Thoughtful Therapists and Gender Dysphoria

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= "psychotherapists and counsellors working in the area of gender and gender dysphoria".



"we are a group of psychotherapists and counsellors working in the area of gender and gender dysphoria. We have come together in a bid to protect the integrity of the open-ended exploration of feelings and ideas that has always been, and is still now, a necessary component of ethical and effective therapy.

We are concerned that the proposed Bill to Ban Conversion Therapy may criminalise or ban beneficial exploratory therapy in the context of gender dysphoria as we feel this will be detrimental to both therapists and clients who want to work in this area. We believe that ethical therapists would never carry out conversion therapy and so the focus should be on protecting the integrity of ethical therapy. We do not agree with faith-based conversion ‘therapy’ and we do not consider it in any way ethical.

We are concerned about the consequences of the Memorandum of Understanding on Conversion Therapy. This document seems to promote an affirmation-only approach for therapists working with individuals with gender-related distress. There is no long-term, high quality evidence base to support the affirmative approach and we are concerned that this narrowminded approach limits the range of therapeutic options available to individuals who are endeavouring to freely explore their innermost thoughts and feelings."



“SEXUAL ORIENTATION is a person’s sexual attraction to other people, or lack thereof. Along with romantic orientation, this forms a person’s orientation identity.” (An Introduction to Supporting LGBT Young People, 2020, p. 68)

We see evidence that, as in the increasing number of gender identities, sexual orientation is being reframed as a spectrum of identities, including (so far) pansexual, asexual, grey-sexual, demi-sexual and queer. Evidence shows that sexual practices such as fetish, kink and BDSM are being reframed as sexual orientations/identities which cannot be questioned. For young people, young women in particular, such practices may be an unhealthy/unsafe choice, or a response to trauma or coercion. In this case would therapeutic exploration be viewed as ‘conversion therapy’?

Therapy for gender dysphoria is not ‘conversion therapy’. The government should not include ‘gender identity’ in any legislation on conversion therapy without specifically clarifying this point, nor conflate this term with sexual orientation. The addition of ‘gender identity’ to any policy on ‘gay conversion therapy’ leaves therapists with no option but to agree with a patient that they are really the opposite sex, foreclosing any possibility of exploration of feelings and meanings, or underlying issues/mental health problems that may have lead to a cross-sex identity, for fear of being accused of ‘conversion therapy.’ This puts children and young people particularly at risk of progressing to a medical transition with lifetime consequences they may later regret. (See for example Keira Bell).

Framing proper therapeutic support as ‘conversion therapy’ mandates ‘affirmation’ as the only legitimate response to children and young people with gender dysphoria. There is no evidence to support this experimental one-size-fits-all approach which serves to cover up any underlying mental health problems or trauma, leaving young people without the mental health support they need. Health professionals have a responsibility to provide normal duty of care to gender dysphoric youngsters. ‘Gender identity’ is not a protected characteristic, has no objective meaning, and its addition to any legislation on conversion therapy would prohibit therapists from offering the same standards of care to young people suffering gender dysphoria as for any other troubled youngster."