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

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

Bad Language and Psychoanalysis

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I’m increasingly becoming concerned when I see language used like this: http://www.nscience.co.uk/10-feb-2016.html by colleagues in the psychoanalytic world.

What I am talking about here is the misappropriation by some sectors of the psychoanalytic community of the terms ‘sadism’ and ‘masochism’ to largely mean acting in a way which punishes others or themselves, (usually with words or thoughts rather than physical activities).

I believe it’s now pretty widely understood that in the real world, sadism and masochism refer to consensual sensation based ‘play’ (giving or receiving pain in sexualised contexts).  I think that in mainstream society this is fairly well understood and  I suspect more people understand sadism and masochism in this context than the obscure psychoanalytic one.

Language is constantly evolving and dynamic and words that for one generation were acceptable are no longer acceptable.  This continued usage is akin to us using the word ‘Coloured’ to mean Black, or ‘cripple’ to mean disabled. It’s outdated and no longer acceptable practice.

In 2012 the British Psychoanalytic Council held its first conference, Homosexuality: Moving On, reviewed here by my former supervisor and friend, the late Dr Bernard Ratigan who was sat next to me.  It really felt there was a genuine desire to apologise for the harms done to the lesbian and gay communities by psychoanalysis.  The conference had an air of the Truth and Reconciliation Commission of the post-apartheid era South Africa..  I know the BPC as an organisation are keen to no longer pathologise homosexuality, although how much progress has been made in their desire for moving on has been reflected in the curriculum of their member organisations psychoanalytic trainings or in their being openly lesbian or gay psychoanalysts as members is another question (there are several out gay psychoanalytic psychotherapists but to my knowledge not a single openly gay or lesbian psychoanalyst within BPC membership.

But what of other diverse sexualities, identities and lifestyles?  Is it acceptable to continue to pathologise members of the BDSM/Kink communities by using outdated and frankly offensive and misleading terms like sadism, masochism and perversion?

If the world of psychoanalysis wants to show it has something to offer those with diverse genders, sexualities and lifestyles and step aside from its history of pathologisation of sexual difference, and heteronormativity, then I think it would be wise to consider the impact of pathologising language on those disenfranchised members of society they might hope to help.

Dominic Davies
CEO Pink Therapy

P.S. In 2004 Pink Therapy’s held it’s first ever conference on the  subject of Queers, Queer Theory and the contribution of Psychoanalysis and Psychoanalytic thinking.  You can listen the audio recordings of the keynotes on our YouTube channel playlist

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).