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.


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.


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.


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

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


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

Following up on BACP

PINK4646 DD Portrait

I wanted to say how incredibly moved I am by the level of support I’ve received since announcing my resignation from BACP yesterday.  I had no idea that my social media influence was quite so effective and I’ve been overwhelmed by the positive comments of gratitude for taking a principled stand and raising awareness of their failure to address the mental health needs of our community.

Concerned colleagues and BACP members have written an open letter to the Board of Governors.  If you wish to join the Pink Therapy closed Facebook group (aimed at therapists working with GSD clients) and follow the discussion click here.

I have also been deeply saddened by seeing the high level of disaffection with BACP – the largest counselling and psychotherapy body in the UK.

“..Removing yourself from such an organisation and doing so publicly gives a voice to all those lgbtq people who have suffered from BACP’s heel dragging and it also empowers the new Society by having you give authority and credence to its stand on issues of sexuality, orientation, and expression.”

I’ve sat by for almost 35  long years hoping BACP would do the right thing and address the issues of improving the quality of mental health provision for LGBT people. 

It’s not as if there are no gay people working in the highest echelons of BACP. But it’s largely cis white gay male privilege reinforcing the status quo from within. I recall in my early days of attending BACP annual conferences (when they had such things) that I’d be largely avoided by ‘discretely’ gay/bi senior officials – fear of guilt by association.  But it gave me some sense that BACP might be alright and looking out for us.

Sadly this is not the case.  They’ve done very little over these three decades to raise the standards of counsellor training to help therapists feel more comfortable discussing sex and relationship issues let alone anything less mainstream like Gender, Sexual and Relationship Diversities (GSRD).  I’ve written about this before: Not in Front of the Students in 2007.  Nothing’s changed as Meg-John Barker and I reported last year in an article on the UKCP Journal The Psychotherapist 

Meanwhile I’ve ploughed my own furrow and made way for a new generation of GSRD therapists and had the privilege of training and working alongside many of them. Developing courses to fill the gap left by the heteronormative mainstream has failed to address.

As Audre Lorde said:
“For the master’s tools will never dismantle the master’s house. They may allow us to temporarily beat him at his own game, but they will never enable us to bring about genuine change. Racism and homophobia are real conditions of all our lives in this place and time. I urge each one of us here to reach down into that deep place of knowledge inside herself and touch that terror and loathing of any difference that lives here. See whose face it wears. Then the personal as the political can begin to illuminate all our choices.”

It’s fascinating that BACP has never sought to create a division around gender and sexual diversity issues.  The old PSRF (Personal, Sexual, Relationship and Family) division got rebranded ‘Private Practice’ and there was, for a few years a RACE division but that limped along poorly supported and so as Lorde predicted, the queers and those of colour created their own spaces for support, training and development.  The Black and Asian Therapists Network (BAATN) is a thriving active body which meets regularly in London (co-incidentally in the same building as we run our training workshops).

Over the years, largely because of the lack of attention to diversity, I have programmed many large conferences addressing gender, sexuality and relationship diversity issues.  Personally taking the risk of financial loss if they’re not well enough attended (and one of these cost me £3k of my savings).  I am enormously committed to improving the quality of therapy available and the training of therapists has been a major focus of my career. Pink Therapy receives no grants or external funding.  It’s entirely funded from training course fees and directory membership fees. We’ve also followed BAATN’s lead and developed a mentoring scheme because of the endemic homophobia, biphobia and transphobia many counsellors feel in their training courses. 

So it feels a kick in the teeth when I hear from people whom I’ve always respected that they feel there is a lack of evidence that Conversion Therapy is being practiced on trans and gender variant people and on asexuals.  They may not know of it happening, they may not have seen the research, but that DOES NOT mean there is no evidence!  (yesterday I cited several studies).  Those of us closely connected to the Trans and Asexual communities are hearing all the time about how crappy therapists have been, how inappropriately they’ve treated them. It’s unfortunate that BACP are so out of touch and uninterested in learning from our communities.

Conversion therapy in the UK is also on a pretty small scale and I’m not sure there has been much ‘evidence base’ for that apart from Bartlett et al who found appalling levels of ignorance amongst mainstream counsellors responding to requests for reduction in their same-sex attractions.  But these therapists wouldn’t have said they were doing “conversion therapy” which is a term largely used by fundamentalist Christians or the Orthodox Jewish organisation Jonah.  Conversion therapy IS big business in the USA but here in the UK it’s more that well meaning, under-trained therapists agree to try to help a distressed client manage their same sex attractions by encouraging them towards heterosexuality.  This is highly analogous to CAMS and other therapists working with children and families who present with gender non-conforming behaviour brought by their concerned parents worried that their child might be gay or trans and being advised to discourage cross gender play. 

I am looking forward to taking up membership of what seems a much more supportive and progressive, albeit smaller counselling body – the National Counselling Society who have a policy of accepting members who are already accredited elsewhere in at the same level as they were.  So in addition to my existing membership and Senior Accreditation with the National Council of Psychotherapists (who few people seem to know about), I will become enjoy Senior Accreditation and continue to be on the PSA Register.  It was tempting to consider joining one of the more renegade groups of therapists like the Independent Practitioners Network, whom I have enormous respect for, but actually I want to be able to try to influence the profession by being a member of a larger body where we can hopefully raise awareness of equality and difference.

I was very troubled to hear though, how BACP seem to be holding a monopoly on who employers recognise as being THE accrediting/registering body for the profession.  One person commented on my post that he didn’t feel he could leave BACP as the NHS (in Wales) wouldn’t recognise membership of any other professional counselling/therapy body.  

Another respondent said: 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 organisation that Dominic mentioned…certainly needs to be thought through before I make any moves as I’m not in a financial position just to leave here not to mention all of the clients I currently see here, many of whom are trans or LGB…

Finally one last significant peeve I have with BACP is how they have been actively promoting the concept of “Sexual Addiction” by holding training events around this subject.  Sexual Addiction is a highly contentious and controversial subject – where there is no treatment evidence base or even any widely accepted diagnostic criteria and was declined inclusion in the DSM V on this basis.  Yet BACP seems to be happy to encourage their members to treat something which most informed clinical sexologists are highly sceptical of.  If you wish to read more about The Myth of Sexual Addiction see David Ley’s helpful book

Dominic Davies
18 Feb 2016

Why I am resigning from the British Association for Counselling and Psychotherapy


I feel incredibly let down by my professional body – an organisation I have been a member of for almost 35 years and where I am a Senior Accredited Counsellor/Psychotherapist and a Fellow.  They have indicated that they are likely NOT to be signing up for a revised Memorandum of Understanding on Conversion Therapy which would be extended to include trans and asexuality.

I am so frustrated by their constant inaction and lack of understanding the issues that I am resigning.  Here are some of the reasons why:
As LGB and T people are over represented in the therapy-consuming population, due to demonstrably higher levels of mental distress and self harm there is an obvious and urgent need for counsellors to be able to provide skilled therapeutic support. 

This is a rapidly changing field in terms of our knowledge about gender and sexual minority groups, language and concepts are continuously shifting especially with regard to trans issues.

There has been fairly recent legislation affecting LGB and T people’s rights, which therapists are likely to be unaware of.  BACP has an obligation to ensure that therapists are to be kept up to date on all this.

Consistently research has demonstrated that LGB and T people have felt poorly served by therapists.  As BACP is the largest counselling professional body it’s likely to be the case that there will be a great many members who have not responded appropriately. 

In case you’re interested: Cordelia Galgut researched lesbians experiences of therapy, Iggi Moon conducted research into therapists attitudes to bisexuality, Tina Livingstone did a similar study but exploring therapists attitudes to trans people.  Karen Pollock researched how comfortable suicidal trans people felt about seeking counselling. Bartlett et al did a large study on the response of mental health professionals to clients seeking help to change sexual orientation ALL found appalling attitudes by counselling professionals to gender, sexual and relationship diverse groups.

The MoU v1 items 18 and 19 make it an obligation that members of the signatory bodies i.e. BACP counsellors should be adequately trained to know how to best respond when someone presents with confusion over their sexual orientation or is seeking a reduction in their same sex attraction or a ‘cure’.

“18 Those with a responsibility for training will work to ensure that trainings prepare therapists to sufficient levels of cultural competence so they can work effectively with LGB clients;

19 Training organisations will refer to the British Psychological Society guidelines on working with gender and sexual minority clients when reviewing their curriculum on equality and diversity issues;”

BACP took two years to resolve a case where someone (an undercover journalist investigating gay cure therapy in Britain) sought the help of a BACP Senior Accredited therapist (Lesley Pilkington) and was offered ‘gay cure’ therapy.  One of the major obstructions in the complaints process was to be able to find an unbiased/neutral complaints panel. I think BACP were also very scared that Pilkington was being defended by the Christian Legal Centre. BACP subsequently wrote to all members making it clear members were not to engage in reparative therapy, but have done very little to improve the confidence of therapists to know how best to respond to such requests from clients since then.

“14: For organisations with practitioner members, each will review their statements of ethical practice, and consider the need for the publication of a specific ethical statement concerning conversion therapy”

Today, I was informed in a “courtesy call, as a Fellow of BACP and someone very involved in these issues” that BACP don’t want to create an ever growing “list of orientations and conditions” [my emphasis], when the Ethical Framework already has principles which make unprofessional and incompetent practice unethical. 

They want to just rely upon their Ethical Framework (and there is a new one out in July) which is based on ethical principles, currently they are: autonomy, trustworthiness, beneficence, non-maleficence, justice and self respect. to ensure members act appropriately and ethically.

However, how are therapists supposed to be able to deliver competent and ethical therapy without specific training about gender, sexual and relationship diverse clients?  For example, without knowledge of the specific mental health needs and socio-cultural contexts in which minority stress and micro aggressions contribute to much higher rates of depression, suicide and self harm, (with bisexuals and gender variant people having significantly poorer mental health than lesbians and gay men).  Research into self harm amongst trans people shows that over 40% of trans people have attempted to take their lives or self harmed, about how relationship dynamics are often different amongst LGB people; about working with gender variant young people.  There has been a 400% increase in referrals to the child and adolescent Gender Identity Development Unit at the Tavi and many therapists in community settings are working with young people and their families around gender identity issues.  We are increasingly hearing stories from trans people about poor understanding of their issues.  Including accounts from gender non-conforming young people being encouraged to follow to gender roles appropriate to the sex they were assigned at birth (i.e. boy’s shouldn’t play with dolls or dress in female clothing etc).

I think BACP are failing to support their members in learning how best to respond to gender, sexual and relationship diverse clients.  The occasional article in the Therapy Today does not count as adequate attention to the training and development needs of it’s members.

It’s my view that BACP has become a large bureaucracy which has failed to use it’s power and resources to address the failures of the counselling profession to improve the quality of therapy for gender, sexuality and relationship diverse clients. 

The decision as to whether to re-sign for an revised MoU inclusive of Trans and Asexuality has been referred to the Board of Governors who meet in March.  It’s been indicated to me that it’s likely they will feel signing up will not be consistent with BACP’s policy and practice.  I seriously doubt the Governors of BACP will be a particularly well informed group of individuals who will have their finger on the pulse regarding trans and asexuality issues so this a great way for the Executive of BACP to pass the buck. I’d be curious to see any briefing papers they have prepared for the Board on the issues involved in whether to sign back up to MoU v2.

I was proud to be made a Fellow of BACP back in 2007 for my “distinguished service to the field” but that award has been pretty hollow given how BACP have rarely sought advice and guidance on what they might need to be doing to meet the needs of their membership with regard to helping counsellors improve the mental health of our communities. 

My BACP membership is due for renewal next month, but I will not be renewing and I will instead be taking up membership of a smaller but much more responsive professional body – the National Counselling Society who have indicated that they have voted for an inclusive MoU v.2 and that my status of a Senior Accredited member can be transferred to their organisation and that their Professional Standards Committee would welcome my application for a Fellowship.  They are also keen to have have my expertise contribute to the way the organisation might support their members.

Perhaps other disaffected members of BACP might want to consider whether they want to continue their membership!

Dominic Davies

17 Feb 2016

Reparative therapy in Rutter’s Child and Adolescent Psychiatry

The new (6th) edition of Rutter’s Child and Adolescent Psychiatry features a chapter on a gender nonconforming young people for the first time, entitled “Gender dysphoria and paraphilic sexual disorders”. This chapter draws upon flawed and outdated research to effectively promote ‘reparative’ therapy, with the intention of changing children’s gender identities. It can be read here.

Authors Kenneth Zucker and Michael Seto suggest that therapists work with parents to “set limits with regard to cross-gender behaviour, and encourage same-sex peer relations and gender-typical activities”. In doing so, they promote the idea that issues faced by gender nonconforming children are due to an innate problem with the child, rather than with the child’s relation to normative societal gender roles.

Reparative therapy for gender identity issues can harm children by leading them to internalise the idea that nonconforming gendered expression is shameful or wrong (Ansara & Hegarty, 2012). It runs counter to explicit guidance on the treatment of children and young people from the World Professional Association for Transgender Health Standards of Care (WPATH, 2012). In contrast, approaches that enable and support children in exploring gender identity and expression have been shown to have beneficial outcomes (De Vries et al, 2013; Ehrensaft, 2012).

The chapter also exhibits poor scholarship. The first author prominently cites his own work no less than 17 times. Strong inferences are drawn from statistically insignificant quantitative findings. Blanchard’s (2010) deeply reductive typology of male-to-female transsexualism is reported on prominently, but the controversy of this theory (Serano, 2010) is not acknowledged.

Zucker’s own Gender Identity Service at the Toronto-based Centre for Addiction and Mental Health was recently recently suspended pending investigation following complaints from a number of parents. It is unclear whether or not the service will re-open, particularly as Zucker’s approach to therapy is now arguable illegal in the state of Ontario following a recent change in the law. Zucker has also been criticised for building his academic profile through an ‘invisible college’ of mutual citation and peer review (Ansara & Hegarty, 2012).

In light of these issues, it is deeply concerning that Zucker was invited to co-author this chapter.

For these reasons it might be best if the 6th edition of Rutter’s Child and Adolescent Psychiatry is not bought for libraries or used within training.

Guest Contributor:
Ruth Pearce
August 2015

Works referenced

Ansara, G and Hegarty, P (2012) Cisgenderism in psychology: pathologising and misgendering children from 1999 to 2008. Psychology & Sexuality 3:2, 137- 160

Blanchard, R (2010) The DSM diagnostic criteria for transvestic fetishism. Archives of Sexual Behavior 39, 363–372

Ehrensaft, D (2012) Gender Born, Gender Made: Raising Healthy Gender-Nonconforming Children. The Experiment Publishing: New York

Serano, J (2010) The Case Against Autogynephilia. International Journal of Transgenderism 12:3, 176-87

De Vries et al (2013) Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment. Pediatrics: 2013-2958

WPATH (2012) Standards of care for the health of transsexual, transgender, and gender non-conforming people. WPATH,%20V7%20Full%20Book.pdf


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.


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.  

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).