AUSTRALIAN PSYCHOLOGICAL SOCIETY (APS)
Controversies around the GAC guidelines and practices of APS
Australian Psychological Society
When I was in LGB Alliance Australia, a psychotherapist and I organised a submission to Australian Psychological Society, January 2022, that drew APS’s attention to the harmful and experimental effects of puberty blockers. I quote that section in full:
[quote] “ACON's TransHub.org assigns three drugs as "puberty blockers" in Australia for the use of minors, Goserelin, Leuprorelin and Triptorelin. The website advises these medications to be taken periodically 3-5 times per year from 9-11 years old. These drugs however are only approved for endometriosis, chemical castration for men with obsessive sexual desires, prostate cancer and for these conditions their labels advise short treatment periods only, generally 5 months. They are not licensed for adolescent gender dysphoria, their use as ‘puberty blockers’ is off label and nor is it recommended that they be used 3-5 times per year over a number of years on healthy bodies.
Usually, before a drug is even tested on humans, let alone approved for use, animal studies are conducted, there have been three animal studies.
a) Nuruddin, S. et al. (2013) shows that sheep’s brains are demonstrably altered by puberty blockers Peri-pubertal gonadotropin-releasing hormone analog treatment affects hippocampus gene expression without changing spatial orientation in young sheep.
b) Hough, D. et al, (2017) shows that sheep’s ability to navigate a maze is impaired long after stopping puberty blockers. ‘A reduction in long-term spatial memory persists after discontinuation of peripubertal GnRH agonist treatment in sheep’.
c) Anacker et al. (2021) demonstrate the dramatic effect of puberty blockers on mice: males develop stronger preference for other males and an increased stress response; females exhibit increased anxiety and despair-like behaviour. ‘Behavioural and neurobiological effects of GnRH agonist treatment in mice: potential implications for puberty suppression in transgender individuals.’
Under normal circumstances such adverse animal findings would halt human trials and preclude their use in humans unless the consequences of not treating were demonstrably worse than the consequences of treating as is the case in precocious puberty and prostate cancer where GnRH agonists are approved under strict conditions and limited period of time.
It appears that ideological pressure has led to normal scientific protocols being overridden. Or possibly the influence of pharmaceutical money as 96% of Therapeutic Goods Administration's budget is paid for by pharmaceutical donations. The use of puberty blockers in gender dysphoric children amounts to experimentation and recent reports from the first Gender Clinics in Sweden document serious adverse effects and physical deformities in youth 3-4 years since start of treatment.
We asked APS to examine:
William Malone et al. Puberty Blockers for Gender Dysphoria: The Science Is Far from Settled The Lancet, 2021.
David Pilgrim and Kirsty Entwistle, GnRHa (‘Puberty Blockers’) and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood, and Freedom of Expression The New Bioethics 2020
Michael Biggs Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria, Archives of Sexual Behavior, 2020, pp. 2227-2229.
https://link.springer.com/article/10.1007/s10508-020-01743-6
Michael Biggs Revisiting the Effect of GnRH Analogue Treatment on Bone Mineral Density in Young Adolescents with Gender Dysphoria, Journal of Pediatric Endocrinology and Metabolism, 2021, pp. 937–939. https://www.degruyter.com/document/doi/10.1515/jpem-2021-0180/html.
Society for Evidence Based Gender Medicine New Systematic Reviews of Puberty Blockers and Cross-Sex Hormones Published by NICE
Society for Evidence Based Gender Medicine Sweden’s Karolinska Ends All Use of Puberty Blockers and Cross-Sex Hormones for Minors Outside of Clinical Studies. Concerns over medical harm and uncertain benefits result in a major policy shift.
Gender Health Query Medical consequences of hormone blockers
SEGM Finland prioritizes psychotherapy over hormones, and rejects surgeries for gender-dysphoric minors
Transgender Trend Are Puberty Blockers Reversible? The NHS No Longer Says So Webpage details important shifts in NHS advice re gender dysphoric children and adolescents (accessed 30/6/20)
The BL Sweden: Hormone treatments for sex change in children causes serious harm, research reveals The Swedish research team, Uppdrag Granskning, revealed that at least 13 children in Stockholm, Sweden, subjected to hormone-blocking treatments to promote their gender change, suffer serious adverse effects and physical deformities.
James Kirkup, “The NHS Has Quietly Changed Its Trans Guidance to Reflect Reality,” The Spectator, June 4, 2020. https://www.spectator.co.uk/article/the-nhs-has-quietly-changed-its-trans-guidance-to-reflect-reality
Australian Psychological Society - LGB (Same Sex Attracted) have issues with APS
In January 2022, whilst a co-founder and Liaison for LGB Alliance Australia I worked with a number of mental health professionals and sent a letter and evidence to the Australian Psychological Society of the harm of mandatory gender affirming 'care' was doing to vulnerable young people in particular LGB youth, Autistic and other Gender non-conforming children along with vulnerable youth, primarily young girls who had experienced abuse).
"Given that we are talking grievous harm, involving sterilisation, removal of organs and permanent injuries
to LGB and other vulnerable young people, there will inevitably be legal cases. In sending you this letter
with its attachments, we are providing you with the means to critically examine the needs of LGB and
other young people vulnerable to the networked surge in trans identification. We urge you to base your
policies on high quality evidence rather than inconclusive, poor-quality research pushed by queer ideology.
While our primary intent is that the APS should cease reckless automatic gender affirmation, this
submission also provides a record that you have been alerted to the risks. Such a record may be useful to future litigants."
Psychologists in process of being sued, by Australian De-Transitioners
Since then, working in LGB Defence and Active Watchful Waiting Inc., with support of two legal firms we have supported two detransitioners (Jay Langadinos and Ollie Davis) to sue their psychologists, members of APS.
In relation to the presenters referencing APS’s current code of ethics, it’s worthwhile mentioning that the LGB community has serious concerns regarding the gulf between the APS Code of Ethics and their current gender policy, which we found to be too heavily influenced by ideology rather than evidence-based decision making.
“Like other Australian mental health organisations, the Australian Psychological Society (APS) has an excellent Code of Ethics, and a reputation for supporting safe, careful and evidence-based practice. Unfortunately, current guidance and InPsych narratives put the APS and members on course for complicity in serious harm, litigation, and reputational damage. In the submission we sent to APS whilst we focused on LGB, their lamentable lack of care and rigor applies equally to many other people vulnerable to ill-considered ‘auto-affirmation’ policy: people with ASD, ADHD, mental illness and trauma. Girls and young women are especially vulnerable, as are socially awkward boys, and young men with Autogynephilia. Current APS policies and InPsych narratives do not just jeopardise vulnerable people, they fail APS members by keeping them ignorant of risks, and by advising practices that contravene the Code of Ethics. These policies and communications expose the APS and its members to litigation.
We requested APS assess whether its Code of Ethics is in alignment with ethical caregiving practices.
“The general principle, Propriety, incorporates the principles of beneficence, non-maleficence (including competence) and responsibility to clients, the profession and society”
The Code requires psychologists to:
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"anticipate the foreseeable consequences of their professional decision, provide services that are beneficial to people and do not harm them" and to "take responsibility for their professional decisions.”
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“Conduct' means any act or omission”
In relation to ‘omission’ we noted that ‘automatic affirmation’ downplays or omits differential diagnoses, ignores risks specific to LGB and other people, and prescribes against exploratory therapy. APS advocacy for ‘conversion therapy’ laws in Victoria, Queensland and the ACT has compounded this.
Harms (maleficence) are likely to result from current APS policy and communications that push ‘automatic affirmation.’ These harms impact the collective - LGB people, and impact individuals.
Maleficence and ethical breaches at the collective level - human rights abuse against LGB people.
The APS current Code of Ethics defines ‘peoples’ as a distinct human group with collective interests, and states that ‘psychologists engage in conduct which promotes the protection of people’s human rights. Legal rights and moral rights. They respect the dignity of all people and peoples.” Current APS policies for ‘auto-affirmation’ in ignorance of the vulnerabilities of LGB people represents an abuse of the human rights of LGB people.
Automatic affirmation, social transition and puberty blockers set young people on course for medical transition who would have resolved dysphoria through maturation. We know that under ‘watchful waiting’ most children resolve gender dysphoria. We also know that gender nonconformity and dysphoria in childhood is strongly correlated with maturation as LGB adults.
In effect, APS policies facilitate ‘Transing the gay away’ - the medical conversion of LGB children and young adults to make them ‘straight.’ We view these policies and InPsych communications as unethical and deeply prejudicial to the wellbeing of LGB people. It is particularly distressing, since our history involves not just murder, brutal physical assault and ‘corrective rape’ for being homosexual. The bodies of homosexual people have been subjected to electric shock, induced vomiting, surgical excision of clitorises, lobotomies, incarceration and forced injection of hormones. These human rights abuses occur in many countries today. In Iran, gay men have a choice of ‘gender reassignment surgery’ or hanging from a crane by the neck. In this way, the state removes their organs and performs body modifications upon them to make them ‘straight.’ The fact is that gender nonconformity in homosexual people is deeply challenging to sexual stereotypes and cultural expectations. Although legal discrimination has ended in most western countries, the accounts of detransitioners make clear that young people suffer from internalised discomfort with same-sex attraction, and in many cases from bullying.
In addition to persecutory laws noted above, LGB people have been subjected to dehumanising language. It is distressing to us that now the only words we have that describe our distinctive experience have been repurposed for queer ideology, and that health professionals who have been strong supporters of LGB people have uncritically gone along with this. The APS document Information Sheet: Sexual Identity and Gender Diversity has redefined homosexual people in such a way that denies same-sex attraction as the basis of our sexual orientation. Respectful engagement with lesbian and gay people must include recognition that we are people with a stable sexual attraction to people of the same sex. This refers to biological sex, not gender identities.
Maleficence - Individuals harmed following automatic affirmation.
We recognise the experience of transgender adults for whom medical transition has been very beneficial. This submission is about those people for whom these interventions were damaging - interventions set in motion by ‘automatic affirmation’ or ‘affirmation only’ health services. Given the accounts of detransitioners, and the exponential surge in young people identifying as transgender, it is highly likely that the numbers of people harmed by ‘automatic affirmation’ will increase. Where this occurs, it is seriously injurious. It is maleficence.
Then LGB Alliance Australia asked them to examine the evidence relating to risks to LGB people:
​see the following links:
1. The body of knowledge that was ignored: gender dysphoria in LGB people
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2. The risk to LGB youth is evident from the stories of detransitioners
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4. Clinical support is NEEDED for detransitioned people
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5. The importance of science-based information about biological sex
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6. Network dynamics amongst client populations
(The influence of social contagion, social media influencers etc.)
7. Network dynamics amongst psychologists
(Psychologists have been verbally attacked for expressing concern about the surge in adolescent trans identification. Psychologists need an environment that fosters the ability to learn, question and consider evidence in relation to these issues, that a diversity of opinion, respectfully conveyed, is not just acceptable but desirable for development of safe practice.)
8. Puberty Blockers are harmful and experimental
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9. The International adoption of a safe policy following evidence reviews
10. The new, hostile environment for LGB young people
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11. A return to safe practice: assessment and exploratory, holistic therapy
12. The gulf between the APS Code of Ethics and current gender policy
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Further in order to serve the LGB community LGB Alliance Australia recommended that the APS:
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Seek to understand the needs of same sex attracted people by exploring the information in the appended document A: Evidence that must be examined in order to create safe policy.’
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Convey to your member's withdrawal of your current guidelines on commencement of the review period. This is important because your current one-size-fits-all ‘affirmation-only’ policy is unsafe for LGB people.
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Educate psychologists about the body of evidence that shows that the majority of children diagnosed with gender dysphoria resolve it as they mature through puberty, with most becoming gay, lesbian or bisexual. Convey this in your policy, InPsych articles and other communications. This is important because your members have been denied this crucial information.
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Educate psychologists about the importance of exploring gender stereotypes in work with clients who experience gender incongruence and dysphoria. Convey this via policy and InPsych articles. This is important because gender stereotypes are particularly toxic for gender-nonconforming children and youth and remain problematic for many gender-nonconforming adults such as ‘masculine’ lesbians and ‘feminine’ gay men.
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Educate psychologists about the experiences of detransitioners and their needs. Convey this via policy and InPsych articles. This is important because detransitioners may seek help from your members.
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Commit to comprehensive assessment and exploratory therapy with children and adults identifying as transgender.
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Recommend against the medical transitioning of children and adolescents. This is important because it is unclear if any psychologist can distinguish between the majority of children with gender dysphoria likely to desist, and the minority likely to continue to experience intense gender dysphoria after maturation.
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Recommend against ‘conversion therapy’ laws that deter or ban exploratory therapy for gender questioning youth and adults. These laws have a chilling effect on clinical interventions needed to help people make sense of their gender nonconformity and dysphoria. With LGB youth swept up in the surge in adolescents identifying as trans, the laws make it even more likely that young people will end up suffering regret for body modification undertaken before they learnt that they were lesbian or gay. APS advocacy for bans on the exploratory therapy needed by LGB people is egregious and constitutes human rights abuse. We urge you to rescind APS support for these ill-conceived laws, and to communicate this on your website.
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Make a clear distinction between sex and gender in your communications. Sex is biological. Gender is social. While gender expression is a spectrum, sex is binary, and no mammal has ever changed sex.
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Maintain clear language that sexual orientation relates to biological sex, not gender. Lesbians are women who are same sex attracted to women. Gay men are same sex attracted to men. Heterosexuals have a stable attraction to people of the opposite sex. There are other words for people who are attracted to diverse sexes AND gender identities, such as ‘pansexual.’ We ask you not to collude with queer ideology’s refusal to acknowledge the same-sex orientation of gay men and lesbians. This new homophobia, like the old homophobia, requires homosexuals to change sexual orientation.
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Educate psychologists about the pressures exerted by queer ideology on same sex attracted youth, so that they can support self-esteem in LGB people who maintain sexual boundaries.
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Distinguish between ideas driven by queer ideology and evidence-based practice and policy.
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Acknowledge that LGB Defence, LGB Alliances around the world represent the needs of LGB people. See our statement here. LGB youth and adults are being harmed by policies promoted by LGBTQ organisations which should have:
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Known about gender dysphoria and desistance in LGB youth and advised accordingly, and
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Picked up on the signals that young LGB people are being harmed.
These safeguarding failures have shown us that groups driven by queer ideology cannot be trusted to protect the interests of LGB people. (By definition, they cannot represent the interests of same-sex oriented people if they no longer recognise homosexuality as ‘same-sex’). As you revise APS policies to align with safe practice, we ask that you seek input from the original authors*, SEGM and the health professionals that contributed to this paper. We represent the interests of same sex attracted people and would look forward to working with you.
Commit to protecting LGB people from harm, by examining the evidence presented in this submission. We understand that the current APS policy results from queer ideology advocacy. However, should you fail to correct this, the APS will shift from ‘ill-informed’ to ‘wilful neglect.’ This would be indefensible from any ethical standpoint.” [/UNQUOTE]