“It’s a kick in the face. The trauma I faced has caused me lifelong health conditions… And I will never get any kind of justice.”

Shash Appan, director of Trans Safety Network and a survivor of ‘conversion therapy’, spoke to openDemocracy as MPs prepare for Monday’s Westminster Hall debate on whether or not trans people should be protected in the UK’s proposed ban on conversion practices.

“No one is willing to stick up for us,” Appan said. “I feel like I am being discarded, left without support after something that the government has enabled.”

In October, more than three years after the UK government (under then prime minister Theresa May) first pledged to outlaw conversion practices, Boris Johnson’s government announced plans for a ban.

But on 10 May, Downing Street confirmed that its proposed law would only apply to practices relating to sexual orientation, not gender identity. It will also only protect under-18s, and contains loopholes for supposedly ‘consenting’ adults and for non-physical forms of conversion practices – exemptions that leave all LGBT people vulnerable, say campaigners.

Following the announcement, a petition for a trans-inclusive ban amassed more than 145,000 signatures, making it the third most-signed currently open petition – and triggering the debate on Monday.

On 12 May, the government responded, pledging: “We will bring forward a ban that protects everyone from attempts to change their sexual orientation as soon as parliamentary time allows.”

But, the response said, there were “different considerations when it comes to transgender conversion therapy”. “One of the complexities is that those who experience gender dysphoria may seek talking therapy. It is vital that legitimate support is not inadvertently impacted.”

This misconception, that the provision of “legitimate support” is at odds with a trans-inclusive ban, is one of the main arguments campaigners expect to hear from opponents during the debate.

Misconception: neutral exploratory therapies will be criminalised

Groups such as the LGB Alliance have claimed that a trans-inclusive ban would “promote an affirmation-only approach to gender identity”, and have accused transition-related services and healthcare of providing anti-gay conversion practices.

Banning conversion practices does not criminalise explorative conversations or therapies, although this is likely to be suggested during the debate, warned Lui Asquith, director of legal and policy for trans group Mermaids.

Conversion practices and ‘conversion therapy’ refer specifically to therapeutic approaches that view one sexual orientation, gender identity or gender expression as innately preferable to another, and attempt to change or suppress someone’s sexual orientation, gender identity or gender expression on that basis. While some forms of these practices, such as those involving physical and sexual violence, are already illegal, conversion practices that take the form of talking ‘therapies’ are not necessarily banned, said Mallory Moore, director of Trans Safety Network.

In religious or pastoral settings, conversion practices may entail shaming people, telling them it is ‘sinful’ to be gay, bi or trans, or trying to ‘exorcise’ transness or same-sex sexuality away from them. In psychotherapeutic settings, talking therapists may “pathologise or find some sort of underlying disease that manifests in the forms of homosexuality or transgender identity or non-binary identity,” Moore explained. “The main goal is to pathologise it and convince the client that they’ve got a disease and not a minority sexuality or gender identity.”

By contrast, genuine therapeutic interventions involve the safe exploration of an individual’s needs and uncertainties, and value self-awareness and self-acceptance, campaigners explained. “This doesn’t mean that you don’t challenge or question [the client], or help them explore who they are. But the starting point is one of respect and dignity for the individual,” said Jayne Ozanne, a gay evangelical Christian and director of the Ozanne Foundation, which works with religious organisations to eliminate discrimination based on gender and sexuality.

“[Therapeutic] conversations are intended to be exploratory,” said Cara English from Gendered Intelligence. “They’re about meeting people where they are and not giving them a fixed destination.

“There’s this wilful misinterpretation that people will be telling young people that they’re trans and working backwards from there. It’s just so bizarre to see it be voiced like that. But it will inevitably be voiced like that by parliamentarians on Monday.”

Affirmative care is about “getting rid of the psychotherapist’s agenda and focusing on the patient,” Moore agreed. “Reflective work is absolutely possible in an ethical, affirmative way.”

This distinction is upheld in the Memorandum of Understanding on conversion practices – a joint statement signed by 25 health, counselling and psychotherapy bodies including the British Association for Counselling and Psychotherapy, the Royal College of Psychiatrists and NHS England – which defines conversion practices as “therapy or persuasive techniques designed to prejudice people’s choices about gender change or sexual orientation”.

Moore also highlighted a tendency for opponents to “deliberately conflate medical affirmation treatments – like hormone replacement therapy and affirming surgeries – with the affirmative therapy model”.

It’s a different thing altogether, she said. “When we’re talking about therapy, we’re referring to talk therapy… Unless they also happen to be endocrinologists or surgeons, psychotherapists are not prescribing hormones or other medical interventions.”

Misconception: ‘Insufficient evidence’ of harm

Opponents of a trans-inclusive ban may also claim that trans conversion practices aren’t happening, or that there is insufficient evidence to show that these practices cause harm, say campaigners.

The government’s own 2018 survey found that trans people are more likely to undergo conversion practices than lesbian, gay and bisexual people. Some 13% of trans respondents said they had been offered some form of ‘conversion therapy’.

And while there is no evidence that these practices can ‘succeed’ in changing sexual orientation or gender identity, there is significant research and first-hand testimonies underscoring their severe, long-term and sometimes deadly psychological consequences.

Research carried out last year by a coalition of UK LGBT charities, together with independent research monitor Richard Matousek, found that gender-diverse participants who had experienced conversion practices were nearly twice as likely to have attempted suicide.

These findings are consistent with a 2018 study published in the American Journal of Public Health, which found that LGBT young people who had experienced conversion practices were more than twice as likely to report attempting suicide following the experience. The American Psychological Association has also linked conversion practices to depression and suicidality in survivors.

To deny that these practices are happening invalidates the experiences of countless survivors who have come forward and testified to the harm caused, Appan said. “It’s a kick in the face, and it denies my current life. The trauma I faced has led to lifelong health conditions,” including fibromyalgia and complex post traumatic stress.

“It’s cruelty,” said Ozanne, who is herself a survivor of conversion practices. “What angers me most is the indifference of those who practice conversion therapy and have no remorse for the harm they have caused.”

All recent legislative bans, including those implemented in Canada, France, New Zealand and Greece, include both sexual orientation and gender identity. Excluding trans people from the ban on conversion practices would be “outdated, harmful and an international embarrassment”, said Lui Asquith, from Mermaids.

“I hope more than anything that the reality of the lived experiences of trans people will come through in the debate on Monday… It’s incredibly important that we debunk the false myths that are being spread and that we understand the harm that trans people are facing,” Ozanne said.

“It will be a dereliction of our duty – as a society that is meant to protect the vulnerable – if we do not include them in the ban.”