Dr Hilary Cass says a trans conversion therapy ban could ‘frighten off’ therapists

A proposed ban on LGBTQ+ conversion therapy in Scotland could frighten therapists away from working with young trans people, the author of the Cass report has said. 

Dr Hilary Cass, whose divisive review was published in April and made recommendations for how trans youth clinics should be run by NHS England, claimed banning conversion therapy for transgender men and women could “frighten therapists who are just doing their job”. 

The Scottish government consulted on plans to ban conversion practices in January, proposing legislation that would “prevent and respond to harmful acts” that attempt to alter or suppress someone’s sexual or gender identity”. 

Giving evidence to the Scottish parliament’s health committee on Tuesday (7 May), Cass said: “Everyone should be protected from conversion therapy – it’s a completely unacceptable practice. 

“But, thinking about the legislation, the issue has been about intent, and if a therapist engages with a young person and they change their views about their gender identity during the course of that therapeutic relationship, then subsequently say it was because the therapist had an intent to change their gender identity, that puts the therapist in a difficult position. How can you legally determine intent?

“The anxiety that you may be the test case is making clinicians even more anxious, potentially, about working in this area.”

Cass added that finding the balance between “protecting people from conversion therapy” and “not frightening therapists who are just doing their job” would be difficult when legislating on a ban.

“I guess the only thing I would say is that no credible professional body would support conversion therapy, so if any practitioner is deemed to be practising conversion therapy, it should, in the first instance, be a matter for their professional regulator before it would be a legislative issue,” she said.

A “very high percentage” of trans, gender-non-conforming or gender-questioning young people are not straight. But, she added, “You can see how the two things could get conflated.”

The Cass Report was met with a mix of praise and criticism, with the review calling for more mental health support for young trans people while also dismissing much existing research into clinical guidance for trans youth as of “poor quality”. 

It also urged “extreme caution” when prescribing puberty blockers to young trans people, despite the medication being used safely for both trans and cis children for years.

Prescriptions of puberty blockers have since been paused in England, Wales and Scotland. 

For confidential help and support for young people, parents and families, call Mermaids on 0808 801 0400 or chat online with a trained operator Monday to Friday 9am-9pm GMT. For 24/7 free crisis support in the UK, text MERMAIDS to 85258. 

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