This article was originally published in December 2021, while the UK government was consulting on plans to ban 'conversion therapy' in England and Wales, as it had first pledged to do in 2018.

In it, advocates told us about the devastating consequences of the so-called 'treatment' and outlined concerns about possible loopholes in the legislation being drawn up.

In the wake of reports about the government's partial U-turn on outlawing the practice on 31 March 2022, we are republishing it below.

“What’s it going to take – another young person dying? – before somebody does something?”

Jayne Ozanne was talking to openDemocracy as the UK government's consultation on banning 'conversion therapy' in England and Wales drew to a close.

In October, more than three years after the UK government (under then prime minister Theresa May) pledged to outlaw the practice in the two countries, Boris Johnson’s government finally announced plans for a ban. It also published a study on the subject. But the current proposals leave “dangerous” loopholes for religious forms of the practice, and therapies provided to “consenting” adults, say campaigners.

Ozanne is a gay evangelical Christian and director of the Ozanne Foundation, which works with religious organisations to eliminate discrimination based on gender and sexuality. She is also the chair of Ban Conversion Therapy, a UK coalition of LGBTQIA+ organisations, faith groups and human rights groups including Amnesty International, Gendered Intelligence and Stonewall, which is calling for an outright ban.

“Anything short of a full ban will allow this degrading and inhumane practice to continue,” Ozanne explained. “The very lives and well-being of LGBT people are at stake.”

‘Conversion therapy’ (also called ‘reparative therapy’ or ‘gay cure therapy’) refers to any therapeutic approach or view that assumes that one sexual orientation or gender identity is innately preferable to another, and attempts to change someone’s sexual orientation or gender identity on that basis. In practice, this means changing people’s orientation or identity to cis gender heterosexuality.

These attempts range from talking therapies – communicating a belief that someone’s sexual orientation or gender identity is wrong, disordered or ‘sinful’ – to physical violence, including beatings and so-called ‘corrective rape’.

While there is no evidence that ‘conversion therapy’ is ‘successful’ in changing sexual orientation or gender identity, there is significant research and first-hand testimonies underscoring its severe, long-term and sometimes deadly psychological consequences.

A 2018 study published in the American Journal of Public Health found that LGBTQIA+ young people who had been exposed to ‘conversion therapy’ were more than twice as likely to report attempting suicide following the experience. The American Psychological Association has also linked ‘conversion therapy’ to depression and suicidality in survivors.

“Conversion therapy scars people for their whole lives,” Ozanne told openDemocracy. “It leads LGBT people to believe they are unacceptable, and the levels of guilt and shame they feel for who they are is crushing and leads so many to contemplate taking their lives.”

Trans people and LGBTQIA+ people of colour are particularly at risk. The UK government’s 2018 National LGBT Survey found that trans respondents and respondents from some ethnic minority backgrounds were twice as likely to have undergone ‘conversion therapy’ as other respondents.

Religious loopholes

The government has come under pressure from evangelical Christian groups, including Christian Concern and the Evangelical Alliance, which have lobbied for exceptions to be made for religious practitioners.

Some faith groups argue that a complete ban would infringe upon “religious freedom”. They also claim that non-physical forms of the practice happening in religious settings are ‘harmless prayer’ that cannot be equated with other forms of ‘conversion therapy’.

Ozanne explained: “This is one of the most dangerous misnomers. There is no second-class form of conversion therapy. All are harmful and all are deeply damaging – because it leaves someone believing that who they are is wrong and sinful and needs to be changed.”

The government’s National LGBT Survey 2018 found that more than half of ‘conversion therapy’ happens in religious settings. Some 51% of respondents who had undergone ‘conversion therapy’ said it had been conducted by faith groups, while 19% said it had been a healthcare or medical professional and 16% a guardian or family member.

Ibtisam Ahmed, policy and research manager at LGBT Foundation, told openDemocracy that arguments for religious loopholes “erase the rich lives of LGBTQ+ people of faith, who should never be made to choose between their lived identities and their religious beliefs.”

In an article published by the Guardian earlier this year, Ahmed Shaheed, the UN special rapporteur on freedom of religion or belief, called on the government to end conversion practices. He said that while “states cannot compel faith leaders to change their beliefs on sexuality or gender diversity [… they are] empowered to protect their people from harm.”

Exemptions for ‘consenting adults’

The government’s proposals would protect under-18s from ‘conversion therapy’ practices, including talking therapies, but they have been criticised for failing to extend protections to all LGBTQIA+ people. Practices for adults are forbidden only in cases where there is “coercion” or “a lack of informed consent”.

LGBT advocates told openDemocracy that there is no such thing as “informed consent” in this context. In theory, many of the callers to the ‘conversion therapy’ survivors’ helpline set up by the LGBT anti-abuse charity Galop ‘consented’ to what happened to them, said Leni Morris, Galop’s CEO. But, he explained, they were not aware of the risks and severe psychological harm that the experience would cause.

“Conversion therapies nearly always take place within imbalanced power dynamics,” Morris explained. “Those who ‘consent’ to conversion therapies are often financially or emotionally dependent on those asking them to do so […] A person cannot freely give consent in the way that the proposal envisages.”

“Faith leaders, healthcare professionals, family members and other frequent participants in conversion therapy often hold a position of power over the intended target,” agreed Cleo Madeleine from trans advocacy group Gendered Intelligence. In psychotherapeutic settings too, “a significant power imbalance exists between practitioner and patient because of the patient’s presumption that the doctor must be right.”

Wera Hobhouse MP, Liberal Democrat spokesperson for women and equality, emphasised there must be no loopholes in the ban. “Some people will be physically forced to undergo conversion therapy while others may walk in and apparently agree to participating, but they do this because of huge social, emotional and spiritual pressure.”

The practice “is nothing short of medieval,” she added. “It’s not healthcare or ministry – it is abuse.”

Public consultation

At the end of October, the government launched a public consultation to gather feedback about the current proposals for a ban – including whether it should include exemptions, restrictions on promotion and profit-making, and support measures for survivors. The consultation closes on Friday 10 December, after which UK equalities minister Liz Truss will decide whether the current plans should be amended.

In addition to a complete ban, the Ban Conversion Therapy coalition is calling for guaranteed protections for transition-related services and healthcare, which are sometimes accused of providing ‘conversion therapy’. Anti-trans groups including the LGB Alliance claim that a full ban would “promote an affirmation-only approach to gender identity”.

However, ‘conversion therapy’ “cannot be conflated with life-saving therapies” for trans people, Ahmed from LGBT Foundation explained: “Genuine therapeutic interventions, such as gender affirmation practices, are aimed at letting individuals safely explore their needs and identities, before coming to a place of self-awareness and self-acceptance. Conversion ‘therapy’ does not have this same foundation.”

LGBT advocates are also demanding that the proposed law has clearer and more comprehensive wording – to provide explicit protection for all LGBTQIA+ people in all circumstances – and includes the language “change, cure and suppress” in the definition of ‘conversion therapy’.

Last month, the anti-LGBT group International Federation for Therapeutic and Counselling Choice held a conference in London in support of ‘conversion therapy’. Speakers included senior members of US Christian Right group Alliance Defending Freedom, which that has spent $26m overseas in the past decade – fighting sexual and reproductive rights across five continents.

Stonewall has published guidance on filling out the government consultation, which closes on Friday 10 December.