Transgender Conversion Therapy

Jackie Doyle-Price Excerpts

Monday 13th June 2022 Westminster Hall

[Elliot Colburn]

I absolutely agree with the hon. Lady. I have had the privilege of listening to many survivors who have come forward to share their stories—I am sure many people in this place have—and those stories demonstrate just that fact.

[Jackie Doyle-Price (Thurrock) (Con)]

The practices my hon. Friend has just described are basically exorcisms and witchcraft, frankly. Does he agree with me that we are dignifying such abhorrent practices by calling them therapies?

[Elliot Colburn]

I absolutely agree. That is why language is so important—that is going to be the theme of my speech. The tight wording of the ban is very important. Conversion practices is a much better description than conversion therapies. I only used conversion therapy for today’s debate because it is the go-to term.

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[Jackie Doyle-Price (Thurrock) (Con)]

Thank you, Sir Graham. It is a pleasure to contribute to the debate. As legislators, our starting point must be to eradicate harms, but in doing so we must not create new ones. It is in that spirit that I will address the proposals in—well, we do not have a Bill yet, so we are flying a bit blind.

My concern is the use of the term “therapy” in this space, which has been discussed. We are talking about coercive and harmful practices based on an ideological opposition to being trans, gay, lesbian or bisexual, and those are the practices that we need to eradicate. The term “therapy” implies something that is benign and designed to alleviate distress, which is clearly not something we want to outlaw in this space—for sexuality as well as gender. My plea to the Government is to re-examine that language.

In respect of transgender identity, when an individual wishes to undergo medical transition or surgical intervention, a therapeutic pathway is essential to establish informed consent. We must not allow any law to be passed that would get in the way of those conversations and clinical interventions, which are designed to alleviate distress.

[Alicia Kearns]

In the spirit of the point that I made in my speech that there are no two sides, I agree with my hon. Friend entirely. I suspect that she will find much unanimity in the Chamber that a ban should be about conversion practices. I am sure that the Minister, who campaigned for a ban for many years before he became a Minister, will be well aware of that and will be doing everything he can to ensure that the right Bill comes forward. I agree with my hon. Friend entirely, and I am sure others in the Chamber do as well.

[Jackie Doyle-Price]

I am grateful for that intervention. Indeed, although I have been outspoken on these issues, I have had this conversation with Jayne Ozanne, who shares this view. In terms of getting to a good law, I make this plea to everyone: we have heard lots of rhetoric today, but if we focus on creating a law that eradicates harm but gives support where it is needed, I think we can generate consensus. Notwithstanding the heat and noise on social media, there is much consensus in the Chamber.

I come to this matter having been the mental health Minister, with responsibility for gender medicine, when the General Synod of the Church of England passed the motion in favour of a conversion therapy ban. It is worth remembering that at that stage it was only about sexuality, and not about gender, which was added subsequently. At the time, however, I made it my business to look into exactly what the evidence was on the practices that we were trying outlaw.

Notwithstanding some of the experiences we have heard about, I could find no evidence of anything happening in a clinical setting after 1970. It became very clear that we were talking about practices that were often based in religious institutions, and very much based on an ideological belief against same-sex attraction and transgender. That is why we need to hammer down on outlawing exactly those things. That is the harm that we are trying to eradicate.

We have ended up with this vanilla term, “therapy”, for fear of alienating those people for whom these are issues of religious belief. Frankly, the risk of outlawing legitimate interventions should not get in the way of that. We need to be clear about what we are banning and that any therapeutic intervention designed to alleviate distress will not be eradicated by the legislation. I look forward to hearing words of comfort from my hon. Friend the Minister, with whom I have had many discussions about these things.

It is also worth noting that the term “trans” can mean any number of things, from declaring oneself non-binary to wanting to go the whole journey of medical and surgical transition. This is where the therapeutic care pathways are so important, because for some people gender dysphoria is a permanent condition that needs to be alleviated with treatment, but for others it can be a symptom of something else. This is not a straightforward condition that has the same pathology in all the people who experience it. We know that it is prevalent among people with autism and that it is very commonly experienced by girls going through puberty.

[Kirsten Oswald (East Renfrewshire) (SNP)]

May I ask the hon. Lady and any other Members in the Chamber thinking of making that connection between trans and autism to be more thoughtful about how they express it? A number of people watching and listening to the debate will find it particularly unhelpful. I think that we can probably be a bit more nuanced in our language.

[Jackie Doyle-Price]

It is important that we understand what we are talking about with gender dysphoria. It can also be a symptom of trauma. It is very important that we have the therapeutic care pathways—[Interruption.] Members may shake their heads, but I am talking about this from experience, having looked deeply into this area of medicine when I was responsible for it. We need to ensure that we are not putting people on to irreversible care pathways that will do them harm. For example, at the Tavistock, where the care pathway is based on therapy, as many as 40% desist. That is why it is important that people are given the space to explore what they believe to be their gender, because it can often be about something else.

[Nadia Whittome (Nottingham East) (Lab)]

Does the hon. Member acknowledge the fact that puberty blockers —I think that is what she is referring to when she speaks about “irreversible” treatment, because they are the only medical treatment that under-18s can have—are not irreversible? The point is to pause puberty, which can be done for many reasons, such as premature puberty. The whole point of the blockers is that they are not irreversible.

[Jackie Doyle-Price]

Puberty blockers are not irreversible—the hon. Member is right. The fact of blocking puberty may mean that the individual does not subsequently go through it, but she is right in the sense that puberty blockers were invented for a different purpose than the treatment of gender dysphoria. They absolutely should be dispensed where appropriate, but they should not be used as a way of treating gender dysphoria without someone’s having gone through the therapeutic care pathway.

The real issue here is the provision of hormone treatment, which is now routinely dispensed to people from the age of 16. Again, the impacts of those things are irreversible. We see a generation of trans men who have desisted and will now have a loss of sexual function, permanent facial hair and male pattern baldness. A more sophisticated way of allowing them to explore their gender would mean that they do not go through such things.

[Wera Hobhouse (Bath) (LD)]

Is the hon. Member not making a mistake by confusing what we are here to discuss banning? We are here to discuss banning pseudo-practices. We are not aiming to ban NHS therapies and practices that are conducted by professional medical experts; we are looking at banning conversion therapy, which is pseudo-scientific, often takes place in private settings and is not controlled.

[Jackie Doyle-Price]

I think the hon. Member is actually agreeing with my general thesis, which is that we should not use the term “therapy” in the Bill. Legitimate care pathways are exactly the things we should be ensuring that people can access, so that they get the right decision for them. As we know, if people cannot access those pathways through the national health service, there is a wild west out there on the internet, and people will start getting very harmful interventions that are not properly supervised.

[Dr Mullan]

Is not the key to all this the intention of whatever is going on? Conversion therapy sets out with a predetermined objective of stopping someone being something or forcing them to be something else. All the other therapies that my hon. Friend talks about are an exploratory process that may or may not, through the choice of the individual, lead to their taking puberty blockers or other things. The therapists themselves will not be entering into it with the intention to force them to do that, or to stop them being something else.

[Jackie Doyle-Price]

Again, I think my hon. Friend is agreeing with me. It is the term “therapy” that I am objecting to in the legislation because we are dignifying these practices with that description. Therapies are exactly the things that I have been describing. There is no doubt that we need better care pathways for people to explore their gender. My hon. Friend the Minister will probably have something to say about that as well.

That is really as much as I want to say. We must make sure that we call this practice out for what it is, we must make sure that the Bill only eradicates those harmful practices, and we must make sure that good, benign and positive therapeutic interventions will not be outlawed by the legislation.

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[The Parliamentary Under-Secretary of State for International Trade (Mike Freer)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the petitioner for securing the debate and the 145,000 people who signed the petition. On a personal note, I would like to recognise the 50th anniversary of Pride, and to thank those who went before me to secure the rights that I have today. We can get caught up in the heat of the debate around the issues we have to address, but it is sometimes important to look back and remember that we have made progress. Let us not lose sight of the progress we have made, while agreeing that we still have further work to do. I have to say that I welcome this debate, because I have spent considerable time and energy on the legislation, not least trying to myth-bust much of the nonsense going around regarding what is and is not conversion practice.

I thank my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) not only for securing the debate, but for what I thought was a powerful and thoughtful speech. It was a speech that he could have made from the Minister’s position—perhaps one day he will.

I have to say that the debate saddens me; I am genuinely sad that we are having this debate yet again. It saddens me that we have yet to achieve a consensus on many of the more thorny or heated topics that people disagree on or choose to misunderstand. It is a real regret that, having spent so much time trying to explain what is and is not a conversion practice, we continue to have this debate. From that point of view, since taking up the position of looking after LGBT issues in the equalities brief, I have genuinely tried to seek consensus, to pursue the debate with a degree of honesty and respect, and to remove the toxicity from the debate.

Many of us do not have direct experience of trans issues, although some of us do. I get deeply frustrated when colleagues make comments—from what I believe to be a position of ignorance—about the trans community, which also hurt colleagues in this House. The trans community is not some invisible, amorphous blob that people cannot recognise. Trans people are our friends and our colleagues. Members of this House have trans siblings and trans children. We have our first trans Member of Parliament. It deeply saddens me that hurtful comments are still being made, even if they are not designed to hurt.

I have taken time to speak to many of the survivors who have been through conversion practices, some of them decades ago. From speaking to them, it is clear that they still live with that trauma today. I have also spoken to people who have survived conversion therapy more recently. When people say that conversion therapy no longer exists, that is absolute, utter nonsense. They just need to go out and talk to people who have survived it, whose partners have committed suicide, or who have seen children taken abroad to conversion camps or to be married off.

It deeply saddens me that people continue to deny the existence of conversion practices. Yes, many of the more abhorrent physical acts are illegal. However, the pernicious, insidious, coercive so-called therapies are what we are trying to address, and they are still present today.

Colleagues have talked about rape being used as a tool to correct people’s behaviour. Part of the Bill that is being drafted will ensure that, while rape is obviously already an illegal act, using rape in the way Members have described would be an aggravating factor. That is the difference. People ask what the Bill will change in law that is not already illegal—that is one example. The use of corrective rape will be an aggravating factor. That is not currently the case.

I recognise people’s strength of feeling for ensuring that the Bill includes trans people. I want to make it abundantly clear that the Bill will protect everyone from coercive attempts to change their sexual orientation. We do not agree with attempts to change someone’s gender, but we wish to ensure that any action that we bring forward on transgender conversion practices does not have wider implications, such as affecting access to legitimate therapies.

At the start of my speech, I referenced the sadness I felt that we have not been able to reach a consensus. I am disappointed that we have not brought forward a fully inclusive Bill, as is fairly obvious from my previous statements, but in terms of where we go from here, I want to use the piece of work that is currently being scoped out, hopefully at pace, so that we can have an informed process as the Bill proceeds in its passage through Parliament. We must try to address the issue of how to ensure with cast-iron clarity, if one can have cast-iron clarity, that clinicians are protected in questioning someone’s gender discomfort—I will be corrected if I get this wrong, but dysphoria is the clinical end of the process. When someone is suffering from gender distress, a clinician needs to have absolute clarity that they are protected, and that their ability to explore why their client is feeling that way is not a conversion practice.

[Jackie Doyle-Price]

I think a lot of people will be very reassured by the tone of the Minister’s comments, because there is genuine fear that legitimate practices would be outlawed. However, one of the issues we have is that campaigners are looking at other laws elsewhere, which has perhaps led them to conclude that things will be included in the Bill that might not be. Could the Minister say what the timescale for a draft Bill will be? No one can predict what will be in the legislation, because we have not seen it yet.

[Mike Freer]

I thank my hon. Friend for asking for clarification. It is certainly my intention that the draft Bill, which is expected to be narrow in scope, clearly setting out what is and is not a conversion practice so that we have that clarity, will be brought forward in—I hope—September or October of this year.