Harming Gay, Autistic and Vulnerable young people
We have duplicated the letter LGB Alliance Australia has sent to the Australian Psychological Society below and providing a direct link also to the document on lgballiance.org.au. With the aim to make the specific topics of interest in the 12 sections below easier to reference online.
A letter to APS from LGB Alliance Australia
Dear Ms Cavenett,
Thank you for initiating a review of the Australian Psychological Society guidelines for clinical management of gender dysphoria and gender incongruence.
We view the current Australian Psychological Society (APS) guidelines as unsafe for young people likely to grow up to be lesbian, gay, or bisexual. We find them so ill-informed that APS policy is in effect facilitating egregious harm to LGB (lesbian, gay and bisexual) young people. The practice of automatic gender affirmation is creating a cohort of young detransitioned lesbians and gay men who have been sterilized by medical intervention, and who now live with lasting injury from puberty blockers, cross-sex hormones, and surgeries. Continued APS facilitation of these risks and outcomes is an abuse of human rights.
The body of evidence shows a strong correlation between gender nonconformity and dysphoria in childhood and adults who are gay, lesbian or bisexual. This evidence is not hidden. It’s not hard to find. However, it has been ignored by LGBTQ groups advising health governance organisations about policy for young people experiencing gender incongruence. Consequently, health governance bodies have adopted ‘affirmative’ policy positions that ignore the needs of LGB youth and put young people at risk of harm (‘LGB youth’ refers to young people likely to grow up to be adult lesbian, gay or bisexual people. LGB people come to know their sexuality as they move through puberty and mature into adulthood).
The harms we are concerned about are serious. LGB people are amongst the rising numbers of detransitioners who experience harms including sterilisation, loss of organs of reproduction and sexual responsiveness: breasts, uterus, testicles, and penises. For females, additional regretted body modification includes masculinised voice and facial hair. The psychological difficulties of those who experienced clinician-enabled harm are complex.
In the past, the APS has been a strong advocate for the wellbeing of same sex attracted people. This is appreciated by the LGB Alliance Australia. We believe the current policy problems have been created because LGBTQ advocates that formerly represented the needs of LGB people are now driven by preoccupation with queer theory. The abrupt shift to queer ideology, with its denial of sex and same-sex attraction creates many risks for LGB youth. As a result, new organisations are emerging to represent gay, lesbian and bisexual people including LGB Alliance groups in Australia and many other countries.
Because the risks of harm to LGB* young people are so serious, we ask that the APS immediately suspend your current recommendations for ‘affirmation only’ mental health practices, and that you convey this suspension to your members. It is not safe to continue with these guidelines during the two years it may take to conduct your review.
We note that your members have been exposed, via several articles in InPsych, to a dominant narrative that all gender nonconforming children and youth with gender dysphoria are necessarily ‘trans’...in other words, communication that ignores the evidence pertinent to LGB* young people. We are extremely concerned that your well-intentioned membership, having absorbed this reductionist view, will be unable to safeguard the interests of LGB people. We ask that you take steps to remedy this by featuring InPsych articles that inform members about the key issues covered in our appended recommendations for evidence: how most children with childhood gender dysphoria resolve it via puberty; how most of these grow up to be gay men or lesbians; and the harmful impact of gender stereotypes - particularly on gender nonconforming LGB people.
We note also that your current guidelines do not mention detransitioned people, yet your members need to be aware of their difficulties and complex needs. The regret experienced by detransitioners often involves distrust of health professionals who facilitated harm. For this reason, it is important that psychologists understand what detransitioners say about their experiences and needs via articles in InPsych magazine and within practice guidelines. We believe that without this effort to inform your members, they will continue to work blind to the needs of LGB and other vulnerable people.
We note that your Code of Ethics requires psychologists to:
"anticipate the foreseeable consequences of their professional decision, provide services that are beneficial to people and do not harm them" and "take responsibility for their professional decisions"
'Conduct' means any act or omission (such as thorough assessment, differential diagnoses, and awareness of risk specific to LGB people), and that
"The principle of Propriety incorporates the principles of beneficence, non-maleficence (including competence) and responsibility to clients, the profession and society"
Your current policies facilitate harm to LGB people.
Given that we are talking grievous harm, involving sterilisation, removal of organs and permanent injuries to LGB and other vulnerable young people, there will inevitably be legal cases. In sending you this letter with its attachments, we are providing you with the means to critically examine the needs of LGB and other young people vulnerable to the networked surge in trans identification. We urge you to base your policies on high quality evidence rather than inconclusive, poor-quality research pushed by queer ideology. While our primary intent is that the APS should cease reckless automatic gender affirmation, this submission also provides a record that you have been alerted to the risks. Such a record may be useful to future litigants.
We take seriously the protection of our youth; we will take what legal and public actions necessary to do due diligence to our community. In this we are supported by other LGB groups, the Coalition of Activist Lesbians Inc Australia, and LGB Tasmania.
Our recommendations are attached. These include:
Attachment A - Recommendations for evidence to examine while developing policy that is safe for LGB and other vulnerable young people.
Attachment B - Recommendations to the APS taskforce reviewing gender policy and communications
We also attach separately a critical review of AusPATH guidelines from the Society for Evidence Based Gender Medicine.
LGB Alliance Australia
Catherine Karena, Community Liaison
Attachment A: Evidence that must be examined to develop safe policy
The exponential increase in children and adolescents referred to gender clinics in Australia, North America and Europe has been accompanied by a reversal in demographics. Whereas most children presenting with gender dysphoria used to be natal males, now the majority are girls identifying as male during adolescence. During this period, health governance organisations ended the ‘watchful waiting’ approach that had hitherto been associated with high desistance rates and high likelihood of LGB outcomes. This has been replaced with ‘affirmative care’ in which every child or young person presenting with gender dysphoria and/or trans identity is assumed to be a ‘trans kid’. With this policy switch came serious risks for children likely to grow up to be lesbian, gay, or bisexual adults.
LGB Alliance Australia believes that the current APS ‘affirmation only’ policy is unsafe for LGB and other vulnerable young people.
As teenage trans identification has surged across western countries, red flags have been raised that youth likely to grow up as lesbian, gay or bisexual are being swept into a one-size-fits-all model of care. Staff at the UK Tavistock Clinic stated it feels like conversion therapy for gay children:
“So many potentially gay children were being sent down the pathway to change gender...there was a dark joke among staff that “there would be no gay people left”
“I frequently had cases where people started identifying as trans after months of horrendous bullying for being gay”
“Young lesbians considered at the bottom of the heap suddenly found they were really popular when they said they were trans”
“We heard a lot of homophobia which we felt nobody was challenging. A lot of the girls would come in and say, ‘I’m not a lesbian. I fell in love with my best girlfriend but then I went online and realised I’m not a lesbian, I’m a boy. Phew.’
In the first instance we ask that the APS working group read the following essay that describes the risks and the consequences of ignoring them:
Uncritical Allegiance: when linear thinking hurts gay kids
Further to this and in order to create safe policy, we ask the working group to make a firm commitment to examine evidence relating to risks outlined in this document.
Click on the 1-12 section links:
1. The body of knowledge that was ignored: gender dysphoria in LGB people
2. The risk to LGB youth is evident from the stories of detransitioners
3. Research on detransition
4. Clinical support NEEDED for detransitioned people
5. The importance of science-based information about biological sex
6. Network dynamics amongst client populations
(The influence of social contagion, social media influencers etc.)
7. Network dynamics amongst psychologists
(Psychologists have been verbally attacked for expressing concern about the surge in adolescent trans identification. Psychologists need an environment that fosters the ability to learn, question and consider evidence in relation to these issues, that a diversity of opinion, respectfully conveyed, is not just acceptable but desirable for development of safe practice.)
8. Puberty Blockers are harmful
9. The adoption of safe policy following evidence reviews
10. The new, hostile environment for LGB young people
11. A return to safe practice: assessment and exploratory, holistic therapy
12. The gulf between the APS Code of Ethics and current gender policy
ATTACHMENT B: RECOMMENDATIONS TO THE APS PANEL REVIEWING GENDER POLICY AND COMMUNICATIONS
We recommend that the APS taskforce:
Seek to understand the needs of same-sex attracted people by exploring the information in the appended document A: Evidence that must be examined in order to create safe policy.’
Convey to your members withdrawal of your current guidelines on commencement of the review period. This is important because your current one-size-fits-all ‘affirmation-only’ policy is unsafe for LGB people.
Educate psychologists about the body of evidence that shows that the majority of children diagnosed with gender dysphoria resolve it as they mature through puberty, with most becoming gay, lesbian or bisexual. Convey this in your policy, InPsych articles and other communications. This is important because your members have been denied this crucial information.
Educate psychologists about the importance of exploring gender stereotypes in work with clients who experience gender incongruence and dysphoria. Convey this via policy and InPsych articles. This is important because gender stereotypes are particularly toxic for gender nonconforming children and youth and remain problematic for many gender nonconforming adults such as ‘masculine’ lesbians and ‘feminine’ gay men.
Educate psychologists about the experiences of detransitioners and their needs. Convey this via policy and InPsych articles. This is important because detransitioners may seek help from your members.
Commit to comprehensive assessment and exploratory therapy with children and adults identifying as transgender.
Recommend against the medical transitioning of children and adolescents. This is important because it is unclear if any psychologist can distinguish between the majority of children with gender dysphoria likely to desist, and the minority likely to continue to experience intense gender dysphoria after maturation.
Recommend against ‘conversion therapy’ laws that deters or bans exploratory therapy for gender questioning youth and adults. These laws have a chilling effect on clinical interventions needed to help people make sense of their gender nonconformity and dysphoria. With LGB youth swept up in the surge in adolescents identifying as trans, the laws make it even more likely that young people will end up suffering regret for body modification undertaken before they learnt that they were lesbian or gay. APS advocacy for bans on the exploratory therapy needed by LGB people is egregious and constitutes a human rights abuse. We urge you to rescind APS support for these ill-conceived laws, and to communicate this on your website.
Make a clear distinction between sex and gender in your communications. Sex is biological. Gender is social. While gender expression is a spectrum, sex is binary, and no mammal has ever changed sex.
Maintain clear language that sexual orientation relates to biological sex, not gender. Lesbians are women who are same sex attracted to women. Gay men are same sex attracted to men. Heterosexuals have a stable attraction to people of the opposite sex. There are other words for people who are attracted to diverse sexes AND gender identities, such as ‘pansexual.’ We ask you not to collude with queer ideology’s refusal to acknowledge the same-sex orientation of gay men and lesbians. This new homophobia, like the old homophobia, requires homosexuals to change sexual orientation.
Educate psychologists about the pressures exerted by queer ideology on same sex attracted youth, so that they can support self-esteem in LGB people who maintain sexual boundaries.
Distinguish between ideas driven by queer ideology and evidence-based practice and policy.
Acknowledge that LGB Alliances represent the needs of LGB people. See our statement here. LGB youth and adults are being harmed by policies promoted by LGBTQ organisations which should have:
Known about gender dysphoria and desistance in LGB youth and advised accordingly, and
Picked up on the signals that young LGB people are being harmed.
These safeguarding failures have shown us that groups driven by queer ideology cannot be trusted to protect the interests of LGB people. (By definition, they cannot represent the interests of same-sex oriented people if they no longer recognise homosexuality as ‘same-sex’). As you revise APS policies to align with safe practice, we ask that you seek input from LGB Alliance Australia. We represent the interests of same sex attracted people and would look forward to working with you.
14. Commit to protect LGB people from harm, by examining the evidence presented in this submission. We understand that current APS policy results from queer ideology advocacy. However, should you fail to correct this, the APS will shift from ‘ill-informed’ to ‘wilful neglect.’ This would be indefensible from any ethical standpoint.