Even if youre not terminally online, theres a meme youve likely seen floating around the internet. Taken from the 1960s Hanna-Barbera cartoon Scooby-Doo, Where Are You!, it features two side-by-side panels. In the first, Fred stands in front of a tied-up masked criminal, hand poised to pull off the mask. In the second panel, the mask has been torn away, revealing the face of a mustachioed villain. Known as the Lets See Who This Really Is meme format, it was co-opted by the internet and has become a go-to way of skewering ironic unmaskings.Its hard not to think of this meme when reading about the Department of Health and Human Services new alternative to gender-affirming care: Gender Exploratory Therapy. In practice, its just a masked and rebranded version of gender conversion therapy, a practice that has been thoroughly discredited as both pseudoscience and as deeply harmful to queer and trans people, the point at which it has been likened to torture. To better understand what Gender Exploratory Therapy is and why its such a dangerous practice, PRIDE spoke with experts: Dr. Michael Grey, a trauma therapist specializing in sexual and gender minority mental health; Lucas Saiter, a licensed psychotherapist and founder of Manhattan Therapy NYC; and Edward Reese, a gender and sexuality expert at Taimi.What is Gender Exploratory Therapy?On May 1, the U.S. Department of Health and Human Services (HHS) released a report that sought to discredit gender-affirming care, a medical intervention for gender dysphoria, and instead promoted exploratory therapy for transgender and nonbinary people. Trans and LGBTQ+ advocacy groups were quick to point out that this was simply a rebranding of gender conversion therapy, and they criticized the reports lack of transparency, including the omission of the reviews authors names.So what exactly is it? Gender Exploratory Therapy (GET) is a phrase created by organizations that believe talk therapy should always come before and often instead of gender-affirming care, Saiter tells PRIDE. Its the opposition to gender-affirming approaches and instead uses talk therapy to explore what they deem as the pathological roots of trans identities and gender dysphoria.Dr. Michael Grey explains that the practice should not be conflated with gender-affirming care and that it is, in fact, in direct opposition to it. While gender-affirming care is guided by the preferences of the client, GET discourages affirmation and instead promotes an exploratory approach using talk therapy to identify potential pathological origins of individuals transgender identity and gender dysphoria, he tells PRIDE. Primarily aimed at youth and young adults, GET may also be experienced by older adults.Its also nothing new, Reese tells PRIDE. In fact, this idea has roots stretching back to the earliest days of modern healthcare and transphobia, when doctors worldwide tried to cure individuals who were either gay or transgender. What has changed in recent years is the language. Conservative healthcare professionals and their allies have sought softer terms to describe their harmful practices. The agenda behind GET is not about genuinely supporting patients, but rather about delaying transitions as long as possible, ultimately aiming to alter how these patients view themselves.If theres any question about the agenda of GET, simply look to whos behind it. The term was popularized by the Gender Exploratory Therapy Association (now called Therapy First), which has ties to groups like Genspect and the Society for Evidence-Based Gender Medicine (SEGM) that have historically opposed affirming medical care for trans and nonbinary people, says Saiter.Who is being targeted for GET?While anyone questioning their gender may find themselves being sucked into GET, Saiter says it's young people in particular who are being targeted.This approach is often marketed to young people questioning their gender identity, especially teens and young adults, he explains. But thats not all: Parents who are looking for providers that will take a more cautious or skeptical stance toward affirmation, may also find themselves falling down the GET rabbit hole, he warns.What does it entail, and how is it similar to conversion therapy?Whats insidious about GET is how it presents initially, which can lull people into a false sense of safety with the practice. On the surface, GET looks like regular talk therapy, warns Saiter. But the difference is that it emphasizes searching for underlying causes of gender dysphoria like trauma, autism, or anxiety while casting doubt on affirmation or transition, he explains. The idea is that transition should be delayed or avoided until every other possible explanation has been exhausted.It is framed as open-ended exploration, adds Dr. Grey. There is no set protocol, which means this could be indefinite, and never really affirm someones identity.That makes it very similar to gender identity conversion efforts attempts to change, suppress, or prevent someones authentic gender identity or expression, adds Saiter. This is why many clinicians, ethicists, and advocacy groups view GET as a modern rebranding of conversion therapy.Like conversion therapy, the experts say that there are dangers associated with GETWe know from research that gender identity conversion efforts are linked to higher rates of depression, distress, and suicide attempts, says Saiter. For young people, delaying or denying gender-affirming care can mean missing out on interventions that are actually shown to reduce suicidality and improve mental health. In short: GET doesnt just slow things down. It can put people at greater risk.The purpose of GET, in part, is about delaying actual gender-affirming care, and that in and of itself puts trans and nonbinary individuals at risk. Research supports that there is not only an increase in distress and dysphoria, but there are delays in accessing medical care, which can worsen mental health care outcomes, for a group of individuals who already experience higher rates of depression, anxiety, and suicidal ideation, says Dr. Grey. It also reinforces stigma, shame, and weaponizes therapy, making people feel pathologized or not believed. You need to justify your existence to people who are already committed to misunderstanding you.The result, says Dr. Grey, is that survivors of GET end up feeling gaslit, shamed, and some have reported experiencing long-term harm from the practice.Is GET effective?The risks of conversion therapy and its ilk are well documented, but is there a reward to the risk? Is it actually effective? No surprise: the experts all agree it is not.There is no credible evidence that suggests that it does, and there is no evidence that supports that GET improves long-term mental health outcomes, says Dr. Grey.However, the opposite is true for gender-affirming care. There is growing evidence that gender-affirming care when chosen and supported by the individual is associated with better outcomes, including less depression and suicidality, says Saiter.Dr. Grey also points out that gender-affirming care is strongly associated with lower depression and suicidality, improved quality of life, and overall better mental health care outcomes and well-being. There are claims that GET prevents regret or de-transitioning, while evidence supports that most transgender folks who have access to affirming care are satisfied with their choices.What should LGBTQ+ people, and those who care about them, know about this practice?With the Department of Health and Human Services rallying behind this treatment approach for gender dysphoria, its more important than ever to recognize the red flags. Saiter says to be wary of any therapy groups that insist you prove your gender identity.However, that doesnt mean that gender-affirming care cant include exploration, he adds. Any good therapist explores history, identity, trauma, and relationships. The difference is that affirming care doesnt frame someones identity as a problem to be solved.Saiter offers some advice for finding an affirming therapist: ask them both how they approach gender-affirming care, and who decides when therapy is enough? You deserve therapy that sees your identity as real, your autonomy as valid, and your safety as the priority.Affirming care doesnt mean rushing or skipping over reflection it just means holding someones identity with respect instead of suspicion, he continues. Therapy should never serve a political agenda. The goal should always be centering the clients well-being and autonomy.