Conversion therapy downplayed and attacks on affirmative model at Tavistock whistleblowers' book launch

by Mallory Moore

Fri Jun 18, 2021 · 4331 words · 22 min

Summary

On 5th June, Marcus and Susan Evans—best known for whistleblowing on the Tavistock GIDS health service—convened a conference entitled "Gender Dysphoria - A Therapeutic Model for Working With Children" to market their new book of the same title. This was advertised through both the British Psychoanalytic Association (BPA)1 and British Psychoanalytic Council (BPC)2. This conference meandered through a range of views and speculation against transition, and against regulations banning conversion therapy. This included attempts to downplay the long and combined history of sexual orientation and gender identity conversion efforts (SOGICE), while undermining existing scientific consensus and research into the harms done by challenging trans people's identities. Over the course of the event, two different psych professionals in the audience spoke out challenging the pseudoscientific nature of the conference, as well as the self-congratulatory terms on which the conference was being held, without even having invited practitioners of the practices being criticised to be part of discussion. Additionally Marcus Evans leaked private information about two individuals he likely should not have leaked.

The conference speakers list included Marcus and Sue Evans (authors of the new book the conference was organised to market), Susan Matthews, Stella O'Malley, and Kirsty Entwhistle, and was chaired by David Morgan.

Early on in the conference, the tone was set by Marcus Evans in the form of not-quite-explicit support for efforts to try and correct trans children through psychotherapy, saying "the sort of problems of adolescence–getting into fixed states of mind about what the problem and what the solution is, is a very age old problem that clinicians throughout the ages would be familiar with". At no point in the conference did the speakers appear to recognise that some children are trans.

One of the speakers—Dr Susan Matthews—is not a clinician but a literary scholar (of William Blake) who's presence was explained by her having contributed to two chapters in "gender critical" philosopher Heather Brunskell-Evans' book Inventing Transgender Children3.

Suggesting trans people are broken and ought to be fixed

During the first session of the conference Susan and Marcus Evans explained were trying to encourage practitioners to feel more confident in taking a similar approach despite the "political situation". Marcus said:

A lot of people that we talk to are intimidated by the environment, a lot of experienced people. So often people with gender dysphoria are sort of working with people who are maybe not so experienced. We're trying to get all clinicians, a lot of the experienced clinicians who sort of stayed away because it's a political hot potato...

It's new in terms of what's going on culturally at the moment, but actually, you know, these sort of problems of adolescence, getting into a fixed state of mind about what the problem is and what the solution is is a very age old problem that clinicians throughout the ages will be familiar with.

This gave the impression that the problem faced by child or adolescent patients are primarily that they are fixed in their belief that they are trans and want to transition, and not trying to help the child in exploring and developing their own self-understanding and their own competence to understand themselves. It also seemed to clearly play down the relevance of modern research around treatment and support for patients with gender dysphoria.

The pair of them shortly after diverted onto a tangent about the "political" move to depathologise what used to be called Gender Identity Disorder. Marcus Evans said it's "unhelpful to say there isn't a psychological issue in terms of what's going on here... the mind has got to be looked at before we make changes to the body."

Susan followed up:

One of the things that you will hear about gender dysphoria is that there are these things called consistence, persistence, and insistence. And I often have heard these talked about, and of course they're there, in a sense, in the presentation, but of course what we will talk about later on, is that actually, the fixed state of mind that would create this insistence and persistence, you know, a sort of rigidity about ideas, actually one of the very things that young people need to be helped with, and it needs to be looked at as part of the presentation.

While the driving point of this seemed (as a viewer in the audience) to be lacking in clarity, the impression it left was that for Susan and Marcus Evans, the fact that young trans people know that they are trans, and insist and persist in being trans is actually something they see as a problem to be addressed by therapy rather than a simple matter of self knowledge by those patients.

While this was couched in compassionate language around helping the patient understand themselves, the focus was based around the therapist identifying the ways that "trauma" or "comorbidities" may be a root cause to the patient's gender identity issues which the therapist to expose. As examples of trauma that might come into play for this they included "illness of a sibling, parental depression, [or] parent separation". These are obviously common things many children have experienced throughout history without this turning them trans.

Throughout the conference, Susan and Marcus Evans did not give any suggestion of what criteria they would consider sufficient to come to the conclusion that a trans patient really was in fact trans. Instead their presentation focused on attacking the "affirmative" model4,5, which assumes that the self-knowledge of a patient who says they are trans should be respected, in the same way as a therapist might be expected to respect the self-knowledge of a gay patient who says they are gay.

The UN Independent Expert report in 20206 note that young trans people in particular are targeted by conversion efforts, including clinical efforts, with a common mode including attempts at preventing young trans people from transitioning.

It is hard to imagine how a therapist approaching a patient of any age who has come to know they are trans, would be able to adopt the Evans’ approach to psychotherapy without fundamentally trying to find ways to psychotherapise and pathologise their continued "insistence and persistence" that they were trans.

References were made by Marcus and Susan to the input and direction that they had taken on this issue from Dr Kenneth Zucker who was in the audience. Trans Safety Network have noted in the past, Zucker pioneered a system of behavioural therapy for coercing young gender non-conforming people into more gender conforming behaviours7 and was fired from practice in Canada after an external review conducted in the wake of laws against conversion therapy coming into place. Zucker is also notorious for having run a series of studies where he asked subjects to rate trans children on a scale of attractiveness.8,9

Marcus Evans then compared respecting and supporting trans patients' self-knowledge and identity as being similar to "colluding with" anorexics drive to starve themselves.

Later on in the afternoon plenary, Stella O'Malley would say "there's lots of ways into gender dysphoria, and there's lots of ways out of it", feeding this idea that being trans is something you can catch, or be cured of.

Institutional Capture

Littered through the session Marcus Evans diverted onto lengthy side-rants about the "political" situation that therapists are in, and how "difficult" it is to speak about, due to the current public conversations on banning conversion therapy. This included claims that the Memorandum of Understanding on Conversion Therapy10 was preventing legitimate psychotherapeutic investigation, and suggestions that conversion therapy had mostly only ever been conducted by religious groups rather than clinicians, and against homosexuals, and even then it had been stopped long in the past. All of these things are false as was clarified by an audience member from the psych profession later. The Memorandum of Understanding on Conversion Therapy (MOU2) itself does not prevent psychotherapeutic investigation and is explicitly clear that:

For people who are unhappy about their sexual orientation or their gender identity, there may be grounds for exploring therapeutic options to help them live more comfortably with it, reduce their distress and reach a greater degree of self-acceptance. Some people may benefit from the support of psychotherapy and counselling to help them manage unhappiness and to clarify their sense of themselves.


Memorandum of Understsanding on Conversion Therapy

Emphasis added by Trans Safety Network

Susan Evans then raised the topic of "the policy capture of our schools and institutions", saying:

There's been a news piece this week about [UK LGBT rights charity] Stonewall sort of asking to remove the name of mother and call us the person who gives birth. ...

Up til now, there has been a very successful way in which our institutions and schools and so on have been kind of captured by this, and I use that word. It's not that there aren't some good messages within it. Of course we're trying to develop tolerance to difference and diversity. It's a very good thing, but unfortunately something rather more political seems to have gotten into the education of young children in schools.

In fact, Stonewall has not tried to remove or ban the word "mother" and instead has only provided suggestions for trans-inclusive gender neutral terms which may help clients address their gender reassignment equality duty when writing and implementing HR policies.

Susan went on to explain that she understands how "difficult it is if your institution is in the grips of a kind of policy that only uses the affirmative approach", linking the growing consensus around affirmation to unspecified and presumably sinister political interests.

Marcus followed up by quoting from a piece he'd read by James Kirkup that "in 35 years, he's never known how effective certain sorts of political groups had become in getting hold of the agenda.", before diverting back to his discussions on the affirmative approach, saying "Ken Zucker will know a lot more about the history of this than we do."

If this transparently smacks of a 'trans' flavoured rerun of the old fashioned "Gay Agenda" narrative there is a reason for that. For readers who are less familiar, the effect of so called Institutional Capture narratives is that they provide an excuse for anti-trans researchers reading through the medical research literature or other reporting to simply ignore evidence contrary to their beliefs as the product of a political ideology and transgender subversion. The supposed ideology installed by this "capture" is often labelled as 'transgender ideology', 'gender identity ideology', or just 'gender ideology'—a conspiracy belief system which has featured as a large part of "anti-gender" disinformation campaigns across Europe11. The jargon and ideas of these conspiracy beliefs—specifically that LGBT organisations are politically infiltrating institutions and references to "gender ideology" were repeatedly referred to by speakers. The European Parliamentary Forum on Sexual and Reproductive Rights recent report Tip of the Iceberg estimates that at least $700million has been invested in Europe for lobbying and disseminating this belief system by ultraconservative groups in the last decade.12

If one accepts the "institutional capture" hypothesis then LGBT equal rights advocacy becomes a pernicious attempt to spread a sexual agenda on children, and any study which indicates that trans people who are not supported in their identity have worse mental health outcomes can be explained away as the product of a politically driven emotional blackmail rather than evidence that disrespecting trans people is harmful and has obvious and predictably bad outcomes very similar to those observed for all forms of conversion therapy.

Overall this sort of narrative is encouraging people to believe a secret cabal of mysteriously powerful trans people are operating to hijack the levers of power over society. Although the references throughout were relatively vague and non-committal this is nevertheless a disturbing thing to be bringing to a conference which is supposed to be about how to provide appropriate and supportive psychotherapeutic healthcare to gender dysphoric children.

Susan Matthews and the Bayswater Support Group

Susan Matthews was present talking about her experiences as a parent who is part of the Bayswater Support Group—a support group for parents who do not want their children to transition. She held a session which focused mainly on noticing patterns between different "stories" expressed by parents who are part of the Bayswater Support Group, which were chiefly based around "the 14 year old daughter", who is "maybe a little bit autistic and self-harming", or the "18 year old son who probably doesn't have much sexual experience" and is overly interested in anime and comics "and all of a sudden they discover they're a woman".

Fundamentally this session presented a parent's perspective of seeing their child present unexpectedly with gender identity issues (which no one would be surprised parents find alarming or surprising), but as an echo chamber of parents worried that something wrong was happening without balance from any of the perspectives of trans adults who had presented similarly as young people and were happy with their trans lives.

In this way, a panic among parents with no particular expertise in trans issues that someone or something is making young trans people be trans was just amplified by this conference without any attempt made to understand or explore the fears there, or to understand the situation from the trans childrens' perspective. Again this is dangerous for trans people because by excluding trans perspectives it becomes easy to justify taking decisions against trans children in order to pacify the alarm and distress of the parent.

While hypotheses about anime and pop culture turning children trans are increasingly popular in anti-trans publications13, noone has yet advanced a theory for why the vast majority of young people who are exposed to cartoons do not show any signs of being trans and this belief has yet to leave the arena of pseudoscience.

Protests from psych professionals

After about fifteen minutes of Susan Matthew's session a psychologist (who we are still seeking out for comment at the time of publication) spoke up, complaining that she felt she had been misled to believe "that this was a professional conference", before promptly being muted by the stream host. She un-muted herself again, advising other attendees present to go and investigate the evidence for themselves before being muted again. Her spoken contributions were erased from a later video copy of the event circulated among attendees.

An unredacted statement from a clinician sent by chat which did remain in the final edit read out by the chair said:

The speakers are focusing on people who regret the medical interventions and not the majority of the cases that transitions are successful. On most cases regret is about the heteronormative environment and hostility to trans people.

A further intervention about 10 minutes later came from Milton Sattler, a BACP accredited therapist, who pointed out that therapists are not doctors and are not in the practice of making medical decisions. He also challenged the idea that the Memorandum of Understanding stops therapists in the UK from working with clients who are questioning their sexuality or gender identity. In response to repeated self-congratulation which had been performed by the speakers about their bravery in coming together to discuss their theories he added:

I don't think it is brave to be here, without the other side, other speakers who think in a different way. It seems so far all the speakers have the same kind of understanding about gender dysphoria which is, in my understanding, that you cannot help kids because they're too young to have a concept.

That was as far as he got before being interrupted by David Morgan, who was followed by Marcus Evans explaining he feels victimised by the existing discussions, by being called a bigot for his views, and finishing with "it might be different in your country". Sattler practices in the UK.

Susan Evans followed, saying: "You could say, you don't believe in gender ideology or you don't think people should be affirmed... in the end, I think things will evolve" before comparing transition to the practice of lobotomies in the 1950s.

The supposed "merging" of gay and trans conversion therapy

Another claim which was repeatedly made was that of the confusion of sexual orientation and gender identity for bans on conversion therapy, suggesting that gay conversion therapy exists but trans conversion therapy doesn’t. At one point Stella O'Malley said "Of course conversion therapy that was carried out in the 1950s and 1960s was a thing against people who were generally gay. I'm not convinced that there's very much conversion therapy happening now", while promoting her organisation Thoughtful Therapists.

In practice, throughout the history of psychotherapeutic, behavioural and other clinically driven interventions against gay and trans people, these practices were frequently performed by the same or very similar psych researchers. These incidents also ran on for long past the 50s and 60s. Disturbing personal accounts by trans women of being subjected to electroshock therapy in the Maudsley were recorded in the conference proceedings document for the 1974 Leeds Transvestite/Transsexual Conference14, and are documented in the British Journal of Psychiatry.15 Biomedical ethics scholar Florence Ashley has shown how the earlier influential research developing psychotherapeutic models of conversion therapy made no distinction between gender identity and sexual orientation, instead focusing on gender-non-conforming behaviours:

Brought together under the normative umbrella of gender role, Green and Money view the children’s effeminacy as a problem to be fixed as it may augur future challenges to normative gender roles in the form of adult “homosexuality and transvestism”. No clear distinction is made between gender identity, gender expression, and sexual orientation in the treatment plan, as failing to comport with socially dominant models of any of the three is cast as a problem to be prevented and corrected…

The strict separation between preventing LGBQ outcomes and preventing trans outcomes used to distinguish Rekers and Lovaas’ conversion therapy and approaches that oppose gender affirmation, such as Zucker and Bradley’s corrective approach to children, is illusory. When it comes to youth, conversion therapy has historically targeted gender non-conformity, not gender identity or sexual orientation per se.


Florence Ashley - Homophobia, conversion therapy, and care models for trans youth: defending the genderaffirmative approach, Journal of LGBT Youth, 17:4, 361-383, DOI: 10.1080/19361653.2019.1665610

Alongside behavioural and coercive practices, practitioners developed less physically invasive talking and family therapy practices in attempts to "convert" lesbian, gay, bisexual and transgender people for many years afterwards, branded by practitioners as "reparative therapy" and seeking to find a pre-supposed psychodynamic root trauma or psychic injury to repair in order to "correct" the sexuality or gender identity of the individual.16 These talking therapy conversion practices are known to still be extremely harmful, inducing symptoms of PTSD in patients and greatly increasing lifetime suicidality rates.17

Some of this history was raised in protest again by Milton Sattler intervening from the audience, who pointed out that evidence in the 2018 National LGBT Survey18 which showed that 5% of LGBT people collectively have been offered it (with transgender men at 9%), and 19% of the cases where conversion therapy had been practiced, it was conducted by healthcare professionals.

In 2020, the Ozanne Foundation commissioned an independently reviewed survey into Gender Identity Conversion Therapy which showed that conversion therapy is a present day practice experienced by a number of transgender people, still practiced in psychological settings and correlated with higher levels of mental health problems.19 Young people are particularly vulnerable to these practices, being with limited agency of their own. According to the Ozanne 2020 GICT report "Nearly half (49%) of respondents were children when they started conversion therapy, and three quarters were under the age of 24". In its opening paragraph, the report states:

The United Nations’ Independent Expert on Sexual Orientation and Gender Identity has defined ‘conversion therapy’ as an umbrella term to describe a wide-range of practices, all of which share the belief that a person’s sexual orientation and gender identity can and should be changed. These are deeply harmful interventions that rely on the false idea that LGBT and other diverse persons are sick and should be ‘cured’. There is no sound scientific evidence that these practices work. In April 2020 the International Rehabilitation Council for Torture Victims concluded that “conversion therapy” is a form of torture, which led the UN to call for a global ban in June 2020.


2020 GICT Report by the Ozanne Foundation

Carelessness with private information

At one point Marcus Evans diverted onto a story about a situation with Thoughtful Therapists where he said that James Esses (the founder of Thoughtful Therapists and the initiator of a petition against the conversion therapy ban applying to conversion therapy for trans people) had been "struck off by his training organisation". The details for this were deleted from the publicly circulated edited version of the video.

Repeatedly Marcus Evans discussed anecdotes about particular patients, giving minor personal details about their stories and lives, as is possibly to be expected to some extent when discussing clinical experience. However, at one point late in the afternoon, Evans talked about a particular child by name, saying, "We can remember, am I allowed to say this? We got a phone call from school saying..." and then giving the age and name of the child the anecdote was about and their history. For obvious reasons we won't repeat these, but they were sufficient to be a clear breach of privacy. Susan Evans quickly prompted him to stop: "we'll have to edit that out of the video for later". The anecdote remained in the edited video which was circulated after the event, although the identifying information was removed. That said, the live conference had over 240 people in attendance, and it's concerning that personally identifiable information about a child was disclosed to the everyone attending.

We reached out to Marcus Evans for comment but received no reply. However, the edited public video with the visible cuts removing the disclosures has been taken down.


References:

3

Inventing Transgender Children is a work based around a theory that transgender children are a modern invention and even contagious, with contributions from among others, a psychotherapist who failed to respect patient confidentiality who was disciplined for this. Susan Matthews' contributions to the book theorised that being transgender can be caught or reinforced through reading books about being trans. A more conventional and less conspiratorial history of transgender childhood, including with cases before the advent of trans healthcare (despite the conspiracy theory that trans children were invented by medicine), can be found in Jules Gill Peterson's Histories of the Transgender Child published via University of Minnesota Press.