This chapter explores dilemmas around self-organization and separatism. Self-organization is underpinned by individual self-definition and collective self-determination that is anyone who self-defines as a woman can join the women's group and contributes to the elaboration of a political agenda around gender. Self-organized activists have not only repudiated separatism but also reframed it in such a manner that the accusation is redirected back to the mainstream union. On a surface level self-organized activists and mainstream unionists often agree that self-organized groups (SOGs) are an important means to the ends of equality and democracy. Trade union terminology might be relatively inaccessible to some learning disabled people, and the stigma which haunts many psychiatric survivors may be qualitatively different from that which faces physically impaired people. The mainstream union is expected to give its seal of approval to the agenda around gender, and to ensure that it is owned and operationalized throughout the union.