Recognition and power: gender variance in international law

Recognition and power: gender variance in international law



by Sandra Duffy

Walking home with a friend a few nights ago, we fell into a conversation about monsters. My friend, Dr Nicola Moffat[1], had written her PhD thesis on representations of monsters in English literature. Pointing out that the word ‘monster’ derives from the same roots as ‘demonstrate’, she told me that the character that is called a monster is not so much in itself a negative force, but a signifier of something which cannot be understood and named. It is not for nothing that women, pregnancy, and babies are often involved in monster myths – forces misunderstood and even feared by the authors of literature and history becoming vilified and associated with the breakdown of order.

Now, I am not working on literature, on symbolism, or on anything quite so diverting. I’m an international human rights law researcher and I work on issues around gender and sexuality. My conversation with Nicola has remained fresh in my mind because over the course of my studies, I have come to think of law as existing somewhere between a language and a worldview. In many ways, identities legible to the law are conferred recognition and therefore power[2], while identities, lives, and bodies which the law does not comprehend tend to be marginalised and rendered alienated from society. The delegitimisation and demonising of states that cannot be easily understood seems to be as much a part of modern legal systems as it was to writers and artists making up the literary canon. The problem is not the groups being alienated. The problem is the forces which enable this alienation.

Gender recognition, law, and the sociopolitical question

My PhD research focuses on attitudes toward, and frameworks for, the legal recognition of gender variance in international human rights law. I study the manner in which the international human rights institutions, such as the United Nations Treaty Bodies and Special Procedures and the regional Courts of Human Rights, approach issues around gender identity and legal gender recognition. My work also includes case studies on the situation of gender-variant persons in Ireland and India, in order to demonstrate the effects of globalised human rights discourse on domestic legal systems.

What seems to be a straightforward question of law – can a person legally change the gender on their identity documents in this jurisdiction? – is in fact a sociopolitical question of much complexity, involving religion, history, social dynamics, and the relationship between postcolonial societies and the international community. This relationship is a reciprocal exchange of attitudes of permissiveness or repression, complicating the functioning of legal systems on both the national and the international levels.

Legal gender recognition is the facility offered to persons, whose inner and deeply-felt gender identity[3] does not correspond to the sex assigned to them at birth, to change the gender marker on their identity documents such as birth certificate, passport, or driver’s licence. The inability to perform such a change infringes on the individual’s right to autonomy and to free expression, forcing them into a position where they must either present documentation which does not correspond to their gender expression, or to refrain from presenting in the manner which most reflects their gender identity every time they must interact with social institutions.

In many jurisdictions, it is possible to have one’s documents changed via legal or administrative processes, albeit with conditions attached. In all but a handful of jurisdictions[4], the choices of gender marker available are solely the binary options of male or female. The legal gender recognition process also almost universally operates under a set of medical or legal gatekeeping procedures, which I will discuss in more detail below.

In referring to the population of persons with a gender identity incongruous with that which they were assigned at birth, I use the terms ‘gender-variant’ for an individual and ‘gender-diverse’ for a population. The term ‘gender non-conforming’ is also in use. Although in this jurisdiction the term ‘transgender’ is the one most commonly applied to the group, from a global view ‘transgender’ is a Western construct which may not correspond to the subtle categories of identities which can vary from culture to culture. Gender-variant, gender-nonconforming, and trans*/trans are terms which allow for the recognition of binary identified male or female persons; non-binary, third-gender, or genderqueer persons; and hijras, berdaches, fa’afafine, and other culturally specific forms of gender diversity.

Gender recognition in Ireland

In Ireland, gender recognition procedures are governed by the Gender Recognition Act 2015. This Act allows for adults to apply for the issuance of a Gender Recognition Certificate from the Office of the Registrar General granting them legal status in the correct gender. A minor aged sixteen or seventeen may make such an application with the consent of their parent or guardian. The application is made on a basis of self-declaration, meaning that there is no medical or psychological evaluation required to determine the person’s gender-variant status before qualification for a Certificate. This principle ranks Ireland among the most progressive European nations in the field of gender recognition[5], as most other Council of Europe members requires medical or psychological certification or intervention before a person’s gender marker can be changed.

The Act also requires that a review of the law be undertaken in 2017. Among the issues which will be raised this year are the lack of recognition for persons of non-binary gender identities, and the lack of facilities for persons under sixteen to apply for legal gender recognition.

The relative ease with which the GRA 2015 functions belies the two decade-long struggle to enact such a legislation in Ireland, which before the signing of the GRA 2015 had no facility for legal gender recognition in any form. A lengthy campaign of pressure and public-interest litigation from Dr Lydia Foy, along with a fortuitously timed decision of the European Court of Human Rights in Goodwin and I v United Kingdom[6], allowed for a the 2007 High Court decision in Foy v An t-Ard Chláraitheoir 2[7], wherein Mr Justice McKechnie held that the Irish government’s failure to allow Dr Foy to change her gender markers on documentation was incompatible with Ireland’s obligations under the European Convention on Human Rights. This ruling was the catalyst for the ensuing lobbying by the Transgender Equality Network Ireland (TENI) to ensure a strong and human rights-compliant legal gender recognition protocol for Ireland.

Gender recognition in international human rights law

Since the early 2000s, gender recognition has steadily been gaining status in mainstream international human rights law. The 2002 Goodwin and I decision was the first to find in favour of a transgender applicant in the European context, and sparked a series of legal reforms across the continent (including the UK’s Gender Recognition Act 2004). The emergence of gender identity as a concern of the United Nations human rights mechanisms began in 2006 with the Joint Statement on Human Rights Violations based on Sexual Orientation and Gender Identity before the Human Rights Council. In 2007, the signing of the non-binding but influential Yogyakarta Principles[8] marked the first declaration of the human rights of persons of diverse gender identities. Since then, the United Nations human rights bodies, such as the Human Rights Committee[9] and the Committee on the Elimination of Discrimination Against Women[10], have also begun to include the situation of gender-variant persons in their member states during their review procedures.

It is clear that legal gender recognition can confer many benefits on the potential applicant. Without identification documents in the gender corresponding to that in which a person is presenting, access to education, employment, and travel becomes increasingly limited. In order to cross a national border, apply for social benefits, or access healthcare services, they must ‘out’ themselves and risk facing a potentially hostile response. Although sometimes critiqued as conferring mostly formal equality on gender-variant persons[11], availability or lack thereof in relation to legal gender recognition has a marked effect on the substantive equality of the gender-variant individual in society.

Legal recognition also renders gender-variant persons more legible to the institutions of state and, in turn, to society at large. Owning a body which deviates from the normative gender standards imposed by society places the gender-variant person in a vulnerable position, making it more difficult to secure their status, health, and well-being. Western – by which I mean Euro-/Ameri-centric – societies and legal systems are built on binary understandings of gender. This choice of male or female maps gender directly onto sex, and includes a biological determinist viewpoint wherein the shape of one’s body must dictate how one’s mind conforms to societal gender norms. Theorists such as Butler have described how gender is not predicated on physical traits in this manner; it is a continual performance of acts and manners of expression, less something one is than something one does. Furthermore, the social construct of gender is complex enough that no person conforms perfectly to all expected gender norms at a given time. Logically followed through, this incomplete performance means that, as Butler states, “those permutations of gender which do not fit the binary are as much a part of gender as its most normative instance”[12].

Legal recognition and societal legitimacy

What impact does this have on legal systems? A system built on a binary lacks space for the grey areas of gender, the non-conforming permutations.  Recognition confers power; legal recognition confers status. The law is a system of power dynamics. It creates categories which become, themselves, constituent of identities. In many jurisdictions, for example, it is necessary for a person seeking legal gender recognition to produce medical certification of their gender variance. The requirements for certification can include confirmation that the person has undergone surgical intervention; references from a psychiatrist or psychologist that the person is suffering from “gender dysphoria”, or the medicalised formulation of gender non-conformity; or records of how long the person has been “living in their gender”. For many gender-variant persons, these can be difficult to obtain or mean that they must adjust their presentation or gender expression in order to comply.

Even though the object of these laws is to liberate gender-variant persons from repression, they often internally demand compliance with other norms. For example, in many instances where the law recognises the existence and legitimacy of binary-identified gender-variant persons, those identifying outside the binary, or presenting in a way which is not recognisable to the legal and medical gatekeepers regulating access to recognition find themselves in a difficult position. Lacking recognition by the law means lacking the protection of the law. Marginalised gender-variant persons are more likely to be the subject of discrimination, exclusion, and violence. There is a reciprocal relationship between legal recognition and societal legitimacy: the doors to societal acceptance often depend on one’s legal status, while legal status depends to a large extent on the views of society and lawmakers.

With this in mind, I find it necessary to problematise the human rights law system as it currently stands. To use a phrase gifted to me by the work of another friend, it is important to look at the “decisions of silence”[13] in the language used by law. The question which needs to be applied to emerging frameworks of legal gender recognition is not solely “which groups are being recognised by this law?”, but equally “which groups are not?”. In Ireland, despite our progressive legislation and the greater societal acceptance of the lives of gender-variant persons which have come with it, for the non-binary person seeking recognition it is as if the law has moved no further than it had before the signing of the 2015 Act.

The ‘T’ in ‘LGBT’ should not be silent

In another facet of this area of law which merits examination, there is a tendency for human rights law to refer to the issues concerning gender-variant persons and non-heterosexual persons as a monolithic category under the heading ‘LGBT issues’. This not only erases the spectrums of identity in those communities, but it risks assuming that the same reforms are needed by both. For example, it is often more pressing for gender-variant persons that healthcare be available on an equal basis than for non-heterosexual persons; equally, the right to marriage equality and to start a family is often very welcome to gender-variant persons, but there is still a fundamental lacuna in their recognition if they cannot obtain a correct set of identity documents. My research has shown that this is a persistent problem from the level of grassroots organisations right up to the international human rights bodies such as the United Nations Treaty Bodies and Special Procedures[14]. As many trans* activists state: the “T” in “LGBT” should not be silent.

I believe in law, written in a human rights-compliant manner, as a mechanism for social change. However, even with advances in the law, gender variance continues to be misunderstood by society. The scaremongering recently seen over the right of transgender persons to use the bathroom corresponding to their gender is evidence of this. Lawmakers in the United States have even introduced legislation banning transgender persons from using a bathroom other than the one which corresponds to the gender on their birth certificate[15], citing a fear for the safety of the cisgender persons also using that restroom.

This brings us back to my thoughts on my friend’s thesis about literary monsters and other various folk devils. Gender-variant persons suffer delegitimisation on many fronts: facing hostility from medical professionals, discrimination in the workplace, the threat of violence, a much higher incidence of socioeconomic disadvantage. Much of this comes down to the vision of the gender-nonconforming body and mind as Other, and the mistrust of that Other. Legal recognition is only one part of the process of demystifying gender variance.

Gender norms are a deeply inbuilt factor in society. They can be used as a form of control; as Foucault stated, ““the norm is something that can be applied both to a body one wishes to discipline and a population one wishes to regularise”. The gender-variant person sometimes seems to appear to lawmakers as an entity to be normalised, regulated, and by naming and recognised, understood. It is the task of human rights lawyers to challenge that viewpoint and to represent gender-variant persons as fully formed rights-bearing subjects; to listen to the voices of the community, and to litigate and legislate according to their wishes.

It would be wonderful to have a conversation about literature and not see in it the manner in which legislators and the public continue to pretend that Otherness is invisible or wrong. Unfortunately, we are not there yet. In the language of fiction, it is possible to represent unknowns by demonising and marginalising them. In the language of law, however, it is vital that we understand that the unknown quantities we discuss are people’s lives, livelihoods, and human rights. We have to challenge the viewpoint that any group of people should be alienated from their rights, and to stand for justice beyond the vagaries of popular opinion – particularly in these frightened and frightening times in which we find ourselves living.


[1] If you want to learn more, Dr Moffat blogs at and is @NicolaMoffat on Twitter.

[2] See Judith Butler, Gender Trouble (1990); Bodies That Matter (1994); Undoing Gender (2004).

[3] Transgender Equality Network Ireland have a full explanation of vocabulary and concepts used in discussion of gender diversity on their website at <;

[4] As of 2016, this number includes India, Pakistan, Nepal, Bangladesh, Australia, New Zealand, and Malta. View this on a map by Transgender Europe here: <;

[5] For a global survey on the requirements for gender recognition across jurisdictions, please see ILGA’s Trans Legal Mapping Report: Recognition Before the Law (2016; Chiam, Z., Duffy, S., and Gil, M.G.).

[6] Case 28957/95.

[7] [2007] IEHC 470.

[8] See <;

[9] First mention of gender recognition law came in the 2008 review of Ireland, at CCPR/C/IRL/CO/3; the Committee has made other observations such as in its 2011 review of Kuwait, on offences of “wearing the clothing of the other gender”, CCPR/C/KWT/CO/2, paragraph 30.

[10] For example, General Recommendation 33, on women’s access to justice; Concluding Observations from reviews such as that of the Netherlands, at CEDAW/C/NLD/CO/5.

[11] The work of transgender legal theorist Dean Spade problematises the system of gender classification in its entirety.

[12] Butler, Undoing Gender (2004).

[13] Another English literature scholar, Dr Maeve O’Brien, author of <;.

[14] See commentary on the UN at <;.

[15] The North Carolina Public Facilities Privacy and Security Act 2016, which applies to all government buildings, including educational institutions.


Monkeys, happiness, and winning debates

By: Lauren Robinson


Monkeys you say? Tell me more.
Jane Goddsfodall once asked me, “Was it you, was it you who put a monkey in the loo?!” If you’re wondering, no it was not. Thankfully she was referring to a poster rather than an actual monkey. Yet, I take it as a point of pride to have been asked and to be working in a field where I regularly get close enough to monkeys to have been slapped by one (truthfully
it’s more than that but I’ve lost count). It was my fault; I was observing the monkeys and how dare that require looking at them. Primatology, the study of nonhuman primates ckvsn(monkeys, chimpanzees, gorillas, etc.), is not for the faint of heart or slow of reflex. It’s a field I fell in love with (I mean look at the baby Sulawesi macaque on the right, it has a heart shaped bum!) during my Masters dissertation studying Japanese macaques (see: photo above of suckling infant).
There are a lot of different things about primates that I could study (having anecdotally and painfully observed their speed) and the area of primatology that I am most interested is primate welfare. What do I mean when I say “welfare”? Well, I use a very broad definition and define welfare as the mental and physical health of an animal. In order to study animal welfare, researchers, such as myself, use methods that cross between the fields of animal behaviour, psychology, and physiology, among others. We observe animals for unusual behaviours, assess them for increased stress levels, and look for signs of injury and illness. Animal welfare science is a growing field and, with pioneers such as Marian Dawkins (Dawkins, 1980) and Temple Grandin, it is one with multiple strong and well known female scientists to look up to.

Enough of that, let’s talk about me.

My research focuses on the individual animal, which is why I’m currently in a psychology department studying individual differences in animal personality. I take the approach that an animal’s welfare is an individual experience and we need to understand the individual differences associated with it, specifically personality. Most of us have a general idea of what personality is, especially when asked to list the traits we love or hate about other people.fvsdknv Over the last couple decades it has become more accepted to talk about animals having personality as well (Gosling, 2001). It’s rare that someone describes their dog as “consistently approaching unfamiliar people and animals in a nonaggressive manner”. Instead, they say their dog is friendly and sociable. In the case of my dog Juneau (left), we describe her as eccentric and too clever for her own good. While some scientists may be on the fence about animal personality my experience has been that the public isn’t, they get it and they believe that animals have it. In order to understand primate welfare I look for the personality differences that influence it, which is the focus of my research. I want to know if certain personality traits make animals more likely to be do well in captivity, in the same way that people with certain personality traits do better in life. For example, more extraverted and sociable people tend to be healthier and happier (Costa & McCrae, 1980; Deary, Weiss, & Batty, 2010).

I started as PhD student at the University of Edinburgh in 2013 working with Dr Alex Weiss. Alex and I have different scientific backgrounds and naturally, we disagree on some things. Key among the disagreements we’ve had over the years is the difference between welfare and happiness in animals. Alex felt that if an animal had everything it needed in captivity (safety, food, companionship, good physical health) then it had high welfare. He noted then even when animals have all these things they can be unhappy, which to him meant that happiness and welfare did not necessarily go together for animals. Alex based this on the observation that some people appear to have everything they could want for (money, friends, shelter) but aren’t happy. I felt differently. As I said earlier, I take the approach that an animal’s welfare is an individual experience. Therefore, if the animal appears to have everything it needs but is still unhappy then, by definition, that animal has reduced welfare. How to find out who is right though? To the Batcave! Yeah, sadly not. Instead it was off to Google Scholar to research and come up with a way of testing my hypothesis that primate happiness and welfare were one and the same.skndcs

What I found was a great article by Franklin McMillan (2005), who says that there are five main things that influence an animal’s welfare: mental stimulation, physical health, stress, social relationships, and control of physical and social environment. When psychologists look at human happiness they typically use questionnaires (Sandvik, Diener, & Seidlitz, 1993) and there is a questionnaire to measure primate happiness (King & Landau, 2003) but animal welfare scientists don’t typically use questionnaires as there are concerns about the accuracy of ratings.
This hasn’t been well studied though so I took McMillan’s five things and created a questionnaire for staff familiar with animals to fill out. To test if it worked I took my welfare questionnaire and the primate happiness questionnaire and sent them out to zoos and research facilities.


Well, you win the debate or not?

Currently, I’m working on finishing my PhD (send whisky for my woes) and have used the questionnaires to study welfare and happiness in three species: Brown capuchins, chimpanzees, and rhesus macaques. First thing I found was that staff familiar with the animals I studied were really good at rating animal welfare. They agreed to the same degree that people do when they rate their friends and family member’s personality. The next thing I found, much to my own happiness, was that welfare and happiness are really one and the same in those three species (I won!). Three species and some pretty compelling results (Robinson et al., 2016; in review; in prep) were convincing enough to get my supervisor to rethink his opinion on happiness and welfare. Did you catch that? The PhD student actually won one! Sure, Alex has taught me a billion things to this one thing I taught him, but I will take it.

So, what about personality and welfare? Personality does influence primate welfare, similar to what we see in people. Animals with certain personality traits have higher happiness and welfare. The brown capuchins that were more sociable, assertive, attentive, and more emotionally stable were those that had higher happiness and welfare. For chimpanzees, seems to be about extraversion and emotional stability. Rhesus macaques, it’s all about confidence; those with more confident personalities had higher welfare and happiness. It’s my hope that now we know more about welfare, happiness, and personality we can use this information to improve the lives of animals. This could be done by using the questionnaire as another tool for measuring animal welfare or by trying to provide more care for animals with personality traits that tend to be related to unhappiness.

Upon reflection…

bfkjdfWhile my research results are better than I could have hoped for the best part of this research were the experiences I gained along the way. As I get to the end of my PhD, and this post, I’m starting to put thesis together and I’m all about reflection about my past three years (when I’m not panicking about the next three). I’ve gotten to study three species of primates, worked in zoos and research facilities (many of you will have thoughts on animals in research, I get that but don’t have room to get into that topic without a separate post), and collaborated with tons of amazing researchers. All of that is fantastic but let’s be honest, the monkeys are the best part.

You may be wondering what monkeys are like. I’ve worked directly with over 100 macaques and there is no doubt in my mind that each one is an individual with very different personality. Some are funny, some are playful, some are grumpy, and plenty are aggressive (learned that the hard way). While I hope that I’ve piqued your interest in primates, their amazing personalities, and their welfare I would be remiss if I didn’t state that primate are not pets (see resources below). I know I’ve spoken of my passion for working with primates but only in professional manner and environment and I never treat them as less than they are, which is wild animals. Primates are far too clever and socially complex to be kept as pets. Anyone that tells you otherwise is flat out wrong. No exceptions to the rule, no anecdotes, no to primates as pets.

Having said my warning, I will finish by acknowledging that while there are a lot of words to describe what I do (science, animal welfare, primatology) the one that always stands out to me is ‘privileged’. Working with primates is a privilege. Studying and working to improve their welfare is the best way I know to show my appreciation of that privilege.

If you’re interested in learning more about primate welfare, there are some public engagement resources that I’m a big fan of:

NC3Rs macaque page

Online tour of German Primate Center

Why monkeys shouldn’t be pets

Animal welfare legislation resources

Costa, P. T., & McCrae, R. R. (1980). Influence of extraversion and neuroticism on subjective well-being: happy and unhappy people. Journal of Personality and Social Psychology, 38(4), 668–678.

Dawkins, M. S. (1980). Animal suffering: The science of animal welfare. Ethology (Vol. 114). New York: Chapman and Hall.

Deary, I. J., Weiss, A., & Batty, G. D. (2010). Intelligence and Personality as Predictors of Illness and Death: How Researchers in Differential Psychology and Chronic Disease Epidemiology Are Collaborating to Understand and Address Health Inequalities. Psychological Science in the Public Interest.

Gosling, S. D. (2001). From mice to men: What can we learn about personality from animal research? Psychological Bulletin, 127(1), 45–86.

King, J. E., & Landau, V. I. (2003). Can chimpanzee (Pan troglodytes) happiness be estimated by human raters? Journal of Research in Personality, 37(1), 1–15.

McMillan, F. (2005). Mental wellness: The concept of quality of life in animals. In Mental Health and Well-Being in Animals.

Robinson, L. M., Waran, N. K., Leach, M. C., Morton, F. B., Paukner, A., Lonsdorf, E., Handel, I., Wilson V. A. D., Morton, F. B., Brosnan, S., & Weiss, A. (2016). Happiness is positive welfare in brown capuchins (Sapajus apella). Applied Animal Behaviour Science, 181, 145-151.

Robinson, L. M., Altschul, D., Wallace, E. K., Ubeda, Y., Machanda, Z., Slocombe, K. E., Llorente, M., Leach, M. C., Waran, N. K., & Weiss, A. (In press). Chimpanzees with positive welfare are happier, extraverted, and emotionally stable. Applied Animal Behaviour Science. 10.1016/j.applanim.2017.02.008.

Robinson, L. M., Capitanio, J. P., Leach, M. C., Waran, N. K., & Weiss, A. (In prep). The influence of personality on rhesus macaque health, welfare, and happiness.

Sandvik, E., Diener, E., & Seidlitz, L. (1993). Subjective Well-Being – the Convergence and Stability of Self-Report and Non-Self-Report Measures. Journal of Personality, 61(3), 318–342.


Improving future asthma care

L0040548 Flyer and advert for "Potter's Asthma Cure"

5.4 million people in the UK have asthma, and every ten seconds, someone in the UK has a potentially life-threatening asthma attack. On average, three people a day die from an asthma attack in the UK – in 2014 (the most recent data available), 1216 people died from asthma. Many of these deaths are preventable, and continued use of asthma medication is an important factor in this (Asthma UK, 2017). But many people don’t stick to their asthma medication routines. Kathy Hetherington writes about her research into a new method of asthma treatment which is significantly reducing the risks associated with severe asthma.

My PhD investigates patient’s response to inhaled steroids using novel monitoring technology. I have spent the past year coordinating this project throughout the UK, within the Refractory Asthma Stratification Programme-UK, (RASP-UK). I work alongside Professor Liam Heaney and Professor Judy Bradley in Queen’s University, and Professor Richard Costello in the Royal College of Surgeons Ireland. As a young researcher in Northern Ireland I am excited in the knowledge that my PhD has the potential to improve future asthma care.

The Problem

Many asthmatics do not use their inhalers correctly. As a result, they don’t receive their prescribed dosage of inhaled steroid. Within Queen’s University Belfast and the Belfast City Hospital, we have developed and implemented a new method of observing and monitoring how patients use their inhalers. This revelation is significantly reducing the risks associated with severe asthma.

In RASP-UK severe asthma centres we record Fractional exhaled Nitric Oxide (FeNO), which is a measure of lung inflammation. An elevated FeNO is a predictor of worsening asthma symptoms or even an asthma attack. Those who continue to have an elevated FeNO are usually considered high-risk patients who need daily oral steroids alongside their inhalers. This elevated FeNO could be due to steroid resistance, or not continuing to use their inhaler (this is known as non-adherence). Determining inhaled steroid response in a difficult asthma population is a major problem in a clinical setting.

The Intervention

Within RASP-UK, we have established and further validated a clinical test using daily FeNO measurements (using a Niox Vero machine – Figure 2) alongside some additional inhaled steroid. The remote monitoring technology we use alongside this test is called an INCA™ (INhaled Compliance Aid) device. The INCA™ (Figure 1) was developed by Professor Richard Costello in conjunction with Vitalograph and is designed to work with the diskus inhaler. The INCA™ device records a time and date when the microphone inside it is activated, and records a sound file of the inhaler being used; these sound files can then be transferred to a computer. The sound files are then uploaded onto a server via a data compression utility programme where it is analysed by an automated and validated sound analysis algorithm. This combination allows us to create a remote assessment of inhaled steroid response and thus identify non-adherence to inhalers. We then communicate this information to the patients to try and improve their adherence to their inhaled treatment.

With further development, we created a web-based interface (Figure 3) to deploy FeNO suppression testing across the UK though our established RASP-UK Severe Asthma Centres. Here, we examined the utility of FeNO suppression testing to predict inhaled steroid responsiveness after a further 30 days on a normal inhaler. This period of prolonged monitoring provides further feedback on patient inhaler use and technique, using the unique presentation method below, enabling us to identify facilitators and barriers which may be involved in optimising inhaler adherence. We are constantly increasing the precision and user-friendliness of this hardware and software so that the data is easily interpreted and demonstrated to the patient.


Figure 3 Data from the Vitalograph server following upload of one week FeNO suppression data and INCA™. The Vitalograph server shows activation and usage of both FeNO machine and INCA™ device (A) and depicts the FeNO data as precentage change from baseline as originally described (y1-aixs figure A).  The INCA™ device time and date stamps the number of inhaler uses (y2-axis – Figure A) and this is shown alongside technique analysis (B). Possible technique errors which can be identified and reported are shown in Graphic 3.


The Future

Though we are only a year into our project, 250 patients in severe asthma centres throughout the UK have carried out FeNO suppression testing. Many have gone on to improve their inhaler usage and asthma control and decrease the inflammation in their lungs. We have presented our UK multi-centre data at conferences all over the world and interest in our project is increasing. In the past 6 months I have had the privilege of being a key note speaker at Severe Asthma Masterclasses and Specialist Asthma Meetings. This summer I have been invited as a symposium speaker at the European Academy of Allergy & Clinical Immunology in Helsinki, Finland which will undoubtedly be the highlight of my career to date!

My PhD has given me the opportunity to be able to work with a wide range of fantastic professors, clinicians, patients and co-ordinators. This PhD has convinced me that we can use this unique test and methods of presentation to improve asthma care throughout the world. I can’t express how much this thought excites and drives me; it is with great humility and privilege that I will continue to contribute to this extraordinary field.

This IS ‘proper’ research: Taking on the social science vs. science debate

By: Rosie Smith 

“So why is your research necessary?”

“How do you get funding for research like this?”

These are just two of the many questions that I was asked recently whilst taking part in a competition for PhD researchers at my university. The competition was interdisciplinary and was aimed at showcasing doctoral research at the institution, whilst also providing early career researchers, like myself, a gateway into public engagement. Needless to say the competition was one of the many uncomfortable things I intend to do this year as part of my resolution to be a ‘yes’ woman and challenge myself more.

Finalists were made up of three researchers per faculty (social science, science, arts and humanities), and as a criminologist I quickly found myself gravitating towards the social sciences camp. It was a full day event in which we were judged on a multitude of criteria ranging from originality, impact, accessibility, interdisciplinary scope, and importance. I use the word ‘importance’ hesitantly, as it’s a term that causes particular anxiety when I consider my own research. My work explores the concept of ‘spectacular justice’ and the way the mass media makes the criminal justice system visible and public. I explore this concept by analysing how high profile criminal cases are represented in media archives from the 1800s to 2016.



And whilst I thoroughly enjoy my research, I still often find it difficult to have confidence that my work is ‘important’, and necessary. In part this is because I am self-funding my research, and at times I find it difficult to have confidence in my work when understandings of ‘good’ research are so closely bound to notions of impact and attracting funding. But it is also in part because of situations like these, when I am forced to contemplate the debate around what constitutes ‘proper’ research.

When I was posed these questions, I admit, I was initially shocked and somewhat taken aback by the abruptness with which they were posed. But at the same time these questions draw on some of the existing anxieties I have as I begin the journey into academia. To me, these questions in some way breach the social conventions on conversation etiquette, not to mention conventions on what is and is not okay to ask a frazzled and distressed PhD student.

To the first, I was honest, and launched into the toils of juggling several part-time jobs alongside trying to develop the aura of a rounded and successful academic.

But it was the question “Why is your research necessary?” that caused me more concern. Looking around the room at the other contestants I began to question whether this question had been asked of the other finalists, in particular the natural, computer, and the physical scientists.

I was transported back to the long debates I had as an undergraduate with my ‘proper’ scientist friends. In these debates I would spend hours defending the position that social science is important and necessary, and that the two disciplines can exist in parallel.

I would passionately defend the position that the relationship between the two does not need to be one of comparison. Admittedly, my efforts to convert them were largely fruitless. And I was often left being endearingly mocked, only to be told that “but it’s not a real science though is it?” And unfortunately this is still a plight I am fighting as I embark through my PhD.

It is as if this debate is a matter of either or. You are either a social scientist or a scientist, with very little scope to dabble somewhere in the middle. This was only confirmed as the day progressed. I overheard the finalist next to me ask a gentleman, “Are you going to go to Rosie’s stand next?” To which the gentleman replied, “I don’t think so, I don’t like social science, I’m a more of a scientist”.


Needless to say I tried my best to convince him of the merits of the dark underbelly of the social sciences, but was left wondering why I had to.

I cannot escape the importance of gender to this debate. Despite being interdisciplinary, the competition finalists were overwhelmingly female, with male colleagues only being represented by the science faculty.

Needless to say there are a large number of male social scientists who contribute greatly to the field, but historically the social sciences have been regarded as a ‘feminine’ discipline.

This is supported by statistics on the relationship between gender and higher education degree choices: in 2016, 17,075 men accepted university offers to study a social science subject in the UK, which amounts to just over half the figure for women which totalled at 30,860 (UCAS, 2016). And so I interpreted the questions “why is your research necessary?” and “how do you get funding for research like this?” not only as a judgment on the value of my research, but a value judgment more generally about the credibility of the social sciences as a predominantly female discipline. I couldn’t ignore the feeling that the feminization of the social sciences served as a double mechanism to justify the position of the sciences as superior.

At times I worry that as a social scientist, the rivalry that exists with science, whilst often only in jest or antics, has a direct impact on understandings of what constitutes ‘proper’ research.

And I question the appropriateness of using one set of criteria to judge and compare the value and ‘necessity’ of the two disciplines. In my opinion they are complimentary rather than contradictory fields. And we should be striving to broaden our understanding of what constitutes ‘proper’ research. Because although my research does not find a solution to world hunger or fight disease, it does have value- just in its own way.

At the end of the day the judges seemed to recognise some of that value too. When the scores came in, I won! It was one of the proudest moments of my Phd so far, as a social scientist, as an early career researcher, and as a woman. This experience has taught me many lessons, but the most important is to take the victories, whether big or small, when they come around. Equally I aim to worry a little less about how much impact my research has, or how much funding I attract (or not) and concentrate on enjoying my PhD and remembering that whilst not earth-shattering, my research is still necessary. All research is proper research.





Mediating Violent Conflict: Where are the Women?

by Dr Catherine Turner

Durham Law School, Durham University.


Former Irish President Mary Robinson (left) and Ethiopia’s Hiroute Guebre Sellasie, the UN’s only female lead mediators

In his December 2016 inauguration speech, the newly elected Secretary General of the United Nations (UN), former Portuguese Prime Minister Antonio Guetterres, indicated that one of the priorities of his term in office would be conflict prevention. He emphasised the need to take more creative approaches to prevent the escalation of conflict, including notably a much stronger emphasis on the use of mediation and creative diplomacy. Prevention, it is said, is better than cure, particularly when conflicts such as Syria, Yemen, South Sudan and Israel/Palestine are proving so difficult to ‘cure’. The emphasis on mediation marks the culmination of a longer process of review within the UN of the ways it responds to violent conflict. A series of reports evaluating the UN’s peacebuilding architecture led to the 2016 adoption of the ‘Sustaining Peace Agenda’, marking a commitment to increased coherence across the organisation in co-ordinating peacebuilding activities.[1] Resolution 2282 (2016) emphasises ‘the importance of a comprehensive approach to sustaining peace, particularly through the prevention of conflict and addressing its root causes, […] and promoting […] inclusive dialogue and mediation…’

 This priority is also accompanied by a commitment by the new Secretary General to address a persistent problem within the UN – the need to ensure gender parity.

Resolution 2282 reaffirms the importance of women’s participation in peace and security, as well as stressing the importance of increasing women’s leadership and decision-making in relation to conflict prevention. The bringing together of these two priorities, namely an increased role for mediation in international peace and security and a commitment to increasing the participation of women in leadership roles within the UN, presents a good opportunity to consider the role of women in conflict mediation.

Of course, a commitment to increasing women’s participation in conflict prevention and peacebuilding is not new. Since the Security Council passed its landmark Resolution 1325 in 2000, the role of women in conflict resolution and peacebuilding has been on the Security Council agenda. The ‘Women, Peace and Security Agenda’ has consistently highlighted the underrepresentation of women in peacebuilding and a number of strategies have been implemented to try and redress this imbalance. There is a very significant body of work on the reasons that women should be included in peacebuilding. This work has highlighted the benefits of including women and has highlighted the different roles that women play within peacebuilding,[2] however it has largely overlooked the specific category of women in the role of mediator. This is despite clear policy commitments throughout the WPS resolutions that call for greater representation of women within high-level UN mediation teams.[3] And yet, despite over 10 years work on the WPS agenda, the number of women actively included in peace talks as mediators remains persistently low. Research shows that, of 31 UN-led mediation processes between 1991 and 2011, only 3 were led by women as the chief mediator. This translates into only 2.7 % of all chief mediators.[4] As a result in 2013 the Security Council passed resolution 2122 further requesting the Secretary General to support the appointments of women at senior levels as UN mediators and within the composition of UN mediation teams. By 2014 the UN had appointed two female lead mediators – the former Irish president Mary Robinson, and Hiroute Guebre Sellasie of Ethiopia – and women held a further 14% of senior UN mediation positions.[5] However this figure remains low in light of the Secretary General’s 2010 commitment to increasing the number of women appointed to lead UN peace processes.[6]

The very low statistics of women in the role of chief UN mediator creates an impression that women are simply not engaged in the mediation of violent conflict. Yet, in practice, we know this is not true.

In conflicted states across the globe women are actively involved in the mediation of violent conflict. The roles they play are increasingly being recognised through the creation of networks of women mediators such as those created by Nordic States, by African States, and in support of the peace process in Colombia. So why, when women are so active in mediation at the local level, do we not see more women in high level UN led processes? My research suggests a number of reasons for this apparent contradiction.

Responsibility for increasing the participation of women in mediation is divided across different departments within the UN. The appointment of high-level envoys or Special Representatives of the Secretary General – those we all recognise as the public face of UN-led mediation – lies with the Department of Political Affairs. The appointment of a mediator in this context refers specifically to the appointment of an individual by the Secretary General to pursue conflict diplomacy on his behalf. These are high-level political appointments and are almost exclusively at the discretion of the Secretary General himself. The Envoy will be the person responsible for convening the Track I – or state-level- talks. Women are very under-represented in these positions.

This focus on high-level talks and on the leadership role of international mediators can be contrasted with the approach taken by UN Women, the body tasked with working with member states to further the empowerment of women and support peacebuilding capacity within the State. At this level, mediation happens at a local level, within and between communities. It is at this level that women mediators are most strongly represented.[7] Women are regarded as bringing significant skills to mediation not only while official Track I processes are happening, but before and after those processes, in some cases enabling the process to take place. Through their roles as intermediaries women can create the conditions whereby talks are possible, for example by negotiating the cessation of hostilities to allow humanitarian access or opening channels for dialogue.[8]

The division of responsibility between the DPA and UN Women, both of which have very different operational mandates, creates a potential gap between mediation in local or national contexts and mediation that occurs at the international level. While women may demonstrate strong mediation skills and have considerable experience of mediating disputes, this experience does not result in inclusion in international mediation teams. There is a point at which women mediators tend to drop out of peace talks, and this is the point at which international actors become involved. At this stage, women are not considered to be ‘political’ enough to want to play a role in high-level mediation.

In these circumstances, women’s local experience is often overlooked in favour of bringing in international experts (who may also be women) to consult on the design and delivery of mediation processes. This means that not only do local women become marginalised in the process, but their insight into the conflict dynamics is also lost.

When women return to the process they return in the role of participants in the process—as a vulnerable group to be consulted rather than as the agents of change they have been. Further, the extent of women’s participation is also largely dependent on how willing the mediator is to include them,[9] leaving women inherently vulnerable to exclusion.

Of course not all women who engage in mediation at the community level will seek international opportunities. Similarly, there may be local gender dynamics that make it difficult for local women to step into political positions. But it is patronising to suggest that all women mediators are satisfied with working at the local level. Many have the skill, the experience and the ambition to play greater roles internationally. What is missing is a route to integrate them into formal processes.[10] While the role of Envoy will always be available only to a very small category of people, there is no reason that women should not play more prominent roles within high-level mediation teams.

There may be a very practical reason for the failure of women mediators to make the transition from local or national experience to international experience. It may simply be, for example, that they are not coming to the attention of the DPA at the time at which mediation teams are being selected. Member States therefore have a role to play in the career development and the nomination of women for inclusion within UN teams. If the DPA relies on nominations from Member States for identifying suitable candidates, then States can potentially support the work of both UN Women and the DPA by bridging the gap between the local and the global. This would include identifying women working as mediators within the community sector, the private sector as well as the Women’s sector, thereby casting the net much wider than traditional approaches. It would involve recognising the contribution that women mediators are already making to conflict resolution.

Taking a proactive approach to identifying women mediators, and ensuring that they benefit from the necessary career development opportunities at the national level, would be a big step towards a more coherent approach to ensuring that women’s contribution to mediation is made visible internationally.

Taking such an approach is consistent with the Sustaining Peace Agenda and speaks directly to the need for greater synergy between the relevant agencies responsible for sustaining peace and promoting gender parity.

[1] Resolution 2282 (2016)

[2] Anderlini, SN and J Tinman (2010) ‘What the Women Say: Participation and UNSCR 1325’ International Civil Society Action Network and Centre for International Studies; Paffenholz T et al. (2016) ‘Making Women Count- Not Just Counting Women: Assessing Women’s Inclusion and Influence on Peace Negotiations’ (Inclusive Peace & Transition Initiative & UN Women)

[3] Resolution 1325 (2000); Resolution 1889 (2009); UN Strategic Framework on Women Peace and Security 2011-2020; Resolution 2122 (2013)

[4] UN Women (2012) Women’s Participation in Peace Processes: Connections Between Presence and Influence. New York. United Nations

[5] Statistics from the International Peace Institute, 2013

[6] UN, 2010 UN Doc A/65/35- S/2010/466

[7] Conciliation Resources (2013) ‘Women Building Peace’ Accord Insight 16

[8] United Nations Global Study on the Implementation of United Nations Security Council Resolution 1325 (2015) 54

[9] Global Study

[10] UN Women (2012) Women’s Participation in Peace Processes: Connections Between Presence and Influence. New York. United Nations