11. A return to safe practice: assessment and exploratory, holistic therapy
We urge the adoption of policies that encourage safe practice that would normally be associated with the APS: comprehensive assessment, differential diagnosis, and exploratory therapy for gender questioning and dysphoric youth and young adults. It is important to note that APS support of ‘conversion therapy’ legislation supports the introduction of laws that potentially criminalise this kind of ethical work. A close examination will show that this ill-considered policy stance will have a chilling effect on the kind of exploratory therapy that LGB youth need, compounding risks for this and other vulnerable client groups. In other words, a policy that, paradoxically, enables harmful ‘conversion’ of lesbian and gay young people to appear ‘straight’ by conforming to gendered expectations and stereotypes: ‘transing the gay away’. For the safety of LGB people, we urge the APS to rescind your support for these bans, and to communicate this change on your website.
We ask APS to examine:
D’Angelo et al One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria, 2020
“exploratory psychotherapy that is neither ‘affirmation’ nor ‘conversion’ should be the first-line treatment for all young people with GD, potentially reducing the need for invasive and irreversible medical procedures. This is especially critical now, when we are witnessing an exponential rise in the incidence of young people with GD who have diverse and complex mental health presentations and require careful assessment and treatment planning.”
“I am here to tell you that the psychotherapeutic relationship is still the safest and best of methods”
ReThink Identity Medicine Ethics - ReIME
“The goals under a truly neutral approach are: (1) “to allow the developmental trajectory of gender identity to unfold naturally without pursuing or encouraging a specific outcome” (2) provide a full assessment and exploration of the conditions and possible comorbidities that may be causing or contributing to the Youth’s self-perception and distress; and (3) avoid over diagnosis and irreversible unnecessary medical interventions that the minor is not competent to consent to and may regret”
…Many also experienced homophobic bullying at school or online and came to resent their same-sex attractions and nonconformity. These clients began obsessively researching gender transition online, coming to believe it would resolve their distress. In the course of therapy, we held this gender exploration in a non-judgmental way, remaining curious about sexuality, normalizing same-sex attraction, thereby affirming their sexual orientation… In the above examples, had therapy prioritized gender affirmation, these young women might now be in the process of making unnecessary and irreversible medical changes to their healthy bodies in an attempt to become boys.
Parkinson & Morris Psychiatry, psychotherapy and the criminalisation of ‘conversion therapy’ in Australia 2021. “The chilling effect of these laws may deter psychiatrists and psychotherapists from providing patients with the mental health support that they need”.
Susan Evans and Marcus Evans, Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents, and Young Adults, 2021.