Trans Hate on Sunday

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

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

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

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

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

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

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

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

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

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

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

Dominic Davies
CEO – Pink Therapy

 

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

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

Stop Our Silence!

Monday 16 Nov 2015 6.30am

Daring not to speak

Daring not to speak

I’m awake early and in my last half an hour of self imposed silence for Gendered Intelligence​. 40 kind people have helped me raise £577 for their funds, by supporting me in my sponsored silence.  For the past 24 hours I’ve not said a single word. [addendum: subsequent donations took me up to £600]

The campaign was a fund-raising idea that Gendered Intelligence are running, to draw attention to gender based violence and bullying. It’s called Stop Our Silence. It’s part of Anti-Bullying week. Which ironically invites us to Make a Noise about Bullying!

Some lessons learned:

  • I’ve learned at quite a deep level how frightening it can be not to be able speak.
  • How frustrating it can be when you’re trying to get through the busy streets of London and everyone seems like an obstacle in your way.
  • How hard it is to assert oneself and complain about things, so that you feel disempowered in your life.
  • How lonely it is to feel that your only safe space is your home and how reliant you are for support from people online.
  • How good it is when someone spontaneously contacts you to ask how you’re doing and encourages you. The people who emailed, tweeted at me and responded to my posts on Facebook kept me going
  • Memories of being bullied at school haven’t left me.  I carry them with me.  Mostly they motivate me.

I was bored, and so incredibly interactive online.  Some people enquired whether I ought to be allowed to speak digitally, and whether I was breaking the rules?

I felt that this is about experiencing similar conditions to those faced with bullying because of their gender presentation or gender non-conforming behaviour. So maintaining an online presence and finding support through online networks is a vital life saver for their sanity. Hiding away from the bullies in their room!

I’m glad I’ve done it, not least so they have almost £600 but also because it’s been a useful learning experience.

If you’re tempted to see how it is, please do!  The campaign is running 14-22 November 2015.
More information on this link: https://stopoursilence.wordpress.com/

Dominic Davies
Founder and CEO – Pink Therapy