Laughing matters?

Attitudes towards trans people betray the wider failures of "alternative" comedy.

Growing up in the Nineties with plenty of "alternative" humour on television, including Chris Morris, Lee and Herring and The Friday Night Armistice, I was told that predictability is the enemy of laughter. The narrative behind their growing popularity ran that the Bad Old Comedy (stand-ups like Bernard Manning and Jim Davidson, and sitcoms such as Love Thy Neighbour) used cheap stereotypes to pick on easy targets, especially ethnic minorities, women and gay men, before rightly being sidelined by a new wave, more adventurous in form and content.

As it transpired - and as Stewart Lee has expertly depicted via a range of television and stand-up shows, and Suzanne Moore recently documented - the Nineties represented the mid-point between the old guard's overthrow and the rise of comics who similarly exploited populist prejudices to become the new orthodoxy. Unlike their predecessors, they may justify their acts by claiming irony or opposition to their straw man conception of political correctness but in practice, their apparent stretching of liberal boundaries is sometimes barely distinguishable from the retrograde bullying of the Seventies, even if the butts of their jokes are slightly different.

Britain's trans community is increasingly concerned with how media representation affects our lives, and frustrated at how regularly comedians reduce our bodies and social challenges to objects of derision. Whilst being far from the only minority group in this position, it's especially damaging as the number of "out" trans people remains relatively small, and so for many people, the clichés in Little Britain or Littlejohn cartoons (for example) go unquestioned, and continue to be used against any trans person who dares to be visible.

As an openly trans woman in a (still) frequently transphobic society, I deal with a certain amount of street harassment. The most stressful encounters nearly always start with being laughed at, sometimes with aspects of my dress or demeanour singled out. This usually comes when I am alone, from a group of people, or a passing car (an act of cowardice just one rung above calling someone a cunt via the internet). Violence, threatened or realised, is rarely their first weapon, but I know that if I object to the taunts, or incidents where my basic existence serves as a comic foil, then I can expect them to assert their power with more aggression than passivity. If I or anyone else reasons with them - it's just "banter".

Often, the insults are generic, and I cannot identify their main cultural influence. However, if some slack-jawed wazzock hollers "I'm a lady!" at me, I know exactly where it came from. At times, it felt that Little Britain (deconstructed here by Johann Hari) and its successor Come Fly With Me served as an index of those which contemporary comedy deems legitimate to ridicule, its "rubbish transvestites" appealing to as low a denominator as its attacks on the white working class or isolated gay men striving to define their identities.

The trend epitomised by Lucas and Walliams's hit series has not been discontinued. Christine Burns and Paris Lees both discussed Russell Howard's recent Good News sketch, made in response to reports of a Thai airline allowing trans women (who struggle to find safe employment elsewhere) to work as cabin crew, which relied upon depictions of trans people that could have been lifted from the Daily Mail. Clearly, some viewers find these images funny - that is their right - and not all trans people find this particularly skit offensive, but it raises questions about when and how it is fair for performers to use stereotypes, and the extent of their responsibility to interrogate their origins rather than merely reiterating them.

When we complain about such comedy, the accusation that we are humourless is often used as a counter, as it was against feminist critiques in the pre-alternative days. The truth that this allegation (which has itself become something of a cliché) ignores, or serves to mask, is that gifted comedians can and often do empower marginalised groups. During my teens, Eddie Izzard's laudable wit in discussing his transvestism, and particularly in exploding the media trope of the psychotic cross-dresser, proved immensely useful, helping me relax about my gender difference and setting favourable terms for me to disclose it to friends.

Despite Izzard's breakthrough, the dialogue remained notably one-sided - until recently. As trans issues gradually become more mainstream, a wave of distinctive, intelligent stand-ups are offering humorous perspectives on them, even if they are not (yet) darlings of the ubiquitous panel shows. This new generation includes transvestite Andrew O'Neill, transsexual women Claire Parker and Bethany Black, and trans man Jason Elvis Barker, all providing fresh takes on trans living and numerous other subjects, undermining the myth that we talk about little besides our own genders.

Ultimately, the Eighties' more inventive voices - Kevin McAleer, Ted Chippington and Simon Munnery amongst them - proved the most resistant to mainstream assimilation. In part, this was because they rose above reactionary rants about "political correctness gone mad" that characterised some of their lazier contemporaries, who have forgotten for too long that the right to free speech works best when balanced with the responsibility to use any position of privilege fairly. Now, 30 years after the alternative revolution broke into clubs and onto screens, audiences look from Love Thy Neighbour to Little Britain, Mind Your Language to Mock the Week, and cannot always tell which is which.

Juliet Jacques is a freelance journalist and writer who covers gender, sexuality, literature, film, art and football. Her writing can be found on her blog at and she can be contacted on Twitter @julietjacques.

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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.