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Conversion therapy has been in the spotlight in the UK since the Queen’s Speech on May 11th announced that steps would be taken to legislate a ban on the practice in England and Wales. More recently, expert witness testimony given against Dr Helen Webberley in her MPTS hearing has raised questions online about whether conversion therapy is happening to trans and non-binary young people under our noses.

In 2017 the British Association for Counselling and Psychotherapy published a Memorandum of Understanding on Conversion Therapy in the UK in which they condemned conversion therapy as a threat to public health. In the memorandum they define conversion therapy as “an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of  sexual orientation or gender identity, or seeks to suppress an individual’s expression of sexual orientation or gender identity on that basis”.

This encompasses so-called ‘gay cure’ treatments, faith-based approaches that suppress LGBTQ+ identities, and any approach – from any direction – that tries to change someone’s identity or stop them from expressing it.

It’s easy to think of this kind of practice as outdated, especially when the UK government touts itself as a world leader on LGBT rights, but unfortunately it is alive and well. Around 5% of LGBTQ+ people in the UK have been offered conversion therapy, while 2% have undergone it. And while these numbers may seem low, they represent some 200,000 odd people being coerced into an identity that isn’t theirs. It’s particularly concerning that transgender and non-binary people are 13% more likely than cisgender people to have undergone or been offered conversion therapy.

So where and how is this happening in 2021? Some LGBTQ+ people of faith have reported being pushed towards conversion therapy by religious groups. While there is absolutely no reason that faith and LGBTQ+ identity should be in conflict – in fact, the UK has many organisations who specifically work with and support LGBTQ+ people of faith – historically the religious belief that sex should be solely for procreation has led to discrimination against homosexuality. In recent years a global rise in religious fundamentalism has led to the expansion of this discrimination to include LGBTQ+ people more broadly, and transgender people in particular.

 

Other individuals have reported undergoing conversion therapy at the hands of medical professionals. It is easy to assume that this is not reflective of the general condition of healthcare in the UK, and to attribute these sorts of therapies to a few rogue actors. However, most research on the means and kinds of conversion therapy suggests a culture of healthcare professionals who either offer these therapies or are willing to make and/or accept referrals for them. A BMC Psychiatry study discovered that 17% of surveyed psychiatrists had offered conversion therapy at least once, and that of those patients 40% were being treated at an NHS practice.

 

In trans healthcare in particular there are persistent practices that amount to the use of conversion therapy. GenderGP has written previously about how conversion therapy, particularly with regards to gender identity and the preference for cis identities over trans ones, is supported by social attitudes, media climate, and medical practices. Even as a conversion therapy ban is discussed in the UK the rights and healthcare of trans people are placed in increasing jeopardy, with proposed reforms to the Gender Recognition Act being ditched, medication being refused to young people, and waiting times for services ballooning to five years or more. And, as a British Medical Journal study of conversion therapy notes, “little consideration has been made of the concept that denying access may constitute a form of conversion therapy.” The effect of the UK system is one of passive conversion therapy, where a lack of access to healthcare and support produces a hostile environment for vulnerable gender-incongruent people and prevents them from exploring their identity – often resulting in extreme harm. This may not even be intentional on the part of the healthcare professional involved – testimony in Dr Webberley’s hearing has revealed that even well-regarded experts are encouraged to avoid treatment for gender dysphoria and preferentially diagnose mental health or developmental conditions if they can.

If this is the case, then why is the UK stalling? A motion to ban conversion therapy was tabled as early as 2013, and reaffirmed in 2018 as part of an LGBT Action Plan by former Prime Minister Theresa May. As of May 2021, however, the Action Plan is dead in the water and the conversion therapy ban has been kicked once more into the future, with the government insisting on holding a consultation in the interests of “protecting the medical profession; defending freedom of speech; and upholding religious freedom.” This is unlikely to bring much comfort to LGBTQ+ people, who have already seen their safety eroded in the name of freedom of speech and had their lives put on hold – sometimes indefinitely – by a medical establishment that lags behind the international standard of care.

Even if the UK government continues to drag its feet, you can still be alert to conversion therapy and try to support those affected by it. LGBTQ+ people who have recently come out or who do not have a good support network are likely to be most vulnerable to these kinds of practices, especially if the pressure comes from people close to them. You can help by checking in on them, asking how things are with friends and family, and offering space for them to talk if they need it.

People who are struggling with mental health issues around their identity may feel pressured to try and suppress their feelings or seek help ‘changing’ them. Exploring your identity can be stressful, and it’s absolutely fine to go to counselling or therapy about it, but it’s important to seek out an LGBT-positive service that will provide you with an affirming journey. GenderGP offers its own non-judgmental advice and counselling services as well as a directory of online LGBT support support groups.

Remember that conversion therapy doesn’t always look like hate speech. In fact, it is precisely by masquerading as good medical or therapeutic practice that most conversion therapy has survived in the UK today. You can protect yourself and those around you by staying alert. For instance, be mindful of family members, colleagues, or peers who suggest that trans people would be happier in their assigned gender at birth, or that exploring gender or sexuality is a phase that will eventually pass. Even if this is a genuine, if misguided concern for a loved one’s wellbeing – being out and proud in the UK comes with its own set of difficulties, after all – it’s important to remember that trying to hide or suppress your identity can cause real harm. Social acceptance is the strongest predictor of positive mental health outcomes for LGBTQ+ people, and people who truly care about your wellbeing will support you rather than try to change you.

We want to build a model of therapy that doesn’t treat trans identity as a deviance or a defect that can be corrected, but rather as a journey to self-acceptance. We don’t believe that there is a ‘right’ gender identity or sexuality to have, or even that once you’ve found one that represents you you have to stick with it forever. We want to get therapy – and the culture that surrounds it in the UK – away from trying to ‘fix’ trans people and into helping them manage their emotions around their identity and become the best person they can be.