Daily Archives: August 14th, 2018

QotD: “Psychotherapy and issues of sexuality”

Jayne Ozanne is right that conversion therapy is almost exclusively carried out by faith groups (‘It takes a lifetime to recover’, G2, 8 August). However, psychotherapists and counsellors should not be complacent. There are things we need to own and attend to.

First, there is a history of homophobic non-acceptance of same-sex love on the part, in particular, of psychoanalysis. Much has been done within that modality to make necessary revisions to theory and practice.

Second, the psychotherapy professional groups need to make it crystal clear that the answer to this problem of continuing – but non-professional – conversion therapy is not to take the entire profession under some kind of statutory regulation. The drawbacks of that are well-established by now. The Professional Standards Authority’s scheme of accredited voluntary registers is working.

Finally, we need to make it absolutely clear that if you come to psychotherapy wishing to explore issues of sex and sexuality, you will still be able to do so. There is no way in which the condemnation of conversion therapy should impose a cordon sanitaire on one of the main reasons people come to psychotherapists.

When I was chair of the UK Council for Psychotherapy in 2009-12, at the time when the memorandum of understanding banning conversion therapy was conceived, we wanted to reassure potential patients that sexuality was still something we expected our clients and patients to engage with. However, this reassurance slipped off the agenda because it was – wrongly – deemed too complex a matter.

Professor Andrew Samuels, University of Essex

Clarity on this issue is really important, because ‘conversion therapy’, the attempt to alter a person’s sexuality, is being conflated with any approach to gender dysphoria or gender identity confusion that isn’t ‘affirmative’, that is, agreeing that the person is in the ‘wrong body’.

There is an example of this in the Guardian very recently, the examples in the article and the films described are all gay conversion, but the journalist describes ‘conversion therapy’ as “any treatment aiming to change a person’s sexual orientation or suppress their gender identity”.

This matters, because, as Jesse Singal reports: “All else being equal, this research suggests that the most likely outcome for a child with gender dysphoria is that they will grow up to be cisgender and gay or bisexual. Researchers don’t know why that is, but it appears that in some kids, nascent homo- or bisexuality manifests itself as gender dysphoria. In others, gender dysphoria can arise as a result of some sort of trauma or other unresolved psychological issue, and goes away either with time or counselling. And in still others, of course, it is a sign that the child will identify as transgender for their whole adult life. While the actual percentages vary from study to study, overall, it appears that about 80 percent of kids with gender dysphoria end up feeling okay, in the long run, with the bodies they were born into.”

There has been no systematic research into the ‘gender affirmative’ approach; but claims of 100% ‘success’ rates from ‘gender affirming’ doctors (ie, of all the children treated with ‘gender affirmation’, none of them desisted).

Transgender Trend reported on this last year:

The UK Council for Psychotherapy has launched a new Memorandum of Understanding on Conversion Therapy to include ‘gender identity,’ leaving therapists, counsellors, GPs and clinical professionals in a position where they may be afraid to do anything but agree with a patient’s self-diagnosis as ‘transgender.’ Anything other than ‘affirmation’ could lay a professional open to the charge of conversion or reparative therapy.

‘Affirmation’ is an untested approach to children with gender dysphoria, a result of demands by political activists rather than an approach developed on the basis of research and evidence.

Of course, we support the original Memorandum of Understanding on Conversion Therapy which outlaws attempts to change a person’s sexual orientation. But ‘gender identity’ should not be conflated with sexual orientation as if the two things are essentially the same issue. For gender dysphoria, the choice of approach is between ‘affirmation’ and ‘watchful waiting’ but its inclusion in the Memorandum suggests that the watchful waiting approach could be considered to be conversion therapy if a child subsequently desists.

What it means is that for a health practitioner to offer any therapeutic support or exploration of underlying factors, motives or reasons for a cross-sex identity in childhood they are now taking a professional risk. Instead, a practitioner must confirm and therefore reinforce a child’s belief that they really are the opposite sex. If a boy thinks he’s a girl, he’s a girl. If a girl believes herself to be a boy, she’s a boy, no questions allowed.

No concession is given to children and young people whose identities are in development and highly susceptible to influence from parents, peers and professionals as well as an increasingly powerful transgender lobby. ‘Affirmation’ is not a neutral approach, it is a strong statement of belief that a girl can be born in a boy’s body and vice versa. No practitioner should be imposing false and non-scientific beliefs on a child or young person or knowingly mislead them about reality.

Ironically, the new MOU asserts that practitioners should be “free from any agenda that favours one gender identity […] as preferable over other gender […] diversities” and yet ‘affirmation’ explicitly favours one identity over another and is wholly dependent upon the agenda of trans activists who have fought to impose this approach.

The statement “no gender identity is inherently preferable to any other” hides the fact that this ideology says that one kind of sexed body is preferable to the other and that the only treatment pathway is medical change of the body to ‘match’ the identity. Under the guise of ‘support’, the assertion “your identity is right” is a cover-up for the underlying message “your body is wrong.”

Professionals are warned that ‘conversion therapy’ constitutes any attempt to ‘bring about a change in someone’s gender identity.’ In other words, even if a child’s belief does not match reality, it must be affirmed as the truth. In no other area of health care is a practitioner compelled to confirm a patient’s false belief. Protection of a child’s belief about which sex they are, by definition takes away all normal protections for a child’s body and fertility. Afraid to do anything which may lead to a change in identity, therapists are compelled to facilitate treatment to bring about medical change of the body.

With no trace of irony, righteous condemnation of ‘conversion therapy’ is used to justify the most extreme medical ‘conversion’ of the physical body into cosmetic imitation of the opposite sexed body. Why, uniquely in this case, are children and young people’s bodies not protected from unnecessary and invasive treatment with some effects irreversible and others unknown, while their beliefs are considered worthy of our greatest efforts at preservation?

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