Seriously Purple -Micro aggressions

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

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

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

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

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

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

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

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

embracing_diversity

Dominic Davies
CEO Pink Therapy – June 2016

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

Following up on BACP

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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

BACP_Member

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.  http://www.bacp.co.uk/ethical_framework/ethics.php 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

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

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 http://www.wpath.org/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf

 

Sartorial Experimenting

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

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

at European Diversit

at European Diversity Awards

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

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

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

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

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

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

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

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

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

 

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

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Some initial thoughts on lessons learned:

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

Dominic Davies
Founder/Director

An introduction to Gender and Sexual Diversity Psychotherapy

A Pink Therapy Summer School in London, July 8-12, 2013

Editor’s note: this is a guest post from André Helman, MD; a relational psychotherapist from Paris.

Pink Therapy is an independent therapy and training institution devoted to LGBT people and to gender and sexual diversity. Located in London, it was created by Dominic Davies, a psychotherapist and sex therapist, who runs it together with a team of fifteen or so therapists and trainers.

I was lucky enough to take part in an international summer school about Gender and Sexual Diversity Therapy (GSDT). Exploring this concept, which was brand new to me, as well as its implications was an opportunity for dramatic breakthroughs and broadening of my field of thought. That is the experience I wish to evoke in this paper. It is not an in-depth reflection about GSD (many books were published about it, and many are still to be written), only a brief report where the author’s subjectivity is freely invited.

The GSD concept

Gender and Sexual Diversity (GSD) and Gender and Sexual Diversity Therapy (GSDT) concepts were elaborated through the recent years by Dominic Davies and his colleagues. The initial book, Pink Therapy, which gave its name to the institute, was directed by Dominic Davies and Charles Neal, and first published in 1996. It dealt with affirmative therapy for gay men. Progressively, the wording evolved: gay affirmative therapy turned into gay and lesbian affirmative therapy, and then sexual minority therapy, until the current term GSDT. Indeed, it appeared that the LGBT concept – even when adding an I for intersex or a Q for queer – would not allow to include all patients who were addressed by this therapeutic approach. For instance, this term excludes asexuals, kinksters, swingers, polyamorous, non-monogamous, flexible heterosexuals, fetishists, “objectum sexuals” (people who experience a romantic attraction to an object), the approach would not be consistent if it added an exclusion to those it intends to stand together with.

Every person related to any aspect of GSD suffers a social oppression, with different degrees and specific forms, which induces an internalized oppression, as an identification to the “norm”, and a counter-oppression, as a reaction. For example, the fight against misogynous oppression – wrongly named sexist – generated diverse types of counter-oppression, among which misandry is a major one.   The common oppression suffered by all GSD persons can be resumed with five injunctions: meet someone of the other sex, get married, have children stay together for your whole life, be faithful… But “the award for conformity is that everybody loves you… but you”. Within the LGBT(IQ…) “community itself, discrimination and difference rejection are common practice. To be oppressed does not prevent you from being an oppressor.

Group dynamics



Our group consisted of twelve persons, originating from 11 countries: Benin (West Africa), Catalonia, Denmark,  Finland, Ireland, Italy, Poland, Scotland, USA and France – and representing many diversities : gays, lesbians, bisexuals, asexuals, flexible heterosexuals, transmen… All of them where psychotherapists, either active or about to complete their training, all of them were very motivated and involved in the process. The course was presented by the same pair every morning (Pamela Gawler-Wright and Olivier Cormier-Otaño), while a different trainer intervened every afternoon, according to the topic.

As soon as the group met first for the time, the leading pair, tactfully and lightly, installed a climate of confidence, mutual respect and freedom of speech which greatly contributed to the quality and profoundness of our sharing throughout the course. Their interventions were rich with information and experiences. Together with the proposed exercises they both inflamed me and confronted me with my limits, my questioning, my fears. Each afternoon trainer, in their own special way, contributed to these dynamics. 

Each participant was invited to share in how they experienced the exercises as well as their own personal and professional experience, as related to the discussed topics. They all did so with a great sincerity, which allowed me to discover some aspects of GSD, I knew nothing about, to be confronted to my own stereotypes and prejudices, and, eventually, to dramatically change my viewpoint about some of them.

The course main lines

Many issues were developed, discussed and deepened through practical exercises. Below, I mention the main ones and what I experienced when tackling them.



Stereotypes and prejudices


As with everybody, our patients carry all kinds of stereotypes and prejudices, which partly contribute to generating and/or maintaining their unwellness. Therapist do too! This contributes to narrow our vision of our patients, our capacity to accept them fully as they are and, consequently, the quality of our support. Without taking the expression “The cobbler’s children go barefoot” at face value, we all should continue to explore and challenge our own stereotypes and prejudices, aiming at getting free from them. As far as I am concerned, this course greatly helped me in this respect. Work is still in progress…

Is my therapist GSD?

Choosing a therapist one considers as heterosexual or, on the contrary, as identically oriented is not neutral. It’s worth exploring what such a choice implies. For instance:

  • The fear a GSD person may experience about confiding in a heterosexual therapist may come from their own heterophobia: to believe a heterosexual therapist is deductively unable to support a GSD patient; conversely, the belief that choosing a same GSD oriented therapist is a sufficient condition is limiting too: it cannot be the only criterion for a successful therapy.
  • As regards a same oriented therapist, there is a risk of collusion (I understand them as I experienced the same thing as they do) or identification (I experience the same thing as they do so what they say relates to me personally).
  • To say or not to say whether I’m GSD: it was very helpful for me to participate in a discussion about this issue. Is it right to answer the patient’s question “Are you gay?” and how to do it?

Lesbianism and lesbophobia

Through “life stories” of Anglo-Saxon lesbian celebrities, illustrated by animated and musical presentations, Pamela Gawler-Wright lightly introduced us to the yet awful word of social persecutions which lesbians experienced since some of them started to claim their visibility and right to be themselves.

Coming out

Half a day was devoted to the coming-out issues. In particular, the following topics were addressed:

  • 
Coming out is multiple: one experiences as many coming outs as there are situations and persons one has to face throughout one’s life; thus, it’s repeated many times, in a different way every time.
  • 
As the consequences of coming out are unknown, it necessarily makes the person feel unsafe.
  • It’s hard to resist the belief “It should be known” (transparency as a moral value).



Shame, vulnerability and internalized oppression

Another half-day permitted to develop and deepen this issue, through exercises in which participants got very involved. As far as I am concerned, it was overwhelming and it taught me a lot. In particular, it presented me with an opportunity of experiencing a real breakthrough about the self-maintained process of superego injunctions.

I feel internalized oppression is a core issue for many of our patients, specially – but not only – our GSD patients. It’s likely to be one the most widely shared psychological processes. Even white heterosexual men cannot escape it (at least not all of them…): many of them have internalized the oppression of sexual performance obligation or that of aggressive machismo as inseparable from their manhood (a young male, smart, open-minded patient recently told me “if I climb stairs behind a woman – as any gallant man should do – and she wears a miniskirt, what will she think about me?”)

For many GSD persons, social oppression is very deep as it is rooted in gender difference. Internalizing it induces the shame of being oneself as well as radical judgements about one’s own desires, thoughts and acts. This shame causes vulnerability and hypervigilance regarding anyone or anything that could question this aspect of the person’s identity. But to be vulnerable does not mean to be weak: on the contrary, accepting one’s vulnerability is a major strength which contributes to coming out of shame and of internalized oppression.

In any case, the psyche authority that judges and pronounces irrevocable condemnations – whether you call it cruel superego or “top dogs” – plays a major part in maintaining shame, especially by justifying it endlessly. If we consider it as a major target of the therapeutic process, it can only benefit to our patients.

Asexuality


Discovering asexuality was one of the highlights of the course for me, particularly as we could take advantage with direct testimonies. Furthermore, Olivier Cormier-Otaño presented us with an enthralling study he conducted via a questionnaire that reached 310 persons considering themselves as asexual. In our hypersexual society, asexuality stands as a very strange, incomprehensible phenomenon.  For us, psychotherapists, it shocks our “knowledge” about sexuality and its issues… where it finds no place. It’s our responsibility to give it its right place if we want to be able to support asexual persons along their way to feel at peace with themselves and get integrated in their environment.

Transsexuality

Here again, direct testimonies were a major contribution to the course. I had already read books and articles on this topic, but coming to meet persons who experience transsexuality is irreplaceable. 
We heard a presentation about the activity of the Tavistock Clinic service dealing with children and teenagers who question their gender – the only service of this kind in the UK. It threw light on how to welcome and answer their questioning, both on a human and medical level.

“Help me not be gay!”

Conversion therapies, even though in loose momentum, still exist in Anglo-Saxon countries – maybe in France, as well, I don’t know. Without going so far, all of us may have to face a person whose request is to help them stop experiencing feelings and emotions related to GSD. How should we meet this request? How can we support them in their quest for an inner harmony, without letting ourselves being carried away by a “pro-GSD” ideology?

Behind such a request, as behind any request concerning identity, there are beliefs, grounded on stereotypes, and which appear to the person as truths, as certitudes. The suggested approach aims at helping the person to see truths as beliefs and to realise that beliefs are not the truth (my simplification…).

As a provisional conclusion

A word imposes itself to me after this experience: empowerment. I could say, feeling confident and deeply free, because of the recognition of my responsibility towards GD persons and my capacity to face it.

I never so clearly realised the pressing urge to acknowledge, accept and welcome human diversity, whatever its form and expression, as well as to challenge the stereotypes and prejudices it inevitably reveals to me.

The GSD concept is just emerging. It’s hardly starting to contribute redesigning the outlines of our ‘community’ and to influence the way we look at our patients, and perhaps at our practice. Meeting GSD persons who embody some GSD aspects I didn’t know, or about which I had rather bulky prejudices, helped me a tremendous lot in accepting them better, hence feeling better with myself and more open to my patients.

André Helman, MD; a relational psychotherapist from Paris.

Russia

Russia

Clearing out some very old papers at home the other day, I found some correspondance about the Russian language translation of Pink Therapy volume 1.

This is the only other language Pink Therapy has been translated into and it was done by a dedicated fan, a psychiatrist I believe, who thought it should be made available to his people.

I’m rather glad he did because I also found a second letter which came from a reader of that Russian edition who came across the book unexpectedly, and it changed her life. The original was badly copied and so has been transcribed and I’ve not tried to clear up the grammar and syntax.

When I get feedback from readers of my books, there is an amazingly gratifying feeling. Writing is a lonely project and not one that comes easily to me, but when I feel I have something to say, I generally have to say it! But one never knows whether one’s words mean much to anyone else. It’s wonderful to hear that sometimes, they do!

Given the really horrible situation most LGBT people in Russia find themselves, I am so pleased that somewhere in random book shops, they might come across Pink Therapy, or perhaps our website which has a more updated paper on Gender and Sexual Diversity Therapy translated into Russian:

Click to access RUS_GSDT.pdf

Dominic Davies