Researching trans people: Ethics through method.
Trans people (sometimes referred to as transgender people) are those people who are not content to remain in the gender assigned at birth. If a person makes a transition to another gender, perhaps involving physical interventions such as hormones or surgeries, they may be referred to as a 'transsexual' person, although this is a medical term which is falling out of favour. More acceptably, if a person has made a transition to a male role they may be called a trans man or simply a man (in circumstances where their trans status is irrelevant), or if a person has made a transition to a female role they may be called a trans woman (or similarly, simply a woman). In contrast, some people may wear clothing not usually worn by their birth assigned gender (and possibly identify as another gender) for some periods of time and spend other times in their birth assigned gender. This may be for reasons of comfort or periodic identity. In this case, the person has sometimes been referred to as a 'dual role transvestite'; or if it is undertaken for reasons of sexual gratification, as a 'fetishistic transvestite' - although again these are medical terms which are not generally accepted by trans people and are given here only for [historical] information purposes. Within the broad rubric of trans are also those people who identify outside of the gender binary of male and female; whether because they have a fluid gender identity, a static gender identity which is not 100% male or 100% female, or perhaps because they do not believe in the very construct of a gender binary. This group of people often identifies as genderqueer, queer, or non-binary, whereas those people who identify as neither male nor female (rather than having aspects of both) may identify as neutrois, gender neutral, or agender. All of these people may come to the attention of people researching trans identities (1) in the widest sense.
Such a range of identities--intersecting as they do with sexuality, embodiment, and the nexus of philosophy, medicine, and lived experience--often appeal to researchers with perhaps no intent other than a fascination with the subject (e.g. The metric features of teeth in female-to-male transsexuals--Antoszewski, Zadzinska & Foczpanski, 2007). Research of this sort can often be undertaken skilfully (2) in that it adheres to all of the usual protocols--perhaps it has been through a university ethics committee and publishes power, effect size, confidence intervals and the like; or if from a qualitative tradition, it may be grounded in a philosophical epistemology and include explicit reflexivity However, such mechanisms often fail to take into account embedded power dynamics between researchers and participants and so may not be sufficient to ensure truly ethical research with marginalised people and communities (3) such as trans people (McNeil, Bailey, Ellis, Morton & Regan, 2012). This is especially the case as trans people's lives have historically been appropriated by researchers and used to buttress theories (e.g. Hakeem, 2006; for more on the problems with this see Green, 2008) or to progress the careers of researchers without making apparent the explicit benefit of that research to the participants or the groups they have been drawn from beyond the trope of 'giving a voice' (see below).
This discussion therefore considers these common pitfalls of research with trans people through examining: the benefits and costs of the philosophies commonly underpinning such research; the issues with researcher reflexivity which may fail to ensure ethical practice; and how the common notion of 'giving a voice' as the benefit of the research to participants consists of problematic power relations. It then goes on to suggest some ways in which these pitfalls may be avoided such that useful research may be undertaken which is ethically grounded throughout, rather than that which has been simply signed off by an ethics committee as having an ethically sound method of data collection.
One of the primary pitfalls facing the researcher into trans people's lives is that of the inherent power dynamic between the researcher and the researched (Hale, 1997). This remains the case even if the researcher identifies as trans themselves as the researcher's identity and personal philosophy may inflect their work, just as it likely will if the researcher is cisgender (4) (see Reflexivity below for more on this). One of the primary ways this power dynamic can express itself is in the positioning of the people being researched within a philosophical framework favoured by the researcher. This may happen for the nefarious purpose of furthering an argument, as when Hakeem (2006) positions trans identities within [his reading of] queer theory as a dissolution of the gender binary in order to obviate the prosaic realities of much trans lived experience as simply men or as women. Indeed, such a theory-driven stance (as opposed to that which is grounded primarily within the lived experience of participants) can serve to embed trans identities in some form of ontology or epistemology (from some academic-philosophical stance) or a taxonomy (perhaps from a medical-positivist stance) which, while coherent to the researcher, may be anathema to the participants or the communities which they are drawn from. This was the case in the imbroglio over Bailey's (2003) book The Man Who Would be Queen which appeared to be internally consistent with the theoretical position of autogynephilia Bailey was drawing upon, but which caused widespread offence amongst some of the participants and many trans communities for portraying transsexual women as being sexually motivated to transition when this was not their experience (Clarkson, 2008). Indeed, when researching historically marginalised groups such as trans people, researchers risk putting the cart before the horse and fitting trans people's lives into the philosophy utilised. This may happen in such a procrustean manner that the realities of those lives may be obscured in a way which holds the potential to do a violence to the people whose voices have been claimed by researchers for their own ends (Richards, Barker, Lenihan & Iantaffi, 2014). This is, of course, exploitative of those people's lives, as the researchers who utilise trans lives to buttress a theory will necessarily be doing a disservice to trans people who may become ensnared in the ensuing academic debates (e.g. Hird, 2002a & b; Wilton, 2002. See also Sanger, 2010; Richards & Lenihan, 2012).
Notwithstanding these issues, both for quantitative analysis and especially for qualitative studies, it is of course quite right and proper to have a philosophical foundation from which to work. Indeed, when faced with such a smorgasbord (5) of identity terms detailed in the introduction, as researchers we will need to reach for some theory in order to be standing somewhere and using something to interpret or describe the world we are investigating--lest we inadvertently find ourselves engaging in journalism. This theoretical ground may be the implicit reductionist logical positivism of quantitative analysis (cf. Field, 2009); the often continental philosophical stance of phenomenological human sciences research (cf. Husserl,  1983); or perhaps some other theoretical position such as postmodernism or queer theory.
Of course such explicit philosophical positions refer primarily to analysis and therefore the data (6) collection methods needed for that type of work. It is therefore in the analyses rather than the deductive interpretation of the data in the conclusion of the research (which is often somewhat aphilosophical in nature, although technically shouldn't be) that researchers may implicitly or explicitly draw upon discourses from philosophies to situate (or indeed buttress) their arguments. For example, a researcher who wishes to investigate trans people's sexuality could draw upon logical positivist philosophies to categorise trans people's sexuality and [coherently] look to such literatures, including medical literatures, for theoretical sources for the categories to investigate. These may lead the researcher to investigate the proportion of trans people, divided into male and female say, who are gay/lesbian, bisexual, or heterosexual. Assuming adequate N, cell numbers, and the like, one might imagine that a simple Chi-Square test would yield useful results. However, as my undergraduate lecturer used to comment: "Junk in, Junk out", for because the number of research categories necessarily has limits set by the researcher (drawing upon researched [logical positivist] literature), other sexualities such as asexuality, BDSM (7)/Kink, infantilism. etc., would be missed as they had been absent from the literature. To some extent this is one of the key components of the quantitative/qualitative debate as qualitative research shouldn't have this problem, drawing as it does on the lived experiences of the participants who wouldn't be bound by the research design detailed above. However for our purposes here it is enough to consider that it is the researcher, and crucially their [philosophical] grounding and assumptions, which are driving this outcome.
Qualitative researchers, however, are not inured from this theoretical bias in their work, and indeed may perhaps be more explicitly a part of the theoretical construction, and so possible co-option of trans people's voices and lives. It can be very difficult for qualitative researchers when the data doesn't match the theory, as in the examples from Hakeem (2006) and Bailey (2003) above, or more prosaically when the participant realities are at odds with the notion of research at all. In my own work (Richards, forthcoming 2016) I have had participants in phenomenological research speak at length about how flawed all language is at expressing the nuance and paradox of some trans experience--effectively taking a poststructuralist approach (Lyotard, 1984 ). Naturally this left me in something of a quandary as to how to analyse their speech from a phenomenological stance which necessarily infers that there is inherent meaning in language.
The ethics of both quantitative and qualitative research must therefore inhere in explicitly considering whether the philosophy underpinning the research, and not merely the analysis, likely matches that drawn upon by the participants (8) as otherwise it risks imposing meanings through leveraging the researcher's power via the weight of the academy. Of course there will be occasions when the science and the participant's worldviews are at loggerheads. There may be a need to take a different stance, for example, in considering the sexed anatomy of trans people (which is at odds with their identity) as a means to improve health outcomes--for example in a study on the prostate health of trans women (9). But such studies should be weighed for ethics beforehand as to whether the design possibly causing further offence or marginalisation is outweighed by the benefits to health or in some other area. This should be made clear to the participants beforehand, and may include the option for participants to check the report pre-publication on that basis. In studies where there is deception of the participants in terms of analysis, for example in cases where the findings may offend the participants, this benefit-to-marginalisation consideration and methodological efforts at mitigation should be undertaken by the ethics committee alongside the ethics of any deception in data gathering as is usually the case (BPS, 2010).
Researchers may argue of course that their intent is pure, that they really are using the appropriate philosophical foundation for their work. That their logical positivist study may have problems with sample bias and recruiting, but that it will improve sexual health outcomes for trans people; or that a queer theoretical approach really is reflective of the fluidity reported by the study's participants. But how is one to know? The university ethics committee is generally not charged with the task of determining fit between population, method and epistemology, and yet as it is here that harm may nonetheless occur I have argued that it is perhaps within the purview of the ethics committee to evaluate these things. However--notwithstanding this--one option is for the researcher to reflexively consider their own motives for undertaking the research, most crucially beforehand and with the intent of abandoning it if necessary, and also throughout and again at the key stage of inferring conclusions from the findings.
Reflexivity is defined as considering: "... my own thoughts, feelings, culture, environment and social and personal history..." (Etherington, 2004, p.32) and "examining personal... reactions" (Finlay & Gough, 2003, p. 16). This is key as, of course, we can influence outcomes through method as in the example above pertaining to categories of sexuality chosen for a Chi- Square analysis, or in terms of what data we deem to be an outlier and so exclude, etc. In qualitative research, even such rigorous methods as Grounded Theory offer scope for conscious or unwitting interpretation influenced by our biases and reactions. For trans people this may be a wish for others to share our experience which may blind us to the diversity of different lives; or cisgender people may similarly have biases, for example unresolved rage at the transition of a partner or friend, or the need to see trans people as very different in order to shore up their own gender identity. Both trans and cisgender people can also be drawn into a hero narrative wanting to 'help those poor people' or into wishing to be 'cool' (Richards & Barker, 2013). Reflexivity is, while not a panacea, a useful step towards ameliorating this. It allows us to be aware of our positioning and (if we are strong enough) likely biases in philosophical stance, methodology, analysis, and interpretation.
The issue, however, is with published reflexivity. Participants are generally anonymised and therefore [to some extent] protected in what they have contributed to the research, however, this protection is necessarily not extended to the researcher, whose explicit reflexivity becomes a matter of public record upon publication (Etherington, 2004). Thus the researcher is forced into taking a public [political] position relative to the matter in hand. For the heteronormative cisgender person investigating trans sexuality, for example, this is often simply a matter of disavowing direct association with the matter under consideration--giving a shrugged mea culpa if you will (cf Smith, 2013)--which at once excoriates and exonerates in that it suggests that there will inevitably be faults due to that personal distance from the subject, but that the heteronormative cisgender researcher cannot be to blame as they will inevitably incur these faults due to their [different, normative] identity. This done they may then continue with the business at hand content that they have 'Done Reflexivity'. Conversely cisgender researchers of good intent may be decried for not being able to understand, when in fact they can. The question arises as to what the motivation is to research trans people when one doesn't so identify and, as stated above, whether the costs outweigh the benefits for the participants and for trans people as a whole.
In contrast, non-heterosexual people and trans people (who may also be non-heterosexual of course) are placed in a different position in that they risk being accused of (and indeed enacting) bias from within the groups under consideration. The difficulty is that the mea culpa defence seems less open to these groups--perhaps because trans isn't a norm from which to operate, but is often seen as a Minority (10) or Other which is requiring of explanation, or indeed excuse (Hall, 1995; Shepherd & Sjoberg, 2012). Thus trans or non-heterosexual reflexivity risks turning the research into a confessional piece, even if the explicit reflexivity does not reflect that (Barker. 2006).
For both heteronormative cisgender and non-heteronormative trans researchers, who are also clinicians, there is also the risk that if their clients access published reflexivity that could adversely affect the therapeutic alliance before it can be established. This would mean that for those clinicians who practice in modalities which require a tabular rasa such as psychoanalysis, research would effectively be precluded; clinicians practicing from other modalities would risk their therapeutic alliance and clinical practice with each publication. This is perhaps ever more the case the further one moves from normativity--if a researcher wished to investigate infantilism (11), for example, it could pose grave difficulties for them to be explicitly reflexive about their own practice within the research. This would leave the academy in the uncomfortable and discriminatory position where only heteronormative cisgender people would be able to carry out research as only they could be generally able to be open about their gender and sexuality--although here I am skating over the bias heteronormative cisgender people may face from queer communities if they are open about their heteronormative cisgenderism. There is therefore an argument that researchers, whether normative or not, should be extremely cautious about explicit published reflexivity as otherwise only those people whose personal and economic situations allow them (such as those within private practice in niche communities and those senior academics protected by tenure) will be able to be explicitly reflexive and therefore able to undertake research.
What then is to be done, given that we have both expressed the need for reflexivity and also suggested that explicit published reflexivity is potentially discriminatory to people with non-normative genders and sexualities; and may also be damaging to therapeutic relationships? Perhaps one answer is for reflexivity to be undertaken with appropriate people--an academic supervisor or colleague as well as a therapist perhaps--preferably drawn from, or closely involved with, the group being researched. And that rather than the detail being published, instead the professionals involved would provide affidavits for publication stating that reflexivity has been undertaken. Of course this would not allow the reader to consider the interpretations of the researcher in the light of any published reflexivity--but given the difficulties outlined above, and given it requires an ongoing supported process with another professional, it may be the least worst option which actually increases the degree of real reflexivity which is undertaken by a researcher who is being encouraged in the endeavour by another professional and is not afraid of the negative consequences of their reflexive practice. Of course in order for this to be effective it would be necessary for ethics committees and journals to ask that all researchers undertake this method of reflexivity, otherwise those people with non-normative identities and practices would be identifiable though their mode of reflexivity
The benefits of research
Effective reflexivity will necessarily include examining the researcher's motivation to undertake the research. Of course most research will serve the researcher in some way--perhaps though academic career success, peer respect, funding, etc. It is to be hoped, however, that when researching marginalised groups these are secondary gains (cf. Goffman, 1961) with the primary benefit being to the participants or to the group(s) from which they are drawn. As stated above, one of the common benefits cited for participants and their groups of origin is that of 'giving a voice' (Dickinson, Cook, Playle & Hallett, 2012; Greenwell & Hough, 2008). However, this invites the questions: Who is doing the giving and by what right? And where are they facilitating the participants' voices to be heard?
The idea that as a researcher one is necessarily more powerful than the participants is, of course, generally true. However this is only within certain academic domains (12) and should not be an unexamined power. It may be examined reflexively or via ethics committees, but it can be uncomfortable for researchers to cede that power to become co-researchers or researcher-participants themselves (Langdridge, 2007). Nonetheless, as seen above, in whatever form the researcher-participant engagement takes, the researcher will necessarily have an impact on the data, and how the data is used, which should be recognised. In leveraging power to 'give a voice [to those less powerful]' care should be taken that researchers are not oblivious to the power of the participants by seeing power only through an academic lens. This is because participants may have power in other domains in which their voices are well heard--perhaps more so than the researcher's own. We can imagine a young researcher, for example who lives at home in the childhood bedroom of her parent's house and whose voice in that domain is consequently subdued. In contrast we might consider the older wealthy trans person who provides and cares for their partner and children--someone who might once have been called 'the head of the household' and consequently whose domestic voice is heard fully. In this circumstance (assuming the participant is not an academic) the researcher offers a route to a voice in an academic field only--the participant's voice is not lost in toto because of their trans status which causes them to be marginalised in an academic domain as they may have a powerful voice in the domestic or work arenas.
The researcher may choose to mitigate that marginalisation though publishing research (and so giving a voice) in an academic journal, however again this exercise of academic power should be considered. Who will read the journal and how will it therefore benefit the participants? There is a fantasy that research, especially that published in qualitative journals, is read by clinicians and policy makers when, in the main, it is not (Morrow-Bradley & Elliott, 1986; Rowland & Goss, 2000; Williams & Irving, 1999). Generally people read within their speciality--thus psychiatrists read psychiatric journals; surgeons, surgery journals; endocrinologists, endocrinology journals and so on. Clinical workloads simply don't allow for anything else. It behoves the researcher then, to consider who they are giving the participant's voice to and if it is people who will simply read with interest and then engage with academic debates which have no actual impact upon the participant's (or the groups they are drawn from) lives.
There is some benefit, however, in simply adding to the sum total of human knowledge and this, as above, should be weighed against the costs to the participants. I suggest, however, that one aspect that ethical researchers, and ethics committees considering research with marginalised groups, may consider is to ensure that there is a pragmatic benefit from the research. This may be a set of guidelines for clinical practice derived from the research which is checked by the participants, and clinicians, and is then disseminated in a format such that clinicians have ready access to it. Another example might be that the researcher sits on a local government committee which utilises the research to draft policy. In each case there is a real-world benefit to the participants, rather than the research being published and simply assumed to have had a life-impact as well as contributing to an impact factor.
Trans people then, may be marginalised in a number of domains and it consequently behoves ethical researchers not to inadvertently further this marginalisation through research practices. To this end a consideration of the philosophical basis of the research and whether it is likely to be at odds with participant understandings can be useful. Similarly a consideration as to the motivation of the researcher and a reflexive consideration of any bias one may be bringing to the research is useful, as is an examination of bias throughout the process, and especially when making inferences, interpretations, and deduction in the conclusions--and not merely beforehand and pertaining to data collection. One way of identifying such bias (aside from researcher reflexivity) may be to encourage participants to check work pre-publication. A quick heuristic for researchers uncomfortable with this notion is that much previous research which was unkind to participants has also proved to be factually wrong. Consider, for example, the notion of autism being caused by cold and distant mothers; schizophrenia being caused by disorganised mothers; and trans being caused by over-identification with a parent of a different gender from the trans person's birth assigned sex. All these ideas were rather unkind, and all have proven to be empirically false (see Baron-Cohen, 2008; Marcopulos & Kurtz, 2012; Zucker, 2008 respectively).
Kindness can also be key in considering the power of the research, who benefits from the research, and the practical benefits which should accrue for marginalised people who are being researched. Ideally trans people should be involved throughout and there are various guidelines detailing these sorts of advice which may be used or adapted when researching such areas (e.g. Hale, 1997; Barker, Richards, Jones, Bowes-Catton, Plowman & Yockney, 2012) as well as more general guidelines on the importance of impact (e.g. ESRC, 2016). Indeed, ethics committees may usefully consider such guidelines alongside the usual documents such the British Psychological Society's Code of human research ethics (BPS, 2010); The British Sociological Association's Statement of ethical practice for the British Sociological Association (BSA, 2002); and the Medical Research Council's Good research practice: Principles and guidelines (MRC, 2012). Additionally, researchers may usefully consider subtleties such as language use in calls for participants as well as write-ups and so avoid inadvertent micro-aggressions which are structural power inequalities that may be inadvertently embedded in the research process. This can be effected through careful thought alongside the groups being researched so as avoid the pitfalls which may curtail even the most humane researcher and, with such pitfalls avoided, will thus create research which aids the researcher, the academy, and most importantly the communities and people being researched.
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I would like to thank Dr Peter Martin for his wise guidance and compassionate council with regards to research and much else besides.
(1) Who may themselves be trans of course.
(2) Although this discussion concerns an expansion of the scope of that which is deemed skilful research such that it encompasses ethics more fully.
(3) I am cautious about using the term community singular as trans people are members of many different communities--younger, older, genderqueer, person with a trans history, etc. For this reason communities is preferred, however, as many trans people are not members of any trans communities the simple term people will also be used here (cf Richards & Barker, 2013; 2015).
(4) A cisgender person is a person who is content to remain the gender they were assigned at birth. (cf Harvey & McGeeny, forthcoming 2015)
(5) Or paella if your prefer--depending on whether your epistemology of trans allows for contiguous or discrete entities...
(6) Or participant contributions in qualitative analysis.
(7) Bondage and Discipline, Domination and Submission, Sadism and Masochism.
(8) Albeit that the participants are not necessarily explicitly expressing it as philosophy.
(9) For unfamiliar readers, Trans women who have had genital surgery will nonetheless retain their prostate which some may see as a 'male' body part.
(10) Note the capital.
(11) This is the practice of an adult identifying as a young child or baby for purposes of relaxation of sexuality. It is quite different from paedophilia in that it does not involve children, attraction to children, or coercion of any sort. (cf Richards & Barker, 2013)
(12) And not necessarily then, when researching academics.
Please Note: Illustration(s) are not available due to copyright restrictions.
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|Publication:||Journal of the International Network for Sexual Ethics and Politics|
|Date:||Jan 1, 2015|
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