A United Nations expert has warned that plans to ban conversion therapy could backfire by preventing doctors from analysing the root causes of patients’ suffering.Reem Alsalem, the UN’s special rapporteur on violence against women and girls, says young women risk being put on a ‘fast track’ to irreversible gender transition.The new Labour government revealed in its King’s Speech in July this year proposals for a Conversion Practices Bill, which would block action to ‘change, ”cure” or suppress’ someone’s sexuality or gender ID. The reforms, to be overseen by equalities minister Annaliese Dodds, have been backed by campaigners as helping people to freely ‘explore their sexual orientation and gender identity’.But critics including Ms Alsalem have raised concerns that lesbian and autistic girls could be encouraged too soon into unsuitable surgery. Reem Alsalem, the UN’s special rapporteur on violence against women and girls, says young women risk being put on a ‘fast track’ to irreversible gender transition Equalities minister Annaliese Dodds is overseeing plans for a new Conversion Practices Bill which would block action to ‘change, ”cure” or suppress’ someone’s sexuality or gender IDShe told the Telegraph: ‘By putting them on that high-speed train, you may inadvertently subject them to the conversion therapy you are trying to ban.’ Ms Alsalem cited the Cass Review of gender services for children, published in April this year, which said many teenagers in the UK were being allowed to change their gender based on ‘remarkably weak evidence’.Report author Dr Hilary Cass, a leading paediatrician, warned there was a ‘lack of high-quality research’ on the effects of giving children puberty blockers and hormones, while saying the toxicity in the trans debate had become ‘exceptional’.The review prompted NHS England, which had already stopped puberty blockers being given to under-16s, to announce a review into the use of hormones.Dr Cass laid the groundwork for schools to introduce clearer guidance when dealing with trans children, ending the exclusion of parents from knowing.She also recommended a ‘follow-through service’ for 17 to 25-year-olds to protect teenagers ‘falling off a cliff edge’ in care when they hit 17.Now Ms Alsalem has said: ‘The review talked about an increasing number of children and young people being referred to NHS support about their gender identity, including a high number of teenage girls who have been impacted by anxiety and depression in recent years.’They are more prone to low self-esteem and body image dissatisfaction. Additionally, the report addresses challenges faced by same-sex attracted children who have suffered from homophobia by wider society or within their families, or who have struggled with accepting their sexual orientation.’We need to provide the time and space to make a full inquiry of the causes of the distress rather than fast-track children on to a path of gender transition that usually begin with puberty blockers but could result in more permanent changes with long lasting consequences.’She warned that any new rules against conversion therapy should also take into account ‘persons who were same sex attracted, rushed through an affirmation process and then detransitioned’.Ms Alsalem also called for the Equality Act to be clarified to ensure biological men can be stopped from competing in women’s sports and also from accessing rape refuges. She said: ‘I believe that it would be useful for the Equality Act to clarify whether the term “sex” in the Act means biological sex or not.’ Dr Hilary Cass’s final report on NHS care for gender questioning youth came out in AprilAnd she said police should compile crime data based on sex rather than gender, adding: ‘We have to diagnose the phenomena of violence against women for what it is, which is that it is perpetrated predominantly at the hands of males against females.’If we start not registering males for females perpetrators, then that skews statistics and then leads to a misdiagnosis.’Ms Alsalem insisted people should not be punished in employment for expressing gender-critical views – and that universities should allow free speech on the issue.She told the Telegraph: ‘Women and men and their allies should be able to speak on issues of sex and gender without fear of reprisals or intimidation or threats or physical abuse.’In the UK, we have seen the cases of university professors that have been attacked or come under pressure, or where when they talk, there’s been demonstrations against them.’The education space is a space where there should be freedom of expression, as long as, of course, you don’t incite hatred.’A ban on conversion therapy, which aims to suppress or change a person’s sexual orientation or gender identity, was first promised in 2018, by former Conservative prime minister Theresa May.It was later downgraded under Boris Johnson’s leadership not to include transgender people, but the Conservative government under Rishi Sunak said in January 2023 that it would ban conversion therapy for ‘everyone’, including transgender people.This did not come to pass, with the Tories saying legislation around such practices ‘is a very complex issue, with existing criminal law already offering robust protections’.A government spokesman said in July: ‘The Government wants to ensure that the criminal law offers protection from these abusive practices, while also preserving the freedom for people, and those supporting them, to explore their sexual orientation and gender identity.’This will mean those providing medical care and support are in no way impacted by this Bill.’Labour referred to research by LGBT+ anti-abuse charity Galop in 2022 which said trans people are ‘significantly more likely to be subjected to conversion practices’. Retired consultant paediatrician Dr Cass speaking about the publication of the Independent Review of Gender Identity Services for Children and Young People, April 9
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The Government has insisted there is cross-party and cross-society consensus to see conversion practices banned, and pledged to ‘work closely with everyone and bring everyone with us’ in developing legislation.News of the draft Bill was welcomed by LGBTQ+ campaigning organisation Stonewall, which said: ‘Each day that these abusive practices remain legal, our communities are put at risk’.But LGB Alliance, a charity formed in recent years to support the rights of same-sex attracted people, voiced concerns about whether, in the case of those questioning their gender, any new legislation ‘would make it illegal for a therapist to ask a young person to consider why they want to change their body’.Dr Roman Raczka, president-elect of the British Psychological Society, said any new legislation ‘must be very clear that it will not prevent ethical forms of therapy, which are non-directive and non-judgmental’ when it comes to people wanting help in exploring their sexual orientation or gender identity. Revealed: Timeline of what has happened since the Cass report was commissioned nearly four years ago Here is a timeline of events since it the Cass report was launched almost four years ago.2020September: The Independent Review of Gender Identity Services for Children and Young People is commissioned by NHS England and NHS Improvement to make recommendations about NHS services for gender-questioning children and young people.Led by Dr Hilary Cass, former president of the Royal College of Paediatrics and Child Health, it is known as the Cass Review.NHS England says it has been established ‘in response to a complex and diverse range of issues’ including the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust from just under 250 in 2011/12 to more than 5,000 in 2021/22.October and November: The Care Quality Commission (CQC) inspects GIDS, which is the only service available in England for children and young people with gender dysphoria, also treating children and young people from Wales.2021January: The CQC publishes its inspection report which rates the service inadequate overall.The watchdog says the service is difficult to access, with young people waiting more than two years for their first appointment, and that staff do not develop holistic care plans for patients, with ‘significant variations in the clinical approach of professionals’ and no clarity in records on why decisions had been made.2022March: Dr Cass publishes her interim report, saying a ‘fundamentally different service model is needed which is more in line with other paediatric provision’, and concluding that a sole provider of such services is ‘not a safe or viable long-term option”.July: The NHS announces GIDS will close and be replaced with a regional network, aimed to be up and running by spring 2023.2023The deadline for the regional clinics to be operating is pushed back amid what NHS England describes as the ‘complex’ set-up of the ‘completely new service’. The new aim is spring 2024.2024March: NHS England confirms children will no longer be prescribed puberty blockers at gender identity clinics, saying there is not enough evidence to support their ‘safety or clinical effectiveness” and that they would only be available to children as part of clinical research trials.April: New regional hubs open as the GIDS at Tavistock officially closes.Led by London’s Great Ormond Street Hospital and Alder Hey Children’s Hospital in Liverpool, NHS England hopes they will be the first of up to eight specialist centres as part of the north and south hubs over the next two years.The Cass Review’s final report is published.