Lyn Brown MP

Member of Parliament for West Ham

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On the 1 December I spoke in the Transgender Equality debate. Speech Below:

Thank you Mr Speaker,

I have listened with interest to the excellent arguments made by Members about how the Gender Recognition Act and the Equality Act ought to be amended to better protect transgender equality rights.  I do hope the Government takes these arguments seriously and that they respond appropriately.  However, I want to use my speech to focus on a different aspect of the excellent report from the Women and Equalities Select Committee: the services provided for transgender people by the NHS.

Trans people experience worse health, both physical and mental, than the general population.  The Equality and Human Rights Commission have found that a higher proportion of transgender people say that their physical health is 'poor or very poor' compared with other LGBT communities and non-LGBT communities.  Levels of poor mental health are also higher in the transgender population, about half of young trans people and a third of trans adults report that they have attempted suicide.  It is therefore imperative that trans people have full access to general medical services.

Trans people also have specific health needs.  Untreated gender dysphoria, which is medically defined as where a person experiences discomfort or distress because of a mismatch between their biological sex and gender identity, can take a real toll on mental health.  Dr John Dean, who is the Chair of the NHS National Clinical Reference Group for Gender Identity Services, has said, and I quote:

“Not treating people, is not a neutral act—it will do harm.”

I could not agree more with Dr Dean.  Some trans people’s health and wellbeing would be greatly improved by gender confirmation treatment through our specialist Gender Identity Clinics.  Trans people have to be able to access those treatments on our NHS if they need them.

Unfortunately the Select Committee Report demonstrated that our NHS is not currently providing a good service for trans people.  In fact, the Select Committee Report found, and I quote:

‘The NHS is letting down trans people.’

One of the first problems identified by the report was discrimination faced by trans people when they tried to access general medical services.  Dr James Barrett, President of the British Association of Gender Identity Specialists, told the committee, and I quote:

‘The casual, sometimes unthinking trans-phobia of primary care, accident and emergency services and inpatient surgical admissions continues to be striking.’

Sadly this discrimination has real consequences.  Terry Reed, of the excellent Gender Identity Research and Education Society, told the Select Committee that trans people were often nervous about accessing services because they were ‘not treated sympathetically or even politely’ by doctors and staff. 

Trans people also have real difficulties accessing Gender Identity Services.  GPs have a legitimate role in acting as gatekeepers to NHS specialists, but I am afraid there is evidence that prejudice and ignorance amongst our GPs is preventing those who experience gender dysphoria from receiving the services they need.  Dr James Barrett, of the British Association of Gender identity Specialists, has said that there is a ‘persistent refusal’ on behalf of some GPs to make referrals to Gender Identity Clinics.  The Beaumont Society have heard of one trans person being told by their GP at their first assessment:  ‘You’ll be taking money away from more deserving cancer patients.’  Completely disgraceful.

If someone experiencing gender dysphoria is referred to a Gender Identity Clinic it can take a long time for them to receive specialist services such as hormone therapy or genital surgery.  The process requires an independent assessment from two separate consultants and typically takes months. Controversially, an additional precondition for genital surgery is that the patient must undergo at least a year of “Real-Life Experience” living “in role” of their affirmed gender.  It’s an enforced pause.

I have read the guidelines that explain the rationale behind this enforced pause.  I understand that the social aspect of changing one’s gender role is challenging, and that clinicians do not want people to take on surgery until they are fully aware of those challenges.  But I think the Government should assess the arguments made by some in the trans community that decisions over whether to go ahead with surgery should be based on an ‘informed consent model.’ Under this model doctors could immediately approve medical interventions if they are satisfied that a patient is fully aware of the implications of their decision.  It is my understanding that this model is already used in parts of the United States, so the Government should be in a position to carefully assess its strengths and weaknesses.

I think it is important that the Government understand that delays in receiving treatment can cause real suffering.  One trans person told the 2012 Trans Mental Health Study, and I quote:

‘Not having had my gender confirming yet has a constant effect on undermining my self-esteem and self-confidence as well as social transition - I hate every day I have to live with ‘boy parts’ and can’t wait to get rid of all recognisable boy bits.’

Another person told the same study, and I quote:

‘Permission for my chest surgery was delayed and I waited double the usual waiting time… This caused me to go into a deep depression. I had panic attacks when I left the house, I lost my job and then found I couldn’t leave the house.’

What these people are describing is real human suffering.  It may be possible that this suffering could be prevented if we improve the speed with which our NHS works for trans people.  Delays should not be any longer than is strictly necessary from a clinical point of view. 

‘Not having had my gender confirming yet has a constant effect on undermining my self-esteem and self-confidence as well as social transition - I hate every day I have to live with ‘boy parts’ and can’t wait to get rid of all recognisable boy bits.’

Another person told the same study, and I quote:

‘Permission for my chest surgery was delayed and I waited double the usual waiting time… This caused me to go into a deep depression. I had panic attacks when I left the house, I lost my job and then found I couldn’t leave the house.’

What these people are describing is real human suffering.  It may be possible that this suffering could be prevented if we improve the speed with which our NHS works for trans people.  Delays should not be any longer than is strictly necessary from a clinical point of view.

Mr Speaker.

As a result of the of problems I have outlined, the Select Committee recommended that the Government conduct a ‘root-and-branch’ review of how NHS services can be improved to better serve trans people and to completely stamp out transphobia in our NHS.

Instead the Government responded by stating that they will look into broadening the terms of reference of NHS England’s existing Task and Finish Group for Gender Identity Services.  I think that when such systematic failure has been identified the Government ought to question the governance arrangements in place, rather than relying upon them even more.  I would then like to finish by inviting the Government to give fresh consideration to a root-and-branch inquiry as part of their commitment to the cause of transgender equality.

Transgender Equality Debate Speech

On the 1 December I spoke in the Transgender Equality debate. Speech Below: Thank you Mr Speaker, I have listened with interest to the excellent arguments made by Members about...

On the 28th October, I spoke about the Homelessness Reduction Bill in the Commons. Speech below.

Thank you Mr Deputy Speaker,

I am delighted to be called to speak in favour of this Bill, which introduces new duties on councils to deal with homelessness.  But I’m not going to stand here and pretend this Bill will solve the homelessness crisis, it won’t build a single new home, it won’t place more properties in the social sector, and it will not reduce rent for my constituents, but I am hoping it is a step in the right direction. 

My constituency of West Ham is in the London Borough of Newham, and we are bearing the brunt of the housing crisis. 

Let me tell you the situation that an average family in Newham faces when looking for a new place to live.  They are not going to think about buying, because the average house price is £352, 272 and it is completely out of reach for all but the few.

They want to enter social housing, with its affordable rents and securer tenancies. But there is a waiting list of 16, 755 households.

So many families have no choice but to look at homes in the private rental sector.  If they were affordable, that wouldn’t be too bad, but they’re not.

According to the Valuation Agency, the current median rent on a 3 bedroom property in the private sector in Newham is £1, 600 per month.  Detailed research from the council shows that the median household income in the Borough, after tax and benefits, is £18, 604, which is about £1, 550 a month.  That’s right, the average new private sector rent in our Borough is actually higher than the average after-tax income.  It’s a truly disastrous situation.

With such an acute housing crisis, it is no wonder that Newham Council have to deal with a huge amount of cases where residents are threatened with homelessness. In 2015-16 Newham Council received 2, 448 homelessness applications.  Compare that to the Ribble Valley in Lancashire which received just 7.  Newham’s rate of homelessness acceptance, that is the proportion of households that they accept as homeless, is almost 5 times higher than the English average, and 119 times higher than that of East Devon which has the lowest rate.  Newham Council work with compassion and diligence to offer what support they can to those threatened with homelessness, but they face an unenviable task and a huge workload. 

In Newham, we also have great charities like Caritas Anchor House.  They provide temporary accommodation and support for our homeless community, and this year they supported 37 of residents into full-time employment and 84 residents into independent living. It’s not just a shelter, it’s a source of community, support and hope for those who desperately need it.

Last week I met some of the people living in Anchor House, and I was really impressed by their resilience and aspiration.  One woman entered Anchor House soon after recovering from a mental breakdown.  She is now training to be a youth worker and wants to take a degree to help her career. I met a man who decided that living on the streets was better than living at home, because that is the only way he could be free from company that was encouraging him to take drugs. He is now clean and training to be a tunneller.

Mr Deputy Speaker.  These people were excited by this Bill, they thought it would prevent other people from finding themselves in the situation where they were without a home.  If the Government are not to let them down, I think there are two things that need to be done.

The first is to be honest that placing these duties on councils will come with upfront costs. There was a 26.5% increase in in households assessed for homelessness in the first year after new homelessness duties were introduced in Wales, which the Welsh Government anticipated and provided funding for. We can only expect even greater increases in workload in London where the housing crisis is that much more acute.  In fact, the Association of Housing Advice Services estimate that Inner East London Boroughs, like Newham, will have to process an additional 7, 581 applications a year as a result of just clause 3 of this Bill. 

I know that there will be a money motion to go alongside this Bill, if the Government do not provide sufficient funds, based on needs for local authorities to deal with this extra workload.  You cannot pass the buck without the bucks.  The Government also have to recognise that changing council duties can only be one small component in the fight to reduce homelessness.  We need more homes to be made available in every sector, and services and support to deal with the complex needs of those driven to street homelessness.  This Bill could be a step in the right direction, but only with appropriate Government support.

End of speech

Homelessness Reduction Bill

On the 28th October, I spoke about the Homelessness Reduction Bill in the Commons. Speech below.

This week, as a nation, we make the most important decision in a generation, one that will impact upon our nation’s wealth and well-being, upon job opportunities and security, for us our children and our grandchildren.

I want to remain.  I see no benefit whatsoever in leaving the European Union.  Half our trade is tied up in our EU membership.  We cannot afford to sacrifice all that.

Some argue we could negotiate trade deals with the EU, like Norway and Switzerland.  That means accepting common rules and regulations.  Sometimes we’ll object, but we’ll have no voice at the top table:  no vote.  That’s not taking control back; it’s chucking it away.

Many international businesses may abandon Britain, if we leave.  For foreign firms, the UK is their gateway into European Markets.  They provide thousands of UK jobs that would relocate to France or Germany.

It’s said that EU membership is too expensive, costing us £350million-a-week.  It is a lie.  It takes no account of the rebate Mrs Thatcher secured, nor the money we receive from the EU to support our fishing and farming industries, urban regeneration or our research scientists; 42% of UK cancer research funding comes from the EU!

The Treasury calculates that every £1 we invest in Europe earns us £10, in increased trade, investment, jobs, growth and lower prices.  We get a good deal.

Nastiest of all the messages from the Leave campaign has been about immigration.

Leaving the EU means fewer immigrants from Europe, they say.  It’s a way to control immigration.  It simply is not true.  Leaving the EU, but retaining single market access, would force us to accept free movement of people, just like Norway and Switzerland.  There will be no change.  Arguably, our control over immigration will loosen.  Our border controls will no longer be at Calais, but instead in Dover and other UK ports.

Let's think long and hard about this decision.  Avoid jumping into the unknown and risking our economic stability.  Let’s not be deceived into quitting the EU.  Please vote to Remain in the European Union on 23rd June.

Newham Recorder Column 22nd June

This week, as a nation, we make the most important decision in a generation, one that will impact upon our nation’s wealth and well-being, upon job opportunities and security, for...


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