Labour's pluralist challenge

Labour is necessary, but no longer sufficient, for progressive advance.

I was 16 when Margaret Thatcher fell from power. One of the ways in which she changed the left was to half-convert the Labour Party to pluralism. Labour asked itself seriously for the first time whether there was anything much wrong with the British state that wouldn't be solved by Labour being in charge of it.

Anthony Barnett's Charter 88 created important civic pressure on Labour and Liberal Democrat politicians to create an extensive reform agenda. New Labour's first term did more to reform the British state than any government since 1911. In power, older instincts re-emerged, yet the effects of devolution and Freedom of Information will endure.

Yet Barnett's latest anti-Labour New Statesman polemic barks up the wrong tree. It would make a hung parliament less, not more likely. Voting against the big two is not the same thing as promoting a hung parliament. Voters who want to stop any party getting 326 seats should back the strongest anti-Tory candidate in any seat the Conservatives could win (until they think a Labour majority more likely than a Tory one).

Write Labour off as a lost cause and there will be no plausible, pluralist governing project for Britain any time in the next decade, either. The Greens seek a parliamentary foothold, the Lib Dems to hold 120 seats after two elections. Then what?

Any new settlement will require alliances, which are overwhelmingly more likely on the centre left. (By all means, try to make David Cameron's centrist rhetoric at least constrain his party's Thatcherite ambitions; the realistic goal may be the conservative one, to protect past advances from repeal.)

The great progressive advances in British politics all arose from various forms of Lab-Lib co-operation. That was true of Labour's 1906 entry to parliament; breaking the Lords veto in the hung parliament of 1911; Attlee enshrining the Keynes-Beveridge settlement; the social legislation of the 1960s; and early New Labour's constitutional legacy.


A fair share of freedom

Outside these sporadic pluralist flurries, the right has mostly dominated. David Marquand's central thesis in The Progressive Dilemma was that Labour was necessary, but no longer sufficient, for progressive advance. If the 1997 and 2001 landslides seemed to disprove this as a matter of electoral arithmetic, the theory looks stronger than ever if we seek a transformative politics.

Pluralism should recognise differences. Different parties on the left of centre have different traditions, identities and instincts. They have much to argue over -- yet these arguments sharpen central challenges.

How can markets be sustainable and fair? We need to restore Labour's instinct for civil liberties, without lapsing into an allergy to state action in breaking down class-based disadvantage. The central political challenge is how to sustain majority public coalitions to be able to narrow inequalities, address climate change and sustain Britain's place in Europe.

Perhaps the defining argument between left and right is whether equality and liberty can be allied, or are always in fundamental tension. The quest that has animated thinkers from Tawney to Amartya Sen -- how to secure the fairest possible distribution of substantive freedom -- should provide a foundation stone for a plural left.

None of this can be achieved by one party alone, nor could any party easily wish the others away. But we must create a more pluralist Labour Party, able to play a leading part, for it to have much chance of happening at all.

Sunder Katwala is general secretary of the Fabian Society

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Sunder Katwala is director of British Future and former general secretary of the Fabian Society.

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How society is failing transgender children

In the wake of the cancellation of a public debate on this subject, one of the speakers shares her view on where society's approach to gender nonconformity is going wrong.

In August this year, several UK councils issued guidance to schools on accommodating female pupils who wear binders. A binder is a constricting undergarment for the upper body: what it binds are the breasts, pressing them down to a flatness that the wearer feels is appropriate to their self-perception as masculine or gender-neutral. According to Cornwall Council, the binder is “very important to [the wearer’s] psychological wellbeing.” But binders have unwelcome physical side-effects too, including “breathing difficulties, skeletal problems and fainting.” Lancashire Council’s advice urges teachers to “monitor [wearers] carefully during physical activities and in hot weather. It may be necessary to subtly offer more breaks.”

When the NSPCC invited me to participate in a discussion on the subject “is society letting down transgender children?” (part of its Dare to Debate series), those guidelines were one of the first things I thought of. They’re written in accordance with the overriding principle of gender identity politics, which is that affirmation is all. Any bodily harms incurred count for little compared to the trauma believed to be inflicted by a “mismatch” between appearance and identity. It’s a doctrine that insists we’ve moved beyond the tyranny of physical sex and social pressure, and into a realm of pure selfhood where all must be able to live in accordance with their own inherent being.

And yet, look again at that list of side effects: breathing difficulties, skeletal problems, fainting, inability to participate fully in exercise. The female adolescents wearing binders have reproduced all the problems of tight-lacing corsets, this time in the service of restrictive anti-femininity rather than restrictive femininity. So is issuing guidance to reduce the harms of binder-wearing in schools an act of care for transgender children, or an abdication of it? Is the role of adults in authority – whether parental, educational or medical – to validate everything that comes under the rubric of transition, regardless of long-term consequences, or could another approach be better?

The number of children who identify as trans is small, but rapidly increasing: referrals to the Tavistock and Portman NHS Trust’s gender identity development service have doubled year-on-year. Putting gender-nonconforming youths on a medical track opens the possibility that they will be prescribed puberty blockers, delaying the physical changes of adolescence that individuals may find distressing. Later, treatment can include cross-sex hormones and surgery to create the desired sexual characteristics.

For many, this can alleviate profound anguish about the self, but not without costs. The long-term effects of hormone therapies aren’t known, and won’t be until the current generation of trans children have lived well into adulthood. There’s a risk that increased medicalisation could be imposing permanent physical changes on children who, left to their own devices, would discover they are quite happy living with their natal sex – about 80 per cent of children diagnosed with gender dysphoria desist before adulthood, but the normalisation of medical transition could commit many to irrevocable treatments they would otherwise avoid.

Remarkably, as I found out when I worked on a long feature on the subject, there isn’t any agreement on what gender identity is or how it relates to the physical body. Which means that transitioning children are receiving an untested treatment for an undefined condition. Medicine often involves a surprising degree of idiosyncrasy and guesswork, but this uncertainty both about what is being treated and the effects of the treatment should be a cause for caution. While many who transition find it wholly positive, not everyone does: doubt and detransition happen, and these stories tell us that the quickest path to reassignment is not always the best treatment for someone presenting with dysphoria.

Sometimes, a diagnosis of gender dysphoria might mask a different underlying cause to a child’s distress. Psychiatrist Susan Bradley reports that children with cross-sex identification are often (not always) either responding defensively to a violent background or engaging in the obsessive behaviours associated with autistic spectrum disorders. A policy of “watchful waiting” – listening to the child, supporting them and giving them freedom to experiment and develop – is vital if we are to give children the kind of help they really need. But in an environment where anything short of total and immediate reinforcement is deemed abusive, “watchful waiting” is not an option.

One more problem: if gender dysphoria is conceived as the problem, and gender reassignment as the solution, then transition represents the summation of a process which should in theory resolve everything. In practice, newly-transitioned young people (especially those crossing the threshold from child and adolescent mental health services to adult provision) can find themselves stranded, no longer in receipt of the support they had during transition. We simply aren’t getting the treatment of transgender children right if we’re only treating their gender.

The consequences extend well beyond children who identify as trans, of course. Schools are suffused with sexual harassment and sexual violence, yet girls are expected to accept a child they previously knew as a boy as female like them, or be called bigots. The naturalisation of sex-stereotypes in parental narratives of transition surely has a limiting influence on other children’s conception of sex-appropriate behaviour. For some gender-nonconforming children, the cultural celebration of transition leads to anxiety about whether they themselves should be trans, even if they’re happy in their bodies. Certainly, many gay and lesbian adults have looked back on their own childhoods and remarked nervously that their behaviour then would qualify them as trans now.

If we’re not able to address these issues, then we’re manifestly failing children. But addressing them is incredibly difficult: practitioners who privately mention their doubts about current approaches to gender noncomformity are afraid to ask questions publicly, anticipating personal attacks and the loss of their jobs.

They’re not wrong to do so. After announcing the Dare to Debate event, the NSPCC was put under sustained pressure, I was persistently abused, and following the withdrawal of the other panelist, the charity cancelled the event. Previous installments in the series have looked at child sexualisation, foetal alcohol syndrome, and asked whether the investigation of child sexual abuse has tipped into “hysteria”, but apparently it would be just too daring to talk about gender. Doctrine so bitterly defended that it must even be protected from good-faith debate is a kind of restrictive garment for the intellect. Wearing it can ease our mental pangs. But the damage it does besides is very real.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.