One of the big concerns for therapists concerning the ongoing proposed legislation to ban conversion therapies (here in the UK and similar legislative attempts elsewhere) has been the lack of reasoned open public debate. One issue, in particular, is the potential for the term ‘conversion’ to apply outside its original target of same sex attracted people (nearly always men) and to be expanded to include people who identify as a different gender. It is notable how successful trans-activists have been in shutting down any critique – our professional bodies in the UK have all signed up to the Memorandum of Understanding (MOU) which implicitly pledges them to mandate affirmative therapy for transgender or gender-questioning clients and appears to relegate exploratory therapy to the category of attempted conversion therapy.

It is therefore highly significant that Insight (the professional journal for the Royal College of Psychiatrists has just hosted a more open forum for the discussion of this contentious issue. In it, different viewpoints are put forward – finally, the appearance of viewpoint diversity! In this issue, contributors such as Dr Stephen Westgarth, consultant child psychiatrist, boldly questions the efficacy of the affirmation-only approach, stating that: “Simplistic ‘affirmation’ of their self-identified gender can be highly problematic; a short-term placation and collusion may generate profound damage on both personal and social levels.”

One contributor, Dr Hilary Cass (author of the recent interim report on The Tavistock GID clinic), addresses the concerns of therapists regarding the practice of exploratory therapy directly at the end of her piece – see her considered position below (verbatim except for added italics):

‘Secondly, regardless of the polarised debates playing out in the media, as clinical professionals we must find ways to debate this difficult topic respectfully, with curiosity and open minds. There
will not be black and white answers. We are seeing a generational shift in attitudes to the meaning and mutability of gender, and away from unhelpful gender stereotyping. However, the question of
whether and when to intervene medically in young people, who are in a dynamic developmental state, is challenging and will not be resolved without thoughtful discussion and the ability to listen to and understand opposing views.

Finally, we have to ensure that professionals feel safe to ask questions in an open, curious and non-directive way, as they would when exploring any other aspect of a young person’s thinking and identity, without fear of legal challenge. The planned conversion therapy bill needs to provide clarity on what conversion therapy is, and what it is not. I have already raised these points with ministers and officials and will continue to do so in the coming months. I strongly believe that with more open discussion, research and clinical collaboration, we can transform this topic from one which causes anxiety and controversy to an interesting and rewarding area for clinical innovation and research, and significantly improve the NHS offering to these children and young people. I would like to applaud RCPsych for providing a platform for different views in this issue of Insight.”’