Therapy First

Therapy First

Established	June 2021; 3 years ago (June 2021)
Purpose	Promotion of "gender exploratory therapy"
Affiliations	Society for Evidence-Based Gender Medicine, Genspect
Website	www.therapyfirst.org
Formerly called	Gender Exploratory Therapy Association (GETA)

Therapy First, originally named the Gender Exploratory Therapy Association (GETA), is a group created in 2021 by members of the Society for Evidence-Based Gender Medicine (SEGM) and Genspect to advocate gender exploratory therapy, which experts consider to be a form of conversion therapy.

GETA was formed in June 2021 by four members of the Society for Evidence-Based Gender Medicine, Sasha Ayad, Roberto D'Angelo, Stella O'Malley, and Lisa Marchiano, and Genspect advisor Joseph Burgo.^[1][2] All of GETA's leaders are on the leadership team of or advisors to the gender-critical organization Genspect.^[3] The Southern Poverty Law Center described Genspect, SEGM, and GETA as the strongest triad within the "anti-LGBT pseudoscience network", sharing over two dozen personnel connections.^[1]

In 2022 GETA published a guide on gender exploratory therapy.^[4] After the World Professional Association for Transgender Health (WPATH) published the 8th edition of its Standards of Care, Burgo launched an initiative called "Beyond WPATH" calling WPATH discredited and stating the signatories, including representatives from GETA, Transgender Trend, the American College of Pediatricians, and Moms for Liberty, were opposed to "the affirmative approach".^[5]

In June 2022, U.S. president Joe Biden released an executive order calling for the elimination of conversion therapy for LGBTQ2S+ youth. Shortly afterwards, Lisa Marchiano spoke to The Economist opposing the order two weeks later, stating a conversion therapy ban could cause a "chilling effect" on her organization.^[3][6][7] In September 2022 GETA members submitted a comment opposing U.S. Department of Education guidance protecting gender identity under Title IX, arguing it would lead to mandatory social transitioning of children without parental consent.^[1] In 2023, members filed a petition with the Food and Drug Administration calling them to end prescriptions of puberty blockers to trans children.^[1]

In late 2023, GETA changed their name to Therapy First.^[8]

GETA labels social transition, the act of adopting a new name, pronouns, or gender expression, and medical transition as "risky".^[3] The organization argues psychotherapy "should be the first-line treatment for all cases of gender dysphoria" and transition related medical care for youth "should be avoided if possible".^[3][9]

Gender exploratory therapy emerged recently as a non-affirmative approach to transgender youth. The founders of the approach argue transgender identities are caused by factors such as social contagion, homophobia, sexual trauma, and autism.^[9][10] The approach requires youth complete mandatory "extended" psychotherapy aimed at identifying possible causes of gender identity or trans identity before any transition process.^[9][11][12] They characterize this approach as neither conversion nor affirmation.^[8][10]

They argue that the gender-affirming approach, which does not view transgender identities as pathological, is a political agenda.^[11]

The Substance Abuse and Mental Health Services Administration issued a report noting that "approaches that discourage youth from identifying as transgender or gender-diverse, and/or from expressing their gender identity" are "harmful and never appropriate" but sometimes “misleadingly" labelled as "exploratory therapy."^[8] Gender exploratory therapy is considered by experts to be a form of conversion therapy.^{[1][13][14][15][16]}

The American College of Pediatricians have cited numerous studies by GETA members to argue conversion therapies are necessary to maintain the "biological integrity" of trans and gender nonconforming people.^[1] The Alliance for Therapeutic Choice and Scientific Integrity, a conversion therapy group formerly called the National Association for Research and Therapy of Homosexuality, hosted a conference where board member Michelle Cretella linked the approaches, stating "It truly is very similar to how the Alliance has always approached unwanted SSA [same-sex attraction]" and "you approach it as 'change therapy'—or, even less triggering, 'exploratory therapy'."^[8]

Erin Reed, a researcher who has studied gender exploratory therapy and anti-trans organizations, has compared them to crisis pregnancy centers which steer pregnant people away from abortions, stating GETA's strategy is to sound cautious and helpful while promoting the view people should live their lives as their birth assigned gender.^[3] The Southern Poverty Law Center has described GETA as part of an "anti-LGBT pseudoscience network."^[1]

• 21st-century anti-trans movement in the United Kingdom
• 2020s anti-LGBTQ movement in the United States
• History of conversion therapy