July 17, 2023 - 10:45am

Teenage girls are coaching one another in gender ideology, in the guise of a “mental health” app supported by the NHS, according to Transgender Trend. “Kooth” bills itself as “your online mental wellbeing community”, offering “free, safe and anonymous support”. Yet it is riddled with highly politicised trans-activist assumptions and leaves a user base predominantly composed of unhappy adolescent girls largely free to “support” one another in affirming and intensifying their shared gender confusion.

The app seems unperturbed by the recent Cass report on NHS gender identity services, published last year, which criticised the Gender Identity Development Service (GIDS) for pursuing an “affirmation-only” model of treatment for transgender youth. Even after the closure of GIDS, Kooth hews instead to the now-discredited “affirmation” model endorsed by the highly politicised British Association for Counsellors and Psychotherapists (BACP). 

Last year, the BACP published a controversial memorandum of understanding on “conversion therapy” that prohibited any therapist from exploring how or why a client might identify as transgender. This effectively banned therapists from adopting any position but uncritical affirmation with a client, placing the association at odds with the Cass report.

It’s clear from the Transgender Trend report that this conflict hasn’t been resolved. The deprecated “affirmation” model for gender distress, promoted by the BACP, is still shaping services that are finding their way into NHS provision, in the process undermining the health service’s own efforts to temper the ideological fervour of the gender lobby with due regard for individual circumstances. But perhaps we shouldn’t be surprised. If the Cass review revealed services that were rushing children to medical interventions after wildly inadequate therapeutic exploration, this was in no small part due to the fact that therapeutic services are labour-intensive and thus subject to brutal cost pressures. 

Demand for in-person talking therapy wildly outstrips NHS supply — especially for young people, who are, according to multiple reports, in the grip of an acute and growing mental health crisis, even as services aimed at this demographic are overwhelmed. But if you do the sums, it quickly becomes clear why: 1.4 million people were referred for talking therapy in 2020-21, while the going rate for therapists in private practice is £50-100 per hour. Talking therapy, in the quantities necessary to make a difference to the people who need it, would be prohibitively expensive to provide at a rate that would enable therapists to make a living. 

A little over ten years ago, as a trainee psychotherapist, I saw first-hand how the NHS squares the circle: subcontracting to nonprofits, which in turn deliver services using unpaid trainees who need to build up practice hours en route to qualification. Even then, services are overwhelmed. So the NHS can hardly be blamed for seeking ways to deliver support more cost-effectively — and products such as Kooth are the result. 

Kooth operates according to a pyramid model, offering users first a library of “therapeutic” articles (riddled with gender ideology), then “peer support” (online forums where girls reinforce each other’s preoccupations with gender). This is followed by limited in-person assistance for the most acute distress, delivered remotely in a chat window by “Online Emotional Wellbeing Practitioners”: individuals who don’t even need a counselling qualification, are paid £20-26k a year, and moderate the message boards and provide chat-window “emotional support”.

There’s something nightmarish about this scenario. Epidemic levels of (predominantly female) youth psychic distress are being funnelled through a kind of online sausage machine of the soul, in the name of “access”. In that sausage machine, any personalised response is only grudgingly granted, while the very format — disembodied and remote — forecloses any of the non-verbal communication widely understood to play a critical role in an experience of encounter and empathy. 

Starved of in-person presence and empathy, nothing prevents the loneliness and misery of young girls being colonised by the disembodied and dissociative one-size-fits-all ideology of gender. Promising a simple physical fix for often complicated emotional difficulties, it’s perhaps the ultimate bargain-basement solution for price-sensitive healthcare, in an age that’s both overtly concerned with “mental health” and profoundly indifferent to what such health would actually imply.

Mary Harrington is a contributing editor at UnHerd.