Therapy First
@TherapyFirstOrg
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Therapy First is an association for therapists who believe psychotherapy is the appropriate first-line treatment for gender dysphoria.
Joined December 2021
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🍏🏋🏼♂️How can we help young people with gender distress build a healthier lifestyle?
Gender distress often profoundly disrupts self-care and other healthy behaviors.
Our October webinar considers therapeutic strategies (drawing on motivational interviewing and acceptance and
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Are you a mental health clinician with concerns about the affirmative model of care for gender dysphoric youth? Please check out our website!
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Therapists are under immense pressure to abandon their professional standards and adopt an unquestioning affirmative approach. This is totally at odds with the clinical assessment and diagnosis they have been trained to undertake in all other clinical encounters.
@thecassreview
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One of the defining questions an adolescent asks is who am I? Young people need a safe place to explore this question. We need to hear their struggle as a symbolic communication. Sonia Appleby
#firstdonoharm
@CanSG_org
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The gender affirming model is now fundamentally discredited.
This medical scandal must finally come to an end.
Why I Am Publishing WPATH Files And How I Got Them
The written WPATH Files come from WPATH’s member discussion forum, which runs on software provided by DocMatter.
Ninety seconds of the 82-minute video was made public last year. We are making the full video available for the
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NEW: A preprint study on testicular development by the Mayo Clinic finds puberty blockers cause "mild to severe atrophy" in boys' sex glands.
The study calls into question claims by supporters of the gender-affirming model that these drugs are "reversible".
If this study from
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Our Therapy First President
@paulgarciaryan
is quoted in this excellent
@nytimes
article by Pamela Paul:
“When a professional affirms a gender identity for a younger person, what they are doing is implementing a psychological intervention that narrows a person’s sense of self
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We are excited to announce our webinar for therapists working with gender questioning youth. This will be an opportunity for therapists to explore GETA's clinical guide as a practical and accessible alternative to the gender affirmation model.
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Adolescents with severe mental health issues did not improve on CSH. One quarter developed new psychiatric needs during treatment with CSH. Rita Kaltiala
#firstdonoharm
@CanSG_org
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GETA is thrilled to share some exciting news that marks a milestone for our organization.
Come December 1st, GETA will be known as “Therapy First.”
This decision reflects our commitment to emphasizing psychotherapy as the first-line intervention for gender dysphoria
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Please consider donating to our GoFundMe. We are building a robust network of therapists who are committed to addressing psychological issues using a psychological approach.
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“More clinicians are now recommending an “exploratory approach” in which the client and counselor carefully consider the source of the gender dysphoria as well as the implications of transitioning.”
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We are so proud to see Therapy First member Tamara Pietzke in
@TheFP
today:
"For six years I worked at a hospital that said all teenagers with gender dysphoria must be affirmed. I quit my job to blow the whistle".
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Shockwaves from the Cass Review continue today. The British public is absorbing the homophobic and misogynistic nature of what has happened in plain sight, on the NHS, in their schools.
"Disproportionately made up of girls and same-sex attracted children, many were put on an
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"Here are the facts these children should be taught: There is no right or wrong way to be a boy or a girl. All of us experience and express varying degrees of masculinity and femininity in a multitude of different ways".
@genspect
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Patients presenting to specialized gender services were not what clinicians expected Dr. Rita Kaltiala
#firstdonoharm
@CanSG_org
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"And I was just lesbian": Dutch detransitioner
@eternalsamo
on how she experienced the traumas of "gender affirmative care" as a lesbian teenager.
#GenspectBiggerPicture
#BeyondWPATH
#TimesUpWPATH
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Dr. Riittakerttu Kaltiala has been at the forefront of Finland's treatment of gender-questioning youth.
In a recent interview she said there isn't enough evidence re the causes of the current wave of gender dysphoria to justify giving life-changing medical treatments to children.
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Experimenting with identity is an important part of adolescence. Most young people will not benefit from physical interventions.
#firstdonoharm
@CanSG_org
Dr. Rita Kaltiala
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Good journalism raises the quality of the debate and protects the public interest. Journalists need to be able to ask questions and raise concerns. Why is
@glaad
trying to silence journalism?
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Doctors & academics at Australia's Children's Hospital at Westmead have published a study of 79 patients at their gender clinic.
They found many serious concerns, stating "the evidence-base pertaining to the gender-affirming medical pathway is sparse".
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Proud to have attended this important event.
Yesterday's
#FirstDoNoHarm
conference organised by
@CanSG_org
was an incredible achievement. The 1st gathering of medical professionals who are blowing the whistle loud & clear on the irreparable harms done to children & vulnerable adults by "gender affirmative care" 1/4
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Youth medical gender-transition treatments do not prevent suicide, a major new study finds.
Today's
@nypost
article by
@benryanwriter
unpacks the first major study to scrutinize claims that the gender affirming model is "life-saving".
In the article, our president Paul
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A new long-term study finds that the majority of young people outgrow unhappiness with their gender.
“In early adolescence, 11% of participants reported gender non-contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26)".
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What has been stolen from these young gay men is unforgivable.
"Realizing post-surgery that you’re actually a gay man means you’re caught in an impossible space. You learned, too late, that so-called “transition” is a lie, but the full-spectrum life of a gay man is foreclosed
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The detransitioner panel with
@BenjaminABoyce
at
#genspectbiggerpicture
was a shocking window into the callous irresponsibility of the gender industry.
Thank you
@funkgodartist
@TullipR
, Camille Kiefel, Michelle Aleva
@lacroicsz
@eternalsamo
& others.
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We are very pleased to offer our free Clinical Guide for Therapists Working with Gender Questioning Youth. Please download and share!
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It couldn't be said more clearly than this: "The gender-affirming model of care is incompatible with competent, ethical medical practice".
Australian psychiatrist Andrew Amos examines the gender-affirming model, and finds it incompatible with the foundational principles and
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The Cass Review in
@PsychToday
:
Does Our Approach to Gender Dysphoria Need an Overhaul?
Thankfully, the conclusion is that it does.
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The gender-affirming model continues to unravel:
@bmj_latest
gives a glowing report on the
@CanSG_org
conference last weekend, citing expert after expert questioning the medicalization of minors with gender dysphoria.
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Gender ideology is pitting parents against their children
@jburgo55
describes the pain and stress of trying to find a way through.
#genspectbiggerpicture
#timesupwpath
#beyondwpath
@genspect
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As mental health care providers we have an ethical and moral obligation to take extremely seriously the patients screaming and crying out that they have been forever scarred by a treatment model advocated and approved of by most of our professional bodies.
#DetransAwarenessDay
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"Similar to anorexia, pubescent girls are offered another, albeit particularly drastic, opportunity to avoid dealing with maturity-related changes and developmental tasks and to express their individual suffering in a form that is accepted in our time and culture".
A new German publication compares two conditions in adolescent females: gender dysphoria and anorexia. It posits that most cases of GD represent temporary struggles, and clinicians should not “hastily collude" in applying a "trans-identification template."
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Today, the American Academy of Pediatrics finally broke its silence on the Cass Review, in response to the
@WBUR
interview with Dr Hilary Cass.
Unusually, for a medical association, the focus of the statement is on politics, rather than on the substance of the Cass Review or the
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"Until reliable measures of regret are available...the public-at-large need to know that the regret and detransition rates are unknown, and that the evidence in hand does not demonstrate that these rates are very low".
@segm_ebm
@SwipeWright
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“Gender affirming care” has a scandalously weak evidence base.
Essential reading as usual from
@LeorSapir
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@DominicRaab
As therapists working to make sure gender dysphoric youth get the best possible treatment and working first hand with the kids directly impacted by getting the wrong treatment, thank you for saying what so many of us have been campaigning tirelessly for.
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We’re aware of a video circulating on social media recycling the tired claim that Therapy First practices "conversion therapy".
To be clear, Therapy First does not practice “conversion therapy”. Our members provide holistic and individualized, developmentally informed therapy.
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🎯"NO ONE - neither children nor adults - can give informed consent to medical treatment if their doctor is misinforming them about the nature of their condition"
@buttonslives
#genspectbiggerpicture
#genspectdenver
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An important vote in England tomorrow to preserve the freedom of therapists to practice the robust, developmentally appropriate therapy that gender-questioning young people deserve.
Members of
@UKCP_Updates
face a vote to oust their board of trustees, who withdrew from the
‼️CALLING ALL
@UKCP_Updates
Member‼️
Following withdrawal from the MoU there will be a vote to oust the board of trustees! It is vital that this does not succeed!
Check your email and DM us if you’d like to discuss it further!
@SaveMHUK
@TherapyAntidote
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“Supporting a social transition without the involvement of parents or carers can create complex difficulties within families and is not recommended. Secrets between parents or carers & their children are problematic and are likely to create further issues”
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A crucial difference between an explorative and an affirmative approach in the treatment of gender dysphoric youth is that the former prioritises psychotherapeutic intervention whilst the latter prioritises medical intervention (with irreversible treatments and surgeries).
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Thank you
@jk_rowling
for highlighting this troubling contradiction.
While psychotherapy for gender distress has increasingly been referred to as “conversion therapy,” this is a false and misleading characterization.
As Dr. Cass pointed out, “the intent of psychological
You can't promise to implement Cass's recommendations but vow to prevent talking therapy with gender-questioning children on the basis that it's 'conversion therapy.' Pick a lane,
@UKLabour
.
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“WPATH has been discredited. What will guide us now? Answer: evidence-based care.” Dr. Louise Irvine
#firstdonoharm
@CanSG_org
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🧵Today Therapy First wrote to
@APA
about their "Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation, and the Role of Psychological Practice and Science"
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"Gender dysphoria is the only mental health condition in which treatment affirms the highly distressing thoughts inside someone’s head or encourages them to physically change their body".
@JamesEsses
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At the London Tavistock’s gender clinic, about one third of young people referred had ASD.
Come along to our Nov webinar to explore the links between ASD and gender dysphoria, with Dr Susan Bradley.
Tickets here:
💻NEW: Our November webinar (with Dr Susan Bradley) will be a deep dive into how ASD can make young people vulnerable to gender dysphoria.
Tickets and further details here:
@genspect
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"The Detransition Rate is Unknown" - people considering transition have the right to a high quality evidence base for these serious medical interventions.
That evidence base isn't there.
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📚When Kids Say They're Trans: A Guide for Thoughtful Parents (by
@LisaMarchiano
@stellaomalley3
&
@SashaLPC
) is now available to pre-order:
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To clarify: we favor caution and a robust understanding of the whole person before any young person proceeds to drugs or surgical options, which will leave them as medical patients for life. In no sane world is this to be described as "conversion therapy".
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It's hard to understand how this doctor, one of the Cass Review's most virulent critics, couldn't find it in himself to put down some of his ideas in writing (and in the process benefit seriously ill children).
Today is the last day for
@DrOBrienMD
to accept the written debate with
@LeorSapir
on "gender-affirming care" that will trigger over $30,000 to be sent to a children's hospital of his choice. Still no word.
I will be refunding all the donors tomorrow.☹️
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Happy to see this strong support for The Cass Review from
@UK_ACP
.
"ACP-UK commends and strongly supports the Review and its recommendations. We congratulate Dr Cass and her team on a truly impressive and comprehensive body of work, conducted and completed in the most hostile,
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"When presenting with gender dysphoria (GD) children and young people can experience diagnostic overshadowing where other co-occurring issues can go unaddressed if all professional support is focused exclusively on their gender identity"-
@thecassreview
, professional concerns.
Perhaps Gender Clinics are overwhelmed because we explained away puberty, social awkwardness, trauma, OCD, Same sex attraction, gender non conformity and autism in a neat all-inclusive package that comes with its own community, available online 24/7.
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If you have a minute today, please support
@pittparents
' campaign to highlight the findings of the Cass Review to the American Academy of Pediatrics.
“We ask you to participate in an email campaign to the members of the executive committee of the American Academy of Pediatrics.” Please send an email to the leaders of the AAP today!, by
@pittparents
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⚖️Detransitioners are taking legal action all over the world.
Join GETA this THURSDAY to hear Peter Jenkins of
@ThoughtfulTs
on the changes this will bring.
Tickets here:
⚡️This September we have TWO webinars!
First up on Sep 14th is UK counselor and legal expert Peter Jenkins, who will examine "Prospects for suing over medical transition: Building the case against WPATH".
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It's been reported in Ireland that over 50% of those seeking gender assessment have autism, and “this number is increasing.”
Come along to our November webinar with Dr Susan Bradley to learn more about the links between ASD and gender dysphoria.
#autism
💻NEW: Our November webinar (with Dr Susan Bradley) will be a deep dive into how ASD can make young people vulnerable to gender dysphoria.
Tickets and further details here:
@genspect
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Describing a 16 year old stepping in front of a tractor trailer as "boldly ending her life" is disgusting glorification. When someone ends their own life, especially a child, it is horrendous, tragic, incomprehensible and beyond devastating.
Here’s my iPhone video of Dr. Ladinsky glorifying suicide in a 16 year old. In case you were thinking I misunderstood.
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"Trapping kids in the place where they feel less confident":
@twisterfilm
speaking at the
@genspect
Bigger Picture conference on the intolerable risks of puberty blockers.
#genspectbiggerpicture
#BeyondWPATH
#TimesUpWPATH
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The hit piece on
@Doctor_Az_
is not the own they think it is. All it does is show the willingness to use manipulative intimidation tactics against competent clinicians and further confirms the dangers of a ban on therapists doing their jobs.
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As a group of clinicians who are working with detransitioners, we are very disappointed to hear that
@AMCTheatres
has canceled the release of the important documentary
#NoWayBack
. This film is not at all anti-trans. It exposes a significant medical scandal.
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⚡️This September we have TWO webinars!
First up on Sep 14th is UK counselor and legal expert Peter Jenkins, who will examine "Prospects for suing over medical transition: Building the case against WPATH".
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From
@wil_da_beast630
: research in gender medicine is flawed as data is gathered only from patients who are in friendly contact with their medical providers, which would not include people who've detransitioned.
#GenspectBiggerPicture
#GenspectDenver
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"These children don’t need body- and mind-altering chemicals and surgeries that turn them into something they aren’t.
"They need caution, counseling, and, most of all, time to come to grips with who they are. In other words, they need exactly what the Endocrine Society doesn’t
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🇩🇪 Post-Cass, the world is waking up!
Germany's major medical body today recommends that:
* The medical treatment of gender dysphoria in minors should be restricted to clinical trials.
* Self-id laws should apply only to adults.
The 128th German Medical Assembly 2024 just passed 2 resolutions: to restrict puberty blockers, cross-sex hormones, and surgeries for gender-dysphoric youth under 18 to controlled clinical trials; and to restrict the self-id laws to those over 18. This is a major development. /1
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We appreciate this nuanced piece calling for better mental health treating for gender dysphoric children.
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"This shocking chapter in medical history, where the ideological objectives of trans rights campaigners trumped the welfare of disturbed children, is coming to an end worldwide".
@VictoriaPeckham
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How can we best work with gender questioning young people?
At our next webinar we'll be discussing this with special guests
@marcuse99903226
&
@sueevansprotect
, authors of Gender Dysphoria. A therapeutic approach.
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⚡️Good news - Therapy First now has a YouTube channel!
Our debut episode of “In Conversation” features social workers Paul Garcia-Ryan, Amber Ault, Dwight Ponazzo, Stefan de Villiers, and Zander Keig tracing the evolution of gender dysphoria within their field.
They reflect on
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We are SO pleased to see Hilary Cass being interviewed at length on NPR's
@OnPointRadio
by
@MeghnaWBUR
It is crucial for the US public to hear one of Britain's most eminent pediatricians outlining the serious concerns she discovered after four years reviewing pediatric gender
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Feminine behavior in boys predicts later same sex sexual orientation. Why are we medicalizing it? Dr. Michael Biggs
#firstdonoharm
@CanSG_org
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💻NEW WEBINAR: What is happening to the word "lesbian"?
How do new uses of the word impact identity formation for women who are same-sex attracted?
Join Terry Patterson on Sat Oct 14th for a fascinating & important discussion.
@ThoughtfulTs
@genspect
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Professor Alan Sokal defends exploratory therapy. “[In] Open-minded exploratory psychotherapy… the therapist helps the young person to explore the causes of his/her/their gender dysphoria…”
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"Gender dysphoria is the only area of mental health in which patients are allowed to diagnose themselves, and physicians and psychologists are barred from making any independent medical judgment".
WHO PUT THE KIDS IN CHARGE?
Another in my occasional series on the trans industry, this one about the history of how the American standard of care evolved to give children and young teens the power to make unchallenged decisions about their gender identity
"The United States
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“Mental health problems should be considered a comorbidity to be managed and not a reason for affirmative care.”
@CanSG_org
#firstdonoharm
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This makes chilling reading. Children who enter foster care are among our most vulnerable, and should not be herded so vigorously into the care of proponents of the now widely discredited gender affirming model.
Joseph Figliolia and
@LeorSapir
: There is a "growing social movement bent on deeming parents 'abusive' for declining to 'affirm' their child’s 'gender identity.'"
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The struggle to find an ethical therapist to work with your gender-questioning child can be exhausting, and too often, unsuccessful.
That's why we started our Directory - do take a look if you'd like to work with someone who offers traditional, non-ideological psychotherapy,
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We are so pleased to be contributing to this new initiative providing low-cost counselling and other vital services to detransitioners and anyone else trying to make sense of their transition journey.
Beyond Transition
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Thank you
@genspect
&
@jburgo55
- there's just SO much need out there for traditional, non-ideological therapy. As we grow, we hope to help more and more.
.
@jburgo55
mentions
@GETAtherapy
, an org for therapists working with clients w/gender confusion and hold monthly webinars. Check out their website: "We are here because those who are exploring gender identity or struggling with their biological sex should
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"The phantasy that the body can be sculpted to rid the self of profound and unmanageable psychological problems needs to come under much closer scrutiny".
My paper was recognized as one of the top downloads last year! Despite the fact that this thinking is clearly in demand, I've had difficulties getting this work published in some PA journals. Thx
@wileyinresearch
Clinicians must be free to debate & think.
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Sixteen senior psychologists have written to the Observer today to point out how seriously the profession has failed children.
"Whether intentionally or not, and many were doing their best in an impossible situation, it was clinical psychologists who promoted an ideology that
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Are you a parent who has found a competent therapist for your gender questioning child? One who will explore their experience in an open-ended way? Tell that therapist about GETA!
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A big win for robust, developmentally appropriate psychotherapy today:
“after very careful consideration, UKCP has taken the decision to withdraw its signature from the Memorandum of Understanding on Conversion Therapy in the UK v2 (MoU) and its membership of the Coalition
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Therapy First President Paul Garcia-Ryan is in
@washingtonpost
this morning.
Paul comments on the Cass Review, shares some of his own experiences, and considers what the future holds for therapists taking a holistic, individualized approach to gender distress.
"It isn’t right
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This
@nytimes
article acknowledges the role of social contagion and clarifies that treatment can bring infertility. Still a lot it gets wrong but a breakthrough in the MSM discussion
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We had a beautiful meeting last night. So inspiring to be around ethical, thoughtful and competent therapists.
@geta
is growing!
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"The Cass Review is a watershed moment. Americans who see the medicalization of trans-identifying children as the scandal it is, irrespective of their other political views, should take a leaf out of the UK’s book".
@Ayaan
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What a month - Dr Hilary Cass' Review has shown to the world the weak evidence base of the gender-affirming model.
It represents a profound contribution to the protection of children.
We are grateful for Dr Cass' calm, empathetic and scientific approach. We are hopeful that
NEW: A month after delivering its damning conclusion that children were failed by NHS gender services, the Cass Review team is winding down. It was my pleasure to speak with Dr Hilary Cass for her final UK interview - her broadest and most reflective yet.
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A chilling account by
@sueevansprotect
of how the medical scandal at the London Tavistock's GIDS unfolded.
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Identity development is the outcome of adolescence, not where it begins. Rita Kaltiala,
#firstdonoharm
@CanSG_org
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Can't deny being VERY excited to see that
@Martina
has reposted our webinar on detransitioner lawsuits.
Please check it out if you're also interested:
Hmm. Maybe this will slow things down in a good way- no way kids should be taking hormones after spending an hour with a shrink. Not saying they shouldn’t but please be sure that that is a good idea…
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"I was a gender non-conforming kid who struggled with gender dysphoria for over 20 years. Only when I let go of internalized stereotypes, misogyny, and stored trauma did I accept that I am female and that no hormone or surgical procedure can change that."
I started a Substack! My first post is a concerned letter to my university professor about the overrepresentation of sex work and gender identity theory in the class's assigned readings. Please give it a read or subscribe for free if you feel inclined.
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We are currently looking for volunteers to translate some documents from English into Spanish, German and/or French. Please DM us if you could volunteer some effort towards this. Thanks :)
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NEW ON OUR BLOG: a therapist explores the experience of working with gender-questioning patients:
"I just had to give myself permission to treat people with gender dysphoria the same way I would treat any other patient".
@genspect
@stellaomalley3
@SashaLPC
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Trans women taking hormones are up to 95% more likely to suffer heart disease.
This is the finding of a new study published in the European Journal of Endocrinology.
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An important development from Australia - how long can health insurers afford to keep funding the medical transition of children?
Major Australian medical insurer declines to continue insuring doctors for “gender affirming care” for minors
“We don’t think we can accurately and fairly price the risk of regret”
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.
@jburgo55
on the awful choice faced by parents: do you pretend to believe or do you stick with the truth while everyone tells your child "your parents are transphobes: get rid of them".
It's an anti-family movement
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Looking forward to listening to Dr Jillian Spencer - a crucial voice for child safeguarding.
"One of the most disturbing things I saw at the hospital was colleagues who I knew, knew the harms, and they would continue to deliver care according to the affirmation model. They wouldn’t even take little steps like taking off their pronoun badges which is not something that
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The stories of detransitioners speak to the need for therapy that helps the patient explore his or her feelings thoroughly.
'Exploratory therapy would have saved me a lot of pain'
Sinead Watson, who originally underwent medical transition before recently de-transitioning, talks about the experience.
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From a psychological perspective, reality and metaphor are now inverted.
Where “born in the wrong body” used to be understood in a symbolic way, it’s now taken as literal truth (
@PamelaParesky
#GenspectBiggerPicture
#GenspectDenver
)
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