Trans Hate on Sunday

I know many people’s leisurely Sunday was disturbed yesterday by another malicious piece of so-called journalism in the Mail on Sunday. I wonder if the Sanchez Manning the transphobic journalist who wrote for the third consecutive week about trans issues, this sensationalist article in the Mail on Sunday has ever sat with a suicidally depressed trans young person or bothered to explore the impact of transitioning on young trans people’s lives? Gendered Intelligence and Mermaids do masses of work in supporting young people and families in this area, and the YouTube is full of fantastic first-person accounts which offer hope and help save lives. The majority of parents of trans and gender-questioning young people are loving caring folk who are doing their absolute best to support their child.

The article referred to the new Memorandum of Understanding (MoU) which I reported on a couple of weeks ago. The MoU working group were always at great pains to ensure that therapists felt competent to have the difficult conversations about gender with their clients but to do so in a way that doesn’t privilege one decision over the other. Had the journalist and Stephanie Arai-Davies bothered to read the MoU they’d have seen that therapists need to be able to work with ambivalence and uncertainty about gender concerns without bias towards a particular outcome. Therapists support the person finding their answers to what they want to do about reconciling the conflict they feel about the gender they were assigned at birth and how they experience themselves.

The MoU stresses the importance of therapists being trained in working with concerns about gender and sexuality and seeing the quotes from Bob Withers, a member of both British Psychoanalytic Council and UKCP; it seems this part of the MoU is both relevant and necessary.  It seems like Bob Withers has a long history for expressing transphobic comments and this is particularly concerning since the clinic he co-founded in Brighton with his wife claims to work with a large number of LGBTQ clients.  Looking at his self-congratulatory posts and retweeting transphobes on his twitter timeline, I would concerned for any trans clients consulting him and wonder whether he might be in breach of the British Psychoanalytic Council and the UK Council for Psychotherapy’s Codes of Ethics for bringing the profession into disrepute?

Sanchez Manning’s interest in negatively reporting on trans issues is relatively apparent and verging on the obsessive. The week before they wrote another sensationalist piece about puberty-blockers under the headline: “We’ll give our son, 12, sex-change drugs: Parents want NHS to give their boy powerful puberty-halting treatment so he can be a girl” which probably wasn’t anything the parents said, but that didn’t seem to worry Manning, who must have missed the style guide on reporting on trans topics issued by Trans Media Watch. Oh, and publishing Alex Bertie’s photos without consent is SO not cool.

The use of anti-androgens (hormone blockers) is a standard treatment recommended by the World Professional Association for Transgender Health (WPATH) and based on best clinical practice.  It’s only used in exceptional cases after comprehensive and careful assessment, usually taking many months, and often at a time when the rapid changes of puberty make their benefit greatly diminished. The decision to use these medications is made by a multidisciplinary team (MDT) of doctors, therapists and social workers usually along with the parent’s support and the theory is that halting puberty will allow space for reflection, more significant cognitive and social development to occur. It’s not unusual to have other co-occurring mental health problems, and this is one of the reasons why an MDT is necessary. If the young person decides not to progress onto cross-sex hormones (currently at 16), they can stop the treatment at any time and puberty will continue.

Let me make this abundantly clear: An appointment with the Gender Clinic doesn’t mean someone IS going to transition, merely that they have someone who is skilled in helping them explore the issues.

The fact that someone in CAMHS refers a young person for specialist assessment could be seen as (a) how poorly trained most mainstream therapists are around these issues, (b) an entirely appropriate response to working within the limits of one’s competence or (c) a highly proper assessment and referral to specialist services. I would like to think it’s (c) because presenting with concerns about one’s gender identity is pretty standard nowadays for CAMHS staff to deal with although there is still a massive need for adequate training. The fact that a parent is unhappy with the referral needs to be worked with by the therapist, but we need to remember a 15-year-old is likely to be Gillick competent and should with all haste be referred. Research tells us that suicide attempts and self-harm rates for young trans people are running at around 50%. So we need to listen and promptly act when a young person finds the courage to come and talk to a mental health professional about their gender dysphoria.

The week before last, Sanchez Manning reported on sperm and egg preserving of trans young people before taking hormone blockers. Again, a recommendation of best practice laid down by WPATH. But Manning doesn’t seem to be that bothered about speaking to those involved in trans health care. They’re working for the Daily Mail after all which seems to revel in peddling hate and misinformation.

I wonder how a fringe group, Transgender Trend is telling a ‘story’ about youngsters being forced by the NHS into transition when quite the opposite is true. I’ve often felt the process of access to treatment (which may include hormone blockers, but more often simply involves psychological support) is incredibly slow, taking account of waiting times for a referral and then the process of assessment to determine suitability. If it’s agreed the young person should go on blockers, there is a further wait for the endocrinologist to see the young person and assess physical suitability (there is one paediatric endocrinologist working alongside the Tavistock GIDS). It has been known to take up to two years. Physical intervention isn’t a rushed process, and by the time someone starts (depending on where they were in their puberty when they entered the system), the impact of the hormone blockers could be very negligible.

What should concern parents is the bullying of gender-diverse young people.  Stonewall recently reported LGBT Bullying which is still rife in schools despite some progress being made in recent years and schools are doing better to address it.  However, 8 in 10 trans pupils are bullied, 4 out of 5 trans young people report self-harming and 1 in 10 receive death threats, there is clearly much more to do and I wonder whether Sanchez Manning and Transgender Trend think they are contributing to this problem?

The current best practice is to respect where the child or young person is at, to believe them, to help the parents support their child. Yes, some many children will change their mind about their gender after a period of social transition, but they will feel loved and respected whatever they decide to do. Childcare has moved on from the authoritarian days of the pre-1950’s where one was supposed to obey one’s parents at all costs to a more collaborative model of consent led mutual respect and where unconditional love is at the centre of ethical parent-child relationships.

Dominic Davies
CEO – Pink Therapy

 

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.

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Dominic Davies
CEO Pink Therapy – June 2016

Today is IDAHOBIT

May 17th is International Day Against Homophobia, Biphobia and Transphobia (or IDAHOBIT) where 130 countries around the world mark lesbophobia (where the term leads the South American efforts), homophobia, biphobia and transphobia.  It started out as IDAHO, then in 2009 added the T and in 2015 we Brits added bisexuality, so you’ll see it spelt differently depending on where you are in the world.  The similarity in name and reference to hobbits wasn’t welcomed by many activists around the world who saw:

*Consultations on the name with activists in 120 countries have concluded that the reference to hobbits might be clever for some parts of the world, but were seen elsewhere as an imposition of Western values. In many places where people are facing daily life threats, this proposal was considered highly inappropriate.

The theme this year is Mental Health and Well-being.

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Dr Felicity Daly, Adernoke Apata, Prof. Michael King & Dominic Davies at Kaleidoscope Lecture

On Tuesday last week, I was invited by Dr Felicity Daly, Executive Director of the Kaleidoscope Trust to take part in a lecture on Global Mental Health and Well-being.  Other panelists were Nigerian LGBT Activist and Asylum Seeker Aderonke Apata and Professor Michael King of University College Hospital. This blog is an extended version of my brief presentation there.
At Pink Therapy we been engaging in a small way on the international stage for a little under a decade. I would occasionally get emails from therapists around the world asking for support and training and our weekend based model of short courses wasn’t conducive to their being able to travel on a regular basis and study with us.   Seven  years ago Pink Therapy ran a not for profit International Summer School.  Over the subsequent years we have had psychologists, psychotherapists, psychiatrists  and sexologists from across Europe (including Central & Eastern Europe (Latvia, Croatia, Serbia, Poland, Hungary).  Plus Israel Malta, Spain, Italy, France Germany, Denmark, Finland, Eire, Portugal, Scotland, NZ. South America: Brazil & Colombia. We’ve even had  one person from Africa (Benin).

There are also a number of overseas countries where I’ve delivered training: (in alphabetical order): Australia, Belgium, Brazil, Colombia,Dublin, France, Germany, Guernsey, Latvia, Malta and New Zealand, each has their own rich and quite different environment for the way Gender, Sexuality and Relationship Diverse people are living their lives.

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Summer School Graduates 2015

Most of the therapists attending our Summer School’s have been working in very isolated contexts, where they might have been virtually the only out gay therapist in their country.  They’ve worked with an incredibly wide range of clients.  Some worked with LGBT victims of war, and of poverty, (the Transgender Roma’s of Serbia), or where the political situation is becoming more conservative and repressive (Poland).

Many of the psychologists/therapists are activist-clinicians.  I met a an amazing intersex activist and therapist Mani Bruce Mitchell when I visited New Zealand or a lecture tour to promote the first volume of Pink Therapy in 1996.  Mani was then the only out Intersex person in NZ.  They recently had a second documentary made about them Intersexion which did very well at the LGBT+ Film Festivals around the world.

One of the earliest people to connect with us was Miguel Rueda-Saenz who went on to set up Pink Consultores an organisation similar to Pink Therapy in Bogota, Colombia and his University invited me to come out and deliver some training in Colombia. We’ve also had Klecius Borges a Brazilian Jungian psychotherapist who has done amazing work raising awareness of LGB mental issues and become a bit of a Brazilian television celebrity. We have had in two different cohorts,  two lesbian therapists from Singapore where homosexuality is still illegal.   It’s still not uncommon to find clinicians in Asia claiming homosexuality is a mental illness.  I heard about this from people in Malaysia and China recently.

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No Pride sticker from Latvia

I was invited to help train the very first LGBT helpline volunteers in Latvia. (The year before the ‘Friendship Parade’ was 300 people marching around a city park heavily protected by armed police and 3000 protestors outside screaming abuse at them.  They were bussed away from the park for their own safety.

Normally the people running such a service would be entirely self-identified as LGBT or T). On my helpline training in Latvia where there were just three brave out lesbian and gay therapists and so heterosexual allies formed the majority of the group.  One of the out gay therapists was Maris Sants  a priest and psychotherapist living in Latvia and one of the most well qualified therapists I’ve met.  He is a survivor of Russian Reparative Therapy and was often brought into the TV studio to comment on LGBT human rights issues.  Subsequently he was frequently spat at and attacked in the street for being openly gay. He is now exiled in the UK, where he initially got a job working in a café as a barista whilst he continued to serve the therapy needs of his fellow gay Latvians via the safety of Skype consultations.

There are so many stories of resistance and resilience we’ve heard over the years.

Our new 2 year Post Graduate Diploma is making a contribution to this deficit. Even in the UK, therapists have virtually virtually NO training in working with LGBT clients, despite LGBT people having much poorer mental health than the heterosexual and cis-gender population.  Across the world, it’s much, much worse.

We know LGBT’s have poorer mental health.  Especially the B’s and the T’s by virtue of the pressures on us due to Minority Stress and even amongst those of us with all kinds of privilege by virtue of gender, race, education, and class, we continue to face the constant toxic low-grade micro aggressions – the kind of marinade of ‘tolerance’ and mild disgust we live with – especially when we make ourselves visible, through the privilege of being able to engage in public displays of affection or state sanctioned weddings.  How much worse must it be when you face prison or punishment rapes or an honour killing for being LGBT?

Mental Health is such an important human right to be fighting for.  It goes to the heart of a country’s well-being – in terms of it’s health care, its culture, it’s spiritual life, and of course  the economy.  So finding a way to improve the legal situation in countries where homosexuality and gender variance are punished is crucial. Kaleidoscope have a project to change the laws in Commonwealth Countries. But so is improving the awareness of our fellow citizens at home.  Things are changing.  Much more than I could have imagined when I was coming out 35 years ago.  But there is still a long way to go.  This is why IDAHOBIT/IDAHOT is so important.

Dominic Davies
CEO – Pink Therapy

We’re all in it together. Aren’t we?

IMG_6098On Friday, I received this invitation. 

I was both thrilled by the recognition that my contribution to British society had been recognised and then immediately felt deeply uncomfortable. 

I wasn’t sure what to do. I just don’t feel comfortable being part of ‘Dirty Dave’s’ PR effort to impress the queers that the Tories care about us. They don’t care about us, and they care about the weak and the vulnerable even less. 

I talked to a few trusted friends and colleagues and came to the conclusion that in all conscience I just didn’t feel it was right to go.  It’s been a complex process and not one that everyone will agree with, but I wanted to explain my reasons for this.

Earlier this year, I had the privilege of representing the working group of the Memorandum of Understanding around Conversion Therapy in a small meeting with Parliamentary Under Secretary of State for Public Health, Jane Ellison MP, in her very smart and newly refurnished office at the Department of Health. I was delighted with how much she seemed to grasp about the complexities of therapists and staff in the NHS who might be approached by people wanting to change their sexuality or their gender.  She seemed compassionate, bright and well intentioned.

It was then somewhat of a surprise, when I saw that she recently voted to support benefit cuts, and  just recently voted against allowing 3,000 unaccompanied refugee children into the UK. In fact, she rarely votes against the Government, but then again, I guess that’s how you get to be Deputy Health Minister.  I am politically quite naive aren’t I?

The Conservative Government under David Cameron has done far worse damage to the Welfare State and to the NHS than Margaret Thatcher did.

Of course, I am delighted that Britain now has some of the best LGBT human rights protections in the world, although let’s not forget they want to opt our of the European Convention on Human Rights.  It seems that so long as we play nice, and want to get married and settle down like ‘normal’ people. But making PrEP available for those filthy gay men who have condomless sex outside of monogamous relationships?  Don’t bank on getting that funded.

If you can afford £50 (or less) a month, you might want to protect yourself and order online!  We have Trident to fund after all!  It’s interesting isn’t it, we can always find money for bombs, even if we can’t afford to look after the more vulnerable members of society like the refugee children who have been made homeless and lost their parents because of our bombs!

I’m interested to see what action get’s taken on the Transgender Equality Enquiry.  I suspect it will get buried. 

Everyone is aware of the cuts in funding of the third sector organisations – LGBT organisations are like PACE closed down and others are having “to do much more for less” and the savage cuts to the benefits system have caused thousands of people to become homeless and die.  Including LGBT teens of course.

I attended Digital Pride on Saturday, and heard from the black panelists on the Race panel (before I chaired the one on Mental Health), how appalling the Home Office are still being in assessing asylum claims for those LGBT Asylum seekers fleeing persecution in oppressive regimes abroad. It’s certainly not getting better for them.

As a result, I’m not sure that I can in all conscience attend this garden party for 200 hand picked LGBT people of influence and pretend to support David Cameron’s government when so many other groups in our society are suffering at his hands.  Wandering around his carefully tended garden with the waft of Terre by Hermés with the A-Gays drinking nice wine and showing gratitude for how far we’ve come, when we have homeless queer youth on the streets, LGBT Asylum seekers being starved and sent home to their deaths, and the Junior Doctors being asked to put patient’s lives at risk because Jeremy Hunt on a whim feels that they can all work a little harder.

Some people have told me that it’s better to be on the inside changing things.  I’m missing out on the opportunity to make connections with powerful people of influence and inform them more about Queer mental health.  But another, less principled aspect of this is that in all honesty, as someone who is socially fairly introverted and finds large gatherings like this a nightmare, I really doubt I would have been able to operate in that sphere and I’d just lurk on the edge, taking selfies for my Facebook page.

There are many people who are great at ‘working’ these events, and having these difficult conversations, and who can stomach to do that in the face of knowing full-well what the wider picture is.  Those are the people who have fought for and won so many of our recent Rights and protections.  I admire them and I’m pleased they are doing what they do.  I just don’t have the stomach for it.

Dominic Davies
CEO – Pink Therapy

BACP Signs up!

I was delighted to learn that the BACP Board of Governors decided to sign up to an inclusive Memorandum of Understanding to extend protections to trans people and asexuals.  This still hasn’t been published on their website but will be soon.BACP MoU statementI am grateful that to everyone who played a part in lobbying the Board with their views, research and concerns.  I think this has been immensely helpful in helping the Board decide that these protections are needed.

All the signatories to the MoU need to follow their due process and consider the implications for signing up and extending the protections.  BACP were doing just that.  It had been reported elsewhere that they had refused to sign, and this was a distortion of what I had been stating, that the Board were to meet in Early March and the indication I’d had was that they might decide not to sign based on “a lack of evidence & research.”  This research was then supplied and the Board of Governors were able to make an informed decision.

I’ve been mulling over whether to still resign over my broader dissatisfactions with BACP. However, I think to resign at this point might look like this queen has had a hissy fit.   

BACP ought to be well aware of the significantly higher rates of mental health problems within the LGB and T community based on research they commissioned in 2007.  However, I am saddened that they’ve not used their considerable resources to ensure that counsellors are adequately trained to support LGBT people.  Their signing up to the Memorandum of Understanding makes this an obligation and I am hopeful they will be auditing their accredited courses more closely on their attention to issues to GSRD issues.

I had hoped that having been made a Fellow in 2007 for my “distinctive service to the field”  that this might signal an opportunity to collaborate in improving the mental health of Gender, Sexual and Relationship Diversities (GSRD). BACP also published my article Not in Front of the Students about the absence of training in their journal in the same year.  But nothing has changed and I’ve felt quite dispirited. Instead, BACP have promoted workshops on treating sexual addiction which is a highly contested and controversial issue which many of us in the field of clinical sexology would dispute See Marty Klein who has blogged extensively on this or the excellent book by David Ley Ley, 2013, Flanagan 2013 and my post Davies, 2013) Sexual Addiction or Hypersexual Disorder failed to be included in the latest Diagnostic and Statistical Manual (the bible for mental health disorders compiled by the American Psychiatric Association) on the grounds of lack of robust evidence for diagnosis and effective treatment.

One of the positives that has come from my having taken stance is that MANY therapists and members of the GSRD communities have been having a conversation about therapy and it’s need to catch up with the rapid evolving field and address the mental health needs of our communities.  [Over 80 concerned therapists and sexologists signed an open letter to the Board.]

It always surprises non-counsellors when I tell them that in what can be between a three to seven year training to become a therapist there is virtually no training in basic human sexuality and relationships let alone in working with people whose sexuality is different to the mainstream. Unless one trains to be a sex therapist, one is unlikely to be able to engage in explicitly sexual conversations.

Perhaps all of this activity over the past few weeks can pave the way for a closer dialogue between all of us who are concerned to see better mental health for our communities. We’ll see!

Dominic Davies
CEO/Founder Pink Therapy

BACP seen as flawed at home and abroad

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There continues to be a lot of support for my stance and criticism not only of BACP but the training organisations that are accredited by them:

 

I’m in my second year of a Diploma in Therapeutic Counselling with an Integrative approach in London. Your post about leaving the BACP over their LGBTQ diversity issues worries me as a trainee. As I’m told at every stage I need to be BACP registered and Accredited. I’m so glad I received today the link from you and a hard copy of Therapy Today on this issue. It is so true that there is a lack of training regarding this. In our institution we have had a days session and if it wasn’t delivered from my colleague who is Trans and myself and aware of your work and other material on Gay Affirmation therapy and how Counsellors / Therapists should work with clients presenting these issues. I would hate to think what would have been delivered. We only presented to one class of three! It really seems a token gesture and not taken seriously for those in current training to challenge their own views and prejudices! 

Not sure why the lecturers didn’t deliver it? Perhaps they aren’t trained or up to date with this??? Needs to be rolled out to all institutions!

Another counsellor responded:

This is so familiar, so many people here delivered the only LGBT component of their course, as students, often having to balance outing themselves with tackling prejudice and outdated notions

Another said:

I qualified as an Integrative Counsellor in 2008. We had no training whatsoever concerning LGBTQI clients. I researched myself and went on a couple of courses with Pink Therapy. Sad to hear it seems much the same in 2016!

Some international support

I read of your resignation from the BACP today. I think you are doing the right thing, and someone of your stature doing this may possibly effect some shift, certainly makes people take notice. I am a fellow psychologist; I resigned from APA years ago due to the terrible issues around torture, failure to take treatment efficacy seriously, and also the foolhardy drive to attain prescription privileges. Better to stand apart, in my opinion, than to be associated with an unethical herd. The issues around conversion therapy are quite serious and real, and no responsible psychologist should ignore it.

and this one:

This morning I read about your resignation from the BACP, and I just want to say thank you so much.

I am lucky to be a young queer woman in Boston, where the atmosphere of most places is somewhere between tolerant and accepting. But in my experiences of mental healthcare, I’ve seen a completely different world. So many psychologists and counsellors are uneducated and untrained about LGBT+ matters, and I’ve seen so much damage done to my queer community because of it. 

I am graduating from high school in a few months, and as I head into college to major in mental health counseling and social work, I feel like it’s important to have faith in the mental healthcare world that I want to work in. It’s really hard to have that faith when I’ve already seen so many problems with the system, especially in the treatment of LGBT+ people. But actions like yours give me hope– I read your statement and remembered that systems can be changed, and the people who choose to work in the counseling world do that work because they genuinely want to help others. 

Thank you so, so much for reaffirming that for me, and thank you for the work you’re doing. I imagine it’s not easy to speak out against a group like the BACP. The LGBT+ world is lucky to have you.

On the monopoly BACP seem to have with employers:

FFS. That leaves me in a very bad situation. It’s not like I have much choice of professional organisations to belong to.

And another:

I’m not sure where else I can go in terms of membership organisations. Makes me feel angry at the conservatism of the BACP.

And another:

I’m a referral counsellor for a therapy centre based on my BACP accreditation, it would mean losing my livelihood unless I could persuade the therapy centre to accept the National Counselling Society.

What could BACP be doing?

Some people have asked me what specifically could BACP be doing to support the LGBT communities better. Here are a few suggestions to be going on with:

  1. Develop some core competencies on Equality and Diversity related issues that take account of the complexity of intersectionality.
  2. Ensure therapists receive some basic sexuality awareness training so that they can discuss sexual issues with their clients.
  3. Ensure Gender and Sexual Diversity issues are woven throughout the therapy training and not just a tokenistic add on.
  4. Closely audit the courses BACP accredit to ensure they are meeting these requirements.
  5. The training should be delivered either by faculty if they feel competent, or by external trainers. Students enrolled in the programme should not be delivering this training.
  6. As the major UK therapy organisation and therefore the wealthiest, BACP could be funding a researcher to produce an FAQ on Conversion Therapy  and develop some training materials on this subject as a resource for all of the signatory organisations and their members.
  7. Actively support people from disadvantaged and underserved communities to train as therapists.  In particular, increase the availability of  therapy from Black and Minority Ethnic (BAME) and Trans and Gender Diverse counsellors.  Both groups are significantly economically disadvantaged in society and yet also have poorer mental health and so we need to ensure training isn’t only affordable by wealthy people. This is why we’re offering a couple of training bursaries for our own two-year PG Diploma in Gender and Sexual Diversity Therapy to Trans and BAME therapists.  It’s estimated that basic therapy training costs between £20-£80k and for those people who then want to go on and specialise in working with Gender, Sexual and Relationship Diverse Clients it’s going to add another £5k.

In one of my earlier blogs I mentioned how both BAATN and ourselves have set up volunteer led mentoring schemes to support those members of our communities who are training to be therapists in what can be quite alienating and hostile environments.

Dominic Davies
22 Feb 2016

Trans Health Care by GP’s

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I’ve recently learned that it’s not uncommon for a trans person, who has had a diagnosis of Gender Dysphoria and requested their GP to enter into a shared care plan with the GIC or specialist treating the person to be declined hormones or shared care by the GP.

It would appear that this could be an offence worthy of reporting to the General Medical Council as it goes against advice from the Royal College of General Practitioners and the GMC.  UPDATE 15/3/2016: The GMC have recently issued this guidance to GP’s

UPDATE: 6/4/2016: Dr James Barrett from Charing Cross GIC has written to the British Medical Journal “Doctors are failing to help people with gender dysphoria.”

I appreciate that some GP’s may feel unqualified to treat trans patients and so decline hormones.  I doubt this lack of confidence gets applied to patients presenting with depression that the GP feels they must refer to a psychiatrist rather than prescribe anti-depressants!  There is a very helpful online e-Learning programme made by GIRES which can bring a GP up to date on how to treat a trans or gender diverse person.

I have it on good authority that NHS England knows about this problem but has so far been ineffectual in addressing it.  This is remarkable given that NHS England commissions each General Practice in England!  They have contract non-compliance powers and they often fail to instigate them equality matters.  If these GP’s are failing their trans patients they are probably also discriminating in other areas (failing to provide teenage girls with contraception or treating their LGB patients with sensitivity).

Some years ago the Lesbian and Gay Foundation (now the LGBT Foundation) produced quality standard for practices ‘Pride in Practice’.

In addition to the links above, I’ve put together a list of useful documents to help trans and gender variant people inform their GP and negotiate for better health care:
Royal College of Psychiatrists guidelines for the assessment and treatment of adults with gender dysphoria

Guidance for GP’s and other clinicians on the care of gender variant people

A guide to hormone therapy for trans people

Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guidelines (US Document)

GMC Good practice in prescribing and managing medicines and devices (2013)

There is also this excellent health guide for Trans men, trans masculine and non binary people

Finally, since most people can’t afford to consult private therapists, there is this excellent guide written for trans and gender variant abuse survivors on accessing therapy

Dominic Davies
CEO Pink Therapy