Mind Games

One therapist's experience opposing gender ideology

Of all the elites that betrayed the vulnerable in this ghastly war on women, perhaps the most reprehensible are those in the therapeutic professions, the very professions which should protect their clients.

Organisations that should have known better like the Association of Psychotherapists Aotearoa New Zealand and the New Zealand Association of Counsellors (NZAC) bowed to the demands and unsubstantiated claims of gender ideologues.

Both bought into the propaganda of vulnerable trans and gender diverse people. Both rejected the notion that believing you are born in the wrong body or have a fetish that requires you to dress as a woman is a mental illness. Both promoted gender affirming care and both sought to suppress discourse questioning the legitimacy of transgender and diverse identities.

In the United Kingdom the Free Speech Union has raised concerns about the potential chilling effect on free speech within the therapeutic professions due to policies opposing conversion therapy. They argue that such policies might deter professionals from exploring a range of perspectives on gender identity, thereby limiting open discourse and potentially impacting the quality of care provided to clients.

Former Wellington counsellor Ann Elborn knows this is true from experience. Until 2022 when she retired, she had 30+ years of experience working in mental health. From 2021 on, she questioned the march of gender ideology into her profession. In the cover image, Ann is on the right.

She began by writing about her concerns to the executive board of the NZAC in 2021 but did not receive a reply. She then wrote a post questioning the gender orthodoxy on NZAC’s facebook page, which has 1900 members. The response was “terrible”. She was informed online that “members should not be sharing certain information or opinions with the group due to possible harm and discrimination.” Someone wrote “Terf opinions are abusive.”

Her post was taken down. Although she attracted a few likes, her posts mostly attracted a pile-on. The moderator removed her post after a complaint and took advice about it. Elborn was later told that one of the organisations she had quoted (the Society for Evidence-based Gender Medicine - SEGM) was a Terf organisation and her post remained cancelled.

In 2023 she and other counsellors took part in online training intended to provide a basic understanding of gender and sexuality run by InsideOut. One of the trainers was Tabby Beasley, most recently seen supporting Benjamin ‘Bussy’ Doyle in the image below. Beasley is the blue-haired woman on his right.

Elborn’s extensive notes from the course reveal InsideOut’s support of gender affirming care and other non-evidence-based views. Her notes are an insight into the trans propaganda masquerading as research and will, no doubt, one day be viewed as odious as Mao’s struggle sessions.

Gender was described as ‘loosey goosey,’ based on an internal view of self. The word lesbian or gay was barely mentioned. Instead she learned trans is an umbrella term which includes non-binary. Clearly ‘Bussy’ did the same course.

Confusingly the group was told that a young person might come out as non-binary and then realise they are trans. Also people don’t have to transition to become that gender but transitioning is good for people and life-saving,

Elborn’s notes contain the usual tropes such as people know who they really are, withholding transitioning can be life threatening and debilitating and denying access to gender affirming care can raise the level of depression and suicidality. Such claims have been rejected by groups like SEGM. The Cass Review is clear that the evidence does not support these claims.

The pathway to treatment was outlined. A general practitioner (GP) referral to an endocrinologist, then a psychologist and then back to the endocrinologist. New Zealand only has one gender surgeon with 14 surgeries per year allocated though this number is often not achieved. Hence many trans people go overseas for treatment.

Beasley said it was disappointing that endocrinologists won’t accept people without a psych assessment. She encouraged people to tell their GP that under the Professional Association of Trans Health Aotearoa (PATHA) guidelines they can prescribe puberty blockers. PATHA’s clinical guidelines for transgender care was analysed by The University of York’s research team as part of the Cass Review. Only two guidelines met the required standards, those of Sweden and Finland.

Although questions were invited they were also told at the beginning of the webnair by an NZAC representative that anyone who “engages in inappropriate behaviour during the webinar we will remove them.” This was later backed up when one of the InsideOut presenters said “this isn’t the environment for debating the reality facing the rainbow or trans community or our right to exist.”

When questioned about rates of regret, the group was told it was as low as one per cent whereas other surgeries had a rate of regret of 14%. Even so, the regretters only did so due to lack of support and discrimination from peers and family. These claims are debunked by SEGM.

Beasley's colleague said he hadn’t heard of any harms regarding puberty blockers. Beasley then followed this claim up by saying “it was important we don’t put too much emphasis on side effects because as a society we take lots of medicine.” The evidence is that puberty blockers are great for mental health . Yes it could decrease calcium but supplements could fix that. Again the spectre of suicidality was raised.

The superior, fluid nature of pre-colonial cultures was invoked, conjuring up a time when there was no discrimination against rainbow and takatapui. Dr Elizabeth Kerekere’s research is quoted however Dr Kerekere has said there is limited direct evidence of diverse gender identities or specific roles for takatāpui in pre-colonial Māori society. In her thesis she noted that, although intimacy and gender expression existed among Māori in pre-colonial and post-contact times and were accepted without punishment, there is not yet evidence that Māori had diverse gender identities or that takatāpui played specific roles in pre-colonial times.

Counsellors were given tips on how to be rainbow inclusive - give positive affirmation to anyone coming out, reassure them about confidentiality and ask for their new names or pronouns.

As a homework exercise the group was told to practice using gender neutral pronouns. Also suggested was “tell yourself a story without using pronouns or use a pet. Practice with someone else using ‘correct’ new pronouns.” Rather than asking people their pronouns, counsellors were told to share their own.

Pronouns had special power since by using the wrong pronoun you could ‘out’ people and cause harm. Counsellors were told to thank those who correct them and not be defensive. The trans person was the most vulnerable here and often belonged to other minorities - religious, disabled etc.

One hour and a half later, the lesson in compelled speech and dubious research ended.

By now Elborn realised that not only would alternative views not be tolerated on its facebook page, NZAC was running training that only endorsed gender affirming care and shut down alternative approaches. She didn’t post again until late 2024. This time she posted a Stuff article regarding the Ministry of Health’s Evidence Brief on Puberty Blockers, that indicated pubery blockers would be restricted (she also mentioned the Cass Review).

Reaction came quickly. One commenter referred to the Cass Review as “biased, unscientific, unethical and bigoted.” Other comments included “restricting access to (puberty blockers) is rooted in transphobia and will result in more harm.” Elborn was also accused of transphobia and her post was taken down.

The next day a new post went up asking that “people refrain from sharing material/opinions that provoke debate about their (transgender people’s) lives and identities.”

Meanwhile Elborn learned there were at least 20 other counsellors who agreed with her but none were willing to go public. Elborn believes they were part of a silent majority but a vocal minority endorsed the censorship and shaming of colleagues who dared to speak up.

Elborn put in a complaint to the ethics committe of the association about her post being removed. The committee said they would make recommendations to the facebook page moderators, but she has never learned what those recommendations were.

Finally at the beginning of this year Elborn and another colleague decided to put up another gender critical post on the Association’s page, hoping that the climate might now be more welcoming. They wrote a letter calling upon counsellors to step back and adopt an open-minded approach in the light of recent developments such as the Cass review. They raised the possibility that gender dysphoria is often a proxy for something else such as autism, unaddressed trauma and same-sex attraction.

“It concerns us that well-meaning Association members may inadvertently be regarded as practising Gay Conversion Therapy in a naive attempt to ameliorate what is a well-known development stage for many gay people.”

The last sentence was “We welcome open discussion on this topic.”

The reaction was swift. A brutal pile-on followed in which they were told:

“If a new member tried to register with NZAC while publicly holding such views, they wouldn’t be accepted as they wouldn’t be considered safe or ethical. Yet existing members are allowed to flaunt their bigotory openly”

“You people think it’s o.k to be regurgitating bigoted, transphobic nonsense. Again?”

“Your resources are debunked and your talking points regurgitated transphobic propoganda”

A few called for the group to lay complaints about Elborn and her colleague.

“I hope due course of action is taken towards the two people that are actively working to undermine the association's Code of Ethics.”

“The NZAC needs to step up against this blatant and continued transphobia. If a new member tried to register with NZAC while publically holding these views, they wouldn’t be accepted as safe or ethical counsellors. Yet existing members are allowed to openly flaunt their bigotry.”

Elborn had become used to this sort of rhetoric, but the comment she thought was particularly Orwellian was when someone sourced a photo of her, her sister and partner from Facebook wearing gender critical t-shirts (pictured above). Along with the photo was the comment:

“I see you are wearing a tee shirt and with another woman wearing a shirt that leads itself to believe that you are anti-trans? Or don’t believe trans women are women? Can you speak to this?”

Elborn says the Minister of Mental Health Matt Doocey needs to conduct a review into the ideological capture of therapy associations and tell them they must follow the Cass Review when it comes to working with gender confused youth.

Elborn’s Public Letter to Association members on fb.

Tena Koutou Katoa

This post is to provide information for counsellors regarding developments in the field of working with young people with gender identity disorder, also known colloquially as gender dysphoria.

Aside from counsellors needing to be made aware of the best evidence and treatment approaches for all clients, we think it is fair to say that conversations about this client group are often fraught. We are aware there are self-identified members of the trans community on this site, but believe it is in the best interests of clients that a full range of information about gender distressed clients is available to association members.

When considering the most ethical and efficacious approaches for certain client cohorts, we believe that robust, compassionate korero is the only way to proceed. Shutting alternative voices down without consideration is dangerous as risk management strategies and cultural considerations around these cohorts are not explored.

The information we are presenting here is important as there has been a growing number of young people presenting to counsellors with gender issues since approximately 2015. The Association has been a proponent of what is commonly referred to as Gender Affirming Care which involves automatically affirming and confirming a young person’s “gender identity” and endorsing the use of medical transition. We think that while respecting how young people present, it is important for counsellors to step back and adopt an open-minded approach regarding what is going on for individual clients. This reflects the underlying kaupapa and principles of the practice of counselling as developed over the last 150 years: listening and validating the client’s experience, but keeping an open mind about what is going on, skillfully questioning our clients to help bring about a positive outcome.

Internationally there is a rolling back of gender affirming care, particularly the prescription of puberty blockers and cross sex hormones. The Cass review, a four year landmark enquiry into gender affirming care in the UK, undertaken by senior pediatrician Dame Hilary Cass found that there was no evidence that puberty blocking drugs have any benefits and that there are concerns about harms these drugs may cause. Overseas the use of puberty blockers have been stopped in a number of countries including the UK and Sweden.

In New Zealand, an evidence review of the use of these drugs was conducted by the Ministry of Health. Their findings as reported can be summarized as follows.“The Ministry of Health is urging doctors to take a “precautionary approach” before prescribing puberty blockers, as the Government moves to limit access to the medications.’.....Those moves came as the ministry released a highly anticipated evidence brief about the use of puberty blockers, which said there was insufficient evidence supporting their use”.

The Cass Review found when it came to psycho social interventions, there was a need for a holistic, comprehensive assessment of children and young people who present with gender issues to inform an individualized care plan. This should include a screening for neuro developmental conditions including autism spectrum disorders and a mental health assessment, because of the higher than expected rates of both in this population.

We think for counsellors working with these young people, this article from Lucy Beney is a useful place to start. It is well-established in our broader field’s literature that gender dysphoria is usually a proxy for something else: autism, unaddressed trauma (from abuse and neglect), and an often distressing development of same-sex attraction being the main three. Cluster B personality disorders as outlined in the DSM-V also prominently feature in many trans-identified individuals.

We believe it is likely in years to come that counsellors practicing a one-size-fits-all approach with gender non-conforming clients (that is, gender-affirming care) may be held responsible in cases of the client’s later transition regret. Further, a counsellor suggesting to a gender non-conforming client that they may be born in the wrong body and perhaps are instead “trans” could be found guilty of Gay Conversion Therapy under New Zealand law. We consider the “born in the wrong body” attribute to be a pseudo-religious faith-based assertion rather than one with any cogent foundation in psychology, hence our legal concerns here.

It is well known that young gay people can present with gender non-conforming behaviours in childhood and adolescence. Indeed, this aspect of development is relatively ubiquitous when growing up as a same-sex attracted individual. It has been established in multiple studies that over 80% of young people who passed through the now infamous Tavistock gender clinic were simply gay or bisexual, not transgender. Lawsuits against various clinicians, including therapists, now number in the dozens in both the UK and the US as a result of this malpractice.This number is growing.

It concerns us that well-meaning Association members may inadvertently be regarded as practicing Gay Conversion Therapy in a naive attempt to ameliorate what is a well-known development stage for many gay people. We welcome open discussion on this topic.