Background James Esses was expelled from his five year MSc therapist training course and notified of his expulsion via email from Metanoia Institute (accredited by Middlesex University), his course provider. Esses had lodged a public petition that sought to safeguard therapy and counselling for vulnerable children with gender dysphoria. The petition subsequently got 10,000 signatures and a response from the government in support of the safeguards Esses was seeking. A social media backlash culminated in his expulsion.