The group trying to quietly rebrand conversion "therapy"

As reports spread on Tuesday that Prime Minister Rishi Sunak has decided to ditch his pledge to ban conversion therapy in the UK, Labour’s shadow Health Secretary did not hold back.  “This is a betrayal of all of those at risk of these abusive practices,” Anneliese Dodds told The Lead on Tuesday, “a craven capitulation by a Prime Minister too weak to stand up to the right of his party.” 

Yet even as professional bodies and advocacy organisations joined in the backlash, one key early opponent of conversion therapy not only withdrew from the professional ban on the practice, but has already begun working to legitimise “exploratory therapy” –  a method critics say is the thinnest of rebrands of conversion therapy. The new approach appears to be particularly targeted at trans patients, but the risks to the wider queer community are self-evident, organisations warn. 

As successive UK governments dawdled on banning the widely discredited practice purporting to “cure” LGBTQ sexual orientations, professional bodies and mental health charities signed up to a memorandum effectively preventing UK psychotherapists from using the approach. But over the weekend, one of the key signatories – the UK Council for Psychotherapy (UKCP) – had withdrawn from the memorandum, citing communication difficulties among the coalition members. The withdrawal means clients who see one of the UKCP's members now have no protection, neither in law nor through professional standards, that their therapist will accept and not try to change their gender or sexuality.

The UKCP boasts 11,000 individual members and 75 accrediting and training organisations. 

"So-called conversion therapy is abuse,” Dodds said when asked about the UKCP decision. “There is no other word for it. The Conservatives promised to outlaw this abuse six years ago but have failed to do so. Labour would bring in a trans-inclusive no-loopholes ban on conversion practices.”

At the same time, Dodds noted: "We are clear that any ban must not cover legitimate psychological support and treatment, non-directive counselling, or the non-directive pastoral relationship between teachers and pupils and religious leaders and their worshippers, nor should it cover discussions within families."

Exploiting the caveats 

The term 'exploratory therapy' has been introduced by mental health providers in the US in early 2020’s. The name seems to suggest a softer, less categorical approach - ideal for exploiting precisely the kind of caveats Dodds outlined in her statement.  But a 2022 paper has already warned the approach is ‘underdefined’, ‘may be unethical’ and shares ‘many conceptual and narrative similarities’ with conversion practices. And in late 2023, an investigation by Slate concluded the new practice is simply conversion therapy - rebranded. 

Nevertheless, ‘exploratory therapy’ is beginning to gain ground in the UK: South London and Maudsley NHS Mental Health Trust hired consultants to provide training on ‘a gender exploratory approach’ to the CAMHS team in 2022.  In November 2023, the UKCP published a statement  on ‘gender critical’ views that attempted to validate 'exploratory therapy'.  “Psychotherapists and psychotherapeutic counsellors who hold such views are likely to believe that the clinically most appropriate approach to working therapeutically with individuals who present with gender dysphoria, particularly children and young people, is exploratory therapy, rather than medicalised interventions such as puberty blockers, cross-sex hormones or reassignment surgery,” the statement read. 

"So-called conversion therapy is abuse... Labour would bring in a trans-inclusive no-loopholes ban on conversion practices.”

This appeared to directly contradict  the UKCP’s own prior stance on conversion therapy. In 2017, the UKCP signed a Memorandum of Understanding that outlawed “conversion therapy” in the consulting rooms of UK psychotherapists. It held the UKCP’s 11,000 members to ‘a commitment to ending the practice of “conversion therapy”’ and is co-signed by NHS England and Scotland, the British Psychological Society and UK counselling bodies BACP, NCS, BABCP, COSRT and the BPC. The memorandum was updated in 2022 when Mind, Rethink, and the Royal College of Psychiatrists (as well as a number of therapists’ professional bodies) added their support. 

But on 5 April of this year, the UKCP withdrew its signature from the Memorandum of Understanding, effective immediately. The statement of withdrawal cites a breakdown in communication. Authors claim that since November 2023, the UKCP CEO and Chair have attempted to engage with the Coalition Against Conversion Therapy to discuss issues and terms but admits that they ‘have not, as yet, been able to have this dialogue’.

Depression, dysfunction and risk of suicide 

Conversion therapy describes attempts to change a person’s sexual orientation or gender identity. Typical contemporary methods include counselling, prayer, and threats of homelessness. There is a strong evidence basis against the practice, and conversion therapy is known to cause harm to subjects, including death by suicide. 

The evidence goes back decades. A 1969 study found 50% of research subjects who experienced ‘sexual orientation change efforts’ experienced harmful effects including depression, suicidal ideaton and relationship dysfunction. A 2009 analysis by the American Psychological Association found evidence that subjects in later studies self-reported deteriorated relationships with family, loss of social support, loss of faith, social isolation, self-hatred, and sexual dysfunction.

Conversion therapy in close-knit communities - such as churches - can be particularly insidious, as many people struggle to recognise experiencing it as a harmful practice. Peter Leonard, 53, experienced conversion therapy twice before coming out at 29, but it would take two decades for him to recognise it as such. 

Peter got married at 21, started a family, and began training as a vicar at 24. At 29, he experienced a breakdown and began steps to end his own life. He managed to stop himself, and two days later came out to his wife and ended his marriage. 

Peter worked as a minister for two decades and continued to seek therapy on and off throughout his life. But it wasn’t until a couple of years ago that he identified his two past experiences as conversion therapy: “My mental health has been up and down my entire life but I happened to be in therapy at the time,” Peter tells The Lead. 

“My therapist at the time said: ‘Let’s just keep this going for a bit longer’, very sensibly. So we did. He said afterwards he thought I might have been avoiding something.

“The shame I felt was made worse by this prayer ministry and I realised it had impacted my entire life to that point. I don’t think I will ever get rid of it, but it’s much much smaller and more manageable now. All my therapists have been great but if I had stumbled into working with a therapist who didn’t agree with the Memorandum of Understanding on conversion therapy, I could have been damaged even further.”

"Unless it’s an excuse to challenge the client's identity, all therapy should be exploratory"

Brazil banned conversion therapy in 1999 and since then 13 countries including France, Germany, Spain and Canada have followed suit; Scotland is now in consultation on a ban. But nationwide, the practice remains legal. The government first consulted on banning conversion therapy in 2021. In 2022, it proposed a ban that would exclude trans people that was widely criticised and rejected by campaigners. Last October it committed to publishing a draft bill, but has not yet done so. In its summary, the Commons Library notes concerns that prohibition of conversion practices could encroach on the ‘freedoms’ of practitioners (such as therapists) who work with LGBTQ+ adults and children.

In the absence of a draft bill, campaign group Ban Conversion Therapy says it will keep pushing for a trans-inclusive ban – something Keir Starmer has also promised should Labour win the next election. 

Therapists fight back

After the UKCP’s initial statement on “exploratory therapy” was published in November, a group of UKCP members, collected under the name Therapists Against Conversion Therapy and Transphobia [TACTT], raised the alarm on social media. They published an open letter to criticise the UKCP, pointing out that this new position has been taken without consultation, in contravention of the Memorandum of Understanding, and directly contradicts respect for client autonomy and staying within competence (two key points in the UKCP's own code of ethics). 

The UKCP responded to the letter in December last year, but once again failed to address backtracking on the Memorandum of Understanding.

TACTT told The Lead they were disappointed with UKCP's initial reaction to criticism: “We are responding to this in detail and hope for a more constructive response from UKCP which centres the needs and safety of trans and gender-expansive clients and therapists,” they wrote. 

“We are concerned about UKCP’s recent statements on therapists holding gender-critical views. Our open letter seeks to draw attention to these concerns, and redress the lack of trans and non-binary voices in writing about therapy.”

TACTT’s original open letter accuses the UKCP of being out of step with both the Memorandum of Understanding and its own code of ethics. Since 5 April TACTT has launched a second open letter, asking the board to reverse its decision and for members to call for a vote of no confidence in UKCP’s leadership. Each letter now has over 1,000 signatures. 

Dominic Davies founded Pink Therapy, the UK’s oldest and largest therapy directory for LGBTQIA+ clients. Davies said he and colleagues were “highly disappointed”.

“They create a false dichotomy between 'exploratory' therapy, i.e. conversion therapy, and 'affirmative' therapy, implying that the latter does not explore issues with the client,” he tells The Lead. “We were grateful to TACTT for their robust statement and desire to challenge UKCP.”

Shelley Bridgman is a coach and psychotherapist, and a member of the BACP (Bridgman left the UKCP last year). She has personal experience of the negative effect of conversion therapy, which she found distressing and ineffective. She now specialises in supporting people questioning or in conflict with their gender. 

“I don’t know what UKCP means by the term ‘exploratory therapy’. Unless it’s an excuse to challenge the client's identity, all therapy should be exploratory,” she argues. 

Bridgman says many young adult clients she works with are “blissfully unaware” of what’s going on at the UKCP, but says that she would recommend all adults seeking therapy to ask where therapists stand on LGBTQIA+ inclusivity: “In light of recent statements, they should be aware that they need to speak to the person they're thinking of working with and ask them what their stance is, for sure.” 

Outside of the psychotherapy profession, other experts in LGBTQIA+ rights have shown solidarity with TACTT.

Robbie de Santos,director of external affairs at Stonewall, tells The Lead: “Professional bodies for psychotherapy have a responsibility to protect potential clients from harm, including conversion practices which seek to influence or change someone’s sexual orientation and/or gender identity. It’s always vital that therapists create supportive spaces for LGBTQ+ patients. While it’s important that workplace rights are understood and respected, this shouldn’t interfere with the way patients are treated.”

Next steps

It seems untenable for the UKCP to hold its current stance in the midst of such outcry among its members; the UKCP is only one of many signatory organisations on the Memorandum of Organisation. Since TACTT’s final letter to the UKCP, the organisation has failed to update its position - and now appears to have officially broken ranks with opponents of conversion therapy by withdrawing from the Memorandum. TACTT has urged clients to rely on the Pink Therapy directory to find professionals who can vouch for a queer-friendly approach. 

Cleo Madeleine, a spokesperson for Gendered Intelligence, warns that bringing politics into therapists’ offices feels like a slippery slope: “The UKCP statement comes dangerously close to endorsing these conversion practices – for instance, with the suggestion that therapists who do not personally believe in medical transition can prioritise those beliefs over the client's own identity, experience, wants and needs.”

Madeleine sees the UKCP’s stance as part of a wider trend across sectors – for example, the loss of the NHS’s LGBTQ diversity programme, and the use of pressure to host a ‘gender-critical’ summit at the RCGP: “This is a testament to the growing influence of anti-trans groups in media, politics, and now in healthcare.”

A UKCP spokesperson said: “UKCP accepts that when exploring gender identity therapists hold a range of perspectives in how this work should be conducted, particularly concerning children and young people. Our position on this is clear: we acknowledge the validity of various approaches by UKCP members, provided the law is adhered to and the UKCP Code of Ethics is followed.

“UKCP is also clear that any approach which seeks to change or deny a person’s gender identity, so-called conversion therapy, is harmful and must not be practised.”

Take Action: 

• If you identify as LGBTQi and want to be sure your therapist will respect your identity, consider consulting The Pink Therapy Directory to locate queer-friendly professionals. 

• You can also read the open letter against 'exploratory therapy' and search its signatories. If you are yourself a therapist or even a trainee, you can add your support. 
• Join the Ban Conversion Therapy campaign directly, by writing to your MP using the campaign’s email template.