Urgent need for CACAP position statement on psychotherapy for gender dysphoria

To the Editor,

I appreciate the recent article addressing psychodynamic psychotherapy for gender dysphoria (“Psychodynamic psychotherapy for gender dysphoria (PPGD) is not conversion therapy”), as it brings attention to an important issue (1). However, it also underscores the need for the Canadian Academy of Child and Adolescent Psychiatry (CACAP) to develop a balanced position statement that clarifies the role of therapists in supporting youth with gender dysphoria in Canada.

In the Canadian healthcare landscape, clinicians face significant challenges in providing therapeutic support to children and youth navigating gender dysphoria. Many are understandably cautious about offering psychodynamic psychotherapy (including PPGD), concerned about potential accusations of practicing conversion therapy and the associated professional risks. This caution reflects a broader environment where therapeutic interventions can be misinterpreted, despite therapists’ intentions to provide respectful and supportive care.

A clear, thoughtful position statement from CACAP is urgently needed to guide clinicians in navigating these complexities. Such a statement should emphasize that the role of therapy is to support individuals in their gender identity journey, not to question or invalidate it. It should provide ethical guidelines that empower clinicians to provide compassionate, evidence-based care while respecting the diverse experiences and identities of their patients.

Moreover, the statement should distinguish psychodynamic psychotherapy from conversion therapy unequivocally, emphasizing that psychodynamic approaches seek to understand and support individuals’ identity development without aiming to change or suppress their gender identity. This clarification is crucial for fostering an environment where therapists can confidently provide care that aligns with professional ethics and patient needs.

In conclusion, while the article highlights an important aspect of clinical practice, it underscores the necessity for CACAP to articulate a position that supports therapists in providing affirming and ethical care to youth with gender dysphoria. Such guidance would not only reassure clinicians but also promote a healthcare environment where all individuals receive respectful and supportive treatment.

Sincerely,