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The trouble with conversion therapy Anything other than affirmation is deemed abusive

(Mark Kerrison/In Pictures/Getty)


August 29, 2023   7 mins

Group belonging is important for human beings. We are tribal mammals and evolution has left some of us as terrified of social exclusion as we are of physical death. But as always, you can have too much of a good thing, and when social cohesion becomes restrictive, when the rules of belonging to a society become rigid, then many despair they can ever fit in.

War tends to increase social cohesion, leaving those statistically at the edge, exposed. And in the aftermath of World War Two , discrimination against gay people reached its zenith. “Homosexuals” were thought too different to be tolerated: they were criminalised and given a psychiatric diagnosis and “treatment”. Considered relatively benign, the so-called “conversion therapy” was deemed a way for troubled people to avoid worse fates and social rejection. Some gay men and women requested the “therapies”, presumably with the hope of passing through life more easily and being socially affirmed as “acceptable”.

Today, conversion therapy is at the heart of another war, as the Government attempts to ban it. Again it involves a marginalised cohort, who despair of fitting in. But this time, “conversion therapy”, which was always ill-defined, has taken on several different meanings.

The term is used to describe a range of medical and psychotherapeutic interventions, early versions of which were offered to gay men and women on the NHS during the Fifties — although these were focused on aversion more than conversion. Pavlovian attempts were made to disrupt any association between (same-sex) sexual stimuli and sexual responses, with electric shocks or medically induced vomiting. Later therapists attempted to actively re-orientate people’s sexuality towards heterosexual stimuli. Methods also included religious counselling, talking therapies, and finally, for some gay men, hormonal treatments.

These attempts to either avert homosexuality or convert lesbian, gay and bisexual (LGB) people to heterosexuality didn’t work — and even killed people. Alan Turing committed suicide two years after opting for “chemical castration”, rather than imprisonment.  Eventually, though, society started to shift. In 1967, homosexuality was decriminalised in England. In 1973, the term was removed from the 2nd version of the Diagnostic Statistical Manual (DSM-II), a handbook used by healthcare professionals to guide the diagnosis of mental disorders. Outside of LGBT communities, the concept of conversion therapy may have comfortably drifted out of consciousness for a while.

The collective amnesia did not last long. In 2011, The Guardian reported that some religious therapists were still trying to convert gay men. This forced therapy organisations in the UK to confront their history, and in 2015 the first Memorandum of Understanding (MOU) on Conversion Therapy was signed by 16 organisations. All agreed that it was unethical for a therapist to try to change someone’s sexual orientation via any means. Two years later, a second memorandum — the MOU2 — was announced. This one had expanded the concept of conversion therapy to include any “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”. The inclusion of “gender identity” is significant.

Gender identity is the term used to describe the profound internal sense that some people have of their maleness, or femaleness, or neither. Gender non-conformity didn’t escape diagnosis for long; when the updated DSM-III was introduced in 1980, the concept of “gender identity disorder”, previously absent, slipped into the gap left by homosexuality.

In July 2018, the day before the MOU2 was officially launched in parliament, the government presented the results of its National LGBT Survey. The online survey of more than 108,000 self-selected respondents stated that, overall, 5% of respondents had been offered conversion therapy, and 2% had taken it up. This rose to 9% and 4% of transgender respondents.

The idea that conversion therapy could still happen in modern Britain is abhorrent to most. And this is why there has been a move to ban it in parliament.. Yet feelings and facts matter. The LGBT survey did “not provide a definition of conversion therapy”. As such, the survey measures whether people perceived something to have been conversion therapy. Furthermore, for those who did feel they had been offered it, only 19% said that it was via a healthcare provider or medical professional. No one knows how many of these were in the NHS.

It is easy to think we understand what we are talking about when it comes to conversion therapy when maybe we don’t. And given the controversy over Government’s decision to include trans people in criminalisation of the practice, it’s vitally important that we do.

In 2018, no one claimed to be receiving electric shock treatments, or medically induced nausea. These interventions are of course already and rightfully illegal. So what is it exactly that people are experiencing? In the NHS, the only conversion therapy treatments that are still offered — albeit not with the aim of “converting” homosexuals — are talking therapies and hormonal interventions.

Let’s address talking therapy first. There is no doubt that some “therapists” will have actively tried to alter their patients’ gender and sex-related thoughts, feelings and/or identities. We have troubling anecdotal evidence that this has happened to some trans-identified people in modern Britain. Whether this is happening away from religious settings — in the NHS or mainstream clinical or psychological practice — is harder to ascertain, but it is possible. After all, potentially damaging interactions between mental health professionals and trans- or gender-questioning people aren’t a new phenomenon.

Treatments attempting to convert gay and lesbian people to heterosexuality were just as unethical and also failed. But they gave rise to an affirmative practice which has taken hold today and which includes medicalisation. “Gay Affirming Therapy” was developed in the early Eighties as a reparative response. This approach wasn’t intended to be a whole-scale model of care, but a therapeutic position wherein the clinician demonstrated warmth and acceptance of a client’s non-heterosexual identity to counterbalance negative messages from society.

It is this affirmative position which has been adopted, and adapted, by clinicians working with transgender adults and gender-incongruent children. But the term “affirmative care” has changed. It has morphed to include, the offer at least, of “medical affirmation” — or hormonal intervention. Medical gender affirmation aims to help reduce an individual’s suffering by trying to better align their physical body with their felt gender identity. The World Health Organization defines it thus: “Gender-affirmative health care can include any single or combination of a number of social, psychological, behavioural or medical (including hormonal treatment or surgery) interventions designed to support and affirm an individual’s gender identity.” Note here how the idea of hormonal interventions has been turned on its head, previously offered as a “conversion therapy” for gay men.

Despite the fact that there is no consensus or good quality evidence to demonstrate that — on balance, on average and over time — these novel gender-affirming medical interventions do reduce suffering, and despite the evidence that they will certainly harm some, many people report that for them, personally, they have felt “life-saving”. These evocative first-person narratives have led some to argue that access to gender-affirming medical interventions should be a human right. From this vantage, anything other than immediate affirmation can be considered equivalent to conversion therapy. As a result, psychotherapy, which might explore different ways of understanding ourselves and in doing so may delay medical intervention, is now understood by some as inherently harmful.

This leaves us in a position whereby offering a medical intervention to someone who identifies as LGB is very clearly understood to be conversion therapy, while not offering the (sometimes same) treatment to someone who identifies as transgender is also understood, by some, to be conversion therapy. Meanwhile, offering psychotherapy that aims to reduce distress by increasing self-acceptance without the need for change is seen as the right approach for LGB people but, sometimes, the wrong one for transgender people.

To complicate things even further, the population of people understood to be transgender has broadened. “Trans” has become an “umbrella term” under which a broad range of experiences are collated. As well as those who identify as the opposite sex, the category now includes gender-questioning people, gender non-conforming people and the gender fluid, among others — depending on who is defining it. The term non-binary, used to describe people who identify as neither male nor female, entered the clinical literature less than a decade ago, but is already being medically treated in the NHS.

We must also note that the demographics of those who identify as trans have also changed significantly over the recent years. No one yet knows why. These changes are particularly striking in younger people, with the number of adolescents and young adults questioning their gender and sexuality has increased exponentially in recent years in particular among young women.

On top of this, sometimes the same individuals move between identity categories — from LGB to T or T to LGB for example — increasing the risk that a treatment felt to be right, lifesaving even, the first time can be experienced as devastatingly wrong for the same person the second time. One person’s affirmation therapy might be another person’s conversion therapy — but no one can agree on which is which.

History doesn’t repeat but it often rhymes. And the NHS is once again trying to reduce the suffering experienced by some gender non-conforming people. Once again, it is offering a range of treatments that don’t — yet — have sufficient evidence to allow us to guarantee any outcome. Once again, people seeking to pass through their lives with more comfort are requesting treatments. And once again, the profound uncertainty about what will work for whom leads to inevitable medical risk-taking. If a patient can’t always predict how they will feel about something in the future, then a doctor or therapist certainly can’t.

No one can envy Dr Hilary Cass, the paediatrician charged with delivering an independent review of the NHS’s gender identity services and find a way forward, for children and adolescents at least. She finds herself on a battlefield where people are fighting over how to define key clinical terms, not least the concept of conversion therapy itself. Yet a quick search of her interim report makes it clear that Cass isn’t too worried. The word “conversion” doesn’t feature once. Instead, without taking medical treatments completely off the table, she calls for the NHS to increase access to psychotherapy. According to Cass, then, gently supporting people to explore identities in therapy is not akin to conversion therapy as most people understand that term.

As we turn our minds to the future, we must keep one eye on the past. Wars, cultural or otherwise, aren’t good for anyone, particularly minority groups. No ethical clinician wants to repeat history and inadvertently hurt the very people they are trying to help. We must focus now on developing therapies that will be acceptable to and appropriate for everyone who might seek them, minimising the risk of current or future harm. To do this we must accept that when it comes to issues of sex and gender, uncertainty and cultural change are the only things we can predict.


Dr Anna Hutchinson is a clinical psychologist who specialises in adolescent mental health, gender and physical health. She works in the NHS and private practice.


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Ewen Mac
Ewen Mac
10 months ago

“… the number of adolescents and young adults questioning their gender and sexuality has increased exponentially in recent years in particular among young women.”
The idea of the “gendered soul” is being introduced in many schools as factual and pupils are encouraged to embrace it as an achievement. In some schools the teacher leads the class in a round of applause for the kid who announces their “new gender identity.” The kid doesn’t have to work at being good at anything – they just make an announcement – in order to get positive attention.
Throw in social media contagion, idiot parents who brag about having “No boring CIS kids,” society’s current hostility toward scientific rationalism, the media & political establishment’s terror of being honest about it, and it’s no wonder kids get confused.

Last edited 10 months ago by Ewen Mac
Phil Rees
Phil Rees
10 months ago
Reply to  Ewen Mac

Yes, its fine if the NHS moves toward psychotherapy as a default but that will be a wasted initiative if the schools keep adopting a hardline Stonewall position. Stonewall needs to be tamed before any sensible therapeutic approach can work, and ‘tamed’ means banning in civil service, kwangos, and schools.

Ethniciodo Rodenydo
Ethniciodo Rodenydo
10 months ago
Reply to  Ewen Mac

“No one yet knows why”
Really. When I was growing up no one was confused as to which sex they were so the proportion of the population with this issue must have been vanishingly small. The problem is people, and particularly young people, are infinitely malleable especially in uncertain times. Provide them with an option that gives them the attention and affirmation they crave and they will by straight over the cliff like lemmings.
The corollary is that that the people behind this are either evil (know what they are doing and get some kind of perverted satisfaction out of it, or they are amoral and swayed by the own self-interest (financial, reputational or otherwise) or psychotherapy is a sham profession with less scientific basis than phrenology

Last edited 10 months ago by Ethniciodo Rodenydo
Janet G
Janet G
10 months ago

all of the above

Janet G
Janet G
10 months ago

all of the above

Phil Rees
Phil Rees
10 months ago
Reply to  Ewen Mac

Yes, its fine if the NHS moves toward psychotherapy as a default but that will be a wasted initiative if the schools keep adopting a hardline Stonewall position. Stonewall needs to be tamed before any sensible therapeutic approach can work, and ‘tamed’ means banning in civil service, kwangos, and schools.

Ethniciodo Rodenydo
Ethniciodo Rodenydo
10 months ago
Reply to  Ewen Mac

“No one yet knows why”
Really. When I was growing up no one was confused as to which sex they were so the proportion of the population with this issue must have been vanishingly small. The problem is people, and particularly young people, are infinitely malleable especially in uncertain times. Provide them with an option that gives them the attention and affirmation they crave and they will by straight over the cliff like lemmings.
The corollary is that that the people behind this are either evil (know what they are doing and get some kind of perverted satisfaction out of it, or they are amoral and swayed by the own self-interest (financial, reputational or otherwise) or psychotherapy is a sham profession with less scientific basis than phrenology

Last edited 10 months ago by Ethniciodo Rodenydo
Ewen Mac
Ewen Mac
10 months ago

“… the number of adolescents and young adults questioning their gender and sexuality has increased exponentially in recent years in particular among young women.”
The idea of the “gendered soul” is being introduced in many schools as factual and pupils are encouraged to embrace it as an achievement. In some schools the teacher leads the class in a round of applause for the kid who announces their “new gender identity.” The kid doesn’t have to work at being good at anything – they just make an announcement – in order to get positive attention.
Throw in social media contagion, idiot parents who brag about having “No boring CIS kids,” society’s current hostility toward scientific rationalism, the media & political establishment’s terror of being honest about it, and it’s no wonder kids get confused.

Last edited 10 months ago by Ewen Mac
Marcus Leach
Marcus Leach
10 months ago

The trans ideologues are promoters and suppliers of the most evil and brutal conversion therapy of all.
Studies show that when confused children and young people do not receive affirmation of their “gender identity” and are not put on puberty blockers, hormones or have their bodies disfigured by surgery, 80-90% grow out of their supposed trans confusion by their early twenties. The majority determine that they are gay.
The trans ideologues, then, are encouraging children and young adults, nine out of ten of whom would have grown out of their gender identity dysmorphia, to undertake a conversion therapy of drugs and surgical amputation in order to “affirm” their “gender identity”. And as the majority of confused children and young adults are really just homosexuals, it is primarily an obscene gay conversion therapy.

Phil Rees
Phil Rees
10 months ago
Reply to  Marcus Leach

Which is exactly why those trans ideologues (including Stonewall, Mermaids, etc) are, in effect, homophobes.

Janet G
Janet G
10 months ago
Reply to  Phil Rees

Lesbians who don’t relish the notion of sex with a “transwoman-with-d**k-testicles-male sexual behaviours” are told to reconsider their prejudices. That is, the trans enthusiasts want to convert lesbians. They do it by exhortation, social pressure, punishment by banishing. Conversion practices are alive and well in the trans “community”.

Janet G
Janet G
10 months ago
Reply to  Phil Rees

Lesbians who don’t relish the notion of sex with a “transwoman-with-d**k-testicles-male sexual behaviours” are told to reconsider their prejudices. That is, the trans enthusiasts want to convert lesbians. They do it by exhortation, social pressure, punishment by banishing. Conversion practices are alive and well in the trans “community”.

Phil Rees
Phil Rees
10 months ago
Reply to  Marcus Leach

Which is exactly why those trans ideologues (including Stonewall, Mermaids, etc) are, in effect, homophobes.

Marcus Leach
Marcus Leach
10 months ago

The trans ideologues are promoters and suppliers of the most evil and brutal conversion therapy of all.
Studies show that when confused children and young people do not receive affirmation of their “gender identity” and are not put on puberty blockers, hormones or have their bodies disfigured by surgery, 80-90% grow out of their supposed trans confusion by their early twenties. The majority determine that they are gay.
The trans ideologues, then, are encouraging children and young adults, nine out of ten of whom would have grown out of their gender identity dysmorphia, to undertake a conversion therapy of drugs and surgical amputation in order to “affirm” their “gender identity”. And as the majority of confused children and young adults are really just homosexuals, it is primarily an obscene gay conversion therapy.

Steven Carr
Steven Carr
10 months ago

‘Alan Turing committed suicide two years after opting for “chemical castration”, rather than imprisonment.’
It is ‘chemical castration’ when people are against it.
It is ‘puberty blockers’ when people want to chemically castrate boys.
It is strange that these drugs caused Alan Turing to kill himself, while the people pushing them declare ‘The drugs have a good track record, with 30 years of follow-up data showing them to be safe and effective.’

Last edited 10 months ago by Steven Carr
Jonathan Nash
Jonathan Nash
10 months ago
Reply to  Steven Carr

I believe Turing’s family strongly dispute the idea that he committed suicide by reason of the chemical castration treatment.

Jonathan Nash
Jonathan Nash
10 months ago
Reply to  Steven Carr

I believe Turing’s family strongly dispute the idea that he committed suicide by reason of the chemical castration treatment.

Steven Carr
Steven Carr
10 months ago

‘Alan Turing committed suicide two years after opting for “chemical castration”, rather than imprisonment.’
It is ‘chemical castration’ when people are against it.
It is ‘puberty blockers’ when people want to chemically castrate boys.
It is strange that these drugs caused Alan Turing to kill himself, while the people pushing them declare ‘The drugs have a good track record, with 30 years of follow-up data showing them to be safe and effective.’

Last edited 10 months ago by Steven Carr
Derek Bryce
Derek Bryce
10 months ago

I enjoyed this piece other than when the author used the unfortunate formulation ‘LGBT communities’. There is no such thing. The conflation of lesbians, gay men and bisexuals with trans is an act of forced teaming that is causing distress and anger among LGB people who find themselves hitched to an imagined state of being which actively denies the materiality of sex – the very foundation of homosexuality and heterosexuality. The conflation of trans with LGB people in the minds of much of the general population is also beginning to roll back the acceptance of homosexuals and our relationships. At least we may take some solace that the author didn’t include the Q for ‘queer’ and other letters in the unbreakable WiFi password that we’ve been consigned to by, let’s be honest, a minority of heterosexual fetishists who’ve colonised gay lives like cuckoos in the nest.

TQ+ imagineers and cosplayers: get out of LGB lives. They are antithetical to our interests and we have nothing in common with them.

Last edited 10 months ago by Derek Bryce
Mark Kerridge
Mark Kerridge
10 months ago
Reply to  Derek Bryce

Good point. The word “community” does a lot of heavy lifting these days in many areas. It’s really just short-hand for putting sometimes disparate individuals into a box when it seems useful.

Denis Stone
Denis Stone
10 months ago
Reply to  Derek Bryce

As soon as you say ‘community’ you have created an Us and Them situation. Surely, one of the great successes of the past 50 years is that LGB people are now fully integrated with heteros in the same society. It’s the T people who knowingly use the term ‘community’ to make the rest of us feel they are marginalised.

RM Parker
RM Parker
10 months ago
Reply to  Derek Bryce

Well said.

Mark Kerridge
Mark Kerridge
10 months ago
Reply to  Derek Bryce

Good point. The word “community” does a lot of heavy lifting these days in many areas. It’s really just short-hand for putting sometimes disparate individuals into a box when it seems useful.

Denis Stone
Denis Stone
10 months ago
Reply to  Derek Bryce

As soon as you say ‘community’ you have created an Us and Them situation. Surely, one of the great successes of the past 50 years is that LGB people are now fully integrated with heteros in the same society. It’s the T people who knowingly use the term ‘community’ to make the rest of us feel they are marginalised.

RM Parker
RM Parker
10 months ago
Reply to  Derek Bryce

Well said.

Derek Bryce
Derek Bryce
10 months ago

I enjoyed this piece other than when the author used the unfortunate formulation ‘LGBT communities’. There is no such thing. The conflation of lesbians, gay men and bisexuals with trans is an act of forced teaming that is causing distress and anger among LGB people who find themselves hitched to an imagined state of being which actively denies the materiality of sex – the very foundation of homosexuality and heterosexuality. The conflation of trans with LGB people in the minds of much of the general population is also beginning to roll back the acceptance of homosexuals and our relationships. At least we may take some solace that the author didn’t include the Q for ‘queer’ and other letters in the unbreakable WiFi password that we’ve been consigned to by, let’s be honest, a minority of heterosexual fetishists who’ve colonised gay lives like cuckoos in the nest.

TQ+ imagineers and cosplayers: get out of LGB lives. They are antithetical to our interests and we have nothing in common with them.

Last edited 10 months ago by Derek Bryce
Jim Veenbaas
Jim Veenbaas
10 months ago

What a mess. If an adult wants conversion therapy, they should be allowed to take it. It shouldn’t matter if they are trying to convert from homosexuality to heterosexuality, or if they are trying to covert from one gender to another. The state has no business policing this.

Children are different. No child should be allowed to undergo medical interventions. They simply aren’t mature enough to make these decisions. I don’t necessarily have an issue with children transitioning socially, as long as I’m confident they aren’t being pushed into it. And with the explosion of children seeking gender affirming care, especially girls converting to boys, I suspect there’s some kind of social contagion taking place.

Steven Carr
Steven Carr
10 months ago
Reply to  Jim Veenbaas

If you are old enough to choose whether or not to buy cigarettes, you are old enough to decide to have your breasts cut off.

Jim Veenbaas
Jim Veenbaas
10 months ago
Reply to  Steven Carr

What’s that junk women are injecting into their lips these days? Isn’t it some kind of toxin?

Richard Powell
Richard Powell
10 months ago
Reply to  Steven Carr

Yes, the age threshold in both cases should be 25 or thereabouts.

Dave R
Dave R
10 months ago
Reply to  Steven Carr

FolX? Might this be irony? Hope so, Steve.

David Morley
David Morley
10 months ago
Reply to  Steven Carr

Why?

cigarettes do long term harm, but the harm is cumulative not instant. The harm is reversible to some degree. Give up, and eventually your risk of lung cancer returns to normal levels. Change your mind, and you can simply give up smoking.

now compare with having your breasts cut off.

your comment is just silly.

David Morley
David Morley
10 months ago
Reply to  Steven Carr

Like several others – think I missed the irony.

Jim Veenbaas
Jim Veenbaas
10 months ago
Reply to  Steven Carr

What’s that junk women are injecting into their lips these days? Isn’t it some kind of toxin?

Richard Powell
Richard Powell
10 months ago
Reply to  Steven Carr

Yes, the age threshold in both cases should be 25 or thereabouts.

Dave R
Dave R
10 months ago
Reply to  Steven Carr

FolX? Might this be irony? Hope so, Steve.

David Morley
David Morley
10 months ago
Reply to  Steven Carr

Why?

cigarettes do long term harm, but the harm is cumulative not instant. The harm is reversible to some degree. Give up, and eventually your risk of lung cancer returns to normal levels. Change your mind, and you can simply give up smoking.

now compare with having your breasts cut off.

your comment is just silly.

David Morley
David Morley
10 months ago
Reply to  Steven Carr

Like several others – think I missed the irony.

Judy Johnson
Judy Johnson
10 months ago
Reply to  Jim Veenbaas

I agree. It seems the very opposite of choice to not allow conversion therapy for those who want it. I am writing of conversion therapy relating to sexual orientation. It is not possible to change the genetic code of every cell in the body.
However, it should not be available for children – Steven mentions below that if they are old enough to buy cigarettes, they are old enough to have their breasts cut off. The entitlement to make one unwise choice does not automatically give the right to make further unwise choices.

Last edited 10 months ago by Judy Johnson
Steven Carr
Steven Carr
10 months ago
Reply to  Judy Johnson

I do find it surprising that transactivists want children to make life-changing decisions, while they would be horrified at the idea of the child being allowed to choose whether or not to smoke.

Steven Carr
Steven Carr
10 months ago
Reply to  Judy Johnson

I do find it surprising that transactivists want children to make life-changing decisions, while they would be horrified at the idea of the child being allowed to choose whether or not to smoke.

Steven Carr
Steven Carr
10 months ago
Reply to  Jim Veenbaas

If you are old enough to choose whether or not to buy cigarettes, you are old enough to decide to have your breasts cut off.

Judy Johnson
Judy Johnson
10 months ago
Reply to  Jim Veenbaas

I agree. It seems the very opposite of choice to not allow conversion therapy for those who want it. I am writing of conversion therapy relating to sexual orientation. It is not possible to change the genetic code of every cell in the body.
However, it should not be available for children – Steven mentions below that if they are old enough to buy cigarettes, they are old enough to have their breasts cut off. The entitlement to make one unwise choice does not automatically give the right to make further unwise choices.

Last edited 10 months ago by Judy Johnson
Jim Veenbaas
Jim Veenbaas
10 months ago

What a mess. If an adult wants conversion therapy, they should be allowed to take it. It shouldn’t matter if they are trying to convert from homosexuality to heterosexuality, or if they are trying to covert from one gender to another. The state has no business policing this.

Children are different. No child should be allowed to undergo medical interventions. They simply aren’t mature enough to make these decisions. I don’t necessarily have an issue with children transitioning socially, as long as I’m confident they aren’t being pushed into it. And with the explosion of children seeking gender affirming care, especially girls converting to boys, I suspect there’s some kind of social contagion taking place.

Miriam Cotton
Miriam Cotton
10 months ago

You can’t change your sex. If sex dysphoria persists into adulthood (80% of the time it does not) surgeries and hormones can sometimes help psychologically but they don’t change your sex. Therapies need to be grounded in these facts and should never entail ‘affirming’ a delusion.

Phil Rees
Phil Rees
10 months ago
Reply to  Miriam Cotton

This goes to the heart of the problem. Parliament needs to pass some intelligent laws, including one that makes psychotherapy the mandatory standard approach, but as soon as therapists adhere to the truth of what you say there will be a huge outcry from the trans ideologues for whom the ability to change sex is utterly central. Unfortunately I see no spine of determination in parliament and pass laws affirming the immutability of a person’s sex. So long as it does not all psychotherapists are under a massive disadvantage.

Phil Rees
Phil Rees
10 months ago
Reply to  Miriam Cotton

This goes to the heart of the problem. Parliament needs to pass some intelligent laws, including one that makes psychotherapy the mandatory standard approach, but as soon as therapists adhere to the truth of what you say there will be a huge outcry from the trans ideologues for whom the ability to change sex is utterly central. Unfortunately I see no spine of determination in parliament and pass laws affirming the immutability of a person’s sex. So long as it does not all psychotherapists are under a massive disadvantage.

Miriam Cotton
Miriam Cotton
10 months ago

You can’t change your sex. If sex dysphoria persists into adulthood (80% of the time it does not) surgeries and hormones can sometimes help psychologically but they don’t change your sex. Therapies need to be grounded in these facts and should never entail ‘affirming’ a delusion.

Max Price
Max Price
10 months ago

The damage this insanity is doing to children and women in the West is obvious. What’s less obvious is the damage this is doing to gay communities in non Western societies. I’d guess this nonsense is putting gay right back a century in the developing world.

S Wilkinson
S Wilkinson
10 months ago
Reply to  Max Price

I think the forced teaming of LGB and TQ+ is damaging acceptance in the West as well. I’ve seen more openly homophobic comments in the last year than I have in the last 20. It’s not helped by the fact that a lot of people are still really confused and think the majority of trans identifying men are gay.

S Wilkinson
S Wilkinson
10 months ago
Reply to  Max Price

I think the forced teaming of LGB and TQ+ is damaging acceptance in the West as well. I’ve seen more openly homophobic comments in the last year than I have in the last 20. It’s not helped by the fact that a lot of people are still really confused and think the majority of trans identifying men are gay.

Max Price
Max Price
10 months ago

The damage this insanity is doing to children and women in the West is obvious. What’s less obvious is the damage this is doing to gay communities in non Western societies. I’d guess this nonsense is putting gay right back a century in the developing world.

Paul T
Paul T
10 months ago

Male-bodied men in heterosexual relationships are transvestites. The idiotic conflation of the “trans” prefix on selected words to mean “woman” (or man) has made a complete nonsense of the whole debate. This is deliberate and must continue to be resisted by us all.

Phil Rees
Phil Rees
10 months ago
Reply to  Paul T

Yes, and in particular the early enforcement of ‘transwoman’ as the label for a transitioned man. It should always have been the more truthful ‘trans man’. Stonewall again.

Paul T
Paul T
10 months ago
Reply to  Phil Rees

TIM – Trans Identifying Man
TIF – Trans Identifying Woman
I think both are extremely clear and deal effectively with the sensible idea that “men who say they are literally women” are accurately described.

Paul T
Paul T
10 months ago
Reply to  Phil Rees

TIM – Trans Identifying Man
TIF – Trans Identifying Woman
I think both are extremely clear and deal effectively with the sensible idea that “men who say they are literally women” are accurately described.

Derek Smith
Derek Smith
10 months ago
Reply to  Paul T

As I’ve said before, just mentally replace ‘trans-‘ with ‘fake-‘. Works every time.

Paul T
Paul T
10 months ago
Reply to  Derek Smith

Much simpler too.

Paul T
Paul T
10 months ago
Reply to  Derek Smith

Much simpler too.

Phil Rees
Phil Rees
10 months ago
Reply to  Paul T

Yes, and in particular the early enforcement of ‘transwoman’ as the label for a transitioned man. It should always have been the more truthful ‘trans man’. Stonewall again.

Derek Smith
Derek Smith
10 months ago
Reply to  Paul T

As I’ve said before, just mentally replace ‘trans-‘ with ‘fake-‘. Works every time.

Paul T
Paul T
10 months ago

Male-bodied men in heterosexual relationships are transvestites. The idiotic conflation of the “trans” prefix on selected words to mean “woman” (or man) has made a complete nonsense of the whole debate. This is deliberate and must continue to be resisted by us all.

Andrew Buckley
Andrew Buckley
10 months ago

The role of the Therapist in all this seems to be lacking both in this article and wider discussion.
A good, honest therapist should have the goal of helping the client to experience life in a calmer, quieter more stable way. What this future life actually looks like really isn’t the province of the Therapist.
But with the two areas outlined in the article it does appear that the Therapist has a personal goal. With gay conversion (stereotypically offered by a religious person) the goal is not a happy life of the client but a conforming client who “changes” to an acceptance of being heterosexual. Similarly with the Therapist in front of someone questioning their gender it does appear that the Therapist who simply tries to help the client to work through strange thoughts whether this ends up with a formal diagnosis of gender dysphoria , an acceptance of same sex attraction or something else ends up with the label of “conversion therapist” unless total affirmation of “in the wrong body” is there right from the start.
I have no idea how any legislation or guidelines can navigate through all this. And I say this as a retired therapist.

Andrew Buckley
Andrew Buckley
10 months ago

The role of the Therapist in all this seems to be lacking both in this article and wider discussion.
A good, honest therapist should have the goal of helping the client to experience life in a calmer, quieter more stable way. What this future life actually looks like really isn’t the province of the Therapist.
But with the two areas outlined in the article it does appear that the Therapist has a personal goal. With gay conversion (stereotypically offered by a religious person) the goal is not a happy life of the client but a conforming client who “changes” to an acceptance of being heterosexual. Similarly with the Therapist in front of someone questioning their gender it does appear that the Therapist who simply tries to help the client to work through strange thoughts whether this ends up with a formal diagnosis of gender dysphoria , an acceptance of same sex attraction or something else ends up with the label of “conversion therapist” unless total affirmation of “in the wrong body” is there right from the start.
I have no idea how any legislation or guidelines can navigate through all this. And I say this as a retired therapist.

Susan Grabston
Susan Grabston
10 months ago

Like many other things in this country, we are no longer prepared to do the hard, critial thinking up front. This meme thinking, combined with semi-violent (no debate) minority activism, is leading us to run the experiment live, and facing the consequences post trial. I believe we’re going to have to wait for the wave of de-transitioning and lawsuits until this particular issue is correctly assessd. Likewise, climate change rejecting technologies like nuclear in favour of windmills, solar, and hypothermia. Likewise, the sexualisation of young children with its opportunities for the “minor attracted” and other vested players. This is the kind of article that reminds me that being a serious prepper isn’t a product of an over active imagination, but a response to institutions which can no longer be trusted at an alarmingly low level of Maslow’s hierarchy.

Susan Grabston
Susan Grabston
10 months ago

Like many other things in this country, we are no longer prepared to do the hard, critial thinking up front. This meme thinking, combined with semi-violent (no debate) minority activism, is leading us to run the experiment live, and facing the consequences post trial. I believe we’re going to have to wait for the wave of de-transitioning and lawsuits until this particular issue is correctly assessd. Likewise, climate change rejecting technologies like nuclear in favour of windmills, solar, and hypothermia. Likewise, the sexualisation of young children with its opportunities for the “minor attracted” and other vested players. This is the kind of article that reminds me that being a serious prepper isn’t a product of an over active imagination, but a response to institutions which can no longer be trusted at an alarmingly low level of Maslow’s hierarchy.

Unherd Reader
Unherd Reader
10 months ago

Thank you Dr Hutchinson for this clear and compassionate overview of the minefield that is ‘conversion therapy’. With no clear definitions of ‘trans’ or ‘conversion therapy’ it is impossible to legislate in this area. This should be required reading for any parliamentarians attempting to do so. Only fools rush in where angels fear to tread. One has to wonder what on earth the signatories of the MOU2 are thinking.

Jeff Dudgeon
Jeff Dudgeon
10 months ago
Reply to  Unherd Reader

No mention of the minefield involved in any new conversion therapy law when challenged as a breach of the Euripean Convention on Human Rights and its Articles (9 and 10) on freedom of expression and freedom of religion. I confidently predict it will never reach the statute book short of a Starmer government.

Janet G
Janet G
10 months ago
Reply to  Jeff Dudgeon

We’ve got them in some states of Australia and NSW has a bill before parliament. Our governments are trans-captured.

Janet G
Janet G
10 months ago
Reply to  Jeff Dudgeon

We’ve got them in some states of Australia and NSW has a bill before parliament. Our governments are trans-captured.

Jeff Dudgeon
Jeff Dudgeon
10 months ago
Reply to  Unherd Reader

No mention of the minefield involved in any new conversion therapy law when challenged as a breach of the Euripean Convention on Human Rights and its Articles (9 and 10) on freedom of expression and freedom of religion. I confidently predict it will never reach the statute book short of a Starmer government.

Unherd Reader
Unherd Reader
10 months ago

Thank you Dr Hutchinson for this clear and compassionate overview of the minefield that is ‘conversion therapy’. With no clear definitions of ‘trans’ or ‘conversion therapy’ it is impossible to legislate in this area. This should be required reading for any parliamentarians attempting to do so. Only fools rush in where angels fear to tread. One has to wonder what on earth the signatories of the MOU2 are thinking.

Jane Awdry
Jane Awdry
10 months ago

The conflation of sexual orientation & ‘gender identity’ continues apace. Gay people were not trying to deny the physical reality of their bodies, they simply wanted to be able to have sex with the people they chose to have sex with – a private affair that affects no one else.

The appended ‘T’ to the LGB movement is a very different thing. Quite apart from the fact that we can all be ‘transgender’ now without doing much more than wearing trousers or growing our hair. That was all done & dusted in the 60s & 70s. It’s transexualism that’s being posited now. The suggestion that we actually can change sex. This has repercussions right across society, as we are seeing in the debacle over males in women’s toilets, prisons, sports etc. it affects women’s rights directly when it comes to ‘trans’ identifying males. So it’s not just an issue of the individual, it’s a societal issue.

So where is ‘conversation’ therapy in all this? The denial of the reality of one’s physical & biological body has no relation whatsoever to someone declaring that they are same-sex attracted. That we realised some decades ago that to be gay was an individual’s right, freeing homosexuality from prejudice, is to be celebrated as a human rights victory. Attempting to ‘convert’ or ‘avert’ that tendency was the act of prurient little busybodies who thought they had a right to dictate what people did in their bedrooms.

‘Trans’ ideology on the other hand tries to force other people to accept falsehoods about the nature of truth, biology, reality. Humans cannot change sex. They can tinker about with hormones, chop bits off, add bits on, use stereotypical clothing etc, but they will always remain the sex they were born (observed to be, at birth). To affirm them in a mental dysphoria by offering what is euphemistically called ‘gender affirming care’ is actually ‘conversion surgery’. How this better than offering people the chance to take time to look at themselves in reality & accept that their mindset needs to come into reality with their bodies? Bodies which can’t be forced into line with a disordered mental picture, because surgery can only offer an illusion. Which would be fine if it was accepted by its subjects as such, but it’s not. They are pretending that they have actually changed -‘transitioned’ – into the opposite sex.

This is at its most dangerous when taught to children. Young minds are gullible & fragile. We don’t let children drive cars, get married, operate complex machinery, run a business, vote. How can we possibly think they’d be able to understand the complexities of their own undeveloped brains? Most of us, however mature our thinking, however long we live, will never in our lifetimes be able to do that, let alone children.

When it comes to sex, you can change the packaging but the contents will always remain the same. All humans need to learn to accept that.

Jane Awdry
Jane Awdry
10 months ago

The conflation of sexual orientation & ‘gender identity’ continues apace. Gay people were not trying to deny the physical reality of their bodies, they simply wanted to be able to have sex with the people they chose to have sex with – a private affair that affects no one else.

The appended ‘T’ to the LGB movement is a very different thing. Quite apart from the fact that we can all be ‘transgender’ now without doing much more than wearing trousers or growing our hair. That was all done & dusted in the 60s & 70s. It’s transexualism that’s being posited now. The suggestion that we actually can change sex. This has repercussions right across society, as we are seeing in the debacle over males in women’s toilets, prisons, sports etc. it affects women’s rights directly when it comes to ‘trans’ identifying males. So it’s not just an issue of the individual, it’s a societal issue.

So where is ‘conversation’ therapy in all this? The denial of the reality of one’s physical & biological body has no relation whatsoever to someone declaring that they are same-sex attracted. That we realised some decades ago that to be gay was an individual’s right, freeing homosexuality from prejudice, is to be celebrated as a human rights victory. Attempting to ‘convert’ or ‘avert’ that tendency was the act of prurient little busybodies who thought they had a right to dictate what people did in their bedrooms.

‘Trans’ ideology on the other hand tries to force other people to accept falsehoods about the nature of truth, biology, reality. Humans cannot change sex. They can tinker about with hormones, chop bits off, add bits on, use stereotypical clothing etc, but they will always remain the sex they were born (observed to be, at birth). To affirm them in a mental dysphoria by offering what is euphemistically called ‘gender affirming care’ is actually ‘conversion surgery’. How this better than offering people the chance to take time to look at themselves in reality & accept that their mindset needs to come into reality with their bodies? Bodies which can’t be forced into line with a disordered mental picture, because surgery can only offer an illusion. Which would be fine if it was accepted by its subjects as such, but it’s not. They are pretending that they have actually changed -‘transitioned’ – into the opposite sex.

This is at its most dangerous when taught to children. Young minds are gullible & fragile. We don’t let children drive cars, get married, operate complex machinery, run a business, vote. How can we possibly think they’d be able to understand the complexities of their own undeveloped brains? Most of us, however mature our thinking, however long we live, will never in our lifetimes be able to do that, let alone children.

When it comes to sex, you can change the packaging but the contents will always remain the same. All humans need to learn to accept that.

Chris Milburn
Chris Milburn
10 months ago

It has struck me that “conversion therapy” is a name that logically would be used to describe the process of adults helping convince minors that they are “born in the wrong body”, and then using cross-sex hormones and surgeries to alter their bodies. Only in an Orwellian world does it mean trying to stop this process from happening by confirming their sex at birth is “correct”. ie: conversion therapy actually means stopping conversion therapy.

Last edited 10 months ago by Chris Milburn
Richard M
Richard M
10 months ago
Reply to  Chris Milburn

The tortuous linguistic cartwheels they are forced to describe to keep up the pretence that it makes any sense at all would be funny (a bit like a Two Ronnies mispronounciation sketch) were the consequences not so disturbing.

Richard M
Richard M
10 months ago
Reply to  Chris Milburn

The tortuous linguistic cartwheels they are forced to describe to keep up the pretence that it makes any sense at all would be funny (a bit like a Two Ronnies mispronounciation sketch) were the consequences not so disturbing.

Chris Milburn
Chris Milburn
10 months ago

It has struck me that “conversion therapy” is a name that logically would be used to describe the process of adults helping convince minors that they are “born in the wrong body”, and then using cross-sex hormones and surgeries to alter their bodies. Only in an Orwellian world does it mean trying to stop this process from happening by confirming their sex at birth is “correct”. ie: conversion therapy actually means stopping conversion therapy.

Last edited 10 months ago by Chris Milburn
Dougie Undersub
Dougie Undersub
10 months ago

“
 the number of adolescents and young adults questioning their gender and sexuality has increased exponentially in recent years in particular among young women.”
Because identifying as trans has become more fashionable than being anorexic, which has suddenly become much less prevalent.

Dougie Undersub
Dougie Undersub
10 months ago

“
 the number of adolescents and young adults questioning their gender and sexuality has increased exponentially in recent years in particular among young women.”
Because identifying as trans has become more fashionable than being anorexic, which has suddenly become much less prevalent.

Peter Kwasi-Modo
Peter Kwasi-Modo
10 months ago

Many thanks to Dr Hutchinson for this piece. I have never been clear about the various usages of “conversion therapy”, but this article has helped me a lot.
I realise that this is not central to the intention of the article, but I would like to understand more about the recent “exponential” increase in young people questioning their gender and sexuality. In particular, is this increase just a fad, as some suggest, or is it the result of young people now feeling that they can constructively question their gender?

Last edited 10 months ago by Peter Kwasi-Modo
Jim Veenbaas
Jim Veenbaas
10 months ago

Up until a couple years ago, a large majority of transitioners were male to female. This has totally flipped now with children, suggesting there is some kind of social contagion taking place.

Karen Arnold
Karen Arnold
10 months ago
Reply to  Jim Veenbaas

I agree there is probably social contagion, but also there will be a number of young females who don’t want to grow up to be adult women, that is very different to actually wanting to be men but trans is falsely offered to them as the solution – it isn’t.

Karen Arnold
Karen Arnold
10 months ago
Reply to  Jim Veenbaas

I agree there is probably social contagion, but also there will be a number of young females who don’t want to grow up to be adult women, that is very different to actually wanting to be men but trans is falsely offered to them as the solution – it isn’t.

S Wilkinson
S Wilkinson
10 months ago

Read J Michael Bailey’s unherd piece published today.
Abigail Shrier has written about the social contagion aspect re teenage girls.
Dr Lisa Littman is worth investigating – I think she was the one who coined the phrase Rapid Onset Gender Dysphoria (ROGD) in order to distinguish the adolescent girl phenomena from the traditional presentation of prepubertal males.

Jim Veenbaas
Jim Veenbaas
10 months ago

Up until a couple years ago, a large majority of transitioners were male to female. This has totally flipped now with children, suggesting there is some kind of social contagion taking place.

S Wilkinson
S Wilkinson
10 months ago

Read J Michael Bailey’s unherd piece published today.
Abigail Shrier has written about the social contagion aspect re teenage girls.
Dr Lisa Littman is worth investigating – I think she was the one who coined the phrase Rapid Onset Gender Dysphoria (ROGD) in order to distinguish the adolescent girl phenomena from the traditional presentation of prepubertal males.

Peter Kwasi-Modo
Peter Kwasi-Modo
10 months ago

Many thanks to Dr Hutchinson for this piece. I have never been clear about the various usages of “conversion therapy”, but this article has helped me a lot.
I realise that this is not central to the intention of the article, but I would like to understand more about the recent “exponential” increase in young people questioning their gender and sexuality. In particular, is this increase just a fad, as some suggest, or is it the result of young people now feeling that they can constructively question their gender?

Last edited 10 months ago by Peter Kwasi-Modo
Andrew Currie
Andrew Currie
10 months ago

“Medical gender affirmation aims to help reduce an individual’s suffering by trying to better align their physical body with their felt gender identity.” It’s quite telling to think that this sequence of events may sometimes be considered as preferable to the reverse, and that “changing one’s body” can be seen as a better option than “changing one’s mind”. Perhaps affirming that our bodies are not some kind of “prison for the mind” or a category “ascribed to us” at birth by some jobsworth official, but actually represent the “real us” might offer an alternative form of alignment.

Andrew Currie
Andrew Currie
10 months ago

“Medical gender affirmation aims to help reduce an individual’s suffering by trying to better align their physical body with their felt gender identity.” It’s quite telling to think that this sequence of events may sometimes be considered as preferable to the reverse, and that “changing one’s body” can be seen as a better option than “changing one’s mind”. Perhaps affirming that our bodies are not some kind of “prison for the mind” or a category “ascribed to us” at birth by some jobsworth official, but actually represent the “real us” might offer an alternative form of alignment.

Tyler Durden
Tyler Durden
10 months ago

The gender militants are adamant that gender concerns neither sex nor sexuality. It is the primary performance of a true, liberated identity that requires full validation by the law and then the medical establishment.
What they are instead doing is converting vulnerable young people into members of a transhuman cult. While other cults do this with sex, drugs and mysticism, aside from the afore-mentioned Internet ideologues middle-class professionals are performing this same function in school education, therapy and general medical practice.
The Republican National Committee is about to take up gender-affirming ‘care’ as one of its key campaigning causes. There may not be a more popular issue with independent voters who lean towards the centre-right.

Tyler Durden
Tyler Durden
10 months ago

The gender militants are adamant that gender concerns neither sex nor sexuality. It is the primary performance of a true, liberated identity that requires full validation by the law and then the medical establishment.
What they are instead doing is converting vulnerable young people into members of a transhuman cult. While other cults do this with sex, drugs and mysticism, aside from the afore-mentioned Internet ideologues middle-class professionals are performing this same function in school education, therapy and general medical practice.
The Republican National Committee is about to take up gender-affirming ‘care’ as one of its key campaigning causes. There may not be a more popular issue with independent voters who lean towards the centre-right.

Richard M
Richard M
10 months ago

Among the many absurdities of the topsy-turvey world of Identitarianism is how many its proponents are adamant that having a p***s/breasts does not make you a man/woman, while at the same time being equally adamant that cutting off your p***s/breasts will affirm you as a woman/man.

Still, I couldn’t personally care less how many body parts adults choose to cut off themselves or what they think that affirms. Its the rest of us being compelled to play along, to the detriment of womens rights especially, which bothers me.

But what really disturbs is how the medical establishment, and other authorities, has stood by whilst unproven, invasive and life-changing interventions carried out on children have exploded. Whatever happened to “first do no harm”?

Last edited 10 months ago by Richard M
Richard M
Richard M
10 months ago

Among the many absurdities of the topsy-turvey world of Identitarianism is how many its proponents are adamant that having a p***s/breasts does not make you a man/woman, while at the same time being equally adamant that cutting off your p***s/breasts will affirm you as a woman/man.

Still, I couldn’t personally care less how many body parts adults choose to cut off themselves or what they think that affirms. Its the rest of us being compelled to play along, to the detriment of womens rights especially, which bothers me.

But what really disturbs is how the medical establishment, and other authorities, has stood by whilst unproven, invasive and life-changing interventions carried out on children have exploded. Whatever happened to “first do no harm”?

Last edited 10 months ago by Richard M
Lord Plasma
Lord Plasma
10 months ago

Gay: I prefer beer to milk. You can’t argue with that.
Trans: this glass of beer is actually a glass of milk. Now that is arguable.

Huge difference and too easily conflated

Jonathan Story
Jonathan Story
10 months ago

A trans therapist-someone was says change your sex-can go ahead, but those opposed can’t. This doesn’t seem very consistent.

Jonathan Story
Jonathan Story
10 months ago

A trans therapist-someone was says change your sex-can go ahead, but those opposed can’t. This doesn’t seem very consistent.

Campbell P
Campbell P
10 months ago

A friend ‘suffered’ from SSA and indulged it. He wanted to overcome it and was ‘converted’ from it by loving counseling, prayer, and support. Why outlaw acces to such? What about his ‘human rights’? They want a blanket prohibition because they want to give in to their feelings and fantasies, and those who have come out of their lifestyle represent a threat to their self-indulgence. Talk about unfair, one sided, and a denial of truth and the facts! No problem with them indulging themselves, just their denial of freedom of choice to others.

Dumetrius
Dumetrius
10 months ago

I do like the line about history rhyming rather than repeating.

Benjamin Greco
Benjamin Greco
10 months ago

What seems odd to me, an American, is that your parliament would be involved in codifying in law what therapies a patient and doctor can decide to participate in. Partly this must be because we don’t have an NHS, and I am beginning to think that may be a good thing. Health insurance in America, including government subsidized care can decide what it will pay for, but it can’t prohibit or approve what care a consenting adult can have, that is between the doctor and the patient. Even when children are involved, healthcare decisions should be made by parents, doctors and patients. The state should stay out of it. It is the responsibility of the patient to be informed about his condition and therapy. The state can’t prevent harm. If the patient feels they were harmed, then they can sue. This is how bad medical practices eventually disappear.
I know at present in the US, states are passing laws that prohibit both gender affirming care and conversion therapy, but these laws are unconstitutional and will soon be deemed so by the courts.
The problem with today’s politics is that principles change with the issues at hand. You can’t be free to choose conversion therapy and not free to choose gender affirming care. You’re either free or you aren’t.

Jane Watson
Jane Watson
10 months ago
Reply to  Benjamin Greco

The NHS actually saves us from some of the worst excesses of trans-affirming medicine. We do not allow/fund double mastectomies for 13yr old girls in the UK. In the US, transitioning children has become a lucrative business, with surgeons advertising their butchery on Instagram.

The NHS has massive problems, but the US model is worse. If you can pay (or get your insurance to cover) some medic will provide – why shockingly late term abortions are allowed. Because the taxpayer funds medical treatments here (including psychological and psychiatric care), there is at least some oversight and accountability.

The British public was alarmed to discover that it was funding ‘gender affirming’ treatments, including puberty blockers, for children. And when the NHS is sued, the taxpayer coughs up again. So we pay attention.

No one should be ‘free’ to access taxpayer funded harm ie taxpayers should not be funding therapies or medicine that are harmful (or of dubious benefit). This is especially true where children are concerned, because they are unable to give informed consent.

Benjamin Greco
Benjamin Greco
10 months ago
Reply to  Jane Watson

The principle here is whether you want to be free to decide what is good for you, even if many will get it wrong or be bamboozled or whether you want the state to decide what is good for you. No country will get the balance right all the time.

Benjamin Greco
Benjamin Greco
10 months ago
Reply to  Jane Watson

The principle here is whether you want to be free to decide what is good for you, even if many will get it wrong or be bamboozled or whether you want the state to decide what is good for you. No country will get the balance right all the time.

Jane Watson
Jane Watson
10 months ago
Reply to  Benjamin Greco

The NHS actually saves us from some of the worst excesses of trans-affirming medicine. We do not allow/fund double mastectomies for 13yr old girls in the UK. In the US, transitioning children has become a lucrative business, with surgeons advertising their butchery on Instagram.

The NHS has massive problems, but the US model is worse. If you can pay (or get your insurance to cover) some medic will provide – why shockingly late term abortions are allowed. Because the taxpayer funds medical treatments here (including psychological and psychiatric care), there is at least some oversight and accountability.

The British public was alarmed to discover that it was funding ‘gender affirming’ treatments, including puberty blockers, for children. And when the NHS is sued, the taxpayer coughs up again. So we pay attention.

No one should be ‘free’ to access taxpayer funded harm ie taxpayers should not be funding therapies or medicine that are harmful (or of dubious benefit). This is especially true where children are concerned, because they are unable to give informed consent.

Benjamin Greco
Benjamin Greco
10 months ago

What seems odd to me, an American, is that your parliament would be involved in codifying in law what therapies a patient and doctor can decide to participate in. Partly this must be because we don’t have an NHS, and I am beginning to think that may be a good thing. Health insurance in America, including government subsidized care can decide what it will pay for, but it can’t prohibit or approve what care a consenting adult can have, that is between the doctor and the patient. Even when children are involved, healthcare decisions should be made by parents, doctors and patients. The state should stay out of it. It is the responsibility of the patient to be informed about his condition and therapy. The state can’t prevent harm. If the patient feels they were harmed, then they can sue. This is how bad medical practices eventually disappear.
I know at present in the US, states are passing laws that prohibit both gender affirming care and conversion therapy, but these laws are unconstitutional and will soon be deemed so by the courts.
The problem with today’s politics is that principles change with the issues at hand. You can’t be free to choose conversion therapy and not free to choose gender affirming care. You’re either free or you aren’t.