The Therapists Breaking Ranks on Gender Ideology | Thoughtful Therapists (#47)
13 November 2025
With Lucy Beney
UK
Lucy Beney and Terry Patterson of Thoughtful Therapists describe how UK professional bodies used the Memorandum of Understanding on Conversion Therapy to suppress exploratory clinical practice. Their account connects directly to the Cass Review's finding that affirmation-only models lack an adequate evidence base — and raises questions about the governance frameworks that enforced those models while the evidence was still being assembled.
Thoughtful Therapists was founded in 2021 by practising counsellors and psychotherapists who had grown uneasy with the direction their professional bodies were taking. Steering committee member Lucy Beney and university counsellor Terry Patterson trace how organisations meant to maintain clinical standards became, in their account, vehicles for enforcing a single position on gender identity — with the Memorandum of Understanding on Conversion Therapy as the primary instrument of that enforcement. The Memorandum of Understanding is a joint statement signed by the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy, and several other bodies, committing them to opposing practices designed to change or suppress a person's gender identity. Beney and Patterson argue that its broad and loosely defined language has made ordinary exploratory therapy professionally hazardous. Asking a young person why her relationship to gender shifted after a period of social anxiety or trauma, or exploring the potential clinical relevance of an autism diagnosis, can be characterised under the MOU's terms as attempting to suppress gender identity expression — and therefore as conversion therapy. The Cass Review, published in April 2024 after a four-year independent examination of NHS gender services for children and young people, found that the evidence base for affirmation-only clinical approaches was strikingly weak. It called explicitly for watchful, exploratory practice as appropriate standard care — precisely the approach the MOU had rendered professionally risky. Professional bodies that enforced affirmation-only norms during the period under review have not publicly reconciled their earlier positions with those findings. When the UK Supreme Court ruled in April 2025 that the definition of woman in the Equality Act refers to biological sex, BACP responded by affirming solidarity with trans and non-binary people and declaring all gender experiences valid. For Lucy Beney, this response — issued in the name of a regulatory body rather than an individual — was the point at which her membership became untenable. She resigned in May 2025. Her account illustrates how a legal ruling on the meaning of protected characteristics was processed by a professional organisation as a political loyalty test. The UKCP's withdrawal from the MOU prompted a sharp backlash from gender-identity advocacy groups. The case of James Esses — expelled from a psychotherapy training programme after publicly questioning gender-identity doctrine, and subsequently vindicated in legal proceedings — demonstrates that professional risks for individual therapists have been concrete rather than hypothetical. Courts in England and Wales have found that gender-critical beliefs qualify as protected beliefs under equality law; professional bodies have been slower to absorb the implications. What emerges is a picture of sustained governance failure. The Cass Review documented how a paediatric clinical pathway was driven by advocacy rather than evidence. Beney and Patterson argue that the same dynamic has operated across the counselling and psychotherapy professions more broadly — through mechanisms of registration, accreditation, and disciplinary risk, rather than concentrated in one visible institution. Their account amounts to a claim that the profession's obligation to individual clients has been systematically displaced by a requirement of ideological conformity.
