The more nebulous concept

Janice Turner on the UK’s proposed ban on conversion therapy:

That young people were once tortured, raped, drugged and subjected to exorcism-like religious rites to make them heterosexual seems not just abhorrent but absurd. How could our hardwired desires be changed? Indeed, such practices in Britain are now, thankfully, vanishingly rare and, as the consultation states, “physical violence in the name of conversion therapy” is illegal already.

Yet the proposed ban applies to both sexuality and the more nebulous concept of gender identity. This has led to grave concerns, not from social conservatives but liberal, compassionate therapists, some LGBT themselves, who for a decade have noted a drastic rise in young female clients, typically same-sex attracted, mostly with profound mental problems such as depression, anxiety, undiagnosed autism or self harm. Many have suffered homophobic bullying, some sexual abuse. Now 75 per cent of referrals to the Tavistock GIDS clinic are female, a phenomenon reported worldwide.

There is good reason to think this phenomenon is socially influenced, but it can be risky to say so.

But therapists are already impeded by their own professional bodies, including the NHS, who have signed a “memorandum of understanding” (MOU) prohibiting therapy that challenges a client’s avowed gender identity. Rather, they must only “affirm” their belief and help to facilitate transition, via referral for hormones and perhaps surgery.

There are at least two reasons that’s profoundly mistaken. One is that sexual orientation and gender identity are not the same thing or the same kind of thing. Another is that affirming sexual orientation requires zero further action, while affirming gender identity, as Turner says, leads on to transition and drastic physical interventions.

A group called Thoughtful Therapists fears the government conversion ban will enshrine this MOU in law. Proposals state law shouldn’t “override the independence of clinicians to support those who may be questioning their LGBT status”. Yet often, distressed 13-year-old girls are not “questioning”: rather they are categoric they are trans. Will the gentlest unpicking of their feelings be classed as conversion therapy and thus criminalised?

And being categoric about being trans is surely at least partly a product of the rabidly absolutist dogma around all things trans, especially “being” trans. Ambivalence isn’t allowed, uncertainty isn’t allowed, doubt isn’t allowed. If you think you might be trans then you are trans and woe betide you if you take it back.

The absence of rigorous gender therapy has been condemned by a growing number of detransitioners, mainly women, including Keira Bell, who brought a judicial review against the Tavistock. Why, they ask, were their mental health and family problems briskly brushed aside in favour of propelling them towards irreversible hormones and double mastectomies they now regret?

Why indeed? When it’s such a drastic thing to do?

It is seldom acknowledged that transitioning is more physically dangerous for girls than boys. Not only does breast-binding damage growing tissue and cause breathing problems, but testosterone’s effect on the female body is far more damaging than oestrogen for males. A girl will have a permanently deepened voice, facial hair, vaginal atrophy, probable infertility and uterine problems that often end in hysterectomy. Transition will be necessary for some but any girl embarking on this path should be fully informed and utterly certain.

And fully informing while asking about certainty is not conversion therapy.

7 Responses to “The more nebulous concept”