On The Couch with Axel Nathaniel Rose Podcast Transcript

[00:00:00] Jennifer Farinella: Hello and welcome to an episode of On The Couch, where we collaborate with experts, practitioners, authors, advocates, and influencers to explore current social themes, sex positive topics, and share stories and insights that matter. This podcast was recorded on Aboriginal country. We acknowledge the traditional custodians of the lands that were never ceded on which we live, work and record upon.

We pay our respects to elders past and present and to those who may be visiting our website or listening to our podcasts today.

While listening, we encourage you to practice good self care. Check the show notes for content details and references.

Wherever you are, whatever you're doing, enjoy this episode of On The Couch.

[00:00:43] Naomi Viret: I'd like to welcome today's On the Couch guest, Axel Nathaniel Rose. Axel is currently a PhD candidate at the University of New South Wales, and we're so grateful for you taking time out of your PhD writing and research to be here. His PhD on queer people's engagement with literature through blogging and a novel about the impacts of climate crisis and social media on young queer people. His experience as a queer, transgender, and disabled man informs all that he does and all that he believes.

Welcome, welcome, welcome, Axel.

Thank you so much for joining us.

[00:01:19] Axel Nathaniel Rose: Thank you so much for having me. It is a really great pleasure. I'm, yeah, so thrilled to be chatting with you.

[00:01:24] Naomi Viret: So, if you feel comfortable and safe to do so, if you would like to kick us off with a little bit of your story and how it is that you've come to be a writer and a really strong advocate in this space.

[00:01:36] Axel Nathaniel Rose: I don't know that I've come to be a really strong advocate, but, I think that writing and advocacy have always been quite intertwined for me. Um, writing was sort of the first thing I really ever did as a small child. I wrote my first novel when I was five. It was called The Evil King and it was about my brother's tyranny over the household armchair.

So, um, that was my sort of entry, level, uh, advocacy work. But I think for me, I, I'm really just, I am a words person. I think that the stories that we tell, the type of language that we use shapes public discourse, it shapes empathy, it shapes the sort of world that we see around us. So as I developed as a writer, developing advocacy alongside that just came very naturally.

And as I aged, um, you know, first developed pretty significant mental illness and disability, then realising I was queer and trans, um, writing was the way that I, that I managed all of that. And in terms of the topic today of consent, I think consent is so much based in, language and consideration and how we see each other.

It’s just so vital. And on that note, just in terms of building safe space, I'll just give some quick content warnings if that's all right. I will be talking about, medical abuse, fairly explicit transphobia, um, and we'll refer briefly to sexual violence, transphobia, and, transphobic and misogynistic public policy.

[00:03:13] Naomi Viret: Thank you so much for that, Axel. Really appreciate it. And I just love how, you know, you touch on the power of words and language and that, our voice is something that we use every day, but we don't necessarily always realise the power of it.

As you've already mentioned, we've sort of spoken about, consent and what that means to different people in different, I guess, situations or circumstances. There is a clinical definition of consent, and often we hear a lot about, consent 101, but just for people joining us, are you able to let us know your working definition of consent and what that role has played, I guess, in your work or in the space that you're moving at the moment?

[00:03:51] Axel Nathaniel Rose: Sure. So I think that consent is the agreement between people, two or more, that something will or will not happen, and usually on specific terms. Consent is given freely, and with as little power imbalance as possible. It's most commonly understood in terms of physical contact, but it very much does also refer to non physical things like giving consent to share information, or, consent to medical care.

"Um, and I think that consent is sort of, it's the undercurrent of most discussions around disabled, queer, and trans healthcare. So it's always been something really significant for me and something I've always wanted to talk about more explicitly, because I think until fairly recently, it's been a hidden idea, uh, behind sort of justice struggles.

[00:04:46] Naomi Viret: Thank you. And I really like that too, that we tie back into the fact that consent is given in so many aspects of our everyday life. It's not just in terms of sexual behaviours, which a lot of people tie consent into. And if we think about consent education, and I know you're going to get into this, there's so many parallel practices and things that we can be doing in our daily life to be practising that consent. So then when it does come to more serious matters of consent, specifically those around medical care and sexual behaviors, that consent feels more comfortable and it feels more natural.

So just to touch on another term, if you don't mind, would you be able to define transgender for us as well, please, just to set some context.

[00:05:25] Axel Nathaniel Rose: Sure, so to be transgender is to identify with a gender different than that we were assigned at birth. So this includes binary, non binary and fluid identities.

[00:05:37] Naomi Viret: Excellent. So, rewind to February 2022. And you wrote a blog for the website Learning Consent, and if Learning Consent rings a bell to anyone, that's because we did do a On The Couch with Dr Joy Townsend, the founder of Learning Consent, so that name may be familiar.

If not, we do encourage you to jump onto the Learning Consent website to check out the great work that Joy and her team are doing. You had written a blog for the website last year, and it was a very emotive read, I have to say, but I really enjoyed seeing the term Consent Culture. Are you able to explore that a little bit more with us, and what do you mean by Consent Culture?

[00:06:20] Axel Nathaniel Rose: Yeah, sure. I sort of used that phrase offhandedly because it felt very intuitive to me. Um, and then I, of course, looked it up and realized there's a whole sort of body of scholarship and many wonderful activists already using the term. I think that the, the person who named Consent Culture was the activist Kitty Stryker.

But a Consent Culture is basically a broad culture, in which everyone works towards prioritizing consent as part of everyday life. So, across domains and across stages of life from cradle to grave, um, it is just a culture in which people are putting energy towards consent. It's certainly not limited to sex and intimacy, but any any Consent Culture is going to build up, great, greater cultures of sexual consent.

So in a Consent Culture, we ideally, we teach children about consent. We train, uh, professionals to understand and practice consent. And I think sort of most importantly, in a way, we check in with each other in day to day life. We talk about consent because it's something, if it goes unacknowledged, it's not really there.

And I mean, a really simple example of, of consent that's been on my mind a lot recently, just because I have delightful little nieces and nephews is, just around young children being pressured in, into physical affection. So, you know, a parent saying, go on, go, go give your auntie a hug, even when the child really doesn't want to.

And it's really similar in nursing and, and care homes. Um, people will come in and, and, and touch someone, without, without a check in at all. So I think, yeah, it's just really mundane. It's, it's, um, it's everyday. It's boring. Um, and practicing consent in daily life is just something that enriches the intimacy between people.

So a Consent Culture is one where we ask each other how best to treat each other as human beings to respect each other's decisions and preferences. And yeah while it was proposed as sort of a direct alternative to the idea of a rape culture, um, in, in which sort of culturally misogyny is so widespread and so normalized that rape is sort of normalized.

Um, in itself, it is a sort of natural conclusion culturally. So Consent Culture is directly countering that idea. It is building up a culture in which rape, sexual violence is not viable it's it's not something that is culturally acceptable. So, like with rape culture or, the continuum of sexual violence, as the academic Liz Kelly calls it, you know, in Consent Culture, we're not saying that asking for consent for someone for, you know, for a child to hug their family member is the same as asking if, if someone wants to actively have sex, but it's on a spectrum. So when we are normalizing practicing consent in those really mundane daily interactions, um, we normalize the more explicit sexual consent as well.

[00:09:37] Naomi Viret: Two words really stand out there, empathy and respect. And without empathy, I think what we face is entitlement. And I think that that's where a lot of that misogynistic rape culture stuff starts to come into it because it's taking somebody's body as an entitlement instead of having empathy for the experience of that person.

Respect first and foremost, always, all the time. And I would like to add to that kindness as well, because I think that's such an important element.

Let's get back to Consent Culture. What advice would you give, to our participants online who are really wondering like how is it that they themselves or people who they're working with or living with can start to practice this Consent Culture?

Have you got any kind of like little tips or tricks as to what that might look like?

[00:10:20] Axel Nathaniel Rose: Yeah, so I think one thing is don't worry too much. You don't need a huge specialized vocabulary or a great theoretical understanding of Consent Culture or the counterpart of rape culture to practice consent. It is about mutual respect. It is about being present in the moment with the person that you're interacting with. You know, the basic practice of consent is just asking oneself, you know, how will my action affect this other person with me? Does this person understand where I'm coming from? Yeah. And You know, there are, there are areas where it is sort of less intuitive than just aiming for empathy.

And I, I think, you know, talking more about medical consent in particular, the sharing of information is something that, I, I don't think the sharing of information or, um, sort of boundary crossing in terms of roles in the family, like, like who, who gets to know a child's medical information, stuff like that. It takes prior thought. So definitely, read about consent culture, if it's something that you, you want more, as you, you mentioned, Naomi, Joy Townsend's project, Learning Consent is, I think, one of the best resources ever, she primarily focuses on, on sexual consent, but other forms of consent as well.

As mentioned, Kitty Stryker, who coined, the term Consent Culture has written. A lot of stuff, which is all really beautiful. And, and her book, Ask: Building Consent Culture, uh, which was co authored with Carol Queen and Laurie Penny, is just a wonderful resource and sort of crosses the different domains of consent.

In terms of, I know we have a lot of people specializing in, in trans and, and queer healthcare and I think Nevo Zisin this in, they've written some beautiful stuff around trans consent, as has Quinn Eades.

[00:12:21] Naomi Viret: I love it. It just goes to show that there is so much out there and how wonderful that is actually that we do have so much information because I can imagine just probably as little as five years or a decade ago that information and those resources would have been quite lacking. So the fact that you can talk to so many resources I actually find really empowering and liberating.

So I just want to say that I think you wrap up consent really beautifully at the conclusion of the blog by saying that 'Consent summarizes many things, it's respect, trust, safety, humility, groundedness, and it's just about being on the same page. Consent as a word can be scary, but practicing a culture of consent doesn't require even saying the word aloud. Quite often it doesn't need anything said at all. But thinking about it every day is how we can build consent into everyday life.'

So thank you so much for those beautiful wise words that you wrapped that blog up with. I'd now like to move into talking about consent in terms of in trans and queer health spaces if you feel comfortable to move forward into that.

Medical consent is perhaps not always front of our minds, as I think you did mention a little earlier, and it's not something that we may think about in terms of health professionals. We might not think about having to give consent. I guess that sometimes there's that assumption of power that somebody within the medical field may have over us as individuals, and they know best, although I would question that we probably know ourselves and our bodies best.

But it is absolutely a consideration in the space that we need to think about. So you've had some very varied experiences in this space from where there was no consent at all, right through to where there's been a very positive interaction with the GP and you did feel safe and respected and that they were checking in with you and giving your consent where you feel comfortable to do so can you please talk us through consent, within the medical space, particularly with referencing trans and queer people.

[00:14:18] Axel Nathaniel Rose: Yeah, absolutely. So I do feel like I need to give the foreword that I have had some extraordinary doctors. I do have, I do have some extraordinary doctors.

More time goes to the harder stories because, you know, that's where stuff can change. And I think that, as I will discuss shortly, you know, the extent of medical abuse faced by transgender people, and intersex people in particular, those demographics, it's extraordinary, sexual violence is sort of just embedded in the health system and how trans, gender diverse and intersex people are engaged with. And that's changing, but that legacy is still there.

So I guess my, my interest. in this area arose, out of my own very negative traumatic experience of medical abuse. When I came out as trans, I was, 11. It was not received very well by those around me. It's changed over time, but it, it was, um, Yeah, not, not a very warm welcome, um, coming out. I was pretty promptly sent to a psychiatrist who "specialized" in trans healthcare, and I put "specialized". We trust that word a lot.

 He was really of the opinion that I was not trans. I was just a very silly little girl. I, I already had a diagnosis of, autism spectrum disorder, or as it was still mainly called then Asperger's. And he framed my identity as trans as being a hyperfixation, um, and specifically as a sexual hyperfixation.

Um, so, me being trans was just a misguided obsession, and I just needed to be forced into getting over it. And in reading up, uh, ahead of speaking to you today, because I'm a big nerd and research is a joy.

Naomi Viret: You're one of us, we love it.

Axel Nathaniel Rose: I found that, like, that exact rationale, has been used, like, around the world, talking to autistic trans kids, and it's becoming more and more prominent, with sort of the trans exclusionary radical movement.

And, you know, there was an article called something like, "They Said It Was an Obsession" and just seeing that title and going, okay, this is an exploration of, of, of medical abuse by autistic people who identify as trans. It was simultaneously like the most validating experience of my life and just utterly devastating because when I looked for help, at the time there was nothing, you know, there was no research being done in that area.

But yeah, over, over the course of several years my psychiatrist verbally and emotionally abused me, and he also violated informational consent. So he shared my medical information, including disclosing, uh, very severe childhood trauma to my school and my teachers. He encouraged my family and community to enforce to me that I was not trans.

I was just a confused little girl and I think a confused, stupid little girl was very much always the energy. Eventually it culminated in him calling, uh, my identity as trans being a form of psychosis. So as someone with a pretty complex mental health picture, my increasing distress, suicidal ideation, eating disorders, it was just all swept away.

It was just all swept away. He said, you know, I, I just, I just needed to keep being told that I wasn't trans. I needed to be forced into girlhood and I'd get it eventually. The crisis point came when he began drugging me without my knowledge, with an anti psychotic, which I had a, a very protracted allergic reaction to. So, I would have nosebleeds that would last for hours and hours at a time. I had vision, vision loss to the extent that I wasn't able to read properly. You know, I could read on screens because I could zoom everything in, but I couldn't read. I couldn't pick up a book. I had just extraordinary, whole body, uh, muscle pain and spasms, I didn't want to move because it hurt so much, and I think sort of more destabilizing than all of that was, was just the level of distress, the sense of profound wrongness, and I didn't know what was happening.

I didn't know I was on this drug. Um, and so I just thought I was dying. I had no idea what was going on. And, um, that's not especially common, but you know, relatively common sort of story for, for trans people where just sort of aggressively medicalised in a way that means we have no say in what happens to our bodies.

And not all of the details are going to be the same for everyone, but being undermined, being forcefully drugged, being spoken down to, and for many also being abused. Severely, sexually mistreated by doctors is, is just very common, and, talking to other trans people about their experiences of medical abuse and trauma, mine seems just insignificant.

It's like, I don't think I know any trans person who hasn't been mistreated by doctors. But we're so deeply embedded in the medical system, you know, we, we need medical care as the vast majority of trans people do. And, I don't know, that was, that was the crisis point, uh, in my experience of medical mistreatment, but there have been similar issues you know, pretty much my whole life, and they, they are ongoing, and very minor in comparison. You know, sometimes it has been due to being trans, sometimes it's due to being queer, and, often it's been due to the fact that, I've been fat or obese for most of my life. Uh, as mentioned, I identify fairly strongly as disabled, and that's in large part because I have, quite quite severe rheumatoid arthritis.

I started showing symptoms, when I was quite a small child and it was sort of care was a bit patchy. But, over years of it getting worse, and sort of ebbing and flowing in severity, as arthritis does, whenever I complained of joint pain, muscle pain, doctors would just tell me to lose weight. That, that was the only thing they would say.

And I did eventually lose a lot of weight, and not in a healthy way at all. And voila, arthritis diagnosis because it was just like, oh, you're in pain and you're not fat. That's a problem. We'll look into that. And I don't really think there was any direct malice in the way I just framed it from the doctors.

It's just such an oversight, you know, as fat and obese people get, you know, medical mistreatment can be more dangerous than anything else. You know, I have joint degeneration now that is never going to go away. That wasn't picked up when I was younger. And I am fairly comfortable attributing that to the fact that it was just, well, you're fat, you're going to have joint pain.

And that's not how it works, it's just very much not how it works. Um, and that's something that's sometimes called, fat broken arm syndrome, which has the counterpoint of trans broken arm syndrome. It's basically just the common story of a trans person or a fat person shows up at a hospital and says, 'Hi, I've got a broken arm'. Or they go to their GP and say, 'Hi, I've got the flu'. And the doctor sees that they're trans or sees that they're fat, and all they want to talk about is that status. Even though having a broken arm, having the flu, nothing to do with being trans or being fat. I think this is, there's more awareness of it now, but you know, because a lot of doctors haven't been trained in trans issues, and sort of understanding of medicine and fat bodies is still very much evolving, it's made out to be a very big deal. And so it becomes something that's sort of fixated on.

So, you know, low training. Low levels of understanding. It leads to, you know, trans person sitting in the ED just hoping for their arm to be set and needing to sort of give a trans 101, even when they're not, facing any other form of mistreatment.

That's, you know, a waste of time and it's, it's painful.

[00:23:13] Naomi Viret: Yeah, and unfortunately, we can still see where that stigma and discrimination is quite embedded in areas where we think there has been so much advancement, but your story has just highlighted the fact that there is still such a long way to go in this area and yeah, to overcome a lot of those barriers and challenges that yourself and as you say, many of the community members have and do sadly continue to face and I just want to say thank you so much for sharing your story and being able to set some context around that importance in medical consent, because as you said, it's not something that a lot of people think of, but your story has really shown how important that is.

So thank you so much for being so open and sharing that with us. You have made reference in, in that discussion to medical autonomy, and that's something that can very often be stripped away, particularly, from a trans person. What is it that medical autonomy actually is, and why do you think it's so poorly understood by professionals when it comes to trans and queer health?

[00:24:13] Axel Nathaniel Rose: Yeah, so medical autonomy refers to a patient's right to make informed and uncoerced decisions about their own health care. It is one of, I think, if not the singular most important idea in, in medical ethics, you know, my best friend is currently in medical school and they have whole ethics units just on medical autonomy.

But it's such a complex idea because unlike the consent between me and my nephew, when he doesn't want to give me a hug, there's a huge power imbalance that is unavoidable and no one is at fault for there being that power imbalance. Like, Medicine is so complex. Most people facing a patient have been training for more than 10 years, quite often, and there is just no way for most patients to have a full understanding of what is being advised to them.

 And that's part of why there's such a strong cultural messaging of, you know, doctors are trustworthy. We need to trust doctors as a society. And I think in general, that's probably fairly true. I'm a big fan of, big fan of medicine. But It's really hard to question medical authority, on a knowledge basis before anything else complicates it, like being trans, like being queer.

And, the only way to really counter it, as far as I can tell, like the power imbalance, is that patients need to be empowered to ask questions, to self educate, to ask for other people's help in self advocating. And that's something that needs to be trained in children from day one, pretty much, because, you know, otherwise we're, we're vulnerable, we will, we will remain vulnerable and not realizing that there are charters on, on health rights, there are charters on, on disability rights.

So I think that, you know, doctors, for the most part, wonderful, I think most, most people for the most part are wonderful. But there needs to be such a conscious effort towards prioritizing patients asking questions, but also just medical professionals being able to approach patients with humility and a willingness to listen.

And I think as queer and trans people, our history is sort of one, at least through the 20th century, of being objectified, being treated as test subjects, being marginalized and hyper sexualized by medicine. And while all of that is changing slowly, it's still happening. We are often treated as ignorant and powerless, and being treated that way by a doctor renders you powerless.

If a doctor considers you unfit to engage with your own care, then you are unfit. Because they have the say there, and, you know, one doctor saying that makes a huge difference in whether a trans person gets to transition or not. You know, a bad doctor can bar someone from transitioning, and it is hard to counteract that.

So, I am of the firm belief that doctors need to not only be trained in trans healthcare, but there needs to continue to just be a growing field of understanding of what patient autonomy is. So, you know, the complete denial of healthcare is one extreme end, but, I always just hope that doctors will be able to trust a patient when they say, look I swear, I broke my arm because I'm clumsy, not because I'm trans.

Can we just give it a rest? And I think, you know, medical consent and autonomy are the issues that underpin the modern, I guess sort of trans justice movement, trans civil rights. And I think so much of it is framed, you know, trans people in the public sphere, we're framed as part of the "trans debate", and uh, I just find it so distressing to hear it termed that, because it is an issue of healthcare.

No one's healthcare should be up for debate. I would never go up to someone and ask if they had had liposuction, or if they were on hormone replacement therapy for any reason, and then tell them all of my opinions about their medical choices. That is just not something I would do. And yet, a great many people seem to have very strong opinions on the trans issue.

And they want those opinions to be heard. And I think, I don't know, perhaps more overseas than here, where we're seeing just a growing systematic and policy based denial of trans healthcare. Politicians and lobbyists are forcing trans people away from medical care, making medical care for trans people illegal, and you know bringing it back to the idea of rape culture, I think this is very linked to the fact that at the same time we're seeing legal limitations on people's right to have abortions, uh, limitations on people's menstrual care, you know, they are, they are all abuses of power. They are gendered abuses of power.

And it's a violation of consent to each individual, but it's also a demographic violation of health care consent. And you know, there's been research on this, which calls it punitive, punitive psychiatry or punitive health care, meaning medical language, or medical justification is used to limit or punish people's actions.

And as far as I know, there's not been a huge study yet into this broad scale medical punitive psychiatry, punitive healthcare, but I, I think that is what we're seeing.

[00:30:08] Naomi Viret: Sounds like a second PhD topic, just saying.

[00:30:11] Axel Nathaniel Rose: Oh God, another one. So close to the end.

[00:30:16] Naomi Viret: No thanks Naomi, why would you do that!?

But two things stand out there for me. These two words that are really powerful that I'm taking from that is voice and choice. And they are so incredibly important for all people. But like you said, there are some significantly vulnerable and marginalized people in community who are being particularly overlooked by systems.

And yeah, it's got to change. I think that moves us perfectly into having a discussion about the barriers and challenges that, trans and queer people are still facing in that health space. So back in 2020, just on the cusp of COVID, you were interviewed by the University of New South Wales. And you know, it was in light of COVID times and how the access to health care was potentially going to be impacting trans and queer people in regards to, you know, maybe some limitations to health access through COVID times.

But, here we are four years later, and I feel like sadly some of what you have said has not changed too much. So I just want to touch on some of what was said in that interview, in regards to barriers and challenges to healthcare for trans and queer people. So you'd said that 'some of the challenges were that the most preventative and positive plan for the future is simply training medical students on trans issues and healthcare thoroughly in consultation with transgender practitioners, policy makers, and patients.

Be open to hearing from us about our medical care, but don't assume that you have a right to know. Don't ask us about "the surgery", whatever that's supposed to be. believe us when we say that we're being mistreated and incorporate education on transgender issues, welfare, relationships, medicine and legal advice into university communities.'

These barriers and challenges are still very much existing and being experienced by the trans and queer community. Would you mind speaking to some of that for us now, if that's okay?

[00:32:08] Axel Nathaniel Rose: Yeah, absolutely. It's always alarming to hear myself quoted because I think, you know, I don't know, I always think I'm getting less verbose and then I hear myself quoted and no, it's just ongoing.

I'll never stop rambling. Um, but yeah, I think my rambly answer shows. Some of the same issues. I think that, overall lack of understanding, lack of willingness to learn, lack of basic respect. Those are ongoing issues, but they are changing. I think on the ground in terms of medical schools, doctors clinics, you know, there is more standardized training and there is more standardized vocabulary.

Doctors clinics, you know, there is more standardized training and there is more standardized vocabulary. There's a lot of amazing advocacy and a lot of amazing research being done. You know, we have people from TransHub and ACON who have, I think, shifted the needle of so many, hundreds if not thousands of trans people's experience of healthcare, to the better.

I think that, I don't know, even four years ago, trans issues were less prevalent, and talking to trans people, say, in their teens today, some of them just can't imagine how unknown the idea of being trans was 15 years ago. And with that said, I'm sure I can't really imagine how unknown being trans was 50 years ago.

The public profile of what it means to be transgender has increased so, so rapidly. And overall, I think it has shifted positively. I think, you know, just a random person on the street is, is likely to be pretty neutral on trans people. But at the same time, just in that sort of four year period, we've had amazing advances in, in healthcare and rights and public policy and services available, but we have also seen the rise of, trans exclusionary radical movement, and a lot of the very right wing work associated with that.

So I think things are getting better on the sort of day to day level, that's my perception. But the extreme end has gotten stronger as well. The extreme bad has gotten worse. And transphobic people's sense of entitlement to violence has gotten a lot worse. So I think that You know, we just have to sort of keep doing the work we're doing, but with this new consideration of, yeah, a growing movement of transphobia.

[00:34:47] Naomi Viret: It's a quote that I come back to often and it's that, you know, 'for all that we've done, there's still much to do'. And I think what you've just said then perfectly highlights that. Do you have any suggestions for how people can help to overcome some of those barriers and challenges for trans community?

[00:35:04] Axel Nathaniel Rose: Yeah, I think looking first just to trans and queer people, definitely link up with trans and queer healthcare services because they do exist, link up with the community groups, talk to other people in the community and crowdsource which doctors they would recommend going to, sign the petitions that say, please do mandatory diversity training at the local GP practice. Like that makes it, it does make a huge difference.

But just on the individual level, feel entitled, feel empowered. You are entitled to say "this has nothing to do with me being trans. Please treat me like any other patient. I will tell you if we need to talk about trans issues right now. Don't be afraid to say "it is not my responsibility to teach you what it means to be transgender. Please research this on your own time. So our appointments can be used to help me. Do not feel ever like you are alone if you are being mistreated, because not only are there other people who feel the same who can empathize, but there are organizations who are there to help you in that situation. There is nothing to be ashamed of and you are not alone in that. And I think shame is one of the most violent forces, sort of contributes to, to how trans people in particular are made to feel about ourselves in society.

[00:36:36] Naomi Viret: Hmm.

[00:36:37] Axel Nathaniel Rose: So that's for queer people just functioning as sort of patients. But, for practitioners, definitely, read, work by trans people, listen to trans people, uh, read queer people, listen to queer people.

There are so many doctors, there are so many specialists, there are so many psychologists who are queer and trans themselves, who put out resources. There are allies who put out resources. I think, like, Naomi, you asked, you know, how does someone get started in consent culture? What is the advice there?

People often say they feel overwhelmed thinking about queer or trans healthcare, but the vast majority of people don't need to learn a lot. It is more about grounding your practice in compassion and humility than it is about having specialized knowledge. If you need to have specialized knowledge, you know, there's professional pathways there. The respect of trans and queer people's right to consent, right to knowledge. Those are the things that you can practice without any, any fancy vocab, and I think that there's a lot of sort of fuss in the public sphere about using the wrong words or the right words, and for the vast majority of trans people in particular, I think we would way rather a clumsy use of language that is clearly well intentioned than just not saying anything at all.

And yeah, for everyone, everyone in society should know that medical consent entails the right to bring other people into your, into your healthcare. You are always entitled to a chaperone or an advocate, you may need to be isolated at some point. You may need to be spoken to alone, but you are always entitled to have someone with you. You are always entitled to go for a second opinion, a third opinion, a fourth opinion. And there are laws, there are policies in place around this, you know. A skim read of the Disability Discrimination Act and the Sex Discrimination Act by every single Australian would make a world of difference to the way our healthcare and medical care plays out.

[00:38:55] Naomi Viret: I feel like we're coming back to some of those really big keywords. So throughout this webinar, right around empathy, kindness, respect, like, it's just, it's just needs to be there in forefront of people's minds, doesn't it? And then as you say, it doesn't matter. Which potential vulnerable or marginalized group you may be working with, it creates that sense of everybody is welcome here and everybody is going to be treated as they need to be treated to get the best health outcome for their situation.

So, yeah, it's, you know, it's just bringing those things to the forefront of our minds. Ongoing.

So I guess as we're starting to come, to a conclusion of the session, just in terms of advocacy, is there any tips for the participants online in terms of how they could better advocate in this space for community?

[00:39:44] Axel Nathaniel Rose: Just talk about trans and disabled and queer people, and listen to us.

But, you know, in the professional sphere in particular, just mention, trans people in staff meetings, mention disabled people in staff meetings. How will this new policy impact this demographic? How are we going to best accommodate this group? The more questions are raised, the more discussion there is, the better it will get.

Definitely look at all of the wonderful resources. Yeah, ask your colleagues, how are you, how are you incorporating care for trans people in your work? How are you caring for disabled people? Read, read lots. I'm a big nerd. That seems to be my advice for everything, but yeah, don't even need to read a lot.

There are, there are podcasts as well. There are videos.

[00:40:33] Naomi Viret: Welcome to 2024.

[00:40:34] Axel Nathaniel Rose: Yeah. It's a multimedia world. But I guess also just be comfortable with people being uncomfortable and that functions both on an institutional level, you know, I've had situations of saying, hey, I think this is going to negatively affect trans students. And that leads to a very awkward silence, and that's fine. But also, on an individual level, I think that a lot of people feel very vulnerable, in the healthcare space, and that is not necessarily a reflection on you, your practice, your ethics, anything at all, but it is just a trace of sort of, quite likely a personal, personal trauma, but also a really intergenerational and ingrained trauma in, in, in the way that we have been treated in, in healthcare spaces.

So I think it's, yeah, talking, but also the really just basic things, sign petitions, talk to MPs, tell politicians trans and disabled care will influence how you vote. Because so much does come from policy and so much funding comes from policy, which, yeah, always a delightful discussion.

 So talk and listen and read and, feel empowered, you know. Whatever voice you have, no matter how quiet it is, no matter how small you may feel it is in the grand scheme of things, it can make a world of difference and a single act of kindness as, as a trans patient, as a disabled patient, as a queer patient can be utterly life saving, in more, in more ways than one.

[00:42:16] Naomi Viret: Mm. So powerful. So very powerful. Thank you, Axel. So, International Transgender Day of Visibility, March 31st, a lot of organizations have the opportunity to celebrate and to be part of Transgender Day of Visibility. Any final thoughts on advocacy or support or something that organizations or services could do to recognize that day?

[00:42:37] Axel Nathaniel Rose: Well, certainly just being publicly, trans affirming, you know, a trans flag in a window, you know, so many people that just feels extraordinary because it's not only being seen, but going, yes, we are going to publicly say, You're welcome here.

Get familiar with some of the wonderful resources. There's TransHub, there's ACON, there's The Gender Centre, there's The Albion Centre, there's many wonderful Caddyshack interviews, and yeah, many other places I'm sure I'm forgetting about. I guess, The nerdy thing for me, something I would love to see more of is people just learning more about like one figure from trans history, like find a trans person from the 1880s, learn about them, see how they're spoken about today.

And just see the continuity of, of Transness, of gender diversity through time. I think the really basic things of normalizing sharing pronouns, they can seem so basic and silly and boring and annoying, like, I get that, and I'm a trans person, like, it's, it's a pain, but it makes the point constantly, do not assume Cisness, assume that people have the right to name themselves, to gender themselves, to be referred to as they wish, so those tiny things, really, really add up.

[00:44:05] Naomi Viret: So powerful. So very powerful. This is your moment for any parting comment before we finish what has been a fantastic session with you, Axel, and we're just so, so grateful for the time and effort that you put into today and for sharing so much of your personal story, but in the hope that your personal story means that it makes changes for at least one other person, which I have no doubt you have touched many people throughout your life and will continue to do so.

 So thank you. Is there any final parting comment that you would like to make before we bid you a fond farewell?

[00:44:36] Axel Nathaniel Rose: Yeah, I'm very indecisive, so unfortunately I got two.

[00:44:40] Naomi Viret: Oh good, I will allow it.

[00:44:42] Axel Nathaniel Rose: Thank you. One is just share stories, share the hard stories, but also share the good stories. Share trans and disabled and queer success and joy, because the trans debate, the queer debate, it's so negative.

We need to help, we need to share stories of joy, but the other thing that I would just like to highlight because it sort of haunts me is, uh, oh gosh, I can't remember the author's name, but an author, put on Twitter a little while ago. 'I had a dream in which I was talking to Ursula Le Guin, and I said to her, I think that queer history is just a thread of pain. And Ursula Le Guin said to me, And what are you going to make with that thread?' And, saying it out loud, it's very clear, I, I am a PhD student in Literary Studies. But just the idea that painful stories, painful history, can be used to make something so beautiful and so positive in the current day. Yes, queer history may be a thread of pain, but it's also a thread of joy, and it's also something that can thread people together now, right now, for the better.

[00:46:01] Jennifer Farinella: Thanks for listening to On the Couch. We create this podcast because we are allies in actively challenging discrimination, microaggressions, and exclusionary behaviors. We want to create spaces where people feel safe to share their thoughts, knowing they will be heard and respected. Such an environment fosters collaboration, innovation, and contributes to a more inclusive society.

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On The Couch is made by Jennifer Farinella, Naomi Viret, Maddy Stratten and Winnie Adamson. Until next time, peace, love and protection.