My Transsexual Summer: The trouble with television

The medium’s ability to improve its own minority representation is strictly limited.

The medium’s ability to improve its own minority representation is strictly limited.

Many of my friends are talking about My Transsexual Summer, which recently began on Channel Four, featuring seven people from across the gender diversity spectrum. Some are cisgender (crudely, not trans), often with little knowledge of trans living beyond what I've told them, who say the show offers accessible, sympathetic insights into the social challenges of transition. Conversely, my trans friends, some of whom had high hopes for the series, have tended to vent frustration that (besides other things) it fails to air the experiences of those who do not simply wish to move from one side of male/female to the other but find space within the gender binary.

I won't review it from a trans perspective: Sarah Lake, Dru Marland and several others have done so, better than I could. The consensus seems to be that My Transsexual Summer has faults -- its title erases the subtleties of the participants' gender identities, and its voiceover and editing do not entirely avoid sensationalism -- but that in showing trans people together, rather than disparate, isolated individuals as in previous documentaries, it demonstrates a vibrant culture on television for the first time.

This is an incremental step forward for trans media portrayal, but still raises questions about how far TV is capable of providing satisfactory minority representation. Maxwell Zachs, of, My Transsexual Summer, has expressed some dissatisfaction with the show, whilst my own engagement with the industry has been less than encouraging.

If you didn't know (and I've had calls from media companies who'd somehow missed it), I'm transsexual, and often write about it, trying to use my experiences to open dialogue about wider trans concerns. (Apologies to my FtM friends: I've tended to focus on trans women as I don't feel as qualified on trans men.) I do this because, for years, I felt that while trans people were regularly discussed in mainstream media, used as objects of ridicule in lazy comedy shows, or attacked by certain feminists or conservatives, we were seldom allowed to frame our own stories and present counter-arguments on an even footing.

In particular, when I began apprehending myself through newspapers, films and TV, I resented the stereotypes of trans women as psychotic (Psycho, Dog Day Afternoon or Dressed to Kill) that persisted into the Nineties (in Silence of the Lambs, for one). These still hadn't quite disappeared nearly twenty years later, when I decided (independently of other groups and individuals pursuing similar aims) to work within the mainstream media towards more positive representation.

After I'd written about six instalments of my Transgender Journey series for the Guardian, which aimed to reduce the decades-long gap between transgender theory and the broadsheet press, I got an email from someone at a company who'd produced films, and programmes for the BBC and Channel 4. This person had read my blogs and proposed meeting about a possible TV drama about people in transition.

Perfect: I'd attempted something like this before writing the Guardian column, as I thought that a colourful, humorous narrative with engaging characters could potentially challenge preconceptions about trans people for a far wider audience. I felt that although I'd created a plausible world with interesting characters, I was average at dialogue and weak on plot. (The inevitable consequence of watching too many obscure French films where no-one speaks and nothing happens.) Now, I might be part of a well-balanced writing team with two promising young playwrights, and we could aim at a cultural landmark equivalent to Queer As Folk or The L Word.

Friends in/around the industry warned that lead-in times are always long; sure enough, we struggled to arrange the meeting. Finally, after fifteen months, resolution: the project had been shelved as "Sky have a drama coming up about a pre-op transsexual hitwoman". As far as the producer was concerned, this programme -- which had annoyed trans bloggers even before it was cast -- meant no market space for anything trans-related, no matter how different, for the foreseeable future. Perhaps, I thought, I'm best out of this.

Writers being disillusioned with the infrastructures of screen media is nothing new: think of Bertolt Brecht or Clifford Odets' disastrous inability to deliver what Hollywood producers required (the latter providing inspiration for the Coen Brothers' Barton Fink), or Jean-Paul Sartre's unwillingness to compromise for director John Huston on Freud (1962). But the television industry's incapacity to foster formally or politically radical content is even more pronounced than its cinematic counterpart, for numerous reasons.

With so many channels broadcasting around the clock, the listings are full of unscripted programmes -- sport, reality TV, panel shows -- which are relatively cheap or have fixed budgets. This has the effect of making television appear a world where writers are neither needed nor wanted, but it happens because the financial and visual demands of written serials are so high. (Charlie Brooker explains the costs brilliantly here.) As audiences will apparently change channel unless the pace is utterly relentless, a programme like Tony Hancock's Radio Ham, set in one room, is no longer tenable, so screenwriters must create fast, action-packed and above all short scenes across a number of locations, keeping firmly within budget.

This is not bad in itself: these constraints offer interesting challenges to writers, and when met successfully, produce fantastic shows. (The first episode of Shameless is a case in point.) The key limitations are not those of form, but content: what really puts off writers with specialist knowledge are producers' prejudices about what viewers will accept or understand which, coupled with their methods of audience testing, remain the greatest barriers to any big improvements in coverage of minority subjects.

Circumventing these gatekeepers is far harder than in writing (where bloggers have successfully challenged editors' beliefs about what people will or won't read). For My Transsexual Summer, a number of trans people, including CN Lester, and Paris Lees of pressure group Trans Media Watch, consulted with Channel Four: the broadcaster's willingness to listen is encouraging, although all the above blogs explicate the number of compromises necessary to get this show -- imperfect but still significantly better than what came before -- to air. At this point, given its financial and political structures, the limited level of improvement in trans representation on TV shown by My Transsexual Summer is probably the best we can expect.

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.