Gender – BPSWatch

Twitter and the Birmingham University Report

7th Jan 2023 AdminBPSWatch

David Pilgrim posts….

Although no one yet has responded to my earlier piece on this blog, there has been some Twitter activity of relevance passed on to me by Pat Harvey. Two historians (Dr Sarah Marks and Dr Kate Davison) have offered criticisms of my arguments about the Birmingham University report. Here are my responses to their claims that my critique of the report was, in some ways, flawed.

1 My piece reflected activism. This is a fair and correct accusation. We are a group of activists concerned primarily with misgovernance in the BPS, with child protection being implicated as a result. My piece was not a journal submission (it would have been stylistically different) but neither was the Birmingham University report, as it was generated for external consumption by paid employees. Both reflect interest work but we are being explicit about our campaign aims. By contrast, the Birmingham group offered a report that was seemingly disinterested – but was it? Cue the next point…..

2 Dr Marks conceded that historians ‘have an agenda’. Indeed they do, and more so in this case. In my view the Birmingham historians were remiss in not making a reflective declaration. Moreover, Marks defends her colleagues in Birmingham for conveniently ‘grouping’ conversion therapy and aversion therapy as an ‘analytical device’. She concedes explicitly that this might well be anachronistic in its logic. If this is so, who exactly then is benefiting from this tolerance of anachronistic thinking from professional historians? Surely they should be the very people who are careful to steer us clumsy amateurs away from anachronisms. I interpret this break from professional methodological convention as a reflection of the virtue-signalling priorities, which now dominate the zeitgeist of identity politics in neoliberal times. (I elaborate that point at length in my recent book Identity Politics: Where Did It All Go Wrong?).

3 Dr Davison noted that in the wider aversion therapy literature, although homosexual men were overwhelmingly the main focus, there were smaller numbers of research subjects of lesbians, transvestites and transsexuals, as well as exhibitionists and fetishists (Bancroft, 1969; Bancroft and Marks, 1968). This does not alter the fact that homosexual men were the focus of the Feldman and MacCulloch work, which was allegedly the very point of the Birmingham report about disgraced ex-staff, and accordingly my piece stayed with that focus. Moreover, that work was research; it did not reflect contemporary clinical routines, cueing the next point.

4 The norm emerging in the 1970s for adult transsexuals was for them to attend for regular monitoring by psychiatrists, while living as the opposite sex, in order to obtain referrals for hormones and surgery. The psychiatric consideration then was on the psycho-social adjustment of adult transsexuals. It is crucially important to note here that the focus was adults, not children who are the focus of recent health policy controversy. This was about the use of mental health assessments of adults prior to their bio-medicalisation, not routine aversion therapy. The BBC2 documentary in 1979, called A Change of Sex, illuminated well this typical psychiatric surveillance of the time. (It had a medical assessor with an unforgivably persecutory professional style when he was interrogating the MtF transsexual, and a poor mistreated patient, Julia Grant). At that point children were not implicated in protocols about transgender care, but that was to change (see point 7 later).

5 For emphasis (for those who are not clinical psychologists) behaviour therapy was about behaviour and it was behavioural criteria that were used to check efficacy. The intention of the research intervention by Feldman and MacCulloch was to displace same-sex arousal with heterosexual arousal. This emphasis on altering sexual interest was aligned epistemologically with methodological behaviourism (hegemonic at the time but, note, not today). By contrast, the concern of transgender activists now is all about identity. This is a much wider existential matter (e.g.‘Who is the real me?, ‘Can I be my true self?’, ‘Will medicine cooperate in my preferences for body modification to make me feel better about life?’). It is simply dishonest to conflate these two matters of the scenario of defunct aversion therapy with recent therapeutic encounters about gender confusion, especially when children, not adults, are the clinical focus. The closure of GIDS and the Cass Report should be our point of reflection today about child protection, not what happened in 1970 to adult homosexuals.

6 If the Birmingham report authors or any other historians, such as Drs Marks and Davison, are inclined to offer us a longer and fuller historical context that is fine and would be welcomed, but that would need to report what has happened since 1980. This has included: the postmodern turn; the gap between second and third wave feminism; the claims from Queer Theory and its neologisms, like ‘cis’; the risky introduction of the provisional Dutch protocol elsewhere as a standard service philosophy; the raised campaigning salience of T not LGB, within expansive identity politics; the decline of the term ‘sex’ and the rise of ‘gender’ in academic discourse; the shift from ‘women’s studies’ to ‘gender studies’; and the new norms of rapid ‘clictivism’, created by social media. To miss out this long list of important details affords a false conflation of aversion therapy, pre-1980, and exploratory psychological therapy of today. This post-1980 scenario has involved the LGB Alliance splitting off from Stonewall. Why has that happened? Why has equality now been displaced by identity? These are pertinent historical questions which cannot be answered by looking narrowly at the long-gone discredited work of Feldman and MacCulloch (or for that matter, Marks and Bancroft). Yes, let us have history; we need much more of it not less. However, it must also consider what happened after 1980 to account for current transgender activism. In other words, why was 1980 different from both 1970 and 2020? It also should consider the wider picture circa 1970, cueing the next point……

7 Professional historians such as Drs Marks and Davison might also help us to ‘get the story right’ about the 1970s. By focusing on the alleged unbroken link between then, when aversion therapy for homosexuality predominated, and now, when the matter in dispute is the reasons for the closure of GIDS, a key feature of the 1970s is then ignored. The care of transsexual adults in the 1970s and beyond was not routinely governed by the goal of the patient accepting their natal sexed body (with or without the use of aversion therapy) but instead in permitting its bio-medical manipulation after a period of psychosocial assessment (see point 4 earlier). Psychiatrists then were gatekeepers for access to other medical specialists (endocrinologists and cosmetic surgeons), not therapists. The later mission creep of this gatekeeping function of mental health services, increasingly implicating psychologists, from adults to children, came originally from the work of Harry Benjamin in the 1960s (Benjamin, 1966). The clinical rationale was to check that the patient genuinely wanted hormones and surgery and then to enable that outcome sympathetically. This rationale was systematised in the 1970s in the standards of care suggested by the Harry Benjamin International Gender Dysphoria Association, which became the World Professional Association of Transgender Health in 2007. Here then is the link with the affirmative approach of GIDS (now closed) which, quite properly, remains the focus of a post-mortem.

Implications

We can see that in the 1970s the clinical rationale evolving about transgender patients was different from the aversion therapy rationale applied to homosexuality. Benjamin conceptually separated homosexuality both from transsexualism and eroticised transvestism. The latter was to be later conceptualised as one aspect of variegated transgender phenomena, ‘autogynephilia’ (Blanchard, 1991).

The mission creep of transgender activism, supported during the postmodern turn by Queer Theory and Third Wave feminism, from adults to children should be at the centre of any historical understanding of why the Cass Report emerged. It also explains why thirty five disaffected therapists left GIDS between 2016 and 2019, with some of them warning of the upcoming medico-legal challenge of de-transitioners suffering iatrogenic symptoms (Butler and Hutchinson, 2018).

There is now a clear link to be made (diverted from our needed attention by focusing on homosexuality and aversion therapy) between the Benjamin care regime for adults in the 1970s and children in the past twenty years. The Center of Expertise on Gender Dysphoria in Amsterdam and then GIDS in London in the 1990s began to experiment with the impact of puberty suppression, while affirming credulously the child’s subjective identity. From the outset no one knew whether this would be effective in creating mental health gain or what its iatrogenic impact might be. The optimistic assumption was that puberty suppression would be readily reversible and would simply press a ‘pause button’, so that the gender confused child could consider options about their identity in the future (Biggs, 2022; de Vries and Cohen-Kettenis, 2012). That Pollyanna optimism is now facing some earnest reality testing in the wake of the internal report at the Tavistock Clinic in 2018 from David Bell and, more importantly, the Cass Review in 2022.

In case the above points from me are dismissed as merely of academic interest, we know that the young are exposed to social media reports that healthcare professionals today supposedly torture gender non-conforming children. This preposterous myth will continue to be reinforced and legitimised, unless we make some important honest distinctions. Homosexuality is not transsexualism and it does not require any self-doubts about the ontology of our sexual anatomy. Children are not adults. Mainstream secular mental health services are not fundamentalist religious organisations.

All these distinctions are important politically right now, if we are to discern what connects the past and present, but also how things have changed and for what reason. The work of Harry Benjamin has much more to offer us in terms of clarifying the role of history than that of Feldman and MacCulloch.

At the heart of the standoff now between gender critical clinicians and transgender activists is the meaning of the term ‘conversion therapy’. The first emphasise that putting healthy sexed bodies, with immutable chromosomes at risk of iatrogenic damage is a form of ‘conversion’. The second emphasises that to offer a cautious exploratory alternative to that bio-medicalisation is a form of ‘conversion’, because it prevents children who believe that they were born in the wrong body having their current desire fulfilled. We can all have a view about which case is more persuasive on empirical and ethical grounds.

References

Bancroft, J. (1969). Aversion therapy of homosexuality: A pilot study of 10 cases. British Journal of Psychiatry, 115(529), 1417-1431.

Bancroft, J. and Marks, I. (1968). Treatment of sexual deviations. Proceedings of the Royal Society of Medicine. 61 (8): 796–79

Benjamin, H. (1966) The Transsexual Phenomenon New York: Julian Press.

Blanchard R. (1991) Clinical observations and systematic studies of autogynephilia. Journal of Sex and Marital Therapy. 17, 4, 235-5.

Biggs, M. (2022). The Dutch protocol for juvenile transsexuals: origins and evidence. Journal of Sex and Marital Therapy. 19, 1-21.

Butler, C. and Hutchinson, A. (2020), Debate: The pressing need for research and services for gender desisters/detransitioners. Child and Adolescent Mental Health, 25: 45-47.

de Vries, A. and Cohen-Kettenis, P. (2012) Clinical management of gender dysphoria in children and adolescents: The Dutch approach. Journal of Homosexuality, 59 (3), 301-320.

Gender, Governance, Identity Politics

‘Conversion Therapy’ and the BPS

19th Dec 202219th Dec 2022 AdminBPSWatch

David Pilgrim posts…

A dozen private detectives, working 24/7, would struggle to fathom everything that is happening and not happening inside the BPS. A case in point is the remarkable persistence of the role of transgender activism inside the Society. In the book emerging from our amateur sleuthing, coming out in the New Year (Pilgrim, 2023a), we devote chapters to two symptoms of the underlying malaise of misgovernance, both of which implicate child protection. One deals with the distortions of risk appraisal in the extant official BPS advice on memory and the law and the other is the flawed, and in my view dangerous, Guidelines for Psychologists Working with Gender, Sexuality and Relationships (BPS, 2019)(GSRD).

We have campaigned, without success, to have this removed it its entirety, in the interests of child protection and to minimise the reputational damage to psychological practitioners. It is a scandal that the guidelines have not been withdrawn. Those purportedly revising the document seem to be more or less the same working group, but now minus several people who refused to be part of the review, some of whom – after complaining – have had their names removed from the 2019 document – Plus ça change, plus c’est la même chose.

While the UK health policy world is moving on apace in the wake of the Cass Review on paediatric transition and the closure of the Tavistock GIDS Clinic, with its ‘affirmative’ service ideology, it feels for now as though the BPS is simply carrying on regardless, with its old ‘trans-captured’ ways (cf. NHS England, 2022). The advice it has given recently to the Scottish government is a case in point.

Another indication of business as usual about a trans-captured organisation has related to the Society’s ‘Diversity and Inclusion’ manager (‘Equality’ has been disappeared as a prefix by ‘the BPS’, in its unending virtue signalling on steroids (cf. Ben Michaels, 2006).). That newly appointed manager operated in an ultra vires role in 2021, as the secretary for the ‘MOU Coalition Against Conversion Therapy’. So we have had a full time Society employee, paid from membership fees, at the centre of a transgender activist political campaign.

This raises a fundamental question about the probity and legitimacy of an organisation still registered, precariously, as a charity and claiming, more and more implausibly, to be a learned body. In the rush to curry favour with an imagined customer base, many organisations are happy to accept, unthinkingly, the challengeable rhetorical claims of transgender activism. The BPS is not alone in this regard; indeed it is probably typical today, as many universities and medical colleges go down the same self-righteous route. However, where there is power there is resistance, and a fight back by gender critical professionals is also underway. More on this now after a brief historical and sociological note for context.

‘The past is a foreign country: they do things differently there’ (Hartley, 1953: first line)

In the late 1960s and early 1970s, some British psychologists and psychiatrists worked together to deploy aversive conditioning techniques (‘anticipatory avoidance’) to try to alter the conduct of gay people. Electrical or less often, chemical, aversive stimuli were used within the broader orthodoxy of applied methodological behaviourism of the time. This was led by the clinical psychologist Hans Eysenck and the psychiatrist Isaac Marks from the Institute of Psychiatry in London, both doyens of the behaviour therapy movement. They encountered angry criticism at the time from an increasingly confident New Social Movement of gay activists (Pilgrim 2023b).

In parallel to the Eysenck-Marks defence of enforcing heteronormativity for the good of the patient, another and more researched and published project occurred between Birmingham and Manchester, led by a clinical psychologist Maurice Feldman and a psychiatrist Malcolm McCulloch. Their work is on the record in reputable journals and books for all to read (e.g. Feldman and McCulloch, 1968, 1971).

By the end of the 1970s aversion therapy for homosexuals petered out and its own early advocates recanted their position. Gay Liberation was in its heyday and homosexuality had been dropped from the Diagnostic and Statistical Manual of the American Psychiatric Association. In any case, aversion therapy simply created distressed homosexual patients, who remained same-sex attracted. Aversion therapy for homosexuality failed on empirical grounds. Moreover, it was now at odds with a successful de-medicalisation shift in societal norms in North America and Western Europe though, note, by no means globally. This controversy was emphatically about aversion therapy (not ‘conversion therapy’) and it was targeted on gay people. Transgender patients were missing from the picture.

However, after 1980, the postmodern turn (everything was now to be about narratives and discourses, not material reality), Queer Theory and third wave feminism began to coalesce to afford a celebration of diverse identities (Butler, 1999; cf. Oakley, 1972; Watkins, 2018). How people saw themselves (subjectively) and wanted others to recognise them (inter-subjectively) now was to become as important as their transgressive actions, as was homosexual activity in past times. By the turn of this century, the grounds for particular forms of special pleading, within expansive identity politics, were becoming slippery to the grasp for many. What about paedosexuality or incels or those ‘into’ BDSM or kink? Should they be embraced in a spirit of unending inclusiveness? That question is pertinent for any reader of the current BPS Guidelines.

Mirroring those changes, ‘sex’ was displaced by ‘gender’ in social, though not biological, research (Haig, 2004). Neologisms like ‘cis’ and ‘misgendering’ created much head-scratching in ordinary people, who were losing confidence in being able to express their common sense perception of others. This culture shock and perplexity about transgender politics is explored at some length in the ten episode series from ‘Nolan Investigates’ (BBC Northern Ireland, October 2021, available on BBC Sounds). This series challenges the legitimacy of public bodies, including the BBC itself, of being coached and appraised by Stonewall about their take on transgender politics.

In the past few years, ‘gay’ and ‘transgender’ became, for many organisations such as Stonewall and those it coached and appraised, the same amalgam target of oppressive norms in society. Hetero-activism, homophobia and transphobia were alloyed as one. The personal bigotry of ‘cis’ and heterosexual people, not the reversal of structural inequalities, became the salient priority to attack. This was reflected in the campaigning of the ever-elastic LGBTQ+ ideological formation, which hid a major contradiction. If we bracket the connecting glue of gender non-conformity, then we find that sexuality and gender identity are orthogonal; they are not the same either conceptually or in practice. Unfortunately, they have been lumped together in the BPS GSRD Guidelines.

Gay people are sexually attracted to those of their own biological sex; this is about sexual desire and preferred forms of intimacy and sometimes sub-cultural habits. By contrast, transgender people may see themselves as straight, gay, bisexual or even a-sexual. Moreover, even the connecting glue of gender non-conformity is open to question. For example, many transgender people do not challenge gender conformity at all; they actually affirm and reinforce conservative gender stereotypes as they alter their bodies and clothing in line with the latter. Also, some gay men and lesbians are not manifestly gender non-conforming in their dress and demeanour. The glue eventually became weak and hence the split from Stonewall of the LGB Alliance; the transgender contention was the catalyst but the lack of clear grounds for ally-ship had been around since the 1970s.

And then there has been the tricky problem for that ally-ship of the ontological, not epistemological or normative, aspect of sex itself (Hull, 2008). Within the transgender activism world, boys and girls with respective immutable XY and XX chromosomes are no longer described validly at birth but, instead, their identity is only provisionally ‘assigned’. Our gender identity has now been reified as a purely subjective matter of choice and a newly sacralised human right, as part of the norms of recent identity politics. The ontology of sex has been ignored or scorned as a political irrelevance.

The objective over-determination of being a man or a woman by materiality (i.e. our chromosomes and being raised in a supra-personal socio-economic regime of patriarchy) have been backgrounded, or simply denied with contempt, and replaced by a kaleidoscope of self-identifications (Pilgrim, 2022). Many gay men and lesbians today know that as children, they could have been shepherded, under the pressure of recent transgender activist demands, into a different and problematic bodily state. Some of them knowing this are concerned for the fate of gay children today. The LGB Alliance now make this point very clearly.

The red herring of intersex is invoked sometimes by transgender activists to demonstrate that ‘sex is a spectrum’. Apart from the fact the 99.99% of us, like all mammals, are sexually dimorphic, even those people who are born intersex still have fixed genetic material. Our genes are immutable. We are not born in the ‘wrong body’, just one that we may or may not come to like. ‘Wrong’ is a human judgement not a biological fact.

The University of Birmingham Report on ‘Conversion Therapy’

What has all the above to do with the BPS? The answer lies in the opening to the recent report (June 2022, available online) conducted by staff members of the University of Birmingham, on behalf of their employers. The title of it is pertinent as a headline message: Conversion Therapy’ and the University of Birmingham, c.1966-1983. This is what it says, in the first paragraph of the executive summary quoted in full:

“The University of Birmingham agrees wholeheartedly with the British Psychological Society and the Royal College of Psychiatry (sic) and numerous other organisations and professional bodies, which state that there is no moral or ethical support for activities aimed at changing sexual orientation or gender identity (often called ‘conversion therapy’). The Memorandum of Understanding on Conversion Therapy in the United Kingdom is endorsed by 26 prominent health and therapy organisations, including NHS England and NHS Scotland. Crucially, there is no robust scientific evidence to support the use of ‘conversion therapy’. This report places that term in inverted commas, precisely because these interventions have no form of therapeutic value. Efforts to suppress same-sex desire or enforce conformity to social expectations of gender do not ‘work’ as intended; in fact there is substantial evidence that shows how harmful it is.”

As with so much going on in the diversionary world of identity politics, this statement has more than a kernel of validity. However, at no point is there any self-reflection from Birmingham on the historical context of current controversies, which leads to a partial (in both senses of the word) account.

This accusation here may seem odd about a report, which is explicitly about history and for the most part is a very good summary of what happened in the 1970s. However, turning what could have been a relatively simple look back at the work of an ex-staff member (Feldman) from fifty years ago, into a political platform for current rhetoric about transgender politics, suggests a virtue signalling exercise with instrumental value for the university ‘brand’. The facts of the central role of a single staff member were known forty years ago. A critical review of his work could have been carried out there and then. So why now and why in this form?

It is not a journal submission or commissioned piece of work by outside historians of British psychology. Instead, it has emerged from within the identity politics zeitgeist now shaping the academy and its public statements (such as UCL’s recent decisions about Galton and Pearson, or Sheffield’s about Darwin). The report is driven by current political decision-making and posturing from university managers in response to consumer pressure from below. The sequencing of sections of the document confirms this point.

First, there is a dramatic health warning about people who might be currently affected by the content of the report (see point 3 below). Second, there is a mea culpa statement from the university’s Vice Chancellor. Third, the report itself is offered, which ipso facto is not about current anxieties but the fifty year-old research of Feldman and McCulloch. In light of this character of the report’s own historical context, the following points are relevant to compensate for that lack of self-reflection, from those producing it and endorsing it uncritically:

1 Past scandals and current risks. The current term of ‘conversion therapy’ is projected backwards onto history. The behaviour therapists used the term aversion therapy and they were focused explicitly on homosexual orientation, not transgender people and their existential confusion. All mental health interventions, inter alia, are about rule enforcement according to the contemporary ’emotion rules’ of a situated culture in time and space, whether that is done with voluntary or coerced patients (Thoits, 1985; Bean, 1986). The behaviour therapists were enforcing rules of heteronormativity in the genuine belief that this was in the patient’s interests in order to ease their social acceptance and personal angst or guilt about being gay. At that time, with male homosexuality only recently legalised (and even then with a lack of equality about age of consent), being gay was still seen as problematic by many people, including some gay people themselves. Cultural norms typically lag behind legal changes; look today at the presence of casual racism, despite the existence of the Race Relations Act.

2 Professional therapy and religious fundamentalism. Conversion practices (not therapy in any reasonable sense) in relation to gay people have remained associated with some conservative Christian groups, not with professional psychological therapy. The paragraph cited from the executive summary quite correctly identifies that professional therapy and counselling organisations today have no truck with aversion therapy. It has been dead in the water since 1980. Given this fact, where is the evidence today in the UK that, outside of a few fundamentalist religious organisations, there is any such thing as ‘conversion therapy’? The truth is that there is none. However, there is evidence that many mental health workers defend exploratory psychological therapy with clients and the need for revisable co-constructed formulations that develop over time.

Those insisting on ‘affirmative’ clinical practice, conveniently reframe this orthodox stance, of supportive cautious waiting and personal exploration, darkly as ‘conversion therapy’. We now find that purported prevalent risk of ‘conversion therapy’ as being weaponised against a cautious wait-and-see approach to existential confusion in unhappy young people. For the transgender activist, the exploratory therapist of today, with their ‘first do no harm’ caution, becomes the very same demon as the aversion therapist, circa 1970.

3 Instrumental vagueness. What exactly was this report trying to achieve? A reader of it is not at first clear or, if they have a critical imagination, they realise that it is open to different interpretations. Despite the fact that aversion therapy from the past no longer exists, which is confirmed by the substance of the report itself, suddenly the ominous term ‘conversion therapy’ crops up, as if it is a grave and immediate danger to many people right now. No evidence provided of this implication or assumption. It is implied strongly in the report because of the yoking of sexual orientation and gender identity (see point 4 below). Indeed, it is considered to be so important that the report’s first page has this dramatic warning sticker, from the outset intimating the grave conclusion of a report which remember has, as its alleged focus, the past not the present. Note the blurring of the past and present, from point 1 above, and the unwarranted privileging of gender identity below, given the time period supposedly under focus:

“ Note: this report deals with activities aimed at changing gender identity and sexual orientation. It discusses psychological ‘treatments’ used in the past in sometimes graphic detail. Readers affected by this material may wish to make use of this dedicated resource: National Conversion Therapy Helpline If you are currently experiencing abuse aimed at changing, altering, or ‘curing’ your LGBT+ identity, or think this will happen to you if you come out, Galop’s Conversion Therapy Helpline is here for you. So-called conversion therapy can have a long-term impact on LGBT+ people. If this has happened to you in the past and you are still struggling with it, you can reach out to Galop’s support services. The helpline can provide a safe, confidential listening and information service to any LGBT+ person aged 13+. There are different ways to contact us. All of them are free: Phone 0800 1303335 Email CThelp@galop.org.uk The helpline is open: Monday to Friday 10am – 4pm Calls will last 40 minutes.”

Instrumental vagueness characterises the report in a range of ways cuing the next point about terminology.

4 The semantic trickery of eliding sexual orientation and gender identity. The compound phrase of ‘gender identity and/or sexual orientation’ is now de rigueur in public documents, when and if sex, gender and sexuality are being considered. In this report, we have the example in the warning sticker of: “changing gender identity or sexual orientation (often called ‘conversion therapy’)”. What used to be about sexual orientation, specifically, has now become an amalgam that routinely includes gender identity. This change came with the revision of the Memorandum of Understanding (MoU) about ‘conversion therapy’ after 2015 by transgender activists from the BPS, Pink Therapy and other therapy organisations. In 2015, the MoU only alluded to sexual orientation but three years later the document was modified, with the repeated and insistent addition of ‘gender identity’ at every opportunity. Dissenters supporting the older focused defence on gay rights, left the working group, when their cautions were rejected out of hand. Accordingly, groups like Thoughtful Therapists and Gender Critical Clinicians have emerged in response to transgender activist capture in their field of interest. In large part, these gender critical campaigning groups are responding to that capture, cueing the next point.

5 Transgender activist entryism. Transgender activists have been assiduous and very effective in entering policy making groups to ensure that sexual orientation is no longer the sole focus of sinister therapeutic intent, even though it is a ghost from the past. The linking of past empirically discredited practices about sexual minorities, who are now tolerated or celebrated (depending on one’s value system), with transgender phenomena, mixes apples and oranges. Homosexual orientation is about same sex desire, whereas transgender phenomena are very wide ranging. They include a minority who, like gay people after 1970, now want to completely de-medicalise their existential state and others, who want free and ready access to biomedical transition (drugs and surgery) with many steps in between. They include children and adults. They include a-sexual individuals, ‘trans-lesbians’, ‘a woman with a penis’ and autogynephiles, in various states of medically-induced body modification. Even the defining notion of ‘gender dysphoria’ moves in and out of relevance, for this mix of people with their varying demands. The ‘trans community’ is not of one voice, even if transgender activists tend to pursue a narrow policy of bio-medicalisation on demand. They decry anyone questioning that, quite reasonably, as being automatically a ‘transphobe’, or a ‘TERF’, or more modestly ‘anti-trans’ in academic discourse. The distinction between legitimate ethical debate or evidence consideration about transgender healthcare and hostility or bigotry against transgender individuals is collapsed. Moreover, the remaining and unresolved tension between second and third wave feminism is simply ignored, when it remains an important point of historical reference.

6 LGBTQ+ or LGB? Gay people in the 1970s recognised that they were objectively men and women, simply described, whereas Queer Theory since then has made it all about language and subjectivity. Gay people in the 1970s, as today, just wanted to be left alone to be full citizens, whereas the demands from such a variegated transgender community now are difficult at times to pin down. Some of it is about being left alone. Some of it is socially performative. Some of it is about intruding into women-only spaces, like prisons and shelters, as well as female sports, with impunity. Within this contestation about transgender politics, which should be opened up to full democratic debate, we find that orthodox exploratory psychological therapy has now been given precisely the same ethically-unworthy status, by activists, as aversion therapy was in the 1970s. This is a deliberate strategic mystification, which has shaped the position of many managers and academics alike in recent times (who may or may not have insight into transgender activist strategizing and tactics). The half-baked report from the University of Birmingham is an example of this point.

What’s in a word?

What then exactly is ‘conversion therapy’ as currently used? The definitional approach of mixing aversion therapy from the past and religious conversion practices since the 1970s, along with the discursive elision of sexuality and gender identity, is reflected in the Wikipedia entry on the topic, which is described as ‘pseudoscientific’. To confuse matters, searching ‘medical views’, linked to this entry, leads to a very strong focus on homosexuality, not gender identity. An outlier was the emergence of the National Association for Research & Therapy for Homosexuality in the USA, which contained socially conservative therapists with religious affiliations, promoting what has also been called ‘reparative therapy’.

Whereas the behaviour therapists were rule enforcers of heteronormativity, some psychoanalysts continued to contend that homosexuality represented a perversion of psychosexual development, even if their therapeutic stance was not prescriptive. It is true then that psychological models do indeed reflect social norms and norms are open to legitimate challenge, as Gay Liberation demonstrated successfully. The question now is whether the vaguer expectations of such a diverse ‘trans community’ can be considered in the same way, logically or politically.

Gay people being left alone to get on with their lives is not the same as the campaigns to have hormones and surgeries on demand, including for children, with wise clinical caution being confused with oppression and bigotry. One indicates a preference for de-medicalisation (the rejection of aversion therapy and a diagnosis of morbidity) and the other the very opposite (demands for a diagnosis of gender dysphoria as an immediate gateway into life-long bio-medicalisation). The expressed need for the first group focuses on citizenship, whereas for the second it is about patient-hood on demand, in the absence of physical pathology. These scenarios are like chalk and cheese.

The warning sticker on the Birmingham report above exemplifies the semantic problem of not dealing with actual or perceived threats from psychological therapists, as in the use of this type of phrase: ‘…..often called “conversion therapy”’. But who is doing the calling and on what grounds? This important question is not explored; ‘conversion therapy’ is simply taken for granted as a ‘bad thing’. However, neither its conceptual validity nor its empirical validity are considered properly. Like the words ‘transphobe’ or ‘TERF’, ‘conversion therapy’ is now a slur requiring no justification. This matters ethically and politically, if aversion therapy and exploratory psychological therapy, promoted by most formulation-based models within professional orthodoxy today, are being casually conflated.

That casual conflation is then a tactical position adopted by transgender captured groups, such as those producing the BPS GSRD Guidelines ; it is all about challenging and defeating those who problematize the bio-medicalisation of unhappy children. The BPS affiliated and staffed MOU Coalition Against Conversion Therapy is a practical expression of the document’s campaigning intent. Moreover, the celebration in the document of BDSM and calling women ‘sluts’ just adds to the heart-sink of reading this prescriptive libertine manifesto, dressed up as professional guidance. For anyone new to this document, they will find no proper literature review and no rehearsal of contention or debate in the field, but instead a long ‘thou shalt’ approach to ‘affirmation’ throughout. The ‘no debate’ position of campaigning is replicated dutifully in the document. This then is not professional guidance from a position of equipoise and careful deliberation, but a manifesto from a group of political activists.

The focus on children by those activists (not on adult transsexuals pursuing biomedical transition) is the very reason that we have identified a serious child protection concern inside the BPS, and we will continue to do so. Yoking aversion therapy from the past, with legitimate and ethically defensible practices in exploratory psychological therapy today, is wrong-headed if it is an honest mistake, and unconscionable, if it being done deliberately by some people in authority. To explore is not to convert. Some who have tried to defend this ethically defensible wait-and-see position in practice, such as the Canadian clinical psychologist Ken Zucker, have been punished. His service was closed down by his employers as a result of transgender activist lobbying and he is now held up as their bête noire, despite his mainstream opinions in the therapy world about best practice (Zucker et al. 2012). He was eventually completely vindicated, via the courts, and his ex-employers had to settle financially in reparation for his wrongful dismissal. However, he remains a target of transgender activist hostility for what he symbolised.

Moreover, arguably the real conversion therapy is to take healthy young bodies and sterilise them with hormones and surgeries (Butler and Hutchinson 2020; Brunskell-Evans and Moore, 2018). This accruing iatrogenic harm means that patients will be angry and feel betrayed by service providers from their past. This reminds us of the serious ethical questions surrounding paediatric transitioning, encouraged by the affirmative approach – note still endorsed by the BPS (Steensma et al., 2017). Here, for example, is an account from a FtM de-transitioner, now in chronic distress in 2019 in a conference in Manchester on the topic:

“It doesn’t make any sense to me why this is called ‘transition’ or a ‘sex change’ because it’s not, it’s castration. And now that I am trying to care for my health as much as possible I spend a lot of time on hysterectomy support sites and message boards for women. For women, because only women get hysterectomies and only women deal with the consequences of a hysterectomy. So, excuse me but what the hell are surgeons doing calling this ‘gender reassignment’ or ‘gender affirming health care’? ( ‘Livia’. Detransition: The Elephant in the Room. Make More Noise (Available from: https://08e98b5f-7b7a-40c9-a93b-8195d9b9a854.filesusr.com/ugd/305c8f_34b673d3097c4df88bf9b9e8f6ed1006.pdf?index=true)”

These sorts of accounts from distressed patients, in the wake of an ‘affirmative’ service ideology which is proposed by the BPS still as a progressive alternative to ‘conversion therapy’, graphically expose why we need to reflect on what we mean, exactly, by the term. These angry victims of bio-medicalisation are queuing up at the doors of medical negligence lawyers today. An irony, which will be recorded historically, is that such a medical scandal has been led not by medical practitioners but by psychologists.

If counselling or clinical psychologists are caught up in this legal reckoning, because of their compliance with an affirmative service ideology, what advice was given to them in the recent past by the BPS and what will it give now? After complaints about the gender guidelines were made, the BPS did not withdraw them (the wise option, for a period of deliberation). Instead the BPS indicated that they were not intended to apply to those under the age of 18. However, the document (which remains on the BPS website) on page 12 still says this, contradicting that claim (and note its heavy biomedical emphasis):

“Psychologists working with GSRD youth should be aware that reproductive options and considerations may be more complex than with their heterosexual or cisgender peers. Assistive reproductive options may be needed and should be discussed openly and frankly, perhaps especially in the case of trans youth who are seeking treatments which will remove reproductive options at an age below that which people commonly consider becoming a parent”

This is a clear indication that the transgender activists driving the production of the BPS Guidelines had a view about an age cohort which cannot consent to sex or a piercing or buy alcohol. Those children are still being encouraged to enter a bio-medicalised lifelong process in the name of social justice and presumed mental health gain. Their wellbeing is being jeopardised and in some cases egregiously sacrificed at an altar of ideology.

Conclusion

Our political action to expose the secretive world of the BPS has quite properly focused on poor governance in general. It did not start with single issue politics in civil society, such as the many now linked to identity politics. However, child protection has come up for us in the two ways I noted at the outset.

In this piece, I have drawn out the contradictions inherent to the politics of gender identity. The Cass Review confirmed that we were correct to open up for scrutiny those mental health professionals, who defend exploratory psychological therapy for the good reason to protect children, on the one hand, and, on the other, the libertine transgender activists, who have captured the policy process for now, in the BPS and elsewhere..

The gaps of understanding between the Cass Review and the one cited from the University of Birmingham are worth exploring. Both reports should be read by anyone new to the topic who wants to demystify some of what has been going on inside the BPS. To finish on a repetition: the contention about the GSRD guidelines is a symptom of a deeper problem of poor governance in the Society. As a consequence the welfare of children continues to be put at risk from what is purported to be professional guidance.

References

Bean, P. (1986) Mental Disorder and Legal Control Cambridge: Cambridge University Press.

Benn Michaels, W. (2006) The Trouble with Diversity: How We Learned to Love Identity and Ignore Inequality New York: Holt.

British Psychological Society (2019) Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity Leicester: British Psychological Society.

Brunskell-Evans, H. and Moore, M. (Eds.) (2018) Transgender Children and Young People: Born in Your Own BodyNewcastle: Cambridge Scholars Publishing

Butler, C. and Hutchinson, A. (2020), Debate: The pressing need for research and services for gender desisters/detransitioners. Child and Adolescent Mental Health, 25: 45-47.

Butler, J. (1999) Gender Trouble: Feminism and the Subversion of Identity. New York: Routledge

Feldman, M.P. and MacCulloch, M.J. (1967) Aversion therapy in the management of 43 homosexuals British Medical Journal, 2, 3 June 1967, 594-597;

Feldman, M.P. and MacCulloch, M.J. (1971) Homosexual Behaviour: Therapy and Assessment Oxford: Pergamon Press.

Haig, D. (2004) The inexorable rise of gender and the decline of sex: social change in academic titles, 1945–2001. Archives of Sexual Behavior 33:87-96.

Hartley, L.P. (1953) The Go-Between London: Hamish Hamilton.

Hull, C. (2008) The Ontology of Sex: A Critical Inquiry into the Construction and Reconstruction of Categories. London: Routledge

NHS England (2022) Interim Review of Gender Identity Services for Young People (Interim Report Chaired by Hilary Cass) London: NHS England.

Oakley, A. (1972) Sex, Gender and Society. Aldershot: Arena.

Pilgrim, D. (ed) (2023a) British Psychology in Crisis: A Case Study in Organisational Dysfunction Oxford: Phoenix Books.

Pilgrim, D. (2023b) Verdicts on Hans Eysenck and the fluxing context of British psychology History of the Human Sciences (in press).

Pilgrim, D. (2022) Identity Politics: Where Did It All Go Wrong? Oxford: Phoenix Books.

Steensma, T.D., Wensing-Kruger, A. and Klink, D.T. (2017) How should physicians help gender-transitioning adolescents consider potential iatrogenic harms of hormone therapy? American Medical Association Journal of Ethics, 19, 8, 762-770.

Thoits, P.A. (1985) Self-labeling processes in mental illness: the role of emotional deviance. American Journal of Sociology, 91: 221–49.

Watkins, S. (2018) Which feminisms? New Left Review 109, 2, 5-76.

Zucker, K.J. Wood, H., Singh, D. and Bradley, S. (2012) A developmental, biopsychosocial model for the treatment of children with Gender Identity Disorder. Journal of Homosexuality 59:3, 369-397

Ethics, Gender, Identity Politics

Gender: Cass, GIDS and BPS Guidelines

7th Nov 20227th Nov 2022 AdminBPSWatch

Is the BPS able to tolerate controversy and step up to the current debates?

Pat Harvey posts…

Background

In 2020, I became aware of some of the extensive issues involved in this case:

“The tangled case of the brothers who became girls, aged seven and three. A couple’s own son transitioned – and within months they were given a baby to foster, who became a girl too.” (https://archive.ph/3rEQw)

The details of the discussion of psychological considerations presented in this court case are very disquieting. Accordingly, I went to the current 2019 British Psychological Society Guidelines (currently downloadable at https://www.bps.org.uk/guideline/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity ). I was naively hoping that my professional body could offer a position statement which would fairly represent a weighing of the dilemmas that would help a court case such as this one.

The document resembled no professional guidelines or policy guidance that I had ever seen during a long NHS clinical, service manager and trainer career, or as a member of the Mental Health Act Commission (precursor to the CQC) or as a panel member of an independent inquiry.

The content of the guidelines was very brief, sketchy yet dogmatic. There was no proper respectful recognition of current controversial clinical issues or social and political context. One approach only appeared to be acceptable, that of non-questioning “affirmation”. Consent issues were not considered. Sexuality and lifestyle issues such as kink and BDSM were lumped together with gender. There were hugely important omissions, such as the dilemmas of working with people who have a sexual interest in children. The limits of the research base were ignored.

I made a very detailed formal complaint about the form, the content and what I had discovered about the process of generating these guidelines. This served to illustrate and to confirm the experience of others – that the BPS complaints procedure was neither adequate, nor was it even followed. The complaint dragged on for months, deadlines were missed, I had to deal with different individuals at different times and important points in my complaint were missed. Unacceptable assertions about the status of evidence were dismissed with “we are a broad church”. The irony of this in the context of an “affirmation only” approach in the guidelines was lost. Only my persistence in the face of these failures got the complaint to Stage 2.

The complaint was closed with little by way of any positive outcomes. There were formal apologies for procedural failing. There was an evasive reply to the assertion I made that the members of the group which generated the guidelines had not all signed off on them. The crucial matter of their woeful inadequacy in the matter of providing responsible guidance for distressed gender questioning children was evaded by a retrospective formal addition, stating “For adults and young people (aged 18 and over)”. This was unaccompanied by any formal public announcement to members, many of who might still be working from the original, unamended version. The contents however, remained ambiguous with respect to age as with the implications that the following paragraph was applicable to minors:

“Assistive reproductive options may be needed and should be discussed openly and frankly, perhaps especially in the case of trans youth who are seeking treatments which will remove reproductive options at an age below that which people commonly consider becoming a parent”.

Hence, since 2020 until the present time, the professional guidance for psychology practitioners and non- psychologists, provided by the British Psychological Society are still held out on their website as follows:

‘These guidelines are aimed at applied psychologists working with mental distress, but may also be applied in associated psychological fields.

The principles they are based upon are derived from both the literature and best practice agreement of experts in the field and may also be applied to other disciplines, such as counselling, psychotherapy, psychiatry, medicine, nursing and social work.”

In my view this is nothing short of a scandal, a failed responsibility to the public. The national Gender Identity Disorder Service was, after all, psychologist led.

Events since 2022, further actions

In August 2022, after the Cass interim report and the subsequent announced closure of the GIDS, I wrote to the Practice Board of the BPS.

I am reproducing the letter in its entirety, followed by the response I finally received in November 2022, after a number of email prompts from myself. I make no further comment beyond my letter and the response in order that the reader might make their own judgement.

********************

Letter to British Psychological Society Practice Board

From Pat Harvey AFBPsS., C Psychol.

16 August 2022

Re BPS 2019 GSRD Guidelines

I am writing to you as a BPS member and an interested party in the process and development of BPS policy statements and the publication of guidelines for psychologists and other professionals working with clients who access services for problems relating to questioning their gender identity.

My interest has developed sequentially from

Experience during 30 years of clinical practice in adult mental health services with Male-to-Female clients, then termed Transsexuals and Transvestites.
Experience directly related to certain high profile and media reported cases of individual families in court.
Engagement with the BPS complaints procedure (August 2020 – April 2021) in respect of the 2019 GSRD Guidelines and the public statements of the Chair of the Task and Finish group responsible for producing those guidelines. There are detailed responses from Karen Beamish which should be available on file.
Responsibility for public content of the critical Twitter account @psychsocwatchuk
Articles published under my authorship on BPSWatch.com.
A chapter authored by me on the 2019 GSRD Guidelines in the forthcoming book British Psychology In Crisis: A Case Study in Organisational Dysfunction edited by David Pilgrim. Phoenix publishers (2022 in press).

I believe that the British Psychological Society has a duty to develop policy and best practice relating to matters central to psychology in the interests of the public and to assist its practitioner members. It also has a duty to keep its members properly informed, but the BPS has a recent history of lack of openness and transparency which operates to the detriment of that those duties. Accordingly, I am writing to you with a series of questions which I believe members have the right to have answered and to be updated on as soon as possible, even if merely to be told that a process of consideration is ongoing.

Are the GSRD Guidelines being reviewed?

I understand that the 2019 GSRD Guidelines may be in the process of revision. I make this assumption on the basis of the twitter exchange below and because the 2019 Guidelines themselves have disappeared from the webpage https://www.bps.org.uk/guideline/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity without explanation.

Why is there no explanation or clarification?

There have been several ambiguous undertakings made to myself, to others and on the webpage to review the 2019 Guidelines over a two year period:

“in the light of the outcome of the Bell vs Tavistock Judicial Review”, November 2020.
“These guidelines will be reviewed following the outcome of the Bell v Tavistock appeal process” https://www.bps.org.uk/guideline/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity
“In the meantime the Chair of the Practice Board has already put in place plans to commence a review of the gender guidelines upon the conclusion of the appeal.” (Karen Beamish to me 9 April 2021)
On Twitter to an individual (see above) “following the Cass review” 1 August 2022.

This is a completely unacceptable way to keep members updated. It is also extremely confusing since the 2019 GSRD Guidelines had a retrospective caveat added as a direct result of my complaint (“we have offered to put a statement on the front of our guidelines, on our website and all points/places where the guidelines are referenced to confirm that the BPS guidelines for psychologists working with gender, sexuality and relationship diversity are for adults. We will implement this urgently”) in April 2021. However, the Tavistock cases related to issues of consent of minors under 18. The remit of the Cass review is that it is the Independent Review by a paediatrician of “gender identity services for children and young people”. So, rhetorically – to emphasis the confusion of the BPS – how are those external drivers central to the decision to review guidelines explicitly stated since 2021 as applying only to adults?

Will the supposed review result in guidelines for children and young people?

It is clear that there has been a “moving picture” with regard to external events, first legal, then with the Cass Review and now the planned closure (in the wake of criticism about service accessibility failures, failures of service integration, ideology, data collection and research evidence base) of Tavistock GIDS. That moving picture, which will undoubtedly develop, cannot preclude the provision of guidelines for practising psychologists in the meantime. The BPS has provided nothing useable for its members to date: there is not any set of psychological principles that support ethical and reflective psychological practice, principles that would weather a changing legal social and political milieu.

The BPS should seek confidently to espouse key psychological principles in this contested area and take a lead. These principles include

Psychological understandings of the formation of identity within a developmental context.
Psychological understandings of the issues of informed and valid consent, especially in minors.
Heterogeneity of factors bearing down upon gender questioning in individuals, complexities and persistence or otherwise of their clinical presentations.
Importance of family dynamics, peer pressure, social contagion and the problem of psychological reductionism within a wider social context.
The pitfalls of biological and medical reductionism, e.g. “transgenderism is innate”.

None of this was addressed in the 2019 “affirmation only” Guidelines.

In recent service delivery for gender questioning and distressed children and young people, the foremost service, GIDS, has been psychologist-led. It is therefore astonishing that there have been no effective guidelines for psychology practitioners forthcoming from the BPS as our professional body. The BPS must grasp this situation and take a lead.

Should revised Guidelines separate Gender from Sexuality and Relationship Diversity?

I raised this in my complaint. The independent investigator brought in at stage 2 did not supply a definite answer; nevertheless he agreed this was an important question for any future revision to consider. He stated the following, reported to me in the letter concluding the complaint investigation from Karen Beamish dated 9 April 2021:

“In a future review, there should be further consideration of the issues to validate their inclusion or alternatively to provide any clarification needed…… it should be something for the Practice Board to consider under its remit to lead on the development of the guidelines.”

There are good reasons for separating the topics. Some are as follows:

Gender guidelines should firmly be covering the whole life span. Sexuality and relationship diversity is largely applicable to adults with some references to adolescent development.
It is strongly argued by many that gender questioning should be conceptually separated from sexuality in order to allow for more complex understandings. These understandings would allow for the very different principles of consent to be satisfactorily unpicked. Legal issues are also very different: for example, in the case of minor attracted persons (MAPS) who present commonly with very difficult challenges for practitioners where borderline illegal behaviour is involved.
The respective research and evidence bases are addressing different issues.
For political and social context reasons, gender has overshadowed sexuality in the 2019 Guidelines despite the demographics of numbers presenting in a clinical and counselling context and the differing expertise required of practitioners
BDSM and Kink should not receive consideration when other more prevalent clinical problems of sexuality and lifestyle such as MAPS require attention. This should not have been inserted via an inane caveat “these Guidelines do not, however, relate to anything non-consensual”. As indicated above, consent in sexual relationships is a complex matter, not a binary “consents vs does not consent”. When clients present in a clinical setting it is highly likely that consent will be one concern in the distress or in the perpetration of abusive behaviour. A quick inspection of “Consent” on forums for BDSM/Kink indicates a much more nuanced and sophisticated understanding than the throwaway approach of the 2019 Guidelines.

Has the BPS reflected upon better process and outcome for reviewing the guidelines?

My forthcoming critical review of the 2019 GSRD Guidelines leads me to suggest

Appointment of a Chair who is not an activist or campaigner, who can allow debate about conflicting views, and where consensus cannot be achieved can allow the conflict and current uncertainty to be ethically and helpfully represented in the text to help others navigate the difficult cultural climate. The need for a less aligned chair than the chair of the 2019 Guidelines can be seen from problematic statements made in a public academic forum on outcomes of body altering surgery: “sometimes people think there is a debate about that and hopefully I have included enough references for you to think that debate is shut. There is not a debate about this anymore” https://www.youtube.com/watch?v=usyYi3Cevdo (@40mins 27 secs in). In an interview about a specialist post, she stated : ”The details of Gender Diversity can be learned, but an open and inquiring mind cannot. Bigots and exploitative theoreticians need not apply! Clever, open people who are interested in clinical practice, research, truly multidisciplinary working, and developing this emerging field are most welcome.”

Appointment of members with differing views including from amongst those psychologists with experience and expertise who felt they had to leave their work in services committed to “affirmation only approach” (See Cass Interim report 4.17, 4.20).

A more lengthy, detailed and critically reflective tone and content, akin to that of the BPS Autism Guidelines (https://www.bps.org.uk/psychologist/working-autism ). In the less than 11 full pages that comprise the body of text of the 2019 GSRD Guidelines, the phrase “Psychologists should” appears 15 times in the 27 headings and an additional 42 times beneath the headings! This is self-evidently not advisory.

Full discussion and critique of the current evidence and research base and inclusion of methodological problems and criticisms which can allow for readers’ insight into the current situation. This cannot wait for the longer-term findings that may come from the Cass research programme. It is needed now by those tasked to provide services.

Balanced consultation with users and user groups representing differing perspectives, not, as previously, just Stonewall and LGBT Foundation. Consultation should also be made with “de-transitioners”.

Sufficient time allowed for well-publicised member consultation, engagement and subsequent amendments.

All task force members should be expected to either sign off the final revision or be recorded as dissenters with “minority report”. This would indicate a move away from what is perceived as an intimidatory climate where differing views are not permitted (see Cass).

I hope you will be able to answer my questions, inform members of the current situation and produce a very much more helpful set of guidelines for the psychological work within the field of gender questioning.

To quote Cass directly:

“4.19 Speaking to professionals outside GIDS, we have heard widespread concern about the lack of guidance and evidence on how to manage this group of young people.

4.20. Some secondary care providers told us that their training and professional standards dictate that when working with a child or young person they should be taking a mental health approach to formulating a differential diagnosis of the child or young person’s problems. However, they are afraid of the consequences of doing so in relation to gender distress because of the pressure to take a purely affirmative approach. Some clinicians feel that they are not supported by their professional body on this matter.”

This is most definitely applies to members of the British Psychological Society. It will, if not addressed, continue to deplete the pool of psychologists prepared to use their expertise to work with and help gender questioning children and adults.

Reply from BPS

Regarding: BPS 2019 GSRD Letter (August 16th 2022)

3rd November 2022

Dear Pat

Thank you for your letter, we welcome the views of our members. The guidelines are designed to support and enable psychologists to work with people of diverse genders, sexualities and relationships (e.g. lesbian, gay, bisexual and transgender people) in a way that is respectful, inclusive and upholds psychologists’ duties under the Equality Act (2010).

Below is a response to your questions regarding the Guidelines for Psychologists working with Gender, Sexuality and Relationship Diversity.

Are the GSRD Guidelines being reviewed?

Yes, the 2019 GSRD Guidelines are being reviewed. All guidance documents are routinely subject to a review at regular intervals to ensure they remain appropriate given the possibility of changing contexts, legislation and evolving evidence. They may also be reviewed at any point in the case of a major change in legislation, evidence or context. As this is a scheduled interim review of the document, the original authors are leading the review process. The Practice Board will ensure the document is externally peer reviewed before publication.

Will the supposed review result in guidelines for children and young people?

This will be considered by the review group and peer reviewers as part of the review process. The review group will take into account the recent NHS review of The Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Trust in London and the public consultation on a new service delivery model.

The Practice Board will consider any recommendations from the review regarding additional evidence-based guidance for children and young people.

Should revised Guidelines separate Gender from Sexuality and Relationship Diversity?

This will be considered by the review group and peer reviewers as part of the review.

Has the BPS reflected upon better process and outcome for reviewing the guidelines?

We continually reflect on our guidance writing and consultation processes and welcome feedback from members and the public. We conduct all of our work in a context of continuous improvement and in that spirit we are grateful for your comments.

Yours sincerely,

Diversity and Inclusion Team

British Psychological Society

e: inclusion@bps.org.uk w: http://www.bps.org.uk

Board of Trustees, Charity Commission, Gender, Governance

What is the point of the Charity Commission?

7th Oct 2022 AdminBPSWatch

David Pilgrim posts….

A couple of years ago, we sent a dossier of case studies to the Charity Commission, enumerating our concerns about governance failures in the BPS. At that time they noted that they were ‘engaged’ with the Society, which was clearly not compliant with charity law. It did not have, and still does not have, a truly independent Board of Trustees and it repeatedly denies relevant information to its members. Our list of postings on this blog has made these points over and over again, with evidence.

Little or nothing has happened since then. We now have one bureaucracy (the BPS) ostensibly under the legal jurisdiction of another one (the Charity Commission) showing the same problem: neither can be trusted to assure the public about probity. As far as governance and accountability are concerned they are both about as much use as a chocolate frying pan. This is not to say that individuals in both organisations, who deal with concerns put to them are not pleasant and well meaning, but the upshot for anyone trying to complain about problems is that inaction is the name of the game.

The norms and culture of both organisations are at odds with reasonable expectations of democratic accountability. It might be better if the Commission did not exist at all – at least then complainants would seek other forms of redress. But it does exist and so we are left with a double problem: the BPS is still poorly governed and the body responsible for rectifying that state of affairs has been ineffectual. I am making strong claims here which might be thought of as nihilistic. However, below I lay out why that is not the case.

This empirical summary of the fix we are all in about reforming the dysfunction in the BPS, with its toothless regulator becoming a ‘passive bystander’ in the face of wrongdoing (Cohen, 2001), is fair comment. We have tried and failed to go through the proper channels. The use of the broken complaints procedure in the BPS failed because it persistently fails all of its members and the general public.

Our campaign for visible and credible reform has run into the sands as well because of the gap between the rhetoric of the Charity Commission and its lack of regulatory potency in practice. My understanding is that it is not even going through the motions any longer of ‘being engaged’ with governance failures in the BPS. It could be that the tinkering on the margins by the BPS (i.e. the laughable sop of a couple of independent Trustees now to be appointed) was enough for the Commission to declare ‘mission accomplished’. Who knows in this mysterious world of public bodies claiming to value transparency but actually offering us bullshit in practice (Spicer, 2020)?

Accordingly, both BPS members and the general public expecting a regulator of charities to, well, regulate charities, are now betrayed twice over. Moreover the relationship between the BPS and the Charity Commission bears scrutiny for two particular reasons, beyond the general failures of each one. I now explain those two points.

‘Engaging’ with Mermaids

The reader may have seen some important recent news, in the wake of the interim Cass Report and the closure of the Tavistock GIDS clinic. That closure remains important because of its ambiguity. Gender critics have invested it with the hope that the castration of children, in the name of medicine, will now come to a halt and exploratory psychological therapy will not be criminalised. However, those promoting the ‘affirmative model’, despite its lack of empirical evidence (Biggs, 2022), look to diverse service providers carrying on with the aspirations of transgender activist organisations. One of these is Mermaids.

News broke recently that the Charity Commission is to investigate its role in providing girls with breast binders. The timing is important. The fact of the supplying of the paraphernalia for young people to deny their immutable natal biological state is not new. Mermaids have not suddenly leapt into action, but have encouraged this and other related practices for years. Thus, the Commission may be blowing with the political wind, for now, post-Cass.

My point here is that this ‘engagement’ initiative raises the prospects for those welcoming the news that this will lead to a dramatic regulatory intervention. Given the track record of the Charity Commission to prefer ‘engagement’ and to rarely close a charity, or take it over as its new statutory managers, the gender critics would be wise not to hold their breath. This intervention from the Charity Commission may work in disrupting the breast binding supply chain, but it may not.

Mermaids may well defend what they consider to be good practice – what will the Charity Commission do then? Analogously, the BPS ignored the advice and directives of the Commission for years with no detrimental consequences for the cabal running the Society. If a regulator is toothless or is perceived to be (which is as important in this case) then the public purse paying for it is being depleted for no plausible reason.

The ubiquity of conflicts of interest

One of the complaints we have made to, and about, the BPS is that it is riven with conflicts of interest at the top. Charity law, amongst other things, intends to minimise or eliminate such a tendency. As I noted, the Commission has failed to put the BPS house in order in this regard and now seems to have given up the effort completely. However, there is a particular twist in the tail of this failure, which neither the BPS membership, nor the general public, are likely to be aware of; being kept in the dark is par for the course in BPS-land.

When the fraud in the BPS came to the attention of its ‘leaders’, the Board of Trustees, there was probably wailing and gnashing of teeth, as threats to personal interests were dawning and scary legal liability might auger a grim future. Some probably favoured keeping the scandal under wraps, whereas others knew the cat would soon be out of the bag and maybe amongst the pigeons.

The fraudster, now in prison, was the PA to the CEO. Multiple sign offs of fraudulent claims (coming from the coffers supplied by members’ fees) were made by her managers. The CEO and the Finance Director were duly suspended, pending the internal and police inquiries. The former is for now ‘back in his office’ but the latter disappeared within a month of his suspension. He found immediate employment elsewhere in the National Lottery Community Fund (NLCF). Yes this is absolutely true folks.

That story deserves more scrutiny elsewhere by critical historians of the Society. However, my concern here is more about a different point about a particular conflict of interest, which demonstrates that the BPS is not the only public body that resists public accountability. As a member of the public and a critical observer of the machinations in the BPS in recent years, I tried to make some inquiries about how this rapid and effortless ‘moonlight flit’, implicating a very senior financial operative occurred. Did the BPS provide him with a reference and, if so, did it mention the investigation and his suspension? Was there due process of checks by the NLCF?

These are pertinent questions in their own right but another aspect of the story emerged while pursuing them. I attempted to contact Helen Stephenson, who has been the CEO of the Charity Commission since 2017. In 2022 she was also appointed as a Trustee of the NLCF, raising an immediate question about a potential conflict of interest. I wrote to her pointing out that prima facie conflict of interest. Her office refused to engage with me about the inquiry (Stephenson was on holiday they said). They also said this was a matter for the NLCF and not the Charity Commission. The buck was being passed.

Accordingly, I sent an email to the Customer Services of the NLCF (the only contact point available), who refused point blank to pass on the concern to the CEO or Chair, as I had requested. Nor would they deal with the concern directly. Basically, I was told to go away in a firm British manner, in which those in power are used to dealing with the public when under threat. I have now written to my MP telling the sorry tale, but am still travelling more in hope than expectation.

So there we have it. Not one, not two but three public bodies are indifferent to the rights of the general public and are happy to swat away or ignore public interest inquiries. Those at the top of all three organisations should be thoroughly ashamed of themselves, though this is not a likely scenario. In the meantime, the mystery of the ex-Finance Director of the BPS and his equivalent role in the NLCF may encourage journalistic interest, as might the clear conflict of interest implicating Helen Stephenson. Please write to your MP about this. Any update from mine will be posted on this blog.

References

Biggs, M. (2022) The Dutch Protocol for juvenile transsexuals: Origins and Evidence. Journal of Sex & Marital Therapy (online 19^th September).

Cohen, S. (2001) States of Denial: Knowing About Atrocities and Suffering. Cambridge: Polity.

Spicer, A. (2020) Playing the bullshit game: how empty and misleading communication takes over organizations. Organization Theory 1, 1-26.

"The Psychologist", 'False Memory Syndrome', Academic freedom and censorship, Board of Trustees, Expulsion of President-Elect, Gender, Governance, Identity Politics, Memory and the Law Group, Prescribing Rights

Legal storm clouds over the BPS

16th Aug 2022 AdminBPSWatch

David Pilgrim posts….

For those new to the chaos in the BPS, its organisational vulnerability today is multi-layered. The Charity Commission has, until very recently, been ‘engaged’ with the Society about lack of compliance concerning governance arrangements. Slowly, maybe resentfully, the leadership in Leicester has tinkered around the edges.

The Society’s ‘Board of Trustees’ has been a phoney structure since the 1960s, but now a few public invites are to be issued, to appoint nominally independent members. All trustees in a charity should have no conflicts of interest, not just a couple of tokens. As with other matters, the BPS leadership seems to lack insight about even the most basic principles of organisational probity (see below).

But compliance with charity law is the least of the problems for the current BPS leadership or, note, past leaders with their ongoing legacy liability. We were told via YouTube, when Nigel MacLennan was expelled kangaroo-court-style, that this has been a ‘challenging year’. This of course was special pleading from those running the Society. The wider membership had been kept completely in the dark about the corruption and misgovernance, so they experienced the lock down, oblivious to any personal pain suffered by the leadership, with its ‘challenges’.

This glib ‘challenging year’ trope in BPS propaganda has persisted, both vague in its detail and directed at sympathy from anyone taking it seriously. Covid-19 had been a safe cover story of collective bad luck and victimhood. Whichever way the challenges in Leicester are spun to the outside world, the reality is that the BPS is in serious legal trouble.

Three imminent legal threats to the reputation of the BPS

Here are three points to consider seriously:

1 Nigel MacLennan’s Employment Tribunal will require that the BPS must now take the dirty washing it has stuffed in a bin bag and put in a cupboard somewhere, and empty it out on to the floor of the courtroom for all the world to see. The evasions and snail-pace adjustments, which might have worked in response to the Charity Commission, will not be tolerated in a court (which is the formal status of an Employment Tribunal). Much more could be said on this, but a sub judice caution comes into play here, so I am just reporting the material fact of what is about to happen in 2023.

2 Post-Cass Review and Post-GIDS closure, the BPS guidance on gender has now been withdrawn. The leadership are not responding, in a timely manner, to a dilemma shockingly new to them. In the autumn of 2019 criticisms I made of Tavistock Clinic GIDS were censored by the BPS. In the summer of 2020, representations from many BPS members about the serious inadequacies of the 2019 guidelines on gender were simply ignored. In the autumn of 2020, a detailed formal complaint concerning the form, content and context of 2019 revision of the gender guidelines was made but not upheld. Also in autumn 2020, further representations about the risks of extending prescribing rights to psychologists (which would have included hormones) were ignored by BPS leaders. In the spring of 2022, yet another multi-signed letter to BPS leaders about the risks posed to the public by the gender guidelines was simply ignored. This did not even receive an acknowledgment, let alone a considered response.

Only when the world outside was telling Leicester in stereo, and at full volume, that the game was up on the ‘affirmative model’, was action triggered. Over the recent years, its own members had been treated with total contempt, when lobbying for the withdrawal of the trans-captured gender document. The wise have kept a copy of the policy document now removed. It cannot be deleted from history, no matter how convenient that would be for all of those, from the Board of Trustees and the Practice Board to the ‘Comms Team’ and The Psychologist, who were complicit actors in a flawed policy.

The credibility of their group-think will now fracture in the full public glare of legal scrutiny. Recently The Times reported an incipient class action, involving up to a thousand ex-patients of the Tavistock Clinic (in truth that figure may be larger or smaller). Whatever their number, the legal bill will be picked up by the NHS Litigation Authority (NHSLA). Its work is supported by top-sliced money from constituent local Trusts, so it is supplied ultimately by the tax payer.

The Tavistock Clinic will survive, albeit embarrassed. It will be rid of a capricious historical deviation, which held the proven tradition of cautious exploratory psychological therapy in complete contempt, confusing a passing and modish social trend with a genuine ‘social revolution’. The medical sterilisation of healthy children is shaping up to be yet another ‘great and desperate cure’ in the murky biomedical history of psychiatry (and now, more importantly, psychology) (Valenstein, 1986). These children, who cannot vote, give consent to sex, buy alcohol or even have a piercing or tattoo at their own request, has been put forward by adult identity politics activists as a harbinger of social progress.

In the censored exchange in 2019 and noted above, between me and Dr Bernadette Wren, that assumption of political and ethical worthiness was debated. As a champion of the now discredited GIDS, Wren actually described the explosion in referrals as reflecting a ‘social revolution’ (sic). I am sure she believed that, but history will surely not vindicate her position, given that her claim is already unravelling and there is a service policy push back, here and in other countries, about the ‘affirmative model’. Social contagion, yes. Social revolution, very doubtful. A passing postmodern phase of anti-realist madness, most probable.

Many liberal and left leaning people (this is not just a Daily Mail editorial frothing at the mouth) simply never bought the GIDS progressive claims. Nor did they fail to spot the trans-capture in the BPS and elsewhere, including in the Royal medical colleges, which should have known better. For example, a group have just written to The Observernoting how the leadership of the Royal College of Psychiatrists had fended off representations, similar to our own in the BPS (see under heading Trans Concerns) https://www.theguardian.com/theobserver/commentisfree/2022/aug/14/why-surprise-when-wealthy-capitalist-makes-large-donation-to-oxford-college

This span of dissenting voices has now been vindicated. Complex existential challenges, each with their unique biographical context, cannot be cured by crass interference with the body, but it seems that mental health professionals are still slow learners. Their organisational leaders, fawning for popular support in an age of identity politics, have for now often lost their rational capacity to assess evidence or accept material realities that are immutable (Pilgrim, 2022).

Faced with this historical moment of reckoning, the BPS does not have the luxury of a legal fund, like the NHSLA, to fall back on. The grateful medical negligence lawyers, who are now welcoming ‘regretters and detransitioners’ through their shiny doors, will inevitably take an interest in the professional advice that supported the ‘affirmative model’, now defunct at the Tavistock. The cabal in Leicester would be wise to take their own legal advice about what is in the pipeline. It will of course be paid for by members’ fees. It may well entail very large amounts of money.

3 And then there is the contentious memory and law group, which has been the other main arena of policy capture, afforded by weak governance. The enmeshment of the BPS and the British False Memory Society is now clear (Conway and Pilgrim, 2022). However, in 2014, the editor of The Psychologist made this definitive and untenable statement: “Neither The Psychologist nor The British Psychological Society has links with the British False Memory Society.”

This denial was at odds with the fact that the Chair (now deceased) of the BPS Memory and the Law Group was on the Advisory Board of the British False Memory Society, during the time that Elizabeth Loftus was on the International Panel of Associate Editors of The Psychologist. She was also an advisor to the US and British False Memory Societies (The first was closed down after the Jeffrey Epstein case.) Loftus testified in defence of both Ghislaine Maxwell in 2021 and Harvey Weinstein in 2020. In the first case she asserted, with no evidence, that the prospect of financial gain could distort the memories of complainants. This line of speculation in legal settings is not peculiar to Loftus. It has been used by convicted individual abusers, as well as those claiming that child sexual abuse is a moral panic.

In this context of the serious legal considerations of sexual abuse, the biases in the BPS policy to date are very important, as is the supportive role of The Psychologist. In May 2014, its editor provided a short hagiographic account of his interview with Loftus (he met at a conference dinner), who had ‘been voted the most influential female psychologist of all time’. It goes on, ‘Her wit and creativity shone through as she rattled through real-life stories, wrongful convictions and ingenious research that all illuminate the faulty nature of memory…. One thing seems undeniable: whatever the future brings for memory research and practice, Professor Loftus will be at the forefront of it for many years to come.’

Because the BPS is an organisation without a memory, others have to recall the origins of its partisan policy focus. The BPS line, from their highly biased report, considering only the matter of false positive decision making, has fed defence teams hired by those accused of sexual abuse. It has offered absolutely no balancing advice about false negatives, in order to support prosecution teams. Those in the BPS, who have been concerned to expand the policy on memory, to include evidence of the social epidemiology of child sexual abuse and its proven mental health impacts (e.g. Cutajar et al. 2010) have been systematically excluded from a new working group looking at the topic.

This scandal of biased policy formation then is ongoing. It is not just a part of BPS history, now regretted. The group recently appointed to update the document remains shadowy and has only included (unnamed) so called ‘memory experts’, from the closed system world of experimental psychology. All attempts by those BPS members interested in the clinical and epidemiological evidence (an open system feature of the world outside of the laboratory) to join the group have been blocked repeatedly. Moreover, all attempts to ascertain who exactly is on this group have been met with refusals on grounds of data privacy. It seems that the older biases to consider false positive decision making may well remain. The implausible claim that the BPS is guided by the organisational principle of transparency is also obvious here.

Meanwhile, the BPS, as with now withdrawn gender document, seems to have no capacity to reflect on the child protection implications entailed in a lop-sided and partisan, form of policy formation. The only sop that excluded critics have been offered is to submit papers to a minor journal, which is under the editorial control of FMS supporters. As with the case of the gender document, the temporary capture of a weakly governed Society, by a particular interest group, has to await external scrutiny to expose its bias and the dangers this poses to the public. Once again, internal dissent has been quashed at the expense of both membership democracy and academic integrity.

As the evidence now accumulates from historical inquiries into child sexual abuse, both in the UK and Australia, the BPS policy is a new potential target for angry survivors, seeking personal justice. Their lawyers will have spotted that line of attack. The current BPS position, to date, has colluded with the idea that child sexual abuse has been a trivial moral panic. The truth of the matter is that its scale has been strongly under-estimated, as is now becoming clear, in both the statutory inquiries and clinical research (Pilgrim, 2018; Children’s Commissioner’s Report, 2016).

Conclusion

The BPS leaders are in for another ‘challenging year’. Hiding in the dark, under the security blanket of group-think, will not make the lawyers disappear by magic. They will still be there, rubbing their hands, when the blanket it whisked away. Critics of all the three forms of BPS failing, noted above, may have been easy to ignore by the cabal. The rule of law is a different matter. If those in Leicester are not worried by now about imminent legal threats to the reputation of the Society, then they clearly do not understand what is going on.

References

Children’s Commissioner’s Report (2016) Barnahus: Improving The Response to Child Sex Abuse in EnglandLondon: UK Children’s Commissioner’s Office

Conway, A. and Pilgrim, D. (2022) The policy alignment of the British False Memory Society and the British Psychological Society Journal of Trauma & Dissociation, 23:2, 165-176,

Cutajar, M. C., Mullen, P. E., Ogloff, J. R. P., Thomas, S. D., Wells, D. L., and Spataro, J. (2010). Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse and Neglect 34(11), 813–22.

Pilgrim, D. (2022) Identity Politics: Where Did It All Go Wrong? Bicester: Phoenix Books.

Pilgrim, D. (2018) Child Sexual Abuse: Moral Panic or State of Denial? London: Routledge.

Sutton, J. (2014). BPS – obsessed with the false memory syndrome? Editor’s reply. The Psychologist 27, 5, 303.

Valenstein, E. (1986) Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness New York: Basic Books.

Administrator’s note

All of these topics have been subject to comments on the blog. By clicking on the category immediately above the title you will find the relevant posts.

"The Psychologist", 'False Memory Syndrome', Academic freedom and censorship, Expulsion of President-Elect, Gender, Governance, IAPT, Memory and the Law Group, Prescribing Rights

The British Psychological Society: Failing the Public

19th Sep 202131st Oct 2021 AdminBPSWatch

Pat Harvey posts….

Because of their acknowledged expertise, Psychologists enjoy professional autonomy; responsibility is an essential element of autonomy. Psychologists must accept appropriate responsibility for what is within their power, control or management. Awareness of responsibility ensures that the trust of others is not abused, the power of influence is properly managed and that duty towards others is always paramount.

Statement of values: Psychologists value their responsibilities to persons and peoples, to the general public, and to the profession and science of Psychology, including the avoidance of harm and the prevention of misuse or abuse of their contribution to society.

BPS Code of Ethics and Conduct, 2018.

A dysfunctional Society

The British Psychological Society’s serious governance dysfunction, the central concern of BPSWatch (1) has important consequences, not only for the way it behaves towards its own membership, but ultimately in how it functions in relation to its responsibilities to the wider community. A Royal Chartered Charity, (2) its formal Objects may not explicitly state that it has that latter duty and responsibility to wider society, but the second Object requires it to have a Code of Ethics and Conduct (3). That Code includes the statement shown above and only a legal weasel or a BPS bureaucrat might, if pushed into a corner, attempt to deny that the Charter does not require a duty to the public at large.

The growing awareness of the organisational dysfunction and the wilful withholding of information about this brought us together to form BPSWatch and the associated Twitter account @psychsocwatchuk. Whilst we and others have as yet failed to create sufficient pressure to see the ongoing involvement of the Charity Commission with the BPS over its governance problems escalate into a full Statutory Inquiry, we have helped to get information out into the mainstream and other media: The Times, The Telegraph and Third Sector. They will no doubt renew and sharpen their interest as anticipated legal cases become public. Meanwhile the individual concerns initially brought to us about specific policy topics which have been mishandled remain unresolved. It is our contention, and that of the complainants who have contacted us, that each of these is a matter of public concern and public protection.

Unbalanced Views and Member Complaints

Psychology is, and should always be, alive and comfortable with controversy and debate. Members have a right to expect an open facilitative climate, where the best of psychological research, practice and policy formation would be supported and discussion promoted. We, and others, think the BPS is failing to do this and efforts to complain about such failures have led to our focus on the actual suppression of viewpoints and the active censorship of controversies including

Gender

Memory-Based Evidence

Prescribing Rights

IAPT

These impact directly on practitioners and the people and services they work with, but they also impact upon discussion in public life. They are matters of concern to the mental well-being of individuals who are vulnerable and finding themselves in threatening situations in their communities, in a clinic or in court. They are psychological matters still open to alignments of differing viewpoints. We believe the BPS has a duty to address these, elucidate their conflictual aspects, review and weigh the evidence base and its adequacy, and specify remaining questions.

Since this has not happened, members have tried to complain. They have often been ignored or met resistance. A network of disparate, dissatisfied complainants discovered each other by word of mouth and email chains, and we were encouraged by this to set up BPSWatch. The writer came into this originally due to what I believed to be grossly inadequate and incomplete BPS guidelines on gender for practitioners (4) which I had discovered in connection with a high profile childcare case which went to court. I considered the guidelines totally unfit for purpose and was minded to complain. I then came across a statement made by a key player in their construction. This person’s formal presentation as an expert psychologist was recorded at an academic forum which was posted in an online video. They made a categoric statement that, based on what they held to be definitive research findings, the question of psychological outcomes of gender reassignment surgery was closed, stating “…the debate is shut. There is not a debate about that anymore…”. This is not a statement that any Chartered Psychologist should be making either in form or in content. It constitutes what will be taken by audience and viewer as authoritative summation of the current evidence base on outcomes of surgery. It misrepresents how psychologists should talk about scientific enquiry, and is actually untrue. It is, therefore, unethical. Furthermore, as a ‘take-away message’ in that forum and online, with the implied weight of the British Psychological Society behind that person’s position and reputation, it is seriously irresponsible. That message had the potential to impact directly, if heard, upon people making life-changing choices.

The BPS complaints team batted the complaint about the statement away. The first response (stage 1), was a blithe and ironic “…we are a broad church…”. I persisted, with references, and this aspect of my complaint, whilst taken more seriously and addressed in more detail, was rejected. They stated “…Although there will always be some dissenting voices, the idea that this represents a real schism in the scientific community [note, this misrepresents my precise concern] … is incorrect…”. In fact, subsequent reputable research publications (5) have strongly supported my contention that the jury was still out on this, and the debate is, and should, remain open. Uncertainty about those outcomes remains, and needs to be the subject of much more adequate data collection, follow-up and methodologically sound research. The psychologist I complained about was peddling certainties, taking a protagonist/activist position in the guise of the science, and the BPS was wrong to continue to support that. Vulnerable people, their families and their rights are ill-served by false certainties coming from supposedly highly authoritative sources, backed by the BPS

Conflict Avoidance

I have cited the above to illustrate not only the tortuous experience of trying to make a complaint to the BPS but also to illustrate how poor is the quality of the Society response. In the case of another of the topics listed above, Memory-Based Evidence, the BPS took a different tack – they dumped the challenge half-way through. The BPS’s previous out-dated guidance on this area was deemed to have been skewed at the time (2008, 2010) by the impact of the false memory/recovered memory lobby (6). The BPS had seemed, over the years and in the pages of The Psychologist, to have had stars in its eyes around a famous and foremost proponent, Elizabeth Loftus (7). She had been made an Honorary Fellow of the Society and lauded for her subsequent awards. Not all members were happy about this (8). For the interest of the reader, an admirable and informative account of the journalistically styled ‘Memory Wars’ can be found outside the pages of academic journals and The Psychologist in the link below (9). Such informed coverage puts the BPS house journal to shame. During the of writing this article, a US jury have shown limited sympathy with the defence case for which Loftus gave her usual form of evidence (10) and Robert Durst has been found guilty of a murder committed 20 years ago.

A BPS-appointed Task and Finish group was set up to revise their outdated guidance. There was a good deal of demand for this from practitioners who appear in court in connection with many kinds of trauma, particularly in the context of historical child abuse allegations. Well into its work, the working group was unexpectedly closed down (11). The Psychologist published a statement from the Chair of the Research Board suggesting this was an amicable and consensual decision – we have been directly informed by participants it was not. As one comment amongst the many to The Psychologist stated “…I am a member of the Memory Based Evidence Group and I would like the right of reply to respond about some of what has happened in this Group, which was tasked on writing a document on Memory and the Law. I am unhappy about the Research Board’s decision to disband the group, and I do not think that there has been a satisfactory answer to why such a decision was made; this decision was made without consultation with the group members, nor with the wider Society….“(11). The announcement in The Psychologist was made with this statement “Unfortunately, the standards of evidence for the report and the need for consensus and a convergence of evidence from experimental work and clinical practice, [my emphasis] as defined within the Terms of Reference for the group, could not be met.”. (11)

Contained within this statement, one which might immediately raise the questions: “Who set those terms of reference?” and “Isn’t the contentiousness the very reason for these guidelines?” is a clue to where some of the underlying and poorly managed tensions may originate. Academic/practitioner conflicts have dogged other psychological associations; for example the American Psychological Association and the Association for Psychological Science in the USA (12). As someone from a practitioner background, my view would be that there are serious drawbacks to research which sets out to answer questions arising from the clinical environment using crudely artificial analogues. Memory based evidence is one topic illustrating the drawbacks in using research set up in staged non-personal settings to discredit the opinions (in the legal sense) of practitioners working in non-analogous trauma related circumstances. If you have any doubts about the dire need for an authoritative dispassionate view on this particular controversy to protect individuals on both sides in an adversarial court environment, consider what the absence of that psychological balance does – it leaves courts wide open to the machinations of the British False Memory Society. How it actually goes about doing its work is described in detail in this video (13). A balanced view from the BPS could surely weigh the concerns about false positives and false negatives within the context of BFMS strategies, the applicability of academic research to traumatic memory, and social context of the serious underreporting of child sexual abuse (14). This would greatly assist in the court setting which itself attempts, as does a practitioner, a case-by-case assessment of veracity. The BPS Research Board have in effect kicked the revision of the guidelines into the long grass, the old guidelines having been archived. These, however, are still available to be cited and used on the uninformed if you know where to look online.

The BPS Working for the BPS?

Further discussion of these topics, and also of the implications of the BPS failings on Prescribing Rights and IAPT, can be found in specific articles on the blog (15, 16, 17). They illustrate a systematic failure to conduct proper consultation over key concerns in service provision models and health service professional practice. Why and how is this happening?

The BPS, it seems, has an opaque system and uses equally opaque criteria for choosing its preferred advisors and for what policies are to be discussed with government departments and the NHSE. Feedback to members is minimal or non-existent. We have been reliably informed that a BPS CEO felt quite free to negotiate with NHSE without the presence of any psychologist. This leaves the room for a Society with an ever more rapacious in-house business agenda to be sucked into any government ideology where a shared vested interest may appear. The wider views of members working in the field may well be sidelined or completely ignored. The alleged current government agenda on privatising health care/moving to insurance models is open to facilitation by the self-interest of particular voices who manage to gain favour. In that context, note the latest BPS attempts to convince the NHSE and PSA that the Society can regulate an influx of less qualified younger members who will bring in fees and subscriptions to swell the coffers. There is little reason to think this will go well. In contrast to welcoming ever wider groups for membership, senior members seem to be regarded as a nuisance – maybe more trouble than they are literally worth, unless they are securely corralled within the system’s tent and staying ‘on script’ with the assistance of the Society’s Comms team – being one of the ‘cronies’.

Cronyism and Its Ills

We arrived at the term ‘serial office holder’ to describe how some psychologists have made a parallel career from being a BPS ‘apparatchik’. These psychologists move from one office to another over years (sometimes decades), sometimes elected, sometimes appointed. They make a virtue of their extended contributions. They are able to use the BPS logo on their websites and list the many impressive offices they have held on their CVs. Thus their BPS career is likely to enhance their professional reputation. They like to give each other honorary lifetime memberships and even when that is done in an AGM on Zoom in 2021, you may be expected to stamp your feet under your desk in approval.

It would seem highly likely that a regime where cronyism is a norm will lead to complacency, lack of critical reflection, closing ranks, and resistance to newcomers taking important roles. An extreme example of this was the opposition to, and the action taken against, the President Elect 2020-21, Dr Nigel MacLennan. He was elected on a reforming mandate and then expelled. The expulsion was heralded in a vilifying YouTube video for all to see even before he had chance to appeal. We know many members thought that horrible and immoral, and one can only shudder at the extent to which living in the BPS bubble has distorted the judgement and the personal morality of those implicated in, and complicit with, show trial tactics. The person chosen to conduct his ‘appeal’, far from being independent of the previous proceedings and personnel involved, described himself in an interview with The Psychologist, on assuming his own presidential office, as “…a BPS Junkie since 1984…”. He has been around the corridors, real and virtual, of the BPS for more than 30 years, the BPS and he being ‘in each others’ DNA’ so to speak.

Not all serial office holders are treated well in the BPS, however, particularly if they start to question how things are being done. They too may be attacked and threatened like MacLennan. We have heard how some become very distressed, visibly so in meetings, but then increasingly conform; others resist but remain peculiarly defensive of some idealised notion of the organisation and its capacity for change despite all evidence of its malign dysfunction. These patterns are reminiscent of what has been called Stockholm Syndrome. It is pertinent to consider how an unhealthy organisational environment where the main focus is self-perpetuation might allow for another form of organisational capture, by activism. Any would-be activist moles would be well-advised to get their feet under the table by not rocking the organisational boat and to volunteer for taking on work others don’t want. Then they just need to wait for their policy agenda to float into view and haul it in.

Psychologists, Psychology and Activism

The writer has been a lifelong political activist and vigorously supports, in her personal life, action on climate change, poverty, inclusivity and world peace. I took to the streets in the 1970s when my town elected National Front/National Party councillors. I was part of the making of a World In Action TV programme on that racist environment. Those passionate views had to be put on mute in my clinical work. I currently hold strong views about many of the contentious topics in psychology, but our focus at BPSWatch is to ensure that no partisan view – including my own – within an area of ongoing scientist/practitioner debate captures the BPS. Some activists had assumed because we criticised BPS bias that we supported their ‘side’ of a particular argument, hence we have revisited and set out our agenda (19) – good governance, not certain ‘causes’.

We argue in BPSWatch that gender, memory-based evidence, prescribing rights and IAPT are amongst the topics that have been captured by a particular viewpoint and its activists. What follows capture is that debate is shut down, information restricted. Certain topics are being precluded from teaching and some psychologists are being maligned. Deeply unfair accusations of transphobia, sexism, racism, classism (the list grows daily) are never challenged by the BPS. This is aided and abetted by The Psychologist which actively fails to give balanced coverage to all legitimate views. Members have told us how their contributions have summarily been spiked in the in-house publications. It is not for the BPS to enter party politics and campaign, for example, on specifics such as Universal Credit. Rather, it should be making available the best research on poverty in relation to child development, adult mental health, crime and suchlike, and vigorously bringing this to the attention of politicians and decision makers. The same applies, as with the topics covered above and numerous others, to public awareness of the best evidenced range of views within which individual people are making the kinds of choices that many face and which will often change the course of their lives. This does not include rushing to be a signatory to a range of worthy campaigns (and how is the decision to sign – or not – made?). These psychological matters are serious.

The Results of Misgovernance are Failing the Public

The well-staffed, wealthy but seriously misgoverned charity that is the current British Psychological Society continues to fail its members and the public on the most crucial of standards, and for this we will continue to hold it to account. We have hoped to see moves for radical change which would enable open communications with the large membership, bottom-up consultations and an inflow of new actively welcomed volunteers. We hope to see new healthy structures at the top of the organisation, independent lay people as trustees. We believe it is only then that the BPS will serve the membership and the public as it should. Sadly, it just is not happening and there are no signs, despite the recent talk of ‘crossroads’, change programmes and tinkering with governance, that the change will come from genuine reflection within. Perhaps, therefore, it must come from without.

**************

Notes and Links

Why the blog and why now? Charity Commission to Blog Author: “We are currently engaging with the society over a number of issues and have found deficiencies in some areas of operation” https://bpswatch.com/2020/11/20/why-the-blog-and-why-now/
https://www.bps.org.uk/sites/www.bps.org.uk/files/How%20we%20work/BPS%20Royal%20Charter%20and%20Statues.pdf
https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/BPS%20Code%20of%20Ethics%20and%20Conduct%20%28Updated%20July%202018%29.pdf
https://www.bps.org.uk/news-and-policy/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.1778correction

“The results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison. Given that the study used neither a prospective cohort design nor a randomized controlled trial design, the conclusion that “the longitudinal association between gender-affirming surgery and lower use of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them” is too strong”.

"The Psychologist", Academic freedom and censorship, Board of Trustees, Gender, Governance

THE BPS AND THE FOURTH ESTATE

16th Jul 202131st Oct 2021 AdminBPSWatch

David Pilgrim posts…

Today the relationship between the cabal running the BPS and the press reflects the governance crisis now evident to us all. When it is ‘business as usual’ then the press office of any organisation simply scans for opportunities to maintain a positive public profile and promote its wares. However, the business as usual in the BPS in recent times has been, to say the least, problematic given the evidence of misgovernance and corruption.

Misgovernance in the BPS probably can be traced back to 1988, when the version of Board of Trustees adopted was a sham of a democratic structure, which had an inbuilt lack of independent oversight. By the turn of this century, corruption crept into the culture. In the past few years both misgovernance and corruption have interplayed. Slowly those outside of the current cabal, which is seeking in a rear-guard action to deny this historical reality or mitigate its personal damage for Trustees, are wising up. That critical scrutiny has come from a range of parties.

The first wave of protest came from disparate members who encountered a broken complaints procedure and a rubber wall of resistance from the centre of the organisation. Some individual members left in disgusted exasperation. Some acted collectively to set up an alternative organisation (the Association of Clinical Psychologists). The second wave came from a reforming President-Elect, who was immediately marginalised, kept in the dark and then expelled in a show trial. In a continuing travesty of justice, he is now the victim of a biased mock appeal process. The third wave came from the Charity Commission in its ongoing attempts to bring the Society into legal and regulatory compliance. The fourth form of critical scrutiny came from the police, with their ongoing inquiries into acts of alleged criminality.

Earlier pieces on the blog have dealt with this challenging scenario, which is now a matter of verifiable fact. That grim reality is the context for Trustees jumping ship or clinging to the wreckage. It is also the grim reality, to be examined in bemusement and disappointment, for ordinary members waking up to the mess. Finally, the ‘fourth estate’ has now begun to play its part in reporting aspects of all of the above.

Impression management during times of crisis

Press officers and advertising executives have a shared concern for what Erving Goffman called ‘impression management’ in relation to the self-presentation of individuals. It was extended by others to political and organisational information control (Peck and Hogue, 2018). How do these gatekeepers of impressions promote good news to advance the interests of their organisation and their current leadership and silence bad news? In the latter regard, in the common parlance of a new management class, with an eye to the training manual of the satire The Thick of It, how do they ensure ‘damage limitation’?

Given the current crisis in the BPS, a number of tactics have been deployed in relation to the above waves of critical scrutiny. This is what has happened in each case. First, they ignored complaints from members or used the complaints sub-system as a rabbit hole. To reinforce this Kafkaesque obfuscation at the individual level, the whole membership was kept in the dark about what was going so badly wrong. The silence in the pages of The Psychologist (‘the magazine of the BPS’) limited the prospect of membership curiosity. Memos were sent to office holders discouraging frank and open discussion. Here is an example of one sent by a Trustee on behalf of their Board to office holders in sub-systems in December 2020:

Dear all, We are aware that questions are being raised by yourselves and by your colleagues. We are able to share the following BPS statement with you, which we have received today:

“We are aware of unhelpful speculation and inaccurate information circulating on social media about a confidential staff issue at the society. This relates to a review about internal procedures within the society. As some of the information that has been shared online is incorrect and potentially defamatory, we have written to the authors of these statements and they have agreed to remove them from their blog and twitter account. As we are sure you will understand, and as the review is ongoing, we have a responsibility to maintain confidentiality and we are unable to comment on this issue further.

We would also like to correct misleading information that states the society is being investigated by the Charity Commission. We are not aware that the Charity Commission has opened an investigation. We take our legal responsibilities as a charity seriously and would always inform our oversight bodies of any relevant issues affecting the society. Several months ago we responded to requests for information from the Charity Commission but we have not received any notification of concerns to date. We would like to assure members that the society continues to operate as normal.”

We hope this is helpful. The statement can be shared with committee members if they are raising questions. Questions can also be directed to the BPS communications team.”

This is a dream memo for those interested in critical discourse analysis. Apart from the overall sub-text, which is ‘please stop asking awkward questions or discussing matters we would rather not talk about’, it is rife with silences about authorial responsibility. If the speculation has been unhelpful then unhelpful to whom and why? If the information is inaccurate then what is the accurate information? Outside of the quotation marks, what does the word ‘we’ refer to? Inside the quotation marks what does the word ‘we’ refer to? Is that the same ‘we’ or a different ‘we’ and how would an ordinary member know the difference? Who exactly is ‘the BPS’?

Turning to the assurance at the end about the role of the BPS communication team, do they have a vested interest in what is said and what is not said? Were individual members of the BPS communication team implicated in the moves to expel the President Elect or not? Did they confect the ill-advised video on YouTube, disparaging the expelled President Elect in advance of his appeal or not? Have they supported acts of censorship in the Society, thus betraying academic freedom or not? Have they been implicated in controlling what is said, and not said, to the press about concerns of misgovernance and corruption, which now has triggered more than one criminal investigation?

Answering the last question, journalists have been kept at bay with a range of tactics, including threatening them with legal action. There is a difficulty though with impression management when the context is one of dire dysfunction (the current actuality at the centre of the BPS). In a liberal democracy, secrecy in organisations and hostile refusals when approached by the press will tend to further encourage the curiosity of journalists. Not only are they used to evasions (they are experts themselves in impression management), they also are part of highly financed organisations with dedicated legal departments.

This is especially applicable to The Times and the Daily Telegraph (the largest broadsheet circulation in the UK). David Brown at the former and Hayley Dixon at the latter have run stories which expose the current BPS dysfunction. Stephen Delahunty in the niche online magazine Third Sector has also played his part in exposing current problems in the Society. I understand that soon more will come on board with this scrutiny from the mainstream mass media. Journalists, like writers on this blog, are not going away and the cabal now have that new headache.

It is one thing for members to be threatened with ‘cease and desist notices’ from the BPS (as applied to this blog in its early days), it is quite another to expect the same tactic to be successful with seasoned journalists and their supportive employers. The futility of the current BPS tactic is borne of two problems for its communications team. First, newspapers, with the confidence of legal backing, will both investigate rigorously and publish confidently. Second, journalists will take more, not less, interest in the story if they meet evasions or threats from the target of their interest.

The BPS as a medium-sized charity can eschew internal scrutiny from its members by using threats and evasions or expelling whistle blowers (see above). However, the press will not be cowed so easily. This leaves the BPS communication team with limited options. They can refuse to put journalists in touch with personnel (staff or non-employed volunteers from the membership) and they might defend a position as being reasonable and so not requiring undue scrutiny. They might simply refuse to comment – the preferred tactic, inter alia, of the defensive police suspect or the aloof government department. Here we do find a consistent line of reasoning: whether critics are internal from the membership or external from journalists, a ‘problem what problem?’ approach has become a sort of magical thinking from ‘the BPS’.

However, members are not stupid (their IQs tend to be well into triple figures) and journalists are certainly not biddable dupes. The waffle in the memo above implies that critics are misrepresenting the truth – what, according to the Trustees, is the truth then? Was the CEO suspended or not? Was there a large fraud being investigated by the police or not? Did the Finance Director leave for employment elsewhere or not while he was under investigation? The distinction between the verifiable material facts, which should be disclosed transparently in the public interest, and the details of any process legitimately warranting confidentiality, in order to protect the fair treatment of individuals, is clear and readily made.

What the cabal has done regularly recently is elide legitimate confidentiality and self-interested secrecy [see here]. The exact reasons for this secrecy will no doubt come out, in details to be eventually disclosed in court proceedings and any future employment tribunal hearings. At this stage, I can only speculate that the need to shroud the misgovernance in mystification and evasions is that Trustees, past and present, are now fearfully and fully aware of their legacy liability. The Trustees have been party to a lack of oversight about a number of serious matters over a period of time and they know this to be a fact.

This scenario was evidenced in the concerns expressed by the resigning Deputy President David Murphy, earlier this year, when making vague allusions on Twitter to his concerns about governance and finance. However, note that he too has not given a full and frank elaboration to the membership of the governance wreckage he was now swimming away from. He knows far more than he is saying publicly.

Secrecy, denials, deflections and evasions, embodied in the strategic ‘problem what problem?’ approach adopted in the communications team’s efforts at impression management, are our starting points for an empirical description of this case study of a dysfunctional organisation. These psycho-social processes have become an irrational collective defence for the cabal against future reckonings. In truth, judgment day will come eventually for those who have resigned, not just for thus who remained. In the eventual history of the BPS, these people will not have covered themselves in glory, to put it charitably. Resignations provide no protection, legally, from legacy liability.

An example of this point, which is already evident, is that to date, with the exception of the expelled President Elect, who repeatedly asked for accountability (and was punished for his efforts), the Trustees have provided no explanation to the membership of the financial cost of misgovernance. If they demanded accountability in this regard, then where might the members read the relevant reports? Remember members have paid for all these shenanigans and yet the BPS continues to claim hypocritically to value transparency. Basically, the Trustees did not ask for, and so cannot provide the membership with, an account of how much money has been lost to the Society.

The fraud is one aspect of this scenario, but so too is the Machiavellian spectacle of the Trustees wilfully using Society funds to seek expert legal rationalisations to punish and disparage the one man who blew the whistle on what was going wrong. And then there is the lack of a coherent and transparent business case for the organisational change programme, with its cool £6 million price tag. The press will probably take an avid interest in this and other matters in the near future. For journalists, money is one thing to reflect on, but so is policy distortion.

A Recent Case Study

On this blog we have highlighted that policy capture has occurred in the BPS from partisan interest groups, including the closure of the memory and law group to exclude the evidence of under-reported child abuse and its implications for adult mental health. Another example of ideological capture relates to some gender-affirmative activists driving BPS policy statements about the extension of prescribing rights for psychologists (a Trojan horse for some enthusiasts to prescribe hormones), the controversial gender document (British Psychological Society, 2019) and the manipulation of wording in the Memorandum of Understanding on conversion therapy.

The latter document shifted from a non-controversial version in 2015, focusing only on homosexuality, to one in which gender identity was bolted on. Logically, sexuality and gender identity are quite separate matters and so should not be conflated in policies. However, that is precisely what activists, including representatives from the BPS, did in their re-writing of the document between 2015 and 2017 [see here and here].

This is a controversial matter, as the difficulties at the GIDS service of the Tavistock Centre have highlighted, with many psychologists who worked there leaving with serious concerns about the ideological capture of service philosophy. The lack of evidence of efficacy for the latter was at the centre of the judicial review, which emerged in December 2020. Despite this clear division within the psychological community about best practice, when responding (or not) to gender non-conformity, in society, the BPS is now linked in its policies to only one side of the argument. This leaves many therapists fearful about exploring options that are not based on routine gender affirmation and referral on for biomedical transition. This story of professional division was then picked up by the press.

A piece from Hayley Dixon in the Daily Telegraph appeared on July 8^th 2021, about the clinical freedom of psychological practitioners. The group Thoughtful Therapists recently successfully lobbied the government to proceed with caution and protect clinical freedom about intervention options. Dixon goes on in her piece (cited in full here):

‘They called on ministers “not to criminalise essential, explorative therapy” and warned that there had been a “worrying number of young people de-transitioning and regretting medical treatment”. After the petition reached 10,000 signatures, the Government Equalities Office responded and said that they would ensure the ban on the “abhorrent practice” of conversion therapy does not have “unintended consequences”. “We will protect free speech, uphold the individual freedoms we all hold dear and protect under-18s from irreversible decisions”, the department promised.

“We will ensure parents, teachers and medical professionals are able to safeguard young people from inappropriate interventions and are clear that this ban must not impact on the independence and confidence of clinicians to support those who may be experiencing gender dysphoria.”

They will be holding a consultation to work out the specifics of the new law in the coming months.

But there are fears that even if clinicians are protected under the ban, their work could be impacted by a memorandum of understanding on conversion therapy which has been signed by all the major health, counselling and psychotherapy organisations in the UK.

Little is known about the Coalition Against Conversion Therapy, which is the steering group for the memorandum, and it has not been revealed whether the document, which is due for review this month, will be looked at again.

The current 2017 document, which included “gender identity” in the definition of conversion therapy for the first time, was written with support of the controversial LGBT charity Stonewall.

The guidelines have widely been interpreted as proposing an affirmative approach and have led to psychotherapists saying that they avoid questioning children as young as six who come to them claiming they wanted to transition.

The Thoughtful Therapists have attempted to contact the signatories – including the NHS, the Royal College of GPs and the UK Council for Psychotherapy – asking to discuss the guidelines as they govern their work with a “vulnerable group of young people with many unknowns and an extremely poor evidence base for significant medical interventions”.

But they have not received a response from any of the members after Dr Igi Moon, chairman of the memorandum and the lead on the document for the British Psychological Society, asked her colleagues “not respond” to the email chain.

Dr Moon, who uses the pronouns they/them and is involved in trans activism, describes those with gender critical views as “terfs”, commonly defined as a feminist who excludes the rights of transgender women from their advocacy of women’s rights, and says that binary gender is inherited “from colonialism”.

In one debate Trans Liberation: What are our demands?, organised by Momentum activists, Dr Moon demanded that more hormones are made available and that GPs offer bridging hormones to those awaiting treatment.

Telling campaigners to lobby the Government, they said that there are “thousands of people who are not receiving treatment” and if it was any other condition that was “killing people” it would be getting more attention because “as we can see from Coronavirus, there are ways to fund health care”. Dr Moon added: “I am not prepared to stand back and watch my community die. It’s not going to happen, not again.”

A spokesman for Thoughtful Therapists said that they are concerned as the document “seemingly mandates an affirmation-only approach to working with gender dysphoria”.

They added: “We are particularly concerned with the lack of transparency by the Coalition governing the document and its chairman Dr Igi Moon, who on numerous occasions has refused to engage with our professional concerns regarding treatment for gender dysphoria and has instructed signatory organisations not to speak to us. For such an important clinical issue, this stonewalling is shocking.”

Dr Moon and the British Psychological Society failed to respond to a request for comment.’(emphasis added, end cited article)

Note then that on a matter of serious public concern, with empirical claims being made about people being killed unless a particular form of healthcare philosophy is imposed monolithically on the British population, via the NHS, those making the claims refuse point blank to comment to the press or professional colleagues. The BPS refuses to offer a view, tacitly therefore supporting the current policy formation shaped by gender activists.

Whatever position a reader may take on this topic (which will vary in a community of scholars and practitioners, mirroring their host society divided on the matter), behind this evasion from the BPS is the recurrent failure of governance in relation to policy formation. I would apply this critical claim to policies that I actually agree with, and even have been party to developing, including, for example, the BPS documents on psychosis (https://www.bps.org.uk/what-psychology/understanding-psychosis-and-schizophrenia), as well as the Power Threat Meaning Framework (Johnstone and Boyle, 2018).

The point here is that if the BPS were functioning properly as a learned society, which routinely set up in advance proper terms of references about any policy and ensured all voices in the Society were then heard, then post hoc protests would be pre-empted, and wasteful publicly enacted divisions avoided. A learned society should be open and transparent about considering evidence, forms of inference and value positions from all parts of the membership academic and applied.

However, as both the law and memory debacle and the example just given demonstrate, this inclusive and scholarly approach to policy deliberation, formation and eventual recommendation are not ensured. They are not ensured because the BPS is not a well governed organisation. To make matters worse, a culture of impression management celebrated by those who have no academic background or experience in the values of psychology, as a discipline, now dominates the BPS in the wake of a management coup.

The press may well continue to play their part in alerting us to what is happening in relation to matters of finance and policy. One thing is certain: that sort of reportage will not be forthcoming from the cabal, nor will it be elaborated in the pages of The Psychologist. The BPS communication team will make that outcome a strategic priority. Meanwhile the world, including journalists, looks on to an organisation that claims to be both transparent and learned. The reader can make their own mind up. But to do so they need access to the story of what has really gone on in the BPS, since the turn of this century.

This blog and curious journalists will keep fleshing out this story. Historians of the Society and the state of British psychology are now beginning their work. A future empirical sign of integrity and probity in the BPS, if it survives as a charity and credible learned organisation, will be that such historical accounts are published not censored. We should be grateful for the role of a free press in helping secure that preferred outcome.

British Psychological Society (2019) Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity Leicester: British Psychological Society.

Johnstone, L. and Boyle, M. with Cromby, J., Dillon, J., Harper, D., Kinderman, P., Longden, E., Pilgrim, D. & Read, J. (2018) The Power Threat Meaning Framework: Towards the Identification of Patterns in Emotional Distress, Unusual Experiences and Troubled or Troubling Behaviour Leicester: British Psychological Society.

Peck, J. A. and Hogue, M. (2018). Acting with the best of intentions… or not: a typology and model of impression management in leadership. The Leadership Quarterly. 29 (1): 123–134.

Board of Trustees, Gender, Governance

Sins of omission – more rhetoric of justification from the BPS Board of Trustees

28th Apr 202131st Oct 2021 AdminBPSWatch

From the Editors of BPSWatch…

The crisis of governance in the BPS has been rumbling on for the past year. Slowly journalistic interest appeared, with articles in Third Sector and the Daily Telegraph leaking to the public what the BPS Board or The Psychologist had failed to disclose to the membership. This invites us to reflect on what is not said as well as what is said, when considering organisational rhetoric to justify the status quo (philosophers interested in absence dub this an ‘omissive critique’.).

For those of us who think a better future must start with an honest reflection on the present, then we cannot rely on the preferred account of reality declared by the BPS Board of Trustees (BoT). They are not the whole problem (that is systemic and cultural as we have noted in several of our postings) but they are the current living proof of that deeper and longer problematic picture. In that context, we now turn to a brief omissive critique of an important Board statement.

The Board response to the recent article in the Daily Telegraph

On April 26^th 2021, Hayley Dixon in the Daily Telegraph provided us with a rough but accurate sketch of the governance crisis and its consequences (see here). Here we provide in full the ‘official’ response offered from ’the BPS’ then next day (see here).

Responding to an article in the Daily Telegraph, Interim Chair of the Board of Trustees, Professor Carol McGuinness said:

“For more than a century, the British Psychological Society has promoted the practice of psychology and advanced professional thinking on often complex and contentious issues. With more than 60,000 diverse members, debates on professional issues are often vigorous and there is sometimes heated disagreement between our members.

The past 18 months have been turbulent for the BPS as we go through a process of significant and much needed organisational transformation. During this period several working groups have considered very sensitive topics which have gone through an expert and democratic process.

Our guidelines for psychologists working with gender, sexuality and relationship diversity are not, in our view, at all contentious. They require our members not to discriminate against individuals and to treat them with respect. This includes the use of appropriate, inclusive language, which all patients and clients should be able to expect.

The guidelines relate to adults and young people and not to the treatment of children, and professionals understand the difference. Our guidance does not contain any reference to the prescribing of puberty blockers for children under the age of 16.

There is general debate across the health sector on the extension of limited prescribing rights for different professions, something that has brought benefits to patients through, for example, the work of nurse prescribers. There are strong views among our members about whether some psychologists should be granted prescribing rights, with vigorous positions presented by those both for and against this potential change.

However, our research to date on prescribing rights, following a two-year consultation process – that it could be useful in certain settings – is simply a contribution to the debate.

The debate on prescribing has no connection whatsoever to our guidance on gender, sexuality and relationship diversity. We have always been clear that the issue of prescribing rights will require further debate and indeed the BPS does not currently have a fixed position on this issue. We have repeatedly stated that we will continue to listen to and engage with our members on this important issue.

Ultimately, the BPS does not have the power to decide on this issue, as it is a process governed by Parliament following extensive public consultation. We are disappointed that the Daily Telegraph has chosen to repeat the views of a small minority of BPS members who are unwilling to accept the outcome of our consultations and policy positions.

As a board of trustees we have been open about the need for improvements across the society which is why we committed a significant amount of money to our ongoing three-year transformation programme. The BPS is not perfect, and there is always room for improvement in any organisation.

It is clear to us that stronger governance processes will be required in the future, and this work is well underway. We have kept the Charity Commission fully informed of developments throughout and continue to engage with them.”

An ommisive critique of the statement

The reader can draw their own immediate conclusions about the adequacy of this response. Here we only want to list what was not said in this statement.

1. Professor McGuinness was voted into the interim Chair role of the BoT in the wake of the resignations of both the President and Vice President (see here and here – you may need to register (free) to access these articles). This reflected a wilful refusal of the Board to comply with Statute 20 of the Society: the chairing role should have been handed over immediately to the Chair Elect. Her authority in the Chair is at best dubious and at worst totally illegitimate. The naïve reader would be unaware of this legitimation challenge for the Board still today.

2. The allusion to diverse views and heated debate does not mention that debate has been actively blocked, with articles censored (see here), review groups closed down and lobbying about policies ignored.

3. The statement does not mention the routine use of threats of legal action against Society members and others such as accusing dissatisfied complainants of harassment in pursuit of their case.

4. Many objections have been raised about the very lack of the democracy and full expertise drawn upon in policy formation in the Society. These have been ignored in relation to the prescribing debacle, the contentious gender document and the peremptory closure of the memory and law group.

5. Describing the gender document as ‘not at all contentious’ fails to mention those objecting, on legitimate grounds, to it both before and after the legal change on December 1^st 2020. However, the prefix ‘in our view’ is relevant because this reveals the self-interest in depicting reality in a particular manner.

6. The claim that there is no connection between the prescribing and the gender polices fails to mention the overlap of decision-makers in the two groups and the fact that a consideration of hormone prescription was part of the first of them.

7. The BoT are ‘disappointed’ in the article from Hayley Dixon, but the statement does not mention that the BPS was unhelpful and, we believe, invoked legal threats about its publication. We understand that other approaches from Third Sector encountered the same aggressive non-cooperation. Journalists encountering such resistance tend to suspect that a story is worth telling.

8. The commitment proffered about the change programme in the BPS as an organisational solution assumes that it will work in the absence of honest reflection about the current crisis of both legitimacy and governance: the very point we keep repeating and illustrating on this blog.

9. The claim that the BoT continues ‘to engage’ with the Charity Commission is the most important rhetorical query for us. To what degree has that engagement been necessary and why? Will they now make all the changes necessary to bring the Society into regulatory compliance? Does the BoT even admit that any changes need to be made? If so will the Trustees need to resign and a fresh start made under completely new governance arrangements?

These questions are all important, the response from Professor McGuinness offers us no clues at all. Surely the membership deserves a full and frank statement about all of these matters, if the alleged principle of openness and transparency is to be put into practice.

The Editors, BPSWatch.

Gender, Governance

How Did We Get Into This Mess?

24th Feb 202131st Oct 2021 AdminBPSWatch

David Pilgrim posts….

The recent description of the BPS as a ‘stultifying bureaucracy’, characterised by ‘administrative incompetence and deliberate procrastination’, seems to be completely fair comment. The evidence to confirm the conclusion, using a range of case studies, was sent in our dossier to the Charity Commission, which I summarised in the earlier posting The Mess We Are In.

Do all charities descend into these cultural norms: are they all on the same tramlines of determination? Possibly the tendency is there in for all, but clearly some of them function better than others. Moreover, when the whistle is blown on problems such as those in the dossier, they do not all react in the same way. As in all open human systems, there is variability of outcome and so precise predictions are offered at our peril. So, we might ask, what is peculiar about the BPS? Its concrete singularity as a dysfunctional charity bears examination.

A personal look back

My own starting point is a memory from long ago when I had just qualified as a clinical psychologist. I was at a conference and was chatting in the bar with Don Bannister about the BPS (a body I had recently joined but knew little about). For those who do not know the name, he was a leader in personal construct psychology, who never shied away from criticising his own discipline. Don was a smart and impish intellectual.

This was in the late 1970s, and I vaguely saw the Society as probably a stuffy but benign organisation, whereas Don had already seen it for what it was. He was of the view that on paper the BPS was indeed a democratic membership organisation. However, in actual practice, this was not the case. The reason, he argued, was that only a self-selecting group of psychologists could be bothered with its bureaucratic intricacies (for their own personality or careerist reasons). They then got their feet under the table and would not budge for years on end.

Today that picture still remains obvious and is why I describe the organisation not just as a ‘bureaucracy’ but also an ‘oligarchy’. I would re-frame the combination as this: it is an oligarchy that uses bureaucratic means to protect the status quo and ward off critical scrutiny. In Orwellian fashion it uses the rhetoric of democracy and transparency to do the very opposite of its claims. Our dossier offers extensive evidence for that conclusion.

Another rhetorical point to note is that ‘recycled’ bureaucratic authority is not declared publicly in a state of shame about personally monopolising a democratic structure. Instead, these oligarchs see themselves clearly as serving the organisation and its membership; a point they make proudly on their CVs and personal websites. (The bankrolling of some of them came to an end just a few years ago, but the status implications remain the same for those working for expenses only.) Of course, some people genuinely move in and on quickly, in a spirit of true democracy but many do not.

As confirmatory evidence that Don Bannister had got it about right, another but more recent memory comes to mind. In 2015, with John Hall and Graham Turpin I edited a book (sponsored by both the Division of Clinical Psychology and the History & Philosophy Section), Clinical Psychology in Britain: Historical Perspectives. It was launched at the DCP Conference and was discussed enthusiastically.

Many of the contributors to the book, who were on the brink of launching the break away group the Association of Clinical Psychologists (ACP), came to the launch. However, out of disdain for the legitimacy of the DCP and the BPS they refused to pay the conference fee. These aging rebels were of the understandable view that they had written their contributions pro bono so why pay? They pitched up anyway and, in a proud act of delinquency, they set up a table and offered their very own prepared laminated badges for those going into the room. The game was up; these were psychologists who themselves had played by the rules of the bureaucratic oligarchy for many years and could not take it anymore.

Cultural history

Here are some ideas about history to account for the above state of affairs. First, from the outset, the emerging autonomy of psychology in Britain tussled with the established disciplines in the academy of philosophy and medicine. Both, in their own way, tried to constrain its development or colonise its agenda. This created a scenario of assertiveness (and some might say arrogance) for the fledgling discipline of psychology in the early 20^th century. The knowledge base of the discipline may have been contested but the self-confidence of all concerned, whatever their competing views, soon became evident.

Second, until the second half of the 20^th century academic psychologists in the Society dominated its leadership, placing those going off to professionalise their wares in applied settings in a secondary position. This led to a paradox of the latter legitimising psychology in public life externally but the Society itself being more dominated by academic leaders internally. A complaint then of applied psychologists was that they had less power than academics and their concerns were not taken as seriously. The BPS was established as a learned society primarily, with its unifying characteristic of being an academic discipline. Its professional applications, which eventually were expressed in its Divisional structure seen today, were self-confident but they also, of necessity, played second fiddle politically to the legacy of organisational history.

The formation of the ACP was one eventual culmination of the contradictions of this legacy. I assume similar imagined futures for applied psychologists in the other Divisions are now abroad. The tension was manifested by a trend over time for applied psychologists to put themselves forwards more for the role of President, though this did not quieten disaffection in Divisional ranks. Moreover, Presidents, whatever their background in the discipline, have tended to ensure cultural reproduction, rather than challenge fundamental organisational roles and norms. When challenge has occurred, it has been met with systemic resistance and personal animosity to the attempted new broom. The genuinely challenging President is a marked man or woman in the BPS.

A recent example of the continuing dominance of academic psychologists being in tension with the views of applied psychologists was the Memory and Law debacle. Collusion between academics on the Research Board ensured that experimentalists favouring the claims of the False Memory Society had taken precedence over the evidence from applied psychology of widespread child sexual abuse in Society. The rapid closure of the group meant that the latter cautions were not to be fully reviewed, with the public protection implications left free floating. As a relevant aside here, I attended the tense exploratory meeting to relaunch this now aborted group in 2018. I applied to be on the substantive group, in order to ensure a proper discussion of the scale and mental health consequences of child sexual abuse. My application to join the substantive group was rejected, despite the fact that I had just finished the book Child Sexual Abuse: Moral Panic or State of Denial? I was given no explanation by a senior manager, who was not a psychologist. She has now left and. I have been unable to ascertain who advised her to reject me and on what grounds.

Third, the separation of the applied from academic wings culminated in the Society abandoning a unified investigatory and disciplinary system to ensure public protection. This then left the Society with no clear role, embarrassingly leaving the matter of ethical impropriety to regulatory bodies like the HCPC on the one hand or employers on the other. Justice for complainants remains then a hit and miss affair. We are in the process of preparing a fuller post about this. If selective management attention is in doubt about this gap in the system, witness how the complaints process is applied assiduously in some cases, while others are just ignored. This is not just inefficiency (though it includes that). It is mainly about interest work that inflects what is investigated properly and what is treated in a tawdry fashion. For example, anyone seriously challenging the status quo about a flawed policy is simply ignored (emails are not answered) or the complaint peters out, with no serious discussion of learning from the process by those running the Society. If a training film was needed on how not to be a ‘learning organisation’, the BPS would be an excellent start.

Fourth, in the past few years the more general shift in organisations to the New Public Management Model and its increasing reliance on digital governance (‘computer says “no”’) has been obvious in the Society. This brings with it the same problems witnessed first in the NHS and then in higher education, with a new management class emerging to control all others. Once this emerges, considerations about the power, status and salaries of this new management elite predominate in decision-making. A ponderous slow-moving bureaucracy then is ensured. Culturally now there is the added sense of being in a lesser amusing episode of The Thick of It, with the unending obsession of BPS leaders with control over both information and people. In this case, ipso facto, this has been at the expense of openness and transparency and a healthy version of membership democracy. Moreover, unlike in the NHS and higher education, where senior managers have often actually had some proper role in their organisations over many years, in the Third Sector we witness a form of managerialism, which can be readily disconnected from the content of the employing body.

Democracy and managerialism in tension

Why should senior managers in the BPS genuinely care about outcomes preferred by the membership, or ensure lay representation within management structures like the Board of Trustees? Like politicians, their short-term interest is mainly in their own domain of power and influence. Other communities of interest might undermine managerialism and so they are instrumentally ignored, or control sought over them. Unlike its ordinary members, managers have no long-term commitment to the Society. The departed employee who kept me out of the Memory and Law group was symptomatic of this here today, gone tomorrow, managerialist culture. Witness the history of the recently and suddenly departed Finance Director, who moved on to a completely different charity before Christmas. As usual, the membership had to find out about this fact; they were not informed.

The oligarchy I describe here and in previous postings then reflects that convergence of interest between a core group of elected or appointed psychologists hanging around in the Society, for years on end, with these career managers. Thus the recycled authority of the same names (tipped off to me in the late 1970s by Don Bannister) no longer represents the single elite group in the Society. It is now jostling for position with the new senior managers, leaving ordinary members and the general public demoted in importance or out in the cold.

For those who are prepared to enter the Machiavellian world of this new political amalgam, and work hard at that insinuation, there are certainly gains to be made. This has been evident in the capture of sub-systems by some activists from within identity politics. Witness their persistent and recurring role over the BPS policies on gender, prescribing rights and the Memorandum of Understanding about conversion therapy. In some cases, this has meant policy indolence in the face of legal circumstances.

For example, the Judicial Review in December 2020 changed the law on biomedical paediatric gender transition. The BPS should have immediately reviewed its policies of relevance but has refused to do so, despite representations. Its magazine The Psychologist instead of reporting the Judicial Review as a game changing legal event and exploring its ethical implications for research and practice instead issued a single pre-prepared biased account, in defiance of the unanimous judicial ruling. Witness also how managers in the BPS have signally failed to rectify the implications of this policy capture in the public interest, with most members probably being unaware of the chicanery involved. This same point applies to those representing the biased interests of the False Memory Society, noted above, embedded in the Research Board over many years.

What Next?

Where is all this going? One scenario is more of the same. The Board of Trustees might continue with its ‘problem what problem?’ approach. It will just carry on protecting the incumbent interests of the oligarchy, with its wilful blindness to endemic poor governance. (An exception here was the resignation recently of the Deputy President, citing the latter as the main reason.) Another is that more and more members will leave in frustration and this might coalesce into new organisational formations, in addition to the ACP. If this is a large fracture, with applied psychology setting up shop elsewhere, then the BPS may need to re-name itself something like ‘The Society for Psychology Graduates’. A final scenario is that a root and branch reform of the Society will ensue, to at last ensure its proper governance, prompted by a combination of press interest and Charity Commission engagement and investigation.

Watch this space.

Academic freedom and censorship, Gender, Governance

David Pilgrim’s ‘disappearing’ article

7th Feb 202131st Oct 2021 AdminBPSWatch

This is the article referred to in David’s previous post which was agreed for publication in DCP Forum (March 2020) but spiked by BPS office. We would also point you to a post also addressing issues of freedom of expression which did ‘not make the cut’, in that case, for The Psychologist.

GIVING AND TAKING OFFENCE

David Pilgrim

Recently clinical psychologists have reported their views on giving and receiving offence and how they might be managed within the profession. This topic reflects a wider historical ethical debate about freedom of expression in speech and writing. The traditional liberal guidance of J.S. Mill is outlined, followed by a discussion of fresh norms about diversity within identity politics, since the ‘postmodern turn’ in the 1980s. It is argued that the wisdom of the first position is being undermined by the latter and that newer well-meant libertarian intentions have culminated at times in authoritarian outcomes.

Over the past year, two seemingly unrelated controversies within British clinical psychology have emerged. The first I was part of (about transgender) and the second I was not (the slavery presentation in Liverpool at the group of trainers’ conference). Both encouraged substantial and illuminating correspondence in these pages. The topics were seemingly unrelated but what linked them was the matter of personal offence and how it could, or should, be managed in the profession.

In my original piece on sex and gender (Clinical Psychology Forum 319) I was not only pleased that the editor published the piece but also that he then welcomed correspondence, whether it was supportive or critical. I was less pleased by efforts on the part of some to explore the threat of litigation in an effort to constrain serious debate about an important public policy matter and the BPS played its role in this regard. For example, material was deliberately delayed for publication and the editor was instructed to print a letter of complaint sent to the BPS and he was found lacking for not making clear that my view in the original piece was not that of either the Society or the DCP. (Please take the same clichéd disclaimer into account for this piece as well.)

Arguably this was a storm in a teacup: eventually people said what they wanted to say. For now freedom of expression was preserved. It was though under threat, raising the question of why we are bothered about it at all. After all, in the era of social media everyone is free to say anything they want apparently. However, the counter to the latter view is that de facto censorship in a new guise has emerged with the ‘post-truth’ society, where asserted personal opinion, fantasy and jettisoned cautions surrounding academic knowledge all mix in the same social media porridge. Now, more than ever, the matter of freedom of expression is important for the sake of both academic integrity and social justice in any society claiming to be democratic.

Liberalism and democracy

John Stuart Mill in his essay On Liberty (Mill, 1859/1974) argued that we must be free to express ourselves and we must be tolerant of views and those expressing them, even if we find both disagreeable. His advice was not absolute though; he offered two caveats. First, with freedom comes responsibility. This means that we might do our best to be considerate about the impact of our expressed views. If we are reckless, then it might be gratuitously hurtful and so this should be weighed in the balance by any responsible speaker or writer.

That weighing up process is context-bound and so neat strictures to guide its success are hard to come by, but it does bring into play the question of intention. On the one hand there might be the regrettable mistake and the complexities of its conscious and unconscious elements; hence the discussion of the need to consider ‘whiteness’ by well-meaning white people in the contention I noted above at the trainers’ meeting. On the other hand there can be the deliberate expression of hateful or disparaging spite for others. The Nazis cast the Jews at every opportunity as being ‘vermin’ and we now know that if people are depicted as being sub-human, then that readily warrants their physical violation (Vicki et al. 2013). This large gap between an error of judgment and knowing hatred and all stops in between is what makes the definition of ‘hate speech’ so difficult. It might be defined as anything that causes offence and so the criterion of ‘hurt’ is relevant but not definitive. For those in the Abrahamic traditions any expressed contempt for God is blasphemy (and so is experienced as hurtful and might evoke reactive anger) but for the convinced atheist it is just fair comment, whether or not it is intended to offend others.

Mill’s second caveat about restraint is therefore more certain: freedom of expression may encourage or legitimises actual violence against others. He was alluding to the difference between hard and soft power. The rhyme learned in childhood that, ‘Sticks and stones may break my bones but words will never hurt me’ is flawed because Mill in his first caution conceded that words can be indeed be hurtful. The question today is whether that outcome is the necessary and sufficient condition for suppressing or punishing freedom of expression. A much stronger claim for restraint applies under his second caveat about the encouragement of violence. When violence actually occurs, his point is proven.

Well over a hundred years after Mill’s defence of freedom of expression with its caveats, we are in the midst of a paradox: newer currents of political philosophy have emphasised a form of libertarianism, which is somewhat different from his classic liberalism. Below I argue that this has culminated not in protected freedom but dogmatic intolerance. Like the well-meaning white person not reflecting on their whiteness, the well-meaning new libertarian defending diversity may end up failing in their good intentions to such a degree that an opposite or different outcome accrues.

Distinctions and dilemmas

When we come to reflect on the tension between Mill’s liberalism and more recent arguments, we can start with two distinctions. These may mingle confusingly at times in both serious academic debates and in daily puerile social media exchanges. When this blurring occurs, more heat than light might be generated, as protagonists on all sides are caught up in the common experience of swelling righteous indignation, despite holding completely opposing views. For clarity then we can note:

1 the distinction between an offensive view and the person expressing it: the challenge of ad hominem logic and;

2 the distinction between identifying offensive views and identifying effective ways of reducing or eliminating those views: the challenge of the pragmatics of the social control of offence to others.

The first of these once was very clear cut and it guided all academic discourse; we learned that we should always ‘play the ball and not the man’ (apologies for the legacy of sexism here). The adage seems to have now been abandoned, with the rise of a different ethical orientation since the ‘postmodern turn’ of the 1980s. That emerged from, and was underpinned by, the cross-currents of post-structuralism, Third Wave feminism and Queer Theory, as well as their direct political expression in our now taken for granted identity politics. This constellation reflected the ‘perspectivism’ of the idealist philosophical tradition, traceable in modern times to Nietzsche, and the rejection of a realist stance on ontology, with its focus on truths and facts.

Today the distinction between a view (offensive or otherwise) and the speaker or writer holding that view no longer exists in the minds of many. More than that, it is one’s social group membership or social position that might be taken to singularly determine the legitimacy or illegitimacy of one’s view. It is not the virtue, cogency or empirical validity of what is being expressed. If a speaker or writer is deemed to be in a state of privilege, then this may then warrant dismissing anything they are saying. The postmodern turn has installed a new version of political and ethical legitimacy, epistemological privilege, which emerges from the ‘lived experience’ of some people and not others.

For example, in the contention about transgender, a ‘cis person’ arguing that sex is not socially constructed, or that the obligation to affirm a child’s self-definition of their gender could expose them to iatrogenic risk, might be dismissed immediately as being transphobic and illegitimate, not because of the quality of their arguments and the evidence offered but because they are not themselves transgender. The neologism of ‘cis’ was only made possible because of this new postmodern logic (Sigush, 1998) and in turn this has led in academic research to a confusing conflation of sex and gender, when describing subjects or participants (Haig, 2004). ‘Cis’ is only meaningful to those who invented it (and those who are now accepting of its validity). This may cause offence to those (natal women in particular) who resent being cast as less worthy in their view about being a woman than the view of a transwoman. For now the NHS has retained an ambivalent policy, with both biological sex and self-identified gender being noted, making record keeping challenging (Dahlen, 2020; https://medium.com/@anneharperwright/sex-gender). Some forms of pathology are unambiguously sex-linked (e.g. cervical and prostate cancer) and so this is important to recognise as a material reality informing decisions about prevention, diagnosis and disease management in health services.

Turning to attempts to socially control offensive views, this has included appeals to legalism and codes of practice to ensure the prevention of hurt, not just violence, rendering Mill’s views on liberty precarious. There has been a ‘cancel culture’ in which those in the public eye expressing unpopular views are attacked and their reputation discarded. There has been direct action from protesters on our campuses (‘no platforming’). There have been acts of violence or potential violence from trans activists, such as bomb threats to women’s meetings discussing sex and gender. There have been gender critical views on social media being deemed as hate speech, warranting police investigation. There has been professional guidance issued that implies that gender critical arguments, or those respecting traditional scientific assumptions about mammalian sexual dimorphism, reflect a form of ethical deficit on the part of any psychologist holding such views.

If this point is in doubt then the reader can consult the relevant guidance issued last year on ‘gender, sexuality and relationship diversity’ (BPS, 2019). The guilt or fear from a psychologist about their views on sex and gender, which to date have been ‘off message’, according to the guidance, invite new forms of compliance or anxious restraint in speaking out about their concerns. The document focuses on the habitual obligation to affirm gender self-identification, in accordance with the ideological roots of the postmodern turn I noted above. Counter-views or scepticism from those not under its sway, whether they are philosophical realists, concerned clinicians working with children or gender critical feminists, are rendered ethically suspect and, not surprisingly, their views are absent from the document.

The effective social control of experienced offence is not easy to achieve. In this case, the core stricture in the document, is about the intersubjective subtleties of respect for and belief in what others say about themselves. But why in social interactions should we always uncritically trust the self-statements of others? For example, we might consider the person to be mistaken, lying or even deluded. These options are the bread and butter of our daily social contract with others.

Even when less ambiguous blanket moralisations have been raised to well-intentioned legal powers, their effectiveness has been in doubt. For example, the expression of Nazi ideology is proscribed in Germany. Holocaust deniers have been imprisoned and Nazi symbols are banned but the far right has not only survived with a swagger, it once again is on the rise. Thus legal measures do not eliminate prejudice and the hatred of others, even if they may have a contributory role in raising awareness about them. Even the latter is difficult to determine empirically in open social systems, with so many other processes at play.

The use of the law is not only a blunt instrument for the social control of offence, it can also lead to precarious outcomes. For example, Deborah Lipstadt accused the ultra-right wing historian, David Irving, of holocaust denial in her widely read book (Lipstadt, 1994). Irving then sued her for libel but he was unsuccessful. However, as Warburton (2009) notes, Lipstadt needed the principled support and substantial financing of her international publisher, Penguin, to rebut Irving, whereas others may have been less fortuitous in having such resources. What secured the truth about the holocaust was not the law (in this case of libel) but freedom of expression (n.b Lipstadt’s, not Irving’s). For Lipstadt, the systematic murder of six million European Jews was not just another ‘perspective’ but simply the truth (n.b. no speech marks) that deserved a clear verification. That truth had to be (re)established by the free pursuit of unfettered intellectual inquiry, including viewpoints being expressed along the way from Lipstadt.

If legal means of social control of hateful bigotry are not failsafe, then non-legalistic forms of influence may have some impact, without compromising the principle of freedom of expression. Satire and other forms of humour against bigotry actively use that principle in order to make the point. Also, the primary socialisation that encourages sensitivity about respect for all human beings and their diverse viewpoints might be altered within families and schools. All this being said, at all times freedom of expression will still be at risk. It is a fragile principle, no more so than when one party in a field of contention seeks to enforce their own particular version of expression and to suppress others.

My own view is that the BPS Guidance document I note above has been captured by that newly emergent tendency to enforce a principle of singularity of viewpoint. This trend has deliberately discarded older traditions, about the rehearsal of competing viewpoints, which eschewed ad hominem reasoning. Now to simply discuss a sceptical position about trans-affirmative ideology and more importantly to defend the right to discuss it renders the dissenter ethically inferior (which is possible but is not a given) and their view as requiring no logical or empirical rebuttal (which is absurd because it is required). Within this new norm, open-ended diversity is liberally encouraged and celebrated as being virtuous except in cases where views are disapproved of by those promoting that diversity (Benn Michaels, 2006).

These new libertarians have thereby become authoritarians at the blink of an eye. Their lack of ethical plausibility is not just that they are authoritarian wolves in libertarian sheep’s clothing but also they expose the ultimate failure of identity politics to provide us with clear guidance on the meaning of social justice. Once diversity displaces or trumps equality it becomes a zero sum game, when the experientially-derived rights of transgender people are asserted against those of natal women who are their gender critical opponents, objecting to the second class citizen connotation of the term ‘cis’. How does anyone decide which epistemological privilege is superior to the other in this stand off?

For those less familiar with academic discussions of healthcare ethics, other relevant case studies can be noted. Some topics have been actively and freely debated (e.g. abortion and the de-pathologisation of homosexuality), whereas others temporarily have taken on a taboo status. One was the consideration on medical grounds for infanticide by Giubilini and Minerva (2013). This led to some ethicists defending not the arguments made by these authors but their right to make those arguments, returning us to Mill’s axiom (Shackel, 2013).

Conclusion

I think we are now at a cross-roads. The ethical questions about transgender and healthcare may be suppressed because for now the topic has been afforded a taboo status by the new libertarians I have discussed. Alternatively, we can insist on our right to explore those questions fully and responsibly and without fear of recriminations. That would mean permitting freely expressed views that do not disparage individuals, whatever their perspective and whether they are ‘trans’ or ‘cis, but which instead attends carefully to logic and the evidence available about the topic in contention. Ultimately blanket moralisations in human affairs, whether or not they are codified in laws or ethical strictures will fail to work in practice, so we may as well concede this point and agree instead on the defence of a frank, respectful and, of most importance, non-violent exchange.

Finally, we can note that the conflation of views and those holding them has a double and limiting significance, because it restricts the topic under discussion to the personal alone. The person giving the offence and those receiving it are certainly part of the socio-ethical picture here, but they are not the whole picture. The content of their claims should also be open to respectful democratic scrutiny and debate. That can only happen if first we all understand why freedom of expression must be defended in principle, provided its caveats and their impact fully considered. We may then be moved to uphold that defence in practice, in the face of likely criticism and censorious pressures.

References

Benn Michaels, W. (2006) The Trouble with Diversity: How We Learned to Love Identity and Ignore Inequality New York: Holt.

BPS (2019) Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity Leicester: British Psychological Society.

Dahlen, S. (2020): De-sexing the medical record? An examination of sex versus gender identity in the General Medical Council’s trans healthcare ethical advice, The New Bioethics DOI: 10.1080/20502877.2020.1720429

Giubilini, A. and Minerva, F. (2013) After-birth abortion: why should the baby live? Journal of Medical Ethics 39:261–3

Haig, D. (2004) The inexorable rise of gender and the decline of sex: social change in academic titles, 1945–2001. Archives of Sexual Behavior 33:87-96.

Lipstadt, D. (1994) Denying the Holocaust: The Growing Assault on Truth and Memory Harmondsworth: Penguin

Mill, J.S. (1859) On Liberty (Published in Penguin edition, 1974) Harmondsworth: Penguin.

Vicki, G.T., Osgood, D. and Phillips, S. (2013) Dehumanization and self-reported proclivity to torture prisoners of war. Journal of Experimental Social Psychology 49, 3, 325-332.

Shackel, N. (2013) The fragility of freedom of speech. Journal of Medical Ethics 39: 5.

Sigush, V. (1998). The neosexual revolution. Archives of Sexual Behavior. 27, 4, 331-359

Warburton, N. (2009) Free Speech: A Very Short Introduction Oxford: Oxford University Press.