Professional advisory bodies have sided with Stonewall against standard pediatric practice
The first few months of 2022 have been eventful and eye-opening in how we treat children and young people experiencing gender-related distress. For anyone paying attention, two very significant things happened: there was an ongoing government consultation on a conversion therapy ban that closed on February 4, and the Cass review published his interim report On March 10. Both events should have attracted the professional interest of anyone involved in the treatment and care of children with gender dysphoria, as well as any lobbyists who advocate for them.
On April 1, all hell broke loose when the government made two quick U-turns in the conversion therapy bill, ending with a bill that left transgender people out. This was met with an immediate and furious response from LGBTQ+ and trans lobbyists. Over 100 LGBT organizations boycotted the government’s flagship Safe to be Me conference in protest, which leads to its cancellation. After Stonewall withdrew, the government really had no choice.
So far, so predictable. We are used to seeing the trans lobby throwing their toys out of the stroller; no one who has been following the topic could have been surprised at all by his reaction. Then something else happened. on april 7 the bbc reported that several professional advice bodies had joined Stonewall et al in issuing their own protests against the government’s decision. The Coalition Against Conversion Therapy (CACT): The loose association of queer theorists now in charge of UK professional practice guidance. Memorandum of Understanding on Conversion Therapy (MOU2) — published a list.
Why do health professional bodies support lobbyist political activism on this issue?
The Cass report exposes a service that has failed in its duty to children
Turning to the government consultation itself, two professional bodies published their responses: the British Psychological Association (bps) and the British Association for Counseling and Psychotherapy (BACP), along with CACT. His answers are revealing. Given that “gender identity” was added to the original MOU in 2017, you may have expected that the management group and major signatories would have important insights to share about the impact of their own professional “conversion therapy” ban. for transgender people. Some research perhaps, or at least a compilation of member responses. But no, they had nothing to add that was different from Stonewall’s arguments. The promise to review the MOU2 after a year has yet to materialize.
In their responses, CACT, BPS and BACP recommend that the government adopt the MoU2 definition of conversion therapy, without having done the most basic research on whether the effects on therapists and their clients have been positive or negative. The wording of their responses is indistinguishable from that of activist groups, in their calls to protect “all people in the LGBTQIA community”, “other gender and sexual people”. [sic] diverse people,” including “bisexual, asexual, intersex, and non-binary people” and an outright ban on conversion therapy for all adults and those under 18.
The Equality and Human Rights Commission (EHRC) referenced the flawed government research these groups rely on to support their position in its much more considered response to the consultation. The EHRC highlighted the “significant challenges in drawing conclusions from the survey” and concluded: “Therefore, we are cautious in interpreting these data.”
The EHRC was left to point out “the possible need to consider a differentiated approach in relation to sexual orientation and being transgender to ensure, in particular, that clinicians and therapists are not prohibited from providing appropriate care and support to people with gender dysphoria. The professional bodies themselves did not think to consider the potential impact on their members’ ability to do their jobs properly.
The EHRC also highlights the need for a clear definition of “being transgender”, which is not a clinical diagnosis, and clarity on what forms of communication would be trapped by the ban on “talking about conversion therapy”. Practitioners should be able to offer legitimate professional services that “should include support to reduce distress and reconcile a person to their biological sex when clinically indicated” without fear of being trapped by a ban.
Between the close of the consultation and the government’s U-turn, the Tavistock Gender Identity Development Service (GIDS) Cass Review, commissioned by the NHS, published its interim report.
If the signatories to MOU2 had not previously considered the impact of a “transgender conversion therapy” ban on their members, there was no excuse not to now. The Cass report was unequivocal about the significant impact the MOU2 has had, referring several times to the concerns of therapists who “feel pressured to take an unconditional affirmative approach.” This is at variance with normal standards of pediatric practice.
This passage from the report is worth quoting in full:
“Some secondary care providers told us that their training and professional standards dictate that when working with a child or youth they must take a mental health approach to formulating a differential diagnosis of the child or youth’s problems. However, they fear the consequences of doing so in relation to gender distress due to pressure to take a purely affirmative approach. Some doctors feel that they do not have the support of their professional body in this matter.”
The Cass report is a stark exposure of a service that has completely failed in its duty to care for children. What has led to these failures? The report says:
“From the point of entry into GIDS, there seems to be a predominantly affirmative, non-exploratory approach.”
And the conclusion:
“A fundamentally different service model is needed that is more in line with other pediatric services.”
Pause for reflection for professional health organizations? Is it time to re-evaluate the MOU2? No. Professional bodies have doubled.
In an act of solidarity with pressure groups, the BACPthe bpsthe UK Psychotherapy Council (UKCP), the Royal College of Psychiatrists (RCPSYCH) and the British Medical Association (BMA) all issued statements expressing their shock and disappointment in response to the government’s U-turn.
According to Stonewall, who on March 10 promised an “in-depth analysis” that has yet to be delivered, neither of these agencies has issued a response to Cass’s interim report.
It gets worse. The dishonored service at the center of Cass Review, the Tavistock GIDS, added his own voice to the outrage of activists in a statement that clearly revealed the ideological underpinnings of the service. Language like “vulnerable marginalized people” and calls like “It’s time to support trans and gender diverse people” are more the language of a political treatise than the impartial considerations of health professionals.
Using politically charged language like “being trans or cis, or any other gender identity” to characterize children would get top marks from Stonewall as the correct view of children seen through an adult political lens. Perhaps Tavistock would like to provide us with definitions of what a “trans child” or a “cis child” is.
GIDS has also not released a response to Cass’s interim report. The only reference to Cass on his website is a letter CEO Paul Jenkins and CEO Polly Carmichael in a defensive response to a Observer Editorial which begins: “Ideology has no place in medicine.”
In their letter, Jenkins and Carmichael make the same claim as their defense in the Bell against Tavistock judicial review, that “only a minority access puberty blockers.” Their own role of 2018 states on average 38-40 percent of all clients attend joint endocrine clinics, technically a minority, yes, but not insignificant. In any case, it is a callous justification for a service that does not provide adequate care: one child put on blockers without thorough investigation or proper diagnosis is one too many.
How would the blunt tool of a ban on conversion therapy help teachers?
On April 14, the National Education Union (NEU) joined the activist protest, calling for a ban on conversion therapy for “trans and non-binary people” and urging the government to work with “every major psychological body in the UK”. The Cass report states that the Final Review will cover the important role of schools; we will have to wait and see what the final recommendations will be. But there is enough in the interim report to make educators sit up and think seriously about the policies currently taking off in schools. Social transition, for example, is described in Cass as an “active intervention because it can have significant effects on the child or youth in terms of their psychological functioning,” adding that “better information on outcomes is needed.”
How would the blunt tool of a conversion therapy ban help teachers to sensitively handle situations with a distressed child, with the threat of criminalization hanging over them if they are accused of doing it wrong?
The only relevant voice in this discussion is that of Dr. Hilary Cass. This is the voice that health agencies and the largest educational union have chosen to ignore, in favor of the ideological proselytizing of Stonewall and other activist groups.
It seems that in this case it is only the government itself that has done the necessary reading and recognizes the central recommendation of the report:
“Children and young people with gender problems should receive the same standards of clinical care, evaluation and treatment as any other child or young person who accesses health services.”
It is extremely naive to think that a ban on conversion therapy would do more than exacerbate the problems outlined in Cass’s sobering report, a report that should be read as a wake-up call to all practitioners that the current politicized and ideologically based system is fundamentally failing and harming vulnerable children.
We only have to take a look at other jurisdictions that have been quick to ban “transgender conversion therapy” to see what the consequences will be for the UK. victory, for example, passed a bill after just a 12-hour debate. How’s that going? The Australian Viewer Reports:
“Any rejection or exploration of a child’s gender distress is considered ‘gender identity conversion therapy’ similar to the barbaric practices inflicted on gays and lesbians in the past. Victoria has effectively criminalized any treatment other than ‘affirmation.’
Criminalizing “conversion therapy” under the nebulous concept of “gender identity” or “being transgender” would be legislation in opposition to the Cass report findings. Why are professional bodies pushing for it?