Moving Forward Sideways Like A Crab: A Summary
For this article I have chosen to use Shani Mootoo’s Moving Forward Sideways Like a Crab. I have selected this novel for its rich text that explores the dilemmas faced by a transgender person as they explore their own gender identity, digging deep into their intersectionality and commitment to starting life anew as a man. As the story unfolds, with the strategic use of contrast between life in Toronto as Sid and life in Trinidad as Sidney, elements of oppression that are unique to trans people are unveiled. The following article is divided into two-parts, in Part A, I will discuss themes of oppression that emerged from the text; how they relate to social work practice; and how, as a Social Worker, I would address these themes using anti-oppression
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practice. In Part B, I will discuss the implications of a social policy to the trans community and social work practice. Throughout the article I will use critical reflections to link theory and themes to my own experiences.
Part A - AOP Theory
In the following discussion I will examine the three levels of oppression in relation to Shani Mootoo’s novel. According to Bob Mullaly in the article Oppression: An Overview there are three levels of oppression, the personal, the cultural, and the structural (Mullaly, 2010). This model is referred to as the PCS model and is adopted by social workers in their client relations as an anti-oppression working model (Mullaly, 2010). Mr. Mullaly describes these levels as being, “in dynamic interaction with one another, with each level supporting, reinforcing, and influencing oppression on the other two levels and in turn being supported, reinforced, and influenced by the other two levels” (Mullaly, 2010). Within this section I will further explore the PCS model illustrated by the experiences of Mootoo’s characters, how this theory relates to social work practice, and how social work practice should address these themes using an anti-oppression approach.
Theory – The Three Levels of Oppression (Personal, Cultural, Structural):
The Personal Level. In relation to the trans community, oppression occurs on the personal level when an individual consciously makes negative hurtful remarks or actions against a trans person or asked overly personal questions out of context. The personal level is located within both the cultural and structural contexts of society (Mullaly, 2010). An example of this from Mootoo’s novel occurs in Trinidad, where Sidney recounts a conversation with Zain’s lover, Eric, during a lunch at a local yacht club. During a conversation with Sid about her exercise routine Eric admitted that he was leading the conversation in order to take the opportunity, “to ask what it was that turned a person into someone “like me”?” (2014, p. 62), referring to Sid’s masculine appearance. I find that this is a clear example of oppression on the personal level given that Eric was engaging in an inappropriate overly personal conversation where the context of their relationship did not invite or encourage it.
The Cultural Level. Privileged or dominant groups are able to maintain cultural levels of oppression through reinforcing their belief system as positive with the use of their norms, values and behaviours (Lee, 2015). This level of oppression is located within the structural context and reinforces both the personal and structural oppression (Mullaly, 2010). In referring to Mootoo’s novel, there is a reoccurring theme within India and Sid’s relationship that illustrates oppression on the cultural level with a contrast in the privilege each person experiences in their social status. In Mootoo’s novel Jonathan recounts a reoccurring argument between his mothers, Sid and India. In this argument Sid was trying to communicate to India that she felt as though India’s friends were not accepting of her because of her Trinidadian immigrant status (2014, p. 179). India’s retort was that she is an immigrant as well, to which Sid reasoned that while India is also an immigrant she is more accepted because she originates from Great Britain, “And the British, regardless of background, were to white Anglo Canadians always more authentic, more grand, than they” (2014, p. 179). According to Sid, as a result of this difference India had been treated significantly better than herself. For instance, at a party the attendants were all presented with tall crystal glasses of wine save for Sid who was served wine in a thick poor quality glass (2014, p. 180). Sid continued her comparison with, while India was treated like a literary genius and congratulated for being a mother, Sid was treated as India’s handmaiden instead of partner and as a nanny instead of as a mother or co-parent (2014, p. 180).
The Structural Level. Oppression at the structural level refers to the ways social institutions, laws, policies, social processes and practices, and the economic and political systems work together in favour of the dominant groups (Mullaly, 2010). It can also be found in education, the production and distribution of goods and services, public administration, and the delivery of social services (Mullaly, 2010). An example of this is found in Mootoo’s novel where the social institutions, laws, and policies did not recognize Sid and India’s same-sex relationship as a legitimate life and parenting partnership and illustrates the power a dominant group has over others. While terminating their relationship, India warns Sid to not to try to fight for child custody rights for Jonathan saying that, “as an immigrant, as a non-wage-earning person and, most importantly, as a person without her connections, I would, she assured me, lose in every way.” (2014, p. 13) For the love and strong connection she had for Jonathan, Sid did fight for custody but because of all the reasons she was warned of (2014, p. 13) and because of the lack in legal rights of same sex couples she lost (Civil Marriage Act, 2005). Up until 2005, when the Civil Marriage Act received royal accent, same sex couples did not have the same end-of-marriage and custody rights as heterosexual couples in Canada (Civil Marriage Act, 2005).
Relating Theory to Social Work Practice:
The Personal Level. Oppression on the personal level can be found in social work practice in the form of prejudice and differential treatment by workers towards their clients that result in blocking the clients’ access to systems, institutions, and organizations (Lee, 2015). In regard to the possible affects this could have on trans people, they could not receive needed treatment in a timely respectful manner, their access to funding could be restricted or denying, and their knowledge of or access to community support services could be restricted. Some trans people could also experience a high level of stress and fear of repercussions if their birth-assigned sex is discovered (Gamarel, Reisner, Laurenceau, Nemoto, Operario, 2014). The repercussions of being discovered can include termination of employment, loss of housing, loss of services, social isolation and other forms of discrimination, harassment and violence (Gamarel et al., 2014). This is type of oppression is reinforced systemically in that such crimes may not be taken seriously or dealt with appropriately by law and justice systems (Gamarel et al., 2014). In Mootoo’s novel there are several instances where Sydney recounts feeling fear of discovery and one very tragic event of violence. While in Trinidad spending time with her best friend Zain, there were a couple moments where, because of her fear for repercussions due to her masculine appearance, Sid had broadened the physical space between them (2014, p. 56) and refrained from consoling her friend while she was crying (2014, p. 57). Later in the novel, as Sydney, he recounts how he blames himself for the death of his best friend, who he suspects was murdered by her ex-lover after he found her sleeping next to Sid (2014, p. 69). Throughout the writing on Sid and Zain, the fear of violence as a repercussion for Sid’s masculine appearance as a female was at the forefront of story. To relate these issues to my future learnings in social work practice I refer to Sakamoto and Pitner’s article, Use Of Critical Consciousness In Anti-Oppressive Social Work Practice. In this article they discuss how there is a lack of AOP at the personal level and social workers should better address the needs and assets of their clients, challenge oppressive social structures, and engage in critical consciousness in order to challenge the power dynamics in the service-provider/service-user relationship (2005). I feel that further developing my skills as a social worker in the realm of critical consciousness will help me identify my own biases and prejudices so that I don't inadvertently block clients’ access to needed systems.
The Cultural Level. The media generally shows a misunderstanding of the issues faced by transsexuals (OHRC, 2012). There is often confusion of terminology used to describe individuals, i.e. not distinguishing between the issues of transsexuals, cross-dressers, etc. (OHRC, 2012). The result is that derogatory or sensationalistic language is frequently used when reporting on issues that are related to transgender issues (OHRC, 2012). In my learning of AOP social work practice so far, I find that it is essential for the worker to be conscious of their social location within interactions with their clients, in the terminology that they use in regard to specific populations, and in being sensitive to their clients’ cultural history and past experiences. I find that it is also essential for social workers to take their work beyond the client in order to educate their agencies and broader communities in trans issues in such a way that amends the erroneous messages sent by media.
The Structural Level.
Service delivery to the transgendered community is generally reported to be poor with hospital and healthcare workers demonstrating prejudicial attitudes once the birth assigned sex of the individual is discovered (OHRC, 2012). The International Gay and Lesbian Human Rights Commission (IGLHRC) frequently report on human rights violations against sexual minorities, including transgendered people. For instance, in June 1998 their newsletter reported the failure of ambulance personnel to assist a transvestite, Marcela, who had been stabbed and was left bleeding in the street for two hours until she died (OHRC, 2012). In social work practice, I find that it is essential that workers support transgendered people in their difficulties accessing shelters and other social service agencies and to coach them on how to maneuver the system so that they can meet their …show more content…
goals.
In reflecting on this theory and the experiences of the characters in Mootoo’s novel I thought back to evenings of going out dancing with family and friends (of the LGBT community and allies) in Toronto. There were way too many times when intoxicated Caucasian Anglo Canadian men uninvitingly engage themselves into our group, making negative comments, and attempting to escalate the interaction to violence. In these situations it was common for the bar owners (who were also Caucasian Anglo Canadian men) to ask my group to leave and treat us as though we were the instigators. In my perspective of this experience, all three levels of oppression clearly exist. On the personal and cultural levels, a dominant group engaged with a highly marginalized group of people with intensions of causing harm. They used their pprivilege to oppress another group of people and that behaviour was reinforced on a structural level by bar owners and treated as an acceptable social norm.
Anti-Oppression Approach in Social Work Practice
Anti-oppressive practice and working to lessen the impacts of oppression experienced by minority populations is an integral part of social work. Transsexual activist, Diana Courvant, from the Survivor Project suggests that to unlearn oppression of trans and intersex people on a personal level or undoing it on an institutional level is to build the trust that makes meaningful cross-community relationships possible (Courvant, 2015). In our practice as social workers I believe that we can engage in this approach by opening a dialogue with our peers about the stereotypes of trans people that exist; we can reach out to local trans or intersex organizations and invite them to be involved in our professional development strategies; and engage as allies in social movements related to trans issues in order to strengthen cross-community relationships. In reviewing this last paragraph it reminds me of our in-class interprofessional simulation project with Char. The role of my group was as social workers within a community organization. Each group needed to develop an intervention plan with Char, my group’s plan was very similar to the above. To me that means that if our group could imagine easily implementing such a plan into our pretend agency than it could also be easily accepted in real life agencies.
Part B – The Ontario Health Insurance Act and its Implications on the Trans Community and Social Work Practice
While there are many social policies related to the themes of this novel such as the Canadian Immigration Act and the Vital Statistics Act, I have chosen to explore the Ontario Health Insurance Act as it directly affects the quality of physical, mental, social and emotional well-being of members of the trans community.
I believe that social policies ensure both how well we are as well as how well we do. The Ontario Health Insurance Act (OHIA) governs the provincial health insurance policy (OHIP), which covers a wide range of services that are deemed by The Ministry of Health and Long-Term Care (MOHLTC) as medically necessary and ensures services are performed in accordance with accepted professional standards and practices (OHIA, 1990). Up until 1998, OHIP covered sex reassignment surgery (SRS), including reconstruction of genitalia and mastectomy, for individuals approved by the Gender Identity Clinic at the Clarke Institute of Psychiatry (now referred to as the Centre for Addiction and Mental Health) (OHIA, 1990). In October 1998, the OHIA was amended to remove SRS from the list of services covered by provincial health insurance (OHIA, 1990). The Ontario Human Rights Commission reported that the trans community viewed this decision as an oppressive action and interpreted it as though the government did not consider the issues of transgendered people as valid, significant, or important (OHRC, 2012). The MOHLTC did not only ignore the needs of the trans community but
also discounted arguments from opposition critics and qualified professionals that identified surgery as a medical necessity and that the consequences of not covering surgery would increase costs in other areas such as counseling and health care (OHRC, 2012). Finally, in June 2008 Regulation 552 of the OHIA was amended to add SRS as an insured service under OHIP (Hoskins, 2008). These decisions have had a profound impact on transgendered people who are a part of a highly marginalized community with often low-incomes, which means they lack the financial resources to pay for surgery. I find that it is valuable for Social Workers, working with individuals who were affected by the impact of the changes made to OHIP coverage, to understand that there could be an elevation of various mental health issues such as suicide and depression, as well as an increase in high-risk behaviours such as drug use and unsafe sex.
In connection to Mootoo’s novel, during a visit to Trinidad Sid was explaining the lengthy process of accessing SRS in Toronto and the psychiatric reviews required to determine that her mental health was compromised in order for OHIP to pay for the surgery (2014, p. 10). I find that her response to her friend’s angst was perfect, “that’s a shame, because there isn’t anything crazy about you.” While I read this it reminded me of conversations I have had over the years with family members, friends, and their partners who were trying their best to navigate the system to have their SRS covered. They were explaining to me how the system made them feel like something was wrong with them, that they felt insecure with themselves after each session with the psychologist, that the healthcare providers they encountered made them feel like they did not believe that they felt this surgery was necessary. I observed the difficulty people have in identify exactly why they feel that way especially since typically no one openly accuses them of anything or denies them of anything specific thing. I sensed a reoccurring element of frustration, of loss, of helplessness, and of depression and anxiety in each of the individual experiences. I find that in regard to trans issues there are deeply set elements of structural oppression embedded into the Canadian healthcare system. This type of oppression is further explored in Carroll, Gilroy, & Ryan’s article, Counselling Transgendered, Transsexual, And Gender, where they discuss how The American Psychiatric Associations designated the label of gender identity disorder (now known as gender dysphoria) to trans people (2002). This label further stigmatizes the trans population by allowing healthcare professionals space to further pathologize them, potentially limiting their access to resources, and growth within their own life course (Carroll, Gilroy & Ryan, 2002).
practice. In Part B, I will discuss the implications of a social policy to the trans community and social work practice. Throughout the article I will use critical reflections to link theory and themes to my own experiences.
Part A - AOP Theory
In the following discussion I will examine the three levels of oppression in relation to Shani Mootoo’s novel. According to Bob Mullaly in the article Oppression: An Overview there are three levels of oppression, the personal, the cultural, and the structural (Mullaly, 2010). This model is referred to as the PCS model and is adopted by social workers in their client relations as an anti-oppression working model (Mullaly, 2010). Mr. Mullaly describes these levels as being, “in dynamic interaction with one another, with each level supporting, reinforcing, and influencing oppression on the other two levels and in turn being supported, reinforced, and influenced by the other two levels” (Mullaly, 2010). Within this section I will further explore the PCS model illustrated by the experiences of Mootoo’s characters, how this theory relates to social work practice, and how social work practice should address these themes using an anti-oppression approach.
Theory – The Three Levels of Oppression (Personal, Cultural, Structural):
The Personal Level. In relation to the trans community, oppression occurs on the personal level when an individual consciously makes negative hurtful remarks or actions against a trans person or asked overly personal questions out of context. The personal level is located within both the cultural and structural contexts of society (Mullaly, 2010). An example of this from Mootoo’s novel occurs in Trinidad, where Sidney recounts a conversation with Zain’s lover, Eric, during a lunch at a local yacht club. During a conversation with Sid about her exercise routine Eric admitted that he was leading the conversation in order to take the opportunity, “to ask what it was that turned a person into someone “like me”?” (2014, p. 62), referring to Sid’s masculine appearance. I find that this is a clear example of oppression on the personal level given that Eric was engaging in an inappropriate overly personal conversation where the context of their relationship did not invite or encourage it.
The Cultural Level. Privileged or dominant groups are able to maintain cultural levels of oppression through reinforcing their belief system as positive with the use of their norms, values and behaviours (Lee, 2015). This level of oppression is located within the structural context and reinforces both the personal and structural oppression (Mullaly, 2010). In referring to Mootoo’s novel, there is a reoccurring theme within India and Sid’s relationship that illustrates oppression on the cultural level with a contrast in the privilege each person experiences in their social status. In Mootoo’s novel Jonathan recounts a reoccurring argument between his mothers, Sid and India. In this argument Sid was trying to communicate to India that she felt as though India’s friends were not accepting of her because of her Trinidadian immigrant status (2014, p. 179). India’s retort was that she is an immigrant as well, to which Sid reasoned that while India is also an immigrant she is more accepted because she originates from Great Britain, “And the British, regardless of background, were to white Anglo Canadians always more authentic, more grand, than they” (2014, p. 179). According to Sid, as a result of this difference India had been treated significantly better than herself. For instance, at a party the attendants were all presented with tall crystal glasses of wine save for Sid who was served wine in a thick poor quality glass (2014, p. 180). Sid continued her comparison with, while India was treated like a literary genius and congratulated for being a mother, Sid was treated as India’s handmaiden instead of partner and as a nanny instead of as a mother or co-parent (2014, p. 180).
The Structural Level. Oppression at the structural level refers to the ways social institutions, laws, policies, social processes and practices, and the economic and political systems work together in favour of the dominant groups (Mullaly, 2010). It can also be found in education, the production and distribution of goods and services, public administration, and the delivery of social services (Mullaly, 2010). An example of this is found in Mootoo’s novel where the social institutions, laws, and policies did not recognize Sid and India’s same-sex relationship as a legitimate life and parenting partnership and illustrates the power a dominant group has over others. While terminating their relationship, India warns Sid to not to try to fight for child custody rights for Jonathan saying that, “as an immigrant, as a non-wage-earning person and, most importantly, as a person without her connections, I would, she assured me, lose in every way.” (2014, p. 13) For the love and strong connection she had for Jonathan, Sid did fight for custody but because of all the reasons she was warned of (2014, p. 13) and because of the lack in legal rights of same sex couples she lost (Civil Marriage Act, 2005). Up until 2005, when the Civil Marriage Act received royal accent, same sex couples did not have the same end-of-marriage and custody rights as heterosexual couples in Canada (Civil Marriage Act, 2005).
Relating Theory to Social Work Practice:
The Personal Level. Oppression on the personal level can be found in social work practice in the form of prejudice and differential treatment by workers towards their clients that result in blocking the clients’ access to systems, institutions, and organizations (Lee, 2015). In regard to the possible affects this could have on trans people, they could not receive needed treatment in a timely respectful manner, their access to funding could be restricted or denying, and their knowledge of or access to community support services could be restricted. Some trans people could also experience a high level of stress and fear of repercussions if their birth-assigned sex is discovered (Gamarel, Reisner, Laurenceau, Nemoto, Operario, 2014). The repercussions of being discovered can include termination of employment, loss of housing, loss of services, social isolation and other forms of discrimination, harassment and violence (Gamarel et al., 2014). This is type of oppression is reinforced systemically in that such crimes may not be taken seriously or dealt with appropriately by law and justice systems (Gamarel et al., 2014). In Mootoo’s novel there are several instances where Sydney recounts feeling fear of discovery and one very tragic event of violence. While in Trinidad spending time with her best friend Zain, there were a couple moments where, because of her fear for repercussions due to her masculine appearance, Sid had broadened the physical space between them (2014, p. 56) and refrained from consoling her friend while she was crying (2014, p. 57). Later in the novel, as Sydney, he recounts how he blames himself for the death of his best friend, who he suspects was murdered by her ex-lover after he found her sleeping next to Sid (2014, p. 69). Throughout the writing on Sid and Zain, the fear of violence as a repercussion for Sid’s masculine appearance as a female was at the forefront of story. To relate these issues to my future learnings in social work practice I refer to Sakamoto and Pitner’s article, Use Of Critical Consciousness In Anti-Oppressive Social Work Practice. In this article they discuss how there is a lack of AOP at the personal level and social workers should better address the needs and assets of their clients, challenge oppressive social structures, and engage in critical consciousness in order to challenge the power dynamics in the service-provider/service-user relationship (2005). I feel that further developing my skills as a social worker in the realm of critical consciousness will help me identify my own biases and prejudices so that I don't inadvertently block clients’ access to needed systems.
The Cultural Level. The media generally shows a misunderstanding of the issues faced by transsexuals (OHRC, 2012). There is often confusion of terminology used to describe individuals, i.e. not distinguishing between the issues of transsexuals, cross-dressers, etc. (OHRC, 2012). The result is that derogatory or sensationalistic language is frequently used when reporting on issues that are related to transgender issues (OHRC, 2012). In my learning of AOP social work practice so far, I find that it is essential for the worker to be conscious of their social location within interactions with their clients, in the terminology that they use in regard to specific populations, and in being sensitive to their clients’ cultural history and past experiences. I find that it is also essential for social workers to take their work beyond the client in order to educate their agencies and broader communities in trans issues in such a way that amends the erroneous messages sent by media.
The Structural Level.
Service delivery to the transgendered community is generally reported to be poor with hospital and healthcare workers demonstrating prejudicial attitudes once the birth assigned sex of the individual is discovered (OHRC, 2012). The International Gay and Lesbian Human Rights Commission (IGLHRC) frequently report on human rights violations against sexual minorities, including transgendered people. For instance, in June 1998 their newsletter reported the failure of ambulance personnel to assist a transvestite, Marcela, who had been stabbed and was left bleeding in the street for two hours until she died (OHRC, 2012). In social work practice, I find that it is essential that workers support transgendered people in their difficulties accessing shelters and other social service agencies and to coach them on how to maneuver the system so that they can meet their …show more content…
goals.
In reflecting on this theory and the experiences of the characters in Mootoo’s novel I thought back to evenings of going out dancing with family and friends (of the LGBT community and allies) in Toronto. There were way too many times when intoxicated Caucasian Anglo Canadian men uninvitingly engage themselves into our group, making negative comments, and attempting to escalate the interaction to violence. In these situations it was common for the bar owners (who were also Caucasian Anglo Canadian men) to ask my group to leave and treat us as though we were the instigators. In my perspective of this experience, all three levels of oppression clearly exist. On the personal and cultural levels, a dominant group engaged with a highly marginalized group of people with intensions of causing harm. They used their pprivilege to oppress another group of people and that behaviour was reinforced on a structural level by bar owners and treated as an acceptable social norm.
Anti-Oppression Approach in Social Work Practice
Anti-oppressive practice and working to lessen the impacts of oppression experienced by minority populations is an integral part of social work. Transsexual activist, Diana Courvant, from the Survivor Project suggests that to unlearn oppression of trans and intersex people on a personal level or undoing it on an institutional level is to build the trust that makes meaningful cross-community relationships possible (Courvant, 2015). In our practice as social workers I believe that we can engage in this approach by opening a dialogue with our peers about the stereotypes of trans people that exist; we can reach out to local trans or intersex organizations and invite them to be involved in our professional development strategies; and engage as allies in social movements related to trans issues in order to strengthen cross-community relationships. In reviewing this last paragraph it reminds me of our in-class interprofessional simulation project with Char. The role of my group was as social workers within a community organization. Each group needed to develop an intervention plan with Char, my group’s plan was very similar to the above. To me that means that if our group could imagine easily implementing such a plan into our pretend agency than it could also be easily accepted in real life agencies.
Part B – The Ontario Health Insurance Act and its Implications on the Trans Community and Social Work Practice
While there are many social policies related to the themes of this novel such as the Canadian Immigration Act and the Vital Statistics Act, I have chosen to explore the Ontario Health Insurance Act as it directly affects the quality of physical, mental, social and emotional well-being of members of the trans community.
I believe that social policies ensure both how well we are as well as how well we do. The Ontario Health Insurance Act (OHIA) governs the provincial health insurance policy (OHIP), which covers a wide range of services that are deemed by The Ministry of Health and Long-Term Care (MOHLTC) as medically necessary and ensures services are performed in accordance with accepted professional standards and practices (OHIA, 1990). Up until 1998, OHIP covered sex reassignment surgery (SRS), including reconstruction of genitalia and mastectomy, for individuals approved by the Gender Identity Clinic at the Clarke Institute of Psychiatry (now referred to as the Centre for Addiction and Mental Health) (OHIA, 1990). In October 1998, the OHIA was amended to remove SRS from the list of services covered by provincial health insurance (OHIA, 1990). The Ontario Human Rights Commission reported that the trans community viewed this decision as an oppressive action and interpreted it as though the government did not consider the issues of transgendered people as valid, significant, or important (OHRC, 2012). The MOHLTC did not only ignore the needs of the trans community but
also discounted arguments from opposition critics and qualified professionals that identified surgery as a medical necessity and that the consequences of not covering surgery would increase costs in other areas such as counseling and health care (OHRC, 2012). Finally, in June 2008 Regulation 552 of the OHIA was amended to add SRS as an insured service under OHIP (Hoskins, 2008). These decisions have had a profound impact on transgendered people who are a part of a highly marginalized community with often low-incomes, which means they lack the financial resources to pay for surgery. I find that it is valuable for Social Workers, working with individuals who were affected by the impact of the changes made to OHIP coverage, to understand that there could be an elevation of various mental health issues such as suicide and depression, as well as an increase in high-risk behaviours such as drug use and unsafe sex.
In connection to Mootoo’s novel, during a visit to Trinidad Sid was explaining the lengthy process of accessing SRS in Toronto and the psychiatric reviews required to determine that her mental health was compromised in order for OHIP to pay for the surgery (2014, p. 10). I find that her response to her friend’s angst was perfect, “that’s a shame, because there isn’t anything crazy about you.” While I read this it reminded me of conversations I have had over the years with family members, friends, and their partners who were trying their best to navigate the system to have their SRS covered. They were explaining to me how the system made them feel like something was wrong with them, that they felt insecure with themselves after each session with the psychologist, that the healthcare providers they encountered made them feel like they did not believe that they felt this surgery was necessary. I observed the difficulty people have in identify exactly why they feel that way especially since typically no one openly accuses them of anything or denies them of anything specific thing. I sensed a reoccurring element of frustration, of loss, of helplessness, and of depression and anxiety in each of the individual experiences. I find that in regard to trans issues there are deeply set elements of structural oppression embedded into the Canadian healthcare system. This type of oppression is further explored in Carroll, Gilroy, & Ryan’s article, Counselling Transgendered, Transsexual, And Gender, where they discuss how The American Psychiatric Associations designated the label of gender identity disorder (now known as gender dysphoria) to trans people (2002). This label further stigmatizes the trans population by allowing healthcare professionals space to further pathologize them, potentially limiting their access to resources, and growth within their own life course (Carroll, Gilroy & Ryan, 2002).