Transgender Conversion Therapy

Wera Hobhouse Excerpts

Monday 13th June 2022 Westminster Hall

[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.

--- Later in debate ---

[Wera Hobhouse (Bath) (LD)]

At last the Government have proposed, and will bring forward, a conversion therapy Bill. I welcome that—it is progress. After all, I tabled a private Member’s Bill to ban conversion therapy in the last Parliament. However, the detail of the Government’s proposal is more than disappointing. The ban will protect people from therapies aimed at changing their sexual orientation, but therapies aimed at changing people’s gender identity will not be banned. If the Government recognise the harm that these cruel and medieval practices cause one group of people, why do they exclude the group that is the most harmed?

Trans people are twice as likely as the rest of the LGBT+ community to be subjected to conversion practices. A recent survey found that gender conversion practices, far from working, create lifelong, deeply traumatic consequences for survivors. Nearly half of respondents said that every aspect of their life, from their mental health to peer and family relationships, had considerably worsened. We all know that, all too often, the catastrophic mental ill health that is suffered leads to loss of life.

Gender conversion therapy is purposefully harmful and repressive. It targets already vulnerable people, and does so overwhelmingly at a very young age. Three quarters of those who have undergone conversion therapy were under the age of 24. Some began as early as the age of 12. These so-called therapies or practices include verbal abuse, isolation, physical abuse and, perhaps most disturbingly, “corrective” rape. For the exclusion of any doubt, we are not talking about professional medical treatment and therapy.

[Hywel Williams]

Does the hon. Lady agree with me that therapeutic and counselling interventions in these situations have to be non-directive, and that that per se excludes anything that has a predetermined purpose, as we are discussing?

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[Wera Hobhouse]

I totally agree. What is damaging about all these practices is that they have an outcome before they even start. That is why they are so damaging.

[Layla Moran]

Does my hon. Friend share my concern that if we end up not banning all forms of conversion therapy, all it will do is encourage families to go further underground to seek practices, particularly through their churches? I know of a family whose church reached out to them. They were then referred to a quack in America who performed abhorrent practices on a young teenager who immediately said to their parents, “This is making me feel like who I am is less than I am.” Is my hon. Friend concerned that if the Government do not act, parents will not know where to turn?

[Wera Hobhouse]

I totally agree. We have to say this again and again: this is not about professional medical treatment and therapy. The conversion therapies that need to be banned are pseudoscientific practices, often conducted in private settings and, most crucially, they do not have an open outcome, but are aimed at changing what a person is.

Legal advice recently published by the Good Law Project makes it clear that the Government risk getting embroiled in legal challenges by breaching article 14 of the European convention on human rights. The advice states that

“the difference in treatment between sexual orientation and gender identity would need to be justified and proportionate.”

So far, the only justification that the Government have provided is to say that the issue is complex.

Why are we even having this debate? Opposition to a trans-inclusive ban is entirely built on stoking fear and division, based on deliberate misinformation. By the Government’s own admission, NHS gender identity services will not stop people having exploratory conversations with their doctors. Legal services will not be affected by a ban. There is no evidence of any negative impact in the countries that have already introduced a ban. Let us be clear: we are talking about preventing the abuse of LGBT+ and gender non-conforming people—our fellow human beings. We need to prevent abuse.

Furthermore, neither would religious freedom be affected by a change in the law. Religious freedom is the freedom to worship without discrimination. As a Christian, I have the right to practise my religion without discrimination. I do not have the right to cause harm. The Church of England has acknowledged that, stating that conversion practices have

“no place in the modern world”.

Nearly all countries that have banned gay conversion therapy have also banned gender conversion therapy. Canada, France and New Zealand, to name a few, have yet to encounter problems with freedom of speech or religious belief. It is baffling—I disagree that it is about getting votes—that the Conservative Government are not committed to banning trans-inclusive conversion therapy, even though their own voters are largely in favour of such a ban. Northern Ireland has moved a motion to ban conversion therapy in all forms. Scotland hopes to ban it by the end of 2023. The Government must follow suit.

The Equalities Minister called this country a global leader on LGBT rights, but it seems the Government have forgotten what the letter T stands for. How can we possibly call ourselves global leaders if we knowingly and purposefully fail to protect trans people from abhorrent practices? I plead with the Government to listen to what is overwhelmingly a consensus in this room—and outside—and make sure we ban conversion therapy in all its forms.

--- Later in debate ---

[Mike Freer]

I thank the hon. Gentleman for that intervention. I know he spends a lot of time on this issue, and we are probably of a similar mindset about where we want to get to.

I am straying into parliamentary draftsmanship, but I think it is possible to draft a Bill that ensures that attempts to reopen the Equality Act 2010 or the Gender Recognition Act would be out of scope. That is one of the dangers: if we write a Bill that is open to being repeatedly amended, there is a risk of the debate widening beyond conversion therapy, which is why I am trying to ensure that the Bill is narrow. However, the way I see it—I cannot give that cast-iron guarantee, because I am not the parliamentary draftsperson—is that a Bill about conversion practices would be amendable. Of course, that is a debate for another time, but our purpose is that the Bill remains narrow, so that it is limited to conversion practices and does not get hijacked and caught up in debates about other issues. I hope that we can keep it very, very narrow.

The extra work of scoping out, which I hope will be done at pace, is about ensuring that legitimate clinicians and therapists are protected in being able to explore all the reasons why somebody might be suffering from gender distress. It is also to make it abundantly clear that parents can have robust conversations with their children. There is nothing wrong with a parent disagreeing with their child’s trans status or sexual orientation—that is not a conversion practice.

[Wera Hobhouse]

We are having a good debate, but can the Minister confirm that conversion practices are those that are aimed at a certain outcome? What he is describing—an open conversation to explore a person’s gender identity—is of course not something that a ban should include, but all practices with a closed outcome should be banned, and that ban should include trans people.

[Mike Freer]

A conversion practice is clearly defined as where a person has the predetermined objective of taking someone away from being trans and pushing them towards not being trans. Being straight and being gay would be symmetrical. Key to the additional work that I am seeking to get undertaken at pace is the clarity that we need to ensure that clinicians, parents and teachers are protected, to ensure that the chilling effects, which some clinicians and therapists have expressed concern about, are equally mitigated.

The Cass report mentions how affirmative therapy could be abused. We will always find a rogue practitioner with any practice, but it is legitimate to consider how affirmative therapy should be performed. Again, it is about achieving clarity so that people are not caught and made to feel that they have practised conversion therapy by simply being a good therapist or clinician. That is why the work that we have scoped and done at pace will, I hope, allow us to achieve a consensus and put to bed many of the fears and concerns that people have legitimately expressed. Although I am clearly disappointed that we are having this debate again and that we are where we are, I feel that it is not unreasonable to take some extra time to try to build a consensus, so that when a Bill comes forward, we can make it as inclusive as possible. I cannot guarantee that we will get there, but that is my aim and objective, and I do not think it is wrong to spend some extra time trying to ensure that we can build as much consensus as possible.

Let me turn to a couple of points that have been raised. We have talked about trans healthcare. I have spoken to Dr Cass a couple of times, and she has clearly put a lot of thought into how we need to reform the healthcare system for trans people—not just for under-18s, but in general. The idea that people wake up on a Monday, decide that they want to change their gender, and have been banged through surgery by Friday is clearly nonsense. Anybody who has spent any time looking at the whole trans journey knows that it is cumbersome, it is not patient-centred, and it does not work. It forces too many people to opt out and, as my hon. Friend the Member for Thurrock (Jackie Doyle-Price) said, to buy things on the internet—the wild west—where we do not know what they are doing and what they are being exposed to. That is an important piece of work, alongside the work we are doing on conversion practices.

I want to reiterate that the call for the ban on conversion practices to wait until Dr Cass has reported in full, and the Government have responded, is missing the point. Dr Cass has said that our work is complementary—we are not sequential—and that her work is not a reason not to bring forward the legislation. She has made that abundantly clear. In fact, she has gone as far as publishing a Q&A on her website, which clearly says:

“The Cass Review was commissioned as an independent review of NHS gender identity services for children and young people. Its terms of reference do not include consideration of the proposed legislation to ban conversion therapy.

No LGBTQ+ group should be subjected to conversion therapy. However, through its work with clinical professionals, the Review recognises that the drafting of any legislation will be of paramount importance in building the confidence of clinicians working in this area.”

That is what Dr Cass said, and she is absolutely spot-on.

I want to put a couple of other things on the record. Hon. Members raised the victim support service, which is already operating and is run by Galop. The service is fully inclusive and available to anybody who believes they have been subject to conversion practices or believes they have been at risk of those practices, regardless of their sexuality, gender or non-binary identity. Galop is the leading LGBT+ anti-violence charity and has significant expertise in that area of work.

To conclude, I remain wholly committed to delivering our commitment to ban conversion practices and to protect victims and survivors. I know many colleagues in this Chamber, from across the House, are equally committed to realising that goal. We have to work together to ensure that the legislation is right and that we are seen to be supportive of people’s right to be who they are. It is not our job to interfere in how people see themselves; it is a matter of autonomy and dignity. I thank all colleagues for their contributions and I look forward to working together to make the Bill a success.