In July 2019, the British Association of Counselling and Psychotherapy (BACP) released the latest version of their memorandum of understanding on conversion therapy1, defining conversion therapy as "therapy that assumes certain sexual orientations or gender identities are inferior to others, and seeks to change or suppress them on that basis". The document, signed by 20 organisations with medical, counselling, and psychotherapeutic expertise, sets out their opposition to conversion therapy and states their goal of ending the practice in the UK. The broad consensus among reputable therapeutic and psychological organisations is that attempts to alter a person's sexual orientation or gender identity, also sometimes called sexual orientation and gender identity converstion efforts (SOGICE), are harmful, with multiple analyses of LGBTQ+ survey respondents showing a correlation between experiences of SOGICE and serious negative mental health outcomes2,3. An investigation by the Independent Forensic Expert Group (IFEG) found that all forms of conversion therapy were "a form of discrimination, stigmatisation, and social rejection" and that "All forms of conversion therapy, including talk or psychotherapy, can cause intense psychological pain and suffering".4
Conversion therapy can often lead to posttraumatic stress disorder. Group therapy, camps and retreats may incorporate highly traumatic elements such as exposure to physical, verbal, and sexual abuse and humiliation. Talk or psychotherapy can also become a repeatedly traumatic event. Session after session, the individual is confronted with their own “deviancy,” while repetition and duration increase its intensity and importance. We have seen that conversion therapies can lead to avoidance behaviours, hypervigilance (e.g., difficulty falling or staying asleep), intrusive flashbacks, traumatic nightmares, and other symptoms of posttraumatic stress disorder.
Conversion therapy has been a hot topic in UK politics recently, with the government facing increasing pressure to take steps to end the practice. Equalitites Minister Kemi Badenoch has claimed that the government is "committed" to ending conversion therapy, despite criticism from LGBTQ+ organisations such as Stonewall that they are not acting quickly enough.5
Anti-trans organisations such as Transgender Trend, however, have generally come out against the consensus of scientists and human rights organisations, arguing that gender identity conversion efforts cannot be called "conversion therapy"6. They do this in part by claiming that therapists who have been condemned as practicing conversion therapy, such as Canadian sexologist Kenneth Zucker, have been unfairly persecuted by "a politically correct climate which is creating a fear to speak out". They further claim that gender affirming treatment for transgender children is actually a form of conversion therapy in itself, misrepresenting mainstream transgender healthcare as coercing gender nonconforming children to transition. As academic Christa Peterson states on Twitter, this claim to support gender nonconforming youth is somewhat at odds with Transgender Trend's insistence that Zucker did not practice conversion therapy.
Transgender Trend tried to write all the memorandum’s signatories about Zucker being falsely accused of conversion therapy but they got confused and said that something he was in fact doing was “clearly ‘conversion therapy’” pic.twitter.com/YOD5Bv5dVm— worms cited (@christapeterso) March 21, 2021
In a 2008 article, NPR spoke with parent of one of Zucker's patients7, describing a process of attempting to suppress an 8 year old child's apparent gender identity by preventing the child from playing with "girls" toys, socialising with girls in the same age group or even drawing pictures including feminine-coded imagery. In the article, the child's mother discusses them becoming increasingly withdrawn and distressed over the course of Zucker's "treatment". It is difficult to see how this does not meet the BACP definition of conversion therapy, described as "therapy that assumes certain[...]gender identities are inferior to others, and seeks to change or suppress them". Indeed, in published academic work, Zucker has stated that he views the "prevention of transsexualism" as "obviously clinically valid".8
TSN spoke to Helen Collins, a Merseyside based NCS and CPCAB accredited therapist, about Zucker's practices.
TSN: Having read the account of Zucker's practice in NPR, would you describe this as conversion therapy? What long term effects would you expect this treatment to have on a child's development?
Collins: Conversion therapy is completely discredited by every accrediting body, and I would call these practices conversion therapy as they meet the criteria. It distinguishes behaviours that are often crucial to a child’s development as problematic, and works to ‘amend’ this by denying the child stimuli in the form of contact and toys. This is a fundamentally abusive practice, which in the most basic terms ties a child’s play preferences in with a mythical ‘value system’ that is built on societal prejudice.
According to IFEG’s 2020 statement (declaring conversion therapy as a form of torture) 68 per cent of the conversion therapy survivors they engaged with have experienced suicidal thoughts. 59 per cent have sought help for mental health issues , but after being so let down in a therapeutic setting who can gauge the accuracy of these figures? Almost all of the recipients reported symptoms that are correlative with a post-traumatic response. This ‘treatment’ is structured cruelty.
A recent letter to the Sunday Times9 signed by a number of high profile anti-trans organisations, including Conservatives For Women, Fair Play For Women, the LGB Alliance and Transgender Trend, as well as high profile individuals such as internet personality Kellie-Jay Keen (aka Posie Parker) and psychiatrist Az Hakeem, repeats the line taken by Transgender Trend in their 2016 letter. The letter disputes the scientific consensus that gender identity conversion efforts are a form of harmful conversion therapy in favour of the unsupported assertion that transition is a form of conversion therapy in itself. The reality, however, appears to be that far from being an alternative to conversion therapy "gender critical therapy" is often carried out using the exact same methods as anti-LGB conversion therapy in the same locations. An investigation for Pink News by Brynn Tannehill has uncovered deeply abusive practices in anti-trans conversion therapy camps in the US10. In these "wilderness programmes", young trans men were forced to engage in gruelling physical activity alongside lesbian and bisexual young women and subjected to repeated "therapy" sessions to force them to alter their identity.
Despite their protestations to the contrary, it is clear that multiple anti-trans organisations operating in the UK support conversion therapy in practice, including examples of practices that are highly likely to cause serious, long-term psychological harm to trans and gender nonconforming children.
JL Turban, N Beckwith, SL Reisner, AS Keuroghlian. Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry. 2020;77(1):68–76. doi:10.1001/jamapsychiatry.2019.2285
Amy E. Green, Myeshia Price-Feeney, Samuel H. Dorison, Casey J. Pick, “Self-Reported Conversion Efforts and Suicidality Among US LGBTQ Youths and Young Adults, 2018”, American Journal of Public Health 110, no. 8 (August 1, 2020): pp. 1221-1227.
BBC: Ministers 'must quickly ban LGBT+ conversion therapy', 8th of March 2021
NPR: Two Families Grapple with Sons' Gender Identity, 7th of May 2008
Kenneth Zucker, "Treatment of gender identity disorders in children", in "Clinical Management of Gender Identity Disorders in Children and Adults" (pp.27-45), 1990