Tag: mental-health

On 2nd November 2023, UKCP published “guidance regarding gender critical views” for their members. We were very concerned by this guidance and wrote an open letter detailing our concerns which has been signed by over 1,000 therapists, trainees and other professionals. There followed an exchange of statements with UKCP, which you can read on our blog and as updates to the open letter. We are now publishing this as our final update, inviting UKCP into dialogue in the hope that the Council may yet find understanding, compassion and empathy for trans life, and that we can work together to protect and support trans clients. At the end, we also address all psychotherapists and counsellors; trans and gender-expansive therapists and trainees; and our current and future trans and gender-expansive clients.

Dear UKCP,

Thank you for your response, published on 15th December 2023, to our open letter about your guidance regarding so-called ‘gender-critical’ views. This will be our final written response in this series of communications, although we otherwise remain open to dialogue with UKCP on this matter. We are using this written response to expand upon points made in our holding statement published in early December, as they were not adequately addressed in your response to us.

We do not wish to volley written statements back-and-forth with UKCP; our concern is making  therapy safe for our trans and gender-expansive clients. We would welcome an opportunity to meet with UKCP and discuss how the Council too can support this work.

At this stage, we would  like to highlight our continuing concerns with the statements published by UKCP, both in your original statement and in your response to our open letter, before addressing other therapists and any clients who may be reading:

1. Once again, this latest response from UKCP entirely fails to explain how it will protect trans and queer therapists, trainees and clients. Indeed, any mention of what trans clients might want from therapy is entirely absent. UKCP is speaking over the people who are most impacted by their statements and creating an atmosphere of fear and confusion. There appears to have been no consultation with trans and queer therapists or clients. This is regrettable given UKCP has shown some effort in the past to include and listen to marginalised groups.

2. TACTT is concerned that this statement either doesn’t understand or misrepresents what affirmative therapy actually is. Affirmative therapy means the therapist supports the client’s right to define themselves. The splitting of ‘exploratory therapy’ from affirmative therapy is now being used to justify a form of therapy based on so-called ‘gender-critical’ beliefs. We cannot stress enough that all good therapy should be exploratory in nature, but weaponising affirmative therapy to make way for so-called ‘gender-critical’ praxis is blatantly unethical and, we believe, amounts to discriminatory practice. The play on language does not hide the unethical attempt at trans-erasure.

We note UKCP’s imperative to remind us that so-called ‘gender-critical’ beliefs are protected under the Equality Act 2010; we remind UKCP that trans people are also protected under the same legislation. We are not seeking to discriminate against people who hold so-called ‘gender-critical’ beliefs. However, if a practising member of UKCP does not believe in the legitimacy of trans life then, according to UKCP’s own Code of Ethics and Professional Practice and the MOU on conversion therapy in the UK, said practitioner would be ethically bound to refer on to competent colleagues.

As practitioners committed to trans-affirmative therapy, we now find ourselves in an uncertain and increasingly unsafe professional environment, where anti-trans activism is emboldened. Those of us who are trans and queer professionals and trainees find ourselves isolated and left to advocate for ourselves against institutions with far more power. The available pool of truly competent and safe therapists for trans and non-binary clients is already small. UKCP’s guidance does nothing to help this.

3. We are dismayed that much of our effort to communicate with UKCP has involved having to remind the Council of its own core values, pointing to the Code of Ethics and Professional Practice and its position as a signatory of the MOU on conversion therapy. UKCP still has not acknowledged that its position on so-called ‘gender-critical’ beliefs, which may cause harm to transgender clients, contravenes its position as a signatory to MOU. We fear that, at best, this will cause significant confusion for members and, at worst, harm to clients.

As stated, we do not want to get into an interminable correspondence with UKCP.  Rather, we would like to invite UKCP to a roundtable discussion with members of TACTT to address our concerns. We seek dialogue, not to call out our colleagues, but to invite you to join us in finding understanding, compassion and empathy for an extremely vulnerable client group.

Alongside this, we will continue to work to improve therapy for trans and gender-expansive people through advocacy, education and campaigning. We ended our open letter by stating that those of us who are UKCP members or training in UKCP-accredited organisations are starting to question our place within the Council. If UKCP is unwilling to engage on these questions, you are likely to continue losing the trust of your members who work in a trans-affirmative way, as well as the trust of clients.

Yours sincerely,

TACTT 

We now turn our attention to the different audiences reading this letter.

To all psychotherapists and counsellors: 

We urge you to expand your knowledge and learning on trans-affirmative therapy, and specifically, seek training and education from trans and non-binary practitioners.

We encourage self-reflection on your own process around gender, transness and affirmative therapy. We further encourage you to seek out appropriate supervisory guidance if you are unsure about any aspect of your work. If you do not feel comfortable or equipped to work supportively and openly with trans and non-binary clients, it is ethical to refer them on to competent colleagues. We suggest a search on the Pink Therapy and Gendered Intelligence therapist directories for such practitioners.

We encourage you to examine your culturally inculcated reactions and responses to this topic and invite you to begin to challenge and work on them, in just the same way you may work on unconscious bias across all the other axes of oppression. 

We also remind you that trans and gender-expansive clients seek therapy for all the reasons anyone of any gender might come to therapy. By engaging in these processes of reflection, you will be better placed to support these clients with matters such as depression, anxiety, bereavement, relationship issues etc. without bringing an unwanted and unnecessary pathologising focus to their gender.

For those who are allies and who have already spoken out on behalf of trans clients, thank you. Any therapist who would like to use their voice for change is welcome to join TACTT.

To trans, non-binary and gender expansive therapists and trainees:

We see you. We know that the continued attacks on trans rights – both within and outside the therapy profession – create an emotional burden which you are shouldering while helping your clients to navigate the same environment. We oppose transphobia across the therapy profession and will continue to work to ensure the voices of trans, non-binary and gender expansive therapists and trainees are heard. 

To our current and future trans and gender-expansive clients:

We want you to know that you are welcome in the therapeutic space, that you belong here. We want you to feel safe accessing therapy, no matter what you come to therapy for – whether that is support through transition, gender questioning or indeed any other issue not related to your gender. We want you to have competent, supportive, knowledgeable and, above all, safe therapists to work with. 

We want you to feel empowered to question a prospective therapist about their stance on trans life to ascertain if they are safe for you to work with. 

Guidance such as the Pink Therapy guidance on how to choose a therapist is likely to be helpful. We also suggest asking a therapist if they have experience in working with trans and non-binary people and whether they have either lived experience or extra training in the subject. You can state you are looking for an explicitly trans-affirmative therapist and ask if they consider themselves to be so. 

Remember, exploration is an important part of any therapy. But the term ‘exploratory therapy’ is being increasingly weaponised by those who hold anti-trans beliefs, so ask your therapist what they mean by any terms they use.

Ask for word-of-mouth referrals from trans and non-binary communities. We also suggest searches on directories that are explicitly trans-inclusive, such as Pink Therapy and Gendered Intelligence, and to use trans-affirmative or inclusive search terms when seeking a therapist. 

We start this with a caveat: the language and definitions of terms are correct as of Dec 2023. This may change in future.

As therapists we work with people from all types of backgrounds and may encounter those of a different race or ethnicity to us, those with a different class, sexuality, gender, those who are (differently) disabled, as well as those who are trans.

Although most UK counselling membership bodies (including BACP, NCPS, UKCP and ACC) have signed up to the memorandum of understanding on conversion therapy (that is – conversion therapy is bad and the evidence overwhelmingly suggests that it has a risk of suicide, there is a current discussion around language and semantics that feels important to unpick.

In light of the UKCP’s statement around exploratory therapy and their response to TACTT’s open letter, this blog sets out a brief overview of key terms as used by gender critical (GC) therapists (which are often in direct opposition to the definitions used by non-GC therapists).

Gender critical: To be ‘gender critical’ (or ‘GC’) exclusively refers to those people who don’t believe that trans is a valid identity. A GC person believes that there are only two sexes, that people can’t change sex and that sex is the axis that matters. Gender critical people do not believe that “trans women are women” and “trans men are men” (and non-binary people exist), but that trans people are at best delusional, and at worst, predatory (‘men aiming to access women’s spaces’ for example). It is of note that the term ‘gender critical’ originally meant almost the opposite of what ‘gender critical’ now means, and therefore it is easy to understand why someone who is critical of gender norms and stereotypes, but who is accepting and welcoming of trans identities, might call themselves ‘gender critical’, not realising they are aligning themselves with a very different way of being.

Conversion therapy: Conversion therapy attempts to explain gender and sexuality divergence as a failure to be cisgender, heterosexual etc., and sees “success” as a client’s embracing of the preferred norms. Conversion therapy is “an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of sexual orientation or gender identity, or seeks to suppress an individual’s expression of sexual orientation or gender identity on that basis.” (MOU) It can include an attempt to ‘change’ a person’s gender identity by suggesting they were abused, or are actually autistic or gay (etc.), and are therefore this means they are not trans, and that other gender identities outside of the white binary don’t exist. Conversion therapy is at best, ineffective and at worst, actively dangerous.

Affirmative therapy: GC therapists will state that affirmative therapy is actually conversion therapy ( that affirming is ‘telling’ someone they are trans) and that exploratory therapy is the only way forward. A non GC-therapist would usually use the word affirmative to affirm the client in their right to explore and to use words that are right for their identity (with the therapist having no preference for the client to hold any particular identity). In the same way that we do with clients who discuss childhood abuse for example– we don’t presume to speak over a client and tell them they were or were not abused; we provide space to allow them to come to what labels (or none) and understandings of their experiences work for them. We affirm their right to do this exploration of self in a non-judgemental space. We do not seek to convert, or to act in accordance with our personal beliefs. The GC-therapists’ claim is that ‘affirmative therapy’ is “telling a client they are trans” and affirmative therapists are pushing those clients towards that identity. This would be tantamount to conversion therapy, were it happening. However, allowing an affirmative space for a client to explore all aspects of their identity, is not the same as trying to convince them of one aspect. Affirmative simply means that we do not think it is a worse outcome if a client decides, for themself, that they are not cisgender.

Exploratory therapy: Exploratory therapy is being cited in the UK as being contra to the (GC) definition of affirmative therapy. Florence Ashley writes a brilliant paper on a GC definition of exploratory therapy and why it is a terrible idea, and is essentially equivalent to conversion therapy. Proponents of exploratory therapy are reluctant to accept trans identities (particularly in young people) and instead look to find the reasons a person may be saying they are trans (such as childhood trauma etc.) to resolve these and ensure a person moves to a cisgender identity. This approach situates transness as pathology, meaning that it is in direct contravention of the MoU, which states that neither being trans nor being cis are inherently better than the other. Of course, if our clients have a trauma history they are looking to explore then we would look to do this. This is not the same as looking at trauma as ‘the reason’ someone is saying that they are trans.

A gender-critical therapist who believes that sex is immutable and more important than ‘gender identity’, will practise exploratory therapy in order to try to find (and fix) the reasons someone says they are trans – there is no therapeutic neutrality here as pathology is assumed. A therapist who believes that trans identities are valid may seek to practise in an affirmative way that does not aim to tell a client what their identity is, but provides space for the client to find their own language. Exploratory therapy (in the way the term is increasingly used) begins from a place of pathology, but although trans people are more likely to have suffered abuse/trauma, this is not the cause of our transness. To attempt to search this out and resolve something where no cause exists, is conversion therapy.