gain any credibility in the gender community. It might appear to someone who wasn't aware that the group consisted of only five activists, that they were speaking from some position of strength, that in some way they represented trannies as they claimed. This was for a very good reason - they wouldn't get it! "Trany" covers a multitude of people and lifestyles and couldn't be claimed as the property of one group.

Letters of Support

I'd like to quote from one of the many letters of support that were sent to the Health Department. This one is from Joanne Charles of Tasmania who used the service last year:

"From my limited experience there is no way that a "trannies only" staffing policy at the Gender Centre could provide the objective, balanced approach each person with gender issues needs and which the current staffing provides. Positive discrimination is a good thing providing that the best person is chosen to do the job, i.e. when two candidates of equal ability, experience etc are being considered for a position ... I believe that a take over by the so called "progressive" group would see the usefulness of the centre diminished and many people like my wife and I left to flounder in a sea of conflicting ideas and objectives".

Trannies Only?

As part of it's campaign to destabilise the Gender Centre, those following a T.L.C. agenda have insisted on only speaking to a trany member of staff. This falls into the overall pattern as intended to demoralise, divide and raise issues of authenticity. In fact, apart from rudeness, it displays ignorance. What kind of trany does this mean? Pre-op or Post-op or one of the 1001 possible varieties of psychosexual identity and gender representation that may identify as trany. Is it to be M.T.F. or F.T.M? There is absolutely no reason why a trained counselor or community worker cannot deal with telephone enquiries (as indeed with those that are face to face). Trannies are not an alien race. We share the common human experience in feelings, language and lives. A counselor may have to deal with people who have issues that she has never personally experienced - but does that make her work invalid? There is no special knowledge that a trany counselor has over and above a non-trany. Empathy and rapport are common human features. If somebody rang up and wanted to speak to someone exactly like themselves then objectivity and perspective would be lost. They should really be asking themselves why they feel so insecure.

Incredibly, non-trany staff members have been insulted, abused and humiliated by T.L.C.. In their view, from their "identity politics" point of view, the fact that non-trannies work at the centre is anathema, they are contemptuously dismissed with the words "you're not even a trany". Whoever said you had to be? Years of attempting to work with others and gain acceptance from society is at risk. Years of staff experience and expertise could be at risk if staff leave due to the abuse they receive from a tiny minority. That means 9000 telephone enquiries and request for help each year would go unanswered as well as the hundreds of people with gender issues who pass through the centre, their families, friends and partners.

The nature of T.L.C.

Think about the characteristics of religious sects that you have read about:

• an authoritarian leader;
• a narrow restrictive ideology;
• high peripheral membership turnover (many ex T.L.C. members say one of the reasons they left was because they were simply not consulted, not part of the decision making process, with this instead handled by an "inner group");
• belief in the rightness of ones cause to the exclusion of others;
• paranoia, fear that others may challenge their ownership of issues;
• switching from the role of bully to victim when tactically necessary; and
• a need to have external enemies to reinforce the ideology and power relations within a sect.

People I've met are worried about what's going on. Alarm bells should be ringing loud and clear.

The whole gender ordered world which marginalises them must be overturned and society cast in their image - an impossible task it would seem to many, yet one which they are of course free to advocate - but why inside the health service? The task of building an inner city, T.L.C., trannies only, "Transgender Space Project" is exactly that - a building task for those who raise the funds and support to do it. It is not something that can be superimposed on an existing health service.

For trannies who assimilate and follow the medical model a special concept is reserved. The F.T.M. co-convener of T.L.C. gave us his thoughts recently in the September issue of L.O.T.L.

"Unfortunately, one trait trany girls bring with them from the male world is they think through their genitals. Like a guy who thinks through his dick".

Post-ops do not challenge anything and are thought to have in some sense "sold-out" or "betrayed" something. This leaves the "pure" the "elect", the ones that know the truth of how gender should be perceived and how trannies should live their lives to struggle against ... well against the whole of society actually! Surgeons are of course demonised and politically incorrect, This explains, but does not excuse, the attempt made by T.L.C. to deny 40 people access to information about surgery at a meeting at the Gender Centre with Dr. Haertsch. He is simply someone who purveys what T.L.C. calls "genital mutilation" that they insist you be saved from.

T.L.C. have succeeded to some extent in using a strategy analogous to the "broad front" rhetoric of leftist political factions to gain post-op trany supporters and voting numbers, thinking they were joining a political lobby group and unaware of the real nature of T.L.C. or it's aims. This strategy gives a small faction the ability to "steer" a larger group in the direction of it's own factional aims.

When political concepts of power and conflict are pushed into health discourse, resistance, in the form of those who subscribe to health values must be overcome - an example of this was provided in the way T.L.C. chose to disrupt the management committee electoral process. They were in a very small minority and only by negating the views, and denying a vote to the majority of the members of the association could their aims prevail. The fact that they were willing to do this, risking the closure of the Gender Centre is deeply disturbing. A lot of very vulnerable new members were shocked and hurt and didn't come back to the second. At the second attempt at an A.G.M. the stark choice was - elect a committee or lose the Gender Centre - T.L.C. gained one committee place out of a possible seven.

One important relationship in health is about listening to and understanding the clients needs, not telling them what they ought to need. It is not the same as a political position which assumes a role of speaking with power and knowing what is required for others. In T.L.C.s case this can often seem merely as an attempt to validate their personal and collective insecurities. Why am I being held hostage to these?

How can health and healing proceed in an effective manner at the Gender Centre? From what has gone before, the centre cannot be seen in isolation. It can only be as effective as the gender community enables it to be. It can either be a football and it's A.G.M.s just an annual sports fixture to be relished with anticipation, or the community could do what all others have done, that is, create their own space outside the health and welfare system to articulate their needs. Look outwards. This means community development on a large scale, new groups formed, magazines launched, art and craft exhibitions organised, businesses owned, run and controlled by trannies - in fact a whole world to gain. When this happens, health provision will be seen in it's proper perspective, as a safety net, a basic provision, a base line of minimum state support.

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.