We don’t need mental health awareness. We need action

Today is World Mental Health Day, and the theme is suicide prevention. Many politicians and commentators will say or write suitably concerned things about the importance of getting help, without acknowledging that they are part of the reason people need help in the first place.

Mental health is political.

The causes are often political. And the shocking lack of support and treatment for people is political too.

I’ve lost two friends  to suicide this year. One of them took his own life while on a too-long waiting list for treatment. His death was the result of political choices. The system might not have been able to save him. But the system never tried.

The grotesque underfunding of the NHS, underfunding that makes vulnerable people wait years for treatment if they live long enough to access it, is not accidental. It’s the result of many years of swingeing cuts, of ideologically driven changes to the way the NHS works, of a deliberate lack of funding for the training of health professionals, of a refusal to fairly tax corporations and the most affluent people in society to adequately fund health and social care.

I’m particularly aware of this because I’ve seen how desperately underfunded mental health services are. It’s even worse if you’re trans: people who are trans have to wait even longer for help, which is why the suicide, self-harm and substance abuse rates in our community are so frightening. In some cases the gap between initial referral and actual treatment can be four or even five years.

That’s political too. Trans healthcare is a grotesquely underfunded and overworked subset of mental health provision. Once again, that’s the result of political choices – choices affecting the wider NHS, and choices such as the UK governments’ persistent refusals over many years to heed warnings of growing demand for trans-related healthcare. The current crisis in the gender clinic system was predicted years ago by credible experts. Politicians chose not to listen, let alone provide any additional funding.

Commentators play their part too. My own mental health has been severely impacted by the daily demonisation of and scaremongering about trans people in mainstream media – Radio 4 was at it again this morning, platforming anti-trans bigots without any dissenting voices – and on social media, where I have to block thousands of people just to be able to use the apps normally.

It’s not just us. It’s the immigrants blamed for putting pressure on the NHS to distract from funding cuts and creeping privatisation. It’s the EU nationals forced to apply for settled status to continue living here, the non-white people demonised in the national press as criminals and terrorists, the so-called “snowflakes” laughed at for daring to talk about their mental health, the people from ethnic, sexual and romantic minorities whose very existence is questioned and whose rights are deemed less important than those of others.

And most of all, it’s poverty.

There’s a reason people in Glasgow’s affluent West End live longer than those in the deprived East, and that reason has existed since the West End came into being: it isn’t race, it isn’t religion and it isn’t sexual orientation or gender identity.

It’s money.

Money enables you to buy better living conditions, better food, a better education for your children, in many respects a better life.

That’s not to say affluent people don’t get mental health problems. Of course they do. But they don’t rot on the same waiting lists that poor people do. They aren’t bullied by the DWP like poor people are. They aren’t on zero-rights, zero-hour contracts like many poor people are. They aren’t reliant on desperately overstretched and underfunded community mental health services like poor people are.

Mental health problems are not a sudden plague caused by who knows what. They are the inevitable result of successive governments removing the safety net for society’s most vulnerable people, the consequences of creating a society where the most privileged are able to deny their responsibility to help the less fortunate and incite hatred of those who need help most. They are the result of inadequate housing, of slashed funding for mental health services, of inadequate protection against hate crimes and discrimination, of a low-wage, low-rights employment market.

They are the inevitable result of a society that works for the few and despises the many.

It’s not enough to say “if you’re sad, get help”. There needs to be help available. All too often there isn’t. And that’s no accident. That’s political.

We don’t need better mental health awareness. We need better mental health provision. We know we need help. For too many of us, the help isn’t there.

Don’t let the politicians away with it. Don’t let them post “it’s OK not to be OK” and consider their job done. Demand answers. Demand action.

Too many people aren’t OK. And that’s not okay.

Go and get the flu vaccine

I was given the flu vaccine the other day. I hadn’t really thought about it but since a lung cancer scare a few years ago there’s a flag on my medical records and I’m considered high risk for pulmonary infections and COPD, so I get invited to this stuff.

As you’d expect, the vaccine didn’t give me flu, make me grow horns or make me autistic, because vaccines don’t do that. What it did do was make me feel a bit crap for a few hours before protecting me from catching – and more importantly, spreading – a really horrible disease.

As Frances Ryan writes in The Guardian, the flu jab saves lives.

Flu is often thought of as nothing more than a week of feeling rotten, but it can be life-threatening, particularly for older people and anyone with an acute illness like cancer or underlying chronic health conditions, like me.

In 2018 I developed flu complications that left me unable to breathe or move and on a ventilator for months. It’s left me with life-changing fatigue and pain, but in many ways I was lucky. Last year 1,700 people died of the flu – despite the fact that this was a relatively mild strain – and further hospital admissions put even greater pressure on an already overstretched NHS.

The vaccine is free for at-risk groups and incredibly cheap for everybody else. You should get it, if only to prevent having to take time off work to feel like shit.

Unfortunately we have a problem persuading people to take vaccines. Ryan:

The UK, like much of the west, is battling an anti-vaxxing movement in which social media has become a gateway for scare stories and quackery. Diseases such as measles are on the rise in England, with the UK recently losing its measlesfree status with the World Health Organization because a growing number of people believe dangerous myths about vaccines.

Things are so serious that one newspaper is taking a stand. Here’s today’s Daily Mail.

The crusading, campaigning Mail is going to fight against the forces of idiocy and darkness that have persuaded parents that vaccines are dangerous.

Forces such as, er, the Daily Mail.

The Mail scaremongered about vaccines for years, and while other UK papers (including the Guardian for a while) did the same it was by far the most vocal. Its sustained, decade-long campaign against the safety of the MMR vaccine continues to inspire and be cited by the global anti-vaxx movement.

As late as 2005, the Mail continued to argue that debunking the MMR/autism scare was fake news and accused critics of disgraced doctor Andrew Wakefield as perpetrating a witch hunt.

The science editor of the Daily Mail argued that ‘the MMR scandal is getting worse. Urgent questions about the vaccine’s safety remain unanswered. The doctor who raised those questions is being subjected to what appears to be a witch-hunt. The parents’ recourse through the courts has been blocked. Now they have to put up with being told yet again that the evidence of their own eyes is fraudulent.’

The Daily Mail spent a decade scaremongering about vaccines: Google “Daily Mail MMR” and you’ll find tons of uncorrected “the truth about MMR” articles and articles that push the long-debunked claim that vaccination causes autism.

Its new campaign is laudable, but it won’t undo the damage it’s done to public safety not just here, but globally.

Little miracles

The Royal Hospital for Children in Glasgow, my son’s home for the last week

I mentioned in a previous post that my son has been in hospital. It’s been a very long couple of weeks: he was misdiagnosed twice before his atypical symptoms led to a correct diagnosis and treatment, which included surgery. He’s home with me now, recovering.

My head is a mess of thoughts just now, but I wanted to post one thing: I’m very grateful to the many NHS staff from surgeons to domestic staff who helped look after us over the last week or so. For all its flaws, the NHS is an extraordinary thing. The people who work for it ensure it performs little miracles every single day.

Why the search for an LGBT+ gene is dangerous

There’s been a lot of publicity over a new study into the so-called “gay gene”; the study reports that although there doesn’t appear to be a single genetic marker for gay people, there may be several. Similar studies have attempted to find a genetic marker for trans people.

Here’s why that’s scary.

This image was posted by Antony Tiernan, and in response the writer Huw Lemmey noted the context: “over a million British people still buy this paper every day.”

Let’s be optimistic and believe that nobody would choose to abort a baby whose genes suggested they might be gay or trans. That doesn’t mean genetic screening for LGBT+ people couldn’t happen, or couldn’t be misused.

The problem with any kind of genetic screening is that it’s a guide. For example, I’ve just had my genes analysed and I have a slightly raised risk of pulmonary disease. That doesn’t mean I will get it. It just means there’s a higher likelihood than perhaps you have.

One of the things I was screened for is abnormalities relating to the BRCA1 and BRCA2 genes, which we know are implicated in many cancers. I’m clear – but the screening only checked a small proportion of the thousands of potential variants. I could still have a difference in one of those genes that means I’m more likely to get cancer.

Now imagine I’d been screened for genes linked to being trans. The same thing could apply: you could check for 100 different anomalies, and that could come back negative – but there could be hundreds upon hundreds of other genetic variations that you don’t check for, and which have contributed to me being the fabulous trans woman you see today.

Why does that matter?

It matters because if we developed a genetic test for LGBT+ people we might decide to use it in asylum claims, because one reason people claim asylum is because they face persecution for being LGBT+ in intolerant countries. Imagine: we could easily differentiate between the real asylum seekers and the fakers!

Far-fetched? Last week a British judge rejected an asylum seeker’s application because he didn’t seem gay enough. He contrasted the man’s demeanour with that of another man who “wore lipstick” and had an “effeminate” manner.

In that case, the judgement was appealed and has been sent back for review. But what if the judge had rejected the applicant because his genes “proved” he wasn’t gay?

It could also be used to “prove” that people are lying about their sexuality or gender identity in other circumstances. There’s already fierce and often malicious debate over whether some trans people are “trans enough”, so for example anti-trans bigots are keen to differentiate between “true” trans people, who they pretend to care about, and “fake” trans people – people like me who haven’t had surgery – whose human rights they want to curtail and whose healthcare and support services they want to defund.

Could failing genetic testing mean I’d be denied NHS treatment such as hormone therapy?

Scaremongering? Here’s TIME magazine with a short history of how bullshit science has been variously used to justify discrimination against people of colour and against women.

In the early 20th Century, out of context IQ testing was used to justify the forced sterilisation of black and hispanic people.

the notion of feeble-mindedness, at least partly determined by IQ tests, was used as a justification for the Supreme Court’s notorious Buck v. Bell decision, which allowed forced sterilization for “insanity or imbecility,” mostly among the population of prisons or psychiatric hospitals.

One of the links in that article goes to a study of pseudoscience on women’s suffrage.

many scientists supported the antisuffrage argument of “physical force,” claiming that women lacked inherent energy needed to physically enforce laws and should be excluded from voting. A secondary argument claimed that such cyclic elements as menstruation and menopause made women too irrational to vote.

More recently, halfwits in Silicon Valley have been pushing the bullshit theory that men are better suited to tech jobs because of exposure to “prenatal testosterone”.

Sexuality and gender identity are complicated and multifactorial, and they are normal variations in human behaviour and biology. That means there can never be a reliable genetic test for being gay or being trans, and we should be scared of anyone who wants to create one.

As TIME’s Jeffrey Kluger writes:

…as long as there is science—which means forever—there will be people willing to misuse what it teaches.

The kindness of women and the sadness of men

Emily Todd VanDerWerff is a critic at large for Vox, and she’s reviewed an interesting video by PhilosophyTube that addresses the issue of men’s mental health.

I thought this bit of her review was particularly interesting.

Thorn suggests that one project worth undertaking, should you have a platform like his to do it, is to increase the number of emotional colors that men feel free to paint with, so they’re not forced to work with such a limited palette. By making a video like this one, he says, other men might be able to recognize themselves in his story and find sustenance and help with the process of navigating their own emotions.

(A personal sidebar: This is deeply true. Since coming out as a trans woman, I’ve found a staggering number of emotional support systems open to women compared to those for men, because women in our culture are expected to be emotional, whereas men are expected to be buttoned-down. If I’m having a hard day or quietly crying at a restaurant, I almost always receive a quick, “Are you okay?” from other women who might be around. This never happened to me when I lived my life as a man…

That’s been my experience too. The conversations I have with women are very different from the conversations I used to have, and still have, with men. It’s not just evident in conversations with close friends; it’s there with people I didn’t know an hour previously too. It’s hard to put into words, but I think the difference is what’s meant by the question “how are you?” from someone you know outside of a professional context.

Having played for both teams, I think there is a difference in the way men and women ask it and answer it. The women I know ask it with meaning and answer honestly. Whereas the men ask it and really hope they don’t get an honest answer – which is handy, because the man being asked has no intention of providing one. He’s fine. He’s always fine.

I think things are getting better – for example the stigma around talking about mental illness seems to be fading – but I think among men of my age and older there’s still that boys-don’t-cry, stiff-upper-lip thing going on. Which is perhaps partly why my friends and I have lost two men to suicide in the last three months: while women are more likely to suffer from mental health problems, men are more likely to kill themselves. In 2017 in the UK, 5,821 people killed themselves. 4,382 of them were men.

This is what we mean when we talk about tackling toxic masculinity. It’s not about tackling all masculinity, changing what it means to be a man or diminishing men in any way. It’s about increasing the number of emotional colours that men feel free to paint with.

Help is here

For the second time in just a few months, my friends and I are mourning another life lost to suicide.

Too many people are struggling with mental health and suicidal thoughts. If you’re one of them, please speak to somebody. The world is a better place with you in it, and can be a better place for you.

Put these numbers in your phone if you think you might need them.

0800 58 58 58 – The Campaign Against Living Miserably; online chat is available on the website.

116 123 – Samaritans. If you prefer you can email jo@samaritans.org.

0808 802 8008 – Music Minds Matter, for musicians and people in the music business. Also MMM@helpmusicians.org.uk

 

Inciting hatred of trans women in the name of feminism is “despicable”

There’s a great interview with the equally great Ruth Hunt, departing CEO of Stonewall, in Buzzfeed News. Ruth hasn’t just had a hard job. She’s had to deal with constant online abuse, some of it criminal, and has been the target of bigoted pundits in the media too.

“Mainstream newspapers running consistently transphobic articles, day in, day out, ostensibly expressing concern about the fate of butch lesbians?!” Hunt sniffs with contempt before finally letting go.

“It’s like, ‘You have not written a SINGLE positive piece about butch lesbians in my ENTIRE ADULT LIFE. Your style pages have not reflected me; your problem pages, your look, your discussion about lesbian identity, has never included me. Don’t you DARE pretend that you are now advocating for me as an excuse to attack trans people. THAT makes me angry.”

The increasingly unhinged scaremongering over trans women has led to Hunt being repeatedly questioned in the toilets because she doesn’t look stereotypically female. On Twitter last night, a Scottish journalist noted that exactly the same thing happened to her wife:

I want to say to “gender critical” people: 

You are damaging trans people, and that’s bad enough. 

BUT YOU ARE ALSO DAMAGING THE PEOPLE YOU CLAIM TO BE PROTECTING.

Back to the article. This, about the online noise over gender recognition reform, is really interesting.

when Hunt’s experience of Twitter was an endless shelling against trans rights, the charity sought external help — specifically, to investigate what exactly was happening on social media and what it meant. It looked as though those against trans inclusion and attempts to simplify gender recognition were a large proportion of the total.

The analysis found that the supposed majority was just a vocal minority.

A similar distortion played out in the media earlier this month. The Sunday Times published a letter from 30 academics urging universities to “sever their links” with Stonewall for “stifling academia” because it encourages universities to oppose transphobia. It appeared to represent, in its dozens of signatories from across British higher education, a predominant position within academia.

But just days later, a counterpetition of academics, supporting Stonewall and opposing transphobia, attracted 3,600 signatures. This was not reported in the Sunday Times.

I liked the bit in brackets here

The decision to embrace trans rights led to her and Stonewall being engulfed in hostility. Regular deluges on social media. Weekly, sometimes daily, criticism in the media. High-profile lesbians and gay men criticising her and her charity, withdrawing personal donations, signing petitions in protest — moves all eagerly published by right-wing newspapers. (It hasn’t worked overall, though: donations are up 11%.)

 

Not mad. Not bad. Just normal.

There isn’t a single day when I don’t see somebody claiming that trans people are mentally ill and/or degenerates. Here’s some geniuses from this morning.

A huge problem is that public awareness of trans people – and of what the medical consensus is about trans people – is incredibly out of date.

For a long time, normal human variety and behaviour has been pathologised – that is, labelled as a medical problem when it isn’t.

A good example of that is in the pathologisation of women. In the Victorian era, women who rebelled against domesticity could be labelled insane and thrown into asylums. Doctors considered women to suffer from an invented condition called “hysteria”, a condition that should be cured by finding a husband. In the 1950s, women were routinely sedated to deal with their unhappiness. In the 1960s and 1970s, feminism was considered by many to be a medical problem.

And that’s before we get to the queer folk. In the US, homosexuality was classified as a medical condition until 1973. It isn’t, of course, but the supposed science was based on gender beliefs about the supposedly essential qualities of men and women. To put it simply, if you weren’t a manly straight man or a girly straight girl there was clearly some sort of medical problem.

The treatment was harsh. Some people were given electro-shock therapy, a practice that continues in China to this day, or aversion therapy, or other supposed cures that caused great damage.

The Bible of psychiatric conditions for US doctors is the Diagnostic And Statistical Manual, or DSM for short. It’s a reference manual produced by the American Psychiatric Association (APA) and its first two editions included homosexuality. The APA was very resistant to improved scientific knowledge because it contradicted its members’ beliefs that gay people had a “degenerative” condition.

American psychiatry mostly ignored this growing body of sex research and, in the case of Kinsey, expressed extreme hostility to findings that contradicted their own theories.

Some gay activists were complicit in this.

…some mid-20th century homophile (gay) activist groups accepted psychiatry’s illness model as an alternative to societal condemnation of homosexuality’s “immorality” and were willing to work with professionals who sought to “treat” and “cure” homosexuality.

It’s easy to condemn now, but “be nice to them, they’re mental” was a step forward from “throw rocks at them, they’re perverts”.

Eventually, though, science won: fact beat faith, and homosexuality was no longer a medical condition in the DSM III onwards – although it remained a “sexual orientation disturbance” until 1987. Nevertheless, “APA’s 1973 diagnostic revision was the beginning of the end of organized medicine’s official participation in the social stigmatization of homosexuality. Similar shifts gradually took place in the international mental health community as well.”

There was a wider context to this: the World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems, ICD for short. In 1948, the WHO published version six of the ICD, ICD-6, which classified homosexuality as a “sexual deviation”.

The ICD listed homosexuality as a mental disorder until 1992.

Most people understand that gay people are perfectly normal, but until very recently the official medical literature said otherwise. And that legitimised hatred.

As a result [of removing homosexuality from the DSM and ICD], cultural attitudes about homosexuality changed in the US and other countries as those who accepted scientific authority on such matters gradually came to accept the normalizing view. For if homosexuality was no longer considered an illness, and if one did not literally accept biblical prohibitions against it, and if gay people are able and prepared to function as productive citizens, then what is wrong with being gay? Additionally, if there is nothing wrong with being gay, what moral and legal principles should the larger society endorse in helping gay people openly live their lives?

The result, in many countries, eventually led, among other things, to (1) the repeal of sodomy laws that criminalized homosexuality; (2) the enactment of laws protecting the human rights of lesbian, gay, bisexual and transgender (LGBT) people in society and the workplace; (3) the ability of LGBT personnel to serve openly in the military; (4) marriage equality and civil unions in an ever growing number of countries; (5) the facilitation of gay parents’ adoption rights; (6) the easing of gay spouses’ rights of inheritance; and (7) an ever increasing number of religious denominations that would allow openly gay people to serve as clergy.

Most importantly, in medicine, psychiatry, and other mental health professions, removing the diagnosis from the DSM led to an important shift from asking questions about “what causes homosexuality?” and “how can we treat it?” to focusing instead on the health and mental health needs of LGBT patient populations.

Guess what? The DSM and ICD also pathologised trans people. The DSM detailed “gender identity disorder” until 2013, when DSM-5 reclassified it as “gender dysphoria” – not perfect, but better.

The widely circulated belief in a made-up condition called Autogynephilia (short version: trans women are either narcissists or confused gay men; as ever, trans men aren’t given much thought) has been thoroughly debunked; being trans is not considered a mental illness in the DSM any more: the problem isn’t being trans, but the distress that comes from trying not to be.

The same thing is happening with the ICD. As the WHO announced last year, “transsexualism” is being removed from ICD-11 – so the diagnosis I have, of “transsexualism male to female ICD10 F64”, will be consigned to the history books. The change was ratified this month by the Assembly of States of the WHO.

As with the DSM, some concerns remain (not least whether US insurers will continue to pay for trans people’s transition-related healthcare).

Here’s the Council of Europe Commissioner for Human Rights.

While the removal of gender identity from the list of mental illnesses is a positive step, several concerns remain with the ICD11, and I call on WHO member states to continue improving the text to promote respect of human rights.

Such concerns include the term “gender incongruence” retained in the ICD11 which may lead to interpretations suggesting abnormality, as well as the continued listing of gender incongruence in childhood in the ICD.

I particularly regret that no progress was achieved in the ICD11 toward depathologisation of intersex people, and that terms such as “sex development disorders” continue to appear in the text. Language in the ICD Foundation suggesting sex “normalising” surgeries remains, which is of major concern.

As with the DSM, it’s not perfect, but it’s better. As the Commissioner says:

The pathologisation of trans people has served to justify serious violations of their human rights over the years, including attempts to “cure” them through conversion or reparative therapies; psychiatric evaluations, and sterilisation. In many countries, legal gender recognition is only possible upon medical diagnosis.

Science, knowledge and understanding isn’t a fixed point. We now know that feminist women are not hysterical or insane. We know that you can’t pray the gay away or make people straight by electrocuting them. And we know that being trans isn’t an illness.

Do you believe us yet?

This is where it leads. The “reasonable concerns”. The “just asking questions”. The denial of science. The platforming of extremists who seem like such nice people. The endless articles telling you trans people are dangerous.

The Trump administration says it’s okay to let trans people die.

Under the discrimination administration’s latest plans, healthcare can be denied to trans people.

Insurers can refuse to pay for treatment.

ERs can refuse to treat trans people.

Paramedics can refuse to save our lives.

Doctors can refuse to treat our children.

Pharmacists can refuse to dispense hormones (something that’s already happening; in one case the pharmacist held onto the prescription so the trans person couldn’t get it filled anywhere else).

It’s not just us, of course. The rest of the LGBT umbrella is being targeted too, as are women who’ve had abortions.

We’re just the headline. People who aren’t trans read it, think “nothing to do with me” and move to the next article.

This is how human rights are lost.

This is how people die.

I’m not exaggerating. I’ve blogged before about Tyra Hunter, left to drown in her own blood because emergency workers discovered she was trans.

Here’s Sam Dylan Finch, who writes for Healthline.

I remember when I lived in Michigan and a trans woman that I knew had to call 911, because a serious wound she had (from an unrelated medical condition) started hemorrhaging overnight.

One of the EMTs went upstairs to her room, and when that EMT realized she was transgender, was visibly disgusted and left the room. Her mom overheard the EMT mocking her as he spoke to the other EMT, referring to her as an “it.”

But the worst part of it was that, when it was decided that she needed to go to the hospital, they made her walk down the stairs herself without helping her. She was hemorrhaging blood from a leg wound. They stood impatiently and just watched her struggle.

…A trans man named Robert Eads died of ovarian cancer after TWENTY SEPARATE DOCTORS refused to treat him. Lambda Legal reported that one of the doctors said the cancer diagnosis should make Eads “deal with the fact that he is not a real man.”

I have known trans people who have been mocked while they were gravely ill in a hospital bed. I have known trans people who were outright turned away by doctors, or have had pharmacists refuse to fill prescriptions that were desperately needed.

I need you to understand that when we say that these protections are a matter of life and death, we mean that LITERALLY. Transgender people have already died in utterly preventable and tragic ways because medical “professionals” turned their backs on us when we needed help.

The scale of this is truly frightening.

The administration wants homeless shelters to refuse entry to trans people. It plans a religious exemption law that enables adoption agencies to discriminate against LGBT families. It has banned trans people from the military. It puts trans refugees in solitary confinement. It has given government agencies and private businesses the right to discriminate against LGBT people provided it’s on religious grounds. Prison policy has been rewritten to place trans prisoners among people of their assigned birth gender, so trans women go to men’s prisons with predictable consequences.

It is slowly but surely removing every single bit of legal protection for LGBT people.

Finch:

This is not about politics. This is about fundamental human rights. I want you to imagine getting into a serious car accident, and as you are literally dying before someone’s eyes, they are MOCKING you when you thought they had come to help you.

I want you to imagine getting a cancer diagnosis, and going to doctor after doctor, TWENTY TIMES, to no avail. Imagine one callously remarking that maybe the cancer would teach you a lesson. Imagine the time is ticking, and no matter how much you plead, no one will help.

I want you to imagine the humiliation of hemorrhaging blood, and being made to crawl down a staircase, while two ambulance workers that you called for help refer to you as “it” and look at you with disgust.

Transequality.org has detailed the assault on LGBT rights and trans rights in particular since Trump took power. It’s a very long list.

Not all of the proposed regulations will get onto the statute books. For example, the administration’s attempts to remove workplace protections for trans people will probably run afoul of other laws, case law, other regulations and various Executive Orders. But the sheer volume of it is shocking. Make no mistake: the administration has declared war on LGBT people and on women.

I can’t imagine what it must be like to be trans in America right now, but I’m very scared that I’m going to feel something very similar here in a few years from now. The same rhetoric, the same “debates”, the same evangelicals and the same deep pockets are fuelling the same anti-trans sentiment here.

The man behind the latest outrage, Roger Severino, is a former staffer and a firm friend of the evangelical Heritage Foundation.

That’s the same Heritage Foundation that supports UK anti-trans activists, the same Heritage Foundation that the leading lights of the UK anti-trans movement fly to America to discuss strategy with.

As our politics lurches ever rightwards, I’m genuinely frightened.

Tthis isn’t about politics. This is about hate. This is about deliberate, cold cruelty, the deliberate othering of a whole group of human beings, a government effectively telling its populace that that group of people are not human.

Diana Tourjée of Vice magazine:

The Christian extremists running the US government will not stop until transgender Americans are dead and gone from public life

…This is not politics. This is social extermination.

For God’s sake, vote

These are the politicians who passed the horrific anti-abortion bill in Alabama. Notice any similarities?

It’s easy to look across the Atlantic in horror at Dark Ages throwbacks such as these yahoos, but don’t forget that right here in the UK abortion is still illegal in Northern Ireland, as is equal marriage.

In Northern Ireland, the people most likely to be in favour of women’s reproductive freedom are much less likely to vote than their religious counterparts.

In the 2015 UK elections, 70% of Catholic women voted but just 55% of Protestant women did. That wasn’t a one-off, either. The pattern has been evident in elections from 1998 onwards.

There are multiple reasons for this, including disengagement from politics and a belief that politicians of all stripes aren’t trustworthy. In the US, the religious right actively engages in voter suppression. But the fact is that if you’re a woman or a member of a minority group, voting isn’t optional: it’s crucial. Because the people who want to restrict your rights vote religiously. Pun fully intended.

There’s a wider issue here, which is about representation more generally. Why aren’t politicians more representative of their diverse constituents?

Here’s Bernard Farga of Indiana University. Farga is the author of The Turnout Gap: Race, Ethnicity, and Political Inequality in a Diversifying America. Farga answers an interesting question: how can a country such as the USA, which is becoming significantly more diverse, elect politicians who cater only for one specific group – right-leaning white people?

I think there’s a countervailing force to this “demographics are destiny,” which is polarization. At the same time that demographic change has happened, we’ve seen racial polarization of partisanship where whites have become substantially more Republican. And despite the fact that the nation is becoming more diverse, and maybe 40 percent minority by 2020, whites are still the majority by far, and will be the plurality group for generations to come… if the parties split on race, then the party that’s catering to white voters will still be dominant.

One reason for that is that the groups the politicians choose not to represent have much lower voter turnout.

…the increase in the minority population is disproportionately among very low-turnout groups: Asian Americans and Latinos. Latinos are the largest minority group in the country; Asian Americans are the fastest-growing minority group in the country. So, these two groups, where turnout rates are as much as 30 percentage points lower than the turnout of rate of whites, that’s the demographic change we’re seeing.

So that means the voting population is lagging far behind the demographic shift that we’re seeing otherwise. And when you combine that with polarization, it means that demographics aren’t destiny… demographically, whites are still a majority of the potential electorate, and the clear majority of the voters.

To simplify something that’s obviously a lot more complex and multifactorial: in the short term, political parties can gain power by ignoring minority groups and pandering solely to the demographic that delivers the most votes. It’s why conservatives put so much effort into appealing to older, white, straight, people: the turnout among other groups means they can effectively be ignored. Improving turnout is therefore crucial if we want a fairer, more representative politics.

Farga isn’t optimistic about where the current divisive politics leads.

…beyond who wins and who loses, it’s about having elections that represent the will of the people, and I think when you don’t have that—no matter who wins or loses—in terms of which party, the outcomes are bad. I think that some of the divisiveness and divisions that you see right now—the polarization—is a product one of the parties… feeling that the strategy to win is basically to keep people from voting, that the only way they can win is by certain people not turning out, because that seems to be what was successful in 2016 and a few elections before that, like 2014 and maybe 2010.

That’s dangerous, because when we start talking about outcomes that are not seen as representative of all the people, and then one party disproportionately winning those outcomes, then the other party says, “Well, this is illegitimate.” And that’s where you see democratic breakdown.