Kate Gould's Blog: Kate Gould

I am a woman-born woman. An adult female. I have two X chromosomes, a vagina and, until menopause, a menstrual cycle. I’m not unusual in this: in fact, there are roughly 3.52 billion of us in the world right now. These are not opinions; they are statements of biological fact. That biology may not define a woman in totality – she has a vagina, she is not a vagina – but it is fundamental to what a woman is. Our biology and our being female are intertwined. As is the biology of men with their being male: a penis and testicles are the biological markers of maleness.

These are neither new nor controversial statements, yet to the emergent trans community, giddy on its own sense of entitlement, they are blasphemous hate speech. Transwomen are particularly vociferous in their responses. They call women, like myself, bigots, haters, TERFs (Trans Exclusionary Radical Feminist), homophobes, transphobes, and an entire roster of expletives. We’re threatened with assault and murder, and told transwomen can’t wait to rape us. Transwomen are calling for genocide and torture of women. (No, I’m not exaggerating. Here and here are just some examples.) Why? Because we told them about the biological basis to sex differentiation: women have two X chromosomes and a vagina; men have an X and a Y chromosome and a penis.

“But gender!” say the transwomen, as though feminists haven’t been deconstructing it since long before they were born. Yes, gender: the socio-sexual constructs we conflate with sex to inadequately explain our differences. The gender argument intrigues me because of the cherry-picking attitude transwomen take to it. They rapidly take on the prettiness of femininity – the shoes, the makeup, the clothes, and the hair – yet leave aside other traits commonly associated with the gender: empathy, compassion, nurturance, receptivity. Those aspects of the gentler sex are discarded because they don’t fit in with the behaviour of men (and transwomen are men) who’ve grown up and lived in a patriarchal society that tells them whatever they want, they should have. This is our cultural narrative: men demand and women defer. Just because they’re wearing dresses, they behave no differently.

Men want to have the right to choose the gender with which they identify and to be able to assert that right. For that is what transwomen’s rights are: men’s rights to identify and behave as they wish. To assume that this right is more worthy of support or more important than the rights of the women with whom transwomen say they identify is misogynist and demonstrates a lack of compassion and deep ignorance of what women deal with in their everyday lives – good and bad. It stems from a position of entitlement and assumption of superiority over women. Before declaring themselves transwomen and expecting to be welcomed by women, I wish they would think about what being a woman actually means. There is more embedded in gender than a change of outfit.

The most public demand is access to women-only spaces. This began – and continues – with transwomen’s demands to use women’s toilets. Women are expected to accept them – welcome them, even – or be vilified as anti, phobic, exclusionary deniers of rights. It’s an odd spot for a battleground, a public toilet. Or, perhaps not, given that it’s both public and private, representative of gender segregation, and a separation of the sexes that is a mass cultural norm to the point of invisibility. Only, now, it’s highly visible.

Transwomen want access to women-only domestic violence shelters and rape crisis centres, either blithely or willfully ignorant of the effect this may have on women using the facilities. Occasionally they want to work in them (a transwomen who wanted to volunteer at Vancouver Rape Relief forced them into a 12-year legal battle when they refused – time and money that could have been spent helping rape victims), but most want to know they can use them. The problem, as if it needs stating, is that these shelters are for women and transwomen are men. The women and children there are at their most vulnerable, many are terrified, and all have suffered abuse by men. A frightened child in a rape crisis centre isn’t going to look at a transwoman and see trans-inclusive ideology. She’s going to see a man in a dress and the last time she saw a man he raped her. If transwomen can’t see why that would be distressing and, therefore, why their presence isn’t welcome in facilities for vulnerable women – or, indeed, any women-only spaces – they’re demonstrating why women don’t want to share our spaces with them.

This encroachment on women’s spaces is coupled with a colonisation of our bodies. In a reduction of women to a set of holes that combines misogyny, porn and rape culture in one, trans terminology appropriates “vagina” for post-operative transsexuals while gifting “front hole” to women as a term for their vaginas. This dehumanising practice is backed by The Human Rights Campaign Foundation document, Safer Sex for Trans Bodies.

If women disagree with transwomen, they are told they are aggressive – violent, even. I’ve yet to see any evidence of violence against transwomen by women and, if we’re aggressive, it’s because we’re rightfully pissed off. The transwomen who attempt to silence us and claim our bodies and spaces as their own seek to remove us both discursively and literally. They attempt to both devalue and claim for themselves all that is female – be it the word “woman”, our bodies, or our spaces. We cannot concede to their demands because, by doing so, is to agree that all that we are is only worth what little value they attribute to it. Instead, we need to guard our bodies and lives against this new misogyny.

Form NCC1, or the Rape Clause, as it is commonly known, has been introduced without a parliamentary vote, ostensibly, as a means by which to provide tax credits for women who have had children as a result of rape or a coercive relationship. What it actually does is force women to relive the trauma of rape in order to apply for child tax credits. It punishes a woman for a crime enacted upon her while the perpetrator is likely – given the low prosecution rate for rape – to remain unpunished. (Perhaps a parallel action offering prosecution of the rapist would give some balance to the policy.) By stipulating that the woman not be living with the child’s father penalises women who have no choice but to remain in coercive relationships.

The policy has been condemned by Engender, Rape Crisis Scotland, and Scottish Women’s Aid (here, here, and here) who have stated that they will not provide the third party support required for tax credit applications for children conceived as a result of rape or coercive relationship. In a letter to The Guardian,  80 psychologists expressed concern over the psychological risks to both mother and child inherent in forcing a woman to relive the trauma of the child’s conception.

So, what can you do? Well, I spent Saturday morning emailing MPs and MSPs with my concerns. If you’re not sure what to say, Rape Crisis Scotland has created a template letter, which I contributed to, and you can find here.

Here’s the list of people I contacted:

The MP for your constituency (find them here)

The MSP for your constituency (find them here)

The MP for Women and Equality, Justine Greening (greeningj@parliament.uk)

Shadow MP for Women and Equality, Sarah Champion (sarah.champion.mp@parliament.uk)

The MP responsible for tax credits, David Gauke (gauked@parliament.uk)

The head of the Scottish Conservative Party, Ruth Davidson (ruth.davidson.MSP@parliament.scot)

First Minister of Scotland, Nicola Sturgeon (Nicola.Sturgeon.msp@parliament.scot)

Prime Minister Theresa May (mayt@parliament.uk).

You can also get in touch with organisations that oppose the rape clause to offer your support. Scottish Women’s Aid, Engender, and Rape Crisis Scotland have made their opposition known so contact them for a start.

There’s a demo in Glasgow on April the 13th at 6pm in George Square, to #scraptherapeclause. Details are on facebook.

I had a fascinating chat with Emma Grinfeld and Leonore Schick about female sexual dysfunction and the Pink Viagra for their show about not coming. You can hear lots of their brilliant podcasts at Very Loose Women.

Some favourites from women who rock: Katie Makkai, Alysia, and Hollie McNish

I have what I call a like-dislike relationship with anti-anxiety medication. It’s not a complex relationship: I like that they work, but I dislike that I need them to. I first started taking them five years ago, to help with anxiety related to epileptic seizures. I’d tried cognitive behavioural therapy, self-hypnosis, alternate nostril breathing, “blowing out the candle” breathing (relaxing, in theory, but decidedly unpleasant when you duck into a public toilet to draw in a deep breath through your nose to hold and release through your mouth), and aromatherapy in an attempt to calm myself and break the negative associations I was forming with a growing list of places in which I’d come to wondering what the fuck just happened. I was tired. I wanted someone or something else to take over, to do some of the work, and I wanted to be able to leave home without my first thought always being “I hope I don’t have a fit when I’m out”.

I spoke to my doctor, told him I’d heard good things about SSRIs and said I’d like to try going on one. He prescribed Citalopram/Celexa and off I went. I was lucky: I didn’t have any problems going onto the drug, it didn’t interfere with my anticonvulsants, and I didn’t have any side effects. In all honesty, it was wonderful. I was able to meet up with friends without a permanent tension in my head, I could walk down the street feeling confident instead of counting the minutes until I’d be home and safe again, I started having baths in the evening instead of thinking I should get into bed as quickly as possible because I knew that was a safe place to be. The slight emotional numbness that can come with taking some anti-anxiety/depressant medication was a welcome relief from the frequent feelings of being utterly overwhelmed. I started putting myself out there with my work and embarked on a PhD studying female sexual dysfunction.

Last summer I started seeing a different neurology consultant. Handily, I had a seizure in his office which enabled him to make a diagnosis of focal epilepsy with a left temporal onset. He explained that the left temporal area of the brain is related to language which accounts for my inability to talk when I’m about to have a seizure. (It’s ever so helpful when you’re trying to explain to someone what’s going on. I carry a medic alert card and my dog, Luna, has a fetching tag with “my owner has epilepsy” engraved on it, ever since someone helping me worked out where home was from her address tag.) He changed my epilepsy medication from a combination of Lamictal and Epilim to Lamictal and Zonisamide. Things were going well: I was enjoying my PhD, I had some brilliant friends and the most amazing dog in the world, and was hoping for great things from my new meds so I decided to try coming off the SSRI.

Because I was on a low dose (10mg a day), I didn’t do a long titration (a mistake, in hindsight). The nausea started within a couple of weeks, followed by the fatigue. Then the crying started. My sense of smell was, at once, acute and bizarre: Luna smelt metallic (my mum said she smelt normal) and I couldn’t bear the smell of anything but the blandest foods. I was horribly noise phobic and the slightest sound would wake me up at night. I was craving odd things – drinking gallons of orange squash and eating pots and pots of mango yogurt. My friends were brilliant, letting me know they were there if I needed them, walking Luna when it was all I could do to get out of bed in the morning and getting me groceries. My mum and her partner took Luna to stay with them for a few days so I could sit watching boxsets and sleep. The doctor prescribed the antiemetic, Cyclizine, to help with the nausea.

I had a seizure and dislocated my shoulder. Putting it back in isn’t usually a huge deal because I’ve done it so many times and, usually, they just give me Entenox at the hospital and “pop it back in”, as they put it. This time, I had a terrifying hallucination that I was being tortured and that they were going to take Luna away from me. Every time I opened my eyes it was as though I was stuck in the hallucination. They thought I was fighting with them, not realising it was because I was somewhere else entirely in my head. In the end, they sedated me and put it back in.

Afterwards, my brother and I joked about the fact that the darkest, most catastrophic scenario my mind could conjure was not Armageddon or losing my family/mind/life but that I wouldn’t be allowed to see my dog again. I suppose it’s rather comforting, in a way, to know that’s as dark as I get.

All the time, I kept telling myself that it was going to be fine and that it was just a matter of time, but the symptoms didn’t seem to be abating. The nausea went, but the fatigue and the crying at nothing stayed. I felt as though I’d lost all points of reference in my life. My mum would ask me what I wanted to eat and I wouldn’t have the first clue. I decided it was about changing the narrative, just a little bit at a time. So, for instance, I decided to think of any sound from my neighbours as a reminder that there were people around me and to keep letting the joy from my scruffy dog wash over me.

I contacted my neurologist and epilepsy specialist nurse, describing my symptoms and saying I’d had to take time off my PhD and was going to have to drop out if I didn’t improve, but they didn’t reply. It was my doctor who worked out the link. Given that it had been nearly three months, he didn’t think I could still be in withdrawal so he looked at the side effects of Zonisamide. Turns out, they’re very similar to the symptoms of SSRI withdrawal so he suggested I try going back on 5mg of Citalopram to see if it helped. I did and, within a week and a half, the symptoms lessened. Here’s how it seems to work: I need to take an SSRI to mitigate the side effects of Zonisamide. I don’t know why, but whatever the Zonisamide does that makes me feel awful, the Citalopram stops it while letting it do its thing as an anticonvulsant.

It’s now mid-March – four and a bit months after I went back on the Citalopram – and things are going well. I started back on my PhD part time this month, I’m doing my 10,000 steps a day (with a two-year-old collie-deerhound cross, you don’t have much choice), and eating healthily. I had my 40th birthday in February and had the most fantastic time which might not sound like an achievement, as such, but given that, just a few months before, having a birthday celebration – let alone enjoying it – was about on a par, in terms of accomplishment, with climbing Everest. I still get tired, but it’s nothing like the bone-crushing fatigue I felt before – it just means I need to take it easy for a few hours or, if I’m pre-menstrual (my PMS has got much worse), give up on getting anything done that day. My seizures have changed lately. It’s as though my brain edges up to having a fit then backs away so I get confused and can’t speak, but don’t actually lose consciousness. I’ve accepted that, for the foreseeable future, I need to keep taking an SSRI. Every week, when I fill up my pill box, I drop in the Citalopram and bear it no ill will – it’s part of a balance I’ve had to find for reasons no one seems to understand. It’s like an essay question for which there is no wrong or right answer: Pharmaceuticals. Discuss.

Should you ever need them, here are my suggestions: 1) Give yourself a break – take it easy. 2) Get some good antiemetics. I’ve found Cyclizine to be very effective at minimising the nausea and light-headedness. Plus, if you happen to be on anticonvulsants, too, it doesn’t interfere with them which is handy. 3) Do some light exercise like taking the dog to the park, but no running/going to the gym/exercise classes etc. 4) Remember that whatever the symptoms, that’s all they are – withdrawal symptoms. 5) No matter how bad you feel, the withdrawal symptoms will go away. 6) Your friends are superhero(in)es and want to know that you’re ok which isn’t the same thing as not talking to them about what’s going on. 7) You’re not a drug addict. Your body is physiologically dependent on a drug which is entirely different to being addicted to it. 8) It’s worth going through withdrawal to get on with your life without medication if that’s what you want to do. I think that’s it.

We are living in a time of sexual confusion. Women are liberated and empowered, free to explore desires like never before; sexual education now includes lessons on consent and, even, pleasure; the acronymous roster of sexual rights (LGBTQQIP2SAA) grows ever more unwieldy as it seeks to encompass every nuance of sexual expression; and yet the acceptance of all that is alpha male is such that an American Presidential candidate can boast of sexual assault and still be elected to the White House. What allows for the co-existence of these disparate and contradictory social attitudes is socio-sexual norms.

Norms are the product of continuing historical, geographical, cultural, and sociological changes; socio-sexual attitudes are not static and are shaped, through complex interrelationships, by the sexual culture that surrounds them. The norms of our sexual culture reflect its confusion: hence, consent can be taught to children while an admission of sexual assault is dismissed as jocular banter; behaviour that is shameful promiscuity to women is simply sexual prowess to men; and rights long-held by heterosexuals must be fought for by anyone whose sexuality exists outside of heteronormativity. Yet there is one sexual norm that remains: an assumption that everyone wants to have sex. If they don’t, such is the peculiarity of their lack of desire that it is assumed to have a medical root.

This medicalisation of the (lack of) desire is the focus of my research; specifically, female lack of desire or Female Sexual Dysfunction (FSD). This condition entered the medical lexicon in 1952 when it was listed in the first edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM I) as a psychosexual disorder, replacing hysteria, one of the most frequently diagnosed yet inconsistently defined diseases in medical history.

The definitions, symptoms, and differential diagnoses of FSD were expanded in successive editions of the DSM, but no successful treatments emerged. In March 1998 Viagra, the treatment for Erectile Dysfunction, received Food and Drug Administration (FDA) approval and, detecting a potential market for a female equivalent to the blockbuster drug, pharmaceutical companies began research into what became known as the Pink Viagra. The search continued until August 2015 when, despite a number of FDA Board members’ concerns about its safety and efficacy, the Sprout Pharmaceutical product, Flibanserin (brand name Addyi), received FDA approval. Anticipating booming sales, Valeant Pharmaceuticals bought the drug for $1 billion only to discover one fairly significant flaw: the pill doesn’t work.

Addyi is the treatment for a sexual state, reworked to look like a medical condition. The drug is a flop because not wanting to have sex is as normal as wanting to; it isn’t indicative of sickness and, therefore, is not a symptom to be cured by a pill. Women aren’t taking Addyi, not only because it doesn’t work, but because they know they’re not abnormal and that their reasons for not wanting to have sex are not going to disappear with a little, purple pill.  (The pill also comes with a lengthy roster of significant side effects.) Childbirth, menopause, the pressures of day-to-day life, or just not fancying their partner are only some of those reasons.

There is also the nature of the sexual culture in which the condition and its treatment were created. Ours is a culture that positions heterosexuality and its attendant expectations of male dominance and female submission as the norm. The attitudes that accompany this norm impose upon the socio-sexual climate an expectation – even demand – of heterosexuality and of penetrative, penis-in-vagina sex.

My research explores female sexuality as represented in the media coverage of Flibanserin/Addyi. It draws on concepts of the model of ideal sex, sex as the subject of medicalisation and pharmaceuticalisation, and the purpose of medical definitions of sexual normalcy in order to examine women’s sexuality in relation to a drug intended to increase women’s desire for sex. This draws on sex and sexuality in a medicalised context – specifically that created by the construction of Flibanserin/Addyi and FSD as a condition. The existence of both the drug and condition is the result of more than a wish to improve the sex lives of women. It is founded on a desire to maintain heterosexual, penis-in-vagina intercourse as the model of ideal sex to which women should aspire. However, there is room in our sexual culture for a new norm: that of the right to choose one’s own sexual normality.