Oppression

squared:
D/deaf and disabled trans
experiences in Europe

Nathan Gale
Imprint
Author: Nathan Gale
Editor and
project coordinator: Mari-Liis Sepper
Proofreading: Naomhán O´Connor and Mina Tolu
Design: Mina Tolu
Layout: benswerk.wordpress.com
Special thanks to: Noah Keuzenkamp, who was instrumental
in the creation of this project.
And to the expert meeting participants:
Anis Akhtar, a disabled intersex person of colour –
whose family and himself are very intersectional
Christine Bylund, Sweden based, crip- and femme-
identified disability rights activist and researcher
Dodo Karsay, a non-binary person with psycho-social
disabilities
Dorian K, a developmentally disabled person
Ellen Murray, a disabled trans activist based in
Northern Ireland
Embla, Guðrúnar Ágústsdóttir, feminist crip queer
activist based in Iceland, co-founder of Tabú
Erika-Evely Ee Eisen
Dr Matson Lawrence
Sandra Alland, Genderqueer crip writer, artist and
events organiser based in Glasgow
Tashi, Queer Linguist based in the UK

If you want to reference this work, please use the following citation:
Gale, Nathan (2017), Oppression Squared:
D/deaf and disabled trans experiences in Europe, Transgender Europe

This report has been created with the greatest care, but it does not claim
to be complete. Please send feedback and suggestions for amendments to
tgeu@tgeu.org.

Transgender Europe, November 2017

Copyleft: You are free to share (copy, distribute and transmit the work) and to
remix – that is to adapt – this work, as long as you attribute the work in the manner
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under the same or similar license to this one.

This publication has been produced with financial support from the Rights,
Equality and Citizenship Programme of the European Union, the Open
Society Foundation, and the Government of the Kingdom of the Netherlands.
The contents of this publication are the sole responsibility of the author and
Transgender Europe, and can in no way be taken to reflect the views of the European
Commission, the Open Society Foundation, or the Dutch Government.
Oppression
squared:
D/deaf and disabled trans
experiences in Europe

Nathan Gale
Table of Contents
Introduction 7

Chapter 1 10
Human Rights violations against D/deaf and
disabled trans people
Healthcare 13
Freedom from torture and ill treatment 23
Living independently 26
Privacy 30
Legal gender recognition 30
Bathrooms 32
Air travel 33

Chapter 2 36
Enabling engagement with LGBTIQ organisations
Internal barriers 37
Communication 37
Events and Activism 41
Attitudes 47
External barriers 51
Transport 51
Financial Barriers 53
Limited Access to Assistance 54
External Barriers: Solutions 55

Conclusion 57

Recommended further reading 59

References 60

Annex A: Venue access information 63

Annex B: Accessibility requirements example questionnaire 66
Annex C: Expert meeting schedule 69
 Introduction
This report is the result of Transgender Europe’s (TGEU) “Expert
Meeting on D/deaf and Disabled Trans Experiences,” held in Berlin in
July 2017. Following approval of TGEU’s revised strategic plan1 at the
General Assembly in 2016, the organisation committed to advocating
for the rights of trans people who face multiple oppressions, including
(amongst others) D/deaf and disabled trans people.

In order to take this work forward, TGEU had to first understand

what human rights issues are the current priorities for D/deaf and
disabled trans people across Europe. At the same time, TGEU saw
this as an opportunity to learn about the improvements that need
to be made for the organisation to better engage with D/deaf and
disabled trans people.

This report is one way of sharing the knowledge that TGEU has
gained with LGBTIQ organisations across Europe, to enable all
organisations to better include issues which are important for D/deaf
and disabled trans people within their work.

The report has two parts: it begins by setting out the various
challenges that D/deaf and disabled trans people face in accessing
their human rights. The first part will also explain how LGBTIQ
organisations can contribute to reducing these difficulties by
including the human rights priorities of D/deaf and disabled trans
people within their trans advocacy. Secondly, the report discusses
barriers that D/deaf and disabled trans people experience in
attempting to engage with LGBTIQ organisations, followed by
an extensive list of practical steps that organisations can take to
overcome or reduce these barriers.

1 TGEU, Strategic Plan 2014-2020,

http://tgeu.org/wp-content/uploads/2016/11/TGEUStrategicPlan_2014_2020.pdf
(17.11.2017).

7
All of the information regarding the situation of D/deaf and disabled
trans people described in the following pages has come directly
from the experts who attended the meeting and is informed
by their extensive experience in D/deaf and disabled activism.
Where available, reference to external research which supports
the information given by the experts has also been made. The
suggestions set out in this report come largely from the experts at the
meeting, but also include contributions from the author.

A note on language
The language used in this report relating to D/deaf and disabled
people reflects the terms used by the experts at the meeting and
more generally by activist communities across Europe. However, it
is important to note the variety of terms that are used by D/deaf and
disabled people to describe their experiences and to acknowledge
that there is not always agreement over the language used. Some
of the words used in this report have historically been used as slurs
against D/deaf and disabled people, such as the terms “crip” and
“mad”, but in the context of contemporary use, have been reclaimed
by activists as empowering ways to describe their identities.
Such terms tend to be used by people as a political statement
for describing their identities, rather than simply indicating that
they have an impairment. When used by individuals to describe
themselves or their communities, these terms are not offensive.
However, in general they should not be used to describe people
unless they have clearly indicated that they want to be referred to in
this way.

8
 The word “Deaf”, with a capital ‘D’, is generally used by people who
identify as culturally Deaf and as part of the Deaf community. Deaf
people do not tend to see themselves as disabled, are likely to use sign
language, and view sign language as just as valuable as any spoken
language. In contrast, “deaf” with a lowercase ‘d’ is used simply to
describe that someone has hearing loss or is not able to hear. People
who describe themselves as deaf are more likely to have become deaf
later in life, and are unlikely to view themselves as part of the Deaf
community or to use sign language. To be inclusive of both groups
D/deaf is used throughout this report.

The expert meeting and this report are underpinned by the Social
Model of Disability. Rather than viewing disability as something that
is “wrong” with individuals, the Social Model acknowledges that
people with impairments are actively disabled by barriers created
by society. For example, a person may have a mobility impairment,
which means that they use a wheelchair but they are only disabled
when they are faced with a set of stairs rather than a lift or a ramp.
Similarly, a person with autism may find talking on the phone very
difficult but if they are able to book concert tickets on the internet
then they have not been disabled by that interaction. When disability
is framed in this way it becomes an active process which puts the
burden on society to make the world more accessible to people
with impairments. The Medical Model of disability instead puts the
burden on individuals to “cure” themselves so they can function in the
world as it is. The words ‘ableism’ and ‘non-disabled’ have been used
throughout this report as this language reflects the Social Model
of Disability. Ableism refers to discrimination or prejudice towards
disabled people. Non-disabled is used instead of the term able
bodied.

9
Expert Profile
Ten D/deaf and/or disabled rights experts with experience of
trans and/or LGBIQ activism were brought together to share their
knowledge and experience with TGEU. All experts have at least
three years of experience in these areas of work; the majority (eight)
have over five years of experience - with three having worked in the
disabled rights field for over a decade. The participants developed
their expertise in a wealth of areas including academia, union activity,
community organising, activism, artistic practice, and the non-profit
sector, and have extensive networks with an extremely broad reach.
Their experience was gained in the following countries: Canada,
Czech Republic, England, Estonia, Finland, Germany, Hungary,
Iceland, Northern Ireland, Scotland and Sweden.

All of the experts identify as D/deaf and/or disabled people, using

a variety of more specific terms to describe their identities such as
Crip, Mad, and Deaf. Nine also identify as trans and/or LGBQ, with
one expert identifying as intersex. The experts have a variety of
impairments including visual, hearing, physical, cognitive,
psycho-social, and developmental. One expert speaks British
Sign Language (BSL) and sign language interpreters were present
throughout the meeting.

10
 Chapter 1
Human Rights violations against
D/deaf and disabled trans people

There are many challenges that D/deaf and disabled trans people
face in accessing their human rights. LGBTIQ organisations have an
important role to play in addressing and reducing these difficulties.
All LGBTIQ organisations can help by raising their own awareness
of these issues. In order for the situation of D/deaf and disabled
trans people to improve, it is particularly important that those
organisations that take part in advocacy are able to reflect the
priorities, set out below, in their work.

The human rights priorities of D/deaf and disabled trans people

discussed in this report are:
1. The right to healthcare;
2. Freedom from torture or cruel, inhumane or degrading
treatment or punishment;
3. The right to live independently;
4. Respect for privacy.

Firstly, barriers that prevent D/deaf and disabled trans people from
freely accessing these rights will be discussed. This is followed by
suggestions as to how LGBTIQ organisations can use their work to
help to reduce these barriers.

The human rights above are guaranteed to all by a number of legal

agreements including the European Convention on Human Rights.
There is one human rights document specific to D/deaf and disabled
people that it is helpful for organisations to be aware of: the United
Nations Convention on the Rights of People with Disabilities. 2
2 Independent Living in Scotland, The ILiS Do-It-Yourself Guide to
The United Nations Convention on the Rights of Disabled People
(UNCRPD): http://www.ilis.co.uk/uploaded_files/ilis_guide_no.2.pdf (20.11.2017).

11
There are a number of human rights issues that will not be discussed
in this report, such as the right to access to justice and the right to
access education. A great deal more research is needed into the
multiple barriers that keep D/deaf and disabled trans people from
enjoying their human rights.

Overarching strategies
Organisations involved in trans advocacy are likely to be aware of the
opportunities that human rights law provide to hold governments
to account or to undertake strategic litigation. Strategic litigation
means taking a case to court in order to try and change the law on a
particular issue. When the advocacy strategies of the D/deaf and
disabled rights movement and those of the trans rights movement
were discussed at the expert meeting, it was found that they were
largely the same. Organisations should bear this in mind when
reading the following chapter, which suggests particular ways of
incorporating the issues affecting D/deaf and disabled trans people
into existing advocacy strategies.

The advocacy strategies of the D/deaf and disabled

rights movement and those of the trans rights
movement are largely the same.

Carrying out research is an advocacy strategy that is widely used,

and carrying out research into the lives and experiences of D/deaf
and disabled trans people has the potential to benefit D/deaf and
disabled trans people in all of the areas that are discussed below.
There is currently a distinct lack of research relating to D/deaf and
disabled trans people in Europe. There is limited research which
focuses on LGBTIQ disabled people in general, but the impact of these
issues upon trans people specifically are not discussed in any depth.
Unfortunately, research into the experiences of D/deaf and disabled
people rarely refers to the specific situation of those who are trans. If
organisations are not in a position to carry out such specific research,
then it is still useful, when carrying out more general research, to ask

12
 participants whether they are D/deaf and/or disabled, and whether
they are trans. It may then be possible to include the number of
D/deaf and disabled trans people who took part in the research, and
to specifically discuss the findings relating to that group.

“I think one of the most important things for organisations

to know, or perhaps remember, is the fact that dis/ability
rights are always intertwined with other civil and human
rights - simply because of the fact that dis/abled people are
multifaceted persons. There is no ‘one issue’ to cover in that
sense”.
Christine Bylund, Sweden based, crip- and femme-identified
disability rights activist

Healthcare

Appropriate and respectful healthcare is one of the human rights that

D/deaf and disabled trans people experience greatest difficulty in
accessing.3 It is a common experience amongst D/deaf and disabled
trans people that when coming into contact with a healthcare
practitioner, they experience either transphobia4 or ableism5, or
both types of prejudice at the same time. Often, the intersection

3 See for example: World Health Organization, Disability and Health

Fact Sheet, 2016:
http://www.who.int/mediacentre/factsheets/fs352/en/ (20.11.2017).
4 See for example: Transgender Europe, Overdiagnosed but Underserved.
Trans Healthcare in Georgia, Poland, Serbia, Spain, and Sweden:
Trans Health Survey, 2017, pages 10 – 11:
https://tgeu.org/wp-content/uploads/2017/10/Overdiagnosed_Underserved-
TransHealthSurvey.pdf (20.11.2017).
5 European Union Agency for Fundamental Rights, Inequalities and multiple
discrimination in access to and quality of healthcare, 2013, pages 65 – 7:
http://fra.europa.eu/en/publication/2013/inequalities-discrimination-healthcare
(20.11.2017).

13
of being D/deaf and/or disabled and trans requires treatment
from a wide variety of healthcare practitioners, all of whom have
specific areas of expertise. As a result of this, D/deaf and disabled
trans people are likely to be treated by practitioners who have little
or no understanding of at least one aspect of their identities. For
example, individuals might get physiotherapy from a practitioner
who understands disability but lacks any awareness of what it means
to be trans. In addition, D/deaf and disabled trans people will access
general healthcare where there is a good chance they will experience
prejudice towards both of their identities.

Ableist attitudes, gatekeepers, poor accessibility and

lack of autonomy are the main issues that impact on
D/deaf and disabled trans people’s access to healthcare.

For people of colour, asylum seekers and refugees, this experience is

likely to be compounded by racism and/or xenophobia
and/or prejudice in relation to their citizenship status.6 Therefore,
this increases the likelihood that D/deaf and disabled trans people of
colour, asylum seekers and refugees will have a negative experience
when trying to access healthcare, if they are able to access healthcare
at all.

“My therapist told me the other day that I’m feeling more
dysphoric because I’m depressed. I wanted to explode. I
thought: OK this is exactly why I don’t talk to you about trans
stuff, because you don’t get it. Let’s just stick to the mental
health stuff. But obviously, I deal with both, so this is not very
helpful.” 
Anonymous participant at expert meeting

6 European Union Agency for Fundamental Rights. Inequalities and multiple

discrimination in access to and quality of healthcare, 2013.

14
 “I had a particular difficulty in accessing health care because
I am Deaf and use signed and written languages. Like other
Deaf people, I often struggle to get access to a sign language
interpreter when I go to the doctor or a hospital. Sometimes
I’ve had my treatment delayed by days, and been left in pain.
Sometimes it’s the other way around, when I’ve wanted
to talk in private with a doctor via writing and had a sign
language interpreter forced on me. This is hard because some
issues are easier for me to discuss via writing due to technical
vocabulary that I know the interpreter isn’t familiar with, and
also sometimes due to the very personal nature of the topic,
like trans stuff. It’s very frustrating and disempowering when
I am not allowed my preferred means of communication for a
given situation.”
Tashi, queer linguist based in the UK

Ableism amongst healthcare providers manifests in many different

ways, from minor inconveniences to life-threatening failings.7 It is
important to recognise that even seemingly minor difficulties can
have a significant impact on mental health and wellbeing when they
occur repeatedly.
Common examples of this kind of discrimination include:

• Judgments about what a person’s goals should be, such as

walking rather than using mobility aids or learning to speak
verbally rather than using sign language. This can reduce the
quality of life of individuals by stopping them from accessing
aids and adaptations that could make their lives easier;

7 Mencap, Death by Indifference: 74 Deaths and Counting a Progress Report

5 Years On, 2012: https://www.mencap.org.uk/sites/default/files/2016-08/
Death%20by%20Indifference%20-%2074%20deaths%20and%20counting.pdf
(20.11.2017).

15
 • Assumptions about whether people can make decisions
about their care and treatment or are entitled to be fully
informed about medical decisions that affect them. This can
have dramatic effects on the course of someone’s life and
lead to them potentially being treated against their will;
• Failures to appreciate, take seriously, or in some cases
even believe, the extent or existence of the pain that
people are in. This leads to them having to live with pain
that is not sufficiently treated, or even treated at all, and
reduces their willingness to talk to healthcare professionals
about pain in the future. In extreme cases, this can mean that
individuals do not seek treatment for pain that turns out to
be due to a life threatening condition.

Due to ableism and the general perception that D/deaf and

disabled people are not sexual beings, access to fertility treatment,
contraception, and sexual health services are particularly challenging
for them.8
There are a variety of factors which contribute to this situation,
including:

• Refusal by health care practitioners to provide, or refer for,

fertility treatment, contraception or sexual health services;
• Providing these services in buildings which are inaccessible;
• Prevention of access to fertility treatment, contraception
or sexual health services by those providing assistance with
everyday living, especially when this assistance is provided
by parents, or within institutional settings;

8 See for example: Committee on the Rights of Persons with Disabilities,

General Comment No. 3, Article 6: Women and girls with disabilities, 2016
at pages 10 and 11: http://www.ohchr.org/EN/HRBodies/CRPD/Pages/GC.aspx
(20.11.2017);
World Health Organisation, World Report on Disability, 2011, page 78:
http://www.who.int/disabilities/world_report/2011/report.pdf (20.11.2017).

16
 • Inaccessible information about the provision of such
services due to the location of such information and/or the
format or complexity of the information itself. For example:
being placed up too high or not being provided in braille,
Easy Read or other alternative formats.9

“When I started the fertility process with my partner, the

doctor at the fertility clinic had all these extra requirements
that we had to undergo. One of those was meeting with a
social worker who was supposed to evaluate our parenting
skills. I know for sure that other patients at this clinic are not
required to undergo any type of parental evaluation before
they receive treatments. IVF treatments are only provided
by this private clinic in the area where we live so we have
no choice on going somewhere else for treatments. For that
reason, our possibilities to have children with IVF treatment
are totally dependent on doctors attitudes and preconceived
ideas about disability. I would not say that we have the same
access to IVF health care treatments as non-disabled LGBTQI
people have in my country.”
Anonymous participant at expert meeting

Among LGBTIQ organisations, it is understood that, in general,

trans people are likely to experience difficulties in trying to access
fertility treatment, contraception, and sexual health services.10 The
challenges described above are therefore likely to make it even
more difficult for D/deaf and disabled people who are also trans to
access this kind of treatment. All of these obstacles, and the risks of

9 FRA, Inequalities and multiple discrimination in access to and quality

of healthcare, 2013.
10 The lack of research in this area is highlighted in Reisner, S., Poteat, T., Keatley,
J., Cabral, M., & Mothopeng, T., et al. (2016). Global health burden and needs
of transgender populations: a review. The Lancet, 17, 1-25:
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00684-X.pdf
(20.11.2017).

17
experiencing ableism, transphobia or both, may prevent some D/
deaf and disabled trans people from attempting to access fertility
treatment, contraception, and sexual health services through medical
practitioners at all. Given the difficulties that migrants face in having
their sexual and reproductive health needs met, it can be assumed
that D/deaf and disabled trans migrants will struggle the most. This
is due to both the lack of consideration of the specific health needs
of migrants, and institutional discrimination in the way sexual and
reproductive health services are provided. 11

Trans-Specific Healthcare
Trans people often experience many barriers to accessing trans-
specific healthcare.12 D/deaf and disabled trans people have even
greater difficulty accessing this healthcare, for a number of reasons.
This is partly directly related to how medical practitioners treat D/deaf
and disabled people, and partly due to the social position of D/deaf
and disabled people in society. The most common barriers to accessing
trans-specific healthcare resulting from the attitudes of medical
practitioners are:

• Trans-specific healthcare providers insisting that mental

health conditions be sufficiently “controlled” prior to
treatment13, which is a significant challenge for mad trans
people and/or those with a psychosocial disability.

11 Keygnaert, I et al (2016). Sexual and reproductive health of migrants:

Does the EU care? Health Policy, Volume 114 (issues 2-3), pages 215 – 225:
http://www.sciencedirect.com/science/article/pii/S0168851013002881
(20.11.2017).
12 See for example: Transgender Europe, Overdiagnosed but Underserved,
2017, page 83; Amnesty International, The State Decides Who I am, 2014,
https://www.amnesty.org/en/documents/EUR01/001/2014/en/
(20.11.2017); European Union Agency for Fundamental Rights, Being Trans
in the European Union. Comparative analysis of EU LGBT survey data, 2014:
http://fra.europa.eu/en/publication/2014/being-trans-eu-comparative-analysis-eu-
lgbt-survey-data (20.11.2017).
13 Transgender Europe, Legal Gender Recognition in Europe. Toolkit, 2016,
https://tgeu.org/wp-content/uploads/2017/02/Toolkit16LR.pdf
(20.11.2017).

18
 This is particularly difficult as experiencing both gender
dysphoria and inaccessible trans healthcare can negatively
impact upon an individual’s mental health;
• Practitioners expecting trans people to talk in detailed
ways about their gender identity when requesting
treatment.14 This tends to include describing feelings and
experiences in quite abstract ways and often using complex
terminology, which can be particularly difficult or off-putting
for people with a learning or cognitive impairment, and/or
those who are neurodivergent15 and/or autistic people;
• As already mentioned above in relation to healthcare in
general but likely to be even more of a barrier in this context,
presumptions by medical practitioners that D/deaf and
disabled people are not able to understand or make
decisions about their gender identity or the treatment they
should receive;
• Restrictions being placed on the treatment people can
access due to weight or ‘Body Mass Index,’ which may be
based on prejudiced ideas, and are not always based on best
medical evidence.16 For example, surgeons may state that
a person must have a BMI below a certain number before
they can have surgery.Having an impairment is just one
factor that can affect a person’s ability to make changes
to their body to conform with these requirements (that is
assuming they even want to). This may mean they are never
able to access the medical treatment they seek.

14 Amnesty International, The State Decides Who I am, 2014:

https://www.amnesty.org/en/documents/EUR01/001/2014/en/
(22.11.2017).
15 For a definition see: http://neurocosmopolitanism.com/neurodiversity-some-
basic-terms-definitions/ (22.11.17).
16 See for example: McArdle, H (18/07/17) Discrimination Claim as
Trans Women Rejected for Breast Surgery, Herald Scotland,
http://www.heraldscotland.com/news/15416178.Discrimination_claim_as_
trans_women_rejected_for_breast_surgery/ (22.11.2017).

19
 “When trying to access gender-affirming healthcare as a
disabled person, it’s common to find your disability used as
a cause for concern by clinicians, often putting the brakes
on your transition. For people with progressive illnesses or
variable disabilities, our changing symptoms can be used to
slow us down – it’s suggested we need to wait until our health
stabilises before we choose to start hormones, for example
- when in reality, our health has very little to do with how we
experience being trans.”
Ellen Murray, a disabled trans activist based in Northern Ireland

Barriers most commonly caused by D/deaf and disabled people’s

position in society include the following:

• Trans specific healthcare is not routinely and consistently

state-funded, resulting in individuals across Europe being
forced to privately fund their healthcare needs.17 This poses
a particular difficulty for D/deaf and disabled people, as they
are more likely to be unemployed due to discrimination, or
being unable to work.18 This situation can be made worse
by widespread transphobia in the workplace.19 Given the
particularly significant employment-related inequality
affecting women and people of colour, D/deaf and disabled
trans women and D/deaf and disabled trans people of
colour of all genders will be the most affected by this barrier;

17 Amnesty International, The State Decides Who I am, 2014.

18 Greve, B (2009), The labour market situation of disabled people in European
countries and implementation of employment policies: a summary of
evidence from country reports and research studies, Academic Network of
European Disability experts: http://www.includ-ed.eu/sites/default/files/
documents/aned2009_-_the_labour_market_situation_of_disabled_people_in_
european_countries_and_implementation_of_employment_policies.pdf
(20.11.2017).
19 European Union Agency for Fundamental Rights, Being Trans in the European
Union Comparative analysis of EU LGBT survey data, 2014, at pages 27 – 34.

20
 • Inaccessible information can make it extremely difficult
for D/deaf and disabled trans people to find out about their
healthcare options and entitlements.20 This can be due to
where it is distributed and/or the format or complexity
of the information itself. A great deal of information is
now provided online, but D/deaf and disabled people,
particularly those with a learning or cognitive impairment,
are far less likely to have internet access than the general
population;
• Accessing transport is a major challenge for many D/deaf
and disabled people,21 both in terms of physical and financial
access. This can make getting to appointments with
healthcare practitioners very difficult,22 particularly given
that, in many countries, there are a limited number of trans-
specific healthcare providers and they tend to be located in
major cities.
• The people responsible for assisting D/deaf and disabled
people with daily living may prevent them from seeking
trans-specific healthcare, undermine them when they
try to access it, or shut down any discussion about their
gender identity at all. This can be particularly pervasive
when assistance is provided by parents or takes place in an
institutional setting.

Advocacy Strategies
Healthcare is the area where there is the most overlap between
the barriers experienced by D/deaf and disabled people and those
impacting trans people. As such, LGBTIQ organisations engaged
in advocacy have an excellent opportunity to take forward the

20 Transgender Europe, Legal Gender Recognition in Europe, 2016.

21 United Nations Committee on the Rights of Persons With Disabilities,
Concluding observations on the initial report of the European Union,
02/10/15, CRPD/C/EU/CO/1 page 7: https://documents-dds-ny.un.org/doc/
UNDOC/GEN/G15/226/55/PDF/G1522655.pdf?OpenElement (22.11.2017).
22 European Union Agency for Fundamental Rights, Inequalities and multiple
discrimination in access to and quality of healthcare, 2013:
http://fra.europa.eu/en/publication/2013/inequalities-discrimination-healthca-
re (20.11.2017).

21
advocacy priorities of D/deaf and disabled trans people when calling
for improvements to healthcare.

Current trans advocacy around trans-specific healthcare has the

potential to improve access for D/deaf and disabled trans people.
Medical treatment that is based on self-determination, advocates
for bodily autonomy and removes gatekeeping restrictions would
reduce many of the barriers faced by D/deaf and disabled trans people
discussed above.
The key to inclusive trans advocacy is working in
partnership with disabled people’s organisations and
taking every opportunity to raise the particular issues
impacting D/deaf and disabled trans people.

There are a number of specific steps which LGBTIQ organisations can

take to ensure that D/deaf and disabled trans people benefit as fully
as possible from improvements to both general and trans-specific
healthcare. These include:

• Working with providers to produce trans-specific

healthcare information in alternative formats such as
Easy Read, large print, audio or sign language, and making
it available in accessible venues and those that D/deaf and
disabled people are likely to attend;
• Providing trans awareness training to as wide a variety
of healthcare practitioners as possible, not just those
commonly seen as particularly relevant to trans people;
• Partnering with organisations that advocate for access to
healthcare for D/deaf and disabled people to assist them
with including the specific needs of trans people within their
work;
• Making use of various interactions in relation to
healthcare, such as with policy makers, healthcare
providers, and practitioners, to raise awareness of the
specific needs of D/deaf and disabled trans people;

22
 • Lobbying local governments and trans-specific healthcare
providers to fund accessible transport to enable D/deaf
and disabled trans people to attend appointments;
• Working with organisations that provide assistance with
everyday living to D/deaf and disabled people to increase
their understanding of the healthcare needs of their trans
clients and ensure that they make referrals or otherwise
help individuals to access treatment.

Freedom from torture and ill treatment

Ableism combined with transphobia put D/deaf and

disabled trans people at a particular risk of experiencing
torture or ill treatment in healthcare settings.

Mad people and/or people with a psychosocial disability, and those

with a learning or cognitive impairment are especially at risk of being
subject to torture or ill treatment in a psychiatric healthcare or social
care setting.23 The types of abuse they are at risk of include physical
and sexual violence, forced treatment, and extreme or unnecessary
restraint.24 This risk may be particularly great for people of colour. In
the UK, for example, people of colour are more likely to be detained in
hospitals or institutional settings25 and are more likely to be ill-treated
when there.26

23 United Nations General Assembly, Human Rights Council, Report of the

Special Rapporteur on torture and other cruel, inhuman or degrading
treatment or punishment, Juan E. Méndez, 01/02/13, A/HRC/22/53,
http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Ses-
sion22/A.HRC.22.53_English.pdf (20.11.2017).
24 United Nations General Assembly, Human Rights Council, Report of the
Special Rapporteur on torture and other cruel, inhuman or degrading
treatment or punishment, Juan E. Méndez, 01/02/13, A/HRC/22/53.
25 Gajwani, R., Parsons, H., Birchwood, M., & Singh, S. P. (2016). Ethnicity
and detention: are Black and minority ethnic (BME) groups disproportion-
ately detained under the Mental Health Act 2007? Social Psychiatry and
Psychiatric Epidemiology, 51, 703–711.
http://doi.org/10.1007/s00127-016-1181-z (20.11.2017).
26 Fanin, I .(05/07/17). Is there institutional racism in mental health care? BBC
http://www.bbc.co.uk/news/health-40495539 (20.11.2017).

23
There is a lack of research across Europe into D/deaf and disabled
people’s experiences of torture and ill-treatment in healthcare, in
particular investigating why these violations take place. However, the
following may at least contribute to the increased risks that D/deaf
and disabled people face:

• Ableism amongst healthcare providers, practitioners and

within institutions as a whole resulting in the lives of people
with impairments being devalued;27
• Judgements about whether individuals have the ability, or
should be entitled to make decisions about their own care
and treatment.28

Considering the prevalence of transphobia within the healthcare

system29 in general, it is likely that all of these experiences are made
more challenging, and the risks of ill treatment increased, for D/deaf
and disabled trans people. As mentioned above, D/deaf and disabled
trans people of colour will be the most at risk due to the additional
pervasiveness of racism within psychiatric healthcare and social care
settings.

Advocacy Strategies
There are similarities between the rights violations experienced
by D/deaf and disabled trans people and the issues facing trans
people in general. Human rights priorities for trans people in this area
include ending requirements for people to be sterilised, admitted to a
psychiatric ward, or diagnosed with a “mental disorder” before they
can receive trans-specific healthcare or legal gender recognition.

27 Karsay, D. , Oliver, L. (2012). Disability, torture and ill-treatment: taking stock

and ending abuses, The International Journal of Human Rights, Volume 16,
Number 6, pages 816-830.
28 Greve, B. (2009). The labour market situation of disabled people in European
countries and implementation of employment policies: a summary of
evidence from country reports and research studies.
29 Transgender Europe, Overdiagnosed but Underserved. Trans Healthcare in
Georgia, Poland, Serbia, Spain, and Sweden: Trans Health Survey, 2017.

24
 Engaging with D/deaf and disabled people who have
experienced ill treatment or abuse, and working with
patient advocates are effective ways for LGBTIQ
organisations to make their trans advocacy more
inclusive.

Even if organisations did not expand their advocacy at all, D/deaf and
disabled trans people would still benefit from these improvements.
Anything that reduces the need for D/deaf and disabled trans people
to come into contact with psychiatric services, particularly as
in-patients, would reduce their risks of ill treatment.

However, it is likely that LGBTIQ organisations involved in trans

activism can use existing relationships and activities to also advocate
for changes specific to D/deaf and disabled trans people.
These include:

• Engaging with D/deaf and disabled trans people who have

experienced these rights violations, to find out about their
priorities and amplify their voices;
• Highlighting the increased risks D/deaf and disabled trans
people face of being subjected to torture and ill treatment
when discussing the issue of forced sterilisation with
politicians, policy makers, and healthcare providers;
• Supporting organisations providing advocacy to mad
people and/or people with psychosocial disabilities, and
those who represent people with learning or cognitive
impairments, to advocate for trans people;
• Lobbying for trans awareness training to be provided to
healthcare practitioners working in psychiatric hospitals
and residential care facilities.

25
Living independently

Having choice and control over who provides them with

assistance with everyday living is particularly important
for D/deaf and disabled trans people so that they can be
enabled to freely express their gender identities.

Some D/deaf and disabled people need support or assistance from

others on a daily basis. How this support is provided varies greatly
across Europe.30 Some countries follow best practice and provide
funds directly to D/deaf and disabled people, enabling them to pay
for the assistance which bests suits them, thus providing the greatest
amount of choice and control over how they are supported and by
whom. At the other extreme, there are countries that provide no
support at all and expect D/deaf and disabled people who require
assistance to either be looked after by their families, or to live in
institutional settings. 31

“When I went through it [assessment for entitlement to

an assistant] I thought of it as a breach of consent. It really
made me think a lot about the nature of consent for dis/abled
people. I never considered having a choice not to do it - it
would mean I wouldn’t be sure of getting a good assessment,
which might or might not grant me the hours I need anyway,
but the risk of losing your hours is higher if you can’t “prove”
your need. Having to get undressed and dressed in front of a
person I had barely met before and feeling like I had no choice
but to do that - that really did something with my sense of
self”.
Christine Bylund

30 European Network on Independent Living, Personal assistance services in

Europe, 2015: http://www.enil.eu/wp-content/uploads/2012/06/Personal-As-
sistance-Service-in-Europe-Report-2015.pdf (20.11.2017).
31 United Nations Committee on the Rights of Persons With Disabilities,
Concluding observations on the initial report of the European Union,
02/10/15, CRPD/C/EU/CO/1, page 7.

26
 Accessing whatever assistance exists is particularly challenging for
some D/deaf and disabled trans people.
The reasons for this include:

• Difficulty in engaging with any government agency when

some or all of your documents don’t reflect your gender
identity and/or chosen name;
• Having to go through some kind of assessment 32 before
a government body will decide what support an individual
is entitled to33. This can involve the assessor, who may be a
complete stranger:

- Asking intrusive questions about personal

aspects of a person’s body and how it functions.
This is particularly difficult for trans people who may
have dysphoria and/or feel shame about their
bodies;
- Making gendered assumptions about the tasks a
person needs or wants to undertake such as whether
or not they shave their legs or put on make-up;
- Not taking into account that some individuals need
assistance to put on binders, prosthetics, or
hairpieces.

All of these difficulties may make it impossible or, at the least, very
distressing for D/deaf and disabled trans people to apply for support
to assist them in living independently. They may, therefore, be forced,
or choose, to struggle without such support, fund it themselves –
which few people can afford – or seek assistance from family and
friends.

32 Amnesty International, The State Decides Who I am, 2014, pages 19 – 21.
33 As at footnote 28.

27
As was discussed above in relation to healthcare, D/deaf and
disabled trans people can experience difficulties in living according to
their gender identity due to the attitudes of those who support them
with everyday living.34 Refusals by support staff to accept or respect
the gender identities of D/deaf and disabled trans people can mean
that they fail to respect their choices as to how they present, such as
their clothing, hairstyle or makeup. If an individual relies on someone
to get them dressed, it can mean that their right to freely express their
gender is taken away.

These issues are likely to occur more often when D/deaf and disabled
trans people are assisted within institutional settings, or by their
families. This is because institutions often fail to take into account
the specific needs of individuals and are not focused upon enabling
people to express themselves. It is also more likely that institutional
transphobia will exist within large public organisations. D/deaf and
disabled trans people risk experiencing all of the same challenges
from their families as other trans people, but they are also reliant
on them for support to live independently. Where a legal guardian
is appointed to make decisions on behalf of an individual, things
become even more challenging as that person has the authority to
refuse to take the necessary steps to enable the individual to access
trans-specific healthcare or legal gender recognition.

It is for these reasons that the choice and control directly provided
by hiring assistants is particularly important for trans people.35
Unfortunately, governments across Europe have been limiting state
financial support over the past 8 years or so, and support to live
independently is becoming increasingly hard to access.36 This means
that the number of D/deaf and disabled trans people forced into
institutional settings, or back into the care of their families, is very
likely to increase.
34 LGBTQI+ Disabled People and Self Directed Social Care and Support,
School for Social Care Research, 2017:
http://www.sscr.nihr.ac.uk/PDF/Findings/RF77.pdf (22.11.17).
35 As above.
36 European Network on Independent Living, Personal assistance services
in Europe, 2015.
28
 Advocacy Strategies

Forming partnerships, providing training, and moving

into this new area of lobbying on behalf D/deaf and
disabled trans people are the keys to inclusive trans
advocacy.

The right to independent living is likely to be a new area of work

for most LGBTIQ advocacy organisations, but many, if not all, will
have lobbied for rights which require similar strategies such as
safe and accessible housing, or appropriate sexual health services.
Organisations should therefore feel confident in taking forward these
advocacy priorities. As our communities age, with more LGBTIQ
people beginning to need support with everyday living, it is an area
which will become increasingly important. Activities that advocacy
organisations can take to improve the situation for D/deaf and
disabled trans people include:

• Lobbying governments to ensure that the specific

concerns of D/deaf and disabled trans people are taken
into account in their social care and independent living
strategies;
• Forming partnerships with disabled people’s
organisations, particularly those specialising in independent
living, to take part in campaigns, share learning, and
champion the specific importance of living independently
for D/deaf and disabled trans people;
• Delivering training to organisations and individuals that
provide assistance with everyday living to D/deaf and
disabled people so that they understand the needs of their
trans clients and will be able assist them to explore and
express their gender identities freely;

29
 • Joining anti-austerity campaigns to resist reductions to
government funding for independent living, to add more
voices to the movement, and to show D/deaf and disabled
trans people that LGBTIQ organisations care about issues
impacting them.

Privacy

D/deaf and disabled trans people experience barriers to accessing

their right to privacy in many of the same areas as non-disabled trans
people. These include:
• Legal Gender Recognition;
• Bathrooms;
• Air travel.

Although these topics seem very different to one another, in human

rights law they all involve the right to privacy. The barriers relating to
each topic will be explored, followed by advocacy strategies relating
to the right to privacy.

Legal gender recognition

Procedures are often inaccessible to many D/deaf and disabled trans
people because:

• Information about how to apply for gender recognition is

often inaccessible due to the format it is provided in, i.e. in
writing, and the complicated language it uses;37
• The process of applying for gender recognition is similarly
difficult as it usually involves answering complicated
questions in writing;38
• There are usually some costs involved – and as discussed
above D/deaf and disabled trans people are at a high risk of
living in poverty;

37 Transgender Europe, Legal Gender Recognition in Europe, 2016, page 31.

38 As above.

30
 • The difficulties discussed above surrounding medical
treatment and independent living mean that individuals
may struggle to meet requirements such as having been
diagnosed with “gender identity disorder” by a medical
practitioner or providing proof of having lived as a particular
gender for the required period (often known as the “real life
test”);
• If the application process involves going to a particular
place and/or speaking to an official face-to-face, this may
be very challenging for a number of reasons including: a
lack of physical access; communication difficulties; and/or
anxiety;39
• As discussed in the Independent Living section, D/deaf and
disabled people may rely on the support of others, or require
someone else’s permission, to apply for gender recognition.
If those providing support or permission are transphobic,
they may well prevent the D/deaf or disabled trans person
from applying. 40

The impact upon trans people of being unable to access legal gender
recognition is well documented.41 One of the greatest challenges
of identifying as a different gender to the one stated on official
documents and records is that interacting with any organisation that
holds that information involves disclosing being trans. Individuals are
then placed at risk of experiencing discrimination, and possibly even
transphobic violence, due to that disclosure.

In general, D/deaf and disabled trans people come into contact with
organisations that have a record of their legal gender more often
than non-disabled trans people. In addition, the organisations that

39 Transgender Europe, Overdiagnosed but Underserved, 2017.

40 As above.
41 See for example: Transgender Europe, Legal Gender Recognition in Europe,
2016; Amnesty International, The State Decides Who I am, 2014.

31
D/deaf and disabled people will be engaging with, such as the social
work department or hospital, can be intimately involved in their
lives over long periods of time. When D/deaf and disabled people
are admitted to hospital, their legal gender is likely to be used to
decide which gendered ward they should be placed in. As well as the
emotional impact of being placed on the wrong ward, individuals are,
once again, put at risk of discrimination and ill treatment due to their
being trans.42 All of these factors mean that legal gender recognition
is particularly important to D/deaf and disabled trans people, so that
they can access the services they need without their right to privacy
being violated, and their wellbeing put at risk.

Bathrooms
Access to bathroom facilities is a constant difficulty for D/deaf and
disabled people in public spaces and premises – for example parks,
schools or libraries, and in private premises - such as shops, restaurants
or entertainment venues. Difficulties may arise due to there being no
accessible bathrooms at all, or because they fail to appropriately cater
for the needs of some D/deaf and disabled people. For D/deaf and
disabled people who do not look disabled in the way that the general
public expect, e.g. using a wheelchair, anxiety about being challenged
can stop them from using accessible bathrooms even when they need
such facilities.

When fully accessible bathrooms are not available, it is likely that

D/deaf and disabled persons’ right to privacy will be undermined in
the following ways:

• Needing assistance which would not usually be required;

• Having to leave the door open due to lack of space;
• Being required to ask someone to unlock the bathroom or
clear it of whatever is being stored in it, which is often done
without any discretion and draws attention to the fact that
someone is using the toilet;

42 Transgender Europe, Legal Gender Recognition in Europe, 2016, at page 8.

32
 • Being expected to use the accessible bathroom which is for
people of a different gender;
• Having to take care of your needs somewhere other than in a
bathroom – for example emptying a catheter bag at your seat
on the train.

For trans people, going to the toilet can often cause a great deal of
anxiety due to the fear of facing harassment or violence. Privacy in the
bathroom is also particularly important to many due to the potential
for being outed as trans in such an environment. That is why it is
important that D/deaf and disabled trans people do not experience
any additional challenges when trying to access the bathroom. One
advantage of being able to use an accessible bathroom, as long as
it meets your needs, is that they are often gender neutral and single
occupancy. This can reduce a lot of the issues that trans people face
when going to the toilet.

Air travel
Accessing transport can be very difficult for many D/deaf and
disabled people. However, it is when attempting to travel by air that
their right to privacy is most likely to be undermined.
This is because:

• Airlines often ask intrusive, and in some cases offensive,

questions about D/deaf and disabled people’s impairments;
• Assistance staff can be very patronising, discuss individuals
with other people (whether they are with the D/deaf or
disabled person or not) rather than the person themselves,
and often ask intrusive questions;
• When going through airport security, if using a wheelchair or
other mobility aid prevents people from going through the
scanner, they will be physically searched by a member of
security staff, often in full view of all other passengers;

33
 • On the airplane, wheelchair users will have their wheelchairs
stored in the hold and so may be unable to move around the
cabin and have to take care of their toilet needs at their seat.
Other mobility aids are often stored in the cabin so that
individuals have to ask someone for assistance when they
need to use them to get to the toilet during the flight.

The invasions of privacy that trans people may experience during air
travel have already been discussed at length in the media.43 All these
experiences can make air travel very unpleasant, and in some cases
traumatic for D/deaf and disabled trans people. For mad people and
those with a psychosocial disability in particular, the anxiety that may
arise because of this might prevent them from even attempting to
travel. The requirement to be physically searched if you are unable
to go through the scanner is especially difficult for many trans people
due to the fear of being outed as trans and then potentially facing
harassment or assault. D/deaf and disabled trans people of colour are
at greatest risk of experiencing intrusive questioning and searches,
and of being harassed when flying due to the racist nature of some
airport security measures (such as racial profiling) and racism
amongst security staff.

Advocacy Strategies
Legal gender recognition, bathrooms and air travel are frequently
raised in trans activism and so are unlikely to be new to organisations
involved in trans advocacy. Once aware of the challenges facing
D/deaf and disabled trans people, organisations should be able
to incorporate them into any campaigning relating to the right to
privacy. Some steps that could be taken are mentioned on the next
page.

43 See for example:

http://www.transequality.org/issues/travel;
https://broadly.vice.com/en_us/article/paeydg/an-airline-refused-to-let-a-
trans-woman-board-her-flight;
https://www.theguardian.com/society/2015/sep/23/transgender-wo-
man-tsa-search-airport-security;
http://www.truth-out.org/news/item/37068-the-trials-and-trauma-of-traveli-
ng-while-transgender (20.11.2017).

34
 Most organisations already have strategies in place
to advocate for trans persons’ right to privacy. The
addition of issues that impact D/deaf and disabled trans
people will enable organisations to begin advocating on
their behalf.

Advocacy strategies include:

• Working in partnership with disabled people’s
organisations to share knowledge and contribute to each
others’ advocacy;
• Collaborate with disabled people’s organisations to provide
information on legal gender recognition in alternative
formats, such as Easy Read, large print, sign language etc.;
• When campaigning for legal gender recognition, include the
specific difficulties facing D/deaf and disabled people;
• Ensure campaigns for gender neutral toilets include a call
for such toilets to be accessible;
• Deliver trans awareness training to staff working for
companies who provide access assistance services at
airports.

There are many similarities between the issues

facing D/deaf and disabled people and those
affecting trans people, but there are ways in
which these issues are compounded for D/deaf
and disabled trans people that create particular
barriers. That is why it is so important for LGBTIQ
organisations to understand these situations
and make a concerted effort to ensure that
their advocacy is inclusive. If organisations only
undertake single issue activism, people experiencing
intersectional oppressions will be left behind.

35
Chapter 2
Enabling engagement with
LGBTIQ organisations

LGBTIQ organisations ought to be aware of the significant

importance that they play in the lives of the people they represent.
Yet D/deaf and disabled trans people report experiencing many and
varied barriers when attempting to engage with them. Hopefully
this knowledge will motivate LGBTIQ organisations to take steps to
reduce these barriers so that they can play as significant a role in the
lives of D/deaf and disabled trans people as they do in the lives of
trans people who do not experience this additional oppression.

The following chapter explores the barriers experienced by D/deaf

and disabled trans people, in two categories: internal barriers, created
by organisational policies and practices; and external barriers, which
are influenced by external factors that impact on their ability to
engage with organisations. Each barrier will be discussed, followed
by suggestions for short, medium and long-term measures that
organisations can take to reduce the impact of the barrier.

The suggestions take into account the variety of working contexts

and access to resources available to organisations. By presenting a
wide array of different suggestions, it is hoped that all organisations
will be able to identify measure/s that they will be able to implement
effectively. It is important to note that genuinely including
D/deaf and disabled people is not something that can be achieved by
completing a set number of actions, rather, it is an ongoing process of
meaningful engagement that organisations must commit to over and
over again.

36
 “D/deaf & disabled LGBTIQ+ people face additional
discrimination; disablism and lack of inclusion by
LGBTIQ+ peers and fear of LGBTIQ+ phobia & exclusion
from disabled peers. This makes us feel lost, alone and
like we don’t belong to either community; always bear in
mind we are all intersectional!”
Anis Akhtar, a disabled intersex person of colour

Internal barriers

Communication
Barriers occur right at the beginning of the process of engagement,
with D/deaf and disabled trans people prevented from even finding
out about or contacting organisations. As well as guaranteeing a lack
of involvement, these barriers can also lead organisations to wrongly
assume that D/deaf and disabled people do not want to be involved
in their activities. There are many ways in which organisations
communicate that can cause difficulties:

• Websites or other online material which are not compatible

with screen readers, preventing access by neurodivergent
people or people with visual impairments who use such
technology;
• Using complicated language makes it difficult for people
with learning or cognitive impairments, and neurodivergent
and/or autistic people to access written material;
• Stating that enquiries must be made by phone, deterring
contact from people with speech and hearing impairments,
mad people and/or those with a psychosocial disability, and
neurodivergent and/or autistic people;
• Videos without sign language interpretation or subtitles,
which exclude people who are D/deaf, and neurodivergent
people who require subtitles.

37
Inaccessible communication can prevent some D/deaf and
disabled trans people from getting the most basic benefits from an
organisation: knowing that it exists and understanding what it can do
for them. It also sends a message to D/deaf and disabled trans people
that an organisation has given no thought to their needs.
Other such signals include:

• A lack of visibly disabled people in the images used by

organisations;
• The organisation using ableist language;
• Events being advertised as “not accessible”;
• Access information about an organisation’s premises
or activities not being provided;
• No mention of measures that can be put in place to assist
D/deaf and disabled people to become involved with the
organisation.

Given how frequently D/deaf and disabled people face barriers

when interacting with organisations, they can, understandably, be
reluctant to engage. However, given the scarcity of trans-inclusive
organisations, D/deaf and disabled trans people are likely to
withstand these additional barriers in an attempt to access the
information or services they require.

Solutions
The way in which an organisation communicates with its audience is
of fundamental importance and it is crucial that D/deaf and disabled
trans people are able to access the information that organisations
share. Accessible communication is also a highly visible way to
demonstrate that the organisation is inclusive of D/deaf and disabled
trans people. The steps that organisations can take to increase access
in this area are discussed on the following pages.

38
 Short Term
• Provide staff with high quality training delivered by a
disability rights, disabled-led organisation on how to
include, engage with and represent D/deaf and disabled
people;
• Use language that is inclusive of D/deaf and disabled
people. This can be done in simple ways, for example if
describing the way a non-disabled person would typically
do something, include alternative ways that disabled people
might do the same thing – “can everyone hear me or see the
sign language interpreter?”;
• Have a variety of mediums that people can use to contact
the organisation, including phone, e-mail, online form, in
writing;
• When an item is published on the website, include a link to
a PDF of the text to ensure it is screen reader compatible;
• If an online tool such as Survey Monkey is used to collect
information, provide a link to a PDF and/or Word version
of the survey so it is accessible to people using assistive
technology, such as dictation software, to complete it;
• Give people the option of phoning the office to complete
a form or survey or to register for an event with a member
of staff, so if they require assistance they will not have
to discuss personal matters with the person who would
ordinarily assist them. It is important to ensure that a
dedicated team member(s) will be available to do this at the
time you have specified;
• Subtitle all video or audio material, whether online or
offline;
• Buy a portable hearing loop that can be used in the office
and taken to events, and let people know that it is available.

39
Medium Term
• As a proportion of sign language users have difficulty in
accessing written information, produce video clips which
are sign language interpreted and subtitled for key
information, important news items, event announcements,
or call outs etc. It is important that the sign language
interpreter has a level of trans awareness expected of
anyone working with the organisation. Also, remember that,
just like spoken language, every country, and in some places,
each state or region, has its own sign language, so make
sure the interpreter uses the same language as the intended
audience.
• Produce Easy Read versions of information leaflets and
reports to be accessible to people with learning or cognitive
impairments. The European Easy to Read Standards should
be used when writing such materials.44 If this is not possible
then simply using language which is uncomplicated, defining
unfamiliar terms, and writing in short sentences can improve
accessibility.
• Use graphics and symbols on information leaflets, reports,
announcements etc. to aid people’s understanding.

Long Term
• Develop a comprehensively accessible website
that complies with international guidelines for online
accessibility;45
• Enable staff to undertake a sign language course so that
there are people within the organisation who are able to
communicate with individuals who use it;
• Provide graphic facilitation training to staff members with
a facilitation role within the organisation, so that they can
deliver workshops etc. that are accessible to people with a
learning or cognitive impairment.

44 European standards for making information easy to read and understand:

http://easy-to-read.eu/european-standards/ (20.11.2017).
45 Web Content Accessibility Guidelines:
https://www.w3.org/WAI/intro/wcag (20.11.2017).
40
 Events and Activism
When disabled trans people are able to begin engaging with
organisations, numerous barriers can occur which prevent them from
doing so effectively and in a way that does not cause them emotional,
psychological or physical harm. Going to events and being involved in
activism can be very rewarding, but for D/deaf and disabled people, it
is often the most challenging way of engaging with organisations.

“It’s frustrating when organisations repeatedly make

tokenistic statements like, ‘Sadly, there are five steps to
the toilets’ or, ‘We are sorry this event is not wheelchair
accessible,’ obviously not sad and sorry enough to hold the
event somewhere else.”
Sandra Alland, genderqueer crip, based in Glasgow

The access requirement that non-disabled people can identify

most readily is physical access to venues. Unfortunately, even this
basic requirement is rarely provided by LGBTIQ organisations.
Organisations hosting events, activities, meetings, etc. in inaccessible
spaces often justify this to D/deaf and disabled people by citing
a lack of funding forcing them to use whichever affordable venue
is available. This sends a message to D/deaf and disabled people
that the organisation decided that it was acceptable for them to
be excluded or that access was simply not seen as a priority. When
organisations consider physical access, they may not do so fully
enough to actually remove access barriers. For example:

• Lifts at venues being too small for people,

particularly those with mobility aids, to fit into;
• No accessible toilets available at events;
• Buildings having ramps that are far too steep for
wheelchair users to propel themselves up.

41
When an accessible venue has been chosen, organisations often
do not think to include access information when publicising their
activities, so D/deaf and disabled people are left wondering whether
they will be able to go or not. Considering how often access barriers
are faced, it is not surprising that people often assume that the event
will not be accessible.

The extent to which these limitations impact people will vary from
individual to individual, but at the very least they are a frustrating
indication that the organisation has not thoroughly considered the
participation of D/deaf and disabled people.

Of course, being able to physically access a space is not the same

thing as being able to meaningfully participate in an activity. People
with sensory impairments are quite often left out of accessibility
planning, which can completely exclude them from taking part. It is
very unusual to see sign language interpreters at events or meetings,
even though interpretation is an essential access requirement for
many D/deaf people who have sign language as a first language.
Similarly, needing to take in a great deal of visual information presents
challenges for visually impaired attendees, yet words, actions and
images are rarely read out or described.

“When people like me have trouble with everyday tasks

like planning or time management, we might need a little
more assistance or guidance in our activism. I often feel like
independence is very much required and expected in activism,
which makes succeeding at it so much harder for people who
struggle with these basic functions. My recommendation for
organisations is be prepared to be flexible in the way people
can be involved, or give people the support and assistance
they need so they can contribute without being held back by
the things they find difficult.”
Dorian K, developmentally disabled person

42
 The acoustics of a meeting space (how sound travels in it) and
lighting can also make it very challenging for people to see or hear, yet
these issues are rarely considered. People with a learning or cognitive
impairment may need additional support to fully participate in
events and activities. If organisations do not reach out to attendees
to ask about the assistance they require, their needs are likely to be
overlooked.

Activities being generally organised around non-disabled people is

one of the main barriers that impacts on the involvement of D/deaf
and disabled people. The most common examples of this are:

• Events being too long or not including enough breaks –

this causes some people pain and/or exhaustion which
can last for days after the event;
• There being no quiet space where people, particularly
neurodivergent and/or autistic people, or mad people and/
or those with a psychosocial disability, can retreat to;
• No reassurance being given to people who need to move
around, leave the room, make noises, tic or twitch, that they
will not be judged for doing so;
• Having to move around from one location to another
throughout an event – causing increased tiredness and/
or pain, or navigational difficulties for people with visual
impairments;
• Lack of assistants available to take notes, get drinks, food,
and materials, or explain things, presenting challenges for
people with a wide variety of impairments;
• A lack of clear and detailed information provided ahead of
time explaining the format of the event and what is
expected of participants – causing stress and anxiety for
many D/deaf and disabled people.

43
 “I go to a lot of meetings and conferences and always need
2-3 days to recover afterwards and have to schedule a lot
of alone time and self-care time during the event so I can
function.”
Dodo Karsay, a non-binary person with psycho-social
disabilities

Solutions
Short Term
• If an organisation only does one thing in relation to the
events it organises, it should provide accurate access
information in all publications about the event, including:
whether there is level entry/steps/a lift into the venue; if
the venue has accessible toilets; whether there are internal
steps/a lift in the venue; if a sign language interpreter,
captions, or subtitles will be provided; the time the event
will end and if there will be any breaks; and if a quiet space
will be available. If the event is not accessible in a particular
way, state this but be specific - this enables D/deaf and
disabled people to make an informed decision as to whether
they are able to attend the event or not (example of access
information provided in Annex A);
• Use the relevant strategies recommended under
Accessible Communication (see above) when advertising
and taking bookings for the event;
• Ask people what their access requirements are when
they are booking to attend the event. It can be helpful to
provide a list of options for people to choose from so that
they know what access your organisation will be able to
facilitate. Always ensure to include an “other” option, as it is
impossible to think of every requirement an individual may
have and, even if it is not something you have
considered, it may be something you can provide (an
example of the question asked of attendees at the expert
meeting is provided in Annex B as a guide);

44
 • Prioritise access for D/deaf and disabled people when
booking venues. If, for example, you have a choice between
two venues and one has the capacity you were looking for
but is not accessible and another has a smaller capacity but
is accessible, choose the accessible one;
• Something is better than nothing: there are many ways of
facilitating access that may not be ideal, but signal to D/deaf
and disabled people that you have considered their needs.
For example, it may be beyond the capacity of an
organisation to provide a sign language interpreter for
a poetry reading event. Instead, the organiser could ask
performers to send them a copy of the work they will be
performing, and provide print outs at the event to attendees
who require the text. Of course, organisations should
strive towards best practice, but that should not prevent
them putting in place imperfect strategies while they work
towards providing comprehensive access;
• Visit venues prior to booking them or ask specific
questions of venue staff to ensure organisational access
criteria are met. Often venues provide inaccurate access
information, for example, they might describe themselves
as “wheelchair friendly” although they do not have an
accessible toilet;
• Plan events, particularly conferences, so that D/deaf
and disabled people do not become exhausted – keep
the event short and include plenty of breaks. Everyone at
the expert meeting commented on how productive it was
because the days were shorter and participants could focus
throughout the whole meeting rather than becoming too
tired (the expert meeting schedule is included in Annex C
for reference);
• Consider availability of accessible transport links and
if unavailable, the organisation can arrange accessible
transport, such as taxis, for those who need it.

45
Medium Term
• Create an Access Policy to be used when organising
events that sets out all of the ways in which the needs of D/
deaf and disabled people should be catered for;
• Develop a list of accessibility criteria for venues and
only use venues that meet these criteria. Over time, the
organisation can build up a database of venues that meet
their access standards;
• Produce access standards that can be given to external
organisations and individuals providing workshops etc. at
events, to ensure (as much as possible) that the input they
provide is inclusive of D/deaf and disabled people;
• Create a tailored access plan that sets out all of the
adjustments that will be made, and assistance put in place,
to facilitate access at an event. This can be shared with
attendees in advance so they can feel confident in the
inclusivity of the event.

Long Term
• Connect with a local D/deaf people’s organisation and
offer a skill exchange as a free or low-cost way of having a
sign language interpreter at events. For example: provide
the organisation with LGBTIQ training or develop a
publication for them;
• Include the costs of facilitating access when applying
for funding and creating budgets and, where appropriate,
allocate a portion of the budget to subsidise travel for
D/deaf and disabled people to enable them to attend;
• Employ an access consultant, either when required, or on a
permanent basis if the organisation frequently holds large-
scale events, to plan and deliver access facilitation.

46
 Attitudes
In addition to practical access challenges, D/deaf and disabled people
experience all kinds of attitudinal barriers that can cause emotional
or psychological harm, and in some cases deter them from engaging
further. Such barriers include:

• Staff acting in a defensive or hostile way when being asked

about D/deaf and disabled access;
• The responsibility for making things accessible being placed
on the D/deaf or disabled person themselves, for example,
being asked to find an accessible venue, hire a sign language
interpreter or bring a personal assistant;
• D/deaf and disabled people being told how much work it is,
or how much money it costs, to make an event accessible.
This can result in people feeling like they are a burden;
• An expectation that individuals should be grateful that their
access requirements are met;
• People who facilitate access being transphobic, for example
sign language interpreters misgendering people and/or
using incorrect, out-dated or offensive terminology.

“Simple things like not using “crazy” to describe

something intense or weird should be automatic in trans
spaces. I always feel so isolated when I hear this word used
like that. Just always think - we might be in the room. And
chances are, we really are and you are hurting us.”
Dodo Karsay

Experiencing staff or other representatives of LGBTIQ organisations

using ableist language is very common for D/deaf and disabled trans
people. People saying things such as “the organisation was crippled
by a lack of funding” or “the volunteer acted like a complete nut
case,” are frequent examples of this. Offensive terms being used can

47
be extremely alienating and send a message that the person using
them has given no thought to the impact their language might have
on any D/deaf and disabled people in the room.

An area of trans activism where there is a particular risk of ableism is

the campaign for trans depathologisation. The aim of this campaign
is to remove the diagnosis of trans people as having “Gender Identity
Disorder,” which is classified as a mental disorder. The process
of classifying and diagnosing something as a medical condition
is referred to as pathologisation. Over the past decade, people’s
understanding of gender identity and what it means to be trans has
developed a great deal. As a result, many trans activists around the
world now feel that it is unacceptable for trans people to be viewed
as having a medical condition.46 At the same time, the campaign calls
for an end to the current situation where trans people are diagnosed
by a psychiatrist before they can access legal gender recognition
and/or the medical treatment they may wish to have.

Transgender Europe continues to be committed to the

depathologisation of trans identities, while acknowledging the risk
of ableism in suggestions or implications that being diagnosed with
a mental illness, or even just being associated with people who have
a mental illness, is a bad thing. This can be alienating to mad and/or
psychosocially disabled trans people and adds to the stigma that they
already experience.

Another risk when campaigning for depathologisation is the

suggestion that, if trans people were free of their “mental disorder”
diagnosis, then they would be “normal,” “just like everyone else,” and
free from any diagnosis at all. Again, the suggestion that people who
have a mental illness are not normal is stigmatising. These statements
also erase D/deaf and disabled trans people for whom diagnosis is
part of life, regardless of the fact they are trans.

46 International Network for Trans Depathologization, Manifesto:

http://www.stp2012.info/old/en/manifesto (20.11.2017).

48
 The campaign for trans depathologisation is still developing, and
there is a need to critically analyse all of the complexities surrounding
the potential ableism within it. There are many ways in which
D/deaf and disabled people are harmed by pathologisation,
particularly mad and/or psychosocially disabled people, in similar
ways to trans people in general. Their experiences would greatly
contribute to discussions that need to be had, thus the facilitation of
D/deaf and disabled trans people’s engagement with the campaign
for trans depathologisation is particularly important.

“I have found some trans depath slogans problematic

because the way the issue was phrased was very ableist and
stigmatizing. It was suggested that having a mental health
diagnosis is inherently bad and trans people should not be
associated with that. This is not cool because many trans
people have mental health issues and this can send the wrong
message to them. Of course, many mad people hate the
psychiatric establishment and its obsession with diagnostic
labels and these should be questioned too. But the issue with
trans pathologization is that mere trans identity is seen as a
mental health illness, and this is wrong.”
Dodo Karsay

Solutions
Short term
• Have a policy that makes it clear that the organisation is
committed to being inclusive of D/deaf and disabled
people and does not tolerate ableism. Make sure it
is publicised and shared with anyone representing the
organisation. It should also set out what an individual can
do if they experience the policy being breached and what
action the organisation will take as a result;

49
 • Share a list of ableist words and suggested alternatives
with everyone working for or representing the organisation,
for example: instead of describing something as “crazy” use
“intense, surprising, or shocking”;
• Have as many D/deaf and disabled trans people as
possible involved in developing new campaigns from the
beginning. This will increase the chance that any potential
for ableism within campaign messaging will be caught early
on.

Medium term
• Have a particular staff member who takes responsibility
for communicating with D/deaf and disabled people
about their access needs. This must not be an alternative to
all staff being trained in D/deaf and disability equality but is
a helpful addition. It would also be useful if the staff member
acts as a point of contact for individuals who experience
ableism;
• Provide staff with high quality training delivered by a
disability rights, disabled-led organisation on the Social
Model of Disability.

Long term
• Provide LGBTIQ awareness training for access facilitators,
such as sign language interpreters, who work at events so
that the organisation has a pool of people it can trust to use
respectful and up to date terminology.

50
 External barriers

D/deaf and disabled trans people experience many extra challenges

in society, which can make it more difficult for them to engage with
LGBTIQ organisations than non-disabled trans people.

Transport
One of the main barriers to engagement is the availability of
accessible transport, as discussed in Chapter One. In many places
across Europe, even within big cities, there is a severe shortage of
public transport that is accessible to D/deaf and disabled people.

“Inaccessibility of transport systems is one of the number one

barriers keeping myself and other disabled people out of trans
activism, and activism generally. The effort required to simply
turn up to events, never mind get through the door, adds to
the ubiquitous activist battles with burnout and fatigue. This
can make disabled people turn away from activism due to
repeated frustrating mishaps due to inaccessible transport.”
Ellen Murray

The access challenges include:

• Lack of ramps or lifts to stations and platforms, meaning it is

extremely difficult or impossible for wheelchairs users and
others with mobility impairments to access transport;
• Trains, trams and buses that people cannot get their
wheelchairs, scooters or other mobility aids onto;
• Taxis that fail to stop for D/deaf and disabled people, refuse
to accept passengers with guide dogs, do not have space
for mobility aids, or claim to be unable to assist people with
mobility aids;

51
 • Accessible transport only being available in specific
locations or at particular times of the day;
• Requirements that assistance for accessing transport has
to be booked in advance, making it difficult for D/deaf and
disabled people to be spontaneous;
• No information on the websites of transport providers
about lifts being out of order, which can sometimes lead to
D/deaf and disabled people arriving at a platform only to
find that they cannot get out of the station;
• No access facilitation provided for D/deaf and/or visually
impaired people, such as recorded timetables, visual and
spoken on-board announcements, space for guide dogs etc.

For neurodivergent and/or autistic people, mad and/or

psychosocially disabled people, or people with a learning or cognitive
impairment, travelling using public transport can be particularly
challenging. There are many factors such as noise, number of people,
lack of space, risk of getting lost, route changes etc. that can make
public transport very distressing.

Some D/deaf and disabled people may only be able

to travel if someone assists them. If they are not out
to their personal assistant, or their assistant is
transphobic, travelling to a trans event may be very
difficult, if not impossible.

D/deaf and disabled trans people may be more limited in their

transport options than other D/deaf and disabled people due to
the risk of experiencing transphobic harassment or violence. Some
individuals may be physically able to access buses for example, but
feel unable to do so at certain times, or at all due to concerns about
their safety. If taxis are not physically or financially accessible to such
individuals, they would still be unable to travel using public transport.

52
 These challenges mean that many D/deaf and disabled people are
unable to travel by public transport, which significantly impacts
their ability to attend the events of LGBTIQ organisations. Even if
individuals are able to use public transport, it may still take careful
planning, be a time consuming and stressful undertaking, or cause
pain and/or exhaustion. Some D/deaf and disabled people may only
be able to travel if someone assists them. If they are not out to their
assistant, or their assistant is transphobic, travelling to a trans event
would likely be very difficult, if not impossible.

Financial Barriers
D/deaf and disabled trans people are more likely to experience
financial difficulties than the general population. One reason for
this is the multiple barriers that they face to obtain employment,
including both disability47 and gender identity related
discrimination.48 There are also extra costs associated with being
disabled – for example, buying specialist equipment, or paying for
medication – and with being trans – such as travelling by taxi for
safety reasons, or paying for trans-specific healthcare – that put
additional strain on D/deaf and disabled trans people’s finances.

Although people would ordinarily apply for state benefits if they

have no or limited income, this can be challenging for D/deaf and
disabled trans people if they do not have legal gender recognition
(as discussed above). A great deal has been written elsewhere
about the general difficulties that D/deaf and disabled people face
in claiming benefits.49 Further, state benefits, where available, often
do not provide enough money to prevent people from struggling to

47 Greve, B (2009). The labour market situation of disabled people in

European countries and implementation of employment policies.
48 European Union Agency for Fundamental Rights, Being Trans in the European
Union. Comparative analysis of EU LGBT survey data, 2014, page 19.
49 See for example: Sainsbury, R, Lawson, A and Priestley, M (2017).
Social protection for disabled people in Europe: Synthesis report,
European network of academic experts in the field of disability:
www.disability-europe.net/downloads/723-synthesis-report-theme-social-pro-
tection-tasks-1-2-and-3-year-2015-2016;

53
afford a decent standard of living. Racism, xenophobia, and sexism
in employment and benefit systems mean that D/deaf and disabled
trans women, and D/deaf and disabled trans people of colour,
migrants or refugees of all genders are particularly likely to struggle
financially. In most countries in Europe, asylum seekers face various
restrictions on working or claiming state benefits, thus D/deaf and
disabled trans people seeking asylum may have no income at all.

Limited Access to Assistance

The difficulties that D/deaf and disabled trans people experience in
receiving support with everyday activities, as discussed in Chapter
One, is another external barrier to engagement with LGBTIQ
organisations. Some D/deaf and disabled trans people will need
assistance to get in touch with organisations, access information, or
attend events. But due to increased difficulty in accessing funds to
pay for such assistance, D/deaf and disabled people have to make
difficult decisions as to how they use the limited support and resources
available to them. Using an assistant to travel to a trans event or to
communicate with a trans organisation may have to be replaced by
something which cannot be foregone, such as having a shower or filling
out essential paper work.

54
 External barriers: Solutions

Short term:
• Hold some events during the daytime so that D/deaf and
disabled trans people who have difficulties travelling at
night are able to attend on these occasions;
• Advertise events far enough in advance to give D/deaf and
disabled trans people time to plan their travel, and, if
necessary, organize access assistance or an assistant to
accompany them;
• When deciding where to hold events, take into account local
accessible public transport links;
• Provide ways of engaging with the organisation other than
in person;
• Invite people attending events to make a contribution
towards the cost of funding another place for someone on a
low income.

Medium term:
• Use a proportion of the budget to fund transport for D/deaf
and disabled trans people, including the use of taxis when
they are a more accessible or safer option;
• Provide remote access to events, for example, by live
streaming events online, using Skype, or enabling people to
contribute via Twitter;
• For large events with many attendees, such as conferences,
hire an accessible vehicle so transport for D/deaf and
disabled trans people can be provided directly by the
organisation;
• If the organisation provides services such as mentoring or
counselling, offer to provide them remotely or in D/deaf and
disabled trans people’s homes;

55
 • Recruit volunteer drivers to transport D/deaf and disabled
trans people who can access their vehicles to events;
• If budgets allow, offer free or reduced price attendance at
events to people on low incomes;
• Have a designated staff member or volunteer at events to
provide assistance to D/deaf and disabled trans people, and
advertise this so that it may be possible for some individuals
to not bring their assistant. Consider offering attendees a
free or reduced cost place if they volunteer to take on this
role.

Long term:
• Raise funds to provide bursaries to D/deaf and disabled
trans people, to enable them to attend events, volunteer,
or otherwise engage with the organisation if they
would struggle to do so otherwise. This may include,
for example, paying an assistant’s wage, for their travel
or accommodation, or providing individuals with
accommodation close to the venue so they do not have to
deal with public transport;
• When making budget applications, take into account the
money that will be needed to facilitate engagement with
D/deaf and disabled trans people;
• Make links with companies or organisations that provide
accessible transport, and encourage them to offer their
services for free or as part of a skills exchange so that
transport can be provided directly for D/deaf and disabled
trans people.

56
 Conclusion
In bringing together experts in D/deaf and disabled trans equality from
across Europe, TGEU has learnt a great deal about the particular ways
in which oppression, marginalisation and exclusion impacts on those
members of our communities who are D/deaf and/or disabled and
trans. The fact that both transphobia and ableism are often ingrained
within many of the numerous service providers that D/deaf and disabled
trans people come into contact with, means they are likely to experience
discrimination in relation to both aspects of their identities when simply
trying to have their needs met. This report has evidenced the many ways
in which D/deaf and disabled trans people are unable to access their
human rights:

• Attitudes, gatekeepers, poor access and a lack of autonomy

are the main issues that impact on D/deaf and disabled trans
people’s access to healthcare;
• A lack of choice and control over who provides them with
assistance with everyday living can prevent D/deaf and
disabled trans people from freely expressing their gender
identities and accessing the trans-specific healthcare that
they seek;
• Ableism combined with transphobia puts D/deaf and
disabled trans people at a heightened risk of experiencing
torture or ill treatment in a healthcare setting;
• The privacy issues affecting trans people are more
challenging for D/deaf and disabled trans people due to
inaccessible practices, policies and procedures.

LGBTIQ organisations have a key role to play in advocating on behalf

of D/deaf and disabled trans people. If that does not happen, then
D/deaf and disabled trans people are unlikely to reap the same
benefits from improvements in trans equality as their non-disabled
peers.

57
LGBTIQ organisations already have the tools needed to undertake
intersectional activism. All that is required is knowledge of the issues
impacting D/deaf and disabled trans people, and the will to broaden
existing strategies to include them. It is hoped that this report will
give LGBTIQ organisations the confidence to begin working towards
that goal.

Working in partnership with D/deaf and disabled people’s

organisations is an important first step towards inclusive trans
activism. It will ensure LGBTIQ organisations take up the most
pressing issues in the most effective ways possible. At the same time,
D/deaf and disabled people’s organisations will gain insight into trans
equality issues, which will hopefully lead to more inclusive advocacy
on their part. If both LGBTIQ and D/deaf and disabled organisations
are including the needs of D/deaf and disabled trans people within
their advocacy, then accessibility for all will improve.

However, inclusive advocacy is of limited value if individual D/deaf

and disabled trans people are still unable to engage with LGBTIQ
organisations on an equal footing with their non-disabled peers.
Therefore, a concerted effort to reduce the barriers outlined above
is also required. In order to do so, it is necessary to view accessibility
as a fundamental value that underpins everything the organisation
does, rather than something that is added at the end when plans
have already been made. The first step to becoming a more inclusive
organisation often has to be an inward assessment of the composition
of the organisation and the practices and policies it has in place. If an
organisation has no D/deaf or disabled employees, board members,
or volunteers, it is unsurprising that D/deaf and disabled people
would not be particularly keen to engage. The people chosen by an
organisation to represent it sends a powerful message about who
belongs in the organisation. Working with D/deaf and disabled
people’s organisations to put recruitment and access policies in
place is the most effective way for LGBTIQ organisations to ensure
inclusion sits at the core of their work.

58
 This report has shown numerous ways in which LGBTIQ
organisations can reduce the barriers to engagement if they are
committed to ensuring that D/deaf and disabled trans people are
genuinely included within the movement.

Engagement with LGBTIQ organisations is just as important for

D/deaf and disabled trans people as for everyone else, and they
are currently missing out on valuable experiences within the trans
community. D/deaf and disabled trans people should not have to
choose which parts of themselves to forgo, and they deserve to be
represented by LGBTIQ organisations who value all aspects of their
identities, not just the parts that they find easiest to accommodate.

Recommended further reading:

Clare, E, Brilliant Imperfection:
Grappling with Cure, Duke University Press Books, 2017

IGLYO, Intersectionality Toolkit (2014)

http://www.iglyo.com/resources/intersectionality-toolkit-2014/

Murray, E, Making Trans Activism Accessible, (2017)

https://ellenmurray.co.uk/accessible/

59
References:
Amnesty International, The State Decides Who I am, 2014,
https://www.amnesty.org/en/documents/EUR01/001/2014/en/

Brait, E, (2015) An Airline Refused to Let a Trans Woman Board Her

Flight, The Guardian, https://www.theguardian.com/society/2015/sep/23/
transgender-woman-tsa-search-airport-security

Committee on the Rights of Persons with Disabilities, General Comment

No. 3, Article 6: Women and girls with disabilities, 2016,
http://www.ohchr.org/EN/HRBodies/CRPD/Pages/GC.aspx

Corcione, D and Valens, A, (2016) Truth Out,

http://www.truth-out.org/news/item/37068-the-trials-and-trauma-of-traveling-
while-transgender

European Network on Independent Living, Personal assistance services in

Europe, 2015:
http://www.enil.eu/wp-content/uploads/2012/06/Personal-Assistance-Service-in-
Europe-Report-2015.pdf

European standards for making information easy to read

and understand, http://easy-to-read.eu/european-standards/

European Union Agency for Fundamental Rights, Being Trans in the

European Union. Comparative analysis of EU LGBT survey data, 2014:
http://fra.europa.eu/en/publication/2014/being-trans-eu-comparative-analysis-
eu-lgbt-survey-data

European Union Agency for Fundamental Rights, Inequalities and multiple

discrimination in access to and quality of healthcare, 2013,
http://fra.europa.eu/en/publication/2013/inequalities-discrimination-healthcare

Fanin, I (05/07/17) Is there institutional racism in mental health care? BBC

http://www.bbc.co.uk/news/health-40495539

Gajwani, R., Parsons, H., Birchwood, M., & Singh, S. P. (2016) Ethnicity and
detention: are Black and minority ethnic (BME) groups disproportionately
detained under the Mental Health Act 2007: Social Psychiatry and
Psychiatric Epidemiology, 51, 703–711. http://doi.org/10.1007/s00127-016-
1181-z

60
 Greve, B (2009), The labour market situation of disabled people in
European countries and implementation of employment policies:
a summary of evidence from country reports and research studies,
Academic Network of European Disability experts,
http://www.included.eu/sites/default/files/documents/aned2009_-_the_
labour_market_situation_of_disabled_people_in_european_countries_and_
implementation_of_employment_policies.pdf

Independent Living in Scotland, The United Nations Convention

on the Rights of Disabled People (UNCRPD) - What it is, what’s
covered and why it’s important,
http://www.ilis.co.uk/uploaded_files/ilis_guide_no.2.pdf

International Network for Trans Depathologization, Manifesto,

http://www.stp2012.info/old/en/manifesto

Keygnaert, I et al (2016). Sexual and reproductive health

of migrants: Does the EU care? Health Policy, Volume 114
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http://www.sciencedirect.com/science/article/pii/S0168851013002881

McArdle, H (18/07/17) Discrimination Claim as Trans Women

Rejected for Breast Surgery, Herald Scotland, http://www.heraldscotland.
com/news/15416178.Discrimination_claim_as_trans_women_rejected_for_
breast_surgery/

Mencap, Death by Indifference: 74 Deaths and Counting a

Progress Report 5 Years On, 2012: https://www.mencap.org.uk/sites/default/
files/2016-08/Death%20by%20Indifference%20-%2074%20deaths%20and%20
counting.pdf

Norah Fry Research Centre, LGBTQI+ Disabled People and

Self Directed Social Care and Support, School for Social Care
Research, 2017: http://www.sscr.nihr.ac.uk/PDF/Findings/RF77.pdf

Reisner, S., Poteat, T., Keatley, J., Cabral, M., & Mothopeng, T.,
et al., (2016). Global health burden and needs of transgender
populations: a review. The Lancet, 17, http://www.thelancet.com/pdfs/
journals/lancet/PIIS0140-6736(16)00684-X.pdf

61
Sainsbury, R, Lawson, A and Priestley, M (2017), Social protection
for disabled people in Europe: Synthesis report, European network
of academic experts in the field of disability: www.disability-europe.net/
downloads/723-synthesis-report-theme-social-protection-tasks-1-2-and-3-
year-2015-2016

Tourjée, D, (2016) An Airline Refused to Let a Trans Woman Board Her

Flight, Broadly, https://broadly.vice.com/en_us/article/paeydg/an-airline-
refused-to-let-a-trans-woman-board-her-flight;

Transgender Europe, Legal Gender Recognition in Europe. Toolkit, 2016,

https://tgeu.org/wp-content/uploads/2017/02/Toolkit16LR.pdf

Transgender Europe, Overdiagnosed but Underserved.

Trans Healthcare in Georgia, Poland, Serbia, Spain, and Sweden:
Trans Health Survey, 2017, https://tgeu.org/wp-content/uploads/2017/10/
Overdiagnosed_Underserved-TransHealthSurvey.pdf

Transgender Europe, Strategic Plan 2014-2020, http://tgeu.org/wp-content/

uploads/2016/11/TGEUStrategicPlan_2014_2020.pdf

United Nations Committee on the Rights of Persons

With Disabilities, Concluding observations on the initial report
of the European Union, 02/10/15, CRPD/C/EU/CO/1, https://
documents-dds-ny.un.org/doc/UNDOC/GEN/G15/226/55/PDF/G1522655.
pdf?OpenElement

United Nations General Assembly, Human Rights Council, Report of the

Special Rapporteur on torture and other cruel, inhuman or degrading
treatment or punishment, Juan E. Méndez, 01/02/13, A/HRC/22/53
http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/
Session22/A.HRC.22.53_English.pdf

Web Content Accessibility Guidelines, https://www.w3.org/WAI/intro/wcag

World Health Organisation, World Report on Disability, 2011,

http://www.who.int/disabilities/world_report/2011/report.pdf

World Health Organization, Disability and Health Fact Sheet, 2016,

http://www.who.int/mediacentre/factsheets/fs35/en/

62
 Annex A:
Venue access information
Example provided by Sandra Alland

Building Access & Travel Information:

Stairs and Whispers: D/deaf and Disabled Poets Write Back at
Scottish Poetry Library, September 27th 2017
 
Travel information:
Address:
5 Crichton’s Close, Edinburgh EH8 8DT
(off Holyrood ONLY by car,
off Canongate or Holyrood by foot/wheelchair)
Crichton’s Close runs between Canongate and Holyrood.
 
Trains:
If getting off the train at Waverley Station, exit at Market Street
(there are lifts). You cannot get a useful bus from Waverley Station.
 
At Market St, you can catch a taxi from the Taxi rank across the
street from the station exit. A Taxi must travel via Holyrood Road up
Gentle’s Entry, and will probably take no more than 5 minutes.
 
Or you can walk/wheel left up the gradual hill until you reach
Canongate. At Canongate, turn left and continue downhill until
you come to Crichton’s Close. Turn right, and the Scottish Poetry
Library will be on your left after a few moments of going downhill on
cobblestones. The entire walk/wheel should take 10-20 minutes.
 
Lothian Buses:
The 35 bus stops on Canongate, a short walk/
wheel downhill to the Library.
The 36 bus stops on Holyrood Road, a few minutes uphill.

63
 
Taxis and Drop-off:
It is not possible to drive from the Canongate into Crichton’s Close,
although taxis are usually willing to stop on the Canongate beside
Crichton’s Close to let passengers out. Taxis and other cars can also
drive up to the close from Holyrood Road: ask the driver to find the
Tun building or Henderson’s Restaurant on Holyrood Road, then turn
up Gentle’s Entry and turn right into Crichton’s Close.
 
Parking:
Crichton’s Close parking restrictions (double yellow lines)
do not allow parking at any time, although unloading is allowed.
 
Parking is available at the following carparks closest to SPL:
Waverley Station long stay carpark 
http://www.networkrail.co.uk/aspx/9494.aspx
St John’s Hill 
http://www.ncp.co.uk/car-park.html?cpid=800319&name=St%20Johns%20Hill

BUILDING AND EVENT ACCESS

(photos included following the text)
 
General Event Access
Films are captioned. Poems that are read or performed will also
be projected. There will be some audio description and there is a
separate quiet space.

Access for D/deaf patrons and others

There is a portable hearing loop which you can use when talking
to staff or for events. Please ask a member of staff. It is a Geemarc
LoopHear. BSL interpreting will be provided from 6:30pm by K.
Yvonne Strain and Catherine King.  
 

64
 Building entrance +
location of performance, toilets, bar and quiet space
Please be aware there is a steep slope up from Holyrood Road, and a
gentle slope down from Canongate. The Canongate access is blocked
to cars by a bollard. Cars can drop off visitors at the door of the library
by driving up Gentle’s Entry from Holyrood Road. Some landmarks
include: Henderson’s Restaurant on the corner of Gentle’s Entry,
Pizza Express, The Tun, and Hemma Bar.
 
You do not need to negotiate any steps to get into the library. There is
a push pad which can be used to open the front door.
 
The lift is located on the left past the information desk. It connects all
three levels of the building:
• ground floor, where the reception desk is situated, drinks by
donation will be served to the right at the back, and “The Space”
will be available as a quiet room
• mezzanine level, where the event will be held
• basement, where a gender neutral and wheelchair-accessible
toilet is situated next to the lift, with a second gender-neutral
toilet beside it, and there are secure offices where you can leave
valuables if necessary
 
The lift doors and toilet doors open to approximately 80cm wide.
The narrowest space to negotiate is on the mezzanine level – this is
approximately 76-78cm wide.
 
The toilet has transfer space on the left and assistance bars. It also has
a pull-down changing table. The sink is at a low level.

Additional information
Throughout the ground floor there are also several comfortable seats
and a sofa where you are welcome to chill out if you need.

Note: photos of the route to the venue and venue itself were also
provided.

65
Annex B:
Accessibility requirements
example questionnaire
Tick all that apply:

Accommodation
☐ A room with a door at least as wide as X
☐ A room with a door that opens out
☐ A room with a door that opens in
☐ A bed that an electric wheelchair can fit next to on both sides
☐ A bed that an electric wheelchair can fit next to on
☐ Left side
☐ Right side
☐ Either
☐ A bed that a manual wheelchair can fit next to on both sides
☐ A bed that a manual wheelchair can fit next to on
☐ Left side
☐ Right ride
☐ Either
☐ A room with two beds that are:
☐ Both double
☐ 1 double and 1 single
☐ either
☐ A room with an adjoining room
☐ A room with an emergency pull chord
☐ A room with a plug socket I can reach from a seated position
☐ A room as close as possible to the entrance/elevator
☐ A room that is NOT carpeted
☐ Corridors that are NOT carpeted
☐ A bathroom with grab rails on
☐ Both sides of the toilet
☐ The left side of the toilet
☐ The right side of the toilet
☐ Either side

66
 Accommodation (continued from the previous page)
☐ A toilet that an electric wheelchair can fit next to on
☐ Both sides
☐ The left side
☐ The right side
☐ Either side
☐ A toilet that a manual wheelchair can fit next to on
☐ Both sides
☐ The left side
☐ The right side
☐ Either side
☐ A toilet with an emergency pull cord
☐ A roll in shower
☐ A roll in shower with a shower chair
☐ A roll in shower with grab rails
☐ A step in shower
☐ A step in shower with a shower chair
☐ A step in shower with grab rails
☐ A shower over a bath with a shower chair
☐ A shower over a bath with grab rails
☐ A shower over a bath

Transport
☐ A taxi in which I can remain in my electric wheelchair
☐ A taxi in which I can remain in my manual wheelchair
☐ A taxi which can accommodate my electric wheelchair
☐ A taxi which can accommodate my manual wheelchair
☐ Public transport in which I can remain in my electric wheelchair
☐ Public transport in which I can remain in my manual wheelchair
☐ Public transport which can accommodate my electric wheelchair
☐ Public transport which can accommodate my manual wheelchair

67
Physical Access During Meeting
☐ Someone to take notes
☐ To use a recording device
☐ Someone to assist with materials, getting drinks etc.
☐ To be able to get up, move around and come and go

Sensory Access During Meeting

☐ A Palantypist (speech to text)
☐ Sign language interpretation (please specify language below)
☐ A hearing loop in meeting room
☐ No noise disturbance from traffic, air conditioning etc.
in meeting room
☐ Audio description of visual material
☐ Good quality lighting in meeting room
☐ Large print documents
☐ Documents in a particular font, colour etc. (please specify below)
☐ To have someone assist me in navigating the venue

Neurodiversity Access During Meeting

☐ A quiet space to be available throughout the day
☐ To be warned of any sudden sound/lighting change
☐ To be able to get up, move around and come and go
☐ To wear ear defenders or sunglasses
without comment or judgement
☐ To be able to make noises, tic etc. without comment or judgement
☐ Someone to explain or rephrase things if I don’t understand them

Other
You can list additional requirements not mentioned above in
the space below. You can also list any language or document
specifications you require.

68
Annex C: Expert meeting schedule
12:00 – 1. Staff will be around
Arrival and Lunch to assist participants
13:30 as required
13:30 –
Intro Session
14:30
1. British Sign Language
2. Information also
provided in writing
Welcome: • Working within
3. Invitation to use
• Introduce the team whole group
recording equipment
13:30 – • Housekeeping (approx. 15 people)
4. Invitation to move
• Plan for the meeting • Receiving verbal
13:45 around/come and go
• Objectives information
5. A quiet space available
6. No sudden lighting/
sound changes
7. Good quality lighting
As above, plus:
Our expertise:
• Each expert shares their
1. Input can be prepared
experience, what their • Working within
13:45 – in advance
particular areas of whole group
2. Input can be read out
14:10 interest are and what • Communicating
by someone else
they hope will be with whole group for
3. Input can be pre-
achieved during the • less than 5 minutes
recorded and played
meeting
back by participant
Group access agreement:
• Experts to decide
• Working within
together what they
whole group
14:10 – need form us/each
• Communicating As above
other/the space to
14:30 with the whole group
ensure they can
as and when you wish
participate fully.
14:30 –
Break
14:45
14:45 –
Intersections
16.00

69
 Adjustments
Session Day 1 Input and Access
Facilitation
Objective:
TGEU has adapted strategies used by D/deaf and disabled rights movements
to further equality and human rights for D/deaf and disabled trans people.

Our experiences
• Working within a small
• Decide whether the
group (3 or 4 people) 1. British Sign Language
list of experiences are
• Communicating your 2. Written information
generally had by people
views on the read aloud
because they are trans,
• question with the group 3. Invitation to use
because they are D/deaf
• One person within the recording equipment
and/or disabled, or if
14:.45 - small group 4. Invitation to move
they are experienced by
• inputting answers around/come and go
15:05 both trans and D/deaf
using on-line poll 5. A quiet space available
and disabled people
• tool 6. No sudden lighting/
• E.g. having people ask
(instructions provided) sound changes
questions of the person
• At least one person 7. Good quality lighting
with you instead of ask-
within the small group 8. Facilitator to input an-
ing them directly of you
explaining the choices swers on behalf
• Group feedback and
the group has made to of group
explain their decisions.
the whole group

• Working within a small 1. British Sign Language

group (3 or 4 people) 2. Written information
Oppression squared
• Communicating your read aloud
• Discuss which of the
views on the question 3. Invitation to use
experiences in the “both”
with the group recording equipment
15:05 – column impact D/deaf
• One person within the 4. Invitation to move
and disabled trans peo-
15:20 small group taking notes around/come and go
ple differently or more
on paper or laptop etc. 5. A quiet space available
severely than people
• At least one person 6. No sudden lighting/
who are trans OR D/
within the small group sound changes
deaf and disabled.
explaining the choices 7. Good quality lighting
the group has made to 8. Facilitator to take notes
the whole group for group

70
 Adjustments
Session Day 1 Input and Access
Facilitation
Modeling a movement
• List the various
strategies used by • Working within a small
D/deaf and disabled group (3 or 4 people)
rights movements to • Communicating your
advocate for equality views on the topic with
and human rights the group
• E.g. the social model • One person within the
15:20 – of disability small group taking notes
• Group feedback on on paper or laptop etc
16:00 As above.
the strategies they • At least one person
have identified within the small group
• Consider how the sharing the list with the
strategies all the groups whole group
have come up with • Communicating your
might be used by trans views on the second part
rights movements to of the exercise with the
similar effect whole group

71
10:30 –
Morning Session
11:30
Objective:
An increased number of D/deaf and disabled people are involved
in TGEU’s internal and external activities

• Listen to a series
of statements
• Respond to the
statement by placing 1. British Sign Language
yourself at some point 2. Statements also
on a line from totally provided in writing
agree to totally disagree 3. Invitation to place
• E.g. “I feel that my access yourself physically
Group check-in needs were met yester- on the line or to put
10:30 – • Feedback on yesterday, day” – if you totally agree down a card with
raise any issues or con- you would place yourself your name on
10:45 cerns, revisit the access at one end, if you totally 4. Facilitator to move
agreement disagree place yourself name cards around
at the other, and if some 5. Invitation to move
needs were met but not around/come and go
others place yourself 6. A quiet space available
somewhere in between. 7. No sudden lighting/
• Respond to questions sound changes
as to why you have 8. Good quality lighting
positioned yourself in
a particular place.

We did all this and • Working within a small 1. British Sign Language
they didn’t come! group (3 or 4 people) 2. Invitation to use record-
• List the barriers that • Communicating your ing equipment
D/deaf and disabled views on the topic with 3. Invitation to move
10:45 – trans people might have the group around/come and go
11:05 in trying to access trans/ • One person within the 4. A quiet space available
queer/lgbt organisations small group taking notes 5. No sudden lighting/
and activism on paper or laptop etc sound changes
• Pass your group’s list to • Passing the paper or lap- 6. Good quality lighting
another small group top etc to an other small 7. Facilitator to take notes
group as directed for group

72
 Adjustments
Session Day 2 Input and Access
Facilitation
• Working within a small
Reduce, reuse, recycle
group (3 or 4 people) 1. British Sign Language
• Propose ways in which
• Receive the “barriers” 2. Written information
the barriers you have
list from an other group read aloud
been given can be re-
• Communicate your sug- 3. Invitation to use record-
duced or overcome
gestions with the group ing equipment
11:05 – • Suggest ways in which
• One person within the 4. Invitation to move
D/deaf and disabled
11:30 small group taking notes around/come and go
trans people can be en-
on paper or laptop etc. 5. A quiet space available
couraged to engage with
• At least one person 6. No sudden lighting/
trans/queer/lgbt organi-
within the small group sound changes
sations and activism
sharing the proposals 7. Good quality lightin
• Group feedback sharing
and suggestions with the 8. Facilitator to take notes
their proposals
whole group for group

12:30 –
Break
12:45
Plan of Action
• Using the outputs from • Working with the 1. British Sign Language
the morning session whole group 2. Written information
create a draft action plan, • Reviewing the material read aloud
setting out the steps from the last exercise 3. Invitation to use record-
TGEU needs to take to • Communicate your ing equipment
make the organisation ideas with the group 4. Invitation to move
11:45 – more accessible to D/ • Discuss and work to around/come and go
12:45 deaf and disabled trans develop other partici- 5. A quiet space available
people and to increase pants’ ideas 6. No sudden lighting/
their engagement with • At least one person with- sound changes
the organisation in the group recording 7. Good quality lighting
the action plan either on 8. Facilitator to take notes
paper, laptop or audio for group
recorder

12:45 –
Lunch
14:00

73
 Adjustments
Session Day 2 Input and Access
Facilitation
14:00 –
Afternoon Session
15:00
Objective:
TGEU understands the equality and human rights issues disabled
trans people view as priorities for their advocacy work

1. Input can be prepared

in advance
Barrier map
• Working within a small 2. Input can be read out
• Recall a barrier to
group (3 or 4 people) by someone else
accessing your human
Sharing your experience 3. Input can be pre-
rights you have experi-
with the group recorded and played
enced due to being D/
• Each participant taking back by participant
deaf, disabled, trans, or
it in turns to identify the 4. British Sign Language
14:00 – both/all and identify;
elements described 5. Invitation to use
- the right you were
14:40 • At least one person recording equipment
trying to access
within the small group 6. Invitation to move
- the source of the
feeding back to the around/come and go
barrier e.g. central
whole group 7. A quiet space available
government, health
• Working with the 8. No sudden lighting/
care provider etc
facilitator to group sound changes
- the type of barrier
the experiences into 9. Good quality lightin
- the impact it had on you
categories 10. Facilitator to take
notes for group

14:40 –
Feedback to the whole group and map the various experiences
15:00
15:00 –
Break
15:15
1. British Sign Language
2. Invitation to use
recording equipment
Prioritise • Working with the whole 3. Invitation to move
From the map created group around/come and go
15:15 – decide which of the barri- • Sharing your views 4. A quiet space available
16:00 ers should be earmarked with other participants 5. No sudden lighting/
as priorities to be tackled • Working with the group sound changes
over the next two years to make decisions 6. Good quality lighting
7. Facilitator to take notes
for group

74
10:30 –
Morning Session
11:30
Objective:
TGEU understands the equality and human rights issues disabled
trans people view as priorities for their advocacy work
TGEU’s Advocacy
• A TGEU presentation • Working with the 1. British Sign Language
on the human rights whole group 2. Information also
advocacy priorities they • Receiving verbal provided in writing
are currently pursuing information 3. Invitation to use
10:30 – recording equipment
10:45 4. Invitation to move
around/come and go
5. A quiet space available
6. No sudden lighting/
sound changes
7. Good quality lighting
Advocating for our rights
• With reference to the • Working within a small 1. British Sign Language
priorities established group (3 or 4 people) 2. Written information
yesterday consider • Reviewing the material read aloud
whether or not TGEU from yesterday 3. Invitation to use
is currently working • Communicate your recording equipment
in these areas ideas with the group 4. Invitation to move
• Where the answer • Discuss and work around/come and go
10:45 – is yes – discuss how to develop other 5. A quiet space available
TGEU can better include participants’ ideas 6. No sudden lighting/
11:30 the concerns of disabled • One person within sound changes
trans people in that area the small group taking 7. Good quality lighting
of work notes on paper or 8. Facilitator to take
• Where the answer is no – laptop etc notes for group
discuss what TGEU has • At least one person
to do in order to start within the small group
work in that area sharing the ideas with
• Feedback to the whole group
whole group
11:30 –
Break
11:45
11:45 –
Closing Session
13:00

75
 Adjustments
Session Day 3 Input and Access
Facilitation
Forging alliances
• Make a list of the organ- • Working with the 1. British Sign Language
isations TGEU should whole group 2. Invitation to use
build links with in order • Sharing your views recording equipment
to take forward its D/ with other participants 3. Invitation to move
11:45 – deaf and disabled trans • Working with the group around/come and go
advocacy work to make decisions 4. A quiet space available
12:15 • Looking back at 5. No sudden lighting/
the action plan – sound changes
consider whether 6. Good quality lighting
anything needs to 7. Facilitator to take
be added to assist TGEU notes for group
in making such links
Round up
• The facilitator will close • Working with the whole 1. British Sign Language
the meeting, discuss group 2. Invitation to use
next steps, and invite • Receiving verbal recording equipment
participants to share information 3. Invitation to move
12:15 – their thoughts on their • Giving your views if around/come and go
experience over the you wish 4. A quiet space available
12:45 preceding days 5. No sudden lighting/
sound changes
6. Good quality lighting
7. Facilitator to take
notes for group

76
This report is the result of Transgender Europe’s “Expert
Meeting on D/deaf and Disabled Trans Experiences.”

It sets out the various challenges that D/deaf and

disabled trans people face in accessing their human rights
and discusses barriers that D/deaf and disabled trans
people experience in attempting to engage with LGBTIQ
organisations.

Finally it contains an extensive list of practical steps that

organisations can take to overcome or reduce these
barriers.

www.tgeu.org