Therapists Push Back on Anti-Trans Continuing Education
Assigned Media investigates as the anti-trans organization Therapy First has begun offering continuing education to medical professionals.
by Veronica Esposito
Last month, Susanna Moore, a psychologist who has spent well over two decades specializing in serving trans youth, shared a concerning email with her colleagues: Therapy First, a group widely known to discredit trans identities and dissuade trans people from seeking gender-affirming medical care, was offering a continuing education class geared toward therapists. Even more troubling, the class was accredited under the auspices of the American Psychological Association (APA), one of the biggest and most powerful associations of therapists in the country.
“I wanted everyone, but particularly the psychologists in the group, to be aware that the biggest membership organization of psychologists was offering continuing education credit for a discredited approach to serving trans people,” Moore said via video interview. “And at a time when this group is under really widespread attack.”
As the world’s largest nonprofit publisher of psychological science, publishing some 90 peer-reviewed journals, the APA is a central body in promulgating standards and best practices for therapy. Based in Washington, DC, it has a budget of well over $100 million per year and makes significant lobbying efforts on national legislation. The organization’s accreditation of Therapy First to offer continuing education courses has sent shockwaves through the community of gender-affirming therapists, who are not taking things lying down. A backlash is brewing.
Available evidence indicates that Therapy First is not a group that supports trans people’s best interests. In a pinned posting at the top of its Instagram page, the organization declares that clinicians should become a member if they agree that “given the weak evidence and the risk of regret, medical interventions for gender dysphoria in children and teens are experimental and should be avoided if possible.” Clinicians should also join Therapy First if they agree that “the ‘affirmative’ model of therapy for clients who are gender questioning or experiencing gender dysphoria is inadequate.”
One prominent member of Therapy First who has taught a seminar under the organization has published work arguing that girls are turned transgender due to overconsumption of pornography.
A 2022 pamphlet published by the Gender Exploratory Therapy Association (GETA) (the organization that eventually became Therapy First)—and since removed from the Internet—downplays the risk of suicide in trans youth, calling discussion of the realities of trans suicide “exaggerated and hysterical rhetoric.” It goes so far as to imply that merely discussing the fact that trans youth are more likely to end their lives is somehow harmful to them: “We aver that the hyper-focus on heightened suicide risk promulgated by clinicians and the media may create an injurious nocebo effect, inadvertently exacerbating suicidality in vulnerable youth.” The pamphlet’s list of suicide prevention methods notably omits providing youth with gender-affirmitive therapy and medical interventions, when desired.
In fact, research has demonstrated that gender-affirming care reduces suicidality in trans youth, and the passage of laws meant to prevent trans youth from living authentic lives is correlated with an increase in suicide attempts. Moreover, it is widely known among therapists that simply discussing suicide risk with clients does not make them more likely to attempt to end their lives and in fact may reduce suicide risk. Following a request for comment made by Assigned Media, a spokesperson for Therapy First directed readers to the organization's FAQ, Statement of Values, and 2025 Annual Report.
Therapy First is not alone in attempting to infiltrate the continuing education process with classes of questionable value to trans people—the area looks to be shaping up as a new flashpoint in the ongoing battle to curtail and control trans lives. Earlier this year it was revealed that Washington State University had given accreditation to continuing education courses taught by the Society for Evidence-Based Gender Medicine, a Southern Poverty Law Center–designated hate group, while Michigan’s Great Lakes Learning had platformed Genspect, another SPLC–designated anti-trans hate organization. Thankfully, both organizations have found their courses suspended after efforts by LGBTQ+ advocates and allies brought the materials under review.
Continuing education is an important part of the medical and mental health fields—commonly, practitioners attain licensure without competent knowledge in working with trans clients, and continuing education helps them to get up to date in best practices. Subverting continuing education by injecting anti-trans viewpoints would likely prove harmful to trans people seeking medical and mental health support, and would also drown out voices in the field who are seeking to make therapy a safer environment for trans clients.
“Generally speaking, continuing education has been mildly to seriously transphobic,” Moore said, “and it’s really new that we’ve had a reprieve, where people who are well-equipped to talk about good, evidence-based care that really values people’s humanity has been around.”
Thanks to Moore and other gender-affirming therapists, there is a backlash brewing against Therapy First’s APA accreditation, and currently the organization is reviewing the approved courses. Therapists such as Moore have been sounding the alarm via listservs and peer-to-peer texting groups, resulting in an outcry that has gotten the attention of the APA.
Emails shared with Assigned Media show fierce debate occurring on listservs of therapists. Some therapists shared articles indicating the harmful approach and checkered history of Therapy First, whereas others continue to share their seminars and argue that the organization doesn’t sound very transphobic at all.
An individual who has participated in efforts to force a review of Therapy First’s accreditation related to Assigned Media the results of the ongoing campaign. Concerned therapists connecting via listservs and peer-to-peer networks have reached out to the APA, arguing that Therapy First’s materials are contrary to the organization’s own guidelines for best practices with trans clients.
In Guideline 6, the APA explicitly endorses gender-affirming therapy, contrary to Therapy First. “Psychologists strive to recognize the influence of institutional barriers on the lives of TGNC people and to assist in developing TGNC-affirmative environments.” In Guideline 14, the APA specifically endorses working in conjunction with medical providers to support medical transitions when desired: “Psychologists in interdisciplinary settings could also collaborate with medical professionals prescribing hormone therapy by educating TGNC people and ensuring TGNC people are able to make fully informed decisions prior to starting hormone treatment.”
“I expressed my sincere disapproval of offering continuing education to Therapy First,” one therapist shared with Assigned Media. “I got a bit emotional, and I pointed out that these courses are contrary to APA mission statements, which are very clear. Four days later got a message from the continuing education office thanking me for reaching out and stating, ‘we’re going to research this closer.’”
Sources who primarily work with trans youth and have knowledge of the APA have expressed a variety of beliefs as to why the organization would offer Therapy First’s materials. Some have argued that, given the volume of continuing education courses offered by the APA and the lengthy application process, these courses may have slipped through accidentally. Others, such as Moore, believe that transphobic influences still operate in the institution.
“I had been surprised at the APA taking a strong stance for trans people,” Moore said. “They haven’t always had the best interests of the people they served at heart.”
The APA did not respond to a request made by Assigned Media to discuss the accreditation process and the current status of the review of Therapy First’s materials.
The current status of Therapy First’s APA accreditation is unclear. At the time of publication, the organization’s webinars page lists an APA-accredited class on “Transition-Related Grief” taught by Paul Garcia-Ryan a high-profile detransitioner who has renounced gender-affirming medical care for those under 25 years of age and has made false statements about such care not being scientifically backed. Garcia-Ryan has been cited by leading transphobes such as Pamela Paul in articles attacking the trans community.
The fear is that such voices will connect with therapists with little knowledge of the trans community and use reasonable-sounding rhetoric to camouflage extreme and harmful ideas.
“Therapy First sounds ok, because who can really argue with therapy,” said Moore. “It’s insidious because people are ignorant and have prejudices that they grew up with. If you attend something like Therapy First, those worst impulses are going to be supported, and your ignorance is going to continue."
Veronica Esposito (she/her) is a writer and therapist based in the Bay Area. She writes regularly for The Guardian, Xtra Magazine, and KQED, the NPR member station for Northern California, on the arts, mental health, and LGBTQ+ issues.