Seriously Purple -Micro aggressions

I’ve been wanting to write this blog for a little while now and I’ve just returned from the Vigil on Old Compton Street to show solidarity with the LGBTIQ folk across the world who are facing homo, bi and trans phobia and hatred within their communities and especially with the people affected by the massacre by a man with a gun shooting over a hundred people at the weekend most of them People of Colour (49 deaths and wounding at least 53 more). But many others have written eloquently about the Massacre, and so this blog isn’t about that.

This blog is about hatred, but not the shooting-your-neighbour-and-their-friends kind of hate, but the impact of what have come to be called the ‘Microaggressions of everyday life’.  The tiny sneers, avoidant gazes and snickers at someone else expense. Being basted with a toxic marinade every day and wherever we go. It’s a very subtle form of hatred that is done to us, and we do to each other.

I think we all know by now the emotional and psychological costs of Minority Stress on the lives of Gender, Sexuality and Relationship Diverse people. The elevated rates of depression and self harm, alcohol and substance misuse, and anxiety and other major mental health problems. The research has largely focussed on LGBT people and has shown much more elevated levels of mental health distress amongst bi and trans folk. 

This is the impact of living on a planet where people are made to feel bad for who they love and how they express themselves.  Research seems to show that for many people finding ‘community’ and selectively sharing the information about one’s gender and/or sexuality, tends to have a positive effect on mental health.  There is even some evidence that being in a relationship is good for our mental health and can build resilience and have physical and mental health benefits.

But when you have found your tribe or community, and when you’ve found someone to share your life with, and maybe even marry them – does life get easier?  I’m not sure it does.  At least it’s not as simple as that.  Every time you reveal yourself IMG_7116to be who you are you’re likely to receive some forms of micro aggression.  Whenever I hold a partners hand out in public, I will almost always encounter some micro aggression or when I’m pulling on my leathers to go to a bar in town for a drink on a Saturday night and travelling on the tube or bus, or when I’m wearing something fab-u-lous like the purple hat I’m sporting here, I will encounter someone else’s negative reaction.  These micro aggressions are most common when I’m amongst the hetero-majority.   People will see that I’m queer and respond accordingly, in a microsecond.  Probably before they’re even aware they’ve responded and if you see them – you will register the tiny micro aggression and it can eat away at your soul and if you don’t feel you have a soul, it will eat away at your confidence, in time. 

When I was with a few thousand other wonderful people on Old Compton Street nobody seemed to care, but a few minutes walk away and my ‘gaydar’ detected two or three individuals who undoubtedly batted for our team and were very close friends with Dorothy, each of whom found a way to ensure I didn’t exist!

So we think by being out and proud and living our authentic life, and being our own special creation, everything is going to be fine and dandy – and most of the time they are. And sometimes they are not.  Sometimes, we can be as guilty about quietly spooning out this marinade over each other and THAT IS NOT GOOD.  We can see someone, especially someone who is looking more fabulous than we are, or behaving in a loud and outrageous manner and giving the game away and we too can ladle it out with a sneer or avoid their gaze, snicker, not want to be seen as like THAT! Not wanting to be one-of-THOSE-people. We can also do it when someone’s body-shape doesn’t match the gay or lesbian ‘ideal’, when someone is significantly older than the others in the bar or club, and when their gender presentation is outside what is considered the accepted cultural ‘norm’.  The years of having to hide, and pass and survive, leaves us all with a legacy, whereby we often, quite unconsciously, avoid acknowledging each other, we withhold our smiles of recognition and warmth for a kindred spirit and THAT IS NOT GOOD!

I think we need to continue to build community, celebrate diversity and be kind to each other and if someone is a bit more full-on or different than we are when we see them in the street, perhaps we can smile and wink and celebrate our differences and our similarities.

embracing_diversity

Dominic Davies
CEO Pink Therapy – June 2016

50 Shades review

Ok, in the words of a few colleagues and friends I “took one for the team” by actually going to see the film rather than sit on the sidelines commenting from afar.

The controversy and hype on Social Media has been intense over the past few days.  The jokes and spoofs have also brought a smile to my lips and I was prepared for a challenging couple of hours so I booked two tickets for the studio cinema of the Genesis which has a bar in the cinema and super comfy sofas and ordered a large glass of Shiraz.  I took a good friend, performer and wit Ernesto Tomasini in one of his rare nights off in London and we settled down for a giggle and a groan!

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Top line: I certainly didn’t feel the film was as bad as the hype,  Jane Fae’s review seemed fair and totally on point.  I read it before and I read it afterwards and it strikes me as the fairest and most balanced. Check it out as it says all that needs to be said.  Allowing ME to focus here on my own perspective and trying to say something that hasn’t been said already.

Christian Grey was a clearly mixed up guy who could use some therapy to heal his emotionally damaged childhood  trauma, but he did seem redeemable and in fact he shifted a fair bit on his “I don’t do romance” by taking her on a joyful and completely gratuitous glider flight and during what was a very empowered “business meeting’ to discuss his submission contract, agreeing to a weekly Date Night.

Ana came across as increasingly empowered and strong character who exited the relationship when she found out at her own request how bad Grey’s punishment might be (six of the best, which was actually pretty mild by most people’s idea of CP play).

In fact his ‘punishment’ scene looked like it hurt him as much as it did her and her punishment of him (withdrawal) was much more severe (as it often is).  She portrayed a much stronger person and not the defenceless weak woman I had expected from the reviewers.

Grey appeared more of a ‘Service Dom’, focussing on her sensual arousal and awakening rather than abusing her and she did seem to be consenting. He was not sadistic or cruel or a self centred lover. There were no skull fucking scenes until she gagged and vomited and he didn’t send her back to her room with her face covered in semen. The sex was sensual, tender, and really very tame and Grey used condoms!  

Lifestyle BDSM in a Dominant/submissive relationship often does involve controlling the submissive’s diet, well being, clothing etc.  It probably wouldn’t be rushed into like it was in the film, and especially not with a virgin ingenue like Ana, and so the laments by the BDSM community (most of which haven’t actually seen the movie when asked to comment) that it’s not accurately representing BDSM are missing the point a bit.  It’s a movie, not a documentary!  I actually think we under estimate people’s ability to recognise that movies are different to real life.

We have so few representations of our lives in film I think community members want to see highly accurate portrayal and that may not make for great drama.  I remember  a few decades ago the uproar when Al Pacino played the gay leather clad lead in a film called Cruising. The gay community had no positive representations of our lives that this disturbing film presented us in the worse possible light. Virtually every gay film for decades contains tropes and stereotypes and we know life isn’t quite like that!

Maybe we need the equivalent of the highly effective Trans Media Watch campaigning for accurate BDSM content? This is something that NCSF and CARAS are doing and there are now lots of opportunities for teaching all the neophytes to BDSM lots of things about consent and safety!

I read one extensive post where virtually no one had seen the film (and most hadn’t appeared to have read the books either), but when asked for a soundbite all managed to come up with something to educate the readership (and promote their websites)!  

Two things did disturb me about his stalking really was the most outrageous and scary aspect but we’ve seen that trope of the boy chasing girl in many movies before and not been labelling it as abusive. I also recall Judi Dench as M waiting in James Bond’s hotel bedroom.  It is always jarring when someone surprises us like that.

Is it the BDSM context for this movie which is actually the subject of most criticism, but that it’s being presented  intimate partner abuse?

One thing that seems to have gone un commented upon so far, I found the early ‘Are you gay?’ joke both unnecessary and offensive.

Bottom line: I’m glad I saw the movie myself, I don’t regret doing so and I feel pleased I had a chance to come to some views of my own.

Dominic Davies
Psychotherapist, Clinical Sexologist

If you’re a therapist have you booked for our Beyond the Rainbow conference which will amongst other things explore BDSM on 21 March 2015 in London

Today I will attend the launch of a new Memorandum of Understanding (MoU) on Conversion Therapy.  This agreement is the first time all the major UK psy/therapy organisations have worked together on a collaborative project. It’s a huge achievement for the therapy world in its relationship to gender and sexual diversities.  Check out the list of signatories to the document at the end of this blog.

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The MoU will be launched at the Department of Health and arose from a meeting last April with health minister Norman Lamb MP who had convened a Round Table of all the psy/therapy professional bodies to discuss whether the government should ban conversion therapy outright.  He was very concerned that vulnerable people were being offered what is known to be a potentially very damaging ‘therapy’.  The Minister had previously asked UKCP to co-ordinate a Consensus Statement which also was launched at that event.

We all wanted to get beyond just fine words and look at how we can ensure therapists know what to do when someone presents for help over conflicts with their same sex attractions. All the professional therapy organisations already had individual statements condemning conversion therapy and attempts to ‘cure’ same sex attraction and their existing ethical codes are robust enough to deal with infringements by their members who might think this is acceptable. 

It was the felt by all attending that making conversion therapy illegal would be impossible to enforce and unhelpful to single out one rogue ‘therapy’ amongst all the other dubious therapies which exist for special treatment would be unhelpful.  Conversion therapy as an overt practice is almost exclusively delivered in the UK by a small group of religious fundamentalists (from both Evangelical Christian and Orthodox Jewish groups) who are likely to claim persecution for their religious beliefs. They are a powerful lobbying force but it’s clear to pretty much everyone Conversion Therapy goes against all the existing ethical frameworks for professional therapeutic work and our understanding of best practice.

However, my concern has always been that Conversion Therapy in the UK as practiced by a relatively small number of vociferous religiously motivated ‘therapists’ was more of a red herring.  What concerned me more was that research published in 2009 (Bartlett et al) revealed that an alarming 1 in 6 secular professional psy/therapists (members of BACP, UKCP, BPS and the RCPsych) had at some point either practiced to change a client’s same sex attractions or referred a client to a practitioner who would. Much of this harmful practice may be attributed to the historical and existing deficiencies in qualifying training to equip therapists to work in informed, competent and non-discriminatory ways with people from gender and sexual minorities.

So what centrally concerned us, was not to scare therapists off from responding to what are often very distressed clients presenting for help. Expectations, or explicit requests, that therapy will change sexual attraction or gender identity by clients struggling in managing their sexuality conflicts in what can often be experienced as life threatening situations (suicide and self harm rates are much higher amongst LGBT people). Intersectionality issues, such as religious, cultural, socio-economic and body type circumstances also may intensify a client’s anguish and isolation, also presenting further real threat of violence, enforced marriage, “corrective rape”, illegal incarceration and even execution.

If our attempts to inhibit incompetent or abusive therapy result in a therapist saying “I can’t talk to you about this” for fear of disciplinary action and complaint then we have reduced supportive safe spaces for that vulnerable person rather than protected and helped them. 

So in the relatively easy step of gaining publicly shared consensus against conversion therapy across the psy/therapy bodies, it is really important that we invest in the harder, less glamorous and more committed work of ensuring therapists are adequately trained and culturally safe and competent. This does not just include knowing that agreeing to requests to change a same sex attracted person into a happy heterosexually oriented one is much more likely to result in harm than success, but also safely holding and supporting the client through this early stage of psycho-education and further in their journey in finding their way to own their sexuality with self-worth and integrity.

Now the work can really begin.  In this document the psy/therapy bodies commit to ensure that all therapists are trained to a high level of cultural competence in working with LGB clients so that they know how to respond when a client presents in distress over their sexuality conflicts.  It’s not enough to just ban Conversion Therapy, it’s important that therapists feel confident in knowing how to work with requests for change in the wider context of that client’s life.

Very few therapy training courses in the UK adequately prepare therapists for working with LGB people (let alone all the other gender and sexual diversities that will be coming through their door).  This document gives a clear mandate that they should be and that the professional associations which regulate therapists will be supporting and monitoring this process.

Therapy is increasingly becoming a highly regulated profession.  Although such regulation is a highly contested area, (we might want to reflect for a moment on the licensing of human compassion), and I don’t want to get into the pros and cons of this in this particular blog.

Some people are concerned that therapists should be state licensed and they are worried that anyone can set themselves up as a ‘therapist’ and offer psychological treatment and help. This is true, but it would be virtually impossible to protect every title of support.  ‘Counsellor’ for example is being used by so many different trades and businesses, and loopholes would soon be found to get around any protected title that got enshrined in law.  We already have several national voluntary Registers which are being regulated by the Professional Standards Authority (PSA) and the major therapy bodies are all well into the process of getting their members on those registers. Furthermore, state licensing does not prevent Doctors from abusing their patients, there is no evidence that it would prevent unethical practice by therapists.  

However, the PSA has no interest in addressing the standards of training in psy/professions as they only regulate the voluntary regulators themselves, not their registrants or training organisations. Therefore there remains tremendous discrepancy in how much quality and assessed training a psychotherapist or counsellor on a PSA registered register has actually undertaken. Only the psy/therapy training bodies can step up to ensuring adequate training in working with LGBT clients as a “voluntary duty” and the registering bodies show action consistent with their words by resourcing these developments in competency standards.  This is a task we’re actively involved in as the next focus is to ensure therapists are adequately trained!

We felt it was therefore also very important is to raise public awareness that any person being consulted for help should be a member of a professional body which has a complaints procedure and a code of ethics and that the professional has had specific training to undertake the work they’re seeking to do and that they are registered, insured and culturally competent and safe to be undertaking the work.

So far, the working group has focussed on Conversion Therapy as it pertains to sexuality change since this had been the major focus in the United States and the UK and was addressing the brief given to us by the DoH.  However, the tragic death of Leelah Alcorn   at the end of last year shows how important it is to ensure that we include gender variance in the definitions of what we mean by Conversion Therapies because trans kids are also being sent to therapists for their gender non conforming behaviour.  Again, this is largely within fundamentalist Christian families as was the case with Leelah, but some years ago Dr Ken Zucker, a fairly well respected Canadian psychiatrist came under criticism for offering conversion therapy to gender non-conforming children attending his clinic.  https://en.wikipedia.org/wiki/Kenneth_Zucker.  

As I understand it, Zucker’s point for trying to discourage gender non-conformity and cross gender play (with all the binary notions that plays into) was that Richard Green and others at the Tavi who did some research some 20-30 years ago on how many kids who expressed gender atypical behaviour in childhood and a desire to change gender, later into adolescence and adulthood didn’t ‘persist’ and ending up identifying as gay.  

However, we’re increasingly seeing larger numbers of gender variant young people feeling able to speak out about their gender dysphoria and services and support for gender variant young people are growing all the time. It would be interesting to see if more young people emerge from childhood and adolescence with a secure trans identity wherever they place themselves across the spectrum.  My own reading of the situation is, there will be many more ‘persisters’ rather than ‘desisters’ if the environment feels safe enough for them to be themselves, and not all will feel that a full and permanent transition of their gender in necessary.  I think we’ll be seeing more non binary and genderqueer identities as gender will be more of a spectrum, than the binary we’ve been seeing it as.

The MoU focused, (at the request of the DoH) on sexuality.  However, as psy/therapy bodies we shall be meeting on a regular basis over the next year to review the implementation of the recommendations and I and many others will be working to ensure that gender variance will be included in its implementation and explicitly included.

I’ve worked my entire career to try to raise the standard of culturally competent and safe therapeutic support for gender and sexual diversities. Often it’s felt like a cry in the wilderness, but finally it seems the therapy world is playing catch up and interested to listen to what we have to say and I am hopeful together we can improve the quality of care and support available for all gender and sexual diversities. 

Dominic Davies
Founder – Pink Therapy

Signatories to the Memorandum of Understanding on Conversion Therapy include:

Association of Christian Counsellors (ACC), British Association for Behavioural and Cognitive Psychology (BABCP), British Association for Counselling and Psychotherapy (BACP) British Psychoanalytic Council (BPC), British Psychological Society (BPS), Gay and Lesbian Doctors and Dentists (GLADD), National Counselling Society (NCS), NHS England, Project for Advice, Counselling & Education (PACE) Pink Therapy, Royal College of General Practitioners (RCGP), Royal College of Psychiatrists (RCPsych), Relate, Stonewall, UK Council for Psychotherapy (UKCP).

Sartorial Experimenting

I was thrilled to make it to this year’s Rainbow List and even more delighted to have been given a higher ranking this year (No. 28) on last year’s initial entry at No.34. I’d guessed I was on the list again because a few weeks ago, I got an email from the editor at the Independent on Sunday inviting me to a celebratory party. This is the first time they’ve had such a party and of course I was delighted to accept. And Nervous. Being a natural introvert, I don’t find these things easy, but I do feel like I want to be there.

Last month I attended the European Diversity Awards with my colleague Leah Davidson. Pink Therapy was shortlisted for the Community Project award and running against some of the big guys like Channel 4 and Croydon Council as well as long standing community projects like Newcastle’s West End Women and Girls project. The awards were being held at the Natural History Museum and after consuming several glasses of champagne and probably more canapés than were wise for someone about to sit down to a three course dinner, we took our seats amongst the Dinosaurs.  The dress code was Black Tie and I had great fun wearing my second hand tux.  It’s only the second time I’d worn a tux, the first being a hired one for last year’s National Diversity Awards (we didn’t win that one either)!

at European Diversit

at European Diversity Awards

The dress code for this party was Dress as You Wish. I would have wished to wear the Tux again but didn’t want to look our of place and too formal.  But I felt this increased placement  in the Rainbow list deserved a new outfit. I don’t shop for clothes too much and I wanted something eye catching and interesting. Living in the middle of Covent Garden I set out for Floral Street and checked out Nigel Hall, Ted Baker and Paul Smith and realised very quickly that this year’s look was tiny print shirts which reminded me of pocket square handkerchief styles or even cotton pyjamas. They just didn’t grab me at all.

I popped into M&S to pick up some pyjama trousers I’d ordered online to be delivered there and as I was leaving the store my eye got caught by this incredible purple velour dress. Why is it women always get the nice clothes, I mused. Came home and ate lunch and my mind kept wandering back to that dress. If there was ever an occasion for me to wear a dress in public, then this even was probably the one. But I just didn’t think I’d have the balls. So I posted my dilemma on Facebook and was told in no uncertain terms that I ought to buy it!

After lunch before heading off to look at nice shirts, this time in Soho boutiques I returned to M&S just to satisfy myself that the dress was too expensive, or the wrong size/cut or something else I could use as a good excuse NOT to buy the dress. However, it was £40, came in every size from 8 to 20 (what size would I be?) and wasn’t super low cut or with big bosom darts. So I picked up three sizes, 16, 18 and 20 and headed to the changing rooms. Without a second glance the assistant gave me a counter for three garments and I slipped out of my male clothes and into a dress! I’m not wanting to do drag, or pass myself off as a women.

I found myself dithering between the 18 and the size 20 Both seemed to fit and I couldn’t easily tell the difference – the fabric was stretchy and I found myself wanting to get the smaller size, despite the 20 maybe feeling a little more comfortable! I’m sure this experience is familiar to many others wanting to squeeze into something smaller, so I decided to get the larger one and play it safe. I also needed something to cover up my hairy legs. I couldn’t easily see lycra leggings and getting more and more embarrassed I settle on some black tights but they need to be thick enough to cover my legs and large enough to fit me. Extra Large 100 Denier looked like they’d do the trick.

I then realised I’d need something to carry my phone, wallet and keys in. Handbags were NOT cheap and so I headed out towards Leicester Square tube and bought a £15 shoulder bag in black – multiple pockets and something that will come in handy for holidays. They had some great hats too and so after ruling out the Purple top hat, I went for a purple trilby!

My big heavy boots looked too clunky but I inherited a pair of pointy toed cuban heel boots from a friend who committed suicide last year. They looked stylish and elegant and drew attention away from my knees!

I feel very nervous going out in a dress, and remember the adage that a man learns more about being a man by wearing a dress for a day that a suit for a lifetime. I’ll get a cab to the venue and one home – as I don’t feel safe on public transport alone in a dress. It has already reminded me of the immense courage that people assigned Male at birth show when they go out in public dressed in female clothing. For most, I guess it’s their intense gender dysphoria which motivates them to present in public and show the world they have every right to be the fabulous person they are. For me, my motivations are a little less honourable. I want to learn more about myself. There will be no makeup, no attempt to overly feminise. I just want to be able to be a bloke in a fabulous purple dress!  Women shouldn’t have all the fun in dressing up!  Genderqueer allows us to redefine ourselves!  I claim my space on the catwalk!

So here are a few snaps of me in a frock.  The first was taken in the kitchen to test out the ‘look’ and so the tags are still on the dress!

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This next one is in front of the sponsor board.  There were professional one’s taken on arrival where I was told to smile more!  I must have been pretty nervous I guess!  Pity the photographic lights had gone off and it all looks so purple.

 

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I stepped outside and there was a magnificent skyline of St Paul’s and the Shard. Pity it was raining or I’d have spent more time out here.  The views were incredible.

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Some initial thoughts on lessons learned:

  • gay men in general either ignore you or see you as weird
  • virtually all male privilege is lost
  • it’s very uncomfortable wearing tights, the top of them comes up to one’s mid torso and then seems to roll down and readjusting it is ungainly and tights really squash your manly bits so that you walk funny!
  • it felt risky to walk the streets (I took cabs there and back)
  • accessorising makes an outfit come together 🙂

Dominic Davies
Founder/Director

Curing the gays

Yesterday, I was invited to meet with Norman Lamb the Minister for Care and Support and the heads (or their representatives) of most of the major psy/therapy organisations (BACP, UKCP, BPS, National Counselling Society, British Psychoanalytic Council, Relate, BABCP, Assoc of Christian Counsellors, Chair of GLAAD representing the Royal College of GP’s) PACE and Stonewall. The topic of this ’round table’ was Conversion Therapy which the Minister told us he was very concerned about and wanted to establish what was happening and what the government might do about it.

Professor Michael King was there representing the Royal College of Psychiatrists and both he and I were invited to make presentations – him on the evidence of efficacy and harm and me, on the training needs for therapists and what the professional bodies should be doing. I’d been waiting for an opportunity like this for my entire career!

David Pink from UKCP gave some background to the issue as UKCP have been taking the lead on this for a while now and recently produced a booklet commissioned by the Government for the NHS Choices website.  Pink Therapy had a hand in this and it seems an important step at the Government making it clear that Conversion Therapy has no place in ethical health care for LGB people.

After Mike King gave some background on the history of conversion therapy and the lack of evidence for its benefit and plenty of evidence for it’s harm, I had around 20 minutes to present my own thoughts.

This is a slightly tidied up version of what I said:

Dept of Health Round Table on Conversion Therapy

Training & Policy

Whilst I’m concerned about religiously motivated Conversion Therapy and have been professionally active on this issue for over two decades, I’m much more concerned with Professor King’s data about 1:6 mainstream therapists of your organisations agreeing to contracts to reduce SSA or cure people. Most of these people are not overtly religiously motivated and so might not feel your Conversion Therapy policy statements apply to them.

These were well meaning mainstream and secular therapists who were poorly trained and inadequately prepared to know how to respond to a highly distressed client. Training in understanding what is different about working with gender or sexual minorities is either absent or patchy in most British therapy training courses and so therapists don’t know how to respond and often have little cultural competency in understanding the social contexts in which their clients live. Noble humanistic concepts about the clients right to self determination are in conflict with what might be a lack of choice over the gender of their sexual partners. The people presenting for ‘gay cure’ are generally likely to be those who have a fixed and enduring sexual identity (Kinsey 6’s) and whereas sexuality can be quite plastic for many people and there are plenty of examples of situational homosexuality amongst heterosexuals in single sex environments and sexual fluidity over a lifespan for many LGB and T people, the people seeking ‘cure’ are unlikely to be those people who feel unable to change.

In some contexts (lesbian and gay Muslim especially) lesbians and gay men may be facing honour killings from family members or alienation from their community and families. They maybe literally pleading for their lives. 

I’m also interested to know how those organisations which have Christian Counsellors or Pastoral Counsellors like Assoc Christian Counselling and BACP’s Association for Pastoral and Spiritual Care Counselling will monitor whether conversion therapy is being undertaken organisations?  Changing policy and forbidding something doesn’t make it go away. 

I’m interested to hear what other colleagues are doing to ensure their Policy Statements are translated into action and how they propose to train their members in ensuring they can respond appropriately to requests for change.

However, it goes wider than this in delivering culturally safe and appropriate mental health services. An example is that whilst we now have full equality in Gay Marriage, we should bear in mind that research shows that between 50-80% gay male couples are are not sexually exclusive. So whilst Relate has become less heteronormative over the years, it is still virtually impossible for a gay couple to get help in opening up their sexual relationship, when the training of the therapists in Relate has been about helping couples maintain sexual fidelity and keeping families together. 

Research is showing that Bisexuals get offered conversion therapy from mainstream counselling organisations too! Some therapists feel they should just help the bisexual pick one identity and either be heterosexual or gay. (Ref: Bisexuality Report and Richards and Barker, 2013)

My recommendations

  1. Accrediting a course, should mean the course gets audited for what they are teaching about working with gender and sexual diversity clients. I’m interested in therapists being culturally safe to offer therapy to sex minority communities. So that LGBT people are afforded dignity to live within their own values and norms. Such training in understanding developmental theory, life stages and relationship models etc should be integrated and run throughout whole curriculum and not be an optional add on for a single workshop. The BPS Guidelines for working therapeutically with gender and sexual minority clients are most helpful and I’d like courses seeking accreditation to be asked to embed these guidelines in their training of therapists so that throughout the curricula therapists are learning how to work with diversity.
  2. Post Qualified counsellors faced with requests for change need CPD to help them better handle these issues. A big stick or forbidding conversion  therapy is not helpful.  You have a duty of care to your members to support them in know how best to effectively respond to genuine distress and requests for ‘cure’.
  3. Therapists and supervisors need training in how to work with the issues. Our own workshops for supervisors were frequently cancelled due to low take up, it seems supervisors (who may well have been trained at a time when homosexuality was still classified as a mental disorder) feel they are above or beyond the need for training in how to supervise therapy with LGBT clients.
  4. Specifically with regard to Requests for ‘Cure’, I recommend a training pack be produced – with video, experiential exercises and some theoretical material and resources which addresses how to work with these issues. We should then offer to train counsellor trainers in how to use the pack so that they can then deliver training to their students.  It would be good if the Dept of Health could help us produce this material – making a video with a Muslim actor playing a gay client who is conflict with his cultural and faith beliefs and sexual orientation.

You will see I’ve used the concept of Cultural Safety.  This arose in Nurse Education in New Zealand and here’s a short explanation:
Cultural safety relates to the experience of the recipient of nursing service and extends beyond cultural awareness and cultural sensitivity. It provides consumers of nursing services with the power to comment on practices and contribute to the achievement of positive health outcomes and experiences. It also enables them to participate in changing any negatively perceived or experienced service. The Council’s definition of cultural safety is:

The effective nursing practice of a person or family from another culture, and is determined by that person or family. Culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability

The nurse delivering the nursing service will have undertaken a process of reflection on his or her own cultural identity and will recognise the impact that his or her personal culture has on his or her professional practice. Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and well being of an individual. 

http://nursingcouncil.org.nz/content/download/721/2871/file/Guidelines%20for%20cultural%20safety,%20the%20Treaty%20of%20Waitangi,%20and%20Maori%20health%20in%20nursing%20education%20and%20practice.pdf [emphasis added]

After the meeting, I had warm and encouraging approaches from the National Counselling Society and the British Psychoanalytic Council who want us to advise them on what they can be doing. Also within hours the Chief Exec of Relate emailed me asking me to meet with their Head of Training.  Interestingly, the representative from BACP remained silent throughout the meeting and afterwards.  I hope I shouldn’t be reading too much into this.

There are plans for a follow up meeting and maybe a Memorandum of Understanding which we will hopefully agree.

This is the first time I’ve seen these professional associations coming together on an issue. They are essentially rivals and many competing for members. It was good to see them in agreement about Conversion Therapy and open to hearing my proposals.

Dominic Davies
Director

Some thoughts on why Chemsex is increasing in London.

I was invited to speak for five minutes at a community outreach initiative on Chemsex at the Manbar tonight.

Some thoughts
I’m a psychotherapist and a sex therapist – who has worked with our communities for over 30 years. I’m Director of Pink Therapy which is the UK’s largest independent organisation to work with our the LGBTQ and Alternative Sexualities communities.

Currently, around half my practice is working with guys who are using or have been involved in Chemsex. It wasn’t like that even two years ago. Whilst there have always been clients who use drugs recreationally in a sexual context, the current situation of Chemsex (specifiCrystal_crack_pipecally Meth, Meph and G) is producing some unique challenges and situations.

I’m learning all the time, from my clients, my friends, my sexual partners and my colleagues about what’s going on here and I’ve been wondering why this has become such a big issue so quickly.

Everyone’s story is of course unique which is why I love my work and have never got bored, and I won’t be breaching any professional confidences here tonight. There are clearly lots of reasons why this is going on.

I have been reading the new Sigma research report which came out on Friday with keen interest and I am seeing what they found in my own practice.

A number of people who have got into trouble with Chemsex have had psychosexual performance difficulties: for example, problems with rapid ejaculation disappear on Chems and men can have sex for hours. This in fact can lead to the opposite problem, not being able to cum and so having to find more guys to have sex with in the hope that they will eventually reach a happy ending.

Concerns about bodies, dick size, what they see as their shameful kinky sexual desires all fade into the background when people get high.

Others report trauma over HIV disclosure and rejection from negative guys who don’t realise what ‘undetectable’ now means.

Most guys do it because sex on Chems feels great,. But then find they can’t remember how to have sex sober, or tell me they’ve never had enjoyable sex sober.

More depressingly they don’t believe anyone would want to have sex with them sober, so prevalent is the availability of Chemsex in some parts of London, and sometimes of the day/night that it’s hard to use sexual networking apps and find guys who aren’t high.

Some men hope to meet someone they really connect with, find a boyfriend and leave the party scene. The drugs give them a sense of intimacy and connection but they find that closeness and connection hard to sustain when they come down.

I’m concerned that by inconsistently taking their anti-retroviral medication many positive guys might well think they’re undetectable because they were when they last had their bloods checked 6 months ago, but the virus has been replicating and unwittingly they might be passing the virus on to a new generation – where smart people understand that a a stable and undetectable viral load means they’re pretty safe to fuck without condoms, but still we see the figures of new cases of HIV climbing through the roof. On average 20 new cases of HIV diagnosed a week in London, and where are the support groups for this many guys, THT?

But the thing that concerns me most though, is how the Benefits Agency are closing in on Long Term Survivors.

Many HIV +ve guys have been on fairly substantial disability benefits for decades awarded at the beginning of the AIDS epidemic when everyone expected them to die.

In the 90’s getting high levels of disability benefits was relatively easy. Unlimited tube and bus travel, perhaps a new Motability car every few years, and Carers allowances meant they could afford not to worry about returning to work when their health stabilised. These benefits will not only be lost once they get reviewed and reassessed as fit for work. They may face fraud investigations for not advising of a change in circumstances.

These men probably, in their 40s-50’s have been out of the workforce for such a long time and may have little chance of finding work especially as we’re in the middle of a recession.

How easy it would be to just take a larger dose of G and end it all – maybe alone, maybe at a party in an ‘accidental’ overdose. This is a frightening prospect.

David Hoyle refers to gay men as being The Greatest Suicide Cult in History. Perhaps THIS is what we’re seeing in the increasing use of Chems and sex? A bunch of gay guys about to lose their benefits and with little prospect of work. Why wouldn’t they be dancing on the Titanic?

What is our multimillion pound HIV charity doing to prepare and support these long term survivors and offer help and hope?

Dominic Davies
Director

Male body dysmorphia: a force for evil in the gay community

“Sorry”, my boyfriend at the time was looking down apologetically; “For what?” I said, a little concerned. He gripped about a half-inch of tan skin on his stomach and said “I had takeaway pizza twice last week… I’m not in my best shape”. I looked at the skin he was gripping, stuck between sympathy and envy.

Muscle Body Dysmorphia – also known as The Adonis Complex or ‘Bigorexia’ – is an illness on the rise. There exist no firm numbers of who might be affected, but cases of men who suffer from body dysmorphia – or a warped perception of their physical self – have increased steadily over the last 20 or so years.

Our current understanding of the Complex is that there are men who see a distorted version of themselves in the mirror. What they see, when we see a potentially very attractive man, is a pale, flabby gremlin. They often have conscious if illogical or uncritical understandings of their condition, such as: potential mates prefer substantial muscle (found to be untrue), they are in competition with their peers or they are addressing childhood memories of being labelled ‘fat’ or ‘overly thin’. Or they have no opinion whatsoever on very extreme behaviour

This does not just affect gay men – straight men, out to assert masculinity against the tides of butch feminism, metrosexuality and overt criticism of ‘male-ness’, have been found to have deep-seated anxieties relating to their physical appearance.

But in the gay community a shoring up of insecurities e.g. family, friends and romantic, can be very toxic when we add body anxieties. Gay men are notoriously critical, or ‘bitchy’, about each other; and the club scene asks, in exchange for inclusion, subscription to certain norms. Two of these ‘norms’: drug use and bareback sex, have been well covered in recent times. But little has been said on the subjective field of physical appeal, although this might be the most tangible on any night out in in Soho, London, or Canal Street in Manchester.

It is why the ‘Adonis Complex’ is an appropriate term for muscle dysmorphia in gay men. In the place of divinity, many men idolise male celebrities or porn stars. Gays are well-recognised niche group for marketers to target – most often (if I little lacking in creativity) with homoeroticism. In these images there is no ambiguity about the ‘ideal’ male body.

These ‘relationships’, I would argue, are important – they are channels through which to celebrate and normalise MSM sexuality. But they foster a dark by-product: physical elitism, which is reenforced by popular images of skin-tight (or absent) clothing, unrealistic muscles and rare beauty.

It makes sense that gay men would be obsessive about their body with this images as a dominent feed between gay men and gay-targeted media. Especially for men who participate in ‘mainstream’ gay cultures, such as the club scene. The ultimate standard for the male body has been set by these media. So it is not hard to see why many men, fearing irrelevance if they become old or overweight, can become ‘over concerned’ (to warily use that word) with their physical appearance. This, again, is true in the straight world as in the gay one.

But in the gay world the catalyst – the male form – is everywhere. In our media, in the clubs, on the streets and in our bedrooms (which is, for the most part, lovely). Gay men are presented with the omnipresent male form in any gay niche group (by definition). Even in drag acts, much of the humour comes from the ungainly and overt masculinity of the performers. We have a common ‘currency’ in the male body – we all have one, and we all to one extent or the other desire one romantically and possibly sexually.

This omnipresence compounds our doubt and anxiety. We have no refuge within popular culture nor within groups of gay men. The nature of this is a cycle: as we try and convince others that we belong to this elite standard, we fuel anxieties in others (“Am I as attractive as he is?), as well as our own (“Does he agree with me? Does he appreciate how often I go to the gym?”).

All this is to say that pockets of gay men experience body dysmorphic disorder as a mainstream cultural presence, not an undercurrent. Stereotypes of gay men – which are, effectively, generalisations taken after a superficial glance – often cite vanity, obsessive attention to physical appearance, and obnoxious neurotic behaviours: “do I look fat? I feel fat” “My hair is so awful today” “don’t take a photo of me, I look disgusting!”. These behaviours do not tell us some gay men are arrogant, vain and in need of reassurance, but that they obsess over fine and often insignificant aspects of their looks. And for no other reward other than to wake up tomorrow and repeat.

Obviously: this is the opinion of gay man who has never lived a straight life, nor been exposed to the cultural stimuli of straight men. From this side of divide, however, the pressure to look good seems stronger among gay men then our heterosexual counterparts.

Either way, the pressure is there, and it is toxic. And if it exists among heterosexual men then: what’s good for the goose is good for the gander (without specifying which is which). Professional, personal and romantic lives are affected by a desperation to ‘look good’, without respecting the subjectivity of looking good or the part personality and mentality have to play in attraction. The internal menace of body dysmorphia is an ongoing concern, and one with far-reaching consequences. There may be no absolute solution – but understanding is the key to progress.

Jack Flanagan

It’s High Desire NOT sexual addiction!

Recent research from functional MRI scans appear to show hypersexuality and “sex addicts” just have high desire.

This is something I’ve expected.  They may not even have a lot of sex, but a lot of desire, which keeps them preoccupied with sexual thoughts.  This seems a valuable piece of research and I hope to read the original paper to find out more.

My own experience over 30 years working with gay and bisexual men who present for help with “sexual addiction” is that they client’s are generally low on education and information about normative sexual behaviour and drives and very sex negative, or feel shame about their thoughts or behaviours or others tell them they are obsessed or ‘addicted’ then they may internalise this ‘diagnosis’ and consider themselves negatively. These people often come from religions which take a highly moralising view of what is healthy and what is sinful

One of the reasons why group work is a positive approach to sexual compulsivity is that it can show the range of ideas and sex negativity and people can realise there is a spectrum of behaviour and obtain some information about what is healthy and understand more about themselves.

Where sexual behaviour gets out of control, this is usually a symptom of some other distress and focussing solely on the sexual behaviour can deflect attention away from responding to the underlying trauma or more serious mental health difficulties.

Dominic Davies

My curious paradox about sexual addiction

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I’m finding myself in a curious paradox regarding ‘sexual addiction’ and it’s one that I feel the time has come to speak out about.  I’m increasingly frustrated at seeing people claim expertise in something which most mental health professionals dispute exists.

How does one claim to be a sex addiction expert when even the expert psychiatrists of the American Psychiatric Association recently revised DSM V were not persuaded to include Hypersexual Desire Disorder, let alone recognise sexual addiction as a diagnosis eligible for treatment?

I’ve been working as a therapist with gay and bisexual men for over 30 years and I would say I have never met anyone I considered to be a “sex addict.”  I’ve met many men who have found themselves out of control with sex, or who have used sex compulsively, or even recklessly, but I wouldn’t call them “addicted.”  I’m also not happy to collude with their self pathologising and self diagnosing.  It just feels unethical to agree to treat someone for something that I don’t believe exists.  If the client is sure they are addicted, then I tend to refer them to others who are happy to collude with this belief.  I readily acknowledge many people feel their lives have been saved by 12 Step Programmes and Sex Addicts Anonymous and I don’t want to stand in the way of someone seeking that kind of help if they feel it’s going to fit their world view better.  However, I feel I have a different view and wish to reflect on the meaning and circumstances of someone’s behaviour through a less pathologising and more personally responsible lens.

For about a decade, I’ve been co-facilitating a workshop for therapists which reframes ‘sexual addiction’ in a variety of other less shaming and more sex positive ways and offers ways of working with this.  I think sexual shame is often at the heart of presentations from gay and bisexual men who present for help thinking they are sexually addicted.  In fact  shame is often at the heart of many presentations for gay men, and since we’re men who choose to love other men, then often this gets focussed around sexual behaviour.  But it’s not the sexual behaviour that needs treating – this is only symptom of other things.  Sex is NOT an addiction. It is a natural biological drive, which is as natural as breathing or eating.

Many years ago I was heartened to come across Marty Klein’s article and we made this core reading for our workshop.  More recently the excellent The Myth of Sex Addiction by David Ley makes a cogent argument and debunks the hype and faux science and covert religious dogma which has been responsible for compounding the shame and guilt of many gay and bisexual men.

Heterosexual men are of course also affected by the myth of ‘sex addiction’ but I think there are some unique features that mark heterosexual men and men who love other men as different that I am choosing to focus my energy and objections to tarring gay and bisexual men with this spurious diagnostic brush.  Both Klein and Ley dismantle ‘sex addiction’ as a concept for everyone anyway and I think they are extremely persuasive.  I just think at Pink Therapy we have some new paradigms to offer and some interesting ways to understand and work with people who are using sex compulsively and so it’s worth focussing on just that group in our training workshop.

So here I am claiming expertise and experience in working with something which I don’t really believe exists!  I too am a sex addiction expert!

Dominic Davies – Founder – Pink Therapy

Addendum 26 Jan 2016
One of the contributors to the discussion below requested their comments be withdrawn.  I hope this doesn’t detract from your making sense of all the other contributions who respond to her.