Tackling COVID-19: Dr Emma Williamson

Dr Emma Williamson
Dr Emma Williamson

As part of the University of Bristol’s #BristolUniWomen campaign to mark International Women’s Day 2021, we’re spotlighting women from the School for Policy Studies who have been using their expertise to tackle the pandemic by carrying out world-class research. 

Dr Emma Williamson, a Reader in Gender Based Violence and former head of the Centre for Gender and Violence Research, has been working with Women’s Aid to highlight how the pandemic has affected those experiencing domestic violence. (more…)

Tackling COVID-19: Dinithi Wijedasa

Dinithi Wijedasa

As part of the University of Bristol’s #BristolUniWomen campaign to mark International Women’s Day 2021, we’re spotlighting women from the School for Policy Studies who have been using their expertise to tackle the pandemic by carrying out world-class research.  

Dinithi WijedasaSenior Lecturer at the Children and Families Research Centre is surveying the mental health of children in State Care in England through the COVID-19 pandemic. (more…)

Tackling COVID-19: Angeliki Papadaki

Dr Angeliki Papadaki

As part of the University of Bristol’s #BristolUniWomen campaign to mark International Women’s Day 2021, we’re spotlighting women from the School for Policy Studies who have been using their expertise to tackle the pandemic by carrying out world-class research.  

Dr Angeliki PapadakiSenior Lecturer in Nutrition, has been Exploring the experiences of community service providers delivering meals to self-isolating adults during COVID-19. (more…)

Tackling COVID-19: Karen West

Karen West

As part of the University of Bristol’s #BristolUniWomen campaign to mark International Women’s Day 2021, we’re spotlighting women from the School for Policy Studies who have been using their expertise to tackle the pandemic by carrying out world-class research.  

Karen West, Professor of Social Policy and Ageing, has been looking at the impact of the Covid-19 pandemic on bereavement in retirement communities. (more…)

The importance of self-identification for trans older adults in the UK

Authors: Dr Paul Willis (Head of the Centre for Research in Health and Social Care, School for Policy Studies, University of Bristol), Dr Christine Dobbs and Dr Elizabeth Evans (Centre for Innovative Ageing, Swansea University).

Recently The Sunday Times broke news that the UK Government would scrap proposals for legal reform to allow trans citizens to self-identify their gender. A consultation on proposed changes to the Gender Recognition Act 2004 in England and Wales (first proposed in 2016) included whether individuals should be given the right to self-define their gender rather than having to prove this through the current medicalised measures embedded in the 2004 Act. A response from the UK Government to the consultation is yet to be released publicly, although the story in The Sunday Times suggests a step away from this proposed action.

Importance of inclusive and gender-affirming environments
Running alongside this proposed U-turn in policy direction have been intensely debated concerns about the ‘threat’ that trans people, namely trans women, represent to single sex spaces for women. This is not the first time that trans individuals have been misrepresented in media press as a threat to the rights of others. Within the title and text of the article published in The Sunday Times the increased recognition and rights for one group (trans citizens) is presented as oppositional to the rights of others (in this case women seeking safe spaces in women-only facilities).

It’s as though we can’t talk about the extension of rights for one group without compromising important safeguards for another. It also secludes the material reality that some trans individuals will require access to safe women-only spaces and services when experiencing abusive relationships. The two groups are not mutually exclusive.

This comes at a time when trans citizens in the UK more than ever need safe, supportive and gender-affirming services. Findings from a recent national survey of 100,000+ LGBT citizens highlight socio-economic disparities between cisgender (individuals whose gender matches the sex assigned to them at birth) and trans respondents. For example, trans respondents were more likely to have left education after secondary school and to earn less, and were less likely to have had a paid job in the 12 months prior to the survey.

The findings bring acute attention to the safety concerns of trans citizens: over two thirds of trans respondents stated they avoided being open about their gender out of concern for negative responses from others. They reported higher rates of verbal, physical and sexual harassment and violence than cisgender respondents. In parallel, hate crimes perpetrated against trans citizens increased by 32% in England and Wales between 2016-17 and 2017-18. This represents crimes that are reported to the police so is likely to be an underestimate.

Trans ageing and care in later life
Trans individuals in mid to later life will be no strangers to debates about the extension or erosion of equal rights and recognition for trans citizens in the UK. They have lived through multiple decades of change to equality and human rights law and social and healthcare policy and provision. Older trans adults are frequently invisible in public discussions about legal and social reform and healthcare provision for trans citizens, with much greater attention being given to the needs and interests of children and adolescents. Receiving good, inclusive healthcare will become more of a priority for many trans adults having to manage multiple health conditions in later life or to those providing care to significant others experiencing health-related changes.

Our recently published paper brings attention to the ageing-related concerns and expectations of trans and gender non-confirming individuals in mid to later life. We report key findings from a research study into the health and social care needs of older trans people in Wales, UK. The study culminated in the creation of practice guidance for healthcare professionals and social workers and the production of four short digital stories. These stories capture the ageing experiences of trans individuals living in Wales and were produced by trans filmmakers Fox and Owl from MyGenderation.

In our new article we highlight the key turning points trans individuals experience in mid to later life that trigger decision-making about seeking to transition socially and medically. A central theme is the notion of ‘trans time’ and the ways in which trans individuals experience the passage of time as non-linear. For some individuals later life has been experienced as a new life-chapter and return to young adulthood, partly stemming from gaining access to gender-affirming and supportive healthcare services.

For others later life was overshadowed by a sense of running out of time as they experienced frequent delays and hurdles in seeking to transition through medical means. This was often a result of systemic problems with the provision of gender-affirmative healthcare services by public bodies in England and Wales. We are happy to report that since we completed the study a new Welsh Gender Service for adults has been launched by NHS Wales. We hope this leads to a much-improved service for Welsh residents. However, there is still much more to be done.

Being able to change gender legally without having to rely on medical diagnosis and treatment would make older age a much more positive experience for many trans individuals seeking to transition in later life. Less time and energy would be spent on having to navigate through a complicated healthcare system; this is particularly important for older individuals who have ongoing concerns about their health and wellbeing and want to experience older age as a new lease of life and receive full recognition for who they are. Older age is too often understood through a biomedical lens of physical and mental decline and impairment – the biomedical lens of old age can eclipse recognition of older people’s social identities, life-experiences and life-history. Untangling medical intervention from gender transitioning and legal recognition would be a step closer to a more positive ageing experience for many trans individuals. Finally, not all people taking part in our study sought to transition through medical means, further highlighting the importance of separating legal recognition from medical requirements.

Self-identification, dignity and maintaining autonomy are important dimensions to positive ageing for older adults; the proposed law reforms would help extend this for older trans individuals.

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Email: paul.willis@bristol.ac.uk

The paper is available to read online as open access: Willis, P., Raithby, M., Dobbs, C., Evans, E., & Bishop, J. (2020). ‘I’m going to live my life for me’: Trans ageing, care, and older trans and gender non-conforming adults’ expectations of and concerns for later life. Ageing and Society, 1-22. DOI: https://doi.org/10.1017/S0144686X20000604

Visit the Trans Ageing & Care website to view the digital stories and other resources. The study was funded by the Dunhill Medical Trust, 2016-2019 (Grant no. R416/ 0515). A summary of the study can be read here.

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Lockdown lunches

Written by Dr Laura Johnson and Dr Zoi Toumpakari

Family life has been transformed by lockdown. Since schools closed on 23rd March many families have had to create classrooms at home and juggle home-schooling with home working. But what has happened to school food at home? Are packed lunches still the norm or are family meals now the dish of the day?

Campaigners like the Food Foundation (@Food_Foundation) have already identified the most vulnerable children and are working hard to ensure that free-school meals are maintained for 18% of families with children eligible. Under half of these families have been given vouchers to buy food, another third has had food prepared for collection or delivery by schools, so provision, to some extent, has continued. But worryingly a third have not had anything. Furthermore, out of necessity food provided is often highly processed to ensure it lasts for a week or more at a time, suggesting that compared with food served in canteens, where school food standards apply, food quality may have dropped. But what about the other 82% families? Are meals worse across the board? Or is it possible that for many children lockdown lunches are a healthier option than the norm?

According to a YouGov poll in April, over half of households haven’t noticed a change in what they eat, but 1 in 3 have reported cooking from scratch more often; 1 in 5 think their diets are healthier since lockdown but 2 in 5 think they are eating more. Straw polls of families we know have reported diverse reactions. Some are more aware of what their children eat, have more control, are providing more fruit or eating meals as a family. Others have been fending off relentless biscuit requests (not always successfully). For some kids it’s meant a switch from cooked school dinners to more packed lunch type fare at home. But is that a problem? What do we know about school food pre-COVID19?

A review of studies up to 2007 comparing the nutritional quality of packed lunches to school dinners found that more energy, sugar, saturated fat and salt was in packed lunches. Back then both school dinners and packed lunches were pretty poor. However, school food standards have been in place in England since 2006 to raise the nutritional quality of food provided by schools. Around the world, as in England, the introduction of school food standards have generally improved the quality of meals provided in schools. Although intakes of vegetables and nutrients like fibre and iron still need attention, fruit intake is up, fat intakes are lower (especially saturated fat) and less salt is being consumed from school canteens.

Improvements in school-meals is great news, a real win for public health, but now the gap in the quality between school dinners and food brought from home has widened and the spotlight is firmly on packed lunches as a key area for action. Food from home still makes up 40% of meals eaten in UK schools. Recent times have seen small changes in how often sweets and how much sugary drinks are packed in lunches, but protein is lower and vegetables remain sparse, at just half a portion a day. Multiple interventions aiming to change packed lunch quality have been tested but with little success to date.

Our work on the National Diet and Nutrition Survey has used the detailed reports of what teenagers ate over 4 days to identify the key differences between meals at home vs. school. We found that most eating (two thirds) happens at home, and only 1 in 8 meals are consumed at school. Nearly 3 out of 4 school eating occasions included foods high in fat and sugar, compared with 2 out of 3 meals at home. We found that when eating at school, foods high in fat and sugar were not only eaten more often but also in larger amounts. We estimated that teenagers ate an extra 59 calories of foods high in fat and sugar in school-based meals compared with a similar meal at home, the equivalent of half a bag of Wotsits.

The kinds of foods high in fat and sugar eaten at school are similar to those eaten at home, including crisps and savoury snacks, biscuits, sugary drinks, cakes and chocolate. But there were some key differences between eating at home and school. Predictably, eating at school occurred primarily at lunchtime (about 50% of all eating) but it was also common in the morning too (40% of eating). In contrast, meals at home happen throughout the day, with around 50% occurring after 5pm (i.e. dinner time). Eating at school is more often with friends whereas at home eating is as likely to be alone (33%) as it is with family (39%).

We also went to talk with teenagers directly about what they thought influences their eating. For most teens, food choices when away from home are a result of many different factors working together. But they told us that they enjoyed eating most when they were with their friends, one said “I tend to prefer to eat at school because I’m with my friends and it’s more sociable really than with my family.”. Social drivers are clearly important. Therefore, creating social school environments that enable and actively promote healthy choices could be an element of achieving positive change in school food future. An interesting challenge in our new socially-distant world.

Many schools are opening up more widely today, what might the lifting of lockdown mean for children’s diets? Some schools, to prevent spreading the coronavirus, have banned packed lunches. In other schools, ensuring a safe school food service is a concern so packed lunches are mandated. Social distancing may limit the kind of interactions kids used to enjoy about lunch times at school, will that affect what they eat now? Times are changing fast, new normals are being created and this may be an opportunity, in the longer-term, to reset the system for the better.

About the authors

Written by Dr Laura Johnson and Dr Zoi Toumpakari, Centre for Exercise, Nutrition and Health Sciences in the School for Policy Studies at the University of Bristol. Dr Johnson is a member of the GENIUS network, funded by the UK prevention research partnership, which aims to build a community of school staff, policymakers, food providers and researchers to generate fresh insights into the challenge of ensuring healthy food in schools and reducing inequalities. Follow us in twitter @GeniusSFN