Is Gender Exploratory Therapy Conversion Therapy?

I’m writing this post in response to an article on Xtra entitled “Unpacking ‘gender exploratory therapy,’ a new form of conversion therapy written by Erin Reed. The subtitle reads “The practice is sold as supportive care-but in reality, it’s used to delay transition until a person no longer identifies as trans”.

As a mental health professional and practitioner of gender exploratory therapy I want to set the record straight regarding the arguments made in this article. Erroneous claims that gender exploratory therapy (GET) is a disguised form of conversion therapy may deter people from finding therapists who can work with gender, leaving them with limited options for accessing mental health support.

Conversion Therapy Legislation 

Conversion therapy is aimed at changing someone’s stated sexual orientation or gender identity. Reed argues that the Gender Exploratory Therapy Association (GETA) supports conversion therapy, because on their webpage there is an article that is critical of proposed legislation in the United States that would broaden the definition of conversion therapy.

GETA does not promote conversion therapy. GETA opposes a definition of conversion therapy that is so broad so as to label anything that is not gender affirmative care, conversion therapy. They argue this would create a “chilling effect” making mental healthcare providers scared of discussing gender related issues with their clients. 

From personal experience I can attest to this reality in Canada where we already have such legislation in place. I recently had an inquiry from a trans individual who wanted to explore their gender but told me that everyone they had seen previously was scared to talk about it and would only support them to transition. They weren’t necessarily wanting to de-transition but were hoping to have a frank discussion about their gender identity with a counsellor who was not afraid to go there with them. Unfortunately in Canada it was very difficult to find such a person.

Exploring Motivations is Not Conversion Therapy

Reed continues with examples from twitter of therapists who posited other reasons that a client may be trans other than “transness” as a way to sow seeds of doubt in the person’s mind as to whether or not they actually are trans. If someone is desiring only gender affirmative care then they have not actually consented to gender exploratory therapy, in which case this type of question wouldn’t be in alignment with their therapeutic goals. The problem here is not gender exploratory therapy per se but that the client has not consented to it. 

Gender affirmative therapy is not really therapy at all, it’s simply supporting someone to transition which anyone can do. Any therapy (gender or otherwise) involves exploring motivations, feelings and assumptions. This doesn’t mean counsellors are gaslighting as Reed suggests, but rather are challenging their clients to look inwards and ask how they came to feel that they are trans.

Understanding how they came to believe things about themselves is helpful for anyone regardless of whether they decide to transition, desist, or de-transition. If someone has doubts about their trans identity, exploring the underlying reasons can potentially make them more confident in their trans identity, if they come to the conclusion that those doubts were unfounded. 

Gender Affirmative Care Could be Considered Conversion Therapy

Reed’s concern with the questions about alternative reasons for a trans identity is that the counsellor posing such questions has a biased preference for a non-trans identity and is subtly leading the client down a pathway towards being cisgender. However one could argue that gender affirmative care is biased towards a transgender outcome, in which case it could be considered conversion therapy.

For example if someone is a lesbian biological female and becomes a trans male that would be conversion therapy away from a gay sexual orientation to a straight one. When it comes to therapy for trans people one might always be in danger of practising conversion therapy whether they use the gender affirmative or exploratory model. 

Therapist Bias is Unavoidable 

The benefit of the exploratory model is that it at least holds open the possibility the person is trans and will not desist. Theoretically the gender affirmative model is not opposed to someone desisting or de-transitioning. However, in my experience because of the fear of being labelled transphobic most healthcare providers lean exclusively towards supporting the transition process uncritically.

Whether working with gender or any topic all therapists will have biases. These can influence the therapeutic process negatively if not openly named and identified from the start. Not doing so can result in a negative experience in therapy. 

Gender Exploratory or Just Bad Therapy?

Reed focuses on examples of therapy in which alleged gender exploratory therapists told their clients the reasons they were not trans. This is not good therapy. A good therapist poses questions, but they don’t come to conclusions for their clients. Reed never cites anything from GETA’s clinical guidelines, and so it begs the questions whether she is even aware of what the therapeutic framework entails. Her method of gathering data involves fielding comments from twitter from people who’ve had a negative experienced in therapy regarding their gender identity. 

If one took this approach I’m sure you could get such responses from people who have had negative experiences with all types of therapeutic modalities. This is more a feature of the fact that there are many poor therapists out there, and also therapists can err since they are human. If Reed was serious about learning about GETA perhaps she should have interviewed someone from that organization.

It seems she’s more interested in slandering this approach than actually learning about it. I’m sure she has good intentions, i.e. to prevent people from being harmed by therapy. If she wants to do a real critique of gender exploratory therapy though she should go to the direct source, not rely on anecdotal reports from twitter. 

Conclusion: We Need More Therapists Who Can Work Effectively With Gender

Any time a therapist tries to assert their own personal agenda over a client and lead them down a predetermined path they have no desire to go, it is unacceptable. The gender exploratory approach does not limit the outcomes of therapy to either a trans, or cisgender identity. As long as an individual understands what gender exploratory therapy is and consents to that from the start these fears of conversion therapy are unfounded.

If we go on a witch hunt after every therapist working with gender who doesn’t conform to the gender affirmative dogma we will be doing a grave disservice to people who are wrestling with issues of identity and gender. This environment of fear will (and I believe is currently) significantly reduce the number of mental health professionals who are willing to work with gender.