a statement of professional clarity and solidarity with the trans community

xph therapy, as a sex-positive, sexuality- and gender-affirming, fully trans-inclusive private counselling practice, is endorsing a statement of professional clarity and solidarity with the trans community.

Amanda Middleton, Gail Simon and Gwyn Whitfield of The Pink Practice, along with Elizabeth Day of Graig Consulting, are circulating a statement of professional clarity and solidarity with the trans community that you can read, in full, below. The Pink Practice is encouraging organisations and networks to share this with members and consider adopting it in full for their websites.

The statement reads as follows:

context

A Letter from the Future to Ourselves is written by a group of queer trans-allied cis-ish therapists to anticipate and question consequences of choices psychotherapists make now in our work with transgender, non-binary, gender fluid and genderqueer clients and colleagues. The letter unlocks an opportunity for therapists and counsellors from across modalities to reflect on the history of professional positioning of LGBTQIA+ peoples, and to consider what we need to do now to achieve ethical coherence in our practice. The letter is not only about gender. It is about power in psychotherapy and asks whose voices inform what counts as ‘good practice’.

A Letter from the Future to Ourselves emerged as a response to a position statement by the Chair of the United Kingdom Council for Psychotherapy (Buckland, 2023), which promotes a conservative stance with trans people in therapy. Gender-affirming therapy is now discouraged in favour of therapists and counsellors exploring why people are transgender, to look for problematic causes beyond the self-identification and experience of being trans. The shift to elevate professional expertise over trans experience reflects the relationship with power seen in the UK government-commissioned Cass Report (2023), which advised on the provision of services to transgender young people. This positioning of psychotherapists is at odds with systemic, person-centred and community-centred values underpinning most psychotherapeutic modalities. Consequently, many psychotherapists and counsellors working with trans people feel anxious about what position to take.

It’s a very worrying time for the trans community. Changes in governmental, legal, educational, medical and mental health attitudes, policy, provision and theory have a direct influence on whether trans people can be themselves and whether society will accord trans people equal status, safety, and wellbeing in society. We thank the generosity of trans, non-binary, genderfluid and genderqueer consultants from our professional and social circles who contributed to the wording of this letter.

2026. A letter from the future to ourselves. 

Dear Counsellors and Psychotherapists, 

This is a letter from us in 2026 to ourselves in 2024. Let’s jump back and see how we got to where we are now in our work with trans and nonbinary people. 

2023 was an important year. As psychotherapists and counsellors of the UKCP and BACP, we anticipated being on the right side of history. We looked back. We looked forward. We felt perplexed and sometimes paralysed by contested ideas posed by senior figures speaking from outside of the trans community but within our professional bodies and governments. We realised not knowing what to think or do was an inadequate response, that we needed to learn from our successes and mistakes as a profession.

It was as late as 1974 that homosexuality was taken out of the international mental health diagnostic manuals (DSM and ICD), following a long campaign by mental health practitioners across all disciplines to depathologise lesbian, gay and bisexual people. In 1991, after lengthy pressure from therapists of all sexual orientations, lesbian, gay and bisexual people were allowed to train as psychoanalytic therapists training in the US. It was even later in the UK. In 2013, “distress caused by homosexual orientation” was removed from the diagnostic manuals as a mental health condition. 

After many decades of psychotherapeutic theory and practice that pathologised lesbian, gay, bisexual and transgender people, the 1980s and 90s generated extensive critique of these theories as colonial constructions which relied on practices of othering, demeaning and dehumanising. These pathologising ideas from within our own professional community fuelled social prejudice and ruined many lives. Theories ‘about’ gay, bisexual, lesbian and transgender people were written by non-gay, bisexual, lesbian and transgender people were written by people who were not gay, bisexual, lesbian and transgender Theories were created by people who believed ‘cure’ of ‘homosexuality’ and gender diversity through psychotherapy was not only possible but desirable. 

In 2009, the UKCP, BPS and BACP issued statements that gay and trans conversion therapy (reparative therapy) was an unethical practice: 

“UKCP does not consider homosexuality or bisexuality, or transsexual and transgendered states to be pathologies, mental disorders or indicative of developmental arrest. These are not symptoms to be treated by psychotherapists, in the sense of attempting to change or remove them.” 

https://www.psychotherapy.org.uk/media/ysznvjr2/ukcp.statement-on-reparave-therapies.pdf Dated Feb 2010. Accessed 20/11/23.

In 2017, a Memorandum of Understanding on Conversion Therapy in the UK was signed by over 25 health, counselling and psychotherapy organisations aiming to end the practice of conversion therapy in the UK. (BACP, 2017.)

In 2019, the American Psychiatric Association formally apologised to lesbian, gay, bisexual and transgender people: 

“Regrettably some of that era’s understanding of homosexuality and gender identity can be attributed to the American psychoanalytic establishment. It is long past me to recognize and apologize for our role in the discrimination and trauma caused by our profession.” 

Lee Jaffe, President of APsA, 2019). https://bit.ly/49Fhry2 

In 2023, the UKCP issued a new statement about ‘gender dysphoria’ supporting ‘exploratory’ therapy but not conversion therapy. The statement negated the possibility of affirmative therapy or therapy that is informed by trans experience: 

“There are multiple factors that can contribute to people questioning their gender. These can include the person’s psychological make-up, genetics, current emotional wellbeing, societal and cultural influences, biological factors, neurodiversity, sexuality, family dynamics, and many more. Gender is usually only one of the presenting issues in the broader totality of the client’s situation.”

Buckland, 2023. https://www.psychotherapy.org.uk/news/ukcp-guidance-regarding-gender-critical-views

The same premise that there may be “multiple factors” to explore when addressing gender identity echoes a trope that underpinned the cruel, undermining thinking across all psychotherapeutic modalities to discourage and delay young gay, lesbian or bisexual people from following their sexual orientation. Their sexual orientation was seen as a fantasy, a symptom of other difficulties, not real.

The profession of psychotherapy sometimes chooses to act as a gatekeeper, using its power to dictate what is considered ‘real’, ‘healthy’, and ‘normal’ for young people’s sexuality and gender.  As a psychotherapeutic community we need to address legal, material and social consequences of our theories and policies which negatively impact the wellbeing of members of queer communities.

Now we are in 2026. The UKCP and BACP counsellors and psychotherapists have supported the removal of ‘gender dysphoria’ from the international diagnostic manuals (DSM and ICD). That term is no longer used because gender is seen as a positive choice, not a problem. Trans people are no longer automatically defined as having a mental health condition and do not need a mental health diagnosis to access gender-affirming health care.

Psychotherapists from across all modalities have listened to trans adults and children and realised that it was us psychotherapists and our theories that needed to change.

This is what we did: 

• We set up listening groups to hear what trans adults and young people told us that they needed from us, and we listened to these life stories. 
• Personally and professionally, we met with many trans people from across different ethnicities, religions, age groups, cultures and abilities to hear their diverse experiences. 
• We recognised how trans people have made many rich, varied and important contributions over time.
• We spent time understanding how we use some theories to colonise people in our attempts to help them. 
• We created reflexive groups for therapists to work through our bias stemming from medical, biological and psychotherapeutic discourses. 
• We supported each other and our institutions to do the work that trans people needed from us and so we could articulate to others why this work was ethical. 
• We rewrote many of the theories about gender in conjunction with trans people. 
• We recreated learning opportunities with trans writers, trainers and trainees in our training programmes. 
• We took ownership in the present moment of history by challenging the dominance of gender-normative theory. 
• We positioned ourselves as trans allies. 
• We pivoted in our allegiance from historic ‘aboutness’ thinking into a humility of learning alongside trans people in therapy and in our professional communities.. 
• We explored our prejudices about gender in ourselves and our relationships. 
• We worked with institutions and communities to ensure the range of transgender people was well represented and influential within our professional policies and service delivery. 
• We apologised to transgender people – in a number of ways – some personally, some through professional statements. 
• We apologised to ourselves for having taken the wrong path while trying to become clear about the right thing to do. 

And the other thing we did was to write this letter to ourselves, to show respect for the honesty and drive that it took back in 2024 to make the change and to be the change that trans people needed to be safely, happily themselves. This working document lends support to other groups of people challenging mental health discourses that are co-opted to discredit the autonomy and wisdom of the people we work with, and how we need to open ourselves to listen with humility to the voices of the communities we serve.

With trust, 

The Psychotherapists and Counsellors of 2026.

authors

The Psychotherapists and Counsellors of 2026 are a community in the process of becoming, rewriting this document, learning from feedback, responding to context. The starting imaginers in 2024 included Amanda Middleton, Liz Day, Gail Simon and Gwyn Whitfield, many trans and non-binary people, and many unnamed trans or trans-allied therapists. We expect others to own this document over time, and elaborate or change it to incorporate other voices, to respond to fresh challenges, new language, and intersectional contexts.

Psychotherapists and Counsellors of 2026. (2024). A Letter from the Future to Ourselves. Murmurations: Journal of Transformative Systemic Practice, 7(1), 1–4. https://doi.org/10.28963/7.1.8

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