Therapists must be allowed to question children who believe they are trans, the author of a landmark report on the treatment options available for young people experiencing gender distress has said (Telegraph).
Dr Hilary Cass, the former president of the Royal College of Paediatrics and Child Health whose landmark review found that children should have extensive therapy before they are allowed to transition, said “exploration of these issues is essential”.
She was speaking amid a growing row at Britain’s leading psychotherapist body over the issue of ‘conversion therapy’ for children
The UK Council for Psychotherapy (UKCP) has over 11,000 individual members, and 75 training and accrediting organisations. It has been a signatory to a memorandum of understanding (MoU) opposing conversion therapy, the practice of attempting to change a person’s sexual orientation or gender identity, since 2016.
However, the UKCP’s leadership has now withdrawn, because the document has been updated to include children specifically and therefore may prevent therapists from discussing changing gender with young patients.
While they strongly oppose conversion therapy for children, the UKCP has argued that including children in the policy could be interpreted as a ban on even discussing with children why they want to change gender, known as “exploratory therapy”.
There are of course some forms of ‘conversion therapy’ that few people would object to being banned, such as attempts to stop a person from being gay or transgender via exorcism, physical violence or food deprivation. No-one is disputing that abhorrent ‘treatments’ of this kind have no place in a free society. But they are already illegal in the UK, and therefore vanishingly rare.
When the Government commissioned researchers from Coventry University to study the evidence on conversion therapy, they managed to find just 30 people from the past two decades who claimed to have experienced such treatment, and the only examples of “horrific and life-altering practices” they were able to unearth were drawn from the United States.
Where things get much more complicated is at the softer end of the spectrum if “conversion therapy” is defined too broadly – specifically, practices that centre on children and adolescents.
In the past few years, a ‘gender affirmative model’ has taken hold in clinical settings like the NHS’s controversial, now closed Tavistock Gender Identity Development Service (Gids).
Faced with cases of gender distress, this model encourages clinicians to ‘affirm’ rather than question a child’s theoretically postulated gender identity, before putting these children – often depressed, sometimes autistic, always vulnerable – on a medical pathway that can have lifelong, irreversible consequences. Various peer-reviewed academic studies have now found evidence that puberty blockers, intended to delay the onset of puberty so children suffering from gender dysphoria can have more time before deciding whether to have surgery, often cause lifelong harms, such as bone disease and infertility.
One of the key findings of the Cass review, published last month, was therefore that children and young people should have extensive therapy before they are allowed to socially transition, let alone begin medical treatment.
Dr Cass also found that no-one under 25 should be rushed into changing gender, not least because children sometimes grow out of their gender dysphoria as they reach adolescence, or experience its symptoms not because they are ‘in the wrong body’ but because of a range of complex psychosocial challenges and/or mental health problems.
As a pluralistic organisation, these are the ‘challenges’ and ‘problems’ the UKCP’s leadership feels its member psychotherapists and psychotherapeutic counsellors should and must be free to explore when working therapeutically with cases of gender-related distress.
Yet the obvious, rather chilling implication of a poorly worded MoU opposing conversion therapy for children is that it risks creating a culture of silence around the basic tenets of gender ideology.
In an environment where failure to unquestioningly affirm a child’s allegedly ‘true’ and ‘authentic’ identity could lead to accusations that a form of ‘conversion therapy’ has been attempted, many therapists will either self-censor and toe the line for career and financial reasons, or simply choose not to see clients who present with gender dysphoria.
UKCP were already warning of this danger back in December, pointing out that it would lead to fewer children “being able to access psychotherapeutic support at a time when they need it most, thereby increasing risk”.
These risks are real. As the journalist Hannah Barnes recounts in the epilogue to Time to Think, when three former Gids staff who previously raised concerns about practitioners blindly adopting an ‘affirmative approach’ to gender distress in young people were recruited to the NHS’s post-Cass review gender services team in May 2023, they were immediately targeted online by a trans activist blogger. Their ‘crime’? Favouring exploratory therapy rather than an affirmative approach, which, this blogger alleged, was tantamount to promoting ‘conversion therapy’.
Predictably, UKCP’s decision to quit the conversion therapy MoU has now triggered a backlash from a sizeable minority of the body’s membership.
A group of trans activists called Therapists Against Conversion Therapy and Transphobia (TACTT) has started a petition calling for a vote of no confidence in the board and demanding the resignation of board members. The fact that it has attracted about 1,500 signatures – more than one in 10 members – raises the possibility of a board election.
“Conversion therapy kills,” TACTT say in an open letter explaining the move. “Not only does [UKCP’s] move potentially leave LGBTQIA+ clients undefended,” they add, “but also leaves the many queer and cisgender straight therapists who are UKCP members, and queer and cisgender straight trainees on UKCP-accredited courses feeling blindsided, betrayed and demoralised that a membership organisation they have either chosen to join, or are required to join as part of their training or job commitments, and [sic] no longer represents them safely.”
Speaking to the Telegraph, the chairman of UKCP, Dr Christian Buckland, insisted he would stand his ground to keep children safe.
“It is deeply disturbing,” he said, “that in return for seeking to ensure the safety of children, the board of trustees of the UKCP has been met with a petition for their removal. As chair, I will not allow the UKCP to be bullied into turning a blind eye to the safety of children.”
He added: “As a regulator of child psychotherapy and psychotherapeutic counselling, our main priority must be the safety and wellbeing of children and young people.
“This is because, compared with adults, it is widely accepted that children require different considerations in relation to healthcare.”
“The current MoU makes no distinction between adults and children, which we believe is not in the best interest of children and could compromise their wellbeing.”
