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

Lord Winston Excerpts

Friday 9th February 2024 Lords Chamber

[Lord Winston (Lab)]

My Lords, it is always a huge pleasure to follow the noble Lord, Lord Forsyth, even when I deeply disagree with him. I congratulate the noble Baroness, Lady Burt, on the Bill. Unfortunately, rather like the noble Lord, I feel there are so many flaws in it that I have to say I have great concern about the way it is worded and how it would work in practice. I recognise that the Bill is the result of a huge amount of work. I have produced two or three of my own Private Member’s Bills in this House over many years, and I remember how much detail has to go into them and how many discussions one has, but I feel there are too many flaws in this Bill to let it slide without being at least pretty critical of it.

I remember first becoming aware of the danger of ever being involved publicly with any aspect of transgender issues, for fear of being called homophobic. I feel quite concerned about that, because I received very serious threats when I discussed gender many years ago in the press. I think I was the first person—certainly in Britain and probably in Europe—to treat ladies of the same sex with in vitro fertilisation; that is to say, they were lesbian couples. Yet we could not tell anybody that they were lesbian couples, because we knew that, if we did so, phone tapping was already available and those people would be identified. It was some years before we explained what we were doing, because there was so much concern about sexuality, which was always in the press—as there is now with this subject. So one must be very careful how one words what we say in this House, for reasons of being thought to be prejudiced. There is no prejudice in my mind about this.

The issue of sexuality is extremely curious. Some time in the 1980s—I do not remember exactly when— a couple of colleagues of mine and I started to look at the metabolism of human embryos in culture when they are completely invisible, at day 2. What we found was completely extraordinary: male embryos were more active in their metabolism of sugar substrates than female embryos. We were very puzzled about that. We were so concerned that the data was probably ridiculous and sloppy that we felt that we could not publish it, so we did not; we thought it would be ridiculed. Now, there is new data coming through with more sophisticated work showing that the thing we refused to publish initially was probably correct, and we might have had a world first. Again, that sensitivity about sex was there even in that decision about publication, and that is worth thinking about.

When you start looking at the data on transgender, the problem we very much have is that far more is not known than is known, and the definitions are extraordinarily difficult. I could refer to any number of papers, but one by Ristori and Steensma is good; it has a big review of about a thousand different cases that have been published. The incidence itself is a problem: it is assessed in that paper as being likely to be about one, two or five—[Interruption.] Oh, my medical practitioner is calling me because I am in pain. I apologise; my phone should have been off. I have a problem with my hip and cannot walk. I struggled to get into the House this morning, but I felt that this was an important debate to speak in. Forgive me.

When I look at this subject, I can see that there so many doubts. For example, the incidence is not very clear. In fact, the incidence seems to change from childhood to adulthood. At the highest level, perhaps 25% of people who really want to be transgender go on to be transgender—actually, it is far less than that who do so. Secondly, it is very clear from my own practice in reproductive medicine that a number of people who have had transgender procedures have deep regrets when they are in the post-menopausal stage of life, so much so that they occasionally become deeply depressed. It does not happen often, and of course most of the time we can see clearly that there are many people who are completely happy with their new gender assignment. But that is not invariable, and we do not understand that.

The basic problem is this: we are at risk of legislating for a piece of biology that we really do not understand. We do not understand the underlying mechanisms. We do not even have the figures to know how common this is, and we do not know the follow-up. None of the papers looking at the incidence have followed up patients for long enough to get a clear view of what is really needed. Therefore, any kind of legislation putting this into law is wrong. What we might want to do is to call for research. We can argue that, rather than having a regulatory authority for human fertilisation and embryology—which is now completely unnecessary, because there are ways of doing that—we could certainly consider a statutory authority for this sort of treatment. There is so much more to understand and learn in following up these patients, so that would be very useful. But it would be quite wrong for us to pass this Bill, and I cannot see that any serious amendments would help it progress.