Lucy Johnstone is a British psychologist and anti-transgender activist. Johnstone and frequent collaborator David Pilgrim are affiliated with anti-trans hate group Society for Evidence-Based Gender Medicine (SEGM). SEGM frequently attempts to align itself with credible researchers like Gordon Guyatt and Johnstone, which boosts their credibility at the expense of the expert’s credibility.
Background
Lucy Johnstone is a critic of disease models of human thought and behavior, Disease models of gender identity and expression are one of the most insidious ways trans and gender diverse people are oppressed.
Johnstone is known for developing an alternative to disease models called the Power Threat Meaning Framework (PTMF). Johnston developed this model with Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read. As Jaime Hoerricks summarizes:
The origins of the PTMF can be traced to a growing dissatisfaction with conventional psychiatric models. Spearheaded by a team of psychologists, service users, and researchers led by Dr Lucy Johnstone and Professor Mary Boyle, the framework was published by the British Psychological Society in 2018. It emerged from decades of research and clinical experience, drawing on diverse fields including trauma studies, social justice, and critical psychology. The PTMF was developed in response to mounting evidence that traditional diagnostic approaches often fail to adequately capture the complexity of human experiences and can sometimes be actively harmful, particularly for marginalised groups.
At the heart of the PTMF are four key interrelated concepts: Power, Threat, Meaning, and Response. ‘Power’ refers to the various ways in which power operates in our lives, from obvious forms like physical force to more subtle influences like societal norms and expectations. ‘Threat’ encompasses the negative impacts of power misuse, including various forms of adversity, trauma, and social inequalities. ‘Meaning’ relates to how we interpret and make sense of our experiences, shaped by our personal narratives, cultural beliefs, and social contexts. Finally, ‘Response’ describes the ways we react to threat, which can manifest as various forms of distress, unusual experiences, or behaviours that are often labelled as ‘symptoms’ in traditional models.
Anti-trans activism
Johnstone was announced as a speaker at the 2025 SEGM conference. Johnstone’s presentation was titled “Taking on a Diagnostic Label.”
References
Hoerricks, Jaime (June 29, 2024). Beyond Barriers: Applying the Social Model and PTMF to Trans Autistic Experiences. The AutSide https://autside.substack.com/p/beyond-barriers-applying-the-social
Aftab, Awais (August 14, 2020). Moving Beyond Psychiatric Diagnosis: Lucy Johnstone, PsyD. Psychiatric Times https://www.psychiatrictimes.com/view/moving-beyond-psychiatric-diagnosis-lucy-johnstone-psyd
Selected publications
Johnstone, Lucy (December 3, 2019). Does ‘Mental Illness’ Exist? The Problem with Psychiatric Diagnosis. IAI https://iai.tv/articles/does-mental-illness-exist-auid-1280
Johnstone, L., & Boyle, M. (2018). The Power Threat Meaning Framework: An Alternative Nondiagnostic Conceptual System. Journal of Humanistic Psychology, 65(4), 800–817. https://doi.org/10.1177/0022167818793289 pdf https://cms.bps.org.uk/sites/default/files/2022-07/PTM%20Framework%20%28January%202018%29_0.pdf
Johnstone, L. (2017). Psychological Formulation as an Alternative to Psychiatric Diagnosis. Journal of Humanistic Psychology, 58(1), 30–46. https://doi.org/10.1177/0022167817722230
Boyle, M., & Johnstone, L. (2014). Alternatives to psychiatric diagnosis. The Lancet Psychiatry, 1(6), 409–411. https://doi.org/10.1016/s2215-0366(14)70359-1
Books
Johnstone, Lucy (2021). Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice. Routledge, ISBN 978-0367559823
Johnstone, Lucy; Dallos, Rudy [editors] (2013). Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems. [2nd edition]. Routledge, ISBN 978-0415682305
Resources
Trauma Informed UK (trauma-informed.uk)
- Webinar: Trauma-informed alternative to psychiatric diagnosis: hearing people’s stories
- trauma-informed.uk/dr-lucy-johnston
Blue Yonder (blueyonder.co.uk) [archive]