I’ve just done a radio interview, with a preamble I’m used to:

Me (on phone): Hello!
Researcher: Hi! Can I speak to Carrie Marshall, please?
Me: Speaking!
Researcher: [pause]

Then professionalism kicks in and the researcher tells me what they’re calling about.

It’s not a big deal; just one of those things you get used to. But it’s one of the reasons people like me do voice therapy to try and get more feminine voices. What causes a little pause for a radio researcher or a frustrating conversation with a car insurance provider can be a lot more serious in public; I can go about my business without being noticed a lot of the time, and then someone hears my voice and suddenly I’m the centre of their attention. I haven’t encountered any trouble as a result of this, but I can’t help adding a word to the end of that statement: I haven’t encountered any trouble yet.

In some parts of the world, attracting other people’s attention can be fatal. Today is yet another day when my news feed brings me a story of a young trans woman who’s been murdered and multiple cases of trans women being abused or assaulted because someone took exception to their existence (trans men face many dangers too, of course).

For some trans women, a more feminine voice can mean safety.

The Guardian quotes Christie Block, a speech pathologist:

“Vocal training can help trans women deal with situations where they’re in danger,” Block said. “I work with clients to show them how they can use their voices and what they can say in dangerous situations as an actual vocal task to practice.”

For trans men, hormone treatment deepens their voice naturally. It doesn’t work the other way, sadly: testosterone’s effects on your vocal cords are pretty much irreversible unless you go for surgery – which as a singer, I wouldn’t risk even if I could afford it.

For trans women, changing your voice means battling a combination of physiology, embedded habits and socialisation. Men and women talk differently for a mix of reasons, and you need to address all of them if you want a more feminine voice.

As I understand it there are three key differences between male and female speech. The most obvious but least important is pitch, which is how high or low your voice is: some of my female friends’ voices are almost as deep as mine, but they are still unmistakably female.

That’s because of reasons two and three: resonance and variety. The former is about where your voice comes from, with men generally speaking from their chest and women from higher up; the latter is about the variety in tone when you speak. That’s entirely socialised: there’s no biological reason why men should talk in near-monotones when women don’t. It’s just that we’re conditioned to take strong, monotonous voices more seriously than more interesting, varied expression. The former is supposedly authoritative, the latter frivolous.

Serena Daniari in The Guardian:

Throughout my own transition, I’ve often wondered whether my voice, which is deeper than that of the typical cisgender woman, diminished my value as a woman. Hormones and surgical alterations had feminized my exterior, however, my voice had not changed and was a persistent source of frustration and angst for me. At times, I wished for nothing more than a voice that was considered “pretty” and “passable,” wanting to change every aspect of my identity in order to live up to what society expects women to be: submissive, subdued, sensual, and feminine.

Over time, I’ve realized that there is no one way for a woman to sound.

I hate voice therapy and wish I didn’t have to do it, but while I don’t want to have a stereotypically female voice I’ve become really unhappy with the old-me voice, as lovely as it was. So my therapist is helping me work towards a more androgynous voice: not high-pitched, but slightly higher and a lot more interesting.

Maintaining it is hard, and I don’t use it in public yet – although when I do phone-in radio interviews or use the phone for work I do make a conscious effort to maintain the right pitch and resonance. I can’t quite bring myself to use it around my friends, though. For some reason I find that horribly embarrassing and much more difficult than in a work situation. A big part of it, I’m sure, is years of seeing trans people portrayed on screen as men with squeaky, unconvincing voices and being scared that’s how I’m coming across to people I want to like or love me.

I have an odd relationship with my voice now, because it’s part of my wider identity as a trans woman: I’m not trying to get a woman’s voice; I’m trying to find my voice.

Daniari:

Like me, Primrose has veered away from the the goal of “passing” as a cisgender woman. Instead, she is working towards achieving a voice that is personally fulfilling. “I want to be the person that I’m comfortable being,” Primrose said. “I don’t necessarily want to have a high voice because it makes you approximate cis women. I don’t care about that. I feel no shame about being trans. It’s who I am. It’s my life’s journey. It’s my identity.”

I can really relate to that. I’m not a cisgender woman and I’ll never sound like one, but that’s okay, most of the time.

My natural voice is different already – I speak much more softly and slightly higher than I did before I started being me full time – but maintaining a more feminine voice is very tiring and takes tons of practice. Because I sing a lot my voice gets a lot of abuse, which works against the feminisation by dragging the pitch of my voice down considerably, and because I have children I constantly get the cold, which does the same. But despite the difficulties, the feeling stupid and the frustration when my voice flatly refuses to play along, I’ll persevere.

It’s the trans experience in microcosm: a lot of work over a very long time so I can feel a little more accepted, a little more comfortable, a little less scared.

PS: As I went to hit publish on this post, my phone went.

Me: Hello!
Researcher: Hi! Can I speak to Carrie Marshall, please?
Me: Speaking!
Researcher: [pause]

My former doctor has been suspended by the General Medical Council. Dr Mike Webberley, who took over the care of trans patients when his wife Helen was censured over an administrative issue, is no longer able to treat patients in the UK.

I don’t know the ins and outs of this one, but I do know what Dr Webberley was like as a GP and I also know that trans-affirming private practitioners have been subject to ongoing campaigns demanding their suspension for some years now. As far as I’m aware the suspension is another administrative one, based on Dr Webberley having not completed a professional course or being on a recognised register of practitioners.

I doubt it’s a coincidence that the Webberleys have become hate figures among the anti-trans activist crowd, who accuse them of sinister behaviour and that old favourite, child abuse.

Webberley’s online practice, GenderGP, is a lifeline for many trans people. It enabled me to stop potentially dangerous self-medication and undertake supervised and conservative treatment instead, treatment that required extensive psychological assessment and various medical tests over a period of several months before it was prescribed and ongoing testing as it continued.

The idea of Dr Webberley as some kind of crazed zealot handing out HRT like sweets simply doesn’t match the reality I experienced. He’s a GP, not a mad scientist, and in my experience he’s a thoughtful and patient professional.

The decision leaves some 1,600 patients in limbo. That number is a devastating indictment of the current system: these are people who’ve been forced to go private because the NHS simply can’t cope.

In my own experience, the road from initial referral to an NHS diagnosis took 23 months; from referral to my first NHS counselling appointment was 29 months.

By UK standards, that’s incredibly fast. As The Guardian reports, trans and non-binary people in the UK face incredibly long waiting lists. The best figures available to me show that in England, waiting lists for a first appointment are now as long as two years followed by another two year wait to meet with a doctor. That’s a four-year wait for people who may very well be in crisis.

The usual newspapers like to run scare stories about the growing number of people being referred to gender clinics, but that increase was predicted more than a decade ago: in formal submissions to the UK government, the Gender Identity Research and Education Society (GIRES) predicted that increasing visibility and understanding of trans and non-binary people would mean more people wanting to access NHS services.

As GIRES put it in 2009: “Policy makers and [NHS] service providers at national and local level are largely flying blind in… meeting the healthcare and other needs of trans people.” In 2009, the NHS gender clinics were already struggling to cope; with referrals growing 15% year on year, GIRES predicted a massive capacity crisis. Which is exactly what we have now.

Chances are, you haven’t attended a gender clinic. My one, by all accounts, is one of the better ones, less overloaded than the English ones. But it can’t afford to have reception staff full time, and the delay between a doctor dictating a letter and having it typed is two months. Like all mental health services (being trans isn’t a mental illness but it’s still treated under the auspices of mental health provision), gender clinics are desperately underfunded and very close to breaking point. Some of the English ones appear to be broken.

As GIRES also noted in 2009, “The NHS facilities are sometimes overloaded… the private health sector plays an important role. It takes pressure off the NHS facilities and thereby improves the overall level of care for people seeking treatment for gender dysphoria.”

To shut down private providers without also expanding NHS provision is just another cruelty towards trans people. And it’s dangerous, because it’ll mean more of us self-medicating without medical supervision. As Tara Hewitt wrote on Twitter:

[NHS] Trans services are failing but have a monopoly on care. Whenever private practitioners try to fill the gap they are targeted in an attempt to close them down. Shame on #gmcuk.

I agree with the GMC on one thing: clinics like GenderGP shouldn’t exist. But not because they’re wicked. Because the NHS is failing thousands of trans people.

The GMC seems very concerned about Dr Webberley’s paperwork. What about his patients?

Scotland’s only openly transgender elected official has resigned over “institutionalised transphobia” in the SNP. Dundee councillor Gregor Murray has repeatedly clashed with senior SNP figures including Joanna Cherry and Joan McAlpine.

Murray:

The SNP has a major institutional problem with transphobia, and is doing nothing to rectify this.

While they rightfully condemn Labour for anti-semitism, and the Tories for anti-Islamic sentiment, they remain silent on anti-trans sentiment at all levels within the party. Councillors, MSPs and MPs have been openly transphobic for months, and the party hierarchy has done nothing to stop them. Nicola Sturgeon’s words on these matters have been perfect – but we do not need any more words, we need action.

There are two main issues that Holyrood are considering right now that affect the trans community – the census, and the Gender Recognition Act (GRA).

“Both of these policies are going through committees with transphobic conveners. Extreme right wing fundamentalists with a history of abuse are being given the red carpet treatment at Holyrood in the party’s name.

SNP MSPs and MPs are attacking trans people, misgendering us and supporting further attacks.

It’s easy to read this as a someone with an axe to grind – Murray says they’ve faced “scurrilous” and “vexatious” allegations and that the party has effectively left them to face those allegations alone – but there does appear to be a problem with some MPs and MSPs. For example, Cherry and McAlpine have clearly allied themselves with some of the worst anti-trans organisations and sentiment.

I hope my MP is different. After writing to him about GRA reform and trans rights generally, I’ve been invited to come and meet him for a chat.

In Scotland, one of the most pernicious bits of anti-trans bullshit is the claim that gender recognition reform is a sudden development, something the Scottish Government is doing in secret and trying to rush through so that women’s groups can’t object.

Not only does that overlook the extensive, well publicised public consultation on gender recognition that ran from November 2017 to March 2018, that received formal submissions from all the key women’s groups in Scotland and whose responses were overwhelmingly in favour of reform. It also ignores the fact that gender recognition reform was a manifesto commitment of every major Scottish political party in 2016.

Here, courtesy of @scottishtrans, is what the parties had to say in their 2016 manifestos.

The SNP: “We will review and reform gender recognition law, so it’s in line with international best practice.” International best practice means self-certification.

Scottish Labour would “provide legal recognition for people who do not identify as men or women and remove the psychiatric diagnosis…Scotland’s young people…would be entitled to do so from the age of 16”.

The Scottish Liberal Democrats would bring gender recognition “into line with international good practice…including consideration of the medical requirements placed on applicants, and recognise the gender identity of nonbinary people.”

The Scottish Greens: “We will back the campaign to reform gender recognition law in line with international best practice.”

And the Scottish Conservatives: “areas that we believe require review are…the Gender Recognition Act.”

Just because some anti-trans activists didn’t notice – a claim I doubt given the formal submissions by various anti-trans and religious groups during the 2017 consultation, all of whom made their supporters very much aware of the issue – doesn’t mean it was a secret.

The reason gender recognition reform didn’t hit the headlines back in 2016 is because it was, and is, a slight reduction in bureaucracy that is of no relevance to the vast majority of people.

I’m not the only one to notice the growing links between anti-trans groups, religious extremists and reactionary conservatives. Writing in Jezebel, Esther Wang explores “The Unholy Alliance of Trans-Exclusionary Radical Feminists and the Right Wing.”

In a sign of how their thinking mirrors one another, it can be remarkably difficult to distinguish between the talking points of the Christian right and the language of trans-exclusionary radical feminists.

As the piece points out, it’s more than just language. Organisations such as the Hands Across The Aisle foundation exist specifically to bring anti-trans activists and evangelicals together. Their members, previously listed on their website but now deleted, include Transgender Trend, one of the most visible and vocal anti-trans groups in the UK, as well as prominent UK feminists.

As I’ve noted before, most of the media panics over trans people follow a script set out by US evangelicals in 2017 that urged activists to:

Explain that gender identity rights only come at the expense of others: women, sexual assault survivors, female athletes forced to compete against men and boys, ethnic minorities who culturally value modesty, economically challenged children who face many barriers to educational success and don’t need another level of chaos in their lives, children with anxiety disorders and the list goes on and on and on.

This activism leads to attacks not just on trans people, but attacks on legislation designed to help women and minorities.

Walsh describes the anti-trans activists’ opposition to the US Equality Act, where angry women have been useful idiots for the republicans who want to discriminate against all LGBT people and who have learned to couch their bigotry in faux-feminist concerns.

In their opposition, they have aligned with conservative, largely Christian rightwing activists and elected officials, who have their separate, reactionary reasons for wanting to maintain the notion that there is a strict dividing line between man and woman and who have, similarly, reframed the debate about trans rights as one about “safety for women and girls.”

None of this is new, but it’s getting more dangerous.

As Mara Keisling, executive director of the National Center for Transgender Equality, said to Walsh:

“I don’t understand how you can hate so much that you go out of your way to sell your soul to politicians and extremist organizations who have fought women’s rights and women’s welfare every step of the way. It’s really astounding and sad and pathetic.”

While commentators whip up hysteria over the imagined threat of trans people in toilets, here’s the reality.

Reuters:

Transgender youth, along with those who do not identify as male or female, are at increased risk of sexual violence in schools that force them to use bathrooms and locker rooms based on their gender assigned at birth, a study published on Monday said.

Correlation is not necessarily causation; it’s possible that the policies reflect an environment where anti-trans sentiment is more widespread, and it’s that culture rather than the bathroom policies that lead to the abuse. But whatever the reason, it’s clear that columnists and social media trolls are perpetuating lurid anti-trans fantasies while ignoring genuine and widespread abuse of trans teenagers.

There’s another well documented effect of this: trans people trying to avoid using toilets altogether. I do this: in an unfamiliar place I’ll avoid drinking so I don’t have to go, or wait well beyond the point of physical discomfort until I don’t have a choice. In schools, many trans kids contract urinary infections as a result.

We’re much more scared of you than you should be of us.