BACP Fellow resigns over transgender conversion therapy

In January 2015 a memorandum of understanding was signed by a host of organisations, including the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy, the Royal College of Psychiatrists and NHS England. The memorandum condemned so-called “conversion therapy” or “reparative therapy”, which aims to turn gay people straight.

I fully agree with the memorandum that such “therapy” is both unethical and harmful. However, it was criticised for not also condemning such tactics when used with transgender people. Just under a year ago the UK Council for Psychotherapy announced it was “developing its position” on transgender people and conversion therapy, but since then nothing has happened. Yesterday Dominic Davies, a fellow of the British Association for Counselling and Psychotherapy, resigned in protest over what he feels is foot-dragging over the issue.

Davies gives his reasons for resignation on his blog.

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 agree with Davies that simply referring people to the Ethical Framework rather than saying in black and white, “Don’t try to convert transgender people” isn’t enough. It’s not hard to imagine a therapist, particularly if they were of a hardline religious persuasion, deciding to interpret the Framework in a way that says, “Yes, it is ethical to try to revert someone to their birth gender.”

The reasons why this is important could not be demonstrated in a more tragic way. In 2014 a 16 year old transgender girl, Leelah Alcorn, threw herself under the wheels of a truck after her parents forced her to attend conversion therapy. In her suicide note, she explicitly cited the “therapy” as a factor in her death. In the USA there is a campaign for a “Leelah’s Law” to ban conversion therapy.

There really is no reason why organisations like the BACP and UKCP should be dragging their feet like this. Yes, the UKCP has said they’re “developing their position”, but how much of a position do they need to develop? All you need is, “There’s nothing wrong with being transgender, and if you try to convert them you could seriously harm them, so don’t try.” It’s as simple as that. If the President of the United States can do it, they certainly can.

In his blog post, and also a follow-up post, Davies also expresses a wider concern with the way the BACP has tended to respond to LGBT issues.

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…

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.

Davies also criticises the BACP for promoting therapies for so-called sex addiction. Despite the frequent media publicity, this is a hugely controversial topic, and currently neither the DSM-5 nor ICD-10 recognise sex addiction as a bona fide condition.

So come on, BACP and UKCP, make a clear statement that conversion therapy is wrong whether it’s done to gay people or trans people. It really isn’t difficult and you could prevent some serious harm if you do.

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19 thoughts on “BACP Fellow resigns over transgender conversion therapy

  1. Therapists should never be allowed to convert anyone to anything. “conversion” and “therapy” contradicts itself

    BUT

    What does disturb me even more is that “There has been a 400% increase in referrals to the child and adolescent Gender Identity Development Unit at the Tavi”
    WTh is going on in this world today that our children are becoming more and more confused about their identity (NOT sexuality!!)? But no surprise the Tavistock has its grubby fingers in that.

    I think we need to be very careful that we are not becoming so correct (we have a habit of that!) that we are actually becoming abusive and censoring and stifling.

    If a client comes to see a therapist and says “I want to be straight, I dont want to be gay” The therapist should help him/her explore whatever feelings s/he is struggling with.

    The therapist should not say “you can become straight again if we do this kind of therapy” but equally if the client wants that sort of “therapy” it is the client’s choice. We must not take away from men and women their right to choose.

    Therapists should not work with a client trying to convert him/her, equally therapists should not work with a client thinking “once gay always gay” when a client is expressing the wish to change.

    The power should be given to the client. Clients must be informed of therapies and should then be allowed to choose. Clients should be allowed to voice their feelings, anxieties and fantasies without judgement and fear of being labelled (as either “you are gay because you are unwell and we can heal you” or “you are gay you will always be gay”)

    The client needs to have the freedom and power to choose to be “converted” if that is what s/he is asking for.
    Equally, clients need to be protected from therapists who want to “convert” clients who are gay.

    This is a dangerous area for clients and therapists alike because we are dealing with very vulnerable people (40% of trans people have tried to commit suicide) who feel very confused (otherwise they would not end up in therapy) and any therapist working with them must be very aware of not influencing this client group in ANY way.

    And it is this that therapists should be taught. Neutrality and acceptance of the client at any given moment (that is why the code of ethics seems very adequate to me)

    But PLEASE let us not dictate to people what being gay means. Everyone has their own thoughts and feelings about this and should be allowed to make their own decisions about this.

    Just a few other things that irked me….

    “But it’s largely cis white gay male privilege reinforcing the status quo from within.”
    Oh please, this card holds no weight any more (thankfully!!). There is no such thing as white privilege. One could see this particular paragraph I just quoted as extreme left wing bollox.

    “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…”

    I dont know Davies and might be misunderstanding his comments but he sounds like he has a huge chip on his shoulder. We are all struggeling in this world, with many issues. If anything, it is the “white non-gay European male that is suffering the most. God help him especially if he looks and acts particularly male and has (not yet) turned metero sexual.

    I really do wonder why this “White male” needs to be brought into it. Stop hating yourself for being white! It just puts a huge Guilt button on your forehead!

    I remember when Ireland voted for the same sex marriage referendum. Most of Ireland voted Yes and the people and parts of Ireland which had particularly high percentages of No votes were attacked and bullied afterwards.

    It is this which makes me very angry. I want to live in a country in which people are allowed to voice their views without being bullied and attacked, whether that is pro gay marriage or against (just to take that as an example)

    Same goes for “conversion” therapy. Clients need to be well informed and should then be allowed to choose what therapy they would like to choose.

    “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.”

    I dont think the BACP has said they are uninterested (but maybe I missed it) and again huge chip on shoulder symdrom. This is not really about getting what is best for each individual person, is it….

    From my experience BACP have always taken complaints very seriously and it is my hope that their new code of ethics will not change much, because NO therapy should be disrespectful, controlling, converting or attacking, no matter what your gender or “sexuality”

    Quickly regarding addictions. There are huge debates regarding addictions: is it nature or nurture? This uncertainty means (for me) that a therapist cannot and should not in my opinion, see addiction as a condition only but should stay open to see it as a symptom.

    But again, treatment MUST be the choice of the client, not the practitioner or the DSM.

    Bleh…

    • I would agree with you that clients should be free to choose conversion therapy if that’s what they want, were it not for two things.

      The first is the principle of non-maleficance. Time and again what happens when people undergo conversion therapy is that they experience an increase in shame, self-loathing and suicidal thoughts. What happened to poor Leelah Alcorn is a case in point.

      The second is effectiveness. All the evidence is that conversion therapy simply doesn’t work.

      If a service is harmful and ineffective, the only ethical response is, “Sorry, I can’t provide you that service.”

      Regarding the Tavistock, I don’t think there’s anything sinister in the upsurge in referrals to them. They’re the location of the Gender Identity Development Service, which is where local CAMHS teams refer young people if they want a specialist service in that field. Having made a number of these referrals myself, I can say that it’s a long-winded process which includes the need to apply for funding. I suspect the reason for the increase comes from the demand end rather than the supply end. My guess is that it’s simply the result of more young transgender people coming out.

    • “If a client comes to see a therapist and says “I want to be straight, I dont want to be gay” The therapist should help him/her explore whatever feelings s/he is struggling with.”

      What if a woman comes to a therapist and says “I want to be obedient, I don’t want to be independent”? Would it be acceptable for a therapist to offer her “Female Obedience Therapy” to help her harmonize her marriage? The therapist should help her explore the feelings that she is struggling, and one of the tools for helping her explore is to challenge her perception of where the problem is and what needs to change.

      What if a client comes to see a therapist and says “I want to be gay, I don’t want to be straight”, what proportion of therapists that offer conversion therapy would try to help them change their sexual orientation just as they would for a gay client?

      If conversion therapy had arisen from a desire to help anyone, regardless of their sexual orientation and gender, change their orientation or gender identity then the argument that this is simply a matter of client choice would hold; but as it stands conversion therapy only offers the options that the therapist deems acceptable.

      If a patient went to a doctor and asked her to infect him with measles she would refuse on the justifiable grounds that she can’t harm patients even if that is what they want. By restricting the options it offers to clients conversion therapy implicitly treats conversion to anything other than cis heterosexual as if it was harmful, in doing so it hides intolerance and bigotry behind a façade of free choice.

      • To be honest, I find it hard to believe that most conversion therapists are only plying their trade in order to assist the client’s autonomy anyway – for the simple reason that pretty much all conversion therapists are working from a religious viewpoint.

        It may also be of note that quite a few give the impression of being so deep into the closet they can see Narnia.

  2. I dont think taking Leelah’s case is an example for anything other than unaccepting (religious) parents driving their child into suicide with “conversion therapy probably being the straw that broke the camel’s back.

    The parent’s should have never put her into this kind of therapy as Leelah did not want to be converted. The parents must be held responsible as well as the therapist who “worked” with her when she didnt want to be changed.

    I have real concern about the common practice of responsibility being given away too easily to others which causes a huge change, shift in society towards being more controlled and having less choice.
    We also need to take some responsibility otherwise we will end up being taken care of by a nanny state.
    Are we really all that dumb and detached that we cannot look after our own children and our selves?

    Leelah’s case is a devestating reminder that no child should grow up in a household, with parents who are judgemental, forceful and abusive.
    It is also a reminder of how powerful and dangerous feelings can be, especially when they are not being held and contained by anyone.

    But to blame just one thing for this child’s death will not bring us safety and protection.
    It almost seems to be a knee jerk-reaction that small children have when they are confronted with something very frightening, they split what is happening into good and bad.

    1. To make sense of it
    2. To keep themselves safe

    A mature mind will be able to see that there are good and bad in everything and that we need to find a balance.

    My fight is, and always will be for the freedom of choice. Leelah had no choice, she was forced, Forced into taking part in this therapy, forced to change when she didnt want to.

    To force someone to look at something when they are not ready can have particularly devastating effects in therapy (hence the present code of Ethics being so important). The client will then experience tremendous amounts of shame, guilt, humiliations, etc which, if there are no safe, holding and containing people, can lead to suicide.

    Leelah’s parents wanted to kill her off, so that Joshua could come back, the parents are to blame for exposing her to such torture and the therapists are to blame for “working” with a child who did not want to be “converted”
    But please do not take the choice away from others who can make an informed decision wether to take part in this therapy or not.

    “If a service is harmful and ineffective, the only ethical response is, “Sorry, I can’t provide you that service.”

    I would agree but the problem with psycho-therapy is… it is not massage therapy done with hot coal or pulling out a tooth without anaesthetic or building a house with asbestos; these are concrete things that can be taken away or added and thereby controlled and improved.
    This is about our mind which will ALWAYS be dangerous because

    1. we know so very little about it
    2. we cannot control it
    3. We are all individuals (or are we 😉 )

    Psychotherapy can often be successful but it can also kill. Does that mean we should forbid everyone to use psychotherapy?

    Again, let us inform the public about what exactly psychotherapy means, let us inform our people what conversion therapy entails so we can all make an informed choice.

    “I suspect the reason for the increase comes from the demand end rather than the supply end.”

    Yes, I probably didnt express myself well enough. The two things that shocked me were the 400% increase in children confused about their identity (hello, am I the only one shocked about this?! or are people just afraid to speak up about it of fear of having the ruthless and unforgiving left wing extremists come down on them like a ton of bricks?)

    the second thing that shocked but didnt surprise me was that Tavis was there to “care” for those people.

    After all it is a well respected institute, right? Sorry for the sarcasm, but anyone who has studied the Tavistock knows what they really are about. And on that note, I think I said all I need to say on that subject.

    • I think a bit of confusion may have crept in here. The GIDS is part of the Tavistock and Portman Foundation NHS Trust, not the Tavistock Institute of Human Relations. The two are separate organisations.

  3. I work in an organisation where we support young people and families in the stages before during and after a Tavistcok Gender Identity clinic referral. the reason for the high increase in referrals ( which is mirrored in the adult gender identity services, which I also work with) is primarlly because of the changes in society, education and access to services ( previously these young people and those around them were unaware of services or support, unable to say what was going on for them and were in the highest risk of suicide groups) I for one am really glad that those immense numbers of young people presenting to the clinic are actually getting support rather than the nothing they had previously. The clinic works in a very sensitive way to ensure the young person concerned is on the right path for them and creating a space for the young person to work that out in a safe way. For some it’s too slow, and for some parents or care-givers it might feel too fast- the primary factor is considering the distress levels of the young person . I have witnessed the transformative effect of a young person being enabled to attend school in their true gender presentation, name etc- rather than being forced to in a presentation that do not match who they are- it impacts their education, ability to be social and all those other important developmental milestones, so it can only be a good thing. the NHS has also been taken by surprise at the numbers emerging as life for gender diverse individuals becomes safer and accepted and are busy playing catch up , and it seems that delay in catching up is being mirrored in other institutions also . ( note to self BACP!) Several small organisations are working to bring awareness to support this need for education , including the little charity I work for who is doing its bit to increase awareness , with a gender conference for educators last year in Cornwall and one planned for Devon this year, The supreme efforts of Pink Therapy to attempt to skill the helping professions over the years is to be applauded, and recognising that many therapists in the SW can’t get to London for this vital CPD, I also run some small workshops in Devon to attempt to also ensure therapists are at the very least aware of the issues for these clients and their families, and aware that they may need to consider the more I depth learning that Pink Therapy offers. I hope the BACP are paying attention to the ‘noise’ and that they have a rethink, and see what a valuable asset Dominic is for them.. I’m also now casting around for an alternative profesional body , but fear that the BACP already have a ‘grip’ on many employing agencies which will sadly impact the decision for many., I’m lucky to be in a position not to be impacted by that ( for now ? – until regulation?)

    • I understand your reasons, though I would hope that it would be the BACP’s stance on transgender people that would change rather than you having to change professional body.

  4. Does the NMC have a stated policy on such conversion therapy?

    • Not to my knowledge, and I haven’t heard of any cases of nurses practicing it in the UK, but I suspect if asked they’d say it was unethical.

      It may be worth noting that the NMC is regulated by the Professional Standards Authority, and the PSA’s position is that conversion therapy is inconsistent with their obligations under the Equality Act.

      • So, the position of the NMC which also governs therapists is precisely the same as that of the BACP, then. They do not specifically forbid it but consider it adequately covered by the more general ethical code. Do you consider their stance to be wrong, also?

      • Well, the NMC governs nurses and midwives rather than therapists, so I suspect the answer is that it simply hasn’t come up on their radar. Like I said, I don’t know of any cases of nurses in the UK using conversion therapy.

        I could ask their press office if you like (I’ve already asked the PSA about their views on conversion therapy and transgender people, but it’s the weekend, so I don’t expect an answer until at least Monday).

        Whether or not I ask the NMC may depend on whether you actually wanted an answer or whether you’re simply trying to make a rhetorical flourish.

      • I am genuinely interested to know. I think the question that it raises is whether, ultimately, the NMC is an appropriate body to register therapists given that it does not focus on the issues such as this one which are specific and essential to the subject as it is not its ‘core business’. The HCPC is in a similar position, I suppose. It might be better to expect therapists to be overseen by one of the bodies focusing on the ethical issues specific to therapy such as the BACP or the UKCP, perhaps in addition to a body like the NMC where somebody does more than one thing. There will be quite a few more therapy-specific issues, especially considering some of the very complex and ‘technical’ areas such as those that some of the commenters here have raised. To be fair, the HCPC do expect people to dual register if they practice in other areas. I suppose if protection of title were ever to be introduced, this might become clearer. Are there any other professional bodies that ‘do therapy’ without specialising in it. Doctors, perhaps?

    • Fine. I’ll ask them.

  5. My sense is that the BACP stance gives the impression that as an organisation they believe that trans issues are not that big of a deal, at least, not to the point of making specific reference such as with the gay conversion therapy (only brought to light by the actions of Patrick Strudwick). The reality, for many people who are transgendered/non-binary, is that it very much is a huge (life threatening) deal and because there is a lack of awareness in the public at large, including many therapists, it is absolutely appropriate, *essential* to give specific guidelines to therapists about this.
    We are evolving…slowly…and I believe that our professional bodies should reflect this.

  6. No response from the NMC? Interesting. How many of the people they regulate do therapy? What percentage of those are not also registrants of an ‘official’ therapy organisation?

    • I had a reply the other day asking about whether I had a deadline, but haven’t had a statement yet.

      Regarding your second question, how would you define “official”? I thought you didn’t want any offical such organisations?

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