A slow but significant step forward combatting the right in the field of psychotherapy has been the Memorandum of understanding on conversion therapy in the UK. The Memorandum is currently signed by twenty-five therapy organisations. The basis of the Memorandum is very simple, aligning therapists with an open approach to what people bring to speak about when they are in distress, and this is the rationale you will find on the website of the largest professional registration organisation, the British Association for Counselling and Psychotherapy (BACP) where they put it like this, “Conversion therapy is the term for therapy that assumes certain sexual orientations or gender identities are inferior to others, and seeks to change or suppress them on that basis”. Now the Memorandum is under attack, and organisations are dropping away from it. Why?
Conversion
The main threat to therapy as a place to speak, and to be heard without being judged or subjected to moral-ideological demands, was seen by many as coming from the religious right, with Christian “therapists” intent on bringing sexual deviants back on the straight and narrow being one main threat. Sexuality and gender have been a battleground in psychotherapy for decades, and gay and lesbian therapists have been active in ensuring that therapeutic space really is safe.
The current wave of transphobe activity by so-called “gender-criticals” – those who want to make gender identity correspond to what they believe to be a basic biological sexed body – has now woven another toxic strand into the debate. This is what seems to be behind the recent shock move by the United Kingdom Council for Psychotherapy (UKCP), the next largest therapy registration body, to pull out of the Memorandum on 5 April.
This is a professional field that is riven with status anxiety, and drawing up the Memorandum was a real achievement, the main organisational players being the BACP with 67,000 registrants (formally the British Association for Counselling, adding “psychotherapy” to its name in 2000 to expand its franchise), the UKCP with 11,000 registrants (which include some psychoanalysts), and the British Psychoanalytic Council (BPC) which has 2,000 registrants.
You can get a sense of the pyramidic structure of the psychotherapy world from these numbers and labels; it is a status pyramid that is currently being reinforced by the SCoPEd framework which sets out levels of training and expertise (and which itself threatens to turn psychotherapy from an open space into one defined by rules and procedures through which people can speak and be heard). Notice that it puts psychoanalysts at the top, with psychotherapists in the middle and huge numbers of counsellors at the bottom of the pyramid.
“Won’t somebody please think of the children?”
The rationale UKCP gave for withdrawing their signature from the Memorandum was that the UKCP Board of Trustees thought, they say, that the Memorandum only applied to “clients” or “patients” over eighteen years old. So, does this mean that they are against “conversion” in line with reactionary ideological beliefs of the therapist when it applies to adults, but that it is cool when done to kids?
There has been some protest at this withdrawal from the Memorandum in the psychotherapy world, particularly among UKCP registrants, and the UKCP were forced to issue a bizarre “clarification” in which they said they were against “conversion therapy” of anyone “for any age”: “The UKCP Board of Trustees reassures all members, their clients and the LGBTQIA+ community that we strongly believe conversion therapy is harmful and must not be practised”.
A 22 April email to UKCP registrants updates their clarification further. There is an nice slip in the email telling readers that it is about withdrawal from the Memorandum about “conversation therapy”. Anyway, UKCP are now arguing that they want to take seriously “concerns relating to children and young people,” and the email refers to what UKCP call “unique developmental requirements” that mean that practitioners need “a unique therapeutic approach that acknowledges their developmental stage and capacity for informed consent”. The implication is that this “capacity” is not to be honoured in the complex decisions children and young people are themselves making about who they are and who they want to be.
After Cass
So, here we are in the wake of the Cass Review, a toxic attack on support services for trans young people which, it is now clear from the government and media response, is beginning with the argument that all of this is being done to defend children but which has the deliberate aim of destroying public welfare trans services altogether. The transphobes have been very busy in the field of therapy. Some websites, such as Sex Matters, have been very explicit about their “therapeutic” agenda of anchoring their own traditional understanding of gender onto biological sex.
There is an insidious use of the term “exploratory therapy” as a code-word for identifying supposed disorder, and “gender dysphoria” is a favourite medical psychiatric anchor term for what the bigots will be targeting in the clinic. This is exactly the kind of terminology that is used as a sign of professional knowledge wielded to separate psychoanalysts from psychotherapists from counsellors in the SCoPEd expertise training hierarchy. An article by a counsellor on the Transgender Trend website (an organisation that has as its strapline “no child is born in the wrong body”) complains about “pressure on the UK government” in the twisting of opposition to religious “conversion” into something that is operating as part of a pro-trans “agenda.” The ostensibly open “exploratory” approach advocated by these people is sometimes framed as “thoughtful therapy.” Beware!
The UKCP decision to withdraw from the Memorandum of understanding on conversion therapy on the grounds that the Memorandum also applies to those under eighteen is disastrous enough, and disastrous in its consequences. Already one of the other organisational signatures to the Memorandum, from the National Counselling and Psychotherapy Society, (NCPS), disappeared without notice or explanation. The NCPS have now responded to inquiries, saying they were forced to withdraw under threat of legal action that their insurers would not cover them for.
Threats and resistance
The BACP (the leadership of which has come under attack from its members for its active participation in the SCoPEd exercise that will confirm the position of counsellors at the bottom of the professional therapy pyramid) has reserves of over five million pounds, and is quite financially secure, but it seems that legal threat to organisations that hold firm on the Memorandum may be a factor in recent backtracking on opposition to conversion therapy. A recent insurance quote for UKCP was 90,000 pounds, for instance, and this kind of thing puts the pressure on. The NCPS is a smaller organisation, potentially at risk from legal action.
There are high-level internal discussions happening inside the British Psychoanalytic Council, which include worry about what the next move of the so-called “gender criticals” will be. Psychoanalysis as a professional speciality is infested with transphobe ideas about what normal gender and sexual identity looks like. Again, there is a risk of reactionary ideas about sex and gender filtering down the status pyramid which psychoanalysts like to position themselves at the apex of. The latest UKCP email to registrants tells us that they are “now in discussion with other counselling and psychotherapy organisations, including the British Psychoanalytic Council (BPC) and the National Counselling and Psychotherapy Society (NCPS) to consult on and draw up new guidelines.”
It seems that the hard-won Memorandum is now to be thrown out the window. The discussions include fear of the very real possibility that cases of “conversion” in therapy, and opposition to it, will be tested in the courts, and this adds to the atmosphere of caution over possible litigation that is being stoked by the transphobes. The British Psychological Society is also having discussions about gender, sexuality and research with young people which will connect with these issues.
The withdrawal of the NCPS signature from the Memorandum was noticed by Therapists Against Conversion Therapy and Transphobia (TACTT). TACTT is “a grassroots collective of therapists, counsellors, psychotherapists, psychologists and other therapeutic practitioners who oppose conversion therapy and transphobia in the therapy profession”. TACTT suggest actions that therapists can take to protest against what UKCP have done. There are progressive therapists willing to defend therapy as a safe place to speak, but to do that it is clear that we need to organise, and be clear that this is a political question that will define us in theory and practice as allies of the oppressed.
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