Doing and being: my relationship with this work, and how it was done

Chapter two continues by covering the methodological details of the project, including an autoethnographic reflection. More broadly the chapter addresses how methods were chosen, adapted and executed, in addition to the management of ethics, rapport, recruitment and analysis.

Conclusion

The conclusion considers what systemic improvements may be made to queer communities and medical provisions, to allow the heterogeneity of non-binary identifying people to feel legitimised in their identities, and have equal access and experience of services. One of the most fundamental recommendations for medical practice that can be made is inspired by those communities that non-binary people expressed affinity with, such as bisexual and kink communities. Such spaces were sensitive and reflexive to gender plurality, and tended to construct language and space to be more fully inclusive. Gendered assumptions rooted in cisnormativity should be challenged within medical practice. Practices in gendered medicine may be similarly adjusted at the administrative level to improve preventative health screening for trans individuals. Much of this may be attained initially through the provision of training to both medical students and existent medical staff and administrators. This is followed by a critical reflection on gender affirming medical services, whereby the impact of a shift to an informed-consent focused model is considered. In order to optimise such recommendations, the limitations of this study and future necessary directions of enquiry are then addressed. This includes final methodological reflections and intersectional factors – such as the limited classed and racial diversity of the participants.

Reviewing non-binary: where have we come from?

Chapter one maps out the scholastic terrain relevant to a sociological consideration of non-binary gender identities. This is divided into three main areas. The first of these covers the relationship between gender diversity and medical practice, the second re-examines older sociological research which didn’t have the specific concept of non-binary, but acknowledged and engaged with people and identities (though often only implicitly) that challenged the gender binary. The third section covers interdisciplinary, 21st century recognition of non-binary people.

Non-binary times, non-binary places: communities and their intersections

This chapter draws attention to times and places that recur as sites of significance for non-binary people, and the negotiation of identity. It argues that the symbolic meaning ascribed to particular times and/or places will be fundamentally informed by the interactions had within them. The author uses time and space as concepts to collectively consider and connect aspects of lived experience through a sociological lens, rather than to specifically construct postmodern theory.

Introduction

The Introduction begins with a brief contextualisation of the significance of the topic of the book, and how recent cultural events (such as the social networking website Facebook introducing dozens of additional options for individuals’ gender identities aside from ‘male’ and ‘female’ in 2014) justifies exploration and recognition.

A strong motivation to tick the boxes: non-binary perceptions and experiences of gender identity clinics

Chapter six looks into gender affirming medical interventions, the vast majority of which occurred in the context of the NHS GICs (although some private practice and non-UK examples are also present). There exists a wide body of literature addressing access to medical services for gender transition. Whilst much of this literature was reviewed across chapters one and two, there is a significant lack of empirical sociological consideration of non-binary experiences of GICs, which this chapter addresses through attention to participant perceptions.

‘Not trans enough’: the relationship between non‑binary gender identities, uncertainty and legitimacy

Chapter three begins by outlining the project’s design, in order to ground the data in research practices, and introduce the participants and their demographics. The chapter then highlights a striking commonality amongst participants – insecurity in relation to gender. This could manifest as an internal uncertainty in being ‘trans enough’, or anxiety over not being seen as trans enough by other people. This chapter explores this phenomenon, whilst considering how hegemonic gendered expectations impact not only the ability to socially exert, but also the ability to internally formulate a non-binary gender identity.

Views of the clinic: non-binary perceptions and experiences of general healthcare services

Chapter five scrutinises accounts of primary care services for the most part (with some mention of secondary care), focusing on the experiences and views participants reported of interactions with doctors and other staff. Experiences are subdivided into ‘gendered medicine’ – healthcare which is differentiated in gendered terms, such as smear tests – and generalizable healthcare experiences, such as arm pain. The chapter also addresses how clerical administration in medical institutions may affect non-binary patients. This includes discussion of how names and pronouns are used and recorded, and medical forms specifically discussed by participants – including feedback forms and documentation related to tertiary care. Whilst this chapter is structured around primary care, the cross-practice nature of administration renders a general discussion that cuts across all forms of care appropriate. Discussion of the key administrative process of referral brings this chapter to a close.