Following recent case law, and the publication of the interim Cass Review report, the UK Council for Psychotherapy (UKCP) is today issuing a statement on the law regarding gender-critical views and its implications for the practice of psychotherapy and psychotherapeutic counselling. This statement is also being made to highlight the fact that exploratory therapy must not be conflated with conversion therapy.
Case law has confirmed that gender-critical beliefs (which include the belief that sex is biological and immutable, people cannot change their sex and sex is distinct from gender-identity) are protected under the Equality Act 2010. Individuals who hold such beliefs must therefore not be discriminated against.
Psychotherapists and psychotherapeutic counsellors who hold such views are likely to believe that the clinically most appropriate approach to working therapeutically with individuals who present with gender dysphoria, particularly children and young people, is exploratory therapy, rather than medicalised interventions such as puberty blockers, cross-sex hormones or reassignment surgery. Such therapy explores the presenting issues through open-ended discussion, and is conducted without any preconceptions or pre-decided theoretical framework regarding the person’s gender identity. An important aspect of exploratory therapy is the ability to explore the fullest range of issues that may contribute to the person seeking help. Within the interim Cass Review report, the exploratory approach is described as ‘therapeutic approaches that acknowledge the young person’s subjective gender experience, whilst also engaging in an open, curious, non-directive exploration of the meaning of a range of experiences that may connect to gender and broad self-identity’.
Psychotherapists and psychotherapeutic counsellors are free to conduct their professional practice in this way if fully consonant with the high standards set out in UKCP’s Code of Ethics and Professional Practice. Working within the Code underpins and informs best clinical practice.
The exploratory approach can, of course, be taken whether or not the practitioner has sympathy with gender-critical views, with effective UKCP practitioners not allowing their own personal views to impede or bias an open, genuinely exploratory approach.
Exploratory therapy should not in any circumstances be confused with conversion therapy, which seeks to change or deny a person’s sexual orientation and/or gender identity. Conversion therapy as so defined is harmful and must not be practised.
The UKCP also accepts that the treatment of gender dysphoria is a complex matter, that psychotherapists and psychotherapeutic counsellors may hold differing views on what approach is in the best interests of their clients, and that these views and practices, and their associated professional diversities, should also be respected – assuming, again, that they are consistent with the UKCP’s Code of Ethics and Professional Practice. This is in line with the UKCP’s values as an inclusive and pluralistic organisation, embracing a variety or modalities and approaches to psychotherapeutic practice.
UKCP Chair, Dr Christian Buckland, said:
‘The UKCP continues to recognise the fact that there are different professional beliefs on many differing topics within the psychotherapeutic community. This position is fundamental to the UKCP. Out of all the psychotherapeutic governing bodies within the UK, we are the only one that encompasses the numerous different modalities within psychotherapy. The diverse nature of the UKCP’s modalities has meant that we are familiar with, and welcoming of, different opinions on how we work with distress. The nature of human diversity means that psychotherapy cannot be a ‘one size fits all practice’. Also, welcoming different approaches means that we are able to open up complex conversations rather than closing them down – a very important feature of psychotherapy as a professional practice.
‘The UKCP welcomes different approaches when it comes to working therapeutically with mental health conditions and emotional issues such as depression, eating disorders and relationship difficulties. Coming together to discuss these different approaches can help advance the profession and how we work with the people who come to us for help. Working with gender issues is no different.
‘Whether a practitioner has gender-critical views or not, it is important to recognise that 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. This is why it is essential, especially for children and young people, that these aspects are thoroughly explored with highly trained psychological practitioners. This can take time, and sometimes a very long time.
‘Medical interventions can potentially be irreversible, and there are risks associated with all medical treatments. Therefore, it is imperative that all underlying aspects to someone’s dysphoria are given the attention and exploration they deserve through professional psychotherapies, in order that the overall risks can be appropriately assessed prior to considering medical intervention.
'Regardless of viewpoints, all professional psychotherapists and psychotherapeutic counsellors who work with gender dysphoria or gender-identity want the best for the person who is struggling and needs help. If this is always kept in mind, these vitally important conversations, however difficult, can take place in a healthy and supportive manner, allowing us to ensure our clients’ and the public’s best interest and safety remain paramount.’
2 November 2023