“My body, my choice” – it was one of the key feminist slogans of the 1970s, and despite recent rightwing attempts to usurp it, it continues to resonate across numerous communities in which people have experience of having their bodily autonomy threatened. A couple of years ago, I used it in the presence of a woman who objected to the idea of trans people changing their bodily characteristics to better align with their gender. “I agree,” she said. “Except…”
Except is, of course, the word that does the heavy lifting. It’s easy to believe that people should have rights when we make exceptions. She felt that it was important for women to have access to safe spaces, except for trans women. Had she been in the US a few decades previously, then she might have wanted something similar but, being white, except for Black women. Often such spaces are accessible to all women except for wheelchair users – and so on. People with privilege don’t generally worry about the exceptions because they’re outside the familiar category of what constitutes a human being. But when we allow people to be treated like that – as less than fully human – we destroy safeguards that are there for all our sakes.
A permanent ban on puberty blockers
When, on Wednesday, Wes Streeting announced a permanent ban on the use of puberty blockers for people diagnosed with gender dysphoria, he crossed a line. He broke the tacit agreement that politicians may deal with matters or broad directional policy and funding, but that individual medical decisions should be made by doctors in the best interests of their individual patients. Streeting is not a doctor. He has no medical or scientific training, and as such is not well placed to assess the evidence he received from external sources. He is, of course, supported by some clinicians, but many more oppose this restriction of an established protocol which is in widespread use around the world.
Streeting’s decision – which the Scottish Government says it is unable to prevent from applying here too – could not have come at a more dangerous moment. There is deep concern among the parents of young trans people about the mental health impact of the ban, and about the physical suffering that young people affected by it will subsequently undergo if they transition post-puberty. Others also have cause for concern – especially women, as we find ourselves in a time when all too many politicians are eager to start interfering in women’s medical decisions once again.
The overturning of Roe vs. Wade in the US was not the first instance of a nation going backwards on access to safe abortions, but it was perhaps the most consequential, not least because our shared language makes us vulnerable to developing the same political problems here in the UK. Indeed, much anti-trans campaigning in the UK was funded by US dark money, and Streeting’s attack on young trans people’s healthcare – which has created a raft of new difficulties for trans adults, too, placing their physical health in jeopardy – came after the US Republicans spent $215mn on anti-trans adverts during their campaign to get Donald Trump re-elected.
Women’s rights at risk
As nightmare stories emerge from the US about children dying after being forced to endure non-viable pregnancies, women being prosecuted following miscarriages and stillbirths, and efforts to stop women travelling in search of medical care, Nigel Farage’s attempts to kick off renewed debate over abortion over here seems mild by comparison. These things always start out seeming mild, however. There were several attempts, under the last Conservative government, to undermine abortion provision through private members’ bills, and although they were unsuccessful, anti-abortion politicians are growing in confidence. Again, a matter which should be between individuals and their doctors is being dragged into the political arena.
One of the principles upon which provision of puberty blockers to young trans people was made was Gillick competence – the law that says that young people over the age of 12 can be individually assessed by medical professionals to determine whether or not they’re competent to make medical decisions for themselves. This was hard fought for by feminist campaigners back in the 1980s and it led to the passing of the Age Of Legal Capacity Act in Scotland in 1991. It’s a principle of particular importance when it comes to reproductive healthcare, as it helps young people to access the services they need even if, for instance, they feel unsafe discussing them with their parents. As such, it helps to protect them from abuse and to get used to the idea that they have ownership of their bodies, which is important as they grow up and negotiate boundaries in romantic and social relationships.
By overriding Gillick competence where trans people are concerned, Streeting has created a risk that it will be ignored in other cases too. Perhaps we shouldn’t be surprised. He seems shaky on the concept of medical consent more generally, as demonstrated by his suggestion that obese unemployed people should be given the weight loss drug Ozempic to improve their health and get them back into work. Although his initial comments on this, which provoked a public outcry, were quickly followed by assurances that it would not be compulsory, concern remains about the vulnerability of people who depend on the state for support, especially those who are disabled, who make up a significant part of the obese population. Like most drugs, Ozempic has side effects and is not appropriate for everyone.
Bodily autonomy matters
When the state interferes with specific medical matters concerning individuals who are, under other circumstances, considered capable of giving their informed consent to medical procedures, it politicises a field which should be entirely focused on individual health needs. Governments are there to coordinate economic and societal activities, to organise defence, manage international relations and (supposedly) ensure that everyone has adequate food and shelter. It is widely agreed that they should minimise their intrusion into private life. There can be nothing more private than our own bodies, especially in a medical context.
We participate in society; we do not belong to it. The fact that a government should think it is within its rights to tell some of its citizens what they are and are not allowed to do with their own bodies should have us all very worried indeed.
More in rights and freedoms.
