Challenging Unethical Practices in Psychotherapy

Anybody who has been canceled for holding disfavored views knows how lonely and depressing the experience can be. It often means watching trusted people in positions of authority turn into bullies and, worse, watching friends and colleagues turn into cowards.

That dark reality makes it all the more important to understand those people who do the right thing and stand up for what’s right. One of them is James Esses, a British attorney in his early thirties who was kicked out of a training school for therapists for raising concerns about the medical mistreatment of children confused about their gender.

As far as cancelations go, Esses’s wasn’t particularly dramatic or noteworthy. He wasn’t a famous actor, musician, or writer. He was just someone who, early in his career, decided he didn’t want to be a lawyer anymore and instead wanted to help people with mental health problems.

Given that protecting the institutions of civilization requires more ordinary people, without the resources of famous artists and authors, to stand up against bullies, we should seek to understand why they do it so that we might encourage more of it.

Esses’ journey began in 2020 when he was in his third and final year of getting his therapist’s degree from Metanoia Institute and volunteering for a charity to staff a mental health hotline.

“I was on the cusp of setting up my own private practice,” he says. “I had children coming through on this helpline saying they were trapped in the wrong bodies and that they wanted to use breast binders and take puberty blockers. They were younger and younger.”

The charity told Esses “to kind of just affirm” the pseudoscientific and dehumanizing idea that some children are born into the wrong bodies.

“Many had come across this stuff online,” he said. “Many of them were being taught it in school. Children have been taught from a very young age that it's possible to be born in the wrong body and that you can essentially change your sex.”

Esses started reading about children being medicalized and given drugs and surgeries. “I couldn't believe what I was reading. We were damaging, irreparably, children in the name of an ideology that isn't founded in evidence or fact. I couldn't believe it."

“The message from the training institutions and our regulatory bodies as therapists was, essentially, affirm,” Esses explained. “Don't explore. Don't challenge. Affirm transitioning, no matter what. And to me, that flew in the face of proper therapeutic ethics and the Hippocratic oath. So I couldn't simply abide by that. I felt compelled to start speaking out about it.”

Esses cofounded with some colleagues a new group, Thoughtful Therapists. “I wrote a petition to the UK government,” he said. “I started engaging on social media for the first time about this, doing some interviews, and writing some articles. And then, out of the blue, one day in May, I received an email from my institution telling me that they were expelling me with immediate effect.”

Esses says the experience was humiliating. “It was a two-paragraph email that simply said that there had been some complaints about my writing and my advocacy and that I had brought them into disrepute, and so they were expelling me with immediate effect.

“They blocked my email and my access to the university Intranet portal,” he said. “And they had, on Twitter, publicized the fact that they had expelled me.”

Esses was shattered. “I was in an awful state. In a single email, my entire future life plans went up in smoke. I hadn't done anything wrong. All I had done was raise concerns essentially about child safeguarding.”

Esses had done the right thing and was now paying a heavy price. “For the first for the first couple of days, I didn't want to get out of bed. You know, I was really that low.”