It is increasingly becoming a new norm in therapy for personal pronouns to be actively negotiated within therapy. Clients may be invited to state their preferences for pronouns when first contacting a therapy agency or an individual therapist. In turn, therapists seem to be increasingly requested to ‘share’ their own personal pronouns within professional meetings, or when publishing articles, or as part of their professional email signature, or within therapy itself.

The rationale for this profound cultural change is carefully pitched to mesh seamlessly with the ethical value of communicating respect for clients, and in particular, to convey a welcoming environment for clients identifying as trans. At a simply human level, for therapists to share their own preferred personal pronouns, often at the invitation or encouragement of their employing organisation, is, at a positive level, to offer kindness and courtesy to clients identifying as trans, and at a perhaps more negative level, to reduce the risk of misgendering such clients (or colleagues) (see recent example from a South African mental health service). One therapist writes powerfully about the emotional impact of such a negative process: “I can be rendered silent, soaked in shame. It still takes courage to correct them. If I don’t correct them, I feel erased. Either way, I have difficult feelings to process” (Baines-Ball, 2021: 31).

So, what could be simpler? Why on earth would a therapist have reservations about sharing pronouns, let alone resist such a humanely pitched invitation? Clearly, for some therapists, sharing their own personal pronouns is not a difficult issue for them, and many will readily agree to do so. However, such collective decisions to share pronouns may then lead to added peer group or employer pressure, even if only implicit, on those therapists who are unconvinced and who are reluctant to follow suit.    

Sharing pronouns: the case against

There is, however, a strong case to be made against adopting pronoun sharing, even at the cost of being out of step with currently developing policy and practice. Therapist concerns about sharing pronouns relate to the subtle (or not so subtle) impact on the therapy itself. Pronoun sharing represents a powerful form of self-disclosure on the part of the therapist. Attitudes towards therapist self-disclosure may vary according to preferred modality, perhaps tending to be more resistant amongst psychodynamic therapists, and more permissive amongst person-centred therapists. Whatever the modality stance on self-disclosure, the research appears to be inconclusive on its effectiveness as an intervention (Egan and Reese, 2021: 214-216). What is distinctly different in this context, however, is that pronoun sharing represents a form of required, managed, or even mandatory form of self-disclosure on the part of the therapist, rather than an optional technique which is informed by the therapist’s own skill, experience and professional judgment.

Rather than a simple courtesy to a potential group of clients, pronoun sharing may instead represent a blurring or breaching of a therapeutic boundary, in providing the client with additional and quite possibly ambiguous information about the therapist’s self-perception. This self-disclosure is quite distinct from the usual selective advance information about the therapist which may be consciously and purposefully made available via an agency’s website or other form of communication. For therapists who give explicit consent to pronoun sharing, this may not be a problem. For therapists who have reservations about the purpose or effect of pronoun sharing, this may be best understood as an ‘enactment’, to employ a useful term from Cognitive Analytic Therapy (ACAT, 2022). Here, pronoun sharing may produce a tangible shift in the inevitably unequal power relationship between client and therapist and present a significant challenge to the established therapeutic frame. For those therapists who feel obliged to disclose their pronouns, their sense of professional autonomy may be correspondingly reduced.

Pronoun sharing may well also have a ‘ratchet effect’ within the therapy, given that one boundary breach, or significant boundary blurring, might lead almost inevitably to expectations by the empowered client of deeper therapist self-disclosure, or at least, of further self-clarification on the part of the therapist. Given this developing process, it really begs the question: what else might agencies be considering in terms of managed self-disclosure on the part of their therapists – HIV status? sexual orientation? non-visible disability? Once this process has been started, how is the genie of managed therapist self-disclosure to be firmly put back into its bottle?

Pronoun sharing by therapists can therefore be much more problematic than has been presented so far, in terms of impacting on the therapeutic frame, and in subverting established therapeutic boundaries. The wider rationale for using the client’s preferred pronouns also needs to be more accurately framed in terms of unstated but clearly emerging themes of trans fragility and trans exceptionalism within therapy (Jenkins, 2022). Thus, at a profound level, the therapist’s understandable wish to avoid inflicting the kind of acute distress quoted above actually overturns a key element of therapy, namely the issue of: who is to take primary responsibility within the therapeutic process for those client feelings which have emerged? Barring any deliberate, aggressive and inappropriate challenge to a client’s self-presentation by the therapist, the therapist should not be assuming primary responsibility for the client feeling ‘erased’ or ‘cancelled’. If the therapist is now to be held primarily responsible for producing the client’s powerfully emerging feelings, how can these then be appropriately addressed and productively explored within the therapy?

In addition, for clients identifying as trans, using preferred personal pronouns may well serve to reinforce a complex system of beliefs about their biological sex and gender identity (Jenkins, 2022). Pronoun sharing is not a neutral act. In fact, it radically undermines the therapist’s traditional stance of therapeutic neutrality with regard to the client’s preferred self-perception. By subtle (and not so subtle) shifts, the process of pronoun sharing therefore moves therapy by degrees away from its primarily individual focus, and increasingly towards becoming an unknowable variant of social advocacy.   

Support for therapist non-disclosure of pronouns

So, what practical steps can therapists take regarding encouragement or pressure to share their personal pronouns in the context of therapy? There is a degree of legal protection in the UK for gender critical beliefs, which would potentially protect employed therapists who were reluctant to share personal pronouns (Free Speech Union 2022, Sex Matters, 2021). Guidance relating to pronoun disclosure suggests that “employees are entitled to decline to take part in this ritual, and to be protected from discrimination, harassment and victimisation if they do so” (Sex Matters, 2021: 1). Therapists in private practice could presumably decide on their own policy regarding pronoun disclosure.

There is additional potential protection for therapists who do not wish to share pronouns under data protection law. This is based on the argument that any pressure on a therapist to display or disclose pronouns could be in breach of the General Data Protection Regulation (GDPR), given that personal may pronouns constitute a form of sensitive personal data. This form of data is termed ‘special category data’. Special category data includes personal data revealing or concerning a person’s health, sex life or sexual orientation (ICO, 2022). Pronouns could therefore constitute a protected type of personal data in relating to sexual health, i.e., revealing or concerning the therapist’s gender identity, or so-called cis gender status. Given this degree of robust legal protection, disclosing pronouns should necessarily require the explicit and freely given consent of the therapist concerned.

In addition, any pressure on an individual to follow a policy or practice of pronoun disclosure could also represent a potential breach of the therapist’s right to respect for their ‘private and family life’, under Article 8 of the Human Rights Act 1998. Finally, as stated in the Sex Matters guidance referred to above, any repeated pressure on a therapist to disclose pronouns could constitute harassment under the Protection from Harassment Act 1997 or other relevant legislation.  

References

Association for Cognitive Analytic Therapy (ACAT) (2022) Cognitive Analytic Therapy and the therapeutic relationship. https://www.acat.me.uk/page/cat+and+therapeutic+relationship

Baines-Ball, L. (2021) “Why pronouns matter”, Therapy Today, 32(2): 30-33. https://www.bacp.co.uk/bacp-journals/therapy-today/2021/march-2021/  (BACP login required)

Egan, G. and Reese, R. (2021) The Skilled Helper.11^th edition. Cengage: Delhi.

Free Speech Union (2022) FAQs on What to Do if You Are Asked to Declare Your Preferred Pronouns at Work. https://freespeechunion.org/faqs-on-what-to-do-if-you-are-asked-to-declare-your-preferred-pronouns-at-work/

Information Commissioner’s Office (ICO) (2022) Guide to the UK General Data Protection Regulation (UK GDPR). https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/

Jenkins, P. (2022) “Through the looking glass: Making sense of the Memorandum of Understanding”, Critical Therapy Antidote. https://criticaltherapyantidote.org/2022/03/25/through-the-looking-glass-making-sense-of-the-mou-part-1/

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By Peter Jenkins, counsellor, supervisor, trainer and researcher. He has been a member of both the BACP Professional Conduct Committee and the UKCP Ethics Committee. He has published a number of books on legal aspects of therapy, including Professional Practice in Counselling and Psychotherapy: Ethics and the Law (Sage,2017).  https://us.sagepub.com/en-us/nam/author/peter-jenkins. Peter Jenkins is also a member of Thoughtful Therapists, whose scoping survey for the government consultation on conversion therapy can be found here: https://thoughtfultherapists.org/scoping-survey-pdf/