Working as a coach, I have had my share of sessions with young people who are transitioning as transgender. This involves visits to the gender clinic comprised of potentially seeing psychologists, psychiatrists, endocrinologists, speech and language therapists, and nurses. Some of these will be obvious, but some less so, such as speech and language therapists. The latter is because voices need to be trained to be moderated and adapt to the gender someone identifies as, moving forward.
I thought I was reasonably well versed in protocol and procedures, however, I was unaware of a very important yet little-discussed elephant in the room: conversion therapy. Now, this therapy is designed to attempt to help you to change your mind about wanting to identify as and feel like you are a different gender, or even to change your sexual orientation, suggesting therefore that either need a ‘cure’, such as this reparative therapy aims to fix.
The same is true of gender expression, which also requires reparative therapy according to the Government. LGBTQA+ people should not have to fear these currently legal practices which may advance upon them via cultural, religious, psychological, or psychiatric avenues. Government figures show that 13% of trans people, 10% of asexual people, and 7% of LGBT people have been offered or undergone some form of conversion therapy.
Consent is also a huge issue here because some people are being coerced into these forms of therapy by their communities, churches and families; and may not feel that they have any choice but to comply, risk their safety, or lose their families and homes. While this is still legal, there is no safeguarding for people who are potentially already vulnerable, to protect them from having sometimes brutal measures applied to them in the name of a cure.
According to the British Psychological Society (BPS), conversion therapy is 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.
I was quite surprised to learn that in conversations about banning conversion therapy, transgender people were not to be excluded and could still and should still go ahead with the ‘therapy’, according to the legislature surrounding this practice. Yet as a marginalised group already, it makes no sense to encourage measures which are not even fully managed by for example a psychiatric team if the therapy was indeed necessary. The American Psychological Association in their systematic review highlighted serious concerns regarding the methodology of SOCE (sexual orientation change efforts) and identified evidence indicating that individuals undergoing this therapy experienced harm.
The Government currently suggests that transgender conversion therapy is too complicated to be included for now (in the ban) and separate work will be carried out into the ‘complexity of issues’. Yet using such extreme measures should surely be seen as carrying its own complexity, even if just ethically as a starter for ten.
Looking at what conversion therapy is, it can include talking therapies and prayer, but more extreme forms are also implied to be used such as exorcism (right?), physical violence, and food deprivation. Yes, you read that right. I mean talking therapies sure, but am I really writing that the other things are going on in 2022 and considered therapy?
The Cass Review Interim report (2022) suggested that some healthcare providers felt that they had to ‘take a purely affirmative approach to young people wishing to transition, which is obviously also a concern, but one that conversation, not conversion, should look to address.
The BPS is clear that conversion therapy is unethical and potentially harmful, in line with the Memorandum of Understanding on Conversion Therapy which the BPS has signed.
This memorandum updates one released in 2015 by the Department of Health, focusing exclusively on sexual orientation, and is endorsed by Stonewall, a charity for the lesbian, gay, bisexual and transgender communities.
So why am I, as a cisgender woman, writing an article which would inevitably be considered an LGBTQA+ topic?
Our young people need to be supported, not tortured, for their right to express a preference of gender, because birth-given gender isn’t always how someone identifies, and it is their right to choose how to express this. Which in itself is not an easy road to traverse without these draconian measures to get through.
It is time that parents of young people who are trans, as well as educators, coaches, and other people working with vulnerable young people, should be fully versed in what this therapy, and I personally use that term loosely here, has been offering to the people who have had to undergo it. The BPS is clear also that this therapy is unethical and potentially harmful. That this was going on into this decade at all is pretty shocking to me.
The designs of SOCE have been found lacking and methodologically questionable by the American Psychological Association.
SOCE include a range of techniques used by a variety of mental health professionals and non-professionals with the goal of changing sexual orientation this treats being transgender as though it is a mental illness to be given curative therapy.
In light of the LGBTQ community has been on the receiving end of bias in numerous forms historically, it is important to tackle this topic now whilst it is up for debate.
So it is of the utmost importance to raise this issue before the date of June 20th when the debate begins at 4:30pm in UK Parliament. This after a petition was received containing some 145,000 signatures asking for a backtrack on the decision made to exclude trans people from the ban of conversion therapy.
Alongside this conversation, there are calls for Government to explain and provide evidence for their current decisions around this and also for transparency around outcomes.
It is time for some conversations and education so that people on the fringe or outside of this have the knowledge and can bring support to people who are being undermined, and potentially harmed by something considered as a therapy, the banning of which had been agreed, except for trans people. This is not and should not be considered ok. As a Banksy street art post suggests: ‘A lot of parents will do anything for their kids, except let them be themselves.’
Caralyn Bains is a coaching psychologist. She is an associate fellow with the British Psychological Society.
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