Category: Identity Politics

David Pilgrim

Introduction

I argue below that the concerted pressure from transgender activists within the British Psychological Society (BPS) has a particular social and historical context. Their claims emerged from a complex mixture of factors at the turn of the 20^th century. That picture included philosophical idealism from Nietzsche via Foucault, New Social Movements in the wake of black civil rights protests in the USA, changes in biomedical ambitions for a technological fix for human distress, the abandonment of redistributive forms of politics to create social justice in favour of the politics of recognition, the shift from second wave to third wave feminism with its celebration of Queer Theory, as well as the direct and indirect financing of the transgender movement. On the latter count, the gender clinic industry is a source of drug company profits (from the use of puberty blockers and cross-sex hormones). In addition, there key billionaire contributions to support transgender activism via charitable foundations (https://4thwavenow.com/2018/05/25/the-open-society-foundations-the-transgender-movement/).

I will return to these synergistic ideological and economic mechanisms below but will start with their practical outcome in recent times in the BPS. By going to and fro between these local and recent events on the one hand, and their social and historical context on the other, I hope to understand why this particular ‘culture war’ about gender has often generated more heat than light. That trend can be seen in purported scholarly organisations like the BPS and in the NHS, where advocates of ‘gender medicine’ have become impaired in their reasoning and their honesty about both evidence and ethics.

The BPS has painted itself into a corner on gender

Since the final Cass Review was published, there has been a stubborn resistance from transgender activists in the UK. Those we listed in our letter to Professor Tony Lavender, Chair of the BPS Practice Board [on this blog August 15th] reflect that push back inside the BPS, from those capturing its policy stance on the contested notion of ‘gender’. We might add others, such as Dr Rob Agnew (Chair of the BPS Psychology of Sexualities Section – see below) and Dr Adam Jowett (Chair of the BPS EDI Board and BPS Trustee). The first, a clinical psychologist, on X described the release of the Cass Review as a ‘…bad day for trans youth…’.

Pride June 29th 2024 – Time is ticking!

We still have some places for BPS members!

Email inclusion@bps.org.uk if you wanna dress loudly, wear a t-shirt with PROUD written in big colourful letters on it, and show the great city of London how many allies there are in the BPS!! pic.twitter.com/0XW9ogMdhO

— BPS- Gender, Sexuality and Relationship Diversity (@BPSSexualities) May 16, 2024

The second, an academic psychologist, provided research to the previous government, which despite its foreboding rhetoric and poor methodology, failed to offer a shred of evidence that conversion therapy for gay or transgender people existed in Britain within mainstream mental healthcare. 

The misleading elision of aversion therapy for gay men in the past and exploratory conversations with children today, is absurd (Pilgrim, 2023a). Despite this, that line of reasoning has continued in the BPS since 2018 with Igi Moon at the helm, spearheading the ‘Coalition Against Conversion Therapy’, using the Society’s resources and its administrative base to lobby government. Take this boast from the Coalition:

“Dr Igi/Lyndsey Moon, who is chair of the Coalition and British Psychological Society lead said:

‘This is a clear sign that the Government has at long last listened to LGBT individuals and national organisations who have tirelessly campaigned for change. We, along with our Coalition partners, have repeatedly called for an end to the practice of Conversion Therapy and will work with the Government to ensure it delivers on its promise.  The Coalition will fully engage with the forthcoming consultation on the best way to implement an end to this practice.’” (https://www.cosrt.org.uk/tag/coalition-against-conversion-therapy/).

Today, trans capture is not unique to the BPS, but the difference is that most other relevant organisations are now adapting to the realpolitik of a post-Cass world and are managing to contain the excesses of their activist members. Within medicine, controversially, the BMA is out of sync with that trend and so it has become newsworthy for the storm that this has created in its own membership (Feinmann, 2024). Hundreds of BMA members are now resigning in protest at trans capture in their trade union and professional body (see https://archive.ph/uRNLH and https://archive.ph/VINHO).

Agnew and Jowett, along with the activist authors of the  Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity (https://explore.bps.org.uk/content/report-guideline/bpsrep.2024.rep129b). (first issued in 2019 and modified in 2024), as well as the collusive support of the editor of The Psychologist, have now painted the BPS into a corner. Because the matter of gender has not been explored fully and properly within the whole membership containing, like civil society more widely, distinctly differing viewpoints, one, and only one, policy, theoretical and ideological position on sex and gender has been left standing. For now, the white, pink and blue flag flutters imperiously above the Leicester HQ. 

This poses a problem for the BPS and is an irritating embarrassment to any ordinary member holding a view non-compliant with transgender activist dictates. If that conclusion is in doubt about policy capture, at the time of writing the BPS has just offered the world an ‘unconference’ [sic] to explore ‘perinatal psychology’ ( https://www.bps.org.uk/event/reflections-equality-diversity-and-inclusion-perinatal-psychology-systemic-vitality-or). Although factually only women can have babies and breastfeed naturally, the BPS now endorses the neologisms of ‘birthing parents’ and ‘chest-feeders’.

I now turn back to the wider context to understand how we have arrived at this strange scenario, whereby a putative scholarly organisation has been reduced to a platform for partisan rhetoric.

The wider context: hegemony and mission creep

The word ‘hegemony’ connotes the dominant role of one viewpoint in a specific cultural setting. It has a dynamic implication, because nothing lasts in human affairs. There is a power struggle and there are winners and losers over time and place. In Western democracies we are living in a time when the dominance of gender ideology has been embedded since the 1990s. However, it is now fracturing. The word ‘gender’ appeared as an alternative to both ‘women’ (‘women’s studies’ became ‘gender studies’ in the academy) and sex, as in the highly risky use of ‘gender’, not ‘sex’, in medical records (Dahlen,2021). This was reflected in the ascendency of Queer Theory, third wave feminism and the politics of recognition, at the height of postmodernism in the 1990s (Butler, 1995; Rubin, 1992; Califia, 1995; Taylor, 1994).  

In the clinical domain, what started in the 1960s as a compassionate acceptance of adult transsexuals, who at that time were mainly men wanting to be women in physical appearance and social presentation (Benjamin, 1966), soon moved into areas of practice that provoked critical opposition for a range of reasons. Those critics, for daring to speak out, were to be dubbed ‘transphobic’ or ‘anti-trans’. This article will probably meet the same dismissal. 

Thus, the right to disagree, in the academy, the clinic or wider civil society was to be quashed at every opportunity by transgender activists. This casts doubt upon the confident cultural dominance of transgenderism. For hegemony to be true to form it needs to acquire a stable matter-of-fact consensus view without coercion; it is a form of soft, not hard, power. That is a defining feature of hegemony: it relies on credible language not on brute force. Thus, transgender activists have not enjoyed that taken-for-granted consensus, as they have had to face opposition from unimpressed and unpersuaded critics. In response, these critics have been personally disparaged, threatened and harassed.

Mission creep in the clinic and the invention of cis bigotry

Under the transgender umbrella it soon became evident that the male to female (MtF) transsexual group contained at times a version of extended fetishism or autogynephilia (Blanchard, 2005). These male cross-dressers were sexually aroused by acting like women and surrounding themselves intimately with natal women. The latter were to be dubbed, patronisingly by transgender activists, as ‘cis women’ raising a logical conundrum. If a transwoman was now declared with total certainty to be a woman, then why was a natal women called something else (i.e., a ‘cis woman’ and not just plainly a ‘woman’)? One answer, which the anti-realist postmodernists found unacceptable, was that women have XX chromosomes and men have XY chromosomes. Postmodern framings ignored facts and instead preferred unending fictions. Another answer was the hierarchy of victimhood created by the logic of identity politics (transwomen were deemed to be more oppressed than cis women).

To say that a woman is an adult human female (a dictionary definition) was then rendered as a form of hate speech by the guardians of identity politics and, at times, this even triggered police involvement. However, a man has never had a baby and never will. The ‘unconference’ noted above will not change that reality. A woman will never die of prostate cancer. A man in a dress demanding to be called ‘she’ is still a man (Greer, 1999). Indeed, for gender re-assignment to mean anything plausibly, it must manipulate a healthy male body to look like a female one or vice versa. This generated another conundrum but this time about social norms. Despite norm-busting claims of celebrating gender diversity, what used to be called a ‘sex change’ has, by and large, hormonally and surgically generated very conservative and caricatured stereotypes of appearance. 

A legacy of these linguistic gymnastics has been the emergence of a ‘woman with a penis’ and even a ‘trans lesbian’, defying the logical and historical agreement that lesbians are females sexually attracted to other females. Old-fashioned common-sense realists (i.e. most ordinary citizens remembering their school biology lessons) were thrown into confusion with all of this postmodernist word play. Wrong footed, unenlightened ‘cis’ social actors were to become bigots for ‘misgendering’ a man in a dress or ‘dead naming’ a person they had known for years as male or female, who has now opted to self-identify as a member of the opposite sex. Just as the victimhood of being transgender was guaranteed, then so too were the inevitable moral failings of untutored ‘cis’ people, with oppressive ‘cis women’ being especially suspect. ‘Black face’ causes understandable offence but ‘woman face’ is supposedly now a symbol of human progress and tolerance (cf. Tuvel, 2017).

Depicting or speaking about something as real is not necessarily the same thing as it being real (technically this is called an ‘epistemic fallacy’). We can recognise a drawing of a unicorn, but unicorns do not exist. People may lie about themselves or be deluded. The recognition of self-statements by others is a negotiation not an enforced outcome on tramlines, a point those defending the ethics of recognition note (Honneth, 1995). But according to gender ideology, insinuated now in the official BPS policy position, if a boy says he is a girl, then he is a girl. Accordingly, ontological realism with its principle of limits was discounted by Queer Theory underpinning BPS policy. Instead, it favoured unendingly elastic epistemological relativism (cf. Henry, 1950). A philosophical realist insists that an adult person with XY chromosomes is a man. By contrast, a philosophical idealist claims that they can be a woman if they say they are. One of them is wrong. 

The principle of limits first discussed by the philosopher and psychologist C.D. Broad in the early 20^th century was defended later by second wave feminists (Broad, 1949). For example, Oakley (1972) accepted that gender expression was socially negotiated over time and place, but she held on firmly to biological reality and the immutability of sex. However, within twenty years, the third wave went much further, rendering the material reality of the natural world irrelevant. Talk, and talk about talk, now became all important, in the hurry towards the promised land of radical social constructivism. Sex as a biological fact was old hat and a likely source of hate speech. 

This switching of priorities in social science, bizarrely later to be adopted by some who should have known better in the natural sciences, with their authority predicated on versions of philosophical realism, conflated ontology and epistemology. Now ‘everything was socially constructed’, a view reinforced by the growth of postmodern psychology in the academy.  In the clinic, it led to GIDS, with its preference for children being ‘assigned’ a sex at birth, as if it were an arbitrary opinion. 

That scorned decision-making from people offering their commonsense observations about a baby boy or girl, must now be trumped by the absolute life-long certainty of self-identification. This must not be gainsaid by anyone, including psychologists. ‘Trans children’, even before they went to school, would signal with certainty that they had been ‘born in the wrong body’, and adults must accept that judgment credulously. 

However, a ‘non-binary’ claim within the transgender panoply created another conundrum and contradiction: if we are all born with a life-long fixed ‘gender identity’, then how can it change from day to day or hour to hour in some, but not all, of us? If our gender identity is like a permanent inborn soul, then how come that for some of us it keeps slipping and sliding away? The mystique of ‘having’ a gender is mysterious indeed and these are serious theological and psychological questions about souls or selves. Ultimately how do we understand personhood? (See Smith (2010) for a critical realist take on that big question.) 

The impact of gender ideology in the BPS

The Guidelines issued by the BPS on gender in 2019 and revised this year reflect this wider context of an ideology which has been imposed on children by adults. Children did not invent gender ideology. However, their views have been shaped by it en masse, encouraged by virtue signalling policy makers in health and education and online social contagion. In truth, ‘trans children’ do not reflect a suddenly recognised aspect of ontology. After all, where were they all 30 years ago?  Instead, in the wake of Queer Theory they were invented by some adults on an ideological mission and nameable activists in the BPS and other organisations reflect that scheming and earnest missionary activity (Moore and Brunskell-Evans, 2019).

Diagnostic overshadowing, revealed in the Cass Review, became evident and was reflected in Agnew’s simplistic view that there is a single reductive category of ‘trans youth’. According to him and the discredited GIDS leadership, we need look no further than self-identification and a moral obligation to affirm the self-statements of gender questioning children. What this insistence closed off was the evidence that the GIDS waiting list contained distressed children who were depressed, anxious, survivors of abuse, might have marked autistic features or had come from a family context of parental homophobia (Barnes, 2023). Psychologists led that now discredited biomedical project and the BPS backed it to the hilt; recent events suggest that it does not intend to abandon that position.

Whilst affirmation superficially signals patient-centredness, it is the very opposite. Diagnostic overshadowing and the reification of ‘trans children’ diverts clinicians from a standard obligation to offer biographically unique formulations. Why were these young people being treated in a different way to any other clinical presentation? Also why were psychologists leading the charge for biomedical interventionism, when that reactionary and bio-reductionist role had been left previously to biological psychiatrists, with their ‘great and desperate cures’ which always focused on the body, rather than biographical uniqueness?

The answer to these questions lay in mission creep from the Benjamin regime, with its focus on adult transsexuals in the 1960s, to children in the 1990s. Once activists made that daring shift it would inevitably be provocative and so it was the case. The psychology leadership at GIDS adopted uncritically that mission creep, modelled in the Netherlands on a small and highly selected sample of children and ‘rolled it out’ in the NHS, as a full-blown service philosophy (Biggs, 2023). Worse than that, a study looking at outcomes failed to demonstrate the clinical effectiveness of an affirmation model in the UK – that bad news for transgender ideologues was actively suppressed for many years (Butler et al, 2022). This obfuscation only came to light because of a freedom of information request (Biggs, 2019). That evasion of the truth from those committed to expanding ‘gender medicine’ in the NHS was confirmed by the unwillingness of managers of adult gender clinics to release follow up data about the outcomes for transgender patients during the Cass Review (https://www.theguardian.com/society/2024/apr/10/adult-transgender-clinics-in-england-face-inquiry-into-patient-care.)

If affirmation is so worthy and the outcomes are so good, then why is evidence about them being cynically suppressed by those promoting and managing ‘gender medicine’? The answer is that ideology has been more important than evidence for those defending its expansion. A summary of this challenge for transactivists about evidence is offered here in Feinmann (op.cit.):

At the heart of the dispute is a series of systematic reviews that rigorously examined the robustness of practice and guidelines underpinning the care of young people with gender dysphoria, in particular influential guidelines by the World Professional Association for Transgender Health (WPATH). A total of seven papers by the York University systematic review group were published in the Archives of Disease in Childhood in April. The papers found that the evidence on the use of puberty blockers and hormones in young people with gender related distress was “wholly inadequate, making it impossible to gauge their effectiveness or their effects on mental and physical health.” Nick Brown, editor of the Archives of Diseases in Childhood, told The BMJ, “A common thread in the review findings was the breathtaking dearth of quality evidence to guide care in this vulnerable group of young people.”.

This need to suppress or evade inconvenient truths, along with the iatrogenic risk that all ‘trans youth’ are exposed to by an affirmation model (Jorgensen, 2023), has culminated in a crisis for transgender hegemony in clinical contexts. It is now breaking down, as the Royal College of Psychiatrists, the Royal College of General Practitioners, the Academy of Medical Colleges, the Association of Clinical Psychologists and the Pharmaceutical Society have now all backed the Cass Review and pulled back from previous degrees of trans capture. This is true also of the incoming Secretary of State for Health who has continued the ban on puberty blockers. That new emerging consensus is clearly leaving the BPS out in the cold in policy making.

The paradox of identity politics writ large in the BPS

The weak governance at the top of the BPS, alongside its largely passive and acquiescent membership have, in recent years, created an open goal for transgender activists. Igi Moon coopting the BPS administration for the wild goose chase of purging the land of conversion therapy (i.e. having routine therapeutic explorations) has been par for the course. So too with Christina Richards, a co-author of the WPATH ‘standards of care’, who had free reign to dominate the BPS Guidelines group. This counselling psychologist left being non-directive at the consulting room door and told us that there was to be no debate and that all identities have equal value. However, on pragmatic grounds Richards modified the ‘Kink’ and ‘Slut’ strictures from the 2019, when the document was revised in 2024. 

The Sexualities Section of the BPS has now become obsessed by transgender rights, mirroring the reason, in wider British society, why the LGB Alliance found it necessary to split away from Stonewall. Those leaving in protest emphasised that in their own histories they might have been shepherded by adults into a biomedical pathway. The BPS Lesbian and Gay Section formed in 1998 initially made only a passing mention of transgenderism (https://www.bps.org.uk/member-networks/psychology-sexualities-section). Today it is called the “Psychology of Sexualities Section”. But, as a sign of how times have changed in the shifting self-righteous world of identity politics it includes the following commitments:

“...developing non-heterosexist and gender-inclusive forms of research, theory and clinical practice in British psychology...”

and

“…taking a broadly affirmative approach towards sexualities, including transgressive sexualities, while also strongly condemning those which are coercive…“

This legitimises the title of the controversial Guidelines, which we have critiqued and complained about on this blog. 

Maybe the gains of homosexual rights, now largely won in formal legal terms in Western liberal democracies, have created the space for a new raison d’etre for both Stonewall and trans captured organisations like the BPS. This focuses on reifying trans identities and appealing to a sense of injustice about a new form of victimhood. The latter seemingly entails the ‘human right’ of existentially confused children to have access to an iatrogenic pathway of hormones and surgical mutilation on demand, being cruelly denied to them by Cass and her supporters.  Accordingly, Rob Agnew the Chair of the newly named Section in a forlorn response on X to the release of the Cass Review said this:

Bad news for our trans youth this morning, but let’s be honest, we knew it was coming. In 2021/22 I reviewed the WPATH guidelines for the General Medical Council for a fitness to practice lawsuit in trans youth healthcare provision. The conclusions and the consequences of Cass are out of step with better quality, more comprehensive reviews, and out of step with approaches in other countries. So over the coming days I, and many other clinicians, will be having a look at the final Cass Review in detail and trying to answer the question ‘Why was Cass unable to find the research needed to provide trans youth with vital medical approaches that other countries found?‘.

Maybe Cass was trying to go beyond the selective approach to evidence preferred by the activist-driven WPATH (see later). Maybe Agnew might indeed ‘look’, but he would find nothing of value to him in the evidence available, unless it is to be approached with a highly biased selective attention. 

All this indignant rhetoric from Agnew reflects a paradox of identity politics as both a libertarian and authoritarian form of adventurism. On the one hand, the politics of recognition seem to invite tolerance and an unending plurality of perspectives. On the other hand, those same politics enforce very strict rules of expression. Its leaders and guardians, in no uncertain terms, tell us what must be spoken and proscribe what must not. 

Second wave feminists, scientific realists and some religious groups have chosen to speak out against this dogma and denial of debate from their particular gender critical perspective, Consequently, they have been vilified and hounded by the gender thought police. Some have lost their jobs. Some had death and rape threats. Some were cancelled on university campuses. All were cast as bigots; the term ‘TERF’, and the recurrent online invitation to kill one, was largely limited to women. A recurrent problem for the logic of identity politics is that special pleading for one social group often might necessitate hostility to another. For example, in the case of transgenderism there is recurring misogyny and a contempt for lesbians (the real ones not the fictional ones).

The ‘no debate’ campaign was clear to see, as freedom of expression in general, and academic freedom in particular, were restricted in ways previously seen only in Nazi Germany and Stalinist Russia. Whether authoritarian control is imposed by the Party or by identity politics from the cyber-mob, the right to speak out freely and disagree with one another is suppressed (cf. Nossel, 2020). But without disagreement there can be no progress about either knowledge production or deliberative democracy (Mercier and Sperber, 2021; von Heiseler, 2020). 

This wider process of suppressed debate has infected the BPS, with consequences for a discipline already theoretically and methodologically contested.  Psychology is at the cusp of social and natural science, and unsure whether to celebrate or reject its older pretensions to be an experimental science guided by statistical precision. It starts in artificially controlled closed systems, like the psychology experiment, or conclusions from spreadsheets of correlations, but then claims authority in the fluxing situated complexity of everyday life (all human systems are open systems). It gets methodologically confused (or sometimes pre-emptively arrogant) about that challenge. Epistemological pluralism and contestation have thus been inevitable. Understandably we are now used to the collective noun for psychologists being a ‘disagreement’. 

Transgender capture has now entered that contested space with its favoured radical social constructivism. It is part of the ‘broad church’ depiction from the Society’s apparatchiks. In relation to gender, that broad church now seems to have been taken over by a cult, or at least a group of socially connected activists, using the manipulative tactics of entryism. In our letter to Tony Lavender, we pointedly named these people. They were joined for a while by others working in gender clinics attempting to extend prescribing rights to psychologists. This had puberty blockers and hormones in their fixed sights. That particular putsch from the trans activists in 2019 failed but it was a close call.

Strictly this network has been ‘cultish’ rather than a cult, as it lacks a defined charismatic leader. Also, the underpinning history of transgender activism has been complex as I noted in the introduction and so the singular ‘cult thesis’ is reductive.  Nonetheless, it makes sense that some gender critics use the term ‘cult’, given the mixture of dogmatism and messianic fervour that characterises the transgender movement for now. The parents of gender questioning children understandably do at times report that they have lost them to a cult.  

Dogmatism and rigidity of thought are well explored by cognitive psychologists. We can reason in quickly needed binaries to ward off risk or spot a friend or foe. As we mature, we also learn cautious reflection to generate situated wisdom (phronesis) and tentative understandings about our inner and outer worlds (Dutton, 2020; Kahneman, 2011). What identity politics have done, reinforced by rapid online digital decisions, is to encourage a fixation in a simplistic toddler mode of thinking, or what previously psychoanalysts called ‘splitting’. Black and white, goodies and baddies, you are either for or against us, ingroup good, outgroup bad, ‘like’/’dislike’ etc. Mature grown-ups show epistemic humility, nuanced reflection and context specific moral reasoning, toddlers do not (Neiman, 2021). The activists capturing the BPS (and the BMA-see below) are like very clever toddlers getting their own way, when they can. 

The point here is that such antics are ripe for psychological understanding, rather than passive and unthinking compliance. It was that compliance, which the transgender activists, who were writing the ‘Guidelines’, were expecting from a dutiful membership. Collusively, the Professional Affairs Board and the Society’s ‘Director of Knowledge and Insight’ [sic] signed them off with unreflective enthusiasm in the same year that the final Cass Review was published. This may be a decision that they are already regretting.

The unlikely bedfellows of the BPS and the BMA

Post-Cass, the transgender activists are not going down without a fight in Britain. Ex-GIDS staff are forming alliances with cooperative medical prescribers to set up new services and keep the old spirit alive in the private sector. The ban on puberty blockers has now made their enthusiasm for the old regime precarious in practice, though workarounds will be tested out and promiscuous prescribers may try their luck again in the court of the GMC. 

Within organisations they are also offering a rearguard action to discredit Cass. Two stand-out examples are the BMA and the BPS, which are bucking the trend of consensus building about implementing her Review (Abassi, 2024; McCartney, 2024). Apart from their tactics of entryism to achieve short term goals, transgender activists are now playing catch up about evidence and accordingly they are in a bind. The reason for the catch up is that evidence has never really been their strong suit. Who needs evidence when the truth about gender identity is taken as a given? The BMA, at risk of losing much of their membership, have announced that they will review the Cass Review in the next few months, a decision flowing from the capture of the BMA council by a handful of transgender activists. Watch that space, when selected papers are cobbled together.  

A shared rhetoric of justification of both psychology and medicine is that they are evidence based. However, this poses a problem for transgender activists. Privately they know that there is still no strong evidence that biomedical affirmative care is either effective or safe. In the case of paediatric transition, this immediately becomes a child protection issue. We have regularly made this point to BPS leaders, and they have regularly ignored us. The Guidelines they have endorsed totally fail to properly consider either empirical evidence in the round, or sound ethical cautions about child protection.

The metaphysical chasm revealed by trans capture

Notwithstanding the antics of activists in the BMA or the BPS when capturing the policy machinery, there is an irrefutable deep metaphysical chasm between gender ideology and its critics. It is not only that the former conflates ontology and epistemology whereas the latter separate them. It is also about a fundamental difference of viewpoint about ethics flowing from that gap. Transgender entryism in the two organizations genuinely brings with it the belief that there is one, and only one, valid ethical framework, which I deal with below. They are so certain on a priori grounds that the unending recognition of the self-statements of any individual, adult or child, must be respected that the consequences of that policy are ignored. 

In line with that moral certainty, which is foundational to identity politics, they take their eye off the ball about evidence.  Alternatively, they suppress inconvenient findings as I noted above and only deal with it as a post hoc rearguard action. In the latter, two features are evident. First, menacingly they attack their opponents, ad hominem style. Second, they assert that their own selective version of evidence is superior by dent of professional expertise or being experts by experience. 

On the first count, Hilary Cass was disparaged for being ‘cis and het’. The degree of vilification she experienced warranted advice from the police that she should not travel on public transport. An immediate response in the journal, which is the quasi-academic outlet for WPATH, has a self-evident title making this point (Horton, 2024). 

On the second count, WPATH now has a major credibility problem when it tries to defend its empiricist credibility, given that it is activist driven. The argument that being expert in a field offers an immediate authoritative position is as flawed in ‘gender medicine’, as in any other branch. However, the activist-with-an-agenda component amplifies that tendency. Those with a vested interest in the field, whether as practitioners or ideologues, raise immediate and unique doubts about their plausibility (Choudry et al 2002). 

Insider lobbyists use their expertise as a claim to legitimacy, but sceptical outsiders argue the very reverse. In the case of WPATH the creation of their own dedicated journal outlet (the International Journal of Transgender Health) guarantees a reliable noticeboard for its aims, while pretending to offer academic impartiality. This has been mirrored in the use of The Psychologist by activists in the BPS. The problem for both WPATH and the BPS is twofold.  Evidence rarely supports their cause, despite their claim to the contrary, and the ethics of recognition are not the only game town, a cue for the next and final section. If the BPS leadership insists on blindly taking its policy lead from WPATH, then it is now entering a particularly sinister phase of collusion.

WPATH, castration and the ethics of recognition

WPATH is the international (though US-dominated) home for transgender activists and those clinicians who have built their careers within ‘gender medicine’. To say the least, this is rather grandiose posturing, given that there is no genuine international consensus on gender medicine. Its worth in principle is doubted by many and those supporting it have no confident agreement on evidence-based and safe practice. 

Unsurprisingly, a core aim of WPATH is to encourage policy makers to expand the availability of ‘gender medicine’, emphasising grounds of equitable access to all transgender people (a capacious group now). In our letter to the BPS leaders, pointing up this enmeshment and expansionist aspiration, we noted that a key figure has been Christina Richards who wrote a section for the eighth edition of the ‘Standards of Care’ issued by WPATH (Coleman et al 2022; WPATH, 2024). Thus, Richards is both a dominant activist within the BPS and a key UK representative on the international scene. Note that two other members of the writing group producing the ‘Guidelines’ in 2024 (Igi Moon and Alex Penny Lenihan) were also WPATH members. This was a triple guarantee that the BPS Guidelines would be WPATH compliant.

The expansionist aim of WPATH is predicated on a plausible ethical claim, aligned with the politics of recognition. The latter emerged in the wake of the American civil rights movement about equal citizenship. It shifted the matter of social justice away from redistribution (a structural focus) to that of personal recognition alone (a post-structural focus) (Fraser, 1999). A consequence of this shift has been that those traditional concerns about inequalities, created by the real material forces of biology and economics, have been replaced in importance by policies of obligated recognition. This is why the ethics of recognition now can only be understood by making sense of the strengths and weaknesses of the politics of recognition or identity politics (Pilgrim, 2023b). 

Transgender activism is one variant of New Social Movements in civil society, expanding since the 1970s and commonplace in the EDI policies of organisations. In truth the ‘E’ has virtually disappeared because it came from an old, and now largely ignored, social movement rooted in the conflict between labour and capital in the workplace (Ben-Michaels, 2006). Recent events suggest that the transgender movement is now faltering because it is dogmatic about fictions but casual about facts, as well as being menacingly authoritarian. Accordingly, it is at odds with the rights of women to be left to their privacy and dignity and of children to grow up naturally without interference. 

Whilst the ethics of recognition are important, and any fair-minded person can reflect on their merits, they are not the only game in town (Häyry, 2009). The Cass Review reflected a different, and equally legitimate, ethical stance based on consequentialist and deontological arguments about the priority of a duty of care to do no harm (the principle of non-maleficence). If gender medicine is not provenly safe, then we need to hit the pause button. This is basically the case from Cass. Thus, the strength of her analysis was its focus on patient protection in general and of child patients in particular, whereas the strength of the transgender position was in its prioritisation of respect and recognition. However, the WPATH guidelines have now entered a low point of credibility in their hegemonic struggle against those like Cass and her legions of supporters. 

The WPATH position has been generated only by activists and gender clinic career professionals. The have no good faith interest in a fully balanced, evidence-based, justification for the very existence of gender medicine. Quite the opposite: it would be like turkeys voting for Christmas.  According to WPATH, gender medicine should be expanded simply because it is inherently a ‘good thing’. And why is it a good thing? Because WPATH and their local missionaries capturing the policy process say so. 

However, their own internal discussions in revelations about the ‘WPATH files’ have demonstrated that its leaders have known for a while that the findings of Cass were substantially correct (https://sex-matters.org/posts/updates/wpath-the-truth-about-gender-affirming-healthcare/). This leaked internal discussion from the WPATH leaders shows that they know full well that major biomedical interventions can be iatrogenic (what a surprise) and that it is impossible for children to give informed consent. The consent is not informed by evidence of efficacy and safety and the capacity to consent is impaired by dint of cognitive immaturity. Despite this indisputable scenario, the most recent version of the WPATH ‘Standards of Care’ now recommends no lower age limits on biomedical transition (except for genital surgery on girls).

Moreover, apart from hiding that damning discussion from public scrutiny (as with the evasions about evidence in the UK I noted earlier) the other step taken in the new ‘Standards of Care’ issued by WPATH has included for the first time ‘eunuch identities’ (WPATH, 2024). This is what the relevant paragraph says:

Eunuchs and eunuch-identified people have existed for millennia. Some eunuchs or eunuch-identified people experience dysphoria about their genitalia and desire that their reproductive organs be surgically removed or rendered non-functional. Due to social stigma and perhaps a lack of previous medical access and information, some eunuchs or eunuch-identified people may attempt to do this by themselves or with people who are not sufficiently trained, often leading to unfortunate outcomes. One of the consistent priorities throughout the SOC-8 is to encourage and highlight the importance of individualized care for transgender and gender diverse people in lieu of one-size-fits-all health care models. This is as true for eunuchs or eunuch-identified people as for other people who identify as transgender or gender diverse. (https://www.wpath.org/media/cms/Documents/SOC%20v8/SOC-8%20FAQs%20-%20WEBSITE2.pdf)

This position from WPATH was fed by those in the Eunuch Archives (https://reduxx.info/top-trans-medical-association-collaborated-with-castration-child-abuse-fetishists/).  The Archives have been generated by men with castration fantasies, many of which include ones about castrating young boys. The link between WPATH and the Eunuch Archives has had a direct impact on the NHS. In Scotland advice from that link was uploaded to official guidance (now removed) (https://archive.ph/rEqzo).

This permeable discursive boundary between pornified child abuse and the WPATH guidelines for ‘gender medicine’ may be shocking to any newcomer to the strange world of gender politics. However, the eunuch question is being dealt with consistently by WPATH, within the broad rationale of both the politics and ethics of recognition. That ‘all identities are of equal value approach’ is germane to the BPS guidelines and is traceable to the politics of recognition and to the sexual libertarianism of Queer Theorists like Rubin and Califia (ibid). 

Contra to the realist’s principle of limits, the collective imagination of gender ideologues has no limits. If an identity (any identity) can be stated, then it must be respected, no question. The problem for the ethics of recognition is that some self-identified groups are offensive to others and for good reason. Paedophiles, incels and necrophiliacs can and do claim a worthy personal and group identity. Will they be next on the WPATH ‘good to go’ list? If they are not, then the WPATH leaders will need to reflect on and articulate ethical criteria other than recognition per se; the ethics of recognition are a one trick pony.  

Whilst any psychologist can read and reflect on the merits of Queer Theory or the ethics of recognition, they may then be found lacking for legitimate reasons. Criticisms should then be listened to respectfully and not shouted down. Why should the BPS membership slavishly adhere to the directives of a manipulative group of transgender activists? Their ‘Guidelines’, are little more than ‘thou shalt’ type propaganda. Why should those of us pointing out that high handed bossiness be silenced? How is that process of silencing consistent with the BPS claiming to be a scholarly society and a ‘membership organisation’? The Society seems to have now sacrificed the principle of academic freedom at the altar of identity politics and it is dancing to the tune of WPATH. 

A problem now for WPATH is that elective castration is deemed to be a matter of serious criminality, when sought and found in non-clinical settings. However, we are then expected, quite seriously, to accept that the same procedures are positively ethical and wholesome, when carried out in clinical settings. Compare the self-righteous defence of elective castration from WPATH above, with how the British courts dealt, in April 2024, with Marius Gustavson (https://www.bbc.co.uk/news/uk-england-london-68977469). He was given a 22-year prison sentence for heading up a ‘lucrative business’ in human castration and variants of BDSM, including electrocution. The sentencing judge described the perpetrator’s conduct as “gruesome and grisly” and “extremely dangerous”.  He deduced a combined motivation for the crimes of financial gain and sexual gratification. Defence lawyers suggested that Gustavson was offering a service to ‘put a smile on people’s faces’ of those suffering, like him, from ‘body integrity dysphoria’. That claim for recognition-based beneficence, from this non-clinical ‘eunuch maker’, is broadly the same as the ethical rationale from WPATH of reducing dysphoria. Any fair-minded reader would struggle to spot the difference between them. 

The claim from WPATH is that adverse outcomes would be minimised (but note not disappear) in clinical settings, but why castrate anyone in principle, ever? How exactly is mutilating a healthy body a life affirming activity? Going back to Kant, this has been a serious challenge for medical ethicists. Where is the longitudinal evidence that elective castration leads to long term mental health gain, rather than it being an extreme masochistic act, surrounded by short term sexual excitement at a no-turning-back existential moment? Why were WPATH content and enthusiastic to rely on the advice of the sinister paraphiliacs in the Eunuch Archives? The answer to these questions is that the ethics of recognition have now been offered as a credible alternative to both the deontological and consequentialist traditions. 

WPATH is now clearly pitched against Cass and a wide range of her supportive gender critics. We all can decide which side we are on or if we are ambivalent. We can reflect carefully on a serious healthcare and education policy matter. WPATH and the BPS want that reflection to cease as they already know the answer: gender medicine must expand and expand, as an exercise in ensured human betterment. Richards told us confidently, the ‘debate is shut’; but some of us disagree and for good evidential and ethical reasons. 

Squaring the circle about the ethics of castration (sordid and criminal or wholesome and beneficent?) may reveal yet another crack in the credibility of the advice of WPATH. In case the obvious needs stating, it is not only those seeking elective castration, discussed with relish in the Eunuch Archives and now in WPATH, who point up this ethical minefield. It is also within the now routinised world of MtF transitioning, or what used to be called a ‘sex change’. The latter is euphemised as ‘bottom’ surgery, which is the removal of the penis and testicles and the construction of a neovagina, with the serious iatrogenic risks this creates (Negenborn, et al., 2017). In the interests of personal recognition, non-medical ‘cutters’ and ‘eunuch makers’, often criminalised, operate just like the prestigious surgeons working in gender clinics. Both destroy healthy genitals, and both put physical health at risk, with no guarantee of mental health gain, case by case.

A complement of this grisly scenario is that healthy young females (usually destined if left alone to become lesbians) are having double mastectomies at the hands of qualified surgeons in pursuit of authentic selfhood. They do not send tissue for histopathological analysis (as would happen in routinely in cancer surgery) because they know full well that the breasts removed are perfectly healthy (cf. Hostiuc et al.,2022). It is little surprising then that the American Society of Plastic Surgeons has just announced that such surgery is unethical, though the litigious culture of the USA may have prompted that judgment (https://www.city-journal.org/article/a-consensus-no-longer).   

This is yet another sign that the hegemony of transgender activism, embodied in the work of WPATH is now breaking down. A further sign is that NHS England no longer uses the WPATH guidelines as its benchmark of good practice. Any resistance to Cass from the BPS or the BMA will put evidence firmly in the spotlight, which has not been the strongest card that transgender activists have played to date. The hegemonic power balance is shifting away from transgender activism at the very point that the BPS has opted to offer its full and unguarded support.

Conclusion

I have placed the trans captured position of the BPS in its social and historical context. The Society has been one international outlet for WPATH triumphalism. At times our local leaders have reciprocated by being international contributors. Activists like Richards have embodied that linkage and other members of the team imposing the Guidelines on the BPS membership were WPATH members. Its database of members is online for all to see and the few cases of UK representatives stand out for their activism in the BPS and their careers in NHS gender clinics and increasingly privatised care post-Cass.  

The BPS now finds itself in an isolated position by defending a pre-Cass position in a post-Cass world. The ACP-UK has a key seat at the table in the latter context of policy development, whereas the BPS has now lost that status. It remains captured by gender ideologues, who have recently enjoyed their salad days in the BPS and other organisations. However, those activists are now losing their grip on cultural dominance. Their lonely isolation may be reduced by the live links they have retained with WPATH and the energising struggle to win their battle over ‘conversion therapy’. In their turn, gender critics will point out that the real conversion therapy is to take a healthy young body and render it sterile and mutilated, with the goal of creating a semblance of the opposite sex, but with no guarantee of mental health gain from case to case. 

The exposure of doubts from lead activists in the leaked ‘WPATH files’, and the Association’s new-found cooperation with the sinister Eunuch Archives have exposed it for what it is, i.e., obsessed by personal recognition at all costs. It seems to be unconcerned with public safety or child protection. The UKCP have now pulled out of the campaign against conversion therapy, while BPS activists remain at its centre. That twin goal from activists, of turning conversations into conversion and defending the discredited GIDS regime, undermines the case from the BPS to be taken seriously today.

On this blog, the more we shine a light on the policy antics of the Society the more it is obvious that it remains a dysfunctional organisation, with little or no claim to public confidence because it has no credible governance. Its penchant for policy developments which are unrepresentative of its broad membership and a threat to public safety is particularly noteworthy and reckless. Allowing the cultish antics of transgender activists to have so much sway is typical of an organisation that has seriously lost its way. 

References

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Barnes, H. (2023) Time to think: The inside story of the collapse of the Tavistock’s Gender Service for Children Swift Press

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Negenborn, V. L., van der Sluis, W. B., Meijerink, W. J. H. J., and Bouman, M-B. (2017). Lethal necrotizing cellulitis caused by ESBL-producing E. coli after laparoscopic intestinal vaginoplasty. Journal of Pediatric and Adolescent Gynecology, 30, e19–e21.

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Pilgrim, D. (2023b) Identity politics: Where did it all go wrong? Oxford: Phoenix.

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WPATH (2024) Standards of Care (version 8) https://www.wpath.org/soc8

Pat Harvey posts….

Transgender ideologues and their activism have colonised and sequestered, through social media and institutional capture, the various mental health vulnerabilities of children and young people and directed them into a narrow medicalised funnel which has pushed them towards physical treatments which are often irrevocable and cause life-long bodily dysfunction. Mental health professionals have either adopted an “allyship” to this ideology, unfortunately subsuming the diversity of individual ages, people’s lives and difficulties into one supposed oppressed “trans community”, or they have mostly been bullied into silence and avoidance. The British Psychological Society (BPS) has resolutely taken the first position.

In what is an extraordinary paradox, psychologists fired by “allyship” and underwritten by the BPS, have led services which eschew psychological formulation in favour of prioritising affirmative acceptance of the diverse reasons for a person’s rejection of their biological sex status and push them unreflectively towards transitioning drug treatments and surgery. 

Actual access to the dominant specialised gender services which promulgate the hope that “transition will alleviate your distress” has been so limited that children and families languish in waiting throughout their adolescence for access to the favoured transition pathway mode. Local services, stretched to their limits across the board, have been only too relieved to offload such clients. At the time of writing, many practitioner psychologists will openly admit they do not consider working with clients and families where gender is an issue. They feel the risk of approbation has become too evident in an intimidatory climate especially when they cannot resort to any reasonable form of support from their professional body for anything other than the affirmation and medicalised approach. The BPS produced Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity  in 2019. These are unlike any normal professional guidelines from that body, or indeed others. They unequivocally assert a quasi-moral requirement to adopt a particular approach – affirmation – as the default position. 

These guidelines are currently subject to a “midterm review” which has been going on for some time. It has to be assumed, as this information is not available to members, that the review is taking place under the purview of the trans rights activist chair – Christina Richards. This was an inappropriately partisan choice to lead the production of the 2019 document. In the review Richards will presumably be supported by three of the original members of the working party: two of the original 2019 working party members had requested their names be removed part way into the life of that document. It will be a source of great surprise, therefore, if the revised document is in any significant way different from the original, or if it changes the default affirmation edict, acknowledges controversy, removes the discredited WPATH reference and offers an any more balanced up-to-date reference base. 

The 2019 document was amended, following my complaint, to indicate it should only be read as applying to adults and young people (aged 18 and over). This has meant that the British Psychological Society has conspicuously failed – during the scandal-ridden rise and fall of a psychology-led national Gender Identity Disorder Service and the creation of the Cass Review – to provide any authoritative guidance whatsoever on a psychological approach to this area of practice with children and young persons. This. too, is a scandal. We hear informally that there may be BPS efforts to address this deficit, but, given the tardiness and lack of independence of the current BPS regime from trans-activist capture, it will be surprising if anything at all surfaces before the BPS renders itself irrelevant to the changing situation around psychological understandings of gender-related distress.

Meanwhile Dr Anna Hutchinson, a clinical psychologist and former employee who blew the whistle on the discredited Tavistock child gender service and contributed to Time to Think by Hannah Barnes, has called for therapists to return to “ordinary best practice” when treating children with gender confusion. She stated that

….therapists now needed to return to the non-medicalised methods they previously used to help the type of young people who sought help from GIDS. Speaking at the First Do No Harm conference, she said: “In ordinary practice we know lots about what children can understand at certain ages of development. We know the last 20 years there’s been a growth of understanding of the sensitive development that goes on in the adolescent brain.

Clinicians know how to work with complicated presentations to develop sets of hypotheses of how to best help distressed children that attend to all parts of their lives. That’s ordinary best practice. We know how to safeguard children, put them at the heart of interventions and how to protect them from possible harms.”

Below is the full text of James Esses’s blog post which we are publishing with his permission. The link to the full post is here which will allow you to view the videos and see comments.

In our view this shows the full extent of the misgovernance, lack of proper oversight and organisational capture within the BPS. This is no way for a learned society to act. Surely its job is to be the place where open, honest, evidence-based discussions are encouraged and supported – it’s not part of its job to be an “ally”. Ultimately, the BPS is failing the public, particularly in relation to child safeguarding. The BPS is increasingly dysfunctional as is shown in our recently published book.

Lunatics Running The Asylum: Going Undercover at the British Psychological Society

The British Psychological Society (BPS) was founded in 1901 and currently acts as the representative body for well over 60,000 psychologists.

I first became concerned with ideological capture in the BPS when I saw that they were actively promoting Mermaids to vulnerable patients (this is the same Mermaids under investigation by the Charity Commission for safeguarding issues, including sending breast binders to children behind parents’ backs).

So, when the opportunity presented itself last week to go undercover to an internal BPS webinar, I took it. The purpose of the webinar was to “shine a light on the history of the LGBT+ community’s experience of receiving healthcare”.However, this was far from a mere talking shop. The BPS stated that the webinar “aspires to equip psychologists with actionable insights and recommendations to implement systemic change”.

It is clear from this blurb that the BPS sought to impress recommendations upon their members.

Before attending the webinar, I looked up the speakers. They included:

·       Dr Adam Jowett – Chair of the BPS EDI Board, who has led research for the government on their proposed ban on ‘conversion therapy’

·       Penny Catterick – A ‘trans’ member of the BPS Human Rights Advisory Group

·       Dr Heather Armstrong – Academic at the University of Southampton

·       Dr Katherine Hubbard – Academic at the University of Surrey

·       Dr Rob Agnew – Clinical psychologist and Chair of the BPS Section of Gender, Sexuality and Relationship Diversity

Clearly, the BPS were bringing out the big guns.

The webinar began with panellists’ thoughts on the current state of play regarding ‘trans healthcare’ in society. The audience were told that “LGBTQ people face huge medicalisation”. This statement was ironic, given that the BPS support puberty blockers, hormones and surgery for those with gender dysphoria – the very definition of ‘huge medicalisation’.

The usual dollop of scaremongering was quickly added. We were informed that we are living in a “precarious and serious time”. Dr Katherine Hubbard, on the theme of patients feeling anxiety and distress, said: “Of course you feel anxious and distressed…look at the world you’re living in and the way your being is being pathologised”.

This is a worrying sentiment from a senior psychologist who appears to impose her own narrative and worldview on vulnerable patients. Rather than seeking to explore potential causation and co-morbidities of gender dysphoria, she simply views anxiety and distress as evidence as to why someone should transition.

However, the most concerning statement of the session came from Dr Rob Agnew (remember, he is a Chair within the BPS).

Agnew began with what can only be described as a rant, claiming that we have allowed “socially sanctioned discrimination” from people who can “hide behind other protected characteristics”.

It is clear who Agnew is referring to here – those of us who hold ‘gender critical’ beliefs, which, as we know, are protected under the Equality Act 2010. How would gender critical members of the BPS feel listening to this?

However, the worst was yet to come. 

Agnew went on to refer to a recent statement from the United Kingdom Council of Psychotherapy (UKCP) as being “transphobic”. This statement was off the back of litigation I had pursued against UKCP and it recognised explicitly that psychotherapists are both professionally and legally entitled to hold ‘gender critical’ beliefs.   

Agnew stated that we should clamp down on therapists with gender critical beliefs “in the way we wouldn’t expect a female client to accept therapy from an incel or a misogynist”.

To compare clinicians who believe in biological reality with incels or misogynists is beyond disgraceful. Shockingly, not a single panellist challenged Agnew on this statement. Remember, these panellists are purporting to speak on behalf of the entire BPS. 

I wrote an anonymous question into the Q&A box, challenging what Agnew had just said. Unsurprisingly, my question was ignored.

Up next was a dose of identity politics from Penny Catterick, the ‘transwoman’ who told viewers that he has “55 years of track experience”,whatever that means.

Reflecting on recent attempts to introduce self-ID in Scotland, Catterick claimed that Scottish women are suffering from “minority stress”, on the basis that they are “living in nested minoritisation in the UK”.Truthfully, I don’t even know what this means…I think Catterick was trying to suggest that because Scottish people are not the majority nationality within the United Kingdom, that this is innately stressful for them…

Catterick, a man identifying as a woman, went on to say that we are “living in a patriarchy”.That he could not see the irony in this statement is truly worrying.

At this point, Dr Rob Agnew chimed in again with more random ranting. He chastised paramedics who “assume a person is a man because they have a beard…putting them in a situation in which they have to out themselves”.

He went on to question: “how relevant is it if they were assigned male or female at birth?”

In the world of emergency healthcare being provided by paramedics, extremely relevant.

But Agnew, blinded by his devotion to gender ideology, cannot even see this. He then said that “social background” is more important that “biological background” and expressed hope that one day we will live in a world in which clinicians can “engage with non cis het people” without needing to know their “personal history”.

This is complete and utter madness being spouted by the association of psychologists – a profession operating within a framework of medicine and science. Or at least they used to.  

I was particularly concerned to hear a recommendation from the panel that “WPATH psychologists should be recognised by NHS”and that “recognition and promotion of WPATH practices by BPS practitioners could likely benefit psychological treatments in the UK.”

This is the same WPATH recently under intense spotlight, following the publication of the ‘WPATH Files’, demonstrating that their clinicians are clearly aware of the serious damage that can be caused by puberty blockers, cross-sex hormones and surgery, in the name of ‘gender affirmation’. This is the same WPATH which recommends breast and penis removal for children as young as 9 years old and has even advised that ‘eunuchs’ are recognised as a distinct gender identity.  

Towards the end of the webinar, the panel engaged in a highly unprofessional and deeply disgusting attack on the ongoing Cass Review – the independent, government-commissioned review into gender services for children.

Dr Rob Agnew said that we should not have a “cisgender person deciding what trans youth services are going to look like” and instead “should have someone we can have faith in”.

To attempt to raise doubt, suspicion and paranoia over the work of Dr Hilary Cass, solely on the basis that she is “cisgender”, is utterly abhorrent and incredibly dangerous.

He went on to claim that there are “risks of explorative therapy” and that explorative therapy is “tied very strongly to conversion therapy”.To allege that therapists who seek to explore issues with clients (a bedrock of psychotherapy) is a form of ‘conversion therapy’ is simply beyond words.

The webinar finished with ‘transwoman’, Penny Catterick, saying that people have always told him “what a courageous person” he is for ‘transitioning’. He then, dramatically, paraphrased Franklin D. Roosevelt, telling his fellow trans people that they have entered the “Theatre of Critics” and reminded them that they are on a “hero’s journey”,even if “people in the cheap seats do chuck stuff at you”.

The webinar finished with a statement that “trans affirmative healthcare is the right side of history.”

I closed my laptop, feeling like I had just come from a Stonewall rally, rather than a professional, psychological webinar.

The lunatics are well and truly running the asylum. This should be of great concern to us all.

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