When a patient sees a therapist, he is typically seeking a solution to a problem — unwelcome thoughts or behaviors that cause him distress. A good therapist will try to help the patient find (as the old prayer goes) serenity to accept the things he cannot change, courage to change the things he can, and wisdom to know the difference. On matters related to “identity,” however, the mere mention of change now inspires fear and rigidity in both patients and therapists alike. And for good reason.
On Monday, the Canadian federal government introduced new legislation to criminalize LGBTQ+ “conversion therapy,” as Justin Trudeau’s Liberal government seeks to fulfill its election promises. This law would prohibit, in accordance with Canada’s criminal code, advertising and profiting from “conversion therapy.” It would also prevent parents from removing their child from Canada should they seek to enroll him or her in such therapy elsewhere.
But what is conversion therapy?
As is often the case, politics is making us dumber, and there is a crucial distinction being lost here. Whether it is ethical, in a therapeutic context, to try to change the erotic preferences of an adult patient — a homosexual who desires to be heterosexual — is a debate, and one that many would probably prefer to avoid. Whether it is ethical, in therapy, or indeed in medicine, to try to change the material sex of a child or an adolescent who believes himself to be of the opposite sex — that’s another debate, and one that we must have.
The first debate appears to be settled. Ever since it was coined in the early 1990s, the term “conversion therapy” or “reparative therapy” has been used to discredit politically conservative and religiously motivated therapists offering treatment to unhappy adult homosexuals. At the time, clinicians expressed concerns about the ethics and effectiveness of such treatment; soon it was viewed, by consensus, as well outside the mainstream of therapeutic practice. The thinking behind this was that sexual orientation was an immutable trait (though a recent large-scale genetics study is less certain in its conclusions). Trying to change a person’s sexual orientation, even if it was a source of angst, would be not only futile but potentially harmful. In considering religiously and ideologically motivated therapies, especially given how homosexuals have been treated by health professionals historically, one can easily understand these concerns.
Of course, with gender dysphoria, there’s an irony. Activists insist that identity is immutable and unquestionable. But as for changing a person’s body — well, that’s completely plastic and malleable. For them, it’s perfectly okay to try to turn an effeminate boy into a girl, as they do in Iran, where homosexuality is not tolerated but transsexualism is. As one prominent gender doctor put it, “if you want breasts at a later point, you can go and get them.” (“Are people like blocks of Lego onto which new pieces can be stuck, taken off and replaced again at will? Is surgery so painless, bloodless, seamless and scarless today that anyone can just have breasts stuck on them at any point and live happily ever after, enjoying their new acquisitions?” Douglas Murray responds in The Madness of Crowds.)
Within the psychiatric and psychological profession, being accused of doing “conversion therapy” is about the worst charge you can face. The result of this has been that few practitioners have been brave enough to stand up to the parasitic work of clinical activists influencing public-health policy related to gender-confused youth. The American Academy of Pediatrics, for instance, disingenuously justifies its one-size-fits-all policy statement “affirming” a child’s preferred gender identity by citing a study of adult homosexual men. But how many readers will check the footnotes? And of those who do, how many will risk being charged with “supporting conversion therapy” by pointing out the error? Among the accused is the American Canadian psychologist Kenneth Zucker, one of the foremost experts on childhood gender dysphoria, who told me in an interview last year:
What’s really masked here is that what they’re essentially saying is that when a young child appears to have the symptoms of gender dysphoria, then the best practice treatment would be an early gender social transition. And that is such an oversimplification of the research literature. It’s absolutely mind-blowing that the American Academy of Pediatrics would endorse this.
Frankly, interfering with the sexual development of gender-confused children for ideological reasons (such that they become sterile and dependent on drugs for life) is just as immoral as electroshocking homosexuals for religious reasons. But in any case, the latter kind of “conversion therapy” simply has not existed in mainstream psychiatric or psychological practice in the United States for decades. The debate about “conversion therapy” for adult homosexuals, then, has been resurrected by transgender activists who seek to hijack the term in order to justify — no, legally enforce — the unjustifiable. Think this is happening just in crazy Canada? It’s in the U.S., too.