As the lead organisation for Cognitive Behavioural Therapies (CBT) in the UK and Ireland we wish to respond to the Supreme Court ruling and the reporting surrounding it.
We are concerned about the impact on mental health and wellbeing for trans, non-binary, intersex, gender-questioning people (TN-B/I) and those close to them or those providing care.
We want to offer our support and compassion to TN-B/I people who will be affected by this ruling. Gender reassignment is a protected characteristic and remains protected in law as such, and people should be able to live free from discrimination and harassment. Although the ruling has specific impacts on attitudes relating to biological determinism and the impact on rights for trans people, the issue remains that there are also further legal grey areas for people who do not possess a gender recognition certificate (GRC) and there are fewer legal gender based rights for those who identify as non-binary. We recognise the legal rights of TN-B/I people are impacted and participation in civil life may become much harder as a result. There is uncertainty for many and misunderstandings of what the ruling means.
International evidence suggests that trans, non-binary and intersex people (TN-B/I people) are statistically at a higher risk of developing common mental health problems and have a higher rate of suicide and self-harm. This ruling is likely to increase distress and experiences of discrimination and other harms for TN-B/I people. Therefore, the impact on mental health and how we deliver CBT as an evidence-based approach to improving mental health is important. Services providing psychological therapies will need to be aware of increased needs of TN-B/I people and respond accordingly.
As an organisation, we are committed to evidence-based practice, which not only applies to individual therapy but also to the environment and systems in which they are delivered. The ruling has been questioned on grounds that it does not take into account scientific understandings of gender diversity and could cause harm to TN-B/I people. (Leading doctors affirm trans and non-binary rights in healthcare – BMA media centre – BMA).
We aim to ensure that we are inclusive for people with diverse and intersectional experiences and characteristics. This means for all our members and the people and communities they provide services for. We oppose discrimination of any kind and are continually working to improve our inclusion of trans, non-binary and intersex voices, and take an active stance against discrimination and inequality. We aim to support our members in providing a safe and equitable therapeutic environment for all people who may seek CBT. That environment will respect the dignity, autonomy and human rights of everyone, whether receiving, providing or supporting those services. This will include ensuring clinicians are attuned to a population that are being pushed to the margins of society and where providing gender-affirming CBT can make a difference in someone’s life. This can include using preferred pronouns in person and in clinical records, addressing the person by the name they wish to be addressed, as well as other actions clinicians can take to be a trans ally.
Our BABCP members proudly represent a cross section of society, and therefore we recognise our members may also be impacted by this ruling. For clinicians who are affected, we would encourage practitioners to seek support through their employers, or local groups. We would also encourage joining our Special Interest Groups (SIGs) to find support within a community, such as the LGBTQ+ Special Interest Group or Women’s Equality & Gender Diversity (WOMGEND) Special Interest Group. We are with you.
Evidence of impact on mental health and increased suicide rate for trans people –
- https://www.sciencedirect.com/science/article/pii/S2352250X23000246 (Minority Stress Model to conceptualise determinants of mental ill health for LGBTQ+ people)
Sources of support
Mermaids – supporting trans, non-binary and gender diverse children, young people and their families
Psychological society of inclusive, intersectional and queer communities – professionals, psychologists and psychology users who hold trans, non-binary and gender-fluid inclusive views
Gender Identity Research & Education Society – Improving the Lives of Trans People
LGBT Foundation – a national charity with LGBTQ+ health and wellbeing at its heart
Good Law Project – support resources in the UK
Belong To – For young people in Ireland
TransActual – Being a TN-B/I ally
Evidence about CBT interventions for trans, non-binary & intersex people
Austin, A., & Craig, S.L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications. Professional Psychology: Research and Practice, 46(1), 21–29.
Austin, A., Craig, S.L., & Alessi, E.J. (2017). Affirmative cognitive behavior therapy with transgender and gender nonconforming adults. Psychiatric Clinics, 40(1), 141-156.
Berke, D.S., Liautaud, M.M., Chen, D., & Sloan, C.A. (2024). Applying cognitive behavioral principles to promote health in transgender and gender diverse individuals. Cognitive and Behavioral Practice, 31(1), 35-47.
Carvalho, S.A., Castilho, P., Seabra, D., Salvador, C., Rijo, D., Carona, C. Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs). The Cognitive Behaviour Therapist. 2022;15:e3
