Those familiar with the regulatory landscape in the UK regarding the psychological treatment of people with gender distress would be well acquainted with the Memorandum of Understanding on Conversion Therapy. In 2015, this MoU was compiled to recognise that conversion therapy aimed at changing a person’s sexual orientation was both unethical and potentially harmful. This MoU was updated, and in 2019 the second version was published, which included gender identity as a prohibited target of therapeutic modification. A major concern was the suggestion that exploratory therapy for gender dysphoria would be regarded as a form of conversion therapy. One such organisation certainly did interpret it this way. This second version of the MoU elicited significant criticism, especially as evidence started to suggest that severe harm was being done to minors with gender distress who were being put on a course of medical treatment for their gender dysphoria.
In 2021, the Cass Review was commissioned, and its findings were published in April 2024. It became clear that medical gender-affirmative practices had very poor evidence base, and such treatments were subsequently halted in the UK. Cass also recommended thorough assessment and psychosocial interventions for gender-distressed minors, which would include exploratory psychotherapy.
While UK-based organisations grappled with this MoU on Conversion Therapy, Ireland remained silent until July 2024, when they issued their 3-page document called, Memorandum of Understanding (MoU) on Conversion Therapy on the Island of Ireland. At face value, it explicitly states that exploratory therapy would be an acceptable therapeutic approach for those “who wish to explore, experience conflict with, or are in distress regarding their sexual orientation or gender identity.” Clinical psychologist Jaco van Zyl critiqued the Irish MoU and, upon closer examination, found that the authors and signatories of this document are trying to straddle both evidence-based psychotherapy and dogmatic commitment to activist ideology:
“This MoU still lacks the necessary evidence-based distinction between sexual orientation and gender identity, in terms of stability and treatment outcomes. A serious drawback is its failure to distinguish between minors and adults. The signatories to this MoU have yet to learn that ideology and time-tested theory cannot coexist. It still bases its definitions and stances on dogmatic statements, demanding that no gender identity or sexual orientation may be regarded as inherently superior to the other. This belief has its roots in politicised postmodern theories, not psychology.”
The full critique can be read here.
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