June 2024

CAMFT Responds-And They Have Done Some Things

2024-06-21T10:47:37-04:00June 21st, 2024|Advocacy|

After posting here and a few posts on Instagram, I got an email from the Executive Director of CAMFT. I will show it below, but she apologized for not responding to my email. I get that emails do get lost. She listed significant changes they had made in the last year. 

My personal opinion is as follows. The revisions to the Letter to the Editor are excellent. They should make sure that no group is ever treated the way that transgender people were in the initial letter.  

I am also impressed with the DEI trainings and adding those for committee volunteers. I hope that this continues as I think it should be an annual training as there are many issues to cover. 

The legal issues are also a positive.  Many of us have a lot of CAMFT baggage from 2008, when we felt betrayed around marriage equality. The CAMFT Board’s approval of the motion to support the California Right to Marry proposition and Repeal Prop 8 Amendment proposition is a positive move towards healing that experience. 

It also indicates to me that perhaps the Board has changed their views. 

They did have presentations at both the 2023 and 2024 conference on Gender Affirming Care (I did not look back further than that). One criticism is that one 2023 presentation was a lunch presentation and it appears to have cost $70 which may not have made it accessible to some. 

Overall, this seems like a great effort. My big ask moving forward is that CAMFT considers a statement similar to the one the APA made earlier this year. 

I have been asking all professional organizations to do this as I feel like it is a necessary part of the advocacy and education work that continues to need to happen. I would also like a future The Therapist magazine dedicated to the topic. It could be issues on Gender Affirming Care, LGBTQ+ issues overall, or I would really love something addressing how what is going on in our country right now affects marginalized people in general. It seems that the ED spoke some about that in her interview regarding the LGBTQ+ community, but obviously, this is something that crosses all marginalized groups. 

I will put it in my calendar to reach out again next year and see what additional progress has been made. I thank Joy Alafia for her commitment to this.

Here is her email to me in its entirety without edits.

Hello Cathy,

I hope this email finds you well.  Thank you for your email and information shared.  Please accept my sincere apologies for the response delay.  I was traveling much of the day on May 30th and I was recently alerted to the fact that I had failed to respond to your communication.  I actually discovered that there were a considerable number of messages that day that I had missed.  My apologies as it is my goal to respond to emails in a timely manner.  I am out of the office this week, however I wanted to respond upon this discovery, given the great delay.

Thank you also for continuing to hold me and CAMFT accountable. We are keenly focused on continuing to demonstrate our commitment to the LGBTQ+ community from various angles including advocacy, financial commitment, training, improving our processes, increasing representation, and being out-front on key issues. I appreciate the opportunity to share just a few updates of what CAMFT has done since May 2023, below:

  • CAMFT has completely revised our editorial guidelines, which encompasses submissions for the Letter to the Editor.  Our process emphasized that we strive to align our communications with both our mission and DEI values.  Below are a few of the criteria for communications:
    • Ethical communication with inclusivity and cultural sensitivity;
    • Non-oppressive terms and equitable representation;
    • Follow evidenced-based research and clinical best practices from reputable sources;
    • Must be respectful in tone;
    • Communications that potentially impact marginalized groups or touch on current controversial social themes, may go through an approval process before being shared through any CAMFT platforms;
    • Employ professional readers with cultural competencies to help address any unconscious bias.

We have already put the new process in practice, for a few articles published.

  • CAMFT continues to support the LGBTQ+ caucus, attending a fundraising event in October 2023 as a main sponsor and we plan to be a sponsor for the upcoming 2024 evetn.
  • Representation matters – we are pleased to again have a member from the LGBTQ+ community serve on CAMFT’s Board who provides valuable lived experience to the Board’s overall direction.
  • We were honored to have member Gretchen Cooper, LMFT present at CAMFT’s Annual Conference on Gender Affirming Care. Gretchen was the author of the article “Gender Affirming Care” published in the Therapist magazine. This is the article that prompted the letter to the editor.  We are grateful to Gretchen for the willingness to continue to share the importance of educating MFTs on this important practice.
  • CAMFT provided a safe space at the Annual Conference for LGBTQ+ members to meet while attending the event.  The LGBTQ+ community meet-up event provided an opportunity to find deeper community within CAMFT while at the annual conference and also build networks of support.  I briefly met with those in attendance and the feedback was very positive.
  • CAMFT honored Sen. Caroline Menjivar with our ‘State Legislator of the Year Award’ for her unwavering dedication to mental health rights! Her groundbreaking bill, SB 372 (Deadnaming), was proudly co-sponsored by CAMFT, and has been in effect since Jan 1, 2024.  The legislation requires the BBS to use the licensees or registrant’s name and not reference a deadname in its online license verification system.
  • We hosted an event on the steps of the State Capitol to promote this legislation and the importance to respect the names of licensees and not to utilize deadnames.  Board members and members at-large joined us in this effort.  We were particularly pleased that Senator Menjivar’s wife, also an MFT, attended the event.  Our work on this legislation was amplified via several news outlets including CalMatters and The Capitol Morning Report, reaching key decision and policy makers in Sacramento and the news outlets’ readership at-large.

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  • On June 7th, I had the privilege of speaking to KTVU Fox news in the San Francisco Bay Area. The reporters cited data form the CDC that shows LGBTQ+ adults are twice as likely to report they’ve been diagnosed with depression and nearly a third report having poor mental health.  I shared that the political climate is challenging, particularly with the onslaught of anti-LGBTQ+ legislation in this country.  I advised that many individuals have to fight to simply exist, and exerting such energy takes a toll; and for LGBTQ+ people of color these challenges can be compounded.  I emphasized the importance of eliminating the stigma that can be attached to therapy as well and reducing barriers to accessing care.  I also shared the importance to have more therapists from the LGBTQ+ community in our field and steps we can take to improve the pipeline.  During the interview, I shared the importance of culturally competent care, and emphasized that CAMFT has offered training on gender-affirming care.  This CAMFT interview was ultimately picked up by several other media outlets, including MSN and Yahoo! news, and has had 3.4M views.

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Again, I genuinely thank you for following up and requesting what has been done since May, 2023.  There is still much work to do.  I continue to share these updates via various mediums including social media, CAMFT’s State of the Profession, chapter events, and our eNewsletter.

We remain committed to adhering to our DEI values, supporting and offering education on affirming care, and uplifting the rights of the LGBTQ+ community.  This is an ongoing effort that remains central to CAMFT’s goals.

Finally, I wanted to advise that I’m out of the office this week, so please forgive if any follow up communication comes next week.

Warm regards,

Joy Alafia

Executive Director

Pronouns: She/her

California Association of Marriage & Family Therapists

What has the California Association of Marriage and Family Therapists done for Transgender People in the last year?

2024-06-19T13:48:50-04:00June 19th, 2024|Advocacy, Gender identity|

A few days ago I wrote a blog post calling for the the NASW, NBCC, and AAMFT to release public statements on Evidence Based Care for Transgender, Gender Diverse and Nonbinary People. One of the reason I began researching this issue is that last year, The California Association of Marriage and Family Therapists (CAMFT), in the March/April edition of their magazine “The Therapist,” published a  letter to the editor that promoted anti transgender ideology. After an outcry, CAMFT removed it from their website and promised to improve. After I sent an email expressing my concerns, I received a May 2023 email from Executive Director Joy Alafia, stating the following.

“Dear Cathy,

Thank you for contacting CAMFT regarding the letter to the editor in the March / April 2023 issue of The Therapist magazine, that was in response to CAMFT’s article on Gender Affirming Care. We take this matter seriously and welcome your input as we create and implement our action plan.

First and foremost, I wish to offer a sincere apology.  We have heard from many members in our community expressing a range of responses, including disappointment, concern, hurt, and anger.  CAMFT acknowledges and takes accountability for our recent publication of a letter to the editor and the harm and pain caused. We are committed to creating a safe and inclusive space for all members of all gender identities and expressions. We want to make it clear, in no uncertain terms, that the views expressed in the letter are not reflective of the views of CAMFT (see our DEI statement:, and have issued a sincere apology to all of our members who were affected by this incident. We are committed to making sure that our magazine and our other communication channels are used responsibly.

We are taking the next steps to identify what procedural, systemic and organizational changes we can institute in hopes to rebuild trust.  We will engage our DEI committee as we outline an inclusive course of action.  I am committed to doing the work ahead and will communicate with you, and others in our community, regarding the steps we will be taking to address this important issue. I truly thank you for your time, your membership, and for speaking up for how we can and must do better.


Joy Alafia
Executive Director
Pronouns: She/her
California Association of Marriage & Family Therapists”

I wrote to her on May 30, 2024, to find out what specific actions CAMFT had taken, but I have not received a reply. I found nothing on the CAMFT website to indicate any action taken.

In the meantime, Erin Reed just posted a June update to her Anti-Trans Legislative Risk Assessment Map: June 2024 Edition. She reports that in 2023, there were 550 anti-trans laws proposed, and to date, in 2024, there have been 586. (Reed, 2024) The Southern Poverty Law Center (SPLC) also recently issued its 2023 hate report. The number of anti-LGBTQ+ hate groups rose by 1/3 to 86. (SPLC, n.d.)

 The rights of transgender and gender-diverse people are under attack in the United States. The SPLC says,

“The cycle of anti-LGBTQ extremism will continue. Right-wing politicians continue to spread disinformation, which is echoed across mainstream media channels, publications and by right-wing social media accounts and then used by anti-LGBTQ politicians to enact harmful legislation that fuels violence against LGBTQ people.”  (SPLC, n.d.)

While this is happening, CAMFT has remained silent as to what they are doing to protect the rights of transgender people in California. There are therapy programs throughout the country that claim to support families with trans youth but instead insist that clients look for all the reasons that they are not transgender, such as the debunked social contagion theory.

CAMFT must express the “next steps to identify what procedural, systemic and organizational changes we can institute to rebuild trust” that they enacted this last year, as stated by the ED in her email. They need to inform us that they have brought in the wisdom of therapists who identify as trans, gender diverse, and/or nonbinary to help them formulate an action plan to address how their journal was used to spread such a hateful message. Diversity, Equity, and Inclusion are not about making statements but instead about a deep commitment to DEI. So far, we have seen just statements and not this commitment from CAMFT.



  1. Personal correspondence email Joy Alafia to Cathy Hanville 5/12/23

Where are the NASW, AAMFT, and NBCC statements on Evidence Based Care for Transgender, Gender Diverse and Nonbinary People?

2024-06-19T13:44:10-04:00June 17th, 2024|Advocacy, Gender identity, Thoughts From A Psychotherapist|

In February 2024, the American Psychological Association issued a significant Policy Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation (APA 2024). This well-documented and robust statement underscores the importance of affirming evidence-based care for transgender, gender-diverse, and nonbinary individuals.

Meanwhile, the National Board for Certified Counselors has posted on their website about monitoring laws and making statements against the anti-transgender laws being considered. They appear to be actively advocating against these laws.

has a statement on its website The National Association of Social Workers (NASW) has a statement on its website encouraging social workers to “support, promote, affirm and “protect the rights, legal benefits, and privileges of people of all gender identities and expressions.” (NASW, 2023). They state that legal advocacy should look different state by state, and I could not find any National Actions by NASW on their website.

The American Association for Marriage and Family Therapists has a statement against discrimination on its website. Still, they stand by their decision to host their 2024 conference in Florida, a state that has been at the forefront of attacking transgender people.

Why do we need these groups to make a strong statement like the APA did? Because lives are at stake every day, they do not. As the group of AIDS activists said, Silence Equals Death. The groups perpetuating the most harm against trans people utilize pseudoscience, debunked research, and often outright lies to perpetuate their harm. Unless professional organizations challenge these groups, their information will stand, and many may believe it is factual.

There are many groups right now that are purporting to offer gender exploratory care but instead approach those identities “with suspicion” and blame it on “unprocessed trauma, childhood abuse, internalized homophobia or misogyny, co-occurring mental illness, social contagion, autism, sexual fetishism, and unconscious drives.” (Ashley, 2023)

It would be easy for a parent to seek out affirming care for their child and instead find a therapist who wants to cure them of being trans. This is conversion therapy, which has long been deemed against therapist ethical codes. Professional organizations need to remind their members of their ethical obligations and discharge those that go against them. The time is now. Recently, the Southern Poverty Law Center’s (SPLC) 2023 hate report shows was issued and stated that anti-LGBTQ+ hate groups increased by 1/3 to 86 in the US. (SPLC, n.d.) They also designated Genspect and the Society for Evidence-Based Gender Medicine (SEGM) as Anti-LGBTQ Hate Groups. (SPLC, n.d.)

Statements of support over a year old do not cut it, nor does not advocating for legal protections against these draconian laws when there are 86 hate groups working actively to harm the LGBTQ+ community.

All therapist organizations need to make strong public statements like the one issued by the APA this year. To not do so is to allow these groups to continue to grow unchecked by the professional organizations with the information and power to challenge them.


  2. accessed 6/17/24
  5. Ashley F. Interrogating Gender-Exploratory Therapy. Perspect Psychol Sci. 2023 Mar;18(2):472-481. doi: 10.1177/17456916221102325. Epub 2022 Sep 6. PMID: 36068009; PMCID: PMC10018052.






March 2024

Raising the Alarm on Gender Identity Change Efforts Disguised as Talk Therapy

2024-03-12T21:34:50-04:00March 12th, 2024|Advocacy, Gender identity, LGBT, Thoughts From A Psychotherapist|

Below is a petition that some concerned California clinicians wrote to both educate providers and consumers and to use to send to mental health professional organizations to urge them to speak out against these practices.

I want to recognize that the American Psychological Association(APA) issued a very thorough statement February 2024 called APA Policy Statement on Affirming Evidence-Based Inclusive Care for Transgender, Gender Diverse, and Nonbinary Individuals, Addressing Misinformation, and the Role of Psychological Practice and Science. It was a great statement and occurred while this petition was being devleoped. You can find the entire statement here. I will quote below two statements that are especially relevant to the petition ask.

WHEREAS such misinformation is widely disseminated through formal and informal networks, yet credible scientific evidence has not been widely disseminated and is not readily accessible to the public, having the potential to further stigmatize and marginalize all transgender, gender-diverse, and nonbinary individuals, hindering their access to indicated and necessary healthcare, worsening existing geographic disparities in healthcare access, and fostering an environment that may lead to discrimination (DuBois et al., 2023; Goldenberg et al., 2020; Weixel & Wildman, 2022);

THEREFORE, BE IT RESOLVED that the APA supports efforts to address and rectify the dissemination of false information to ensure the well-being and dignity of transgender, gender-diverse, and nonbinary individuals

The below petition can be viewed and signed here. I am encouraging everyone to both sign it and share it. It is important to the well being of the trans community that we get information such as this out there to counter all of the false information that exists. It is also important the reputable organizations like make strong statements like that of the one from the APA to fight the narrative that supporters of gender affirming care are extremists when the reality is that there is wide support of such care.

Thank you to all the therapists that took the time to engage in this work which is critically important right now.



We are a group of concerned therapists, psychologists, and psychiatrists writing to ask your associations to put out a statement regarding the rise in Gender Identity Change Efforts (GICE) disguised as psychoanalytic or talk therapy. The effort to delegitimize and provide an “alternative” to gender-affirming therapy and the World Professional Association for Transgender Health (WPATH) Standards of Care (Coleman et al., 2022) is being led by a small group of clinicians who start many organizations that attempt to wield power through promoting debunked research. The main organizations involved in this effort are Wider Lens Consulting, Therapy First (formally the Gender Exploratory Therapy Association), Thoughtful Therapists, Genspect and SEGM. We are asking your association to put out statements warning against these organizations for their dishonest and fraudulent advertising, as well as naming them as organizations promoting GICE.

1. Dishonesty, Fraud, and Deception:

All of these organizations are careful to sound like they promote reasonable, well-informed, evidence-based treatment for those with gender dysphoria – “a neutral ground between the ‘radical’ gender-affirmative model and ‘unethical’ conversion practices” (Ashley, 2022). The byline for Therapy First reads: “Therapy First exists because we see a great need arising from the current oversimplification and politicization of gender dysphoria in the field of mental health.” Therapy First represents itself as apolitical. However, multiple clinicians on the advisory board and clinical team have participated in political activity aimed at anti-trans legislation and related to many of the trans health bans that we are seeing today. Stephen Levine, one of the clinicians who authored the Therapy First clinical guidelines, was the sole “expert” witness for the state of Arkansas’s ban on gender-affirming care for minors. It was struck down in June of 2023 (Levine, 2020). SEGM has been the central subject of subpoenas by the state of Alabama to the American Academy of Pediatrics, WPATH and the Endocrine Society in the trans youth care ban case Boe v. Marshall (Lannin declaration).

The clinicians involved in founding these organizations are part of a large web of anti-trans organizations aimed at attacking trans rights (Anti-Trans Conversion Therapy Map of Influence), including the American College of Pediatricians, which has been labeled an anti-LGBTQ hate group by the Southern Poverty Law Center (American College of Pediatricians | Southern Poverty Law Center).

Stella O’Malley, who founded SEGM and Wider Lens Consulting, has stated that her mission is to make sure that children are stopped from medical transition (Leveille, 2022). In emails leaked in March of 2023, Lisa Marchiano, LCSW, another board member of Therapy First, SEGM, and Wider Lens Consulting, was caught trying to obtain private information about a transgender journalist with the intent of leaking information to Fox News. When the private information was leaked, it resulted in online harassment of the journalist (Doyle, 2023).

The claim that Therapy First, Thoughtful Therapists, Wider Lens Consulting, SEGM, and all affiliated organizations have no political agenda is completely dishonest and deceptive. We need reputable clinical organizations to make this known to both consumers and therapists.

2. Gender Identity Change Efforts (GICE) by these organizations:

Even though Therapy First claims to not promote so-called “conversion therapy,” further investigation into the organization and client experiences points to GICE. The Therapy First clinical guidelines promote a “psychotherapeutic approach” to gender dysphoria, stating:

“Psychotherapeutic inquiry does not simply accept that a person has the wrong body or gender, it explores why and how a young person came to have negative feelings about their sexed body or that their body or gender is “wrong.” This involves exploring relational and developmental history, the quality of relationships with parents, any traumas or losses that have affected the family, the presence of marital dysfunction, domestic violence, sexual abuse or other detrimental interpersonal dynamics. It also involves exploring social relationships with friends and peers (Ayad et al., 2022, p. 41).”

In practice, what this often looks like is searching for any possible reason for a youth or young adult being transgender, rather than simply being transgender (Santoro, 2023). Marchiano spoke out against the executive order against conversion therapy signed by Joe Biden in June of 2022, telling The Economist that it would have a “chilling effect” on the practices promoted by these organizations. She acknowledges the goal of gender exploratory therapy, which is for trans children and teens to resolve their dysphoria through finding the root psychological cause of their dysphoria (“The Biden administration’s confused embrace of trans rights,” 2022). Furthermore, the Therapy First Clinical Guidelines contain detailed assessment questions including intrusive inquiries about the client’s masturbation habits and sexual fantasies (Ayad et al., 2022, p.26). This type of pathologizing, gaslighting, and delaying any gender-affirming care until a talk therapist rules out every possible cause for the gender dysphoria, besides being transgender, is highly problematic and psychologically damaging (Matouk & Wald, 2022; Boerner, 2022; Bhatt et al., 2022; Tordoff et al., 2022).

Everything put forth by members of these organizations points to their belief that being transgender is undesirable and therapy should seek to explain and resolve the transgender identity so that the patient “accepts themself” as the gender they were assigned at birth. The case studies presented in the Therapy First’s clinical guidelines highlight these beliefs and intentions (see Therapy First clinical guidelines pages 57-102 for case studies) (Ayad et al, 2022).

These organizations have been able to wield extensive power in a short amount of time and are attempting to replace the WPATH Standards of Care. Gender Exploratory Therapy/Therapy First has been recommended as the treatment in many of the trans health care bans gaining traction across the country (Reed, 2023b). It has also gained notoriety in prominent problematic articles in The New York Times (Paul, 2024), which greatly inflate the statistics regarding “detransitioning” and conversion therapy (Reed, 2024; Urquhart, 2024; Urquhart, 2023).

Research continues to confirm that gender-affirming care is not only evidence-based but life-saving (American Psychological Association, 2024). The results from the national trans survey have found that 94% of people who pursued a form of medical transition report greater life satisfaction (U.S. Trans Survey, 2024).

The NASW, AAMFT, and the two APAs are signatory associations of the United States Joint Statement Against Conversion Efforts (United States Joint Statement, 2023), a statement by 28 professional associations clearly asserting that so-called “conversion therapy” is unethical and potentially harmful.

We ask that the NASW, AAMFT, and the two APAs (both psychological and psychiatric) also make a clear statement about Therapy First, Genspect, SEGM, Wider Lens Consulting, and other affiliated organizations, warning potential clients about their false and deceptive advertising.

We also want it made clear that social workers associated with these organizations are violating the NASW code of ethics, and potentially their local state laws, as they pertain to Gender Identity Change Efforts and conversion therapy.


American College of Pediatricians. Southern Poverty Law Center. (n.d.).

American Psychological Association. (2024, February 17). APA policy statement on affirming evidence-based inclusive care for transgender, gender diverse, and nonbinary individuals, addressing misinformation, and the role of psychological practice and science.

Anti-Trans Conversion Therapy Map of Influence.

Ashley, F. (2022, September 6). Interrogating gender-exploratory therapy. Sage Journals.

Ayad, S., D’Angelo, R., Kenney, D., Levine, S., Marchiano, L., & O’Malley, S. (2022). A clinical guide for therapists working with gender-questioning youth, Version 1. Clinical Advisory Network on Sex and Gender.

Bhatt, N., Cannella, J., & Gentile, J. P. (2022, Apr-Jun). Gender-affirming care for transgender patients. Innovations in Clinical Neuroscience.

The Biden administration’s confused embrace of trans rights. The Economist (2022, June 23).

Boerner, H. (2023, March 30). What the science on gender-affirming care for transgender kids really shows. Scientific American.

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., Nieder, T. O., … Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, Version 8. International Journal of Transgender Health, 23(Suppl 1), S1–S259.

Doyle, J. E. S. (2023, March 23). Inside the Terf Harassment Machine. Medium.

Gender Exploratory Therapy Association.

James, S.E.,Herman, J. L, Durso, L. E. and Heng-Lehtinen, R. (2024, February 8). Early Insights: A Report of the 2022 U.S. Transgender Survey.

Leveille, L. (2022, April 3). Leaked audio confirms Genspect director as anti-trans conversion therapist targeting youth. Health Liberation Now!

Levine, S. B. (2020, March 12). Expert Submission of Dr. Stephen B. Levine, MD – PA General Assembly.

Matouk, K. M., & Wald, M. (2022, December 8). Gender-affirming care saves lives. Columbia University Department of Psychiatry.

Paul, P. (2024, Feb. 2). As kids, they thought they were trans. They no longer do. The New York Times.

Reed, E. (2023a, January 13). Unpacking ‘gender exploratory therapy,’ a new form of conversion therapy. Xtra Magazine.

Reed, E. (2023b, May 29). Ohio rep. pushes conversion therapy; Bill mandates it for trans kids. Los Angeles Blade.

Reed, E. (2024, February 2). Debunked: Misleading NYT Anti-Trans article by Pamela Paul relies on pseudoscience.

Santoro, H. (2023, May 2). How therapists are trying to convince children that they’re not actually trans. Slate Magazine.

Tordoff, D. M., Wanta, J. W., & Collin, A. (2022, February 25). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open.

United States Joint Statement (2023, October 11).

Urquhart, E. (2024, February 6). Pamela Paul shows NYT Opinion’s lack of accountability to the truth. Assigned Media.

Urquhart, E. (2023, December 1). What it actually means to listen to detransitioners. Slate Magazine.

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