Setting the record straight on trans issues

This is a more fully referenced copy of a letter I sent to the BACP Journal Therapy Today

I read with dismay the two letters published in December’s Therapy Today in response to Kaete Robinson’s excellent piece Look beyond the binary. I have been reflecting to myself whether such prejudice would have been published were it related to another minority group, although it is of course impossible to draw comparisons between the struggles of different marginalised minorities.

Obviously, Therapy Today does not publish all letters, and as such it must believe the ones it does publish have some merit. I wish to contradict this assumption.

Bev Gold’s letter first: In it she compares gender dysphoria with anorexia, and with negative self beliefs that lead someone to be “uncomfortable in their own skin”. But we have recently heard conclusive evidence from a Lancet study that gender dysphoria is indeed not a form of mental illness, but a legitimate phenomenon that needs not to be pathologised. She talks about the mental distress of trans people but ignores the sizeable body of evidence that suggests any mental health issues are created by stigma, negative attitudes, and barriers to transition, with studies demonstrating that support in transition and acceptance alleviate this distress, while efforts at reparative therapy, what she is clearly suggesting, only do harm.

I am left wondering if someone was as clearly arguing for reparative therapy of gay people, would their letter have been published? As someone who is a member of both trans and LGB communities, I experience a disparity between a growing intolerance of anti-LGB ideologies and an abiding tolerance and dissemination of anti-trans ideas.

In addition, Ms Gold makes the frustrating conflation that accepting someone as transgender will necessitate them having surgical transformations. Many trans people do not have medical treatment. For those that do, it has been proven to be inordinately successful in alleviating dysphoria, with very low evidence of regret. Ms Gold infers the opposite, that this is somehow a dangerous and tragic path.

Ultimately, trans identities need to be accepted and validated whether or not someone has made medical changes. The underpinning message of Ms Gold’s letter is that if a client enters the room and states their name and pronouns and how they experience themselves, we should cast doubt on this, pathologise it and force them to explore it, whether or not that is what they are asking for in their therapy. This is profoundly unacceptable and contrary to the principle of Autonomy in the BACP Ethical Framework.

The second letter is referenced, which lends it a veneer of respectability, however it transpires that one of the references, although appearing to be a reputable journal, is actually a renowned anti-trans blog, another reference is from Tumblr, a social media site, and that the author herself is a prolific anti-trans campaigner. The letter trots out some well-worn anti-trans myths. That detransition is common (it is rare); that the fact detransition occasionally happens means that transition is overall harmful (strong evidence refutes this); and that 80 per cent of trans children “desist” – this is evidenced in many places as a conflation of trans and gender non-conforming children.

In fact, studies have shown that genuinely gender dysphoric children have gender identities that are as consistent as those of cisgender children. In other words, if we talk about not allowing trans children to express their gender through pronouns, clothes, and gendered names, then we should equally be concerned about gendering cisgender children in the same manner.

Most concerning of all is her characterisation of “the autistic spectrum disorder teenage daughter [sic]who suddenly declares herself [sic] to be a boy”. First, let’s be clear that while there is a known correlation between autism and gender dysphoria (birth differences come in clusters, no surprise there), there is no evidence that autistic people lack the self-knowledge to understand their own gender. In fact, my local gender clinic in Nottingham has an autism specialist on staff whose main role is to help gender doctors to take autistic trans people as seriously as they would any other trans person, and not engage in blatant discrimination or infantilisation of the autistic community.

Secondly, she talks about “sudden onset” of symptoms, apparently having no knowledge or understanding of the lengths of time involved in obtaining a diagnosis of, and treatment for, gender dysphoria, or that clinicians will be looking for a consistent pattern and enduring and stable gender identity. Evidence demonstrates most trans people identify their dysphoria from a young age, and any “sudden onset” symptoms would not lead to treatment in anything less than years. Meanwhile, this child will be subject to the relentless doubt, questioning, bullying and attack that you trans people are subject to. It is far more plausible that trans children are dissuaded from transitioning by this stigmatising and hostile world than that we live in a culture where being trans is over-enabled. Anyone making this assumption is fundamentally unaware of the reality of trans lives and likely to do considerable harm.

There are many other inaccuracies and prejudices, too numerous to comment on. I experience the disrespectful tone of Ms Davies-Arai as unprofessional, and not appropriate for a journal, again out of chime with the Ethical Framework’s principles. She talks about “Transgender Indoctrination” as if it is possible for our tiny community to outbalance the from-birth indoctrination of cissexism – that is, the assumption that we should attach entire legal and social structures, names, pronouns, toilet arrangements and much more to the shape of people’s genitals. Not forgetting that intersex children often endure normalising surgery in infancy and later sometimes hormonal treatment, to artificially fit this binary – an issue that somehow incites considerably less outrage than the treatment of trans children in adolescence with entirely reversible puberty blockers.

The treatment of transgender children and adults is, contrary to these letters, slow-paced, conservative, well studied over nearly a century, and very well clinically evidenced. While there are intersections between the gay and trans communities, to suggest that trans people are simply confused gay people or that being trans is somehow more accepted and supported than being gay is not only ludicrous, it is a deeply regressive attitude that does not merit sharing in the pages of a professional journal.

My own article referenced below contains links to many of the studies referenced in this letter, and further information is available in the resources section of my website.

Sam Hope

MBACP, Accred.

FURTHER REFERENCES

https://hopecounsellingandtraining.wordpress.com/2016/11/17/it-is-vital-we-talk-about-the-welfare-of-trans-kids/

http://www.chicagotribune.com/news/nationworld/ct-transgender-mental-illness-classification-20160729-story.html

https://hopecounsellingandtraining.wordpress.com/research-papers/

http://www.torontosun.com/2015/06/08/suicide-rate-much-higher-for-transgender-canadians-study

Advertisements

2 thoughts on “Setting the record straight on trans issues”

  1. Thank you for writing this, I considered sending in a response, but, feared that my lack of academic qualifications would mean that it would be dismissed (pointing out the classicism which surrounds who can access post graduate training is perhaps another issue which is ignored)
    Alongside the events on a social media page recently, it suggests their is a deep rooted transphobia problem within counselling, leaving trans and gender non conforming people at extreme risk. Basic parts of the ethical framework are being thrown out as soon as the issue of gender is raised, and it seems the BACP is willing to turn a blind eye to this

    Like

    1. Our profession certainly has a long way to go! I have been disappointed at how conservative it is, and at times quite surprised. My trans partner certainly has an easier time in IT than I do in counselling – I would have assumed ten years ago that it would be the other way around. I think the underlying lack of awareness and cultural competence is the main issue.

      You should write to the BACP – my letter is going into the February issue, I’m certain it would enjoy some company! Perhaps describing the personal “jolt” and sense of letdown you experienced – not everything has to be academic.

      Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s