Dr Bob Withers, psychoanalytic psychotherapist

Robert Withers, psychoanalytic psychotherapist, on the risks to exploratory therapy of including “gender identity” in a conversion therapy ban.

The Hannah Barnes book ‘Time to think’ lays bare the medical scandal that has happened at the Tavistock GIDS. There is a real danger that if ‘gender identity’ is included in a legal ban on ‘conversion therapy’, that scandal will be perpetuated, rather than learned from.

My own involvement in this subject began in the early 1990s when I worked psychoanalytically with a man who had fully medically transitioned, lived for nine years as a woman, but was troubled by the same mental health issues that had driven him to transition in the first place. When I saw him he wanted to return to living as a man.

Sadly that work continues today. I have been working recently with a man who now realises his trans identification arose out of his inability to accept his homosexuality and a woman who now realizes her trans identification arose out of a reaction to sexual trauma stored (unconsciously) in her body. ( All three of these people regret their medical transition. They have given me permission to write about them)

All three have desisted from their trans identification. None of them appear on any evidence base recording outcome data for this type of treatment. All three wish they had had effective psychotherapy before making the permanent changes to their bodies they have come to regret.

The inclusion of ‘gender identity’ in a bill to ban conversion therapy could render such therapeutic help impossible. The Memorandum of Understanding 2 is a document that NHS England and all the leading psychotherapy bodies have signed up to.

The document was originally designed to end the abhorrent practice of gay conversion therapy. In 2017 gender identity conversion therapy was added to the document without any discussion with the general membership. The MoU2 defines conversion therapy as any therapy that explicitly or implicitly demonstrates a preference for one gender identity over another.  The proposed legislation is grounded in the MoU2. So, any therapist attempting to help a trans patient feel more at home in their body by coming to terms with trauma held there unconsciously, would have to be able to convince a court of law that this did not constitute ‘implicit conversion therapy’.

But acceptance of the sexed body would be likely to result in a change of gender identity- where e.g. trans identification is a response to sexual trauma. So it could be argued that trauma informed therapy constitutes conversion therapy because it implies a preference for one gender identity over another.  We contend however that therapists have an ethical duty to help their patients explore ways of managing their gender distress before undergoing radical medical treatment. But even if a court of law upheld our view, few, if any, therapists would be willing to undergo the ordeal of a criminal trial. ‘Gender affirmative therapy’ and its associated medical treatment would quickly become the only type of therapy available and the scandal of the Tavistock GIDS would be perpetuated.

The cost of this to the NHS could be astronomical. Both of my recent detransitioners are in the process of suing NHS practitioners for compensation. If their claims are successful it could open the floodgates to the numerous other detransitioners already harmed. Please do not add to that harm by criminalizing ‘gender identity conversion therapy’.