Readers of our articles are very well aware of the debate surrounding gender dysphoria and its treatment, especially among the current adolescent cohort. We have contributed to this debate, especially the one involving the UKCP and their Memorandum of Understanding on Conversion Therapy. While the controversy around conversion therapy involving gender dysphoria appears to be far from over, ideologically committed psychotherapists have doubled down on a conspiracy of non-thinking. In their article A Letter from the Future to Ourselves, in Murmurations: Journal of Transformative Systemic Practice, Gail Simon, Gwyn Whitfield, Elizabeth Day, and Amanda Middleton argue for an unwavering commitment to gender self-identification, challenging the UK Council for Psychotherapy’s (UKCP) 2023 statement, which differentiates between exploratory therapy and medical interventions such as puberty blockers and cross-sex hormones. However, their article notably omits any discussion of the broader controversy surrounding these medical treatments, particularly their long-term effects and ethical implications. This omission is significant, as it sidesteps the crucial question of whether automatic affirmation should take precedence over careful therapeutic inquiry.
The authors attempt to strengthen their argument by drawing a parallel between the historical treatment of homosexuality and contemporary concerns about gender identity. They suggest that questioning a person’s gender identity is as harmful as past efforts to pathologize sexual orientation, portraying UKCP’s call for exploratory therapy as cruel and undermining. However, this analogy is flawed in a fundamental way—unlike sexual orientation, which requires no medical intervention, gender dysphoria is often accompanied by a desire for medical treatments that carry serious and potentially irreversible consequences. By failing to acknowledge this critical distinction, the article disregards the ethical complexities of affirming gender identity without deeper exploration, especially in cases involving minors.
Another key issue with the article is its rejection of traditional psychotherapeutic inquiry into gender-related distress. The authors argue that examining the underlying causes of distress constitutes an invalidation of trans identities, prioritizing lived experience over empirical evidence. While personal experiences should inform clinical practice, the article presents affirmation as the only acceptable therapeutic approach, dismissing concerns about comorbidities, sociological factors, and the recent surge in young people seeking gender-related medical interventions. This perspective suggests a reluctance to engage with the broader, nuanced realities of gender dysphoria, reducing the conversation to a binary choice between affirmation and oppression.
As we have noted elsewhere, the psychology of reality-disavowal can be a spell that is resistant to breaking. It does seem, however, that sanity is slowly returning to our profession with more individuals challenging the anti-therapeutic course of rogue psychotherapy. Recently, Mark Hurst of the NHS Foundation Trust wrote a critique on the article by Simon et al. (2024). Hurst highlights the misdirected course gender-affirmative practice has set, and points out the multiple flaws in the ideological approach by the said authors:
While this article is ostensibly a critique of the psychotherapy tradition it has a powerful subtext that any attempt to make sense of gender-related distress is automatically bad. I suspect this is less about conflation of distress with gender identity, and more about the authors’ wish to advance the claim that gender dysphoria is entirely a consequence of minority stress. This would imply that any reference to understanding, exploring or treating gender-related distress is therefore misguided and pathologises gender identity itself. This argument, of course, also implies ‘affirmation’ as the solution.
Hurst, 2025.
The full response can be read here.
References
Hurst, M. (2025). The Elephant in the Future (A response to ‘A Letter from the Future to Ourselves’). https://www.researchgate.net/publication/388631033_The_Elephant_in_the_Future_A_response_to_’A_Letter_from_the_Future_to_Ourselves’
Simon, G., Whitfield, G., Day, E., & Middleton, A. (2024). A Letter from the Future to Ourselves. Murmurations: Journal of Transformative Systemic Practice, 7(1), 98-101. https://murmurations.cloud/index.php/pub/article/view/243/142.
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