Gender

 “I am aghast and appalled at any people who decide that another group should not have their rights. We’re all each other’s people.” - Maya Angelou

I have only met a handful of trans people in real life. I have no great knowledge or insight into the intricacies of their lives, other than to know that any mention of transgender issues, or even using the word “gender” on social media, can spark a flood of contrary opinions and occasionally fairly savage vitriol. This is a touchy subject, which appears to be ironically very binary for those who voice an opinion on it - black or white, yes or no, sex or gender, women or men. 

I have spent quite some time trying to learn more, and read more, and open my heart to all the nuances. I have read about the issues with sports and prisons and toilets and changing rooms. I have read about the rates of self-harm and suicide and murder and hate crimes. I have watched Euphoria and been disgusted by my own instinctive need to know what Jules’s genitals look like, how she has sex, how can this be?

And I think I have figured out my core belief on this one. I cannot align myself to people who are filled with hatred. That’s pretty easy. I need karma on my side, and hatred and karma do not mix well. So what about the people who I otherwise admire, who are generally Good People, and who say that their concerns for trans people come from a place of love? They do not want to see children who may be confusing gender dysphoria with any other dysphoria being funnelled down a clinical pathway which results in them having potentially irreversible damaging surgery, or being counselled in the direction of gender reassignment to the detriment of their overall wellbeing in the long term. They also state that the society is “at the mercy” of men who choose to represent themselves as women, in order to gain access to protected spaces and inflict harm on women within. They voice concerns about the erosion of what it means to be a woman, and very much dislike the use of inclusive language such as “menstruators” or “people with a cervix”, stating that this reduces women to their anatomical body parts. 

So they are against bad medicine, unethical psychological therapy, violence against women, and the improper use of language. Me too. 

They are against inherent unfairness, or downright cheating, in competitive sports. Me too. 

They are against violent protests or threatening behaviour towards people who choose to publicly state their concerns on these matters.

Me too. 

What I do not agree with, however, is the dehumanising of people who are just trying to live their lives in contentment. Or the assumption that trans people are going through their life-changing personal journeys without serious consideration of the effect their choices will have on their future selves, or on those around them. And I simply cannot get on board with any kind of narrative that excludes a fundamentally disadvantaged community from accessing the health and social care they need. 

We know that trans people avoid doctors and healthcare settings, because of the difficult conversations that can arise. If you knew there was a chance that your doctor fundamentally disagreed with your core beliefs, even if they were “nice” about it, you would wait until you were really very sick before you would engage with their system. If you have spent a lifetime wary of physical violence, like most members of minority groups, you are going to find it hard to be sure when a situation is friendly or not. 

I am not, cannot, bring myself to be exclusionary. I am easily swayed by all sorts of arguments whose basic premise is “think of the children”, but I have not been convinced that denigrating and excluding a group of people is the right way to go about it. 

When the world has changed to a point where gender doesn’t matter, then it won’t matter what your genitals look like when you are born. But we are a long way off that, and in the meantime, I want to support people who are frequently unsupported, simply because of how they choose to live their lives. 

Screen Time

I have been working in cancer screening for seven months now, and I have had the opportunity to reflect on what that means for me, as a cancer patient myself. 

I thought I took on this job because I am interested in women’s health, and I was looking for a new challenge, and I admired the team I was joining. I didn’t consciously think about my own personal experience of cancer, but realistically it probably did motivate me. I have been involved in patient advocacy in a few small ways since my own diagnosis, and had applied for a couple of positions that were related to that, but I did not think this was particularly relevant for my job with CervicalCheck. For a start, my cancer is colorectal not cervical, and besides it is unrelated to screening as I was diagnosed at an age that is outside of the screening parameters. I just had “unlucky” cancer, not “preventable” cancer. But of course all cancer is unlucky, and not fully preventable. 

In Ireland, we have structured screening programmes for three types of cancer; breast, bowel and cervix. Why these three? Why not any or all of the other types of cancer? Shouldn’t we be doing our best to prevent everyone from ever getting any cancer? The answer comes from a proper understanding of the principles of screening, those seven criteria made famous by Wilson and Jungner that every medical student learns (and forgets immediately, if they are anything like me). Basically, the test should be acceptable and make a difference to the outcome for most people (but not all), and the benefits should justify the costs. Carrying out screening can turn a “person” into a “case”, and there are significant responsibilities associated with that. Why would someone who feels perfectly well subject themselves to a medical test? Why would you go out of your way to be poked or prodded or procedured? Particularly when the screening test involves intimate bits of you like your breasts, vagina and poo?

Doctors like screening because it helps them to find cancers at an earlier stage, when it can be chopped out without too much fuss, and they can use their favourite word – “cured”!

People like screening because it makes them feel safe, and responsible, and protected. We are understandably terrified of the idea of serious illness, especially cancer, so we choose to do things that will stop it from happening to us. Or, at least, that’s what we think we are doing. We can get bored quite easily by the old chestnuts of healthy eating and exercise and no smoking and no drinking and no craic and no crack and no bacon and no radon and blah blah blah fingers in the ears. It is much more proactive and scientific to get a proper doctory test done with forms and signatures and result letters and all sorts of officialness which tells us, in carefully crafted language, that we are All Clear. Sorted! Let the crack-soaked bacon cocktails roll!!

It is quite a shock, then, to discover that the fancy official test and fancy official result are not bullet-proof guarantees that you won’t get cancer. And you get cancer anyway. That cancer, the one you got tested for. That very bloody cancer. How lousy is that? What’s the effing point so?

The point is that, although you were unlucky and got the cancer, some other people who did the test didn’t get cancer. Or they did, and it was found and treated quickly, and now they are better. You didn’t do anything wrong. They didn’t do anything right. It just happened that way. Because that's how screening works. If more people do the screening test, the number of people who don’t get nasty cancer will go up. The number of people who DO get it won’t necessarily go down, but the percentage of them will. Statistics is a head-melt. The screening test isn’t really for you, it’s for everyone. That is also a head-melt. 

So am I happier that I got a cancer that no one was looking for? Should I be cross that I wasn’t being checked for it? Would it help me to be cross? Would I be more cross if I had been checked for it, and they didn’t find it? How cross would I be if they had offered to check for it, and I didn’t get around to having the test, and then I got it? Another head-melt. 

I am lucky. I got an unbelievably unlucky cancer, and I lucked my way out of it. I am grateful. I am not angry. I don’t feel let down. 

That said, I don’t think about it too much. And I’ll take any screening test going, just in case. 

Contrary

Whatever the prevailing sentiment, I can be pretty much guaranteed to feel the opposite. 

I am the epitome of contrary.

 

If the world insists that all jeans must be skinny, I will hunt down the last straight-legged pair in existence.  

If everyone agrees that sea swimming is the absolute best thing ever, I will stuff my wetsuit trousers into the back of the wardrobe until all the townies have worn their DryRobes to a frazzle and moved on to nude zip-lining or whatever.

Whatever the zeitgeist declares I must do, I scrunch up my face and say No! like a tantrummy toddler. I am not a trend setter, I am a Trend Opposer.

So when I discovered that Everyone on the Internet was denouncing the notion of New Year’s resolutions, I was delighted to be obliged to make a grand big list and announce them all publicly. 

So here goes:

Ahem.

1. Do some kind of creative writing course

2. Buy a campervan (and sell a car)

3. Spend the summer in West Cork – find a longterm let/holiday rental for 2-3 months that won’t cost a fortune

4. Change the open fire to gas 

5. Replace the busted flooring downstairs

6. Instal a perspex awning outside so I can have my breakfast in the rain

7. Do good gardening

8. Use the library and stop buying so many books 

These may not be as life-affirming as your standard influencer, and are entirely non-transferrable, but I’d be delighted to achieve even a few. And now that they are written down, I can tick them off! Yay!