Parliamentary debate briefing 13th June 2022

Medical clinicians against proposed re-inclusion of gender identity into the conversion therapy ban

We are a group of approximately 70 clinical staff, (and growing), comprising NHS doctors, nurses, psychologists, psychotherapists, and other clinicians across a wide range of health specialities. See here our full submission to the conversion therapy ban consultation.

We believe that the government is right to exclude gender identity from the conversion therapy ban:

  1. Gender identity and sexual orientation are not equivalent terms

The term ‘conversion therapy’ is broadly understood to describe a group of interventions designed to alter a person’s sexual orientation from homosexual to heterosexual. These unethical practices are ineffective and no longer available in modern healthcare. However, the extension of the emotive term ‘conversion therapy’ to cover gender identity has the potential to lead to irreversible physical and psychological harm to many vulnerable patients.  

Many people with gender dysphoria or who adopt a gender variant identity, seek complex, invasive and irreversible medical interventions. We believe, based on our professional commitment to ‘first do no harm’, and in keeping with norms of mental health care, that such patients must initially be offered non-physical forms of treatment such as psychotherapy, to explore causes of distress. In the course of their therapy, an individual’s sense of their gender identity might change once they understand the roots of their dysphoria and become reconciled with their body. Under proposed legislation, this could be considered a form of ‘conversion therapy’. This is an actual and not a hypothetical scenario, currently experienced by colleagues, (contact our website for details). Vested interest groups promoting medical transition will use the law to impose their own agenda. This would have a chilling effect on those wishing to practice standard ethical exploratory therapy increasing the likelihood of medical transition in vulnerable patients. In Victoria, Australia, which has adopted similar legislation, failure to support a child’s wish to take puberty blockers is deemed a ’conversion practice’ and illegal.  

  1. Definitions in law need to be unambiguous 

Key terms in the Government paper have not been defined, or the definitions are unclear e g: gender identity, transgender, conversion therapy, legitimate support. This risks confused legislation that fails the people it sets out to support. Good law needs clear definitions. 

  1. Need to safeguard Children and Young People: Serious unintended consequences

We are concerned that under 25s will be particularly harmed by this legislation. Research shows that a person’s sense of their gender identity is not fixed at birth, but fluid throughout childhood and adolescence and that gender dysphoria usually resolves after puberty (in 61-98% of children). Many grow up to be lesbian, gay, or bisexual. For them, a ban on gender ID conversion therapy could inadvertently encourage what amounts to gay conversion therapy by depriving them of help coming to terms with their sexuality. Gender dysphoria disproportionately affects those with autism, other mental health issues and childhood traumas. ‘Affirmative care’ is non-explorative care and disregards the many causes of distress and instead concretises gender identity, increasing the likelihood of medicalisation. NICE has shown current interventions lack an evidence base, safety and cost effectiveness. Importantly, there has been no long term follow up for these patients and the growing number of detransitioners who regret medical interventions illustrates the importance of safeguarding these young people.  

  1. The Interim Cass Review report: Concern with current provision for children and young people

The interim findings of the government-commissioned Cass Review emphasises concerns with current practice and the importance of young people’s access to safe, evidence-based, and effective psychological support. The starting point for any legislation must be to support best care.