Conversion Therapy Prohibition (Sexual Orientation and Gender Identity) Bill [HL]

Lord Sandhurst Excerpts

Friday 9th February 2024 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, my concern is safety and well-being, living in a free and fair country. As it stands, this Bill will apply to acts which cause no injury or distress and even to acts to which the recipient has consented. It applies across the range of life and in the home. The Bill will criminalise expressions of personal conviction made without expressions of hatred or intolerance, improper purpose, coercion or abuse of power. That is a wide-ranging interference with fundamental rights.

To take an example, a 15 year-old teenage girl informs her gender-critical parents that she wishes to change gender. She repeatedly asks her parents to support her request for puberty blockers. They refuse and seek to persuade her otherwise. This could demonstrate their assumption that a particular gender identity is inherently preferable. It could demonstrate that they seek to change their child’s gender identity and that they seek to suppress expression of that gender identity. It would leave them vulnerable to prosecution. The Government’s 2021 conversion therapy consultation paper explained that

“our existing criminal law framework means no act of harmful physical violence done in the name of conversion therapy is legal in this country”.

Therefore, we do not need to legislate for physical coercion.

I turn, all too briefly I fear, to the interim report of Dr Hilary Cass. It is absolutely essential reading. It shows the dangerous waters in which this Bill swims. First, as she reminds us, sex is biological, determined by anatomy, while gender is a social construction. In the short time available, gender issues are my focus today. I will give some direct quotations.

Dr Cass writes:

“there is a lack of agreement … about the extent to which gender incongruence in childhood and adolescence can be an inherent and immutable phenomenon for which transition is the best option for the individual, or a more fluid and temporal response to a range of developmental, social, and psychological factors … staff have told us that they feel under pressure to adopt an unquestioning affirmative approach and”—

I emphasise this—

“that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters”.

Dr Cass writes:

“many of the children and young people presenting have complex needs, but once they are identified as having gender-related distress, other important healthcare issues that would normally be managed by local services can sometimes be overlooked … Evidence on the appropriate management of children and young people with gender incongruence and dysphoria is inconclusive both nationally and internationally. … A lack of a conceptual agreement about the meaning of gender dysphoria hampers research, as well as NHS clinical service provision”.

Discussing sex hormones, Cass reports that

“the long-term risks and side effects are well understood. These include increased cardiovascular risk, osteoporosis, and hormone-dependent cancers … given the irreversible nature of many of the changes, the greatest difficulty centres on the decision to proceed to physical transition … Decisions need to be informed by long-term data on the range of outcomes … The NICE evidence review demonstrates the poor quality of these data, both nationally and internationally”.

Finally:

“Regardless of the nature of the assessment process, some children and young people will remain fluid in their gender identity up to early to mid-20s, so there is a limit as to how much certainty one can achieve in late teens. This is a risk that needs to be understood during the shared decision making process with the young person”.


I add that Keira Bell and others are plainly victims of this.

To conclude, for family members managing a young person with gender identity issues, the topic is complex. There will be well-meaning missteps. The Bill is in no way suitable, creating as it does a far-reaching criminal offence; thought crime comes to mind. The noble Lord, Lord Winston, is absolutely right: this is a mistaken Bill.