On Wednesday morning, Profesor Robert Winston made some wild claims regarding trans people on BBC Radio 4’s “Today” programme. He talked about “horrific” surgeries, extremely high surgical complication rates and linked this to a high level of regret. For those not familiar with the topic this might sound like solid science from a respected personality.

It’s not science.

One possibility is that he’s just clueless about the topic. After all, he’s a fertility rather than gender specialist. Another option is that he’s dishonestly using statistics to engage in scaremongering based on a political, not scientific, viewpoint.

Winston made equally wild claims about cycle lanes causing pollution last year. He didn’t say what paper he was referring to so he couldn’t be fack checked. This time, he sourced his claims the following day via Twitter and the article is available online for a fee.

One of Winston’s statements on Radio 4 was that there are complications in about 40% of trans surgeries. That figure does not appear in the paper. It actually says the complication rate is 32.5%, but we also get into confusion over terminology.

You see the same confusion with “elective” vs “emergency” surgery. These are medical terms with specific meanings not apparent to the layperson, and elective just means it was scheduled in advance, but it can still be life-saving surgery. And if you worry about such things, don’t ever read the patient information leaflet for Ibuprofen. Apparently, it causes heart attacks.

Someone as senior as Winston is no doubt aware of the possibility of confusion when using technical terms. But he wants us to believe trans surgery is terrible, so he abuses this confusion and talks about complications then moves on to “horrific” surgeries. He leads the listener to believe that all complications are “horrific” and many surgeries have unwelcome results.

They don’t.

Most complications are minor, and might not even register with the patient as a complication. For example, nearly half (44%) of the complications in the study are “Meatal Stenosis”. These form the bulk of the 21.7% “reoperation” rate, largely from one German study (The paper is available for free, but contains graphic genital surgery images not suitable for an office environment) It might sounds serious and make it seem like SRS is Germany is very dangerous. However, in lay terms, it means “you probably piss in a funny direction, or dribble a bit”. The fix is minor in most cases and might not even need an operation. The Germans seem to use a two-stage technique, so appear to be unfussed by needing “re-operation” – they have already scheduled a second-stage operation.

Some things can go wrong of course, as with any surgery, but most of the “complications” are in this vein or even more minor.  A bit more bleeding than was expected or some tissue granulation.

Now we get into issues of individual agency. If the patient understands the possible consequences of a treatment and has given informed consent, isn’t that OK? Even with the scary prognosis Winston paints, it’s better than the alternative of a lifetime on Spironolactone or Zoladex. And that’s before we worry about the mental health issues involved.

I am a liberal, and I believe firmly in individual agency. It is entirely possible Winston has a more authoritarian view on this. But without knowing his views on similar issues such as abortion and the right-to-die, I don’t know what his outlook is.

Having planted the scary 40% figure in people’s minds, Winston then goes on to conflates regret with surgical complications. Signal boosting stories of regret and framing the debate to exaggerate regret rates is sadly a common anti-trans media tactic right now. However, trans surgeries have one of the lowest regret rates of any surgery – recent studies report it as being around 1-2%, with a meta-study looking at papers all the way back to 1960 when surgical techniques were less developed still only places the figure at 2.2%. For comparison, surgical regret rates for prostate surgery was a whopping 47% in one study. Another paper found that breast cancer surgery had a 24% regret rate.

Finally, the programme was nominally about trans children.

Children can’t get surgery.

Last night, I gave a talk at Pembroke College as part of Cambridge Hub’s Michaelmas Series. The topic was censorship.

This morning, I woke up and saw that the headline story in The Times is Jo Johnson, the Secretary of State for Education, wanting to “guarantee free speech” at universities.

It is worth noting there is already a law that ensures freedom of speech at universities, but it would seem that Johnson wants even more extreme guarantees. The existing law is not invoked or referenced when we have one of the regular fusses about high-profile figures having their right to free speech violated. That is because they are not being censored.

Despite existing free-speech laws, there is already quite a bit of censorship at our Universities, and it comes from two sources. Neither form is good, and neither should be extended. Paradoxically, increasing the latter of these two forms of censorship is precisely what Johnson’s proposals will do.

The first is the PREVENT duty. That duty is supposed to target all extremism that leads to terrorism. Controversially, it usually ends up targeting Islamic and other non-white forms of extremism. In a university context, it is used to question room bookings and the nature of invited speakers. I doubt Islamic societies at universities will be welcoming Johnson’s statement today. It is unlikely the duty will be relaxed in support of “free speech”.

The other source is the de-facto censorship of students and student protest against influential media figures.

Wikipedia says censorship is “the suppression of speech, public communication, or other information”. I have mentioned PREVENT, and there’s no doubt that duty involves censorship even if there is disagreement over the desirability of PREVENT overall. China censoring WeChat is an example of that most in the West would regard as negative, and we have also seen cases within LGBT+ communities of censorship gone wrong with unintended consequences.

There is a common theme in those cases. Positive or negative and deliberate or accidental, it is those with power doing the suppression.

What is not censorship is selling only eight tickets to an event and having the venue cancel, as happened to Kate Smurthwaite. Smirthwaite seems to believe “free speech” means she can demand people listen and that venues give her a free platform. Consequently, she used her media contacts and influence to spin a story about how students were suppressing her free speech. The publication of her ideas was undoubtedly not restricted as a result. Quite to the contrary, the resulting media fuss and claims to martyrdom at the altar of free speech gave her an even more prominent platform.

Peter Tatchell was not censored when a student learnt he was due to speak at the same event as her and pulled out. She did not want to share a platform with someone she believed is racist and transphobic. Her withdrawal was not public, but Tatchell’s outrage at being unable to demand the energy of someone less powerful was. He used every possible media outlet he could muster to denigrate her.

A particular shout out needs to go to Julie Bindel at this point, who has repeatedly claimed to be censored herself but has just resorted to issuing legal threats against Brooke Magnanti, a.k.a. Belle De Jour. It is not surprising that Bindel’s claims have not received any media coverage condemning her attempts at silencing. There is a common theme running through these claims of censorship against media figures. Allegations are always targeted at those with less power.

There is a chilling effect hidden within these false claims of censorship, however. Those whom the allegations target become figures of derision in the press with no way of responding. They do not have their voices heard. I was at the event held in parallel to Greer’s Cambridge Union slot, and I know several of the students involved felt traumatised by resulting coverage. They are less likely to now engage in activism.

Media outrage is increasingly invoked to shut down legitimate free speech rights such as protest and running petitions. It happens merely because high-profile disagree with protests or feel threatened.

Ratcheting up that rhetoric will only increase the pressure on students to conform. Contrary to what Johnson believes it will not broaden the minds of young people. Instead, it will teach them that the powerful will not tolerate criticism.

There has been some press coverage today of another proposal on Lords retirements, this time to limit the length of service to 15 years. This isn’t the first time this has been proposed, and something similar with a ten year limit was part of Liberal Democrat ideas for House of Lords reform during coalition.

Firstly, let us take a look at the proposal I discussed previously, namely retiring peers on the basis of age. Is there any correlation between age and how often a peer contributes? How much someone contributes to politics is a largely subjective measure, but for the purposes of this discussion I have used the number of days a member is mentioned in Hansard over the last year. The raw number of mentions is a less helpful measure as a few people have over a thousand mentions due to extended back-and-forth discussions in less well-attended debates. (Click for larger versions of the charts)


Age of Peers vs. Number of days contributed


There’s certainly some link between age and contributions, with 90-year-old members of the house understandably contributing less than those in their 40s. But there is no sudden drop-off and it is hard to identify an age at which members are no longer pulling their weight.

The new proposals do not appear to retire existing life peers, so we would still have the problem I outlined in my previous post about needing members to retire to make more space any time soon. But if this proposal did go ahead, is there any drop off in length of service and contributions?

Length of service for peers vs Days contributed

As we can see, there is definitely a tendency for long-term members to be about less often but perhaps not as much as would be expected, and there is no obvious point at which peers suddenly stop attending. The most prolific Lords tend to be within their first five years but there are plenty of newer peers who don’t contribute as well as a number who manage plenty of engagement – cross-bench peer Lord Hyldon contributing on over 100 days over the last year despite having been a member for nearly five decades stands out, for example.

So it would appear that term limits for peers are not perfect, but a better way of dealing with the excessive number of Members of the House of Lords than mere age.

Longtime readers of this blog will recall that I have previously written about the census in some detail. And if you’ve been about the last day or so, you’ll have seen the fuss over the news that the Office of National Statistics might make declaring your sex optional in the 2021 census.

The full details are not known as the Sunday Times story is from a leaked report and contains few details. This did not stop the Times breathlessly rushing to get quotes from two well-known anti-trans “feminists”. It seemed no trans people were asked for quotes.

The misreporting around this issue is even more widespread than usual for trans-related stories. Misreporting caused by concerns that facts will get in the way of a good headline that further demonises trans people. So here are some myths already doing the rounds, debunked.

Myth: Gender will no longer be recorded in the census, or we will have inaccurate data on gender
There are many forms in existence in which make gender optional, and most people still tick the appropriate option. Religion is a far more sensitive issue and even when the question was made optional in the 2011 census, only 7% of people chose not to provide an answer.

And the Office for National Statistics are likely to use “imputation” to fill in the gaps – a system they routinely use and causes problems analysing statistics for minority communities, such as trans people and poly households. In a nutshell, if you put your name as Mary and don’t tick “Female”, the ONS may still record you as female in statistics.

Myth: This will erase women’s identity
Tick the box, or don’t tick the box. Your choice, nobody else’s. Established religion has not disappeared since the question was made optional in 2011.

Myth: Trans people and only trans people will not answer the question, which is why it’s optional
Most trans people identify more strongly with one gender than the other, and are likely to simply tick the box they most closely identify with. The groups most likely to skip this question are, roughly in order of likelihood:

  1. Those who think it is “none of your damn business”. (A view that’s been held by some feminists quite separate from trans concerns for some time)
  2. Respondents who didn’t understand the question, perhaps because of language issues
  3. People who simply couldn’t be bothered.
  4. Non-binary people

I predict that we will see some attempts to extrapolate the non-binary population of the UK based on 2021 data. I doubt such extrapolations will be valid.

Did the Office for National Statistics get this right?
In a word, no. At least, it doesn’t look like they have but it is hard to say until the final report is published – it may be that there has been selective quoting from the report in the original article (£) and the ONS considered other factors more important. In particular, I find it a little over the top for a government report to state that asking about sex rather than gender is reallys “unacceptable”. But that may have been one side point in a longer article, or reporting the views of a focus group.

And “Other” was rejected because it was “thought to homogenise trans people and differentiate them from the rest of society“. That statement suggests that whoever wrote the ONS report has a tentative grasp of trans issues at best, as it is only true if you start from the assumption that all or most trans people will tick “other”. Liberal Democrat Conference speakers cards have an “Other/Prefer Not To Say” option on them for gender for over a year, and we have not had any complaints about that. If we were going to get complaints about getting an equality issue wrong, that’s precisely the environment in which I would expect them to surface.

And finally, there seems to be some conflation in the quotes between non-binary and intersex issues. It is unclear why the ONS has lumped intersex people in with non-binary people in this way, as they are overlapping but still distinct groups in much the same way as being Irish and having red hair are.

There has been a bit of a fuss in the media recently about the House of Lords. This is a perennial discussion and this time it was triggered by a BBC documentary “Meet the Lords”, which apparently portrayed the upper chamber as a bunch of out of touch scroungers.

I say “apparently” because I have not watched it. I know many members of the Lords, and certainly that description does not hold true for the ones I know and I don’t much feel like watching something I know to be inaccurate. That may be because the Lords and Baronesses I’m most familiar with are part of the 400-odd working peers who regularly turn up.

Not that I begrudge Lords membership to the others because many will have done their time. Yes, they can retire under current rules. But there is little incentive to do so and retiring might upset the political balance that exists if one party’s members retire quicker than another’s.

But it is very clear that having over 800 members is unsustainable and reform is needed. And the latest discussion has gone back to the idea of a mandatory retirement age. 80 is the most common cited retirement age, although 75 is also sometimes quoted. I should state here that I am against this idea, not just because it is not enough (as we’ll see momentarily) but because age and the ability of someone to contribute to politics are not necessarily correlated. The data used for this post has been extracted from the UK Parliament Data Service who also provide details on attendance and speaking, so I might try to see what correlation exists between age and attendance in a subsequent blog post.

Back on topic, I was interested in how retirement at 75 or 80 would affect the size of the House of Lords. I had a hunt around for this but other than some fairly rudimentary estimates for the size of the house in 2022, I could find no other information on the topic so performed my own investigation.

We can have a pretty good guess at what the Lords will look like under current rules, because statistical data on life expectancy is available and calculating retirement is easy. What we cannot predict is how fast Prime Ministers will create new peers, but a very conservative estimate would be no less than 12 a year. (The averages for Heath and Brown) It’s hard to know how fast peers will retire voluntarily as the rules allowing this are new, but 18 retired last year so a restrained Prime Minister should just about be offset by voluntary retirements.

As we can see, even retiring peers at 80 doesn’t shrink the upper chamber quickly. The membership will drop below the current size of the Commons (650) in 2020, versus 2027 under current rules, but 400 is reckoned by many to be a more sensible size and even without new appointments that level isn’t reached until 2028, 11 years from now. (Versus 2033 under current rules) The more aggressive approach of retirement at 75 does immediately make the Lords smaller than the Commons, and 400 members is reached by 2023.

You may have noticed the long tail on the graph above. This is not because we have some immortal members of the House of Lords, even though it might feel like the opinions of some more senior members hark back to some distant and long-forgotten past. This is because even without new appointments by the Prime Minister, there remain just over 100 hereditary peers plus the Church of England bishops. Removing those posts and letting the same rules apply to those members as currently applies to life peerages does not really affect the overall outcome much.

Whatever the solution to the House of Lords is, mandatory retirement age might be a step in the right direction, butoes not seem to be it. We’re back to needing more fundamental reform, such as an elected upper chamber.

And finally, if you wonder about how all this affects party balance: In every conceivable scenario of retirements, both with and without hereditary peerages and the bishops, the Conservatives remain the largest party in the Lords but they never quite achieve a majority whilst the bishops are present. However, scrapping hereditary peerages and Bishops woudl result in a Tory majority in the upper chamber some time between 2036 (Retirement at 75) and 2044. (Current rules)

Last Saturday, The Times published an opinion piece by Janice Turner in which she tells a version of events that took place at Speakers’ Corner last week during a protest by trans activists. By the time of publication, Janice’s narrative of an elderly woman being beaten up had already been proven false by video circulating on YouTube. This is my letter to the editor in response to that piece, sent on Saturday afternoon – The Times have chosen not to publish it.

Dear Editor,

I am writing in response to Janice Turner’s article “The battle over gender has turned bloody”.

Janice seems to be unaware that the incident which occurred during a protest last week was videoed and that it was posted on YouTube. The video tells a very different story to the one she presents, in which she claims a trans activist committed an unprovoked assault on a 60 year old woman. Or perhaps she has taken a leaf out of Donald Trump’s campaign playbook, and wants to try to establish her view as the pure and unadulterated truth regardless of the evidence to the contrary.

What the video shows is Janice’s “60-year-old in specs and sensible shoes called Maria”, who she clearly want to portray as someone defenceless, holding a trans activist in a headlock and trying to kick them repeatedly. I understand the police were called, viewed the video and concluded no action was needed because Maria’s injuries had been sustained as a result of her being pulled off by one of the activist’s friends.

Although stills are available, the video has since been taken offline. Presumably because the person who posted it realised that crying foul when you sustain injuries in the process of assaulting someone else is not a good PR tactic.

I condemn all violence. If Janice wants to condemn violence, she too should condemn all violence. Not just those incidents that help prop up her narrative of hate.


Councillor Zoe O’Connell

Companies House advice on dead names
A topic that comes up frequently in Trans circles is the problem of “Dead” (I.e. pre-transition) names, something that many trans people are reluctant to make public for a whole variety of reasons. Unfortunately, many forms ask for this information with the assumption that most people who have changed names have only done so because they have married.

I ran into this problem myself just over a year ago, in the context of a charity I became trustee of as a result of my role as a councillor. Neither Companies House nor the Charities Commission actually require this information but that is not made clear, and when holding public office it is often necessary to dot the i’s and cross the t’s on paperwork to avoid unforeseen repercussions later on. I asked both organisations for confirmation, and I reproduce both their responses complete with reference number in the hope that it helps others in future.

Charity Commission advice on Dead Names Click the images for full size versions, and plain text versions of the respones from Charity Commission and Companies House are also available if anyone needs them.

I have not been keeping a particularly close eye on online pharmacy services for a while, but an interesting email from InHouse Pharmacy sent to their customers has come my way – and it suggests that the ongoing pressure on online pharmacies has not let up recently, with international payment provider OrbitRemit now refusing to serve online pharmacies.

I could not find any further information about this change on either InHouse Pharmacy or OrbitRemit’s web sites, although I did run across an FAQ on IHP’s web site that’s now specifically blaming “BigPhama” – something that’s long been assumed to be the root cause of their problems, but had not previously been confirmed: “Unfortunately we no longer accept Visa Debit and Credit Cards or MasterCard due to lobbyist pressure from BigPharma interests.

The good news for IHP and those using their services is that Bitcoin is becoming increasingly mainstream and now list this as their preferred payment option. Although it offers no buyer protection compared to other services, it is hard to see any way that pressure can be brought to bear on IHP via this route.

State Opening of ParliamentI noticed a couple of the usual outlets today reporting that the Queen’s speech included measures to protect LGBT+ people. So I went to check the text – and that’s not quite what it says:

My government will make further progress to tackle the gender pay gap and discrimination against people on the basis of their race, faith, gender, disability or sexual orientation.

That is a half-complete list of the protected characteristics from the Equality Act 2010. The complete list is race, faith, gender, disability, sexual orientation, age, marriage/civil partnership, pregnancy/maternity and gender reassignment.

I can understand why some of these might not be included if the topic is employment protections – but the exclusion of gender reassignment given the track record of both the DUP and some (not all, thankfully) of the Conservative Party on these issues is worrying. I hope this is merely an oversight, but it seems worthwhile keeping a close eye on any legislation that comes forward during this parliament, to make sure it is fully inclusive.

It would be very easy for someone to slip through legislation that misses or even penalises trans people while parliament is busy dealing with Brexit.


Update: I have now received a copy of the briefing notes for the Queen’s Speech, and whilst they do include trans-related provisions they are all in the past tense. There does not appear to be anything in here for LGB people, let alone T+!

LGB&T Equality

• We have established a £3 million programme from 2016 to 2019 to prevent and address homophobic, biphobic and transphobic bullying in schools.

• To support transgender equality we have increased investment in Gender Identity Services and issued new guidance to prisons on the treatment and management of transgender offenders.


Parliamentary copyright images are reproduced with the permission of Parliament – yes, I know it’s a photo from the wrong year but free-to-use ones aren’t up yet

It will come as no surprise to anyone following the results that no trans members of parliament were elected yesterday, as despite the shock over the overall result relatively few seats actually changed hands. However, a record number of people standing (9) also means some record results – yesterday saw three trans candidates gaining second place. The last time a trans candidate at a parliamentary level reached second place was also the first known trans parliamentary candidate, Alexandra “Sandra” MacRae, who stood for the SNP in 1992.

General elections are predominantly national rather than local campaigns, and the fates of trans candidates have followed those of their party colleagues standing elsewhere – Labour up but with limited gains, Liberal Democrats slipping slightly in non-target seats and the Greens struggling to make an impact.

Liberal Democrats Helen Belcher
2nd place, 25.6% (-3.8%)
Majority: 29.1%
Green Party Aimee Challenor
Coventry South
5th place: 1.3% (-2.6%)
Labour Sophie Cook
East Worthing & Shoreham
2nd place, 39.3% (+19.8%)
Majority: 9.3%
Green Party Andrew Creak
6th place, 1.1% (-1.2%)
Liberal Democrats Charley Hasted
Swansea East
5th place, 1.8% (-2.4%)
Green Party Dom Horsman
North West Durham
5th place, 1.1% (-2.6%)
Green Party Lee-Anne Lawrance
Runnymede and Weybridge
5th place, 2.6% (-1.5%)
Zoe OConnell Liberal Democrats Zoe O’Connell
3rd place, 4.3% (-0.1%)
Labour Heather Peto
Rutland & Melton
2nd place, 22.7% (+7.3%)
Majority: 40.1%


Photo sources – not all Creative Commons. Please check before reuse:
Helen Belcher, Charley Hasted: Liberal Democrat candidate promotional literature.
Aimee Challenor: CC BY-SA 3.0, credit Green Party of England and Wales.
Sophie Cook: Labour party candidate promotional literature.
Dom Horsman, Lee-Anne Lawrance: Provided by the candidates for use on this blog.
Zoe O’Connell: CC BY-SA 3.0, credit Zoe O’Connell.