Transgender Conversion Therapy

Nadia Whittome Excerpts

Monday 13th June 2022 Westminster Hall

[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.

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[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate the hon. Member for Carshalton and Wallington (Elliot Colburn) on the sensitivity of his opening remarks. He set the scene incredibly well. He talked about access to justice. Justice as a concept means something different to each of us. I wholeheartedly agree with the hon. Member for Thurrock (Jackie Doyle-Price): to do this work properly, we must extinguish the term “therapy” in any legislation, because it sanitises a practice that is absolutely not therapy. That is something I think we should approach with real sincerity.

Perversely, in some respects I am glad that the Government made the decision to withdraw the trans community from the Conversion Therapy (Prohibition) Bill—not necessarily because of their position on that, but because that led to the petition, which led to this discussion. Discussion has been absent for so long, and the absence of sensitive discussion has been deeply damaging. To really understand how we move forward, we must listen to some of the messages and understand them with sensitivity, rather than getting on our high horse and take a polarised position. We must harness our experience and insights, wherever they come from, to ensure that we make the right decision. Our job as legislators is to interrogate the legislation and ensure that it is fit for purpose and will deliver on its intent.

My perspective comes down to information. When I grew up in the ’70s and ’80s, and started my nursing career in the ’80s, Scotland was not the beacon of equality that it has become. It was a tough gig, to say the least. One of my first placements was on a surgical ward. A bus driver was brought in with abdominal pains and was rushed to surgery for a laparotomy. Surgeons opened him up and discovered that he had extensive cancer, before stitching him back up and sending him back to the ward. That was the end of the discussion with him. He was not told; his family had decided that he should not be told the truth, and everybody was quiet about it. Back then, it was not abnormal for the patient not to have that information.

That has fundamentally changed. We now have the concept of informed consent. When I worked in adolescent psychiatry, we did not affirm that the dysmorphia of dysmorphic anorexics was real; we gave them therapy to help them resolve the challenges that they faced.

[Nadia Whittome]

The hon. Member will correct me if I am wrong, but it sounds as though he is suggesting that being trans, which is to do with somebody’s identity, is as harmful as anorexia—the most deadly psychiatric condition.

[Neale Hanvey]

Absolutely not. I am not making that parallel at all; I am talking about information and consent.

During my clinical practice and academic research, I conducted primary research into the supportive care of adolescents as they went through their cancer journey. That grounded theory framed supportive care as care that maximises personhood by considering all aspects of that individual, maximising who they were as they went through that journey and ensuring that they were supported to be the best version of themselves despite the trauma of intensive treatment.

Informed consent is something that children and young people are incredibly capable of dealing with. I have had conversations with young people about how and where they would like to die, and whom they would like to be there with them. I have had conversations with young people who have come in at the start of their cancer journey about sperm and ovarian tissue cryopreservation. [Interruption.] I do not know why that is funny; it is quite a serious issue. Those conversations have been handled in an incredibly capable way by young people, who are absolutely able to deal with difficult and complex information. They could be guided through that process in an absolutely natural and capable way. Certainly, in my experience, young people’s ability to deal with such information should humble everyone in this place.

Many of the late effects of cancer are a rich gold mine that we should look at when considering the impact of puberty blockers, because there are parallels. When somebody makes the decision to detransition, what impact will it have on later life? When somebody has high-dose chemotherapy, all their rapidly replicating cells can be deeply damaged, so they can completely lose their fertility. That is why sperm and ovarian tissue cryopreservation are really important and one of the important questions that we need to ask ourselves on this important matter.

The next part of consent is when it is not possible.

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[Nadia Whittome (Nottingham East) (Lab)]

It is a pleasure to serve under your chairship, Mr Mundell, and to follow the hon. Member for Glasgow East (David Linden), who made a powerful speech. I congratulate and thank the hon. Member for Carshalton and Wallington (Elliot Colburn) for securing the debate, and also the creators of the petition, along with the 145,000 people who signed it, for ensuring that it was debated here today.

LGBTQ people do not need to be fixed or cured. There is nothing wrong with who we are; what is wrong is how society treats us. Mind, the mental health charity, has said that

“all forms of conversion practices can result in poor mental health”.

People have reported suicidal thoughts, self-harm, and feelings of guilt, shame and self-hatred. The United Nations has said that conversion practices can amount to torture. The Government’s 2018 national LGBT survey found that 5% of LGBTQ people had been offered, or threatened with, conversion therapy, and one in 50 had been put through it. Trans people are twice as likely to have been offered conversion practices than those who are cisgender and gay or bi.

The Government have now been promising for four years that conversion practices for LGBTQ people will be banned. Now that a ban has finally made its way to the Queen’s Speech, in which conversion therapy was described as “abhorrent”, the proposals it puts forward are discriminatory and unacceptable. If the Government truly believe that conversion therapy is abhorrent, why do they intend to ban practices aimed at changing a person’s sexual orientation but not those aimed at changing their gender identity? Mind has described that differentiation as “deeply disappointing”.

I am extremely concerned that trans people’s exclusion is yet another cynical attempt by this Government to create a culture war between these different groups—that they are scapegoating trans people, who already face a tirade of violence and discrimination, with the aim of stirring up so-called anti-woke sentiment. We have seen it all before. The Government do the same to migrants, refugees and people of colour. We saw Thatcher’s Government whip up the same moral panic against gay people in the 1980s. I believe that, just as society looks back with disgust at how gay people were treated in decades gone by, we will hang our heads in shame at trans people’s treatment in decades to come.

It is also deeply worrying that, even for sexual orientation, the ban covers only under-18s. That means that adults can consent to non-physical forms of conversion practices. People cannot consent to their own abuse—and that is what conversion therapy is. It should be banned without caveats. I urge the Minister to listen to LGBTQ organisations, mental health experts, MPs here and our constituents, and ban conversion practices for everyone, in all circumstances.