DISSENTING VOICES. 

https://thepsychologist.bps.org.uk/volume-33/october-2020/freedom-expression-around-diversity-guidelines

A letter in response to the guidelines. Reproduced, in full, below.

Freedom of expression around diversity guidelines

Numerous psychologists call for review of the BPS Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity; plus response.

Following the response to J.K. Rowling’s essay ‘Reasons for Speaking Out on Sex and Gender Issues’ and the 18 June Newsnight report of safeguarding concerns at the NHS Gender Identity Development Service, we call for an immediate review of the recent BPS Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity (BPS, 2019).

These guidelines state that a ‘gender-affirmative’ stance should be the default position adopted by psychologists. We are concerned that the instruction to ‘integrat[e] an affirmative stance into their model of practice’ restricts the use of many core models (systemic, trauma-informed, developmental) in formulating the factors resulting in the clients’ presentation. This places limitations on researchers and practitioners exploring the wider context of ‘gender’ and seeking to establish ‘best-evidence’ for the support of individuals with gender dysphoria.

For those unfamiliar with the guidance or discussion in this field, ‘gender affirming’ practice calls for psychologists to work on the basis that an individual’s belief in self-ascribed gender is ‘valid and legitimate’. We hope all psychologists value and respect the varied understandings that people hold of the world around them and of their personal experience. We suggest it is possible to value and respect a client’s experience, without taking a position of affirmation. Indeed we often do this within our work with various client groups. The BPS guidance stipulates that practitioners validate a belief in gender (both in general and in particular to the individual’s sense of self) without considering the evidence base in relation to the practice of belief validation.

Individuals who are questioning their identity with respect to their sex and gender clearly report significant levels of psychological distress. The long-term implications for this population resulting from the provision or denial of access to treatment are substantial. We recognise that appropriate, evidence-based guidelines are imperative to support the skilled psychological practice which our profession seeks to uphold. However, such guidelines can only be effective when these are the result of comprehensive research, conducted in an environment that supports free and independent enquiry.

In particular, we think it is imperative that psychologists are not prevented from using our core professional skill of formulation, exploring the origins and nature of distress rather than ascribing to one pre-determined ‘diagnosis’ or explanation. With other presentations we are in agreement that there are multiple contributory factors to psychological distress. It is only from this exploration that we can develop individualised formulations to guide our attempts to alleviate that distress. We think the current guidelines effectively prohibit psychologists from taking a questioning approach and applying ethical practice in these situations. The absence of a robust evidence base supporting psychological and medical intervention is a concern in this rapidly growing population, leaving significant gaps in our understanding of many relevant issues. The disproportionate increase in presentations of females to services, the phenomenon of so-called Rapid-Onset Gender Dysphoria, the voices of individuals who have desisted or detransitioned, and the experiences of those for whom existing treatments have been of value must all be addressed in the search for quality research informing best-evidence practice. Such research can only be conducted in an environment that is open to discussion in a respectful and professionally inquisitive manner.

We would like to see the current guidance withdrawn and the topic reviewed afresh in accordance with the rules of proper intellectual inquiry: the weighing up of evidence; the ethical considerations of psychological practice; and the avoidance at all times of ad hominem forms of argument. Some of the signatories below, with others, have submitted a formal request for the withdrawal of the guidance to the Society. We hope that readers will support our expectation that the freedom of expression of all psychologists will be defended, unambiguously and at all times, in relation to both research and practice.

SIGNATORIES.  (Some names are witheld)

Dr Katie Alcock (Senior Lecturer in Psychology)

Rachel Corry (Occupational Psychologist)

Ms Nina Gadsdon (Psychology Masters Student)

Dr Louise Fernandes (Clinical Psychologist)

Ms Pat Harvey (Guinan) (Former Chair of the Division of Clinical Psychology)

Dr Peter Harvey (Former Chair of the Division of Clinical Psychology)

Mr Ian Hancock (Retired Consultant Clinical Psychologist, Director of Psychological Services, NHS Dumfries and Galloway).

Dr John Higgon (Consultant Clinical Neuropsychologist)

Dr Anna Hutchinson (Clinical Psychologist)

Dr Gill I’Anson (Consultant Clinical Psychologist)

Mr Eric Karas (Retired Consultant Clinical Psychologist)

Dr Jeanie McIntee (Consultant Clinical & Forensic Psychologist & Psychotherapist)

Dr David Pilgrim (Former Chair of the History and Philosophy Section) 

Julia Richards (Educational Psychologist)

Cas Schneider (Consultant Chartered Clinical Psychologist)

Karen Scott (Retired Educational Psychologist)

Dr Sarah Verity (Chartered Clinical Psychologist) 

Dr Robert Watts (Clinical Psychologist) 

Anne Woodhouse (Clinical Psychologist)

Colleagues who felt they needed to remain anonymous:

Consultant Clinical Psychologist NE England

Clinical Psychologist NE England

Consultant Forensic Psychologist S England

Clinical Psychologist NW England

BPS RESPONSE TO THE LETTER

Society response: We acknowledge that the BPS is a broad church, and there will always be differing views among our members on some issues. We are confident that our guidelines are based on the best current evidence and research in this important area, having been developed by experts working in the field. Clearly we share your concern about the safeguarding of children and young people, but our guidance is specifically for the care and treatment of adults, not children.

The draft guidance was sent out for Society-wide consultation on 19 March 2019. It was also sent to the Royal College of Psychiatrists, APA, BACP, BABCP, UKCP, Stonewall, LGBT foundation and COSRT for comment. At the close of the consultation on 12 April 2019 34 responses had been received. Just one of these responses mentions the issue of dissenting voices that is raised in your letter. This respondent also stated that the document was ‘well intentioned and positive’.

All our guidance is periodically reviewed. This particular guidance is the second version, having been revised in 2019. If there is a change in practice or evidence, then the need to revise the guidance would be established. In this instance, we will review the guidance if there are implications for the care and treatment of adults following the outcomes of:

• the judicial review regarding the use of hormone blockers in child services on grounds of capacity to consent
• NHS’s Independent review of puberty suppressants and cross sex hormones
• NICE review of the latest clinical evidence.

As a Society we are committed to our members having a view and welcome different perspectives. As such any revised guidance will be sent out for Society-wide consultation and we would welcome your input into the revised consultation process.View the complete article as a PDF document
(Please note that some pictures may have been removed for copyright reasons)

This is part 3 of a series on the British Psychological Society. This blog will examine the BPS treatment guidelines, referenced in the BPS position statement, covered in Part Two. Unless otherwise indicated, all quotations are taken from this document. 👇

Guidelines and Literature Review for Psychologists Working Therapeutically with Sexual and Gender Minority Clients (2012)

Part One

In Part One I looked at the background to a Memorandum of Understanding (MOU) that commits a number of organisations to reject Conversion Therapy. The concern I have is the MOU to oppose “conversion therapy” includes both Sexual Orientation and Gender Identity. An unintended consequence is gay males and lesbians may be placed on an unnecessary medicalised pathway to “transition”. Ironically this is actually a form of Gay Conversion. Therapists should be able to prioritise reconciliation to biological sex/sexuality as the ideal outcome. Same sex orientation doesn’t involve lifetime dependence on cross-sex hormones/surgery. This MOU effectively bans therapists / parents from affirming biological sex and sexuality.

In Part Two I looked at the BPS position statement, on therapy pertaining to sexual orientation, and examined the profiles of the authors. The BPS statement mentions “gender identity” only in passing, yet the full guidelines centre Gender Identity issues as much as sexual orientation. This has all the hall marks of yet more “stealth” activism.

Part Two

Part Three looks in detail at the recommended treatment guidelines and illustrates how far they stray from the impression given by the position statement. Even the title deviates from a focus on Sexual Orientation: “Psychologists working therapautically with Sexual and Gender Minority Clients”.

Unsuprisingly some prominent people from the UK main Gender Identity Clinic / Trans Activists  were involved. ⇓

Christina  Richards is employed at the Gender Identity Clinic (GIDs)  sometimes, informally, referred to as the Tavistock. You can read about Christina here.  Richards has a very high profile in the field of Gender Identity and especially in organisations which promote an “affirmation only” approach to Gender Dysphoria. :https://christinarichardspsychologist.wordpress.com/

Christina may also be remembered for defending a job advert which sought to recruit more people to work at GIDs and included this memorable part of the selection criteria: 

Polly Carmichael is the director of the Gender Identity Service (GIDs) as I write.  Penny Lenihan is also a psychotherapist based  at GIDs.   Meg Barker (now Meg-John) is an activist who campaigns on Bisexual issues and was the author of a bat-shit crazy document for the BACP (British Association of Counsellors and Psychotherapists). She campaigns for the  recognition of those practicing  BDSM/Kink /polyamorous relationships.   Meg also thinks Bi-sexuals are stigmatised by the assumption that they are involved in diverse sexual practices.  She/He/They/Zie (who the hell knows/cares?)  states that the “bi” in “bisexual” is problematic as it suggests there are only two genders.  Of course, sexual orientation is described, as same gender attraction which, as we now know, is not synonymous with biological sex. This has the effect of undermining  Same-Sexual Orientation.   (See later definition of “lesbian”)

Note also contributor Christine Burns, a prominent Trans Activist and editor of a collection of essays,  in the book “Trans Britain”.  Also Stephen Whittle, who obtained law qualifications,  to better advocate for trans rights.  These two names crop up numerous times, both are “trans”

Sexual Identities. 

Here is a flavour of what the authors mean by “sexual identities”. It is not, as you may have expected, a reference to different sexual orientations. It includes sexual practices such as sado-masochism, transvestism as well as the more benign sounding asexuality.

The BPS document is very clear it includes “Fetishistic Transvestism” as shown by the quote below. Bear in mind that transvestites, now referred to as part-time cross-dressers, are officially under the Trans Umbrella, according to Stonewall UK. I wonder if this definition will appear in the 2019 version of this document? The protection of “sexual minorities” is now extended to people with a paraphilia, and by people I mean men. Remember this when you tweet out vacous statements about supporting people to “live as their authentic self”. I am pretty sure most people don’t realise this is what we are being asked to sign up to…. Did the MOU signatories?

Here we are reassured that not all of the cross dressing men, now officially transgender, are fetishistic. Once again women cry: “How do we know which one’s?”. Remember single sex spaces are not because all men are predators but because a minority are. The same applies to men. who identify as transgender. How do we know which part of the umbrella they come under? Too many policy makers are treating any male with a Cross-Sex Identity as identifying as if this magically transforms the statistical sexual offending profile to literally equate to that of natal (for emphasis only) women. There is no evidence of this, quite the contrary.

BDSM (Bondage, Discipline, Sadism & Masochism). 

Another aspect of Gender Identity Ideology is the integral notion of power relations between “genders”.  The notions of dominance and submission are necessary for sexual power games. The only subversion here is sometimes the sexes get to “play” different roles.  The hierarchy remains intact but, gender identity ideologues argue, this somehow undermines “gendered expectations” and liberates us all!   BDSM normalises the notion of pain, submission and servitude.   To get an idea of just how liberating this has been, for women, find me a man who has died at the hands of a woman who then used then used the “rough sex” defence to avoid prison. Doesn’t happen.   

To get a further idea of just how regressive this is let me quote an excerpt from a Master’s thesis. It was written by a man who documented how BDSM helped cement his identity as a transwoman. He had an unpleasant, sexual, encounter where his safe words were disregarded by the other participant. This is what he took away from that encounter:

“Sex Work”. 

Naturally Queer Theory proponents avoid the unpleasant truth about prostituted women. Despite the fact clients are practically always men and the percentage of male prostitutes, also servicing men, are dwarfed in comparision to the females. The clinicians are warned about pathologising issues such as sex addction and pornography use.

In an outbreak of honesty they do, briefly, acknowledge there is a body of work (See Gail Dines) on the objectification of women in pornography.

The centrality of pro-prositution arguments within Trans-Activist ideology is indicated by the two slurs used against women, who question this belief system. These are Swerf and Terf, acronyms for Sex Worker/Trans Excusionary Radical Feminists. Some radical feminists are ex prostituted women who remain deeply concerned for the women who remain in prostitution. Others are opponents of the sale of women’s bodies and care deeply about the women labelled “sex workers”. Here the BPS pay lip service to the women who need an “exit strategy” . (What work requires an exit strategy?) but shamefully tries a “bad on both sides” argument re the perpetrators of violence. Even worse it suggests the “sex workers” need a route to empowerment and to learn to be assertive. Shame on everyone who agreed with this paragraph.

The centrality of pro-prostitution narratives is striking in prominent Trans activists and Celebrities. Janet Mock saw prostitution as a good way to validate their “womanhood”. Mock even compared prostitution to the underground railway that enabled Black people to escape the South and Slavery. Seeking male validation of your womanhood, via prostitution, runs counter to feminist campaigns to reject our commodification/ objectification. Yet another example where the “feminist” agenda of ,self-described, Transwomen, actually undermines women’s position in society. It is almost as if the interests of the new kind of women are perfectly in tune with men’s rights and diametrcally opposed to the interests of women.

I have seen many sad stories about gay males entering prostitution to fund their flight from their sex and sexuality.  I have not seen any voices expressing concern about the rate of prostituted males killed in countries like Brazil.  We see lots of concern about the deaths of transwomen but very little acknowledgment that their deaths are related to the prostitution industry which has a a high rate of violence and death.  Not so much empowering but devouring this demographic.   Clients are overwhelmingly men despite the attempt to pretend there is a high demand from women.  I think the Chicks with Dicks phenomenon is likely near as dammit 100% male. 

I include this quote just to note that the theme of Lesbians changing their orientation is recurrent. 

Cultural appropriation: Lesbians

Here the BPS gives the word “lesbian” to males, who present as male, but describe themselves as “lesbian”. To all those people denying this is actually happening. Here is yet more confirmation.

The BPS also endorse the idea that sexuality is fluid.  While there are complex debates around whether sexuality is innate and unchanging one of the key victories in Gay Rights movement was that their sexuality was fixed and therefore Conversion Therapy should not be attempted, and moreover, it won’t work.  However this doesn’t chime with the idea that a Lesbian can express their sexuality with a male-bodied “lesbian”.  Is this why the idea of a fluid sexuality has gained ground in advocates of Queer Theory?  

Gender Performance. 

Here the BPS explains that an absence of socialisation related to your preferred gender may mean that trans people have difficulty with their “gender performance”. That may explain the lingering male socialisation that generates so many woman-identified people threatening women with their male genitalia. Very interesting use of the word “performance” here. Performative femininity is something feminists have sought to resist and reject illustrating, once again, that it runs counter to women’s liberation for our sex to be reduced to simply an “identity”.

I would love to see some research about the long term mental health impact of pretending to be something you are not. The Imposter Syndrome must be debilitating and I cannot imagine it is psychologically healthy.

Therapy or Social Engineering?

Another interesting observation below. Yes! There are people who are fine with all sorts of personal self-expression and not conforming to expected sex stereotypes should be supported. The next sentence is fascinating. Ideologues insist that young people should be encouraged in this, regardless of personal cost, because it aids the “deconstitution of the gender binary”. That doesn’t read like a careful, therapeutic approach to clients with “Gender Dysphoria”. It reads as an appeal to harness them as activists for a wider project of social engineering. Is that even ethical?

Medical Interventions for Gender Confusion.

The quote below contains an important acknowledgment of research which highlights that the majority of “gender atypical” youth will be young gay males/lesbians. It also stresses the it is “imperative irreversible medical decisions should not be made“. This document is therefore not reflective of a purely affirmative model and thus gives contradictory messages. It is also interesting this comment survived the edit , though the BPS go on to advocate stopping puberty and early surgery. How clinicians were supposed to navigate these mixed messages is a mystery to me.

The document also raises some concerns which are echoed by those of us concerned about the impact of Gender Identity ideology on gay males and Lesbians. Here Clinicians are warned about the cultural context surrounding sex stereotypes. They raise the issue of father’s who may be concerned that they have a “sissy” for a son, we could call this homophobia. Again they also highlight that the majority of pre-pubertal children desist and later identify as gay or bisexual. I will be very surprised if this survives the BPS guidelines for 2019.

Furthermore it goes on to acknowledge the treatment for Gender Identity Disorder (previous name for Gender Dysphoria) is “experimental”. Note that by 2011 GIDS had already begun blocking puberty for children as young as 10. A decade later they still have not published the research outcomes from that “Study” ,despite being obliged to do so. I use inverted commas here because I am not the only one who feels this “study” was a pretext for embarking on the early medicalisation of gender confused kids/teens. We are starting to see some of the fall-out from this approach in the emerging phenomena of de-transitioners.

Another series of startling admissions echo the experience of parents dealing with our Gender Dysphoric kids/teens. Clinicians are warned that an obsession with changing sex may arise due to schizophrenia or Asperger’s syndrome. They also warn about the role of the internet in fostering a trans-identity. Furthermoe they caution people of the consquences of advising people who you do not really “know”. Anyone who has visited the Trans related subreddits will see that this sort of “coaching” is a regular feature of that forum.

Even more worrying is the growth of on-line Gender Identity services who are facilitating the dispensing of hormone treatment. These  operate on the “informed Consent” model which basically hands the treatment decisions to their “clients”. Basically these practioners discourage any gatekeeping (caution) and  agree that a “Trans” person knows their gender identity best. It is therefore the role of the clinician to “affirm” not “question ” a client’s Gender dentity. The caution expressed below seems to have all but disappeared in modern practice.

Below they highlight that trans individuals may “embellish or limit personal history information in order to obtain desired treatments”.  Parents are well aware that our offspring re-invent the past and, in my opinion, this is one reason why we are demonised and sidelined.  When our offspring claim to have always felt like the opposite sex we are the people who can offer a counter-narrative based on facts. 

Here they present a list of the surgeries that may be on the list to enable people to “live as their authentic self”.

Next up: THE 2019 guidance and some dissenting voices from within the BPS membership.