Gender Exploratory Therapy Association

This content was last updated Nov. 17, 2023, 4:11 p.m. UTC

Gender Exploratory Therapy Association (GETA) is a non-profit organization that promotes gender exploratory therapy, an alternative to the affirming model of treatment that seeks to find psychological explanations for gender dysphoria and discourage patients from transitioning.

On November 16, GETA announced that they would be changing the name of their organization to "Therapy First." The Twitter thread announcing the change misleadingly suggested that proponents of gender affirming care for youth do not already use therapy as the first treatment offered to youth, with medical interventions coming later, as needed, and on an individualized basis.

The group is most known for releasing a set of clinical guidelines for therapists working with those up to the age of 25. These guidelines suggest that transitioning should only be supported and applied in extremely rare circumstances, and proposes the exploratory model as an alternative for therapists to use. Unlike gender affirming care, gender exploratory therapy currently has no evidence base.

Some therapists operate on underlying assumptions that gender identity distress is always a sign that a client is trans, and that a client’s current understanding of their gender identity will remain permanently fixed. Such assumptions may lead the therapists to neglect the work of psychological exploration, and instead, act as a facilitator for acquiring hormonal and surgical interventions (which come with a heavy medical burden and potentially negative consequences).

GETA about page


GETA was announced to the public on December 5, 2021, and was founded by Stella O’Malley and Sasha Ayad, two prominent voices in the anti-trans sphere. GETA was officially registered as a nonprofit in July of 2022. Lisa Marchiano, a prominent activist affiliated with organizations such as Genspect and Society for Evidence-Based Gender Medicine (SEGM), is listed as the principal officer of the organization.

Of their purpose and goal, GETA writes, “Our goal, therefore, is to develop a network of “Gender Exploratory” therapists: mental health professionals who practice ethical and developmentally appropriate therapy with clients who are experiencing distress regarding gender or biological sex. We provide a place for such therapists to network, dialogue, and learn from one another. And we provide resources, information, and therapy referrals for clients and their families.”


GETA brings in less than $50,000 in revenue a year, as per the IRS tax exempt organization search. The exact dollar amount for their revenue and how this money is allocated is not publicly visible as organizations of this size are not required to provide Form 990s.

Some of GETA’s revenue sources are known. Therapists need to spend $25/year to join GETA’s network. They also accept donations.

History of Anti-LGBTQ+ Activism

GETA seeks to promote gender exploratory therapy and oppose gender affirming therapy. As seen in their mission statement, they view gender affirming care as something to be greatly skeptical of. They view any aspect of affirming care, including social transition, as risky and something to be avoided.

GETA’s alternative is gender exploratory therapy, which views expressions of non-cisgender gender identity primarily as psychological issues to work through. Some members of GETA, including Lisa Marchiano, have opposed conversion therapy bans due to them potentially including gender exploratory therapy.

GETA has ties to many other organizations, including Genspect and SEGM as well as smaller organizations such as Alliance for Therapeutic Choice and Scientific Integrity and Pediatric and Adolescent Gender Dysphoria Working Group. GETA has also been engaged in policy debates, as seen when they wrote a brief to the Biden administration opposing non-discrimination laws that included transgender individuals.

2022 Clinical Guidelines

In 2022, GETA released their first clinical guide, tailored to therapists of patients under the age of 25. Reaching over 120 pages, this guideline advocates squarely for gender exploratory therapy, positioning it as the middle-of-the-road ideal between gender affirming care and conversion therapy. Unlike gender affirming care, which has a robust evidence base, there is currently no evidence confirming the safety or efficacy of exploratory therapy. Because the goal of exploratory therapy is to avoid transition, it may even be harmful to patients.

GETA’s guidelines were widely acclaimed by opponents of transgender rights, including right-wing outlets such as Daily Wire and Epoch Times

Further resources:

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